The concepts of the words “drunkenness” and “” have different definition, but they combine all forms of alcohol abuse. Any of these definitions has a negative impact on a person’s health; in addition, it leaves an indelible mark on relationships with others, as well as on one’s professional and work activity. Let's look at each concept in more detail.

How to distinguish domestic drunkenness from alcoholism?

Casual drunkenness is a person’s tendency to moderate, episodic or systematic drinking of alcohol without entering into heavy and prolonged drinking. At the same time, the person maintains control over the amount of drinking. Drinking people can be divided into groups according to E.E. Bekhel's classification of everyday drunkenness: abstinents - people who abstain from drinking alcohol, but can drink under pressure from others; casual drinkers - alcohol does not bring them pleasure, their intoxication is not significant, they control themselves and their actions; moderate drinkers - they experience pleasure while intoxicated, show interest in drinking, but never organize it themselves; systematic drinkers - people who constantly increase the dose of alcohol, their behavior will be disrupted, they will develop a certain style and lifestyle, and negative consequences will arise. social consequences , appears over time.

How to distinguish everyday drunkenness from alcoholism?

The consumption of alcoholic beverages is associated with a number of established customs, rites, and rituals, the so-called complex of drinking drinks containing alcohol. All this has been and is being transmitted through generations, developing into an integral phenomenon in society, leaving, unfortunately, a catastrophically negative imprint on the worldview and system of psychological and spiritual values. Recently, use alcoholic drinks acquires the ability for rapid growth, due to the expansion of occasions, advertising, distribution and increase in the range of alcohol. The first sign when a drunkard is on the verge of becoming a drunkard is the absence defensive reaction the body - vomiting, even with a significant amount of drinking, this is the so-called addiction, because alcohol is undoubtedly a narcotic substance.

Drunkennessand alcoholism

, this is far from a habit, but rather a progressive disease. In the 19th century, the Swedish physician Magnus Huss put it in the dictionary medical terms the word “alcoholism”, which is translated from Arabic “al kegol” - “intoxicating”. And so alcoholism is a disease characterized by a painful addiction to drinking alcoholic beverages, leading to defeat internal organs.


External development factors: education, propaganda and encouragement of alcohol consumption, advertising and availability of alcoholic beverages, as well as cultural characteristics and traditions of the people.
Alcoholism can be divided into several stages: prodrome, first stage, second stage and third stage.
Prodrome or stage zero, very close to the onset of alcoholism, but not yet a disease. A person still has the opportunity to stop systematically drinking alcohol, but with daily drunkenness, after 6-12 months the prodrome easily moves into the first stage.
The first stage of alcoholism is when dependence appears; in the absence of the opportunity to drink, the craving for alcohol goes away for a while. The patient becomes irritable and aggressive, but a critical attitude towards drunkenness does not appear, and every use of alcohol is constantly justified. Gradually, this state moves to the second stage.
The second stage of alcoholism is the addiction stage, the tolerance for alcohol increases, but self-control weakens. Alcoholic psychosis occurs, accompanied by hallucinations, and the person becomes dangerous to society.
The third stage of alcoholism – the body’s strength is exhausted, significant degradation of the patient’s personality occurs, and irreversible damage to the internal organs and nervous system occurs.
All this in best case scenario ends long-term treatment in the hospital, or at worst, fatal. L.N. Tolstoy described the effect that alcohol has on a person in the best possible way: “Wine destroys the physical health of people, destroys mental abilities, destroys the well-being of families and, most terrible of all, destroys the souls of people and their offspring.”

The first stage of treatment for drunkenness or alcoholism is

Drunkenness and alcoholism are the real scourges of our time. Alcohol has become a constant companion in the lives of the vast majority of people. Drinking small amounts of alcohol every day becomes as common as performing daily duties. Therefore, it is customary to distinguish between domestic drunkenness and chronic alcoholism.

Usually, household alcoholism is understood as a way of life of people, which is based on the habit or desire to “celebrate” all events occurring in life by drinking alcoholic beverages almost every day. At the same time, the strength of alcohol can depend not only on the importance of the event, but also on the mood of the drinker, on the time of day, or on whether alcohol is consumed alone or in company.

Compared to chronic alcoholism, in the case of everyday drunkenness a person is able to voluntarily stop drinking alcohol at any time, but does not do so.

The main danger of regular drinking is that it gradually transforms into a habit and it is very difficult to recognize the moment when the desire to drink becomes an alcohol addiction.

Causes of domestic drunkenness

Motive for daily use alcoholic beverages in each individual case can be anything. The real reasons great multitude. However, the most common reasons for not having a “dry” day can be combined into separate groups.

So, they distinguish:

• Daily stress, a state of constant psychological tension and the inability to relax without drinking alcohol.
• Traditions celebrate all holidays, memorable dates, extraordinary events with the obligatory presence of alcohol, when it is “indecent” to refuse an offered wine glass or glass or is supposedly a violation of some ritual.
• Availability of free time in large quantities and a person’s inability to manage it. In this case, weak alcohol can become one of the ways to organize your own leisure time, especially when the presence of fun drinks can be a reason for gathering company. Very often, this is how young people and teenagers spend their free time.
• And etc.

Types of household drunkenness

It’s not just everyday drunkenness and chronic alcoholism that separate them. Even in everyday alcoholism, there is its own classification of the forms of this condition and people’s attitudes towards alcohol.

Highlight:

1. Abstinents - people who categorically abstain from drinking alcohol various reasons. For example, due to alcohol intolerance, for religious reasons, for medical reasons.
2. People who drink occasionally. This category includes those who extremely rarely, no more than a few times a year, take alcohol in small doses, and this often happens under public pressure (holidays, traditions, events, etc.). People of this type do not enjoy alcohol intoxication and, therefore, they do not strive to somehow increase their usual meager norm or frequency of drinking alcoholic beverages.
3. People who drink occasionally, up to 3–4 times a month. Accepted norm their alcohol content varies from 100 to 500 ml and they experience pleasure from being intoxicated.
4. Habitually drinking people. These include those for whom it is normal to drink 200–500 ml of strong alcoholic beverages 2–3 or more times a week.
5. Chronic alcoholics. These include people who consume about 30 liters of alcohol in total per year. This counts the usual norm alcoholics. In order to achieve such indicators, you need to drink one glass of vodka, or two glasses of wine, or 2 liters of beer daily.

So by chance drinking man, increasing the dosage and regularity of alcohol consumption, can become a chronic alcoholic.

Symptoms indicating domestic alcoholism

By observing a person for a short time, you can determine whether there is a place for domestic alcoholism in his life.

The most common symptoms indicating this are:

1. The number of reasons for drinking alcohol is significantly increasing. In this case, a person either more willingly succumbs to the influence of the public (comrades, colleagues, etc.), or independently comes up with a reason for drinking alcohol, or takes it without any particular reason, just like that. For example, he drinks beer when it’s hot, working in the country, doing home renovations, etc.
2. Along with the number of occasions, the frequency of drinking alcoholic beverages also increases.
3. Over time, the dosage and volumes of drinks consumed increase. For example, the daily half-liter bottle of beer increased to 2 liters by the end of summer.
4. Health problems appear during or after drinking alcoholic beverages. Such as, severe hangover, changes and surges in pressure, pain in the kidneys, liver, heart, swelling, etc.
5. Very important symptom, signaling danger - when drinking alcoholic beverages for a person becomes a way of solving or avoiding solving problems, or when a person simply ceases to be interested in being sober and he constantly “tops up” weak alcoholic drinks so that the lung condition alcohol intoxication.

In addition to the listed symptoms, others are possible, depending on individual characteristics a person and his physical, mental and psychological state.

Signs that distinguish between everyday drunkenness and chronic alcoholism

The main difference between everyday drunkenness and chronic alcoholism is that the person does not have an alcohol addiction.

But besides this criterion, there are others by which, with varying degrees of probability, it is possible to determine whether everyday drunkenness has turned into chronic alcoholism or not.

These include:

1. Lack of desire to drink and indifferent attitude towards alcohol without any good reason or at least simply without reason.
2. A person's ability to control the situation to some extent. In this case, a person is able to stop and stop drinking alcohol when there is a feeling of overdoing it with alcohol. Often it is this feeling that allows you to avoid the hardest alcohol poisoning, although a severe hangover in this case can be guaranteed.
3. Lack of a developed “habit” of the body towards alcohol. So, among everyday drunkards, unlike chronic alcoholics, in case of “overdoing”, symptoms are possible alcohol intoxication: nausea, vomiting and even loss of consciousness.
4. Quite often, household alcoholics, after heavy libations, will experience feelings of shame, remorse, and guilt before loved ones. Chronic alcoholics do not always manage to preserve these valuable human qualities.
5. Chronic alcoholism is a progressive disease, and neglect of it will necessarily lead to personality degradation in both physical and mental aspects. Household alcoholism can remain at the same level for quite a long time, without obvious signs personality degradation.

Signs indicating the transition of domestic alcoholism to chronic

Most people who drink regularly are convinced that they are not dependent on alcohol. But in reality, the line separating the everyday form of drunkenness and alcoholism, which has become chronic form very thin. To recognize this boundary, you need to focus on the following signs:

1. A chronic desire to drink appears at all costs. Without the usual dose of alcohol, a person’s mood deteriorates and depression appears.
2. The volumes and strength of alcohol consumed are increasing, and cases of drinking alcoholic beverages are becoming more frequent.
3. The number of circumstances and good reasons for drinking alcohol is reduced. A persistent desire to drink pushes a person to drink alcohol alone and without reason.
4. The body develops resistance to alcohol, and the symptoms of alcohol poisoning decrease or completely disappear.
5. To remove hangover syndrome a new portion of alcohol is required, since neither folk remedies nor medical supplies do not provide adequate relief.
6. In a state of alcoholic intoxication, manifestations of aggression towards others are possible even without any provocative actions on their part.
7. And etc.

Is it necessary to treat domestic alcoholism?

Domestic drunkenness is not considered a disease and is not subject to correction medical point vision. However, in order to prevent the habit from developing into a chronic disease, it is still recommended to take some measures.

When talking about the effect of alcohol on a person, one should distinguish drunkenness from alcoholism. Domestic drunkenness in most cases is possible at home. But with the treatment of alcoholism, everything is more complicated - getting rid of this disease most often requires a rather long hospital stay. What is the difference between drunkenness and alcoholism, and how much alcohol can you drink per day, you will learn from the material posted on this page.

2.4 million Russians have been officially diagnosed with alcoholism. However, in reality, about 17 million people suffer from alcohol dependence to one degree or another. This is almost 12% of total number population. Since 1991, alcohol consumption has been growing in Russia. In 1996, per capita, we drank approximately 7.5 liters of pure alcohol. According to experts, current per capita consumption of pure ethanol is 15 liters. If we take into account only people over 15 years old, then this is already 17 liters.

Currently most scientific research showed that moderate consumption of low-strength, high-quality alcoholic beverages does not harm and even helps our body protect itself from cardiovascular diseases, but any step towards abuse will lead to the exact opposite and very serious consequences.

So how to determine the permissible dose of alcohol and where is the line after which each subsequent glass will harm you? The main role in the formation of a reasonable attitude towards alcohol belongs to family upbringing and influence social environment in which a person develops.

Safe dose of alcohol per day according to WHO criteria

According to WHO criteria, a safe dose of alcohol for men is 2 units of alcohol (30 g of ethanol - 96% alcohol)

A safe dose of alcohol per day for women is 1 unit (15 g ethanol)

1 conventional unit alcohol are:

• 30 g vodka, cognac, whiskey
• 120 g dry red wine
• 330 g beer

For people who completely give up alcohol, the risk of developing complications various diseases, including cardiovascular, and death is slightly higher compared to those who drink alcohol within a safe dose.

The WHO report “Diet and prevention chronic diseases"(1993) the doses of alcohol that reduce the risk of developing coronary artery disease were determined.

How much alcohol can you drink per day?

How much alcohol can you drink per day? healthy people so that strong alcoholic drinks have a beneficial effect on the body?

• For men - 10 - 20 g ethanol (96% alcohol)
• For women - 5 - 10 g ethanol

Naturally, no one claims that everyone who drinks more than the specified limit is an alcoholic. However, it is necessary to know that the amount of alcohol consumed by them is dangerous and harmful to health.

Consuming more than 30 g of ethanol per day leads to increased risk development arterial hypertension, stroke, myocardial infarction, liver cirrhosis, pancreatitis.

Adverse effects of alcohol on the human body

The adverse effects of alcohol on the human body are associated with the effect of ethanol on the human body. At the central level nervous system ethanol acts like a narcotic. The main pathogenetic link of the narcotic effect of alcohol is an increase in the threshold of pain sensitivity, the formation of emotions and behavioral reactions. Disruption of the activity of these systems due to chronic alcohol consumption causes the development alcohol addiction, withdrawal syndrome, change in critical attitude towards alcohol. When alcohol oxidizes in the body, a toxic substance is formed - acetaldehyde, which causes the development of chronic intoxication of the body. Alcohol has a particularly strong effect on the body on the walls of blood vessels (acetaldehyde stimulates the progression of atherosclerosis), liver tissue (alcoholic hepatitis), and brain tissue (alcoholic encephalopathy). In addition, ethyl alcohol increases the stickiness of red blood cells, which leads to the formation of blood clots and significant disturbances in blood circulation in all organs and tissues of the body. This explains the toxic effects of alcohol on health and leads to heart and kidney diseases. Chronic alcohol consumption leads to mucosal atrophy gastrointestinal tract and the development of vitamin deficiency.

In September 2006, surrogate alcohol poisoning became a national epidemic in Russia: about 3,600 people were affected. People were admitted to hospitals with a diagnosis of toxic hepatitis", and not everyone was saved. Due to the fact that ethyl alcohol is taxed, prices for high-quality alcohol are rising. Unscrupulous producers of “leftist” alcohol have switched to another raw material - isopropyl alcohol, which is a hundred times more toxic than ethyl alcohol. This is the drink that is sold for 45-50 rubles, and it causes severe poisoning.

Young people in age group People under 40 are more likely to die in car accidents or violent deaths than from heart attacks. The greater the alcohol abuse, the higher the risk of death from accidents while intoxicated.

In older people, the leading cause of death is cardiovascular disease. The effect of alcohol on human health in old age is especially detrimental.

The harmful effects of alcohol on a woman's body

For women, the norm for safe alcohol consumption is 2 times lower than for men. Malicious influence alcohol on a woman’s body is due to the fact that the female body is significantly different from the male body. Therefore, the path from drunkenness to alcoholism is much shorter for women - from one to two years (for men - up to 8-10 years).

Firstly, in female body contained less water compared to men's. Accordingly, the alcohol concentration at the same doses in women is initially higher.

Secondly, Negative influence alcohol on women is explained by the fact that their enzyme (alcohol dehydrogenase), which breaks down alcohol, is less active, and accordingly, intoxication occurs faster.

In pregnant women, alcohol abuse leads to negative impact for the fruit. Meanwhile female alcoholism most common during childbearing years.

It is believed that alcoholism is inherited. This is not entirely true. In families that drink, negative traditions can lead to children becoming alcoholics more often. The disease itself is not transmitted from parents to children, but hereditary predisposition to alcohol really exists.

What is the difference between everyday drunkenness and alcoholism?

Domestic drunkenness and alcoholism are different concepts. Alcoholism is characterized by a strong mental and physical dependence on alcohol and, as a disease, goes through several stages, which are characterized by an increase in alcohol dependence, a decrease in self-control regarding alcohol consumption, and the development of somatic disorders caused by chronic alcohol intoxication. Among people who abuse alcohol, the following groups are distinguished:

• no signs of alcoholism;
• With initial signs alcoholism (loss of situational and dose control, binge drinking);
• With pronounced signs alcoholism (regular binges, damage to internal organs, mental disorders).

Test to distinguish between drunkenness and alcoholism

To check the difference between drunkenness and alcoholism, and at what stage you are, test yourself with a small test.

1. Have you ever thought that you need to reduce your alcohol consumption?

2. Do you lose control over your dose of alcohol?

3. Are you criticized for your intemperance with alcohol?

4. Do you feel guilty about drinking?

5. Do you take alcohol in the morning to get rid of unpleasant feelings?

If you answered “yes” to three or more questions, then you need to reconsider your attitude towards alcohol and urgently consult a specialist.

To diagnose alcoholism, the following signs must be present.

Joyful excitement in anticipation of drinking. If it does not take place, then aggression and oppression appear.

Impaired ability to control alcohol use, i.e. initiation, cessation and/or dosage.

Usually an alcoholic does not remember the events of yesterday's drinking, even if he was conscious.

The presence of withdrawal syndrome, that is, a hangover: nausea, headache, anxiety. After taking another dose of alcohol, the condition temporarily improves.

Continuing to drink alcohol despite obvious harmful health consequences.

The patient never admits to himself that he is sick. It is very difficult to persuade him to see a doctor.

Drug and psychological treatment of alcoholism

There are several key points in the treatment of alcoholism:

Drug treatment of alcoholism is used to suppress alcohol dependence and eliminate disorders caused by chronic alcohol intoxication.

Methods psychological treatment alcoholism help to perpetuate negative attitude the patient to alcohol and prevent relapses of the disease.

Measures for social rehabilitation the patient is called upon to restore the patient with alcoholism as a person and reintegrate him into the structure of society.

For successful treatment alcoholism, it is necessary to realize that a drinking person cannot control himself. Drinking glass after glass, he does not relax, does not relieve stress, does not become freer, but only deafens his consciousness. To free yourself from this addiction, you must not only seek help from qualified specialist, but also firmly decide for yourself that you want to break the chain that fetters your will and destroys your life. You should not believe advertisements that “guarantee” 100% recovery or cure in 1-2 sessions. You should seek help from a narcologist with a good professional reputation. In such situation real help Relatives and friends should provide assistance.

Alcoholism on last stage Often incurable, this disease breaks down the body’s internal protective barriers, and sometimes it is no longer possible to restore them. After medicinal withdrawal from a drunken state, the alcoholic is prohibited from drinking forever, otherwise the clinical signs of alcoholism will return. It is extremely rare for a former alcoholic to return to “cultural” drinking. If he starts drinking in moderation, then a relapse of the disease is inevitable, and the person will soon go “peddling” again.

This must be clearly understood by the patient’s friends and relatives, and this must be instilled in him himself. And after treatment, try to eliminate or minimize situations that can provoke alcohol consumption.

The similarity between drunkenness and alcoholism is that alcohol abuse occurs. Alcoholic drinks in any form are ethyl alcohol, diluted to reduce the concentration to make it more convenient to drink.

However, drunkenness and alcoholism are not the same thing and there are big differences between them.

Depending on the frequency and amount of alcohol consumed, there are groups of people who:

1. They don't drink alcohol.
2. Consume alcohol in moderation.
3. They abuse alcohol.

These individuals are divided into those who:

• There are no signs of alcoholism.
• Initial signs of alcoholism (control over the situation and the dose of alcohol is lost, binge drinking begins).
• Pronounced signs of alcoholism (constant binges, destruction of internal organs, mental disorders).

"Zero" stage

This is not alcoholism, but everyday drunkenness. Such drunkenness is not a disease, but a tradition existing in our society to drink if there is a reason. Such a person does not focus his attention on drinking; for him it is not an end in itself. At this stage, he can stop drinking alcohol without consequences for himself, or this stage may drag on for life, but the amount of alcohol consumed remains at a certain level. However, if relatively “harmless” everyday drunkenness develops into regular use alcohol, then the onset of the first stage of alcoholism is not far away, and with it the difference between a drunkard and an alcoholic is erased.

Stage one

A person appears desire drink, and it’s not easy to drink, but to get drunk. Reason for such drinking: fatigue after work, troubles at work, quarrel with friends and relatives. In a state of severe intoxication, irritability and aggressiveness appear, and control over the amount of alcohol consumed is lost. At this stage, drinking goes from being an “occasional” activity to a regular activity. The body begins to develop resistance to drinking alcohol. The concept of drunkard begins to form.

Stage two

At this stage, the drunk’s body’s resistance to alcohol increases and a hangover begins to appear after drinking. The desire to drink appears at the slightest provocation and without it. With minor alcohol consumption, control over one’s behavior weakens or is completely lost. If possible, drinking continues until consciousness passes out.

Stage three, the most severe

The body's resistance to alcohol consumption quickly decreases. A person at this stage only needs to drink two glasses and become very drunk, but he continues to drink until he passes out. Due to the daily consumption of alcohol, health problems and degradation of the individual begin. This is no longer an alcoholic, but a real drunk.

Alcoholism is a disease that requires treatment. Drunkard can't live without outside help stop drinking, reduce the dose. Changes begin in his body that require the presence of alcohol in large quantities constantly, so the drunk cannot help but drink. This is not just a disease, it progresses and inevitably leads to the complete destruction of the body and personality.

You can get rid of drunkenness, but you cannot completely recover from alcohol addiction. After treatment, an alcoholic can lead a sober lifestyle, but only until the first drink, which can return him to heavy drinking again, since in addition own desire do not drink, there is no other remedy for binge drinking. A drunkard can partially control himself, but an alcoholic is controlled by illness.

To determine whether a drinker is a drunkard or already an alcoholic, you just need to consult a doctor - a narcologist. The doctor cannot examine the patient without the desire of the patient. Everyone must decide for themselves whether they need the help of a doctor.

Most people believe that it is impossible to get free treatment in our healthcare system. They will make an inaccurate diagnosis, treat you for the wrong disease, cure you or send you to a mental hospital. And paid treatment is very expensive and not affordable for many. That's why people seek treatment for alcoholism folk remedies, herbs, spells, removal of damage. However, if you do not consult a specialist in time, drunkenness can turn from a habit into a progressive disease.

Alcohol is an evil that stubbornly and cruelly cripples the health of a huge number of people, destroys all human organs (including the brain), often causing premature death. All these changes do not begin immediately. At first they are almost invisible, but gradually the disease progresses. And even the cause of death is often explained by some other diseases, although alcoholism is the basis.

Scientists and the general public have long been sounding the alarm about the rapidly growing abuse of alcoholic beverages. A national disaster, collective suicide of nations, a road to nowhere - this is the unanimous assessment of this sad phenomenon with catastrophic consequences.

First of all we're talking about about countries where the level of alcohol consumption is not only already high, but also tends to progress. These are Russia, France, Scandinavia, Ireland, Korea. Over the past hundred years, a steady increase in this indicator has been revealed, which gives grounds to talk about the genetic tragedy of humanity. The countries of the Islamic world and the Mediterranean basin, as well as China, are more prosperous in this regard. The level of alcohol consumption in these countries does not cause concern, unlike the countries of Western civilization.

The social changes that are currently taking place in Russia have caused a sharp increase in alcoholization in society.

In recent years, Russia has become one of the world leaders in terms of alcohol consumption per capita. If in 1950 there were 2 liters per year per person, in 1979 - 10.6 liters, then by the mid-90s. - 14.5 l, and in some regions - 16.0-16.5 l. After 1994, a decline in alcohol consumption began (13.5 l), which continued until 1998, and by 1999 the level of consumption began to rise again (A. Nemtsov, 2001). In Karelia, this figure reached 20 liters - whereas, according to experts from the World Health Organization (WHO), a relatively safe level of alcohol consumption for the state is 8 or less liters per person per year. Based on this, it becomes clear what serious consequences the consumption of alcoholic beverages among the Russian population leads and can lead to.

Alcoholism is associated with 50% of road accidents, 50% of murders, 25% of suicides, and up to 50% of families break up due to alcohol abuse by one of the spouses.

Drunkenness and alcoholism are one of the causes of mortality, so high that it outpaces population growth. Only “excessive” alcohol in 1993 killed more than 400,000 people in Russia as a result of direct and indirect effects. According to the State Statistics Committee of Russia, mortality from causes associated with alcohol consumption - poisoning, alcoholic psychosis, cirrhosis of the liver - among the working age population (16-59 years old) has been steadily progressing in recent years, and in Russia these figures are 2.5 times higher than in the most “drinking” countries of Western Europe.

For 1990-1994 the number of deaths as a result of alcohol poisoning in adolescence has tripled; in 1995, the number of children and adolescents registered for alcoholism increased by 10%.

The population of Russia, including Karelia, is characterized by the predominant consumption of strong drinks (vodka) and the predominance of large, impact doses (“northern type” of consumption).

Noteworthy is the fact that death from alcohol poisoning now occurs at significantly lower concentrations of alcohol in the blood. Thus, in Karelia in 1992, the average lethal concentration of alcohol in the blood decreased by 1.4 times, while fatal alcohol poisoning increased by 3 times.

According to WHO experts, in the 90s. The life expectancy of men in Russia decreased by more than 7 years and amounted to about 57.5 years, and mortality from alcoholism among men increased by 2.5 times, and among women by 3 times. Such losses of the working-age population are typical only during wars. Referring to the opinion of WHO experts, the main reason for this situation is associated not only with the “collapse of the healthcare system and psychosocial stress,” but also with the extremely high alcoholism of the Russian population.

An unfavorable situation is also developing due to the fact that a large number of counterfeit alcoholic drinks have appeared on the alcohol market, some of which are highly toxic. Thus, according to the Ministry of Internal Affairs of the Russian Federation, in 1996, from 40 to 60% of alcoholic beverages sold in Russia were counterfeit. Consumption of these drinks leads to damage to internal organs and fatal poisoning. (For comparison: France ranks 2nd in the world in per capita alcohol consumption. At the same time, life expectancy remains high - according to this indicator, France ranks second in the world. Consequently, the causes of the severe consequences of alcohol abuse are not only the amount of alcohol consumed, but also the quality and strength of the drinks.)

Alcohol consumption is also associated with large expenditures for the population. In a number of countries, as much money is spent on these purposes as on food, and much more than on satisfying cultural needs.

The number of crimes committed while intoxicated is growing: according to the Ministry of Internal Affairs of the Russian Federation, after 1992 it increased by 1.6 times, and the number of administrative offenses by 1.9 times.

Karelia is one of the most disadvantaged territories in Russia in terms of the number of people suffering from alcoholism; the number of patients with alcoholic psychosis has increased 4 times since 1990. This pathology is most common at a young age (15-30 years), among divorced or single people, as well as people with a lower level of education and antisocial tendencies in their lives. adolescence. The average prevalence of alcoholism is 10% among men and 3-5% among women.

Karelia is characterized by:

high alcohol consumption per capita

predominance of strong alcoholic drinks. "Northern" typedrinking alcohol

high mortality from alcohol poisoning

increase in the number of alcoholics

build-up alcoholic psychoses

increase in offenses under the influence of alcohol

Year after year, there is an increase in the level of alcohol consumption by women, youth and children.

In recent years, in Karelia there has been an increase in alcohol consumption among adolescents, especially among girls, a decrease in the age of first initiation into alcohol - from 16 to 13-14 years, and the emergence of schoolchildren who drink alcoholic beverages more than 3 times a month. 3 Beer consumption is growing, especially among young people.

And it began like this: intoxicating drinks entered everyday life long before our era. In the Middle Ages, alchemists searched for the philosopher's stone. A theory arose that all metals can be turned into gold, but in order to achieve this, it is necessary to first obtain the philosopher's stone. Only the power inherent in it will help to obtain a noble metal from a base metal. They didn't find the stone, but they did discover something. The Arab alchemist Ragesz found a way to obtain pure alcohol. He called it “al ke gol” (translated from Arabic - “the most subtle, pure essence of a thing”).

The alcohol obtained by alchemists received another name - alcohol. In Latin, “spiro” means I breathe, so it was believed that it gives health and defeats diseases. Therefore, the mixture of alcohol and water was dubbed “aqua vita”.

C,H 5 OH - ethyl or wine alcohol (ethanol) - is the main component of all alcoholic beverages, it belongs to substances that can cause addiction and painful addiction - alcoholism. WHO experts on drug dependence classify ethyl alcohol as a substance of the alcohol-barbituric series, addictive(painful addiction). The properties of ethyl alcohol include:

The ability to cause the need for intoxication, i.e. achieving a state of euphoria followed by analgesia, which creates a feeling of pleasure or relieves physical and mental stress.

Increasing tolerance (resistance) to alcohol as a consequence of adaptation and the need for ever-increasing doses.

The occurrence and establishment of withdrawal syndrome.

Psychotoxic effect, i.e. ability to cause acute and chronic mental disorders(alcohol psychosis), as well as disrupt behavior and cause personality changes due to alcohol abuse.

General toxic effect with long-term abuse.

What doses of alcoholic drinks are dangerous? According to some experts, safe consumption doses range from 20 to 60 g/day. conventional pure 100 percent ethanol for men and 10-40 g/day. - for women. Systematic consumption of alcohol exceeding these figures significantly increases the risk of developing toxic damage to internal organs (liver, pancreas, heart, etc.) even before the development of alcoholic illness. Regular, or systematic, consumption of alcohol is considered once a week or more often, regardless of the dose (V. Nuzhny, 1996).

With regular consumption of alcohol in quantities exceeding the individual's ability to oxidize incoming alcohol and its metabolites, a state of chronic alcohol intoxication (CAI) occurs, in which alcoholism and alcoholism develop.

Alcoholism is a dynamic process that has its beginning, course and final state. It is formed gradually, gradually, often completely unnoticed by others, by the future alcoholic himself. This is the period that is called everyday or habitual drunkenness (G. M. Entin, 1990).

Drunkenness is the excessive consumption of alcoholic beverages, which negatively affects work, life, people's health, and the well-being of society as a whole. As for moderate

consumption of alcoholic beverages, then this is a relative concept, since any consumption of alcohol, supported and strengthened by the alcoholic tradition, prepares the ground on which alcohol abuse and, as a consequence, drunkenness and alcoholism arise.

E. E. Bechtel (1986) offers the following classification of people who drink alcohol:

Withdrawals- persons who do not drink alcohol or drink them so rarely and in such small quantities (up to 100 grams of wine 2-3 times a year) that this can be neglected.

Casual drinkers - persons who consume an average of 50-150 ml of vodka (250 ml maximum) from several times a year to several times a month.

Moderate drinkers- drinking 100-250 ml of vodka (maximum 400 ml) 1-4 times a month.

Regular drinkers- drinking 200-300 ml (up to 500 ml) of vodka 1-2 times a week.

Habitual drinkers- those who drink 500 ml of vodka or more than 2-3 per week, but do not have clinically significant disorders.

A few additional words about terms.

Withdrawals- these are persons who abstain from drinking alcohol, deviation from strict rules for them it is a tribute to established alcoholic traditions. As a rule, if they drink, it is only under pressure from others.

Casual drinkers- do not experience pleasure due to the state of intoxication and therefore do not strive to drink alcohol frequently. Their intoxication is insignificant, they maintain control over their actions and the amount of alcohol they drink.

Moderate drinkers- experience pleasure from the state of intoxication; the euphoric effects of alcohol are moderately expressed. Although they show interest in possible drinking, they rarely organize it themselves. A spontaneous desire to drink occurs extremely rarely; signs of intoxication are not expressed harshly.

For systematic drinkers, in addition to frequent drinking and increasing the dose, it is typical to appear in a state of intoxication

behavioral disorders, they develop a completely specific style and way of life. Gradually, their drinking becomes more and more severe, doses increase, and negative social consequences often arise. Alcohol takes an increasingly important place in their lives every year, becoming the main source of pleasure. Ultimately, alcohol abuse among systematic drinkers affects their professional level, family life, and their social status.

Domestic drunkenness different people progresses unevenly and lasts on average from five to ten years before transition to alcoholism. It has been proven that in cases where people start drinking before the age of twenty, 3.6% develop alcoholism, and alcoholism develops earlier and is more malignant.

CAUSES OF ALCOHOLISM

In addition to alcohol itself, a significant role in the development of alcoholism is played by three groups of factors: social, psychobrain teaser And biological.

The ratio of these factors may be different for each person.

Social factors. Research shows that the most significant role in the development of alcoholism is played by the level of education, general culture, environmental factors in which a given personality is formed. A fairly common prerequisite for the development of alcoholism is a misconception about the healing and stimulating effects of alcohol.

Play a great role in the formation of alcoholism psichological factors, and in particular, the presence of some personality defect that complicates social adaptation - timidity, difficulty in establishing contacts, self-doubt, impatience, irritability, anxiety, hypersensitivity. Such people may experience periods of low mood, and alcohol, due to its euphoric effect, helps compensate for these disorders. In other cases, there may be an increased level of aspirations, with insufficient opportunities to achieve their goals, and alcohol gives them a feeling of inner strength and success. This is how an emotionally positive attitude towards alcohol is formed, and then dependence on it, which directs a person not to see a doctor, but to look for an opportunity to drink. Alcohol becomes very convenient and the easy way receiving a feeling of pleasure, positive emotions.

Concerning biological factors diseases, then, apparently, this is the result of complex relationships between the biological vulnerability of the body and the influence of environmental factors. Heredity plays an important role.

Children of alcoholics have a fourfold risk of developing alcoholism compared to other children. Neuropsychiatric diseases predispose to the development of alcoholism childhood. Even in ancient times, people assumed that parents suffering from alcoholism could produce children with various physical deformities, the weak-minded, and those who later become alcoholics. According to some scientists, under the influence of alcohol, the metabolism in the fetus's body changes, and this then leads to special susceptibility. In addition, the environment surrounding the child plays an important role, which, through imitation, shapes attitudes. Alcoholism is characterized by metabolic disorders (especially the balance of B vitamins and vitamin C), changes in enzyme metabolism, and the ratio of chlorine and sodium in the blood plasma.

An undoubted role is played by the characteristics of higher nervous activity: temperament, physiological characteristics.

It should also be said that there is a certain level of alcohol in the human body, the so-called endogenousalcohol. The content of this internal alcohol affects a person’s temperament and his style of behavior. Some people have this level high(these are self-confident, active people with a slight uplift in mood), for others - short. The low content of endogenous alcohol depends, firstly, on the innate qualities of the individual, and sometimes these are the consequences of parental alcoholism. What are children like who have low levels of endogenous alcohol from birth? A child who has a low level of endogenous alcohol from birth is lethargic, passive, slow, does not think well, and is susceptible to even mild stress influences, because Stress itself reduces the level of available internal alcohol. The body always strives to return internal alcohol to its previous normal level. Hence the danger of early alcoholism, which, as a rule, is severe, and the development of sooner or later developing alcoholism in the future.

To increase the level of endogenous alcohol, which is low from birth in these children, drugs are used to stimulate biochemical reactions that result in the formation of internal alcohol in the body.

The teenage period for these children is especially intense, filled with stress, which in itself reduces the level of endogenous alcohol. It requires replenishment, which often leads to frequent alcoholism. The nature of their intoxication is also special: without elevating their mood, rather with excitement. Due to the peculiarities of enzyme metabolism, intoxication is often severe and sometimes fatal (alcohol oxidizes faster than usual, and the breakdown products - phenols - cause poisoning).

Alcohol in the body is broken down into carbon dioxide and water, but intermediate breakdown products (phenols) poison the body. In cases of systematic or frequent consumption of alcohol, the body becomes practically poisoned, which leads to the development of visceral (organ) alcoholism. Along the way, the enzymatic systems involved in the neutralization of toxic products of alcohol oxidation also neutralize endogenous alcohol, which is not only a physiological guarantee of the stability of the emotional state, but also plays a significant role in metabolism. As a result of this process, first the mental, and then the physical dependence drinking from alcohol: the endogenous (internal) alcohol produced by the body is no longer sufficient and alcohol intake from the outside is used to equalize the level of alcohol in the body. A person drinks to at least feel good. Hence alcoholic depression during periods of forced abstinence from alcohol. A new alcoholic way of life is being formed.

It has been proven that residents of the Far North become drunk faster than Europeans. This is due to the ethnic enzymatic characteristics of these peoples; alcohol oxidizes faster to phenols, which leads to massive poisoning; the content of endogenous alcohol quickly drops, leading to alcohol dependence, systematic drunkenness and rapid degradation. For Europeans, this process is 10 times slower, but also inevitable. Some researchers believe that Asians have a more aggressive atypical alcohol dehydrogenase enzyme, which breaks down alcohol.

It should be noted that under normal physiological conditions, up to 0.2% ethyl alcohol is determined in the human body. When alcohol is introduced from the outside, approximately 95% of it is utilized, the rest is excreted unchanged from the body with urine, sweat, and exhaled air. Ethanol oxidation occurs mainly in the liver and is regulated by a number of enzymes, the activity of which determines individual alcohol tolerance. During the recycling process, through a series of intermediate stages, alcohol is converted into acetal dehyde (acetic acid), ultimately breaking down into carbon dioxide and water. Acetaldehyde is highly active and very toxic substance, exceeding in this respect the effect of ethanol by 5-10 times. It is suggested that the clinical manifestations of alcohol poisoning and hangover disorders are precisely associated with the accumulation of acetaldehyde in the tissues of the body. And the lower the activity of the enzymes that break it down, in particular alcohol dehydrogenase, the higher the tolerance and pronounced clinical manifestations. The literature provides data on fluctuations in alcohol dehydrogenase activity over a wide range. A certain level of it can characterize both an individual person and an entire population, being a kind of national feature. In this regard, the facts of the high prevalence and relatively more malignant course of alcoholism among American Indians and a number of northern peoples, which we discussed above, find their explanation.

HOW DOES ALCOHOLISM OCCUR?

Alcoholism- this is one of the forms of substance abuse, which is characterized by an addiction to the use of substances containing ethyl alcohol, the development of mental and physical dependence, and social degradation of the individual.

In its course, alcoholism goes through three stages.

Stage first- neurasthenic, characterized by mental dependence on alcohol. The painful nature of the craving for alcohol arises and strengthens. It is determined by the emergence and development of a constant need to take an intoxicating dose of alcohol, i.e. We are not talking about the attraction to alcohol as such, but specifically about bringing oneself into a state of intoxication. Unlike a habitual drunkard, who can still resist the attraction to alcohol and does not realize it when external circumstances counteract this, the alcoholic practically loses this ability. The attraction begins to take on an obsessive nature, which reflects a person’s mental dependence on alcohol. Periods of abstinence are reduced, the number of days of drunkenness is equal to the number of sober days and exceeds them. Outside of intoxication, a person is dependent and experiences psychological discomfort, which again leads him to drinking alcohol. Resistance to alcohol (tolerance) increases, which increases by 2-3 times. Vomiting disappears during an overdose, and vomiting is an indicator of the limit of intoxication and, ultimately, protection from further intake of alcohol into the body. Reactivity to alcohol changes, which is expressed not only in growing tolerance, but also in a change in the form and nature of intoxication, when the period of excitement with disinhibition lengthens (for moderate drinkers this period is 30-60 minutes, for habitual drunkards - up to two hours, for alcoholics - few hours). When it declines, there is a desire to take a dose of alcohol again. In a state of alcoholic intoxication, the alcoholic becomes agitated, aggressive, his mood drops, he begins to pester others, looks for someone to blame for his failures, and becomes conflict-ridden and explosive. During this period, memory impairments often appear: failures or loss from memory of individual episodes of intoxication (palimsests), when the next morning a person cannot remember what happened to him the day before. Quantitative control over what you drink is lost, and the first portion does not cause the desired intoxication, but the desire to drink more and more arises. This very persistent symptom, having arisen, does not disappear, which explains the fact that a person cannot switch to moderate alcohol consumption even after treatment or long-term abstinence from alcohol. Moreover, even several years of sobriety do not save a person from relapse into alcoholism. As a rule, patients themselves deny this symptom. An alcoholic says he can drink like everyone else.

The form of drunkenness changes, the personality of a person changes. Occasional drinking, which used to be associated with a particular situation, is now permanent, where a person can drink for several weeks. After severe intoxication and troubles, there may be breaks. But at the same time, it is worth noting that there is no physical craving for alcohol.

At this stage, alcoholics sometimes switch to a system of solitary drinking or drinking with random drinking buddies. Since the drinker knows that when intoxicated he looks bad and behaves unworthy, therefore he believes that it is safer to drink with casual acquaintances or alone, so that it is not so noticeable. He does this quite skillfully, so that those around him do not realize for a long time the true extent of his drunkenness.

A characteristic feature is loss of situationalcontrol, those. the ability to control the situation, to correlate the irresistible desire to drink with moral and ethical considerations. He stops taking into account circumstances and can drink in any environment, even the most inappropriate.

High tolerance to alcohol and decreased self-control cause an increase in alcoholic excesses. Drinking becomes systematic and binges occur. Breaks in the constant intake of alcohol are determined exclusively by family and social conflicts, lack of money, etc., that is, they are forced.

A very important, early-onset sign of alcoholism is personality change. Concept personality includes a stable set of socially significant characterological features that make a person different from others. Alcoholism, due to the chronic toxic effects of alcohol on the central nervous system, distorts a person’s personality and introduces new traits that were previously unusual for him: increased irritability, exhaustion, mood instability, self-doubt, loss of previous interests. The moral and ethical standards to which one adheres are reduced this person. Deceitfulness, unceremoniousness, and boastfulness appear. These new traits become so entrenched in the personality that they gradually turn into stable behavioral stereotypes. The longer the drinking period, the more the personality changes.

Thus, initial stage characterize alcoholismis a mental dependence on alcohol, a decrease in the amount natural and situational control, increased tolerance, memory impairment, mental and physical disorders standing of a person. The first stage can last from 5 to 10 years.

In the second During the stages of alcoholism, these symptoms increase, but at the same time a whole series of qualitatively new manifestations arise. The most important sign of the second stage of alcoholism is the formation physical dependence from alcohol, which manifests itself in the form hangover syndrome orwithdrawal syndrome. Tolerance reaches its maximum level. Pseudo-binges are observed. The peculiarity of the second stage of alcoholism is that alcohol becomes an integral part of the patient’s metabolism. His absence

in the body the patient experiences a serious, painful condition. An alcoholic does not suffer from the fact that he drank a lot yesterday, he suffers from the fact that he did not drink today. He drinks to relieve his condition. The metabolism in the body of a patient with alcoholism changes so much that the presence of a certain amount of ethanol becomes necessary to maintain these changed metabolic processes. A decrease in alcohol concentration in the body is subjectively experienced as a very serious physical condition - what is called a hangover. This state determines the irresistibility of the craving for alcohol, the physical nature of this craving, and dependence. Withdrawal syndrome is characterized by severe disturbances in the physical condition, autonomic nervous system, and mental disorders. It occurs during the period after sobering up and is relieved by hangover. With alcoholism, hangovers can last from several hours to several days. In mild cases, the picture is limited to vegetative symptoms: sweating, palpitations, loss of appetite, and a feeling of weakness. The patient still copes with the desire to immediately take a new dose of alcohol and can postpone the hangover until the evening. In more severe cases, disturbances appear heart rate, changes in blood pressure, nausea, vomiting, hand trembling, and then the person cannot resist taking a new dose of alcohol. In the most severe form of withdrawal syndrome, mental disorders appear in the form of fear, anxiety, low mood, often accompanied by ideas of guilt and thoughts of suicide, sleep disturbances, and nightmares. Resistance to alcohol (tolerance) in the second stage continues to increase and remains consistently high over a number of years, which leads to an increase in doses of alcohol. During this period, a person changes significantly - he begins alcohol degradation: The level of personality decreases sharply, and there is a loss of individuality and creative activity. Lost interest in everything that is not related to alcohol. Callousness and soullessness appear, and moral standards decrease. These changes are especially clearly visible in communication with loved ones. Alcoholic “flat” humor appears, rude, cynical, inappropriate. There is a social and professional decline, the level of critical attitude, especially towards oneself, is falling. The patient looks for and finds mitigating circumstances that led him to drink, denies the presence of alcoholism (anosognosia). A. A. Korsakov also wrote that an alcoholic blames everyone - his wife, children, service, but not himself. In the second stage of alcoholism, physical diseases often worsen, but even more often new diseases arise that are associated with the influence of chronic alcohol poisoning: diseases of the liver, stomach, heart, and central nervous system. At this stage, alcoholic psychosis may develop.

Third stage of alcoholism - initial, organic. Sometimes it is also called stage of alcoholic dementia. It is this third stage that is the result of the severe toxic effect of alcohol. It is characterized by a decrease in resistance to alcohol, a decrease in mental and increased physical dependence, and a further increase in physical, mental and social degradation of the individual. By the way, these are not necessarily elderly people: 30% are people under 40 years old, and the average age at this stage is 45 years.

The decrease in tolerance is expressed in the fact that patients begin to get drunk already from small dose or switch to less strong alcohol. The protective gag reflex may reappear. Attraction is violent and develops after the first drink. Patients cease to experience the feeling of joy from alcohol, they completely lose situational control. To get alcohol, they do anything: get into conflicts with the law, are ready to beg. The attraction is so strong that patients are able to use any, even toxic substances, if there is any hope of finding even the slightest dose of alcohol in them. Drunkenness is constant and binge drinking. Withdrawal is extremely severe, and the patient may die in this condition, since withdrawal symptoms often occur during abstinence. seizures and alcoholic psychoses. The mortality rate of patients with stage III alcoholism is 1.5-4 times higher than the mortality rate of the population of similar age groups. During this period, signs of serious brain damage are especially pronounced - the brain is poisoned, memory is impaired, thinking becomes unproductive, intelligence decreases and the patient loses all his human qualities. He is incapable of work, incapable of productive communication, there is no will, all interests are focused on alcohol. Thus:

Istage. It is characterized by the development of mental dependence, the disappearance of the gag reflex, high tolerance to alcohol, loss of situational and quantitative control, systematic alcohol consumption, and changes in a person’s personality. Duration from 5 to 10 years.

IIstage. It is characterized by the development of physical dependence, the highest tolerance to alcohol, the development of withdrawal syndrome, the presence of binges, the addition of mental disorders (alcoholic psychoses), and alcoholic personality degradation.

IIIstage. It is characterized by a decrease in tolerance, an increase in physical dependence, the development of severe withdrawal syndrome, the occurrence of alcoholic psychoses, an increase in mental and social degradation of the individual, and the appearance of alcoholic dementia.

ALCOHOL AND HEALTH

As science develops, the possibility of more accurate and detailed identification of the effects of alcohol on the body opens up.

It has been established that the seemingly smallest, but systematically administered doses of alcohol cause human health problems. Only 10% of the alcohol consumed is excreted from the body, and the rest enters into complex metabolic relationships with tissues and cells.

Alcohol disease is a disease in which prolonged, repeated intoxication with ethanol leads to organic changes in organs and systems (V.S. Paukov, 1994). The pathogenesis of alcoholic illness consists of the following stages:

stage of repeated acute alcohol intoxication

drunken stage

stage of alcoholism and accompanying complications (mental and physical dependence, withdrawal syndrome, alcoholic psychoses, etc.)

At the molecular level, alcohol interferes with the synthesis of carbohydrates, proteins and fats. At the subcellular and cellular level, the conduction of impulses is disrupted. The harmful effects of alcohol on the liver, stomach, heart and other organs have long been known.

It has already been noted that there are stages in the development of alcoholic illness: from initial changes in character and habits, noticeable only to an attentive eye, to persistent and irreversible changes in personality. A similar phasing can be seen in the disruption of the activity of internal organs. The initial link in the development of these disorders is a violation of nervous regulation and control of the activity of internal organs by the nervous system, associated with the toxic effects of alcohol, for the first blow of alcoholic poisonIt is the nerve cells that take over.

Damage to internal organs begins from the very beginning of systematic alcohol consumption - alcohol abusers complain of pain in the stomach, liver and other internal organs. Blood pressure rises, sleep is disturbed, weakness and fatigue appear. The patient does not associate all these sensations with alcohol. Often he has to see a doctor. The patient receives sick leave where this or that disease is noted, but the cause of all these troubles is abusedrinking alcohol.

There are certain target organs that are most often affected by alcohol abuse. These are the heart, liver, brain, pancreas, lungs. It is the diseases of these organs that often cause death in patients who abuse alcohol (90.8%).

It should be noted:

in the stage of drunkenness when refusing to drink alcoholreversible changes occur in internal organs

with alcoholism, changes in internal organs are irreversiblewe lead to the death of the patient

Damage to the respiratory system. The cause of death in more than half of cases of alcoholism is diseases of the respiratory system. Lung damage in alcoholics occurs 3-4 times more often than in people who do not abuse alcohol. This is facilitated by the fact that 5% of alcohol is released through the lungs (this is why the exhaled air has the smell of alcohol, the smell of fumes). Alcohol and its breakdown products have a detrimental effect on the delicate lining of the bronchi and lung tissue.

The main mechanism contributing to the development of diseases of the respiratory system is the exacerbation of bronchopulmonary infection against the background of a sharp inhibition of the protective functions of the body. Inflammatory processes occur in the trachea, bronchi, and lungs, sclerosis of the lung tissue occurs, and pulmonary emphysema develops.

Most alcoholics are heavy smokers. The combined effects of alcohol and nicotine on the respiratory system contribute to such frequent diseases. Tracheitis and bronchitis are often combined with damage to the pharynx and larynx; the voice of alcoholics becomes hoarse.

Pneumonia in alcoholics occurs 4-5 times more often than in people who do not abuse alcohol. Their pneumonia is severe, takes a protracted course, and complications are often added that can cause death.

Pulmonary tuberculosis is much more common in alcoholics than in the general population. The risk of developing lung cancer increases.

Damage to the cardiovascular system. Medical studies show that 95% of people who regularly drink alcohol have impaired functioning of the cardiovascular system. The risk of developing alcoholic heart disease increases sharply with significant alcohol abuse (more than 100 g per day when converted to 100% ethanol). The frequency of lesions increases as alcoholism progresses. At stage I it is detected in 37.5%; at III - in 95.8% of patients. Obesity and dystrophy develop in the heart muscle. She becomes flabby. Signs of impaired myocardial contractility appear and heart failure develops. Damage to the heart muscle is aggravated by impaired metabolism of vitamins (especially group B), magnesium salts, potassium and blood gas composition. Sometimes a single overdose of alcohol can lead to severe negative effects on the heart muscle. Patients are worried painful sensations in the area of ​​the heart, palpitations, interruptions in the functioning of the heart (arrhythmia), as the disease progresses - shortness of breath, swelling.

Heart attack before the age of forty is a common occurrence in people who abuse alcohol. Many similar examples can be given by employees of the cardiology department who observed severe myocardial infarctions that developed in young people as a result of excessive drinking.

Hypertension develops twice as often in people who abuse alcohol compared to moderate drinkers. In hypertensive alcoholics, drinking alcohol leads to a significant increase in blood pressure; with abstinence, it decreases. There is a higher incidence of strokes associated with hypertension.

Damage to the digestive system. The effect of alcohol on the digestive system is as follows:

direct contact of alcohol with the mucous membrane oral cavity, esophagus, stomach and intestines, and strong drinks have a more significant damaging effect; the effect of alcohol on the central nervous system, which regulates the function of the digestive organs

the effects of alcohol at the cellular level through the circulatory system

violations of food hygiene that accompany a state of intoxication (consumption of spicy foods, low-quality products, etc.), which creates an additional negative effect on the digestive system

Alcohol can lead to acute and chronic diseases of all parts of the digestive tract.

A connection has been found between alcohol abuse and careleftovers of the esophagus. Most often, esophagitis develops (inflammation of the esophageal mucosa).

Under the influence of alcohol in low concentrations, secretion increases gastric juice, with large ones, on the contrary, the content is suppressed of hydrochloric acid increases. Digestive processes are disrupted. Gastritis occurs. Alcohol slows down the rate of healing of peptic ulcers, promotes frequent exacerbations peptic ulcer disease. Patients have a reduced appetite, heartburn, nausea, belching, and pain in the stomach, which disappear after drinking alcohol. Vomiting with mucus, sometimes mixed with blood, often occurs in the morning.

Defeat intestines leads to disruption of digestion and absorption of the main components of food. The absorption processes of vitamins, as well as potassium, sodium, magnesium, phosphates, and folic acid are especially disrupted. A deficiency of these essential elements, in turn, leads to various disorders: anemia, vitamin deficiencies, encephalopathies, cardiac arrhythmias, etc. Intestinal damage in patients is manifested by diarrhea and weight loss.

Alcohol damage pancreas ranks second in importance after alcoholic liver damage. Alcohol consumption is the main cause of chronic pancreatitis (40-90%). Occur less frequently acute pancreatitis(3-25%). Most often, pancreatitis develops in men aged 30-40 years. The latent period for the development of the disease is 3-10 years, subject to regular consumption of ethanol.

Alcohol is one of the leading causes of lesions neCheni. Of the internal organs, the liver is most often affected. This is determined not only by the effect of alcohol intoxication on liver cells, but also by the fact that ethanol oxidation mainly occurs in the liver. Alcoholic hepatitis and liver cirrhosis occur (the term “alcoholic hepatitis” was adopted in 1978 by WHO to designate liver damage caused by alcohol). Liver damage does not depend on the type of alcoholic beverages, but is determined by the alcohol content in them. Most researchers believe that in 20-50% of cases, cirrhosis of the liver is caused by alcohol intoxication. The incidence of liver cirrhosis in alcohol abusers is 5 times higher than the incidence of cirrhosis in non-alcohol abusers. In alcoholic patients, the risk of liver disease is directly dependent on the dose of alcohol consumed. The risk of developing liver cirrhosis in men who drink 120-180 g of alcohol per day is 24 times higher than in those who drink less than 60 g, and 150 times higher in men who drink 240 g. The disease is severe and has a progressive course. Jaundice and ascites occur (the appearance of fluid in the abdominal cavity). Often accompanied by lesions of the stomach and pancreas (gastritis and pancreatitis). Every third alcoholic dies from cirrhosis of the liver. In 5-15% of cases, alcoholic cirrhosis of the liver transforms into cirrhosis-cancer. Women have an increased sensitivity of the liver to the harmful effects of alcohol. The development of liver diseases in them is possible even due to a relatively low level of alcohol in the blood, as well as after a short but significant intake of alcohol.

Alcohol worsens the course of dental diseases, such as such as gum inflammation, periodontal disease, promotingprevents the development of caries. To a certain extent, specific dental alcohol syndromes can include symmetrical enlargement of the parotid salivary glands. The increase develops over a long period of time and gradually. A certain role in the hypertrophy of the salivary glands is played by the irritating effect on the mucous tissue of ethanol released with saliva.

Kidney damage. Kidney damage in alcoholism develops as a result of direct action alcohol and its metabolites, and due to other mechanisms associated with involvement in pathological process other organs (liver, pancreas, etc.). Acute and chronic kidney damage occurs (glomerulonephritis, pyelonephritis). The disease is severe, the amount of urine excreted decreases, the urine turns red, and swelling occurs. Kidney damage is especially pronounced when consuming surrogates of alcohol, perfume products or other liquids that contain kidney poisons. In such cases, acute renal failure sometimes develops, in which only an “artificial kidney” device can save the victim.

In recent years, evidence has accumulated indicating the role of alcohol in the occurrence and development of malignant tumors. An increased incidence of cancer of the oral cavity, pharynx, larynx, esophagus, stomach, liver and lungs has been established in chronic alcoholics. For heavy drinkers, the risk of developing oral cancer is 10 times higher than for non-drinkers, and if they also smoke, the risk increases 15 times. The overall mortality rate from cancer of all sites in alcoholics is 25% higher than the population average.

Quitting smoking and alcohol reduces the incidence of cancercom on 76%.

Drunkenness and alcoholism are among the leading factors in the spread of sexually transmitted diseases and HIV/AIDS. In a state of alcoholic intoxication, sexual desire increases. Promiscuous sexual intercourse occurs. There is a high incidence of infection with syphilis and gonorrhea.

The effect of alcohol on the fetus, pregnancy and reproductiontive function.

It has long been known that in families where parents abuse alcohol, there is a higher risk of having defective, weakened children.

Alcohol and its transformation products in the body affect offspring in different ways:

lead to illness in parents, which negatively affects the development of the embryo and fetus

cause pathological changes in germ cells

have a direct effect on the embryo and fetus

Chronic alcohol intoxication causes a number of sexual dysfunctions in women and men. The effects of alcohol directly affect the reproductive cells (sperm and egg). Alcohol has a particularly adverse effect on the development of the male gonads and the sperm they produce. Men who abuse alcohol may experience infertility, decreased libido, and early impotence. Signs of endocrine system disruption often develop (growth of mammary glands, etc.). The frequency and degree of dysfunction of the male reproductive glands depends on the amount and duration of alcohol consumption. In 40-60% of women who abuse alcohol, ovarian dysfunction occurs and menopause occurs prematurely.

There is a relationship between the damaging effects of alcohol on the fetus and the intrauterine development of the fetus. In the intrauterine development of the body, two main periods are distinguished: embryonic (embryo) and fetal (fruit),

Embryonic period lasts from the moment of fertilization of the egg cell until the end of the 2nd month of pregnancy. During this period, the rudiments of all the most important organs and systems, the formation of the torso, head, face, and limbs occurs. Adaptive mechanisms have not yet been developed, so the embryo is extremely sensitive to the action of damaging factors. The influence of alcohol, nicotine, microbes, viruses, and lack of oxygen can cause developmental disorders and death of the embryo or the appearance of congenital deformities.

Fetal period- begins from the end of the 2nd - beginning of the 3rd month of pregnancy and continues until the birth of the fetus. During this period, rapid fetal growth, tissue differentiation, and development of organs and systems occur.

In the embryonic and fetal periods of development, stages are distinguished when the embryo has increased sensitivity to the action of damaging environmental factors (alcohol, hypoxia, some drugs, ionizing radiation, etc.). These periods are called “critical”.

First critical period development is considered to be the time preceding implantation (the introduction of a fertilized egg cell into the uterine mucosa) and coinciding with it.

Second critical period development is the period of formation of the rudiments of organs and systems of the embryo (3-7 weeks of development) and the process of formation of the placenta (9-12 weeks of pregnancy).

Exposure to damaging factors during the first critical period usually leads to the death of the embryo in the early stages of its development (embryotoxic effect). Damage to the embryo during the period of organogenesis (the formation and development of internal organs occurs) and placentation (formation of the placenta) is characterized by the occurrence of deformities (teratogenic effect); an embryotoxic effect is less often observed. In the process of the occurrence of deformities, those organs and systems that, at the time of exposure, were in a critical period of their development are primarily affected. In the embryo, the most vulnerable are the central nervous system, organs of vision, endocrine glands and gonads, therefore anomalies of these organs are most common. For different organ anlages, the critical periods do not coincide in time, so the effect of the damaging factor in different stages organogenesis causes deformities various organs embryo. Thus, the most dangerous (critical) periods of development for the nervous system are the 18th day after conception, for the eyes - 25-30, for the genitals - 36-180. Multiple fetal deformities occur when long-term use alcohol, and in the early stages of pregnancy.

Numerous studies have proven that alcohol is a substance that has embryotoxic, fetotoxic and teratogenic effects, depending on what periods of the formation of the embryo and fetus it acts and how long it affects.

The toxic effect of alcohol affects the course of pregnancy and leads to various complications: spontaneous abortion, premature birth, bleeding in postpartum period, fetal death. Alcohol consumption and its amount during pregnancy are of significant importance for the occurrence of pathologies of pregnancy, childbirth, as well as for developmental deviations and the occurrence of deformities. Daily consumption of alcohol up to 125 ml leads to miscarriages in 9%, over 125 ml - in 18%. In alcoholic mothers, the mortality rate of children during childbirth and immediately after it increases significantly, reaching 11.1-12.3%, which is almost 12 times higher than in the control group.

How are children born? WITH low body weight, absence or weakening of the sucking reflex, frequent infectious diseases of newborns (diseases of the umbilical wound, pemphigus, sepsis). During the first year of life, there is a slight increase in weight, convulsions and bedwetting often occur, they begin to walk and talk late, and they lag behind in physical development. More severe lesions often occur. Such children have mental retardation (oligophrenia) in 64%, epilepsy in 30%, neuroses and psychogenic disorders in 27.8%. Deaf-muteness, hydrocephalus (dropsy of the brain) and other developmental anomalies are possible.

A set of fetal developmental anomalies is commonly called fetal alcohol syndrome. It is characterized by certain clinical manifestations: disorders of the central nervous system, slower growth and development of the fetus, the presence of characteristic developmental anomalies, especially of the facial skull, and the presence of other deformities (limbs, internal organs, etc.). Nervous system disorders are observed in 80% of children. Newborns have characteristic appearance: small eyes, squint, low forehead, underdeveloped chin, small saddle nose, altered ears, large half-open mouth, flattened nape. There are also other anomalies in the development of internal organs. There is a relationship between the frequency and amount of alcohol consumed by parents and the severity of the syndrome. Fetal alcohol syndrome may occur even with occasional drinking by a woman in early pregnancy.

Children of alcoholics are 4 times more likely to get sickalcoholism

The most severe consequences for offspring are observed with alcoholism of both parents

So, there is no such organ, no tissue or cell that does not suffer from the toxic effects of alcohol. At the same time, one can hear the following objection: if vodka is so harmful, then why do so many people drink it and don’t seem to get sick very often? The special insidiousness of alcohol is manifested in the fact that it acts gradually and significant health disorders do not arise immediately, but gradually. Often in the initial stage of the disease, when a person experiences malaise, weakness, irritability, when his ability to work decreases, he is inclined to attribute this not to the destructive effect of alcohol, but to other reasons: overwork, troubles in the family. In addition, the human body has the ability to adapt to certain harmful influences and therefore First stage The disease is hardly noticeable to the drinker himself and to the people around him. Such patients often come to the doctor when the disease is already quite advanced and alcohol has had time to significantly undermine their health.

ALCOHOLIC PSYCHOSES

In cases where we are talking about a mature alcoholic disease, the risk of developing alcoholic psychosis is quite high, which occurs in approximately every third person who abuses alcohol for a long time. Alcoholic psychoses are a whole group of mental disorders; they can be short-term, acute, or have a long-term chronic course. They occur in the form of exogenous, endoform and psychoorganic disorders that arise in the second and third stages of alcoholism. Psychoses sometimes develop during periods of heavy alcohol consumption, but more often they occur during abstinence. Psychosis is often preceded by a physical illness. Even E. Kraepelin in 1912. noted that the most important cause of psychosis in these cases is not so much the direct effect of alcohol on the brain, but metabolic disorders and the toxic effects of ethanol breakdown products. When psychoses develop primarily as a result of prolonged intoxication, internal organs are damaged and metabolism is significantly disrupted. Such psychoses are called metal-alcohol psychoses.

The classification of alcoholic psychoses is based on taking into account the clinical picture and the nature of the course of the disease. It is customary to distinguish between alcoholic delirium, encephalopathy (including Korsakoff psychosis), hallucinosis and paranoia, as well as a state of pathological intoxication, which, essentially, is short transient psychoses. The most common symptoms are delirium and hallucinosis. As a rule, they do not occur at the height of binge drinking, i.e. not during the period of greatest alcohol intoxication, but after them, when there is no alcohol in the blood or its content decreases sharply (Victor M, Adams R, 1953). According to WHO, alcoholic psychosis occurs in 10% of people suffering from alcoholism. The maximum incidence of alcoholic psychosis occurs at the age of 36-44 years in men and 45-49 years in women (Kachaev A.K., 1973). Psychosis occurs much more often in men than in women. Statistics indicate an increase in the number of women suffering from alcoholism: if in 1988 the share of women registered for alcoholism accounted for 12.6%, then in 1996 women already accounted for 14.2%. In the 80s The ratio of men to women with alcoholism was 9-10:1, in 1996 it changed to 6:1. At the beginning of 1997, in Russia there were 334,000 women with alcoholism and registered in drug treatment clinics, which is 430.3 per 100,000 female population.

In recent years, Russia has seen a sharp deterioration in the drug addiction situation, which we have already written about above, and this is manifested not only in an increase in the number of patients with chronic alcoholism, but also in a certain pathomorphism of these diseases, in an increase in the number of acute psychoses. Moreover, it should be noted that the very course of these mental disorders has become more severe and dangerous, which ultimately led to an increase in mortality from alcoholism and, in particular, alcoholic psychosis. Modern researchers (Hoffman A. G., 1998; Polykovsky A. A, Chirko V. V., 2000) emphasize the pronounced pathomorphosis of the clinic of acute alcoholic psychosis. It should be noted that the number of psychoses has increased, the ratio of delirium and hallucinosis has increased. For men and women, the dynamics of this ratio are opposite, and, most importantly, the mortality rate from alcoholic psychosis has increased. There is a particularly rapid growth rate of alcoholic psychosis among young people and women. The picture of mental disorders that arise in patients with chronic alcoholism is becoming more and more atypical, with the development of deeper psychotic disorders, in particular amental states, coma, which are accompanied by noticeable somatic disorders and an unfavorable prognosis.