- 1 What is alcoholism?
- 2 Alcoholic or alcoholic?
- 3 How does alcohol act in the body?
- 4 Alcohol metabolism
- 5 Causes
- 6 Risk factors for alcoholism
- 7 Evolution stages of alcoholism
- 8 How to recognize an alcoholic? Symptoms of alcoholism
- 9 Drunkenness: alcohol intoxication
- 10 Blood alcohol content and its consequences
- 11 How is the diagnosis of alcoholism made?
- 12 Does alcoholism have a cure? What is the treatment?
- 13 Drugs for alcoholism
- 14 Physical and psychic consequences of alcoholism
- 15 Relapse: how to deal?
- 16 How to prevent alcoholism?
What is alcoholism?
Alcoholism, also known as alcoholism, is a term used to describe alcohol dependence . People who suffer from this condition usually have a compulsion for alcoholic beverages, difficulty in stopping drinking and end up developing tolerance to the effects of the substance.
It is a psychiatric disease, considered by the World Health Organization (WHO) as “a disease with physical and mental components”. This is because addiction is often purely psychic, but there are also physiological components involved. Most people, incidentally, can drink sporadically without having any major problems.
Alcoholism is more common in men than in women, but they are not safe from the problem: 30% of alcoholics are female, and the number is growing more and more. The cause of this is probably related to the greater freedom that women have achieved in modern times, being able to consume alcoholic beverages without being judged as they would have been a few decades ago.
Although health is the main factor that is at stake with excessive alcohol consumption, affective relationships and social roles are also affected by it. It is worth remembering, however, that alcohol dependence can be treated and controlled. There are several programs and qualified professionals to help in this challenge, the most well-known group being Alcoholics Anonymous.
For many years, the term “alcoholic” has been used as a synonym for alcohol addicts. In recent times, however, many researchers believe that this nomenclature is inadequate.
If we look at the etymology of the word, we will see that an alcoholic literally means a worshiper of alcohol . This nomenclature leads us to understand that the individual loves alcohol and chooses to continue drinking because he likes it so much, when, in reality, there is a chemical dependence on the substance.
People who suffer from addiction are already badly spoken, called “shameless”, and the term alcoholic only makes the situation worse. Therefore, the word is considered stigmatizing and should be avoided when referring to a person who has problems with alcoholic beverages.
The term alcoholic has the connotation of a disorder, making it clear that the individual is not responsible for his illness, but alcohol. Popularly, the term is still strange and little known, but researchers and health professionals seek to spread it more and more.
Due to widespread dissemination, this text adopts the term “alcoholic” as correct as well.
Alcohol is a nervous system depressant drug and, although there are always those friends who are sad at parties, this does not mean that it causes sadness. In fact, this means that it slows down vital functions .
Have you noticed how that drunk friend doesn’t say anything with anything, has difficulty balancing, takes time to react to situations and even more so complains that he is seeing twice? That’s exactly what alcohol does by depressing the nervous system.
To better understand, we must keep in mind that the central nervous system is formed by neurons, cells that conduct electrical energy and pass “messages” to each other through chemical substances, called neurotransmitters. Each neurotransmitter has an effect on the body, some of which are related to pleasure, others to fear, etc.
It is these messages – partly electrical, partly chemical – that make our brain keep our body functioning. Be sure that any movement you make and any thoughts you have in your head are thanks to the functioning of this system!
Anyway, let’s get to it: how does alcohol change this whole game?
Upon entering the body, ethanol (the type of alcohol used in alcoholic beverages) reaches the brain quickly. There, it stimulates the release of excitatory neurotransmitters such as serotonin , dopamine and endorphins, responsible for feelings of pleasure and well-being. That’s when the people at the bar start to get excited about the party!
Right after that, exactly the opposite effect happens: alcohol stimulates the brain’s main inhibitory neurotransmitter, gamma-aminobutyric acid, better known as GABA. This neurotransmitter connects to neurons and makes them more boring, making them less receptive to new messages coming from other neurons. In this way, communication between one neuron and another is hampered.
Do you understand now why it is a “depressant” drug for the nervous system? Precisely because it makes the brain less active! And this is what causes the symptoms of drunkenness to appear: slurred speech, lack of motor coordination, difficulties with balance, mental confusion and changes in perception are very common.
Curiosity: why do people do so much wrong when they drink?
You have certainly heard stories of acquaintances who did a lot of nonsense while they were drunk. Situations like trying to jump from too high places, hitting on a clearly committed person (in front of the boyfriend!) Or being with someone who would not be so interesting if the individual was sober are very common. But why does this happen?
Studies show that the depressive activity of alcohol has a very potent effect on the prefrontal cortex, the area of the brain responsible for judging values and making decisions. With outdated activity in this region, our ability to assess risks is impaired and we ended up becoming too optimistic.
So, next time, don’t judge that friend who drank too much and went out paying micão: she just didn’t care that she was doing nonsense!
Most of the alcohol is metabolized by the liver, and the rest is eliminated by the kidneys, skin and lungs. That is why, even after stopping drinking, the person continues to drink alcohol for a few hours.
During metabolism, each gram of alcohol produces 7.1 kcal, slightly less than 1 gram of fat (8 kcal). Therefore, people who wish to lose weight should stay away from alcohol.
What makes a person drink? Or worse: what drives a person to continue drinking, even if it has already affected their health, career and relationships? This is a very complex question that has no clear answer. The fact is that it is a disease – not a choice – with obscure causes, but well-defined risk factors :
Some factors can favor the emergence of alcohol dependence. Check out:
Ease of access
One of the biggest risk factors for alcoholism is, of course, the ease of access. As we are inserted in a society in which alcohol consumption is seen as something positive and fun, it is not surprising to see how affordable the drug is.
It is worth mentioning that people who never drank alcohol cannot become alcoholics, since alcoholism happens with the chronic use of the drink, which, in turn, is favored and encouraged in our culture.
The consumption of alcoholic beverages is often associated with several modern social rituals: parties, bars, clubs, fun nights, among others.
The more people drink around the individual, the greater the chance that he will start drinking too. This is because we are social beings and we need to be part of groups with which we have something in common.
When attending these places and participating in situations like this, the individual is increasingly exposed to the drug, increasing the chances of developing tolerance and dependence.
However, drinking socially does not mean that you will become an alcoholic, but doing so often is certainly a risk factor for the development of the disease.
There is evidence that there is a genetic factor involved in alcoholism, which can be sought by analyzing the family history of several alcohol-dependent patients.
Children of alcoholic parents are more likely to develop the disease. When a single (equal) twin manifests the addiction, the other will most likely manifest as well.
Problems with mental health
Due to escapism needs, impulses and difficulties in dealing with what one feels and thinks, people with mental disorders are more likely to become dependent on alcohol and other drugs, including illicit drugs.
Several theories of psychology also believe that the habit of drinking is associated with bad experiences in childhood, especially during breastfeeding, when the child’s pleasure was in relation to the sensations received in his mouth. These traumas also have repercussions on several personality traits of the individual, and alcoholism often ends up being just a consequence.
Early contact with alcohol
A large portion of people have their first contact with alcohol in their teens.
Researchers at the National Institute on Alcohol Abuse an Alcoholism (NIAAA) found that people who started drinking before the age of 15 were 50% more likely to become addicted to alcohol in adulthood.
Similar results were found for those who started drinking between the ages of 15 and 17.
Alcoholism is more common in men, although it affects women as well.
It is believed that this is due to cultural aspects, such as the repression for women not to drink, and physical – women, because they have less body mass, tend to feel more the negative effects of alcohol use, which reduces the chance to develop tolerance.
Alcoholism, like many diseases, has phases. The first one is the most peaceful, and many of us have already passed. It starts to get complicated when we go to the second one. Understand:
Right after the first contact with alcohol, the adaptation phase occurs. It is there that one begins to drink to socialize, to be part of the crowd, in short, to use the drink as a crutch to have a social life.
Many teenagers take advantage of this phase a lot because of the inhibitory effects of alcohol, which help them to relieve the anxiety and anxieties of this phase of life.
When the central nervous system adapts to alcohol, the individual does not feel its effects much. It is the case of that guy who always fills his face and never gets drunk, besides bragging that he is not knocked over by the drink.
Because it is at this stage that blackouts, or blackout syndrome, appear , characterized by an amnesia of the moments when you were under the influence of alcohol.
Dependence and withdrawal syndrome
In this phase, there are physical symptoms of withdrawal when you spend a lot of time without drinking. Thus, the individual continues to drink to get rid of these symptoms, being a real addict to the drug. It is at this stage that physical, mental and social deterioration begins in a more visible way.
In general, it is at this stage that health problems related to excessive alcohol consumption begin to appear.
Like any disease, alcoholism also brings symptoms. Often, these symptoms are only noticed by people who live with the addict, as he tends to deny his need.
In general, alcoholics:
- They drink alone and for no apparent reason;
- They continue to drink, even if they are losing important things: family, job, among others;
- They lose their job or school year;
- They become aggressive when they drink;
- They cannot go a day without drinking an alcoholic beverage;
- After they start drinking, they find it difficult to stop;
- They drink more and more to maintain the concentration of alcohol in the body;
- They may have paranoia and hallucinations;
- They always have an excuse to drink;
- They move away from friends, family and social events to drink;
- They avoid going to places where they cannot drink;
- They try to hide excessive alcohol consumption;
- They eat poorly or stop eating;
- They show tremors and withdrawal symptoms when they spend a long time without drinking alcoholic beverages;
- They lose their memory.
If you have noticed any of these behaviors in a friend, family member or acquaintance, try to talk openly, without repression, about this problem. Offer help, but don’t force him to do anything.
Chronic drinkers suffer from severe symptoms if they go without drinking for a long time. This is because, to compensate for the depressant effect of alcohol, the brain increases activity in excitatory circuits.
When you spend a lot of time without drinking, the brain becomes overloaded with the excitatory activity of these circuits, which do not meet the resistance of the depressant action of alcohol, which can cause numerous symptoms. Are they:
- Nausea and vomiting;
- Excessive sweat;
- Increased body temperature.
Delirium tremens : withdrawal with hallucinations
Delirium tremens is the name given to a kind of psychotic episode caused by alcohol withdrawal in alcoholic patients. It usually occurs about 3 days after the first withdrawal symptoms, and the episode can last for several days.
The main symptom of delirium tremens , which differs from the common withdrawal crisis, is mental confusion . In such cases, the alcoholic may have:
- Disorientation of temporal space;
- Intense anxiety;
- Delusions (unreal and irrational beliefs);
- Visual, tactile and auditory hallucinations;
- Crises convulsivas.
When a patient is in this state, he must be taken to a hospital for medical follow-up. It is often treated with anxiolytic drugs with anticonvulsant properties, such as benzodiazepines and barbiturates, and anticonvulsants.
This episode is seen more often in people who withdraw after having consumed large amounts of alcohol for more than a month.
Mortality during the state of delirium tremens ranges from 15% to 40%. In most cases, this is due to seizures , which can be very violent.
According to the speed at which the person drinks and the amount of alcohol consumed, it accumulates in the bloodstream, initiating the intoxication process. In reality, the real name of drunkenness is “alcohol intoxication”. That is, every time you go out with your friends to drink and “go crazy”, you are going out to poison your body with a drug. It doesn’t sound so cool, right?
Intoxication occurs when the levels of ethanol in the body pass a certain point, which generates its effects. The symptoms depend a lot on the amount of alcohol ingested, but the most common are:
- Difficulties with motor coordination;
- Facial flushing;
- Slurred speech;
- Difficulty in assessing situations and risks well (impulsivity);
- Nausea and vomiting;
- Difficulty breathing;
- Altered perception.
Alcoholic amnesia ( blackout syndrome )
After a long night of drinking, your friends keep talking about the things you did last night, and you just don’t remember anything. Sound familiar?
This is the blackout syndrome , a type of amnesia caused by alcohol intoxication. This is because the substance interferes precisely in the neuron circuits responsible for storing new information. Basically, the brain stops recording what happens.
Several effects of ethanol depend on the concentration of the substance in the blood. The more alcohol, the more dangerous its consequences. Below is an explanation of the drunkenness stage and its consequences.
It is worth remembering that some people need less and others more to reach a certain stage.
When there is between 0.1 and 0.3 g / L of alcohol in the blood, the individual has a subclinical condition – with no health consequences – and normal behavior.
It occurs when the blood alcohol concentration is 0.3 and 0.9 g / L. At this stage, the individual is slightly euphoric, becomes more talkative and sociable.
There is an increase in self-confidence, disinhibition, decreased attention, judgment and a little control over yourself. Here the impairment in motor coordination begins, giving that slight feeling of dizziness .
The peak of excitatory activity after alcohol consumption occurs at a concentration of 0.09 and 1.8g / L. There is an attenuation of the inability to judge, and there is already impairment in memory, understanding and perception of things around.
The individual has less sensitive response, that is, he feels less the physical sensations, and the reactive responses (ability to react to some event) are slower. The peripheral vision is smaller and the person tends to see blurred or double.
Balance and motor coordination are affected, there are greater difficulties to stand and perform precise movements. At the end of this stage, drowsiness starts to show.
The confusion period is between 1.8 and 2.7g / L of alcohol in the blood. It is characterized by disorientation, mental confusion and, sometimes, numbness. Emotions are exaggerated, visual perception of shape, color and dimension is impaired, in addition to worsening motor coordination.
Speech is slurred and it becomes difficult to understand what the individual is saying. In addition, he may exhibit apathy and lethargy.
This stage approaches loss of consciousness, with extremely impaired motor functions. There may be vomiting, urinary and fecal incontinence, as well as little response to stimuli. Often, the individual cannot even stand, let alone walk. Stupor occurs in concentrations between 2.7 and 4.0g / L.
Characterized by loss of consciousness, coma occurs in concentrations of 4.0 and 5.0 g / L in the blood. The reflexes are so few that they do not seem to exist, the body temperature is below normal, there is incontinence and impaired breathing and blood circulation.
It is the last stage before death.
At concentrations above 5.0g / L, death occurs by central respiratory block: the brain stops sending messages to the lung to breathe.
We know that it is very difficult to diagnose the alcoholic, not because the symptoms are not clear, but because they are very reluctant to admit that they have a problem and seek help. Unfortunately, some people need a complication to occur before pursuing their health. This is the case for many alcoholics.
There is no laboratory or imaging exam that is able to diagnose the disease. Instead, many psychiatrists use questionnaires and are based on the diagnostic criteria of the International Code of Diseases (ICD).
Diagnostic criteria for ICD-10
According to the tenth edition of the ICD, the diagnosis of alcohol dependence is made when the individual, in the last 12 months, has felt or exhibited at least 3 of the following conditions:
- Strong desire or compulsion to consume alcohol;
- Difficulty in controlling the behavior of consuming alcoholic beverages in terms of start, finish or levels of consumption;
- Physiological withdrawal status when ceasing or reducing substance use or use to relieve withdrawal symptoms;
- Evidence of tolerance: the individual increasingly needs larger doses in order to achieve the effects of alcohol;
- Progressive abandonment of activities and other interests at the expense of drinking, in addition to the greater amount of time needed to recover from the effects of the drink;
- Persistence in alcohol consumption, even with clear evidence that it is damaging your health, mood and cognition.
The CAGE questionnaire
One of the questionnaires to diagnose alcoholism is the CAGE, developed by Mayfield and collaborators. The acronym CAGE is related to the keywords of each question. In all, there are 4 questions:
- Have you ever tried to cut or cut (“ c ut down”) your drink?
- Have you ever been bothered or irritated (“ a nnoyed”) with other people for criticizing your drinking?
- Have you ever felt guilty (“ g uilty”) for the way you drink?
- Have you ever had to drink to relieve your nerves (stress / tension) or reduce the effects of a hangover (“ e ye-opener”)?
If there are positive responses, even if it is just one, there are signs that you may have problems with alcohol. The more positive responses, the greater the chances of being an alcoholic.
Michigan Alcohol Detection Test, short version
Developed by Pokorny and colleagues, the short version of the Michigan Alcohol Detection Test consists of 10 questions that can be answered with “yes” or “no” and that receive a score. Check it out below:
Do you consider yourself a normal drinker?
- Yes: 0 points;
- No: 2 points
Do your friends or relatives think you drink normally?
- Yes: 0 points
- No: 2 points
Have you ever been to a meeting of Alcoholics Anonymous (AA)?
- Yes: 5 points
- No: 0 points
Have you ever lost friends / girlfriends or boyfriends / girlfriends because of drinking?
- Yes: 2 points
- No: 0 points
Have you ever had problems at work / job because of drinking?
- Yes: 2 points
- No: 0 points
Have you ever abandoned your obligations, your family or your job for 2 or more days in a row because of drinking?
- Yes: 2 points
- No: 0 points
Have you ever had delirium tremens, tremors, heard voices, seen things that were not there after drinking a lot?
- Yes: 2 points
- No: 0 points
Have you ever sought any help because of drinking?
- Yes: 5 points
- No: 0 points
Have you ever been hospitalized for drinking?
- Yes: 5 points
- No: 0 points
Have you ever been arrested or fined for drunk driving?
- Yes: 2 points
- No: 0 points
If, when answering all these questions, the sum is less than or equal to 3, there is no reason to worry. If the sum is 4, there are signs of alcohol problems – but not yet alcoholism – and above 5, alcoholism can be thought of.
Unfortunately, alcoholism has no cure . There is only remission of symptoms , but the alcoholic will never be able to take a single sip of alcohol again. The treatment process is complex and time-consuming, but it can be done safely when accompanied by trained professionals. Know more:
The first stage of treatment is detoxification, in which the patient enters a period of abstinence from alcohol. It must be done with a psychiatrist and hospitalization may be necessary.
During this period, the physical and mental damage of consuming alcohol in large quantities and for so long is evaluated.
Sometimes, the doctor may prescribe medications to assist in detoxification. They work by controlling impulsivity and giving unpleasant sensations when consuming alcohol, for example.
After detoxification, psychotherapy is the next step in remission of symptoms. The most used approach in these cases is Cognitive-Behavioral Therapy (CBT), which involves learning techniques to prevent relapses, as well as helping to change habits and thoughts that can serve as a trigger for drinking.
Other psychotherapeutic approaches such as psychoanalysis and gestalt therapy can also help, especially if drinking is associated with other mental disorders.
Although individual psychotherapy helps, some studies show that group therapy is more effective in preventing relapses, changing habits and social situations. There are many clinics and programs specializing in the recovery of alcoholics.
Perhaps the largest organization dedicated to the recovery of alcoholics in the world, Alcoholics Anonymous (AA) is a voluntary community that promotes meetings of alcoholics in abstinence to achieve and maintain sobriety.
Born in the United States, AA is easily found in several cities around the world, under the premise of maintaining sobriety and anonymity. The institution is maintained through donations from the members themselves and does not accept funding from any other source.
To help with the detoxification phase, your doctor may recommend some medications. Are they:
- Disulfiram : This drug promotes an unpleasant sensation if the individual ingests any minimal amount of alcohol, creating an aversion to alcoholic beverages;
- Naltrexone : Helps to reduce compulsiveness and the urge to drink;
- Acomprosate: The exact mechanism of action of this medication is not known, but it is believed that it restores the chemical balance impaired by the use of alcohol;
- Sodium oxybate: Improves the neurotransmission of GABA and decreases glutamate levels, helping in the detox period.
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Alcohol is a major risk factor for the development of several diseases, many of which are very serious. Always pay attention to the health of that loved one who had or has problems with alcohol, as many diseases can lead to death.
Some of the main consequences are:
Damage to the nervous system
Excessive alcohol consumption is related to damage to both the central and peripheral nervous systems. When it comes to the CNS, substance abuse can lead to dementia , while in the peripheral, there is a possibility of decreased sensitivity and muscle strength in the legs.
Gastritis and ulcers
Not infrequently, alcohol leads to erosion of the stomach walls, triggering an inflammation of the stomach mucosa ( gastritis ), as well as gastric ulcers, wounds that can develop in the stomach, esophagus or intestine.
Give us liver
The liver is definitely the organ that suffers most from alcohol attacks.
It starts with a simple accumulation of fat in the liver, which soon progresses to hepatitis (inflammation) and fibrosis, in an attempt to defend the liver. Gradually, the situation worsens, until it arrives to cirrhosis , a disease characterized by scarring and liver failure.
Pancreatitis and diabetes
Aggression of alcohol by the digestive tract can also cause inflammation in the pancreas. This inflammation can lead to the destruction of pancreatic tissue, along with insulin-producing cells. In this way, diabetes can also develop .
As alcohol affects the absorption of some nutrients, it is common for alcoholics to suffer from Wernicke-Korsakoff syndrome as well. This disease is characterized by a lack of vitamin B1 (thiamine), causing paralysis of some muscles, ophthalmic problems and disorders of mental state.
Alcohol also promotes changes in blood circulation, which can lead to diseases such as hypertension ( high blood pressure ) and increase the risk of stroke (stroke).
By altering the functioning of the liver, alcohol abuse affects cholesterol levels in the bloodstream. Thus, cholesterol can accumulate on the walls of the arteries, leading to hardening and narrowing of the arteries. This condition is called atherosclerosis .
Frequent alcohol consumption is a major risk factor for the development of cancer , especially in the digestive system, which involves the mouth, esophagus, stomach, intestines and liver. However, the risks of cancer are not limited to this path, and may increase in other organs as well.
Fetal alcohol syndrome
Alcoholic women of childbearing potential must take great care not to become pregnant until they are able to stay abstinently. This is because alcohol consumption while pregnant, regardless of quantity, causes damage to the fetus, leading to congenital malformations.
The alcoholic can also suffer from many social problems by not being treated.
Not infrequently, the addict ends up missing work, school, college or other occupations, because they are places where he cannot drink, or because of the symptoms of a hangover. This can lead to unemployment .
Interpersonal relationships are in the background and many end up being broken up. The alcoholic can end up becoming violent , both when he drinks and when he is abstinent. Family and friends may abandon him , or he may even end up leaving the house to indulge entirely in drinking, going to live on the street .
Both due to acute intoxication and complications, alcohol leads to death. While the accumulation of more than 5g of alcohol per liter of blood can lead to respiratory arrest, several diseases caused by alcohol easily lead to death.
After a few months or years without drinking anything, the news comes: the alcoholic in remission has resumed drinking. It is a horrible situation, in which the individual feels himself a failure and the people around him may end up disappointed instead of understanding.
Some tips for what to do when this happens are:
- Understand that relapses are part of the recovery process and one should not blame or judge the individual who, deep down, was only trying to alleviate the bad feelings that come with abstinence;
- When the individual shows irritability, he misses the support group meetings, seems to be frustrated and his performance at work and / or school worsens, he may be relapsing. In such cases, it is important to seek help as soon as possible;
- Encouraging the addict to create new healthy habits helps to keep him busy with other things, preventing a relapse;
- Physical exercises are great substitutes for alcohol, since they release neurotransmitters related to pleasure in the brain, avoiding feelings like anguish and anxiety caused by withdrawal;
- Avoid situations that resemble addictions: parties, people involved in addictions, celebrations where there are drinks, etc .;
- Encourage new friendships, healthy relationships with people who have good habits and, mainly, do not drink;
- In case of relapse, encourage the addict to return to the clinic. Leaving it as it is and pretending it will be okay will only make the situation worse;
- Assist the patient in a reorganization of their own routine, with new activities such as a new job, courses, therapies, among others. Keeping your mind busy is important for resisting temptations;
- Encourage the alcoholic to never abandon professional follow-up, as many cases of remission, when they stop therapy or support groups, go back to drinking;
- The support of family and friends is indispensable for a good recovery. Never scold the alcoholic, especially after relapses, and always show support and affection.
Taking into account that alcohol dependence is triggered mainly by its chronic use, the best way to prevent the problem is to stay away from drinks always .
It doesn’t matter if it’s at a party, or just once a week: individuals predisposed to the problem should avoid drinking alcoholic beverages.
If you have no family history of alcoholism in the family, it does not mean you are free to drink as much as you want. If you drink, the ideal is to stay within the healthy level stipulated by the WHO of a maximum of 1 drink per day for women and, for men, 2 drinks.
As much as the person denies it, a diagnosis of alcoholism is a serious thing. Often, the individual takes a long time to seek help because he simply denies having any problems with alcohol.
If you know someone who can’t stop drinking, or if you identify yourself with these symptoms, get help! Treatment can greatly improve your quality of life and social aspects.
Share this text with your friends and family so that more people know how to identify and help an alcoholic! Any questions, you can ask that we will answer with pleasure.