Studies on alcoholism and alcoholism in Germany delineate a specific age group that is most exposed to the risk of alcohol abuse. The results of these studies clearly indicate that the main consumers of alcoholic beverages are found between the ages of 18 and 40. In this age group the excessive drinkers are particularly frequent. At the same time, this means that in the next decades we must expect an increasing number of alcoholics in the pathological sense, if we do not achieve a change in their behavior towards alcohol among this age group today.
General information about alcoholism
Alcoholism can lead to a wide variety of consequences in affected individuals, both acutely and in its chronic course. The liver is particularly affected. In further analysis of our surveys, we found that it is mainly the single people (singles) and the working and unemployed women and men who are at risk (in the case of women, this is an equality tendency that we certainly do not wish to see). We always have to find in the surveys that people know little about alcohol and alcoholism. This is not surprising, since the majority of doctors themselves know very little about the causes of alcoholism. Although alcoholic beverages have been enjoyed for centuries, it was not until the 19th and 20th centuries that scientific research into the problem of alcohol was undertaken, without, however, clarifying the causes of alcoholism to a sufficient extent. The determination of blood alcohol content – an important prerequisite for the quantitative measurement of qualitative changes in human behavior – was made possible mainly by certain discoveries made in the 1920s. However, a specific method, i.e. a method that determines only ethyl alcohol (ethyl alcohol), was developed by German and Swedish scientists independently only in 1951. This fact means that – strictly scientifically speaking – we did not have a specific method for ethyl alcohol detection until the 1950s. Today, we are able to detect physiological as well as elevated blood alcohol content with absolute certainty. Yes, we can even determine by back-calculation the concentration of alcohol in the blood that was present during the “time of the crime” and in this way indirectly determine the degree of influence. Only our present methods of determining the degree of drunkenness are accurate and reliable. This pleasing fact, however, is at the same time an indication of how much we must still be in the early stages in other questions of alcoholism – for example, in the question of principle for our society: Why do certain people develop into alcoholics? The exact proof of alcohol can capture the momentary situation – but not the phase in which someone develops into an alcoholic; nor can it give an answer as to how far this state has already progressed in the persons concerned. We do not wish to cite here the various theories on this question-emphasize theories-because we do not know, as yet, why and when a person becomes an alcoholic.
Types of alcoholics according to Jellinek
However, we consider it necessary to briefly outline here the most widely accepted theory of the developmental stages of alcoholism – elaborated by E. M. Jellinek. We are convinced that this theory corresponds most closely to reality and is typical of every alcoholic in some respect.
Problem drinker (alpha drinker).
Drinking has a social motive in our country. People drink on various social occasions. Not only the future alcoholic notices after a certain period of time that drinking gives him a relief, a relaxation. At the beginning, he quite rightly thinks that this comes from the happy mood in the company, that is, from the accompanying circumstances and the ritual of drinking, less from the consumption of the alcoholic beverage itself. (This can be explained by the development of conditioned reflexes, in which all factors coinciding in time with a positive reaction process already cause the entire behavioral and sensory process after regular repetition.Thus – after someone has repeatedly felt relaxation while drinking alcohol in company – alcohol alone can also trigger relaxation in him).
Occasional drinker (beta drinker).
Soon the occasional drinker feels the connection between the drink and the relief. He drinks larger quantities than the others, because in order to bring about the feeling of relaxation – which was in fact initially contributed to by the company – he needs more and more alcohol; that is, his drinking becomes regular. This is the initial phase of alcoholism, which passes smoothly into the second, the warning phase. Now the person becomes aware of the fact that he drinks differently from his fellow citizens and needs larger amounts of alcohol to bring about relaxation. He has made the observation that drinking is not a social matter for him, but a need – he gets feelings of guilt.
Addictive drinker (gamma drinker).
A characteristic symptom of the warning phase (addictive drinker) is said to be the so-called memory gaps; the person cannot remember certain events that happened during drunkenness. He fears criticism, is also ashamed and therefore begins to withdraw from his social circle. At this stage he still overlooks his situation and could get out of it if he knew that he is in this stage of development. Unfortunately, most people who believe that they can solve their problems by drinking, do not realize that after a few years this stage smoothly turns into the critical phase of alcoholism. This phase is characterized by the loss of control over drinking. If the person concerned has already had an alcoholic drink, he feels the need to keep on drinking – until he is fully drunk. He cannot deny himself the further glasses after the first one; however, he can still decide now whether to take the first sip at all. So, at this stage, he is able to live without alcohol for weeks or even for months. After this time, however, he believes that he can now satisfy himself with only one sip, and does not suspect that the loss of control over his drinking, which occurs with necessity, is not due to his weakness of will, but is the result of abuse to his body, of a complicated pathological mechanism of morbid reflections that he can no longer control. To get out of this situation, he tries to justify his drinking more and more under some pretext. He looks for credible reasons why he had to get drunk in this or that specific case. He needs this justification primarily for himself, then more and more for those around him.
Mirror drinker (delta drinker).
His drinking is generally noticed – society begins to be interested in his drinking. Therefore, he avoids the social circle and his family and isolates himself. We must already call this person an alcoholic. He starts the day already with the morning drink, during the day he needs some maintenance drinks, and only in the evening he drinks himself full. It is quite clear that this way of life does not allow normal work performance, that he gets into financial and social difficulties and one day sees no way out. And this is the beginning of the final phase of alcoholism: Now he gets drunk during work, for which even very small amounts are enough, which he used to tolerate without any problems. A typical sign of this phase is the decrease in alcohol tolerance. His lies, self-deception collapse; he is abandoned by family and friends and stands helplessly alone. A cure in the true sense of the word is possible here only if the person concerned never touches an alcoholic drink again for the rest of his life, for he can never again learn moderate social drinking. As E. M. Jellinek and after him other scientists have proved, the individual phases always take years.
Causes
But why one person becomes an alcoholic and the other does not is still not known. So far, we have not been able to determine in the initial phase whether this person will develop into an alcoholic or not. One fact, however, has been impeccably proven: Alcoholism cannot develop without alcohol.That is why we demand that all people come into contact with alcohol as late as possible – that is why we have legal regulations to make it impossible or more difficult for children and young people to drink alcohol. But medical demands and legal regulations alone will never be enough to decisively curb alcohol abuse. The fight against alcoholism is a social problem in which everyone must participate. It already starts in the family, in the working group, etc. Perhaps some people think that drinking is not so bad after all. The presentation of the developmental phases of alcoholism has shown us how wrong this trivialization is. If today we have to estimate that one percent of the population is chronically alcohol impaired, i.e. belongs to the last phase described, then this is reason enough for all levels of society, down to the smallest family circles, to review their customs and consider whether it is appropriate to “pour alcohol” on every opportunity that presents itself.
Symptoms, complaints and signs
An alcohol disorder is primarily noticeable through the behavior of an addict. Affected individuals have a desire to consume alcohol and then often lose control of their drinking behavior. In addition to these classic signs, there are other physical and psychological symptoms. Externally, the disease is noticeable, among other things, by a reddened and bloated face, bags under the eyes and a clogged tongue. Addicts also suffer from excessive sweating, especially on the hands and face. They may also experience weight loss and glazed eyes. If sufferers do not drink, their hands begin to tremble (tremor) and further withdrawal symptoms occur. For example, sufferers are often irritable and suffer from depressive moods when they do not consume. Inner restlessness, forgetfulness and lack of concentration are also among the typical psychological symptoms. Alcoholism can also cause sleep disorders and lead to impotence in the affected person. If these complaints occur over a period of several weeks and months and are accompanied by neglect of the environment, a dependence can be assumed. In the further course, alcoholism manifests itself by severe liver damage and sometimes also by a decrease in physical and mental performance.
Complications
Alcoholism can lead to a wide variety of consequences, both acutely and chronically. The liver is particularly affected. Chronic alcohol consumption can lead to increased accumulation of fats in the liver, resulting in a yellowish, doughy-looking fatty liver, which can develop into cirrhosis as the disease progresses. This is mainly characterized by synthesis dysfunction, fewer proteins are produced for the blood, including the important coagulation factors, and the bleeding time is prolonged as a result. Blood circulation in the liver is also disturbed. The blood is increasingly diverted into bypass circuits. This causes varicose veins in the esophagus, which can burst and lead to severe internal bleeding. Hemorrhoids can also be the result. In addition, the detoxification function of the liver is also disturbed. Toxins accumulate in the body, especially dangerous ammonia, which can lead to hepatic encephalopathy. Bacteria can also spread in the blood as a result, leading to sepsis. Furthermore, alcohol consumption also damages the brain, so that it can lead to Korsakow syndrome. The affected person has no more relation to reality, does not know where he is and who he is. Confabulations often show up here, which means that the affected person covers up memory gaps with spontaneously invented realities.
When should one go to the doctor?
As long as there is not yet a psychological or physical dependence on alcohol, the problem can be managed in many cases by consistently changing drinking habits without medical help. A visit to the doctor should be made if the need for alcohol is constant and alcohol consumption is getting out of control. Physical withdrawal symptoms such as sweating, trembling and sleep disturbances when the amount of alcohol is reduced or when it is completely abstained from give as much cause for medical examination as the necessary continuous increase in alcohol intake to avoid the occurrence of these complaints.Talking to a doctor is also advisable if alcoholism dominates large parts of one’s life and other areas such as family, hobbies and job are neglected for it. Regular participation in road traffic under the influence of alcohol or repeatedly appearing at work under the influence of alcohol also indicate alcohol addiction, which must be treated with the help of a doctor. The first point of contact is usually the family doctor, with whom a trusting relationship already exists:
Depending on the extent of the addiction problem, he or she can initiate a referral to a psychologist or an inpatient admission. The liver, stomach, intestines, heart and brain are severely affected by constant excessive alcohol consumption – any complaints that arise as a result require immediate clarification by a family doctor, internist or neurologist.
Outlook and prognosis
Alcoholism represents a very unhealthy condition for the patient’s body and, in the worst case, can also lead to death. In many cases, prolonged use of alcohol causes irreversible damage to the internal organs of the body and also to the brain. Furthermore, alcoholism can also lead to psychological complaints. Many affected people suffer from depression and other psychological complaints. It is not uncommon for patients under the influence of alcohol to also become aggressive and can severely injure themselves or others. Life expectancy is significantly limited and reduced by alcoholism. Those affected also suffer from constant fatigue and exhaustion. Likewise, the risk of a heart attack increases enormously. The treatment of alcoholism can be done by a psychologist or in a closed clinic. In some cases, the affected person can also carry out the treatment on his or her own. However, it cannot be universally predicted whether this will result in a positive course of the disease. In many cases, the damage can no longer be reversed. This may result in psychological and neurological limitations.
Aftercare
To ensure the success of withdrawal therapy in the long term, patients should continue to receive psychological care after completion. This usually takes place on an outpatient basis in addiction counseling centers or with established physicians and therapists, and an exchange with other affected persons in a self-help group can also be helpful. The alcoholic is shown ways of solving conflicts and coping with everyday stresses without seeking help in alcohol. If there is a high risk of relapse, temporary accommodation in a special residential facility for addicts may also be appropriate. Furthermore, aftercare includes reintegration measures that enable a return to work and social life. Social isolation and boredom pose a great danger during the dry phase of alcoholism – it is therefore advisable to accept help to structure the daily routine in a meaningful way and to organize leisure time. Family and friends should support the patient in making a new start without alcohol and respect his abstinence: Under no circumstances should he be encouraged to drink. In many cases, it is necessary to break away from the old circle of acquaintances and build up a new circle of friends – promoting social contacts therefore plays an essential role in aftercare. Regular medical examinations are equally important in order to detect and treat alcohol-related organ damage at an early stage.
Here’s what you can do yourself
An alcohol-related illness must always be treated under professional supervision. Accompanying the typical discomfort during withdrawal can be alleviated by some home remedies and tricks. First, it is advisable to identify and eliminate possible triggers for the addictive craving. A pleasant environment and contact with understanding people are important cornerstones for successful withdrawal. Stress and physical exertion should be avoided in the first few days if possible. Measures such as meditation or light relaxation exercises, which support the body and psyche during alcohol withdrawal, are more sensible. As far as nutrition is concerned, the following applies: exclusively low-stimulus and low-salt food and few animal fats. The diet should consist of fiber-rich whole grain products, plenty of protein, polyunsaturated fatty acids and vitamins A, C and E as well as zinc and thiamine.In addition, liver-calming teas made from milk thistle seeds or Heidelberg powder are recommended. Valerian and St. John’s wort can also be used due to their calming effect. After consultation with the doctor, light sleeping pills or painkillers are also recommended, always depending on the severity of the alcoholism and the patient’s physical condition. To avoid complications, all measures should be discussed with the doctor in advance.
