Alcoholism • Ways out of alcohol addiction

Alcoholism, also known as alcoholism or alcohol addiction, describes the harmful use and dependence of alcohol. Alcohol is a widespread addictive substance: More than 7.4 million Germans consume the maximum amount recommended by the World Health Organization (WHO).

Alcohol is a neurotoxin that is intoxicating. How strong its effect is depends on the amount you drink, your physical constitution and condition and how you get used to drinking. Because alcohol dissolves particularly well in water and fat, it is absorbed very well by the body – it quickly "gets into the blood". The alcohol reaches the brain via the blood, where it neutralizes the inhibitory effect of various neurotransmitters.

The higher the alcohol content in the body, the more pronounced the disturbances in coordination, movements and language. At particularly high concentrations, alcohol poisoning occurs with a coma and respiratory failure.

Causes of alcoholism

The basic cause of alcoholism (alcoholism or alcohol addiction) is excessive consumption of the corresponding beverages. The alcohol contained in alcoholic beverages is actually called ethyl alcohol (ethanol). It arises from the fermentation of sugar or sugary substances and is contained in many beverages and foods. The most commonly consumed alcoholic beverages are beer, wine, spirits and mixed drinks.

The risk of developing alcoholism increases with increasing alcohol consumption. In order to better classify this risk, the four consumption classes are suitable:

• Low-risk consumption: up to 40 grams (men) or 20 grams (women) of pure alcohol daily
• Risky consumption: 40 to 60 grams (men) or 20 to 40 grams (women) of pure alcohol daily
• Dangerous consumption: 60 to 120 grams (men) or 40 to 80 grams (women) of pure alcohol daily
• High consumption: more than 120 grams (men) or 80 grams (women) of pure alcohol daily

A small glass of beer (0.33 liters) contains around 13 grams of alcohol, a glass of wine (0.2 liters) contains an average of 16 grams of alcohol.

From alcohol consumption to alcoholism

The boundaries between alcohol consumption and alcoholism (alcoholism) are fluid. Several causes play a role in the development of alcoholism:

• Socio-cultural influences
• Psychological influences
• Biological factors

The drinking habits in a society have a major influence on the development of alcohol addiction. In different cultures there are religious or social rules for dealing with alcohol. Alcoholism is comparatively little widespread there. Drinking behavior within the family or among friends plays an important role in dealing with alcohol, especially among young people.

Attention! Hidden alcohol in food

Psychological factors can also contribute to alcoholism. Alcohol is often used to make situations and emotional states more bearable. The resulting conditioning – after consuming alcohol, the problem is less or no longer present – leads to dependence in the long term.

Genetic factors are also discussed as contributing factors to alcoholism. For example, cases of alcohol addiction are more common in some families. Exactly which gene variation is responsible for this increased susceptibility has not yet been clearly clarified. Only alcohol dehydrogenase, a gene that controls alcohol metabolism, could be identified.

Symptoms of alcoholism

Alcoholism is one Addiction diseasewhich is characterized by the typical addiction characteristics. In particular, these are the compulsion or the irresistible desire to consume alcohol, getting used to ever larger amounts of alcohol and withdrawal symptoms such as tremor: tremors all over the body when abstaining. Despite the health and social consequences, alcohol is still consumed, other areas of interest are increasingly being reduced in favor of alcohol consumption. However, drinking behavior with alcohol addiction is very different and, according to Jellinek, can be divided into five types:

• Alpha drinkers: Alcohol is not drunk uncontrollably, but is undisciplined and is used to ease conflicts. Dependence only shows up psychologically.

• Beta drinkers: Here, too, there is no loss of control; alcohol is consumed out of adaptation and habit and on certain occasions. There is no addiction.

• Gamma drinkers: There is initially a psychological, later also a physical dependency. Drinking leads to a loss of control – larger and larger amounts of alcohol are consumed.

• Delta drinkers: There is no loss of control, but periods of alcohol abstinence are no longer possible. The alcohol intoxication is not particularly strong, but it happens regularly.

• Epsilon drinker: Alcohol is consumed excessively and permanently, it leads to loss of control, alcohol intoxication for weeks and months is possible.

Excessive alcohol consumption is always harmful. A distinction is made here between short-term and long-term consequences. During the Alcohol intoxication there is an increased risk of accidents due to the coordination disorders. Excessive drinking can damage organs; in the worst case scenario, there is a risk of alcohol poisoning.

Diagnosis of alcoholism

The suspicion of alcoholism (alcoholism) mostly arises because of the externally visible signs. In addition to the effects on social life and the environment, these are the typical smell of alcohol and constant signs of alcohol intoxication. Talking to the doctor about that Medical history (anamnesis) There are also a number of other indications:

• Skin changes (redness, blood vessels)
• Shaking hands (tremor)
• Unsteadiness
• Increased perspiration (especially wet hands)
• Performance degradation
• Decreased sexual desire, impotence

In addition, various questionnaires can be helpful in diagnosing alcohol addiction. A widely used tool is the CAGE questionnaire, which consists of only four questions:

Cut down: Have you ever felt that you should drink less alcohol?

Annoyed: Have you ever been annoyed that others have criticized your drinking behavior?

Guilt feelings: Have you ever felt bad or guilty about your drinking habits?

Eye-opener: Do you need alcohol in the morning to get active, calm your nerves or relieve your hangover?

In the advanced stage, symptoms of organ damage appear. They are usually identified during an extensive physical exam.

Alcohol Disease Therapy

The Treatment of alcoholism consists of a combination of different instruments that are used depending on the severity.

Withdrawal phase

It is advisable to start therapy with withdrawal. These measures can be carried out as an inpatient or at home. Since there is initially a detoxification with possible undesirable side effects such as cramps, severe depression or circulatory disorders, it is advisable to carry out the withdrawal under medical supervision. These measures are offered in numerous addiction clinics.

The physical withdrawal symptoms usually disappear after a few days, while the psychological symptoms persist for a much longer period of time. There is a lifelong possibility of relapse.

Phase of weaning

Immediately after withdrawal is weaning. During this time it is important to overcome the psychological dependence or at least to get it under control. Weaning is often carried out first in a special facility and then in the form of psychotherapeutic support in everyday life. When staying in an institution, the relapse rate is lower than when weaning at home. Alcoholism: Ways Out of Alcohol Addiction

In order to abstain from alcohol or regain the ability to drink in a controlled manner, it is advisable to secure long-term support. Psychotherapy or visiting a self-help group can help. Alcoholics and relatives take part in numerous groups together. The best known support group are Alcoholics Anonymous (AA).

What is the alcoholic illness like?

Long-term effects of excessive alcohol consumption

The family and social environment also reacts to alcohol addiction: There is isolation and exclusion and increasing conflicts. The prognosis of alcohol addiction is highly dependent on social and psychological factors. Above all, a stable social environment and the separation from the old "drinking environment" are important factors for a good prognosis.

• Liver diseases: Fatty liver, alcohol-related hepatitis, cirrhosis of the liver, liver cancer, Zieve's syndrome
• Pancreatic disorders: Inflammation of the pancreas (pancreatitis), pancreatic cancer
• Heart and circulatory diseases: Enlargement of the heart muscle, heart failure (heart failure), cardiac arrhythmias, high blood pressure
• Digestive system disorders: Inflammation of the gullet (esophagitis), inflammation of the lining of the stomach (gastritis), cancer of the stomach, cancer of the esophagus
• Peripheral Nervous System Disorders: Polyneuropathy, cerebellar cortex athropy, seizures (epilepsy)
• Diseases of the central nervous system and the psyche: Depression and dementia

If organs are already damaged, therapy for the disease in question is based on a strict one Alcohol abstinence. Abstinence significantly improves the prognosis.

How can I prevent alcoholism?

The safest prevention against alcoholism is controlled drinking or abstinence. Young people in particular who drink alcohol regularly or excessively are at risk. Anyone who drinks to forget problems or avoid conflicts increases their risk of developing alcoholism considerably. It is advisable to be particularly cautious about alcohol, especially if there are already people in the family who suffer from alcoholism.

More about alcohol addiction on the BZgA page "Know your limit"