Forms of alcoholism. Types of alcoholism: names and characteristics. Consumption of alcoholic beverages in Russia and in the world

Classification of types of alcoholism according to Dzhelinek. Drunkenness, constant use, sporadic use for psychological reasons, social alcoholism (domestic drunkenness), true hard drinking. The need to treat any form of alcoholism.

In case of alcoholism problems, it is important to start treatment on time. The further alcoholism progresses in a person, the less chances he will be cured. In addition, there is a "point of no return" (the third stage of alcoholism), where alcoholism is considered incurable. And in order to start treating alcoholism, it is important to track its symptoms in time. And here problems can begin, since the disease of alcoholism is heterogeneous, there are different types of it with different forms of use. This article describes five forms of alcoholism according to the Jellineck classification.

γ-alcoholism ... Drunken form of alcoholism. The most common in our culture. Typically, the cycle of periods of binge and sobriety occurs as follows. Let's start our discussion of this cycle by getting out of the binge. After getting out of the binge, a person experiences a multi-day withdrawal syndrome (a hangover state), in which he experiences a combination of a negative physical state and moral mental anguish (strong feelings of guilt and shame, depression). Under the influence of this complex of suffering, he makes a promise to himself to stop drinking (either permanently, or for a certain period). Further, after a period of withdrawal symptoms, there is a period of euphoria of sobriety - the joy of a sober life, enthusiasm to never drink again, not understanding why he did not quit before, etc. This period can last from several days to a month. Then the euphoria passes and a period of depression sets in - sobriety ceases to please, irritation, depressed mood, depression, anxiety, etc. appear. Psychological stress gradually increases, and as it grows, the decision to stay sober weakens. At some point, a person has doubts about the correctness of the decision to stop drinking. He is still consciously sober, but subconsciously looks for reasons to drink (or creates them himself). And then the moment comes when a person decides to try to use in a controlled manner. After the first controlled use, the second, third, etc. necessarily follow. But in the end, the period of controlled use ends with a new binge. The cycle repeats each time with more and more serious consequences. Certain periods in this cycle may occur - for example, there may be no period of euphoria, or a period of conscious sobriety, or a period of controlled use. In general, in its most abbreviated form, this cycle can consist of only two phases - binge and withdrawal symptoms. The drunken form of alcoholism usually progresses in the following way: the appearance of hard drinking (at the beginning of the second stage of alcoholism), the establishment of the frequency of hard drinking and an increase in their duration (somewhere in the middle of the second stage), a decrease in the duration of periods of sobriety between hard drinking, that is, an increase in the frequency of hard drinking (in the second half of the second stage), a decrease in the duration of hard drinking and an increase in the duration of the withdrawal syndrome (transitional from the second to the third stage), the establishment of a new periodicity of short hard drinking with prolonged withdrawal symptoms and a short period of sobriety (third stage). In the end, a scheme is established: a short binge (several days), a long severe withdrawal syndrome (up to two weeks), and immediately a new binge.

δ-alcoholism... In second place in terms of distribution in our culture is constant drunkenness. A person drinks a certain dose every day, usually without getting drunk. There is an apparent control, but in fact this is uncontrolled use, since a person cannot not drink at all, or drink less than he needs, a dose. That is, if the norm of a person with δ-alcoholism is half a liter, then he will need to drink it, but not less. With δ-alcoholism, the social consequences of consumption are less pronounced than with γ-alcoholism, but due to the constant poisoning of the body with alcohol, the somatic consequences are more pronounced.

α- and β- alcoholism- alcoholic excesses. There is no particular frequency of use, a person begins to drink with psychological problems (α-form) or with social pressure (β-form). With the α-form, consumption is usually one-day, often without intoxication; with the β-form, it can be consumed for many days due to social pressure, with collective intoxication (this form of alcoholism in the "common people" is often called household drunkenness). Uncontrolled use is replaced by controlled use, which often confuses the alcoholic, making him think that he can use controlled. Often in the literature, even quite authoritative, these forms of alcoholism are spoken of as those in which only psychological dependence is present. This is a completely erroneous opinion, because in these forms of alcoholism all the signs of physical dependence are also present: hangover, increased tolerance, loss of control, lack of protective reactions, etc.

ε-alcoholism- binges with periods of prolonged sobriety. The drunken form of alcoholism differs from γ-alcoholism by long periods of abstinence (from six months to several years), during which a person practically does not think about alcohol. The binge comes suddenly, without any special precursors. For some reason, the drunken form in ε-alcoholism was called "true binge drinking."

It should also be noted that several forms of alcoholism may be present together. For example, combined γ- and δ-alcoholism: there is a period of “controlled” daily consumption of small doses of alcohol, then binge drinking develops with a complete loss of control, which then again turns into “controlled” daily use.

So, with any form of alcoholism: there is a loss of control over use (despite the seemingly controlled use in some forms of alcoholism), any form of alcoholism progresses with an increase in the severity of the use and its consequences, the forms of alcoholism can turn into one another. And most importantly, any form of alcoholism is a progressive disease that leads first to physical and psychological degradation, and then to death. Therefore, if you notice symptoms of one form or another of alcoholism, you should stop using it once and for all. If this does not work, you should seek help in treating alcoholism. What is the treatment of alcoholism, and how it happens, you can read in the article "

Alcoholism itself is not so easy to recognize. When the word "alcoholic" is often thought of as a drooping, dirty person with unshaven eyes and glassy eyes. However, virtually anyone can be an alcoholic: from an elegant woman to an exemplary teenager. Acute intoxication can happen to any person if the alcohol consumption rate is exceeded. Acute alcoholism syndrome is more common in non-drinking people, since the body is not tolerant to ethanol. The identity of acute and chronic alcoholism is zero.

Chronic alcoholism

At chronic alcoholism, alcoholic beverages are consumed regularly. This type of alcohol addiction is developing at a very fast pace. Often people around know about the problem of a person with alcohol. Alcohol is consumed as part of a kind of ritual: for example, a glass is taken after a hard day as a reward for a “hard day”. It is possible to take alcohol with a specific person at each meeting. The treatment for chronic alcoholism begins with the destruction of drinking rituals. In chronic alcoholism, the body's response changes:

• self-control is lost;

• hangover syndrome develops;

· Changes the body's resistance to alcohol;

· Alcoholic psychosis is manifested.

In the earliest stages, it manifests itself as a loss of self-control. The main symptom of chronic alcoholism is hangover syndrome. This syndrome manifests itself with tremors, sweating, tachycardia and depressed mood. Convulsions and hallucinations may occur, which are alleviated by drunkenness.

Drunken alcoholism

Drunk alcoholism is typical for people who do not have the opportunity to drink regularly. On weekdays, a person can afford to drink a little, but if psychological destabilization occurs, he goes into binge drinking for several days. A particularly difficult case if binges continue for months. Coming out of the binge (with the help of doctors or on their own), they return to their normal life. After some time, the binge is repeated. Others may not always recognize a drunken alcoholic. This type of alcoholism is very dangerous for human health, since the body's resistance to alcohol is very low. To start treatment, it is necessary to determine the cause or "trigger button" with which the binge begins.

Covert and beer alcoholism

Secret alcoholism can be chronic or drunkenness. The main difference is that he is carefully hidden from others. The secret form of alcoholism is most often inherent in wealthy people and women who consider this addiction a shame. People are often successful in hiding their illness with ingenuity. This creates a false belief about ignorance of others. However, after a while, alcohol can manifest itself: affect the appearance or cause diseases. While hiding their addiction, people can resort to two ways of drinking alcohol: constantly drink a little low-alcohol drinks or drink a lot of hard drinks at a certain time.

Beer alcoholism is the final and inevitable stage of long-term beer consumption. With beer alcoholism, a person drinks at least 1 liter of beer every day or several times a week. This type is insidious in that many consider drinking beer to be an innocent occupation that does not harm health. Often beer alcoholism accompanies chronic or drunkenness. Beer addiction is also characterized by ritual: over the years, the habit of drinking beer is formed in certain situations.

Alcoholism is also classified by types:

· Alpha alcoholism - low alcohol drinks are consumed every day;

· Beta alcoholism - low alcohol drinks are rarely consumed;

· Gamma alcoholism - spirits are rarely consumed, but in large doses.

Alcohol addiction in women and children

For alcoholism is especially dangerous for women. Their process of getting used to alcohol is much faster than that of men. Since the development of addiction symptoms is very rapid, the treatment of alcoholism becomes more difficult. The most common pathology for women who drink alcohol is damage to the pancreas and liver. The effects of alcohol often lead women to promiscuous sex life. Lack of hygiene during intimacy leads to sexually transmitted diseases.

With prolonged alcohol abuse, women develop mental disorders, character changes, nervousness and aggressive behavior appear. Causes of female alcoholism:

1. Problems of a social nature: difficulties in material terms, problems at work.

2. Emotional shock, stress.

3. Communication with drinking men.

4. Diseases of a nervous or mental nature.

5. Work in the alcoholic sector.

6. Crime, prostitution.

Since women rarely admit their alcohol addiction, the process of treatment is much more difficult for them.

Childhood is alcoholism, the symptoms of which are manifested in a child under the age of 18. Alcohol intake by children is not only harmful to health, but also causes deviant behavior. Children become aggressive and parents lose control over them. This type of alcoholism causes great harm to society. Under the influence of alcohol, violent crimes are often committed. Childhood alcoholism is characterized by the following features:

· Quick addiction to alcohol;

· Drinking alcohol in large doses and secretly;

· Low efficiency of treatment;

· Rapid development of binge drinking.

Most often, children consume alcohol in the society of their peers. Teenagers believe that drinking alcohol makes them seem more mature. Severe intoxication in children is the result of a lack of self-control. The list of causes of alcohol dependence in children is very long. The most common ones are:

1. The child is trying to assert himself in the company of friends.

2. Troubles at school, misunderstanding of parents, personal failures.

3. Parents drunkenness.

4. Out of control money.

5. Influence from outside.

- a disease in which there is a physical and mental dependence on alcohol. It is accompanied by an increased craving for alcohol, an inability to regulate the amount of alcohol consumed, a tendency to binge drinking, the occurrence of a pronounced withdrawal syndrome, a decrease in control over one's own behavior and motivations, progressive mental degradation and toxic damage to internal organs. Alcoholism is an irreversible condition, the patient can only completely stop taking alcohol. Even after a long period of abstinence, the consumption of the smallest doses of alcohol causes a breakdown and further progression of the disease.

General information

Alcoholism is the most common type of substance abuse, mental and physical dependence on the intake of ethanol-containing drinks, accompanied by progressive personality degradation and characteristic damage to internal organs. Experts believe that the prevalence of alcoholism is directly related to an increase in the standard of living of the population. In recent decades, the number of alcoholics has been growing; according to WHO, there are currently about 140 million alcoholics in the world.

The disease develops gradually. The likelihood of alcoholism depends on many factors, including the characteristics of the psyche, social environment, national and family traditions, as well as genetic predisposition. Children of people with alcoholism become alcoholics more often than children of non-drinking parents, which may be due to certain character traits, hereditary characteristics of metabolism and the formation of a negative life scenario. Non-drinking children of alcoholics often exhibit a tendency to codependent behavior and form families with alcoholics. Treatment of alcoholism is carried out by experts in the field of narcology.

Ethanol metabolism and the development of addiction

The main component of alcoholic beverages is ethanol. Small amounts of this chemical compound are part of the natural metabolic processes in the human body. Normally, the ethanol content is no more than 0.18 ppm. Exogenous (external) ethanol is rapidly absorbed in the digestive tract, enters the bloodstream and affects nerve cells. The maximum intoxication occurs within 1.5-3 hours after taking alcohol. Drinking too much alcohol causes a gag reflex. As alcoholism develops, this reflex weakens.

About 90% of the alcohol consumed is oxidized in the cells, broken down in the liver and excreted from the body in the form of end products of metabolism. The remaining 10% is excreted unprocessed through the kidneys and lungs. Ethanol is excreted from the body within about a day. In chronic alcoholism, the intermediate products of the breakdown of ethanol remain in the body and have a negative effect on the activity of all organs.

The development of mental dependence in alcoholism is due to the effect of ethanol on the nervous system. After taking alcohol, a person feels euphoria. Anxiety decreases, the level of self-confidence increases, and it becomes easier to communicate. Basically, people are trying to use alcohol as a simple, affordable, fast-acting antidepressant and anti-stress drug. As a "one-time help", this method sometimes really works - a person temporarily relieves stress, feels content and relaxed.

However, drinking alcohol is not natural and physiological. Over time, the need for alcohol increases. A person, who is not yet an alcoholic, begins to regularly consume alcohol, not noticing gradual changes: an increase in the required dose, the appearance of memory lapses, etc. When these changes become significant, it turns out that psychological dependence is already combined with physical dependence, and independently drinking alcohol is very difficult or almost impossible.

Alcoholism is a disease closely related to social interactions. At the initial stage, people often consume alcohol due to family, national or corporate traditions. In a drinking environment, it is more difficult for a person to remain teetotal as the concept of "normal behavior" shifts. In socially well-off patients, alcoholism can be caused by a high level of stress at work, the tradition of “washing away” successful deals, etc. However, regardless of the root cause, the consequences of regular drinking will be the same - alcoholism will develop with progressive mental degradation and deterioration in health.

The consequences of drinking alcohol

Alcohol has a depressing effect on the nervous system. At first, euphoria occurs, accompanied by some excitement, a decrease in criticism of one's own behavior and current events, as well as a deterioration in motor coordination and a slowdown in reaction. Subsequently, excitement is replaced by drowsiness. When taking large doses of alcohol, contact with the outside world is increasingly lost. There is a progressive distraction of attention in combination with a decrease in temperature and pain sensitivity.

The severity of movement disorders depends on the degree of intoxication. In severe intoxication, gross static and dynamic ataxia is observed - a person cannot maintain an upright position of the body, his movements are strongly uncoordinated. Control over the activity of the pelvic organs is impaired. When taking excessive doses of alcohol, weakening of breathing, cardiac disorders, stupor and coma can occur. Fatal outcome is possible.

In chronic alcoholism, typical lesions of the nervous system are noted, due to prolonged intoxication. Alcoholic delirium (delirium tremens) may develop during recovery from binge drinking. Somewhat less often, alcoholic encephalopathy (hallucinosis, delusional states), depression and alcoholic epilepsy are diagnosed in patients with alcoholism. Unlike alcoholic delirium, these conditions are not necessarily associated with abrupt cessation of alcohol use. In patients with alcoholism, gradual mental degradation, narrowing of the range of interests, disorders of cognitive abilities, decreased intelligence, etc. are revealed. In the later stages of alcoholism, alcoholic polyneuropathy is often observed.

Typical disorders of the gastrointestinal tract include pain in the stomach, gastritis, erosion of the gastric mucosa, and atrophy of the intestinal mucosa. Acute complications in the form of bleeding caused by ulceration of the stomach or violent vomiting with ruptures of the mucous membrane in the transitional section between the stomach and the esophagus are possible. Due to atrophic changes in the intestinal mucosa in patients with alcoholism, the absorption of vitamins and microelements worsens, metabolism is disturbed, and vitamin deficiencies occur.

Liver cells during alcoholism are replaced by connective tissue, cirrhosis of the liver develops. Acute pancreatitis, which has arisen against the background of alcohol intake, is accompanied by severe endogenous intoxication, may be complicated by acute renal failure, cerebral edema and hypovolemic shock. Mortality in acute pancreatitis ranges from 7 to 70%. Typical disorders of other organs and systems in alcoholism include cardiomyopathy, alcoholic nephropathy, anemia, and immune disorders. People with alcoholism have an increased risk of developing subarachnoid hemorrhages and some forms of cancer.

Symptoms and stages of alcoholism

There are three stages of alcoholism and prodrome - a condition when the patient is not yet an alcoholic, but regularly drinks alcohol and is at risk of developing this disease. At the prodrome stage, a person willingly takes alcohol in company and, as a rule, rarely drinks alone. Drinking alcohol occurs in accordance with the circumstances (a celebration, a friendly meeting, a rather significant pleasant or unpleasant event, etc.). The patient can stop drinking alcohol at any time without suffering any unpleasant consequences. He is reluctant to continue drinking after the event ends and easily returns to his normal sober life.

The first stage of alcoholism accompanied by increased craving for alcohol. The need to drink alcohol resembles hunger or thirst and is exacerbated in unfavorable circumstances: during quarrels with loved ones, problems at work, increased overall stress levels, fatigue, etc. temporarily decreases until the next adverse situation. If alcohol is available, the alcoholic drinks more than the prodrome patient. He tries to achieve a state of pronounced inebriation by drinking in company or drinking alcohol alone. It is more difficult for him to stop, he strives to continue the "holiday" and continues to drink even after the end of the event.

The characteristic features of this stage of alcoholism are the extinction of the gag reflex, aggressiveness, irritability and memory loss. The patient takes alcohol irregularly, periods of absolute sobriety can alternate with isolated cases of drinking or be replaced by binges lasting several days. Criticism of one's own behavior is reduced even during a period of sobriety, an alcoholic patient tries in every possible way to justify his need for alcohol, finds all kinds of "worthy reasons", shifts responsibility for his drunkenness to others, etc.

The second stage of alcoholism manifested by an increase in the amount of alcohol drunk. A person takes more alcohol than before, while the ability to control the intake of ethanol-containing drinks disappears after the first dose. Against the background of a sharp refusal from alcohol, withdrawal symptoms occur: tachycardia, increased blood pressure, sleep disturbances, trembling of the fingers, vomiting when taking fluids and food. Perhaps the development of delirium tremens, accompanied by fever, chills and hallucinations.

The third stage of alcoholism manifested by a decrease in alcohol tolerance. To achieve intoxication, a patient suffering from alcoholism, it is enough to take a very small dose of alcohol (about one glass). When taking subsequent doses, the state of the patient with alcoholism practically does not change, despite the increase in the concentration of alcohol in the blood. There is an uncontrollable craving for alcohol. Drinking alcohol becomes constant, the duration of binges increases. When you refuse to take ethanol-containing drinks, alcoholic delirium often develops. Mental degradation is noted in combination with pronounced changes in internal organs.

Treatment and rehabilitation for alcoholism

Prognosis for alcoholism

The prognosis depends on the duration and intensity of alcohol intake. At the first stage of alcoholism, the chances of a cure are quite high, however, at this stage, patients often do not consider themselves alcoholics, and therefore do not seek medical help. In the presence of physical dependence, remission within a year or more is observed in only 50-60% of patients. Narcologists note that the likelihood of prolonged remission increases significantly with the patient's active desire to refuse to take alcohol.

The life expectancy of patients suffering from alcoholism is 15 years less than the average for the population. The cause of death is typical chronic diseases and acute conditions: alcoholic delirium, stroke, cardiovascular failure and cirrhosis of the liver. Alcoholics are more likely to suffer accidents and commit suicide more often. Among this population group, there is a high level of early disability due to the consequences of trauma, organ pathology and severe metabolic disorders.

Alcoholism is a disease that develops against the background of frequent alcohol consumption and the formation of a pathological craving for it, psychological, and after it physical. Alcohol disrupts metabolic processes in the body, the cumulative effect of alcohol poisoning provokes the development of psychosis. Dementia develops in the later stages of alcoholism.

Disappointing figures showing the danger of alcoholism:

• One in every 10 adults has serious alcohol problems.
• Alcohol intoxication accounts for one third of ambulance calls.
• In psychiatric hospitals, half of the patients are male alcoholics.
• Alcohol poisoning is the cause of every two out of three deaths.
• Half of the deaths and dangerous injuries in road traffic accidents occur due to alcohol intoxication.
• 50% of murders, 40% of robberies, 35% of rapes and 30% of suicides are due to someone's alcoholism.
• 80% of fires are caused by sleeping with a cigarette while intoxicated.
• An increase in alcoholism was noted due to the consumption of beer, the introduction of women and adolescents.
• Among adolescents, 88% of boys and 93% of girls use alcohol. At this age, the maximum alcohol consumption is noted.
• 22 out of 100,000 adolescents are sick with alcoholism, 827 adolescents suffer from psychological dependence.
• In Russia, 3500 people die from alcohol in a year (as a result of "drinking").
• Alcohol shortens life by an average of 10 years.
• It has been proven that addiction to alcohol is transmitted genetically. Even the conditions of raising children of alcoholics in a foster and prosperous family do not guarantee success.

Thus, alcohol itself is dangerous, but its social and psychological consequences are even more dangerous. It is worth noting that alcoholism is different from domestic drunkenness. Drunkenness is the forerunner of alcoholism. It does not necessarily go into it, but it happens often. Drunkenness is not viewed as a pathology or addiction. It's a drinking habit. Alcoholism is a disease requiring complex treatment, including medication.

Forms of alcoholism

According to the risks of the transition of drunkenness to alcoholism, G.V. Starshenbaum identified the following stages of alcoholization (1 dose - 30 g of vodka or 150-200 g of dry wine, or 300-500 g of beer):

• One to two doses 6-8 times a year is a low risk.
• One to two doses 10-20 times a year is a moderate degree of risk.
• One to two doses 6-10 times a month or three to four doses 20-40 times a year is a dangerous level.
• Three to four doses 6-10 times a month (onset of alcoholism).

In the international classification of diseases (ICD-10), alcoholism belongs to the F10 code. Moreover, several alcoholic disorders and disorders have been identified with stages characteristic of each.

Acute alcohol intoxication

Alcoholic intoxication. It can be simple, complicated and pathological. In simple terms, there are:

• mild stage (euphoric agitation, or hypomania);
• the middle stage (euphoria alternates with dysphoria, speech and coordination of movements are impaired, arousal is replaced by sleep with depression, headache and partial amnesia upon awakening);
• severe stage (severe impaired coordination of movements, incontinence of urine and feces, vomiting, grimacing, blue discoloration and icing of the limbs, unconsciousness, complete amnesia upon waking, loss of appetite and weakness).

A complicated form of intoxication is accompanied by a dysphoric, depressive or hysterical mood mixed with drowsiness:

• With dysphoria, a person manifests (breaks things, bully other people, loses self-control in fights, inflicts wounds on himself, being alone).
• When a person is depressed, they cry, blame themselves, or reproach others. Sometimes it turns into a gloomy mood, reticence, and unexpected suicide attempts.
• The hysterical mood is manifested by "performance", "performances", suffering and hysterical fits.

Alcohol dependence syndrome, or A-dependence

Pathological alcohol consumption, entailing violations of the social and professional functions of the individual. A person cannot stop drinking himself, despite obvious somatic disorders. A person functions normally only if he regularly drinks small doses or goes into binges. Obviously, this is not welcomed by society in the family and at work.

The addiction syndrome is signaled by:

• an increase in alcohol tolerance (an increase in the dose required to achieve the desired and previous effect);
• withdrawal symptoms (hangover).

There are 4 types of hangovers (any of them signals addiction syndrome):

• Psychopathological: anxiety, vague fear, pessimism, dysphoria, suicidal thoughts, insomnia, self-blame, auditory and visual hallucinations.
• Neurovegetative: insomnia and trouble falling asleep, edema, sweating, asthenia, thirst, hypertension and hypotension, decreased appetite, tremors of the extremities, palpitations.
• Cerebral: nausea, cephalalgia, fainting, dizziness, seizures similar to epileptic ones.
• Somatic: nausea, abdominal pain, vomiting, diarrhea, heart rhythm disturbances, bloating, colic, arrhythmia.

Withdrawal syndrome

It manifests itself as alcoholic epilepsy or delirium tremens, arises as a result of the complete cessation of alcohol consumption after prolonged use. Withdrawal syndrome is diagnosed when at least three of the following symptoms are present:

• tremor of the fingers on outstretched arms or the tip of the nose, or eyelids;
• sweating;
• nausea and / or vomiting;
• high blood pressure or heart palpitations;
• psychomotor agitation;
• headache;
• insomnia;
• malaise, general weakness;
• hallucinations and illusions (auditory, visual, tactile);
• convulsions and fainting.

Alcoholic delirium

Severe withdrawal syndrome. It is noted in alcoholics with at least five years of experience and frequent binges. Delirium occurs 2-7 days after the cessation of prolonged and intense alcohol intake. The following violations make themselves felt in turn:

• weak and fast heartbeat;
• increased sweating;
• hypertension and hyperthermia;
• insomnia;
• motor excitement;
• vague fears;
• irritability;
• tremor of the lips, tongue and hands, speech disorders;
• convulsions and seizures;
• bright visual and tactile hallucinations in the form of insects and animals that are dangerous to humans, anxiety and confusion of thoughts;
• disorientation in time and place, confusion of consciousness;

The last two points are typical signs of delirium. Symptoms last for 3-7 days from the moment of the first manifestations, and after the patient falls into a long and deep sleep. After waking up, the symptoms disappear, only asthenia remains. Delirium is fatal in 25% of cases without treatment.

Alcoholic hallucinosis

As a rule, it occurs in middle-aged alcoholics, with physical dependence, after prolonged binges. Manifested by auditory hallucinations. Consciousness remains clear, but already on the second day after the binge, the patient hears sounds, calls, calls, and later threats, uttered by some voices. As a result, a persecution delusion is formed with characteristic motor activity, psychomotor agitation and affects. The person becomes socially dangerous.

Hallucinations last from several hours to several weeks. Without treatment or with an unfavorable combination of circumstances, hallucinosis becomes chronic. The patient hears voices all the time, but they are neutral and do not make the person socially dangerous. The patient's fear and excitement disappear.

Paranoid

Delusional state with a sense of persecution and defensive behavior. The patient everywhere hears threats and thoughts about his murder (finds this meaning in the words of others or suffers from auditory hallucinations). For protection purposes, the patient may contact the police or attack first. The duration of the state is from a couple of hours to 2-3 weeks.

Delusional state, accompanied by aggression. Most often, jealous delirium. It is on the basis of paranoia that domestic murders take place. An alcoholic with paranoia is capable of causing bodily harm to a partner, killing him or his relatives and acquaintances. Characteristic signs of jealous paranoia:

• distrust and disappointment in a partner;
• quarrels that flare up under the influence of alcohol;
• feeling of humiliation;
• problems in relationships with others;
• guilt;
• increased sexual activity (need) against a background of reduced capabilities (impotence).

Jealousy takes on inadequate proportions. Your own feelings of inferiority are projected onto your partner. Without correction, regardless of the further frequency of alcohol intake, delirium becomes chronic.

Depression

Alcohol and suicide - a classic combination, occurs as often as murder motivated by alcoholic jealousy. The specificity of the phenomenon is that depression and alcohol are interconnected, that is, both depression can lead to alcoholization, and alcoholism can cause decadent and self-deprecating motives, suicidal thoughts and actions.

Pathological intoxication

A state of delirium. The alcoholic looks detached from the real world, shows senseless aggression and cruelty, runs aimlessly somewhere, acts alone and silently. At the same time, it is noted:

• pallor of the face;
• dilated pupils;
• relatively adequate view (you can't say that he was very drunk).

In the end, the person falls asleep soundly and really forgets about everything that happened. At the time of delusional intoxication, consciousness changes, unexpected insights with erroneous interpretation occur, a person is tormented by fears and hallucinations (visual), illusions.

Types of alcohol addiction

German researcher Georg Jellinek identified several types of addiction:

• Alpha addiction. Alcohol is used as a remedy for getting away from troubles, relieving stress, and improving mood. This type of addiction develops quickly.
• Beta addiction. A person drinks because of or when it is impossible to resist the temptation. Addiction is forming more slowly. Somatic changes are noted: vascular disorders, deterioration of the work of internal organs, decreased immunity, exhaustion ().
• Gamma dependence. Combination of psychological and physical addiction. Withdrawal syndrome occurs, alcohol tolerance. The patient can go without alcohol for a long time, but if he gets on the tongue, he will not stop.
• Delta addiction. Severe psychological and physical dependence. During the day, the patient maintains a constant concentration of alcohol in the blood. Withdrawal symptoms appear more frequently and more easily, and alcohol tolerance increases.
• Epsilon addiction. Binge drinking intermittently up to several months. The beginning of the binge will coincide with the end of the week or month, salary. The patient drinks alcohol for several days in a row in large quantities.

Stages of alcoholism

In total, it is customary to distinguish 3 stages of alcoholism.

First stage

At the first stage, the following are noted:

• vivid and positive memories of alcohol;
• the transition to strong drinks;
• the difficulty of refusing and the constant willingness to drink;
• drinking in one gulp;
• loss of control;
• use impulsively, secretly, for physical relaxation, before and after a responsible business;
• avoiding talking about alcohol;
• thrifty attitude to alcohol (there is always something at hand);
• canceling plans for a drink;
• the gag reflex and the need to eat disappears;
• tolerance increases;
• euphoria is more and more difficult to achieve (after a long time and (or) after large doses);
• light sleep, frequent awakenings in a state of asthenia;
• discomfort without drinking;
• "Dose collapse" (an adequate state after the first dose and a state of deep sharp intoxication after a second dose).

Later, there are blackouts and mild amnesia the next day. A person has fears that he will do something undesirable in a state of intoxication. Symptoms develop gradually in the order indicated above.

Second stage

The second stage is characterized by false binges or constant alcohol abuse. Physical dependence is formed. Withdrawal syndrome is noted, while craving for alcohol increases. In addition, it is noted:

• decreased appetite;
• general weakness;
• impotence and decreased libido;
• jealousy on this basis;
• justification of alcoholism (search for reasons);
• withholding the source of alcohol intake;
• lying about everything related to alcohol;
• drunkenness alone, neglect of social contacts;
• the distinctive personality traits prevailing before the disease are sharpened;
• aggression, resentment, attempts to impress and earn authority, to be impressive;
• job loss or frequent job changes;
• guilt.

The more a person accumulates problems, the greater his desire to regain control over alcohol. Attempts to abstain, control the volume and frequency of intake begin. Often there are thoughts about changing the place of residence ("from scratch"). Of course, a change in external conditions will not solve the problem.

Third stage

Constant alcohol abuse persists, but tolerance decreases. As a result, the patient switches to low alcohol drinks, smaller doses and surrogates. Together with that:

• personal degradation is observed (immorality, weakness of memory and intellect, strengthening of the lower ones);
• euphoria with black, rude and vulgar;
• dysphoria sharply replacing euphoria with aggression and delinquency;
• health deteriorates;
• efficiency decreases;
• there is alcohol consumption in the morning;
• drinking with people of low social level and status;
• loss of job, family, friends.

The patient experiences remorse, he is tormented by uncertain and, but he does not admit the existence of a problem (alcoholism). A person needs treatment in a narcological hospital.

Alcohol personality change

This is an independent diagnosis, which is assigned the code F07.0 in the ICD-10. In fact, this is personal degradation, which was mentioned above. Alcohol personality change is diagnosed when there are at least two of the following:

• a noticeable decrease in the ability to purposeful, especially with a delayed result;
• emotional swing (euphoria and emotional flexibility, inadequate humor mixed with irritability, anger, aggression or apathy);
• satisfaction of needs and impulses in any way, neglect of norms and consequences;
• suspicion or paranoia, preoccupation with one narrow and abstract topic;
• change in the tempo and speed of speech, random associations, hypergraphics;
• changes in sexual behavior (activity, passivity, promiscuity, change in preferences).

Features of alcoholics

The psychological aspects of alcoholism, the characteristics of future and present alcoholics have been studied for a long time. The main idea, which the researchers agree on, is that alcohol is an analogue of the family. Alcohol gives a feeling of confidence, security, warmth, peace, that is, it performs functions.

Alcoholization are more prone to:

• personality with antisocial;
• infantile and immature;
• suggestible;
• people with dysthymia;
• unsure of themselves;
• with an increased need for power;
• disturbing;
• dependent or demonstratively independent;
• personality with a poor imaginative ability for abstraction and analytical thinking;
• with an unmet need for affection and care, love.

Often, alcoholism is an unconscious revenge on parents. It arises as a result of a destructive parenting style.

Alcoholics Games

Alcoholism is often viewed in a box. Its founder, Eric Berne, described the alcoholic's game as follows:

• The goal of the game is torture with a state of hangover and self-flagellation.
• The psychological reward is booze. She is rebellion and consolation, a pleasant procedure, a substitute for sexual and emotional intimacy.
• A quarrel with a wife or close people, which is biologically (according to the reactions of the body and hormones) identical with anger and love and existentially reinforces the alcoholic's attitude "no one understands me, everyone is against me."
• Shame, guilt (beginning of the game).

If we consider the involvement in the process of alcoholization of the three I's of the personality (child, parent, adult), then the following patterns can be distinguished:

• The position of an adult is always skillfully ignored, or it is simply not developed initially. A person cannot adequately assess himself, his life and the problem.
• The child is ruled by fear of alcohol and a feeling of joy from drinking it, the removal of barriers and prohibitions, the fulfillment of all desires, euphoria. The child's position prevails at the first stage of use.
• The parent criticizes the behavior, shames, forbids. This position is noticeable at the second stage of alcoholization. The parent's position is often contradictory, depending on the models and authorities learned in childhood.

Alcoholism treatment

Treatment of alcoholism is possible only in the context of complex work with a narcologist and psychologist. It is important to understand that even under professional supervision, relapses occur in 75% of cases. But a trained physician is able to recognize an impending relapse and prevent it. There is an extensive classification of the criteria for an impending breakdown, which is used by specialists.

Alcoholism is a disease, not. It is impossible to get rid of it on your own. Psychotherapy is selected strictly individually, taking into account the conditions and characteristics of alcoholization, the individual and personal characteristics of the patient. Rational psychotherapy, directive, social, mediated or psychological, is used depending on the case:

• Rational psychotherapy is indicated for patients with (the cause of alcoholism), who do not understand their problem, an inferiority complex, skeptical about treatment.
• Directive psychotherapy is prescribed to people without demands and claims, incapable of reflection, infantile, obeying orders and outside influence.
• Social psychotherapy is used in the treatment of people in need of social activity (seeking recognition, inclined to), changing the circle of friends, changing social status (profession, place of residence, family, business and friendships).
• Mediated psychotherapy is indicated for gullible, suggestible and fearful patients, anxious, infantile and pedantic individuals who need direction and support in life.
• Psychological therapy is prescribed for people in need of self-education and pedagogical correction, self-improvement, distraction, switching attention (changing the direction of activity).

In addition, aversive therapy and suggestive, autogenous training, muscle relaxation, neurolinguistic programming, supportive therapy (assistance in social recovery), correction of noted personality disorders, family psychotherapy are used. Group therapy is used, the most popular methods of which are:

• affective countertribution;
• collective emotional stress therapy by Rozhnov;
• Dovzhenko coding;
• mass emotional and aesthetic psychotherapy;
• therapy for creative self-expression;
• groups of alcoholics anonymous.

Alcoholism is alcohol addiction. In the understanding of a modern person, alcoholism acts not so much as a mental (somatic) illness, but as a detrimental social influence of society. Moreover, people often have a number of stereotypes. In the modern view, an alcoholic is a person who has sunk to the very bottom of the social ladder. The alcoholic also has financial and housing problems.

This definition of an alcoholic can only be associated with a person who is at the last stage of alcohol addiction and is economically unable to exist. In view of the attitude of modern society towards alcoholism, such a person is not perceived as a full-fledged cell, which lowers a person several steps in the social ladder. A person who has even the first stage of alcohol addiction, under the pressure of society, can become a mentally unbalanced homeless person.

Despite stereotypes, it is not easy to recognize an alcoholic in a crowd. The majority of Russian citizens, and citizens of the CIS countries, are in fact at an early stage of alcohol addiction.
The first stage of alcohol addiction is household alcoholism.

Household alcoholism - the desire to drink an increased dose of alcohol for every convenient socially acceptable reason (birthday, new year, first salary, first scholarship, hiring, retirement, wedding Christmas and other holidays).

Even in the second stage of alcoholism, there is not always a chance to separate the alcoholic. After all, a respectable person with a family and a good job may turn out to be an alcoholic. The reason for this can be both problems in the family itself and the addiction that developed from an early age.

Types of alcoholism

In view of the pandemic spread of alcohol addiction in our time, it is necessary to have a number of important knowledge that will help you or your friends cope with the problem in the future.

First you need to know how to separate an alcoholic, and what types of alcoholism exist.

There are a large number of types of alcoholism, while it should be understood that in the absence of a full-fledged catalog (such as ICD-10 or DSM-3R), it is almost impossible to clearly separate one type of alcoholism from another.

Types of alcoholism:

• Household alcoholism: most of the population of the planet Earth suffers from this type of alcohol addiction. It originates from an early age, in view of social prejudices, which imply the presence of alcohol at every serious holiday. In addition to the hangover syndrome, such alcoholism destroys the human reproductive and mental systems. It is from domestic alcoholism that all other types grow;
• Drunken alcoholism: this type of alcoholism often develops in people who have problems in the family, or are simply not balanced (have a mental disorder of the schizophrenia class). Such alcoholism is accompanied by fits of rage. And the very essence of the type of alcoholism lies in the entry of a person into a state of binge. Binge is being in the stage of alcoholic intoxication (ethanol poisoning) for more than one day. Moreover, in ordinary life, such a person does not show his alcohol dependence in any way, and may not differ from people who do not have alcohol dependence;
• Chronic alcoholism: a subspecies implying the development of alcohol dependence up to the third stage. People with chronic alcoholism are practically unable to cope with addiction on their own. They may not come out of the binge state for many months.

Or take a certain dose of alcohol every day, which they consider to be the norm (this is especially noticeable in the case of beer alcoholism).

A separate subtype of chronic alcoholism is beer alcoholism. It has the same symptoms as chronic, with one single difference. In the case of a beverage, consumption of beer remains preferable. At the same time, the dosage of a beer alcoholic starts from 0.5 liters per day.

It is important to understand that alcoholism is a mental disorder of the type of addiction. Like other addictions, alcoholics suffer from addiction no less than other people in view of a number of symptoms:

• Inability to get rid of addiction without outside help;
• The tension that arises in anticipation of alcoholic libation;
• Mental discharge, which occurs at the time or after drinking alcoholic surrogates (such discharge is the main reason for the presence of mental addictions; it is caused by the stimulation of dopamine centers, which are responsible for the feeling of happiness and pleasure);
• Chronic craving for alcohol surrogates is present not only mental, but also psychological dependence on ethanol and its surrogates;
• Reducing the working time in which a person is able to be without accompanying cravings.

• A false desire to get rid of addiction at a certain stage;
• Increase in the consumption of the subject of dependence (increase in the volume and strength of drinks);
• Depressive states in case of impossibility to join the subject of addiction for a considerable time;
• The aggression that an alcoholic will show if forcibly distracted from libation.

• Signs of increased enthusiasm that an alcoholic experiences during prolonged binges;
• Darkening of all thoughts, except for those that accompany the subject of addiction;
• Decrease in the general level of performance due to the change in life priorities;
• Desperate attempts to hide alcoholism;
• The transition to alcohol surrogates (triple cologne and others) in view of their cheapness, especially often due to the economic inability to pay for more expensive and high-quality alcohol.

• Loss of time frame and inability to follow the real world during long binges;
• Willingness to spend all economic savings on ethanol surrogates;
• Disruptions in life mode (food, sleep);
• Irritability at the time of a hangover, or unexpected aggression for no reason;
• Desocialization due to contradictions with society;
• A persistent feeling of depression and suppression (this is especially pronounced in the later stages of addiction).

- as a severe mental state, which includes all the main signs of psychological and somatic dependence, has been described more than once on the Psytheater portal.

The following aspects of alcoholism were considered in detail: treatment, problems of society and its relationship to alcohol addiction, problems of female alcoholism, ways to identify an alcoholic in a crowd.