Modern and effective methods of treating alcoholism. Symptomatic treatment of alcoholism

Anti-alcohol treatment should be continuous and long-term. Often, after stopping alcohol consumption in the initial stage of treatment, the patient becomes a so-called sober alcoholic. This definition emphasizes that stopping drinking alcohol does not mean recovery from the disease.

Anti-alcohol therapy should be as differentiated and individualized as possible. Anti-alcohol treatment must be comprehensive; its effectiveness is determined by the unity of medication, psychotherapeutic and rehabilitation measures. Treatment should be staged and consistent. Currently, a three-stage treatment system has gained recognition. At the first stage, alcohol abuse is interrupted, alcohol addiction is stopped as soon as possible withdrawal syndrome, acute consequences and complications of alcohol consumption are eliminated, the patient is examined, and psychotherapeutic contact is established. At the second stage, active specific anti-alcohol treatment is carried out, aimed at persistently suppressing the pathological craving for alcohol, developing disgust or indifference towards alcohol, and eliminating disorders associated with alcohol intake. At the third stage, the main volume of rehabilitation measures is carried out, supportive and anti-relapse treatment is carried out.

Suppression of pathological craving for alcohol (elimination of mental dependence)

Suppression of desire is based on aversion (from the English aversion - disgust) therapy - the development of a conditioned gag reflex to the sight, taste and smell of alcohol or fear of drinking it due to an unusually painful effect.

Conditioned reflex therapy was first tried by N.V. Kantorovich in 1929: the type of alcoholic drinks, their smell, the inscriptions associated with them, were combined with an electric shock to the hand. The effect turned out to be very unstable. A more advanced method was developed by I.F. Sluchevsky and A.A. Friken in 1934. Small doses of alcohol are given against the background of the action of emetics (injections of apomorphine or emetine, taking ipecac, decoction of lamb, thyme, etc.). After several combinations, a conditioned gag reflex is formed to the sight, smell and taste of alcohol. However, like all conditioned reflexes that are not constantly reinforced, it subsequently fades away, and therefore the effect of treatment turns out to be unstable.

Sensitizing therapy was carried out by O. Martensen-Larsen in 1948 in the form of regular administration of Antabuse (Teturam, Disulfiram). Under its action, the enzyme acetaldehydroxidase is inhibited in the body. When alcohol enters the body, its oxidation is delayed at the stage of acetaldehyde, the accumulation of which in the blood produces a transient toxic effect in the form of a feeling of lack of air, fear of death, rapid heartbeat, nausea, and redness of the face. But in rare cases, severe complications may occur: hypertensive crises, angina attacks, collapse, convulsive seizures. To enhance and strengthen the action, under the supervision of a doctor in the treatment room, one or two teturam-alcohol reactions are deliberately caused in the patient (after taking the next dose of teturam, he is given a small dose of alcohol). When painful disturbances arise and the fear of death appears, the usual symptomatic remedies are used (for example, an infusion of glucose with caffeine), thereby strengthening the patient’s idea that drinking alcohol is dangerous for him. Long-term use of Teturam can be complicated by severe asthenia, gastritis, and less commonly, hepatitis and polyneuritis. However, patients may voluntarily stop taking Teturam and begin to abuse alcohol again. To avoid such a temptation, a long-acting drug, Esperal (Radoter), was proposed. The patient undergoes intramuscular implantation of sterile Teturam tablets. At the same time, they take a receipt from him that he has been warned that drinking alcohol is fraught with serious complications that do not exclude death.

Other sensitizing agents used include metronidazole (Trichopol, i.e., an anti-trichomonas drug), furazolidone, cyamide, nicotinic acid, etc. Against the background of their action, taking alcoholic beverages causes a reaction similar to teturam-alcohol, but less pronounced.

Other methods of suppressing the craving for alcohol include the use of small (sub-void) doses of apomorphine and psychotropic drugs, but after stopping their use, the craving usually returns.

Psychotherapy is considered by many to be one of the most effective methods that can give the most lasting results. Perhaps this is due to the fact that the full course of treatment can be carried out by someone who himself strives to be cured or who manages to awaken this desire. Suggestive techniques (suggestion in hypnosis or in a waking state, narco-hypnosis, emotional stress therapy) are based mainly on the development of aversion to alcohol. People with hysterical or emotionally labile character traits are more amenable to these methods. As alcoholism develops, suggestibility often increases. Experienced psychotherapists skillfully select easily suggestible patients for treatment, so the effect of therapy can be amazingly high. Rational psychotherapy (explanation, persuasion) can be carried out either individually with each patient or with a group. Group psychotherapy involves the active participation of group members in discussions, mutual emotional support for each other, and the development of an attitude toward sobriety. More often, group psychotherapy is used in the process of maintenance (anti-relapse) treatment.

Maintenance (anti-relapse) therapy is due to the fact that the pathological craving for alcohol is usually not completely eliminated, but only suppressed. Under unfavorable circumstances, for example, during family and work conflicts, there is a desire to forget, to get away from troubles. In an environment of forced idleness and boredom (unemployment, retirement, etc.) under the influence of mental trauma, pathological attraction can flare up with renewed vigor.

Anti-relapse treatment is carried out in the form of courses combining conditioned reflex or sensitizing therapy with the use of psychotherapy methods, especially group and family ones. In our country, maintenance therapy is regulated by instructions: in the first year of remission, courses should be repeated every 4 months, in the second - every six months, then at the end of the third year, and in the 4th and 5th years - as needed. Such formalization does not take into account the stages of alcoholism, provoking circumstances, the degree of social adaptation and other incidental factors. The most indicated can be considered long-term ongoing group psychotherapy in clubs of former patients, in societies of anonymous alcoholics, which are very popular in the USA and are beginning to emerge in our country. Repeated courses of conditioned reflex or sensitizing therapy are indicated when real threat relapse, when the first signs of resumption of pathological desire appear (“alcoholic” dreams, emotional revival when talking about alcoholic beverages, interest in previous acquaintances, etc.).

If there is a tendency to cycloid subdepression, during which the craving for alcohol may also worsen, long-term treatment with lithium salts or carbamazspin (finlepsin) is indicated.

Relief of withdrawal syndrome (elimination of physical dependence)

Treatment of stage II alcoholism begins with interruption of abstinence. Very effective means are used aimed at detoxification and elimination of painful symptoms.

Detoxification is carried out using intravenous drip infusions of hemodez, rheopolyglucin, 5% glucose. Injections of thiol preparations (unithiol, sodium thiosulfate), as well as large doses of vitamins - thiamine, pyridoxine, ascorbic acid - are also used.

The use of osmotic diuretics (urea, mannitol, uroglyuk) is also proposed. All this is intended to accelerate the oxidation and removal of metabolic products from the body, in particular accumulated acetaldehyde.

Elimination of painful withdrawal symptoms is achieved with the help of various psychotropic and other medications. For anxiety and restlessness, sibazone (Seduxen, Relanium), thioridazine (Sonapax, Melleril), chlorprothixene (Truxal) is used, and if anxiety is combined with depression, amitriptyline or pyrazidol. For insomnia, reladorm or a combination of eunoctin (radedorm) with phenazepam has a good effect. For severe autonomic disorders (sweating, chills, palpitations), Grandaxin or Pyrroxan are more indicated. For vivid, colorful dreams and especially for hypnagogic (at the moment of falling asleep or waking up) hallucinations (threat of developing alcoholic delirium), it is necessary to use tizercin (levomepromazine). If withdrawal symptoms include dysphoria and anger, Neuleptil (periciazine) is most effective.

Relieving withdrawal symptoms does not eliminate the pathological craving for alcohol, which can remain strong and stable for a long time, and at a certain period even sharply intensify. Therefore, after the withdrawal symptoms are relieved, they begin treatment aimed at eliminating mental dependence.

From a medical point of view, alcoholism is a disease characterized by a painful addiction to alcohol, with mental and physical dependence on it. Alcoholism is an acute problem in our society. Lack of confidence in the future, difficulties in professional activity and problems within the family - all this is the source of problems not only for an individual, but also for the demoralization of society.

It is not for nothing that alcoholism is considered a serious disease, especially since it always occurs in a chronic form. It brings a huge amount of trouble not only to the patient himself, but also to his close relatives. Therefore, people suffering from alcoholism need active treatment. But it is equally important to carry out timely prevention of the development of the disease. After all, any pathology, including alcoholism, is much easier to prevent than to treat. Moreover, it is impossible to completely cure alcoholism; it is only possible to achieve remission. Its duration can range from several months to many years; patients often lead a sober lifestyle until the end of their days.

How does alcoholism develop?

Depending on its severity, alcoholism is divided into three degrees:

1. The first degree of this disease is popularly called “domestic” drunkenness. At this time, the patient can drink alcohol every day and not experience severe intoxication and boast of his body’s resistance to alcohol.

There are still no signs of a hangover, but mental dependence is already arising. If it is not possible long time drink another glass, the person begins to get angry and very irritated. It is rare to find a patient with the first degree of alcoholism who is ready to seek help. medical care. Most often, at this stage of the disease, patients persistently try to prove the absence of a problem to others. And they don’t admit its presence even to themselves.

2. Second degree of alcoholism. To all the above-mentioned symptoms of the disease is added a hangover or, as doctors call it, withdrawal symptoms. It is characterized by symptoms such as nightmares, a feeling of weakness, lack of appetite when sober, and pain throughout the body. The next portion of alcohol allows you to get rid of them for a while. In patients with the second stage of alcoholism, changes in personality and mental abilities are observed. This degree of alcoholism lasts for several years. Against this background, patients may experience delirium tremens (delirium tremens).

3. Third degree of alcoholism. Pronounced changes in the patient’s liver and pancreas reduce the body’s perception of alcoholic beverages. A person drinks in small but frequent portions, often consuming “weak” drinks - diluted vodka, wine. Significant changes occur in the patient’s body, against the background of which diseases such as stomach ulcers, liver cirrhosis, polyneuritis, hepatitis, pancreatic necrosis and many others develop. If left untreated, the third stage of alcoholism lasts from three to five years and ends in death.

Beer alcoholism

Drinking beer in moderation is equated to alcoholism and is a big problem in the mass consumption of this drink. Manufacturers are cultivating the fashion for this low-alcohol product. And as a result, we sometimes drink beer without thinking, to lift our spirits in a friendly company, to quench our thirst, to keep our nails strong and our hair beautiful.

It’s no secret that people like to drink beer with various salty foods, such as crackers, salty fish or chips. Excess salt in the body causes thirst. As a result, a person begins to consume significant amounts of liquid, both with the beer itself and after drinking it. This increases the load on cardiovascular system, leading to the gradual development of changes in the heart, increasing blood pressure.

When examining beer lovers, doctors often tell them that they have a “beer heart,” i.e. with hypertrophied walls and expanded chambers.

Many people believe, and this is wrong, that beer alcoholism is harmless phenomenon. In a person who drinks beer excessively, along with heart pathology, inflammation of the stomach and esophagus is also observed. Cobalt, which is part of the intoxicating drink, promotes these inflammations.

In addition, beer alcoholism reduces potency in men and reduces the fertilizing activity of sperm. Beer lovers often also experience diseases of the pancreas and kidneys.

Female alcoholism

The most severe type of alcoholism is without any doubt female alcoholism, which is a particularly acute social problem.

Female alcoholism is considered to be an independent disease, because The features of its course and complications differ significantly from male alcoholism. For example, for a man to become an alcoholic, it will take about 10 years of almost daily drinking, but the first stage of female alcoholism usually lasts no more than three years. Then you can observe a rapid increase in symptoms and the appearance of complications accompanying this disease (liver cirrhosis, hepatitis, pancreatic necrosis).

Especially quickly with female alcoholism, personality changes arise and develop: hysteria, anger develop, the woman becomes touchy and sexually promiscuous. Today, female alcoholism is less common than male alcoholism. The following factors lead to the development of this disease in women:

* Unfavorable social circumstances;

* Strong emotional shocks;

* Presence of relatives suffering from alcoholism;

* Work in a drinking establishment.

Treatment of alcoholism and its prevention

Alcoholism, like all other diseases, must be treated. The sooner treatment for alcoholism is started, the faster the results will be noticeable. An effective aid in its therapy is the desire of the patients themselves to as soon as possible get rid of addiction. But more often, alcoholism treatment takes place under pressure from administrative institutions and the patient’s family.

Treatment includes several stages and most often begins in a drug treatment clinic. First of all, with the help medications relieve symptoms of withdrawal symptoms. Vitamin preparations that improve metabolism are prescribed. If necessary, sedatives or tranquilizers can be used.

After the patient’s general condition improves, they move on to the second stage of treatment. It can last quite a long time, sometimes for several years. It starts at inpatient conditions, and then continue on an outpatient basis. The main goal of the second stage of alcoholism treatment is to develop in the patient a persistent aversion to drinking alcoholic beverages. A variety of methods are used for this: medications, hypnosis, coding, psychotherapy.

And social rehabilitation is the third stage in the treatment of alcoholism. It is carried out with the support of family, psychotherapist and sobriety society.

Unfortunately, it is impossible to achieve complete recovery from alcoholism, as we said at the very beginning. Therefore, patients suffering from alcoholism should receive supportive care throughout their lives. preventive treatment, and also refrain from drinking any, even the weakest, alcoholic beverages.

As you can see, treatment for alcoholism is long and very complex. Therefore, it is important to prevent its development, i.e. carry out prevention. One of the important responsibilities of parents, educational and public organizations, medical institutions and a number of government agencies is to conduct regular preventive conversations about the dangers of alcohol among the younger generation and the healthy. It is necessary to use all methods in the fight to prevent alcoholism: limit the sale of alcoholic beverages, especially to minors, promote a healthy lifestyle, and conduct explanatory conversations among the younger generation.

Update: October 2018

No matter how many people would like to believe it, alcoholism is a disease. It, like any disease, is characterized by a stage-by-stage development and, as with other pathologies, only reasonable and proven treatment can save you from it.

The problem of alcoholism begins when a person - no matter whether it is a woman or a man - begins to enjoy alcohol and associate pleasant moments in life with it. At this time, ethyl alcohol reacts with fat molecules present in the body and is gradually integrated into the ongoing metabolism. To “remove” it from there, you need to completely remove alcoholic beverages from consumption and, one by one, correct emerging metabolic disorders. Then, within about a year, metabolic reactions will be restored to their original state, the structure of blood vessels will return to normal, and work will begin to “correct” the damaged internal organs. The main thing is that no alcohol enters the body during this time.

Effective treatment of alcoholism is only possible if the patient himself wants to get rid of addiction. This is what therapy is aimed at specialized clinics and centers where, in addition to removing toxic products of alcoholism from the body, work is carried out with the altered human psyche. Forced and “unauthorized” treatment produces poor results.

Alcohol, or more precisely, ethyl alcohol (ethanol), has a toxic effect on almost all human organs. The more often it appears in the body (the more high doses, the more it is found in some fruits), the more harm it causes.

Ethyl alcohol is absorbed very quickly, and after 60-90 minutes its maximum concentration is observed in the blood. The rate of absorption increases if:

• the person has an empty stomach;
• the alcoholic drink has a high temperature (drinks based on heated wine, for example, mulled wine);
• the drink contains sugar and carbon dioxide in the form of bubbles (for example, in champagne).

If alcohol is taken with a large amount of food (not on an empty stomach), especially fatty food, its absorption slows down.

Having entered the blood, ethanol enters mainly 2 organs: the brain and skeletal muscles, and this is already 70% of body weight. IN adipose tissue and the bones receive alcohol in a smaller volume.

The liver and, to some extent, the stomach try to neutralize ethanol. The liver tissue produces the enzyme alcohol dehydrogenase, which converts ethanol into very toxic acetaldehyde. It must be converted to safe acetic acid by aldehyde dehydrogenase. After this, thiokinase “turns on”, which converts acetic acid into acetyl-coenzyme A. It produces ketone bodies that are toxic to the brain.

With constant use, the level of alcohol dehydrogenase decreases. Then the enzyme catalase takes over to neutralize ethanol. It works more slowly and oxidizes alcohol to more toxic derivatives.

In addition to these enzymes, the conversion of alcohol in the liver is carried out using the enzyme cytochrome P450. This enzyme is also involved in the processing of most drugs, especially antibiotics. Therefore, if you take drugs together with alcohol, there is a high risk that the drug will take up space in the enzyme system, and the alcohol will remain “underprocessed.” This can be life-threatening.

The end products of ethanol conversion in the liver are carbon dioxide and water. As a result, energy is generated: 60 g of alcohol produces 477 kcal.

Is the possibility of becoming an alcoholic “written” in the genes?

The 2 “major alcohol” enzymes—alcohol dehydrogenase and aldehyde dehydrogenase—can be produced in “fast” and “slow” forms. What forms a person will get is programmed by genes. It is the forms of these enzymes that 90% determine whether a person will become prone to alcoholism or not.

So, if both enzymes are “fast” (for example, among Indians South America), a person hardly gets drunk and quickly sobers up without feeling any signs of a hangover. The slower these enzymes are, the more a person needs to drink to get drunk (this is typical for Europeans, Slavic and African peoples). They feel all the effects of alcohol: euphoria, relaxedness, sociability, and after a while (it depends on the dose of ethanol) they begin to suffer from a hangover. In order for such people to become alcoholics, they need to drink “hard” and often.

Representatives of the Mongoloid race - Asians and residents of the Far North - are characterized by the production of “fast” alcohol dehydrogenase and “slow” aldehyde dehydrogenase. It is enough for them to take a small dose of alcohol to become intoxicated (with almost no signs of euphoria), and very soon a severe hangover sets in (acetaldehyde has already formed, but will not be neutralized). Alcoholics are rare among these peoples: 91 times less common than among Europeans.

In Russia, about 10% of residents have fast alcohol dehydrogenase, and among the Chuvash - up to 18%. It is interesting that most of these people live in Moscow. Such people hardly feel intoxicated, which “insures” them against alcoholism.

Those peoples (Evenks, North American Indians, Chukchi) who were originally characterized by a nomadic lifestyle, when transitioning to a settled life, especially when moving to the city, begin to drink themselves to death. Recent studies have shown that this is not related to alcohol and acetaldehyde dehydrogenases. Scientists say that a change in the type of diet and the associated level of adrenal hormones is to blame. So, when it was fat and protein, which was necessary for the nomads to eat less often, they produced less stress hormones than with a carbohydrate diet. More stress plus a sedentary life, when alcohol consumption is cultivated by the media, and has led to the emergence large quantity alcoholics among these peoples.

Interesting. A predisposition to alcoholism can be recognized by two factors:

1. if your face does not turn red after drinking alcohol (redness of the skin is a sign of acetaldehyde release);
2. if after a heavy libation a person wakes up early on his own.

"Norm" of alcohol

Safe for health, without alcoholism you can drink a day:

• Women: 300 ml of beer or 130 ml of wine, or 50 ml of vodka.
• Men: 500 ml of beer or 200 ml of wine, or 75 ml of vodka.

This “dose,” equivalent to 25 g of ethanol in women and 30 g in men, can only be taken 5 times a week. Another 2 days should be without alcohol.

The maximum permissible dose is 60 g of pure ethanol for men, 50 g for women. The permissible amount of ethanol in women is lower than in men, which is due to the characteristics female anatomy: more fat tissue, less muscle. This is dictated by female sex hormones.

Blood alcohol concentration can be calculated by first multiplying 0.7 (this is the 70% that makes up the brain and muscles where most of the alcohol is absorbed) by body weight, and then dividing the amount of ethanol in grams by this figure. The lethal concentration is considered to be 3.5‰, although in practice there are people with higher levels who are not even in a coma, but in consciousness.

What alcohol “can” do

You can understand the consequences of alcoholism if you know how ethanol affects different organs.

Nervous system

Ethanol has a direct toxic effect on nerve cells and alters the production of various substances in the brain. Yes, accumulation gamma-aminobutyric acid– the main inhibitory neurotransmitter – leads to relaxation, euphoria, drowsiness. It causes the release of endorphins, which provoke the release of dopamine, and this whole “cocktail” that causes a feeling of bliss stimulates the desire to drink again.

Alcoholism reduces brain volume, especially in the frontal lobe. The death of neurons in this area leads to:

• decreased mental functions;
• attention disorders;
• slurred speech;
• changing the character and personality of a person.

The blood vessels are also damaged, and in these areas the brain is saturated with blood. Hemorrhage can be extensive and lead to death.

Also, with alcoholism, psychosis and lesions may occur. spinal cord and cerebellum. At stage 2 of the disease, the nerve trunks leading to the limbs are affected. As a result, sensation and movement are lost in the areas of the legs and arms where socks and gloves are worn. This is called alcoholic polyneuropathy.

Liver

If you take large amounts of alcohol for just 1 year, it will cause liver disease. First, the level of acetyl-coenzyme A and the “energy” substance NADH will increase. They will slow down the reaction fat metabolism, as a result of which fat will begin to be deposited in the liver. As long as there is still 5-50% fat, the process is reversible (you can stop drinking, and the liver will recover on its own, without “cleansing”). But after this, the death of liver cells begins, and tissue similar to scar tissue begins to grow in their place. This is liver fibrosis, the irreversible first stage of cirrhosis. This is followed by cirrhosis, in which the functions of the liver, important for the entire body, are disabled one after another.

Heart

Ethyl alcohol causes the destruction of red blood cells, resulting in the development hemolytic anemia, causes the accumulation of “bad” (causing atherosclerosis) fatty acids. This leads to the development of heart diseases (cardiomyopathy, arrhythmia), and also worsens the course of existing cardiovascular diseases. Alcoholics develop heart failure much faster than people with chronic heart disease, which quickly leads to death.

The American Heart Association urges people not to believe “advice” about the health benefits of red wine or cognac. All necessary vitamins and antioxidants, they say, can be obtained from healthy foods: berries, fruits, vegetables.

Metabolism

Alcohol leads to a decrease in the deposition of glycogen in the liver - a bundle of many glucose molecules that are a reserve of energy in case it is suddenly needed. At the same time, alcohol itself provides a person with a certain amount of energy, so when drinking it, a person, especially someone already suffering from alcoholism, does not eat food. If glycogen reserves are depleted, after another libation, acute hypoglycemia (a sharp decrease in blood glucose levels) may develop, which causes depression of consciousness and convulsions. It can even lead to death, especially if the person is sick diabetes mellitus.

Incomplete oxidation of fatty acids in the liver, which develops during alcoholism, leads to the accumulation of ketone bodies in the body. There are especially many of them if there is no longer any glycogen left in the liver. This condition is called ketoacidosis. It leads to symptoms such as weakness, vomiting, abdominal pain, dizziness, drowsiness, and weight loss. If alcoholism is combined with diabetes mellitus, ketoacidosis can develop into a ketoacidotic coma.

Ethyl alcohol interferes with the absorption of B vitamins (especially B1 and B6), which is why Gaye-Wernicke syndrome develops:

• heat
• a loss mental activity, up to depression of consciousness to coma;
• memory loss;
• double vision;
• lack of coordination.

Gastrointestinal tract

Chronic alcohol abuse leads to stomach damage and small intestine. Diarrhea occurs due to impaired absorption of water and electrolytes, impaired absorption of lactase.

In addition, repeated vomiting may cause ruptures in the mucous membranes of the esophagus and stomach, accompanied by bleeding. Damage to the pancreas also develops - pancreatitis, which can acquire a necrotizing form (the gland tissue dies) and lead to death. Gastritis develops in 95% of patients.

Alcoholism greatly increases the risk of developing cancer diseases: intestinal cancer, stomach cancer, esophageal cancer.

Joints

Constantly taken ethanol leads to retention in the body uric acid. Its excess accumulates in the joints, causing gout.

Impact on the gene pool

Ethanol poisons both female and male reproductive cells, increasing the risk of having a sick child or even fetal death. Drinking alcohol is especially dangerous for a pregnant woman.

Alcohol causes additional harm through harmful additives. They increase damage to the liver and kidneys, through which they are excreted, as well as to the blood vessels and heart, which ensure their passage through the body.

Why does alcoholism develop?

For the development of alcoholism, the combination of “slow” dehydrogenases alone is not enough. It is necessary for a person to begin periodically taking ethyl alcohol with the transition to more and more frequent use. This happens mainly with psychological problems:

• low (less often high) wages;
• stress at work;
• drinking friends;
• lack of friends;
• problems in family relationships.

Symptoms of alcoholism are more likely to be found in people of a melancholic nature, prone to depression and self-deprecation, as well as those who grew up in a family of alcoholics.

How to suspect alcoholism

Many families are accustomed to drinking alcohol on holidays or after significant events/major purchases. How can you tell if a relative may become an alcoholic?

There is such a thing as domestic alcoholism, also called domestic alcoholism. It is characterized by the absence of complete dependence on ethyl alcohol. For such a person, an everyday drunk, alcohol does not interfere with his work. A person, periodically making a promise to himself or his loved ones to “quit”, still drinks alcohol. If this habit is not dealt with, it will develop into a disease. In women this happens earlier, in men - later. It is easier to treat everyday drunkenness, but he definitely needs the help of a psychologist or psychotherapist: this way a person can find the reasons why he drinks and, together with a specialist, eliminate them.

Household drunkards are considered not only habitual drinkers who drink alcohol up to 3 times a week, but can calmly refuse it if they have another job that is pleasant for them. Drinking alcohol 1-2 times a week (systematic drunkenness), and 1-3 times a month (episodic drunkenness), and even “only on holidays” (moderate drunkenness) will be considered home drunkenness. The main criteria are:

• availability of an approximate measure when drinking alcohol;
• joy, excitement before drinking an alcoholic drink;
• the obligatory presence of a reason for drinking alcohol (a person will not create it artificially);
• severe hangover(severe and prolonged headache, nausea, weakness);
• feeling of guilt before relatives “for yesterday”;
• non-aggressive, rather on the contrary, a complacent mood when consumed small doses alcohol.

Stages of alcoholism

The first signs of alcoholism are:

• attraction to alcohol even without reason;
• All holidays are celebrated and Friday is obligatory;
• if family members ask you to do some tasks that would prevent you from drinking, you may become hot-tempered, aggressive, and irritable.

If alcoholism is not stopped at this point, the person “slides downhill.” Depending on how much his personality and internal organs suffer, there are 3 stages of alcoholism.

Stage 1

It is called mental dependence: ethanol has not yet been fully integrated into metabolism, and there are limiting factors - family, friends, work. But free time is happily spent drinking a glass. At first, a person still needs drinking buddies, but sometimes he can drink on his own, but in small quantities.

When Friday comes, you go to the garage, fishing or hunting (where there will be alcohol), joy appears, a sparkle in your eyes. The person himself does not notice this.

Drinking alcohol causes joy, talkativeness, and euphoria. A person becomes disinhibited, he wants to sing, dance, and meet the opposite sex. If he has “too much,” then nausea, vomiting, headaches appear, blood pressure rises and the pulse quickens.

Further progression of the disease is characterized by the need to gradually increase the dose of alcohol to obtain pleasure. Oppressed vomiting reflex, because of which a person can greatly exceed the permissible dose of alcohol, drinking into an alcoholic coma. Life values ​​are decreasing, principles are changing. Now it doesn’t make much difference to a person what to drink: he can buy cheap alcoholic drinks if he can’t afford the usual ones.

Stage 2

It is characterized by a worsening of the hangover syndrome: nausea and headache are accompanied by hand tremors, increased heart rate, arrhythmic heartbeats, and increased blood pressure. If you drink alcohol (for example, beer) against this background, the condition will return to normal. To differentiate: if there is no dependence, these symptoms will intensify, which is due to an increase in the number of alcohol substitutes.

Physical dependence on ethanol appears: if you do not drink it for 1-2 days, your head begins to hurt, nausea appears, the person does not want to eat anything, sleeps poorly, and is very irritable. He may have seizures up to epileptic seizure. When drinking alcohol, all these symptoms of withdrawal syndrome (withdrawal) disappear, everything returns to normal. While on a binge, a person hardly eats, he loses weight.

In order to prevent withdrawal, a person constantly drinks, and not necessarily large doses: even a bottle of beer helps maintain the mood and well-being he needs. Usually the binges last for 2-3 weeks, then he stops drinking, his conscience torments him, a desire appears to code himself, but a new meeting with friends or new reason drinking leads to repeated binge drinking.

At this stage, changes in the patient’s personality become noticeable: he becomes rude, he is irritated by any little things.

Binge drinking can cause complications: heart attack, stroke, gastrointestinal bleeding.

Stage 3

At this stage, a person drinks in small doses, quickly sobers up and continues to drink again.

Complications arise from internal organs: nervous system, liver, pancreas, heart, kidneys. They may develop into cancer or cirrhosis, but the problem can still be solved. Only a change in personality cannot be changed: a person loses life values, the ability to think productively, analyze, and conduct a conversation. There are hallucinations - visual and auditory. When alcohol is withdrawn, delirium tremens (delirium tremens) develops.

Why is it difficult to treat alcoholism?

Finding a cure for alcoholism is very difficult, which is due to changes in the patient’s psyche:

1. Inappropriate attitude towards one's own condition. An alcoholic either completely denies that he has an addiction (this is the hardest thing to deal with), or believes that he can stop drinking at any moment, or says that he is already extremely dependent and will not be able to stop alcoholism.
2. The patient becomes fixated only on himself (egocentrism), which leads to his alienation from close people.
3. Constantly changing your decisions, words, self-esteem.
4. The patient's refusal to take independent decisions, perform any volitional efforts. He goes with the flow, not bothering himself with anything other than getting money for alcohol.

In all these cases, it is best to treat the disease in specialized paid clinics, where in the first phase of therapy it is possible for psychotherapists who know how to interact with such patients to visit the home.

Treatment of alcoholism

Alcoholism in men and women needs to be treated as early as possible, even at the stage of everyday drunkenness - until there is no personality change.

Indicators that it is no longer possible to delay the help of a relative are the following signs:

• loss of drink;
• searching for reasons for alcoholism;
• relief of hangover symptoms that occurs with repeated consumption of alcohol;
• partial amnesia for the events that happened while drinking alcohol.

Stages of treatment

Treatment of alcoholism must be carried out in 4 stages:

Stage 1

It involves removing alcohol breakdown products from the body and relieving withdrawal symptoms. The stage is called detoxification. It is better to carry it out under medical supervision, as violations are possible heart rate, blood pressure rises to high levels, breathing problems. Starting from stage 2 of alcoholism, detoxification is carried out only by narcologists or anesthesiologists who have experience in treating this particular addiction.

If, in your opinion, the drinking relative is healthy, has never complained of an irregular heartbeat, and there has been no breathing problems or loss of consciousness while quitting alcohol, you can start treatment at home, keeping your phone ready to call an ambulance.

Here's how to detoxify on your own:

• calm the patient;
• give him sorbents in the maximum possible dosages (Polysorb, Atoxil, Enterosgel);
• 1 – 1.5 hours after the sorbents, they give a vitamin B1 tablet and drink sweet tea. You can give 10 mg of the drug “Anaprilin” (for the heart), but provided that the pulse is more than 60 beats per minute, and the “upper” pressure is above 90 mm Hg;
• after another 1.5 hours the sorbent is given again;
• after another 1-1.5 hours, you can give a sleeping pill or sedative (Pavlov’s Mixture, “Barboval”, valerian tablets, “Somnol”). At this stage it is good to accept ascorbic acid(500-1000 mg), put the person to sleep.

All this time, the frequency and rhythm of the pulse (should be within 65-105 beats, rhythmic), and blood pressure (not higher than 150 mm Hg) are monitored. When the pressure rises above 140 mm Hg. you need to give ½ Captopress tablet and measure the value after half an hour.

Irrhythmic, frequent or rare pulse, high or low blood pressure (should be within 100-140 mm Hg), convulsions, irregular breathing, panic attacks, psychosis - a reason to call an ambulance.

Medical detoxification, especially if you called a paid drug treatment team from a clinic, can also be carried out at home. It is as follows:

• intravenous administration of saline solutions - to maintain water and electrolyte balance;
• intramuscular administration of vitamins B1, B6;
• intravenous administration sedatives(also known as anticonvulsants), respiratory analeptics, antiarrhythmic drugs, nootropic drugs

If breathing problems, convulsions, or a threat of heart attack or stroke appear during withdrawal, the patient must be treated in a drug treatment hospital or a paid drug treatment center/clinic.

At the end of stage 1, the following goals must be achieved:

1. normalization of cardiac activity;
2. normalization of breathing;
3. restoration of appetite and sleep;
4. relief of nausea and vomiting.

Only after this can you proceed to the next stage.

Stage 2

It is called intervention and is carried out if the patient does not consider himself as such and does not want to be treated. For this purpose, a meeting is organized between the alcoholic and psychologists from specialized centers.

It is important at this stage not to exert any moral violence or psychological pressure.

The intervention can and should be carried out when the patient is still “under a drip”, but it is already much easier for him.

If for some reason you decide to treat alcoholism without the knowledge of the patient (and this is a much more difficult and long way), the intervention stage is skipped. You can immediately proceed to stage 3, but start it only if there is no alcohol intoxication or "withdrawals".

Stage 3

Here, negative conditioned reflexes are developed to the effects of alcohol - its taste and smell. This could be herbs, pills - if you decide to treat alcoholism at home. There may be suggestive influence, hypnosis, coding - if treatment is planned at home, but with the help of specialists (short-term hospitalization may be required during coding).

Also this stage can be carried out in specialized paid clinics (not in a drug treatment or psychiatric hospital).

We’ll talk about all the methods of this stage – herbs, pills, hospital treatment and coding for alcoholism – a little lower.

Stage 4

It includes supportive treatment and social rehabilitation. Lasts 2-3 years. The stage is very difficult, requiring constant moral efforts on the part of relatives rather than the patient himself. It is held at home.

It is advisable for a former alcoholic to attend support groups consisting of people like him who were able to give up alcohol. He needs to be helped to find new hobbies and interests so that he has as little free time as possible, which he could use to return to old habits. Here it is important to exclude communication with old “friends,” but not by force, but by communicating with a psychologist to evoke such a desire in the patient himself.

The rehabilitation stage also involves work and periodic communication with a psychologist. If a person was treated at a clinic, he can periodically come there for examinations.

If the rehabilitation stage is successful, there is a high chance that the person will not drink again.

Forced therapy

On this moment Compulsory treatment of alcoholism was abandoned as an ineffective and extremely costly method. This method of therapy is possible only in exceptional cases provided for by law. Russian Federation. The main indication for compulsory treatment is the patient’s danger to himself or others: attacks on relatives and neighbors, failure to turn off the gas stove or water. At the same time, it is important that in a state of binge, the psychiatric hospital - and it is the one that deals with compulsory therapy - will not accept an alcoholic. Even if the patient was hospitalized in the drug treatment department of a state hospital or in a state drug treatment hospital during “withdrawal” or binge drinking, without a court decision psychiatric clinic will not be transferred. He will be discharged home.

If an alcoholic is dangerous for relatives living with him, the order of their actions is as follows:

1. Go without a patient with alcoholism to the district or city mental asylum, find a local psychiatrist, describe the situation to him.
2. The local psychiatrist will give an example of an application addressed to the chief physician of the hospital.
3. The statement will need to indicate examples of aggressive behavior, verbal threats, inappropriateness and disorientation that occurred.
4. This case will be considered by a commission of psychiatrists, they will visit your home and give an opinion on whether hospitalization is necessary or not.

Cases where the alcoholic lives separately are especially difficult for the legislation, and it will be difficult to indicate aggression on his part.

An alcoholic can also be sent for compulsory treatment by court order, but this is possible when a person, being able alcohol intoxication, broke the law. If you testify that he regularly drinks alcohol, the judge can forcibly send him to a psychiatric hospital.

Treatment of alcoholism in a specialized clinic

A person suffering from alcoholism voluntarily goes to a clinic to undergo a course of treatment. Upon admission, specialists talk to him: narcologist, psychologist, psychiatrist. They identify the personality disorders that alcohol use has led to and choose how alcoholism will be treated. Methods can be different, for example:

• 12 step program;
• Minnesota Program;
• the impact of the Therapeutic Community;
• Deutop model.

The period of adaptation of a person to the conditions of the clinic lasts several days or weeks. He gets used to the environment, and the first individual and group lessons are held with him. He communicates with people who need to get rid of alcoholism, with people who have gotten rid of addiction. Relatives can come to the patient.

Next, the integration stage begins, during which an aversion to alcohol is formed. Individual classes are also conducted, the patient attends trainings and groups, and keeps a diary in which he notes his psycho-emotional state. Relatives come and cheer the patient up.

The next stage is stabilization. The person continues to keep a diary and communicate with a psychologist and in a group. Now his task is to strengthen the desire to lead a healthy lifestyle. He is already sharing his knowledge and experience with newly admitted patients.

Treatment at home

It needs to start with the fact that relatives (especially the person whose communication and opinion the patient values) convince the alcoholic to undergo treatment. If he is aggressive or too passive, he needs the help of a psychologist.

You need to convince an alcohol addict at the right time: after waste of wages, a fine for drunk driving, and so on. At the same time, it is important that the alcoholic is not nervous, and the conversation is not conducted in the manner of notation (with sobs, appeals to conscience). It is important to convey the message that treatment will return him to his family, but during treatment the family will support their beloved relative. You also need to outline a happy future for him without alcohol: a career, respect from colleagues, happy children and a wife. That is, the point of treating alcoholism is to make not only him happy (especially if he considers himself a “finished” person), but also those who depend on him and who love him.

Coding

Coding for alcoholism is one of the methods used in complex treatment diseases. It was invented back in the 30s of the 20th century in Russia, by scientists Sluchevsky and Fricken, who used apomorphine for this. Soon, apomorphine was replaced by disulfiram, and the technique was supplemented with suggestive influence and hypnosis.

Coding can be based on one of two methods of influence:

1. reciprocal – when it is formed negative impact the smell of alcohol itself;
2. operant – formed according to the principle of “punishment”. The patient can take alcohol, but after this he experiences serious side effects: vomiting, weakness, tachycardia, shortness of breath.

Encoding can be:

• medicinal: the patient is given medication or has it stitched in the form of an implant. When alcohol is consumed, the drug causes such bright and unpleasant symptoms that the desire to continue alcoholism disappears;
• non-medicinal: for example, according to the method of Dovzhenko, Malkin, Rozhnov - using hypnosuggestive influence. This involves working with the patient's psyche;
• combined (for example, the “Double Block” method), when both medicinal and psychotherapeutic effects are performed;
• hardware: such physiotherapeutic techniques are used as artificially increasing body temperature, inducing convulsions using electricity. This effect is ineffective and unsafe, so it is rarely used. Recently, laser coding has been offered; reviews speak of it as an effective method.

Medication coding

It involves one of several effects:

• adding alcohol blockers;
• administration of ethanol inhibitors in the form of injections;
• taking medications in the form of tablets.

Each of the effects has its own duration: injections last for several months, sutured implants last from several months to a year. If the drug is injected into fatty tissue, it remains there for several years. During this time it should be carried out psychological work upon the patient's refusal to drink alcohol.

The procedure is considered the most effective, but is “suitable” for repetition two or maximum three times. If an alcoholic cannot resist drinking alcohol, further “fixing” does not make sense: he will still drink. In this case, you need to choose a different method.

The following drugs are used:

1. Opiate receptor blockers (Naltrexone, administered intravenously or in tablet form). They block the release of endorphins in response to alcohol. Accordingly, drinking alcohol ceases to cause the usual joy and euphoria.
2. Drugs that, when combined with alcohol, cause pronounced toxic reactions: Disulfiram (Teturam, Antabuse, Esperal, Algominal, Aquilong). The dosage of medications is selected individually, depending on the patient’s health status, the usual dose taken, and the degree of dependence on alcohol. These drugs are not used for alcohol intoxication: first they relieve it with Naloxone or Naltrexone, then begin treatment with Disulfiram or its analogues. The ampoule is sutured under the skin of the interscapular region, buttocks, and axillary fossae to a depth of about 40 mm. When drinking alcohol, nausea, vomiting, tachycardia, panic attacks, and surges in blood pressure occur.

Before filing disulfiram, an alcohol-disulfiram test is carried out: the person is given 1 tablet of the drug, after which he needs to drink 30-50 ml of vodka. After this, 4 stages of the test develop:

1. Starts in 10 minutes. Consists of reddening of the skin, increased breathing, the appearance unpleasant odor from mouth. Euphoria appears, similar to a similar feeling when intoxicated.
2. Appears after another 10 minutes. Euphoria passes, anxiety and fear appear. My head starts to hurt and my blood pressure drops.
3. Develops within 40 minutes. Blood pressure drops even more, which is manifested by a throbbing headache and numbness in the fingers.
4. After another 30 minutes the condition is restored.

Tests are carried out only in a hospital where medications are available for urgent assistance, and where anesthesiologists work.

Alcohol-disulfiram tests are usually repeated 2-3 times until an aversion to alcohol is formed. If a person is not sure that he can resist drinking alcohol, 8-10 tablets of this drug are sewn under his fascia.

It is necessary to take into account: the very first relapse after installation of a disulfiram implant can be difficult and even fatal.

The advantage of drug coding is that many doctors can work with these drugs - it is not necessary to look for a qualified narcologist. In addition, these anti-alcoholism pills can be given at home.

Disadvantages - high cost of drugs, pronounced aggression of the patient if these drugs were given to him without knowledge. Failures after such coding can lead to a worsening of the condition: an increase in the time of drinking bouts, an increase in the dosage of alcohol.

Contraindications to medication coding

It cannot be performed when:

• the alcoholic’s reluctance to get rid of addiction;
• allergies to disulfiram and its derivatives;
• diabetes;
• heart failure;
• cancer;
• mental and neurological disorders;
• tuberculosis;
• bronchial asthma;
• chronic renal and liver failure;
• pregnancy;
• peptic ulcer in the acute stage;
• lactation period.

Laser coding

This technique is used only in drug treatment clinics in large cities, which can afford to purchase expensive equipment.

The essence of the method is the impact of a laser beam on special points of the brain. The authors of the procedure claim that this way the data on addiction to alcohol is “erased”, that is, in a normal situation a person is not tempted to drink. This does not protect against relapse when meeting drinking buddies or celebrating at home, so laser coding must be supplemented with psychosuggestive or other type of influence.

The procedure is performed only by qualified specialists and has no side effects. Although it requires a course course that is strictly adjusted in duration, it does not require huge or lengthy financial costs. Effective only for stage 1-2 alcoholism.

Psychotherapeutic influence and hypnosis

It doesn’t matter which method – according to Dovzhenko, Malkin, Rozhnov or hypnosis – is chosen. The main thing is to find qualified specialist, which with a word can cause an aversion to alcoholic beverages in the patient.

Hypnosis is carried out using proprietary methods that are not widely available. To select a hypnosuggestive effect, a psychiatrist must first examine the patient, talk with him, and then choose a technique for influencing his consciousness. The principle of hypnosis is in a state between sleep and wakefulness, with the help of a word, to extinguish an area of ​​excitation in the brain that is pathologically excited by the smell or taste of alcohol. The doctor convinces the patient that the smell and taste of alcohol causes nausea or vomiting.

Dovzhenko's method uses words that should cause a negative reflex to alcohol. This psychotherapeutic effect lasts 2 hours, while the patient does not fall asleep, but enters a trance state: his emotions remain, but the cortex turns off. Such coding requires highly qualified physicians.

The doctor performing the procedure repeatedly repeats to the alcoholic about the suffering of loved ones caused by alcoholism, about serious changes in internal organs associated with ethyl alcohol, and about the fear of death. An alcoholic is taught responsibility for his own actions, especially those related to family and children. He must feel a lot of negative emotions associated with his dependence on alcohol, feel the difference between alcoholism and in a healthy way life.

Before coding according to Dovzhenko, preparation is needed - cleansing the body of alcoholization products. To do this, the patient must take activated carbon or other sorbents for several days; foods with a lot of fiber, laxative teas and tablets are added to his diet.

The duration of the procedure is less than 3 years. It needs repetition.

It is important to know: after hypnosuggestive coding, relatives need to try as much as possible to occupy all the patient’s free time so that he does not have hours of idleness that he could devote to drinking.

There are situations where coding led to reverse effect– the person began to drink even more. In this case, drug intervention was necessary.

"Double block"

In this case, an implant is sewn under the skin of the alcoholic, after which a suggestive effect is carried out using Dovzhenko or another method. The method loses effectiveness after 2-3 repetitions.

Consequences of Coding

Any coding can lead to a change in the patient’s psyche: the person becomes irritable, picky, aggressive, and inattentive. His relationships with family members may deteriorate, often decreasing sexual attraction. Trying to fill the resulting free time, a person comes up with a new addiction: he starts playing computer games, maniacally improves own body, throws himself into work. Against this background, he often develops depression and suicidal attempts, including unexpressed manifestations (therefore it is important to continue communication with treating narcologists and psychiatrists).

This is a difficult stage for the family, during which it is important for relatives not to break down, but to continue to provide psychological support to the patient, sometimes through joint sessions with a psychologist. If relatives survive this stage, they build new, but no less warm and trusting relationships with the patient, psychological problems gradually go away and the risk of relapse into alcoholism becomes extremely small.

Medication coding at home

Medicines taken at home must be agreed upon with a narcologist, as they can greatly harm the patient and your relationship with him.

Alcoholism pills

1. “Teturam” and analogues discussed in the section “ Medication coding" These drugs block acetaldehyde dehydrogenase, as a result, toxic acetaldehyde is not converted into acetic acid, but accumulates in the body. They can not only be filed, but also taken in tablet form. Only short courses are practiced, since long-term use causes inflammation of the liver, nerve endings; there may be psychosis.
2. "Metronidazole" It is an antibiotic that also has an antiprotozoal effect. Its metabolism occurs through the liver, using the same enzymes that break down ethyl alcohol, so alcohol accumulates in the form of toxic metabolites. Drinking alcohol while taking metronidazole causes a feeling of fever, vomiting, and tachycardia. The antibiotic is not taken together with Teturam and its analogues.

For hangovers, aspirin-based drugs are used: “Zorex Morning”, “Alka-Seltzer”, “Alka-Prime”, “Alco-buffer”. To accelerate the elimination of acetaldehyde and other toxic products from the body, Enterosgel, activated carbon, Filtrum, and Rekitsen-RD are used.

Drops for alcoholism

Basically, anti-alcoholism drops act in the same way as pills. Their main advantage is that they can be dripped into food and drink. But many of them are not used without the knowledge of the patient: they can cause a reaction with alcohol, which is also contained in foods or medications taken by a person, as a result of which he will feel very unwell, he may even develop a stroke, heart attack, or severe rhythm disturbance.

1. Colma. Active substance– cyanamide. It blocks acetaldehyde dehydrogenase, as a result of which, after taking ethanol, a person develops fever in the face, nausea, shortness of breath, and tachycardia. After 1-3 such attacks, a negative reaction is formed even to the smell of alcohol. The dosage of the drug is prescribed by a doctor (usually 12-25 drops * 2 times a day). It is not used for heart, respiratory, liver failure, during pregnancy and lactation.
2. Extra blocker. The substance also contains herbs, which when combined with alcohol cause unpleasant side effects, as well as B vitamins, necessary for the prevention of acute encephalopathy (Wernicke's syndrome), as well as a sedative - glycine. Taking this dietary supplement improves general state man and doesn't let him drink. Take it 35 drops * 3 times a day, stirring in 100 ml of water or a non-alcoholic drink without carbon.
3. Proprothene 100. These are drops that interact with S-100 proteins located in the brain and responsible for information transfer and metabolism. It influences those brain structures that are involved in the formation of positive emotions when drinking alcohol; enhances the production of “calming” amino acids. The drug reduces the severity of withdrawal symptoms and reduces the desire to drink.

Herbs for alcoholism

When traditional healers are asked how to cure alcoholism, they advise taking herbs:

• after alcoholization - plants that have a detoxification effect: dandelion, chamomile, pueraria root, oat sprouts (before the appearance of spikelets), sweet clover, cyanosis root, speedwell;
• after relieving hangover symptoms - herbs, disgusting to alcohol;
• during rehabilitation - plants that have a tonic effect: ginseng, eleutherococcus, Schisandra chinensis.

Consider recipes from herbs that cause aversion to alcohol:

1. Need 4 tbsp. thyme, 1 tbsp. herbs wormwood and centaury. Mix dry herbs, take 25 g of the mixture, pour 250 ml of boiling water, leave for 2 hours. Strain, give 50 ml * 4 times a day. The effect appears after 2 weeks.
2. Need 1 tbsp. cleft grass leaves. Pour 250 ml of boiling water over it, let it boil and simmer for 10 minutes over low heat. Give 1 tbsp. with food and when drinking alcohol. No more than 2 tbsp per day. infusion. The duration of treatment is no more than 3 days.
3. You need 5 g of club moss grass. They are poured with 250 ml of boiling water, simmered over low heat for 10-15 minutes, given 50-100 ml each, separately from food and alcohol intake. Course – 5-7 days. Before starting the course, you need to go without alcohol for 3-4 days. The herb has a toxic effect on the cardiovascular system and liver, so it should not be taken by a person who has had a heart attack or suffers from cardiac, hepatic or renal failure, diabetes mellitus, tuberculosis, bronchial asthma.

Rehabilitation after coding

The duration of the rehabilitation period is 3-5 years. The most difficult period is the first few months, so it is optimal if it takes place in a specialized clinic where:

• doctors monitor the patient’s behavior;
• meetings with visitors are supervised by staff;
• there is an example before your eyes - people who were able to get rid of addiction and can talk about their experiences, thoughts and feelings, which will be very useful;
• exercises must be performed physical therapy, taking into account the general state of human health;
• Daily individual or group lessons are offered.

If treatment in a clinic is not possible, rehabilitation is carried out at home. In this case, it is recommended to communicate with a psychologist or psychotherapist, and attend groups who have recovered from this addiction.

We need to help the recovering person find a hobby: get a pet, start growing something, making something, and so on. It is better to go through this stage together with the addict in order to share the joy of new achievements.

Treatment of alcoholism without the knowledge of the patient

This therapy has high risks associated with side effects. It is ineffective because it does not include the will of the patient. In addition, there is a risk of breaking the relationship between the alcohol addict and the person who treats him this way.

Nevertheless, if you have chosen this particular path of treatment for a relative, we will give some advice:

• always keep your phone handy to call an ambulance (the doctors will have to tell you everything). In your mobile phone, enter the city numbers of the ambulance substation at your place of residence;
• There should be nitroglycerin in the first aid kit - to eliminate heart pain. Give it to a person with blood pressure below 80 mm Hg. it is forbidden;
• put vitamin C in your first aid kit, preferably at a dosage of 500 mg/tablet;
• There should also be tablets that reduce blood pressure (Captopress) and activated carbon.

For alcoholism without knowledge you can give:

• An aqueous solution of puppeteer that has no taste or odor. It is prepared like this: 1 tsp. herbs are poured with ½ cup of hot water. Let it sit for an hour and strain. Add more water to make a total of 250 ml. It is given in a dosage of a few drops, adding them to food or alcohol, but not every day. If you drink 10 drops of puppeteer every day, even without alcohol, death occurs within a few days.
• Alcobarrier. These are drops made from acacia resin, artichoke extract and motherwort. It does not cause poisoning when simultaneous administration with alcohol, on the contrary, it alleviates the symptoms of a hangover and improves brain function, supplying it with vitamin B6 (prevention of Gaye-Wernicke syndrome). The drug still has a weak taste and smell, so it is recommended to add it to coffee.
• Extra-blocker (BAA). It is discussed in the “Drops for Alcoholism” section.
• Proprothene 100 in the form of drops. It eases withdrawal symptoms and reduces the urge to drink alcohol. Does not cause symptoms of intoxication when taken with alcohol.

Treatment prognosis for alcoholism

Starting treatment at the first stage, you can be 70-80% sure that the disease will be cured. With an expressed desire to quit drinking and with good relationships in the family, this chance increases. At stage 2, the chance of 1 year without alcohol is only 50-60%.

Female alcoholism

Female alcoholism is much more terrible than male alcoholism. Due to physiological, endocrine and mental characteristics, a woman becomes an alcoholic drinker much faster, and her chance of recovery is much lower. Drinking men they treat and try to return her to the family, but the woman, basically, receives constant negative communication from those around her and even close people. They turn away from her, although it is correct drug effects, psychotherapy and the love of her family can help her return even from stage 2.

Women start drinking as a result of various, usually moral and everyday problems:

• sick children;
• seriously ill elderly parents;
• constant monotony in everyday life and at work;
• domestic violence;
• divorce or infidelity of the husband;
• problems at work;
• the desire to be closer to the alcoholic husband, to control the dose he drinks.

The last reason is very common. Starting from codependency with an alcoholic, she soon becomes the initiator of drinking, and degrades almost 2 times faster than a man. As a result, he initiates the divorce, leaving her with nothing.

Causes faster degradation:

• greater permeability of the barrier between the blood, where the alcohol enters, and the brain. As a result, neurons suffer faster and to a greater extent;
• a large amount of adipose tissue in women. Ethyl alcohol forms compounds with it, similar to ether for anesthesia, which causes pleasure from alcohol;
• Fewer enzymes that break down alcohol.

The stages of female alcoholism have some differences:

Stage 1. Positive attitude towards drinking, self-initiation of occasions. A woman drinks equally with men, persuades others to drink, and mocks those who do not drink at all or drink small amounts. She ends up drinking herself into unconsciousness every time. She drinks only those drinks that she likes (wine, liqueur, cognac).

A woman can drink secretly, hide from others, snack on alcohol with sweets and chewing gum, but the next morning she is severely tormented by a hangover. Memory lapses gradually appear, and the gag reflex disappears when drinking alcohol. Pseudo-binges can develop: they stop as soon as an important occasion arises (vacation or money runs out, an urgent matter needs to be completed). They happen 2-3 times a year.

Stage 2. True binges appear: you need to drink, because without ethanol your health worsens. “Heavy drinks” are used. A woman can drink in unfamiliar company or even alone. Her appearance changes: in an attempt to hide changes in her face and skin, she puts on a lot of makeup, resulting in a vulgar appearance.

At this stage, alcoholic psychosis occurs. A woman becomes aggressive, her moral standards decrease. Internal organs suffer.

Stage 3. Small doses are enough to cause intoxication; further consumption of alcohol does not change the situation. Attractiveness is completely lost, as the “lady” stops taking care of herself, even bathing and washing clothes. Delirium tremens due to alcohol withdrawal makes a woman aggressive and dangerous. She, unlike men, does not understand that she is dealing with hallucinations.

Treatment of female alcoholism is carried out according to the same principles as male alcoholism. The best option for a woman is treatment in specialized clinics for a long time. At the same time, psychological work is carried out with the woman’s relatives so that they try to support her and not blame her.

Beer alcoholism

In medicine there is no such thing as beer alcoholism. Doctors admit that this problem is now significant, since beer is considered a safe, and even healthy drink. Because of this, beer is drunk more often, in large quantities. In the meantime, it is more difficult to detox from beer (due to the presence of additives in it) than from vodka, moonshine or diluted alcohol.

The permissible dose of beer for men is 500 ml/day, for women – 330 ml/day, and you cannot drink it 2 days a week. However, TV screens show that beer is drunk in much larger quantities while doing ordinary household tasks: cooking, doing repairs, talking with friends.

Women drink beer, even children are happy to give it to them. It is easy to buy in any store and kiosk, even for a teenager.

Phytoestrogens contained in beer suppress the functioning of women's own sex hormones, making them more masculine: the voice becomes rougher, the face, figure and gait change. Phytoestrogens make men effeminate: a “beer belly” appears, female breasts appear, and problems with potency arise. A child, having seen such an attitude from his parents since childhood, considers drinking beer to be the norm.

The stages of beer alcoholism do not differ from those when drinking more than strong drinks. His treatment is also not particularly specific; it should begin as early as possible, before the destruction of a person’s personality occurs.

At alcohol addiction problems arise due to the impossibility voluntary refusal from its use. The patient is aware of the harmful effects of alcoholism on his physical and mental state, but spends a lot of time searching for and drinking alcohol, as well as recovering from it. Patients underestimate the harm caused by alcohol consumption at home, e.g. daily use beer or wine.

Only a trained specialist can help a patient using medicinal methods and psychotherapeutic techniques. This often requires treatment in a clinic with a psychiatrist-narcologist. Coding is popular, but this procedure is not always effective and does not guarantee cure of the disease.

Stages

There are three stages of alcoholism.

At stage 1, the patient ceases to control the amount of alcohol, he needs to drink more and more. Alcohol consumption becomes regular, about 300 ml of vodka per day. At this stage, the problem is not yet related to physical addiction. The patient develops mental dependence. This stage lasts up to 6 years. The patient is recommended to undergo an alcohol dependence test to ensure the presence of the disease.

At the 2nd stage of the disease, a person’s condition improves only after drinking alcohol, for example, with a hangover. The volume increases - up to 2 liters per day. The desire to drink becomes irresistible, and binges appear. There are memory lapses and changes in personality traits. At this stage, acute psychosis is possible. Stage 2 lasts up to 12 years.

At stage 3, toxic damage to the nervous system occurs. The personality changes completely. The amount of alcohol consumed is reduced. Internal organs, primarily the liver, are irreversibly affected. This stage lasts 5 – 6 years.

Signs

Clinical signs alcoholism are grouped into 3 syndromes:

• altered reactivity;
• drug addiction;
• toxic-organic manifestations.

Altered reactivity consists of the following symptoms:

• lack of a protective vomiting reaction;
• alcohol consumption gradually increases, and only at a later stage decreases;
• change in intoxication: sleep disturbances, depression, foolishness, binges, memory impairment.

Drug addiction is manifested by withdrawal syndrome. After sudden cessation After consuming large amounts of alcohol, the patient experiences guilt, shame, and remorse. Depression and thoughts of suicide may occur. Repeated intake of alcohol (“hangover”) usually improves the condition. IN severe cases convulsions, hallucinations, sleep disturbances, and delirium occur. Signs of the disease in a man are well expressed depending on the stages of the disease.

The toxic effect of alcohol on the nervous system is manifested in changes appearance sick, loss social connections(family, work), significant change in character (aggressiveness, decreased intelligence). Prolonged delusional psychoses appear.

Signs of addiction in women appear later; the disease is usually not recognized at an early stage. Depressive disorders predominate in the clinic. In patients, the liver suffers faster, reproductive function, lungs.

Causes

Periodic drinking of alcohol can develop into drunkenness under the influence of various factors.

Causes of alcoholism:

1. Psychological. This is an individual predisposition, taking alcoholic beverages as a medicine, as well as many mental illnesses.
2. Social. These are unemployment, poverty, stress at work, family troubles. IN childhood Drinking alcohol may begin as an imitation of adults or “in company” with peers.
3. Biological. These include the genetic predisposition of the sons and brothers of alcoholic men to develop the disease. There are situations of physiological low resistance to alcohol and, as a result, to the rapid toxic effects of ethanol, for example, in women.

The binge-drinking form usually occurs as a result of the habit of “relieving stress” with the help of alcohol, against the background of a feeling of inferiority, a burden of problems, nutritional deficiency, and disruption of the nervous and endocrine systems.

A variety of reasons make it difficult and long to recover from addiction.

Kinds

Alcoholism is a disease with typical symptoms and a staged course. It has characteristics for different groups of people. The harm is obvious: as a result of the disease, mental degradation develops, the heart, liver and most other organs suffer. Long-term use of alcohol negatively affects the ability to think, remember and dramatically changes the patient’s behavior. Help for addiction depends on the form of the disease and should be provided by a specialist.

Female alcoholism

Women's addiction to alcohol has some features compared to men. Already at an early stage, female alcoholism is manifested by episodes of alcohol consumption (binges, pseudo-binges). Even with a short period of illness, the character changes, a decreased emotional background, irritability or excitability. Long-term use in women it is accompanied by depression. Hysterical and psychopathic personality traits appear.

Characteristic is the early development of moral degradation and social maladjustment. They appear earlier than in men physical changes facial skin, signs of early aging and diseases of internal organs. They leak more heavily. Infertility and early menopause occur. The transition between stages of the disease occurs faster.

Pregnancy pathology occurs; 7% of children have developmental defects. Subsequently, the mother's child develops more slowly than his peers due to chronic neurosis, lack of proper care and attention.

Compulsory treatment for addiction is prohibited, so women usually avoid hospitalization. Such patients are helped not only with medication, but also with the use of various forms of psychotherapy.

Alcoholism in men

Symptoms of alcohol addiction develop more slowly in men than in women. Narcologists distinguish 3 stages of alcoholism in men with clearly defined symptoms.

Male alcoholism often begins with the desire to drink beer every day in order to “relax.” After this, excitement or apathy sets in, and inability to act. Addiction in men changes their appearance early: swelling appears on the face, blood vessels on the surface of the skin dilate, the voice becomes hoarse, and trembling appears in the hands. Subsequently, serious illnesses, primarily cirrhosis of the liver. It often leads to bleeding from the veins of the esophagus, from which the patient can die.

The patient denies his craving for alcohol. However, he becomes animated only in a situation where alcohol consumption is possible. First, psychological and then physical dependence appears. At the same time, it develops characteristic symptom"I'm hungover." At the second stage of the disease, binge drinking occurs.

A man refuses everything that prevents him from drinking regularly - work, loved ones, and usual social circle. After another binge, he repents, and at this time coding is often carried out. It is more effective in men.

Adolescent and children's alcoholism

The syndrome is registered in every 10th teenager. Predisposing factors:

• traumatic brain injury;
• developmental delay;
• chronic diseases nervous system;
• parental dependence (the risk of getting sick increases 4 times);
• bad influence of the company of peers.

Childhood alcoholism develops quickly, without a phase of everyday drunkenness. The child drinks alcohol irregularly, but the problem of craving for alcohol and loss of control quickly arises.

Teenage addiction goes through the usual stages, but they are incomplete and incomplete. Withdrawal syndrome quickly forms, but this condition is not accompanied by trembling, anxiety and tension predominate, and suicide attempts are possible.

The teenage psyche has characteristics that result in the predominance of altered forms of intoxication: aggression, a tendency to conflict. Alienation and coldness arise in the family.

The negative impact of addiction on a teenager’s health is very great. An unformed organism suffers more from the toxic effects of ethanol. Cases of severe poisoning are common. There is a delay in the growth and normal development of the child.

Beer alcoholism

The habit of regularly drinking one or more bottles of beer after work is not harmless. Beer alcoholism develops more slowly, but its effect on human health is no less harmful.

IN initial stage disease, the patient, often a man, drinks several bottles of beer a week. Gradually, the dose required for “relaxation” increases, and the person becomes dependent. He drinks several bottles of beer daily, and when he refuses it, withdrawal symptoms develop.

In addition to personality changes, beer addiction in men is accompanied by disruption of the brain and circulatory system. The exchange of sex hormones is disrupted, as a result of which female sex hormones begin to predominate in the body. This is accompanied by obesity, enlarged mammary glands, and impotence.

Beer - common reason addictions in women and adolescents. Treatment of this disease by a narcologist causes difficulties because the patient denies his addiction. Anonymous treatment is one of the effective methods to get rid of this disease. Joint discussion of health problems helps the patient to understand the disease and stop drinking beer and other alcoholic beverages.

Chronic alcoholism

Drinking alcohol for a long time leads to mental disorders and personality degradation. Chronic alcoholism accompanied by constant intoxication and the formation of irreversible brain pathology - encephalopathy.

Personality degradation can occur in three ways:

• loss of moral qualities, deceit, boastfulness, aggressive behavior, rapid change of euphoria and depression, aggravation negative traits character;
• impaired memory and attention, apathy, insomnia, thoughts about the uselessness of life, suicidal attempts;
• During withdrawal symptoms, patients may inflict demonstrative superficial wounds on themselves - this is a psychopathic type of personality disorder.

With chronic addiction, the required dose of the drink is gradually reduced, and vomiting reappears. Long-term psychotic disorders with delusions and hallucinations develop. Signs of female dependence in the chronic stage develop faster.

The liver takes on the main action of toxins. Developing alcoholic hepatitis, then cirrhosis and portal hypertension. Myocardial dystrophy or other heart diseases occur. Suffering greatly nervous system with the development of various types of encephalopathy. Pneumonia often develops. This phase of the disease continues for several years. If you do not provide help to the patient, he will die from concomitant diseases.

Treatment

The problem of poor treatment results for alcohol dependence is associated with late consultation with a doctor. The patient denies his illness. In addition, ethanol has an analgesic effect, as a result of which symptoms internal diseases are suppressed. How to cure alcoholism? To do this, it is necessary to actively identify patients and involve them in treatment at an early stage.

Treatment for alcoholism includes:

• elimination of external manifestations of the disease;
• getting rid of the craving for alcohol;
• formation of a psychological attitude towards sobriety and intolerance to alcohol-containing drinks;
• rehabilitation in family and society.

Acute intoxication and withdrawal symptoms are treated in toxicology departments of clinics. At the same time, they eliminate mental disorders and restore sleep. The patient's stomach is washed, sedatives, medications to support the heart, and antihistamines are administered. After withdrawal symptoms are lifted, the second stage of treatment begins, in which special drugs are used.

Physiotherapeutic procedures, acupuncture and hyperbaric oxygenation sessions are carried out.

Psychopharmacological therapy and drugs from the group of antidepressants are used. A fairly effective medical technique is conditioned reflex treatment. Coding is also used - mediated psychotherapy.

How to get rid of addiction? In this matter, the main thing is not the fight against the pathological desire to drink, but a change in a person’s attitude towards drinking alcohol. Therefore, various psychotherapeutic courses are used. Patients are instilled with an attitude of sobriety, taught to look at life through the eyes of healthy person. They are told how to restore their social environment, as well as physical health. In the case of effective psychotherapy, the patient accepts responsibility for his destiny and is ready to live without alcohol.

Alcoholics Anonymous groups operate in Moscow and other large cities. This method of group psychotherapy was formed in the USA. Its effectiveness has not yet been proven. But attending such meetings often keeps a person from drinking alcohol, as it relieves him of the feeling of loneliness and isolation.

The patient is also asked to take anti-addiction medication. This could be metronidazole, nicotinic acid, teturam, esperal and others. However, without changing the patient's views, such treatment may be ineffective.

Remedies for alcoholism

Drugs used to treat addiction have a sensitizing effect, meaning they increase the body's sensitivity to ethanol, causing physical discomfort similar to a severe hangover. There are various medications that can be alternated. They have a sufficient number of contraindications and side effects. Therefore, a doctor must prescribe a remedy for alcoholism and its dose.

Medicinal methods addiction treatments are quite popular. One of the main drugs for relieving cravings for alcohol is teturam (Antabuse). It is available in tablets for oral administration, and there is a form for subcutaneous sewing. If a patient drinks alcohol while taking Teturam, this substance will slow down the breakdown of ethanol in the body and cause poisoning - nausea, weakness, chest pain, shortness of breath. This forms in the patient conditioned reflex. Taking medications is combined with intensive suggestive therapy (suggestion).

Coding prices depend on the treatment method. The cheapest cost is implantation of the drug “Esperal” - from 3,000 rubles. Coding according to Dovzhenko costs from 8,000 rubles, treatment with Vivitrol – from 22,000 rubles, and a course of Naltrexone for 3 months will cost 30,000 rubles.

Treatment with traditional methods

Traditional treatment of alcoholism is based on the same conditions as medication. One of the main conditions is the voluntariness of taking medications; this is the only way to form an aversion to vodka.

How to treat addictions with medicinal plants? A decoction of club moss is effective. Take 10 grams of dry herb per glass of water and boil for 10 minutes, then add water to the original volume of 200 ml. The patient is given half a glass of decoction to drink, and after 10 minutes - 30 ml of alcoholic beverage. A person begins to experience severe vomiting and other unpleasant symptoms that create disgust. A course of 6 such procedures is required.

Treatment of alcoholism at home can be carried out using the following recipe: 15 g of thyme herb, pour 500 ml of water, boil for 15 minutes, add water to the previous amount. Give the patient 50 ml of the decoction 4 times a day, each time after 15 minutes offering a little vodka. Nausea, vomiting and other similar symptoms develop. The course of treatment lasts a week.

Folk remedies for addiction should be taken only on the recommendation and under the supervision of a doctor. They have significant side effects, and if used incorrectly, they will not help, but will only worsen the patient’s condition.

Disease prevention

To prevent the development of addiction, it is necessary to limit the daily consumption of alcoholic beverages to 45 ml of strong alcohol for women and 90 ml for men, and it is better to abstain from regular drinking altogether.

Prevention of alcoholism in adolescents lies in parents understanding this problem and monitoring their children. The child should also develop negative attitude to abuse and set your own positive example.

To combat the spread of the syndrome among young people, measures are used at the state level, for example, age restrictions on sales, a ban on drinking in public places, and so on. Information about the disease, its prevention and treatment methods should be posted in medical institutions.

If a person shows the first sign of addiction, for example, a craving for alcohol and thoughts about drinking, he needs to urgently consult a narcologist. At an early stage, the personality has not yet changed, and treatment is most effective.

In the future, you can be encoded; this technique often stops the development of the disease.

Rehabilitation helps people make the right decisions in situations where they might use alcoholic drink. Participation in the Alcoholics Anonymous program allows many patients to abstain from drinking alcohol and remain in remission.