Alcoholism

Definition

The newest classification of World Health Organization, gives the following definition: “Every repeated alcohol drinking which is being continued beyond the harmful consequences is harmful alcohol using”. Behind this harmful using, comes evolutional phase in process of drinking alcohol and it is alcoholism. This is process which is not limited on period of one human life, or on just one generation in family.

Naturally that is social-medicine disease, medicine because toxic effects of alcohol and metabolic changes make damages to the organism, and social because the surroundings makes a very important impact for organism genesis, and are also important, but as important as this are consequences regarding behavior disturbances among alcoholics in surroundings where they live and work.

Three basic characteristics can be abstracted from the definition:

  • Long period, uncontrolled drinking followed by problems
  • Psychical and/or physical dependence
  • Healthy (physical and psychical) and social (family, professional) consequences

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History

In the most societies and cultures drinking alcohol is very accustomed appearance, which already exists for a lot of centuries, and now we can speak about social psychological appearance with elements of «natural process», present «everywhere and on every place».

References from history of civilization show that a man during his development very early noticed pharmacologic effect of alcohol, which is relaxing and euphorically. Steinglass in his book “The Alcoholic Family” illustrated that with the cases of Nona and Loti, two mythological people from the past, in whose drinking he noticed first clinical symptoms of alcoholism (shame, incest). A long time ago, before Christ, monarchs tried with commands, rigorous punishments to prohibit drinking alcohol. Before three thousands years king of Sparta issued a command that drunkard legs should be cut, so they could not done any adversity. In Roma's empire by the low was forbidden alcohol drinking for people younger than 30, because they thought that it were the best years for making a family and progeny, and that it represents a limit for psychical and emotional development.

Car Dusan in his famous legal code regulated how they have to punish a drunkard: “If drunkard injures someone, or shear, but not kill, that drunkard's eyes should be pulled out and hand cut off, if in drunken condition he doesn't strip something or put down the hat, or do some other disgrace, but without blood, they should hit him with 100 sticks and close him in the cell, let him from the cell and hit him again and then let him go…”.

It is believed that drinking of Serbian soldiers, night before the Maricka battle with Turkish in 1371, was the basic reason for defeat.

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Spreading and statistics

Alcoholism is disease which appears in every climate, extended all over the world. It is considered as disease No. 3 of the modern world (after cardiovascular disease and Ca). According to estimations of World Health Organization (WHO), 3% of population is diseased of this sickness. However this number has to be multiplied with 3, because every drunkard imperils the life of at least three people around him.

Especially have to be pointed out that and alcoholism at women is in increase and that relation is 1:3 last few years, certainly on three men is one woman.

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Influence of misusage alcohol on human organism

Development of alcoholism and addiction

Disease begins slowly, sneaking, so called perfidious and passing through a few phases:

  • Initiation
  • Intensification
  • Try to win the addiction
  • Salvation.

Start of drinking alcohol is link with ritual drinking in family, in peer group, different celebrations, stress situations and social is not accommodation. Drinking alcohol in this phase has a form of social accepted drinking, and like that is unobtrusive. A lot of them don't pas in second phase.

More factors decision that one person pass in intensification phase, dependence phase, at firs place psychological state, alcohol effect on person as pharmacology alcohol effects. Factor which is very important for incoming in the phase of addiction is change in manner of drinking, exactly in giving more importance on drinking alcohol than on the other forms, whish had more values early. Person, already drunker, doesn't recognition his dependence and think that he is as “someone who like to drink”. It is hard to find a limit in that period between periodically drinking which is social excepted and occasionally drinking with desire “that make les worry and tension of that day”. More frequent drinking leads to special attitude about drinking. That moment when person feel relation between drinking and subjective state (happiness, reprieve) is made first link of psychical addiction.

In this phase important characteristic are:

  • Developed desire for drinking
  • Tendency for doze addition (raise tolerant)
  • Psychical dependence
  • Absent of physical dependence, without abstinence syndrome
  • Influences of harmful alcohol effects on person (health, social and professional plan)
  • Made heavy control on behavior for taking alcohol in sense of start and the and of drinking
  • Continue to drink in spite of unpleasant experiences (intoxication, spewing, aggressive behavior).

In this cases a person is liable, as and his around, to disregard experience, to cancel a problem and toward every next drinking he thinks this time will not be the same. Sometimes, but very frequently in this phase, a person locates a test to itself that doesn't drink in definite situation, or to drink less than in otherwise case in order to convince itself or the other that it is not dependence. This is mesh, because this is world about compulsive control on drinking and behavior, what is possible to do because he knows that he will drink next time in unlimited quantity.

Toxically phase are characterized as psychic and physical dependence:

  • Loosing drinking control
  • Alcohol amnesia
  • Abstinence impossibility
  • Tolerance degradation.

Physical dependence doesn't have directly appearance, when it comes in toxically phase, but it is linked with abstinence impossibility for existing abstinence syndrome (perspiration, tired, alcohol thirsty, perform impossibility till he drinks his dose). Following symptoms are:

  • Making drink reserve
  • Drinking /and/ at home (sole drunker)
  • Drinking in the morning
  • Drinking overloading
  • Neglecting regularly eating
  • Minimizing drinking, rationalization.

Retreating and personal isolation are accented. The centre of all drunker activities is alcohol. He more thinks on that how the other activities d not allow him to drink with people from the more ignoble level in society (the case with doctors, teachers, and public persons)

Drunker slow down more and more perturbing his health, but he entails with himself and the other members of family.

Physiological consequences

Body consequences issue from drinking long years ago and appearance in toxically phase. All organs in organism have disturbance function, reversible or irreversible. The level of health disturbances is in the dependence with personal predisposition for some diseases, the term of alcoholism duration, kind of alcohol. Some health consequences can be sanitized by abstinence and added medicament therapy, while some of those are persistent and can make invalidity or seriously endanger life.

Digestive system (boiling organs) gullet, belly, bowels, liver is disturbance of toxically alcohol effects and metabolic mutations, so here appearance gullet blooding, gastritis with symptoms of spewing and pains in belly. Damages of mucous membrane of bowels give diabetes. Liver can be multiplied in first stadium, than pass in cirrhosis and giving to hardly metabolic changes, water accumulating in abdomen and legs swelling.

Heart muscle is very sensible on toxically alcohol effects, and becoming tachycardia, arrhythmia, and flux disturbance coming in angina pectoris or infarction.

Especially is important accidence of central nerve system, as and periphery. Nerve cells are very sensible and tolerate irreversible changes, so and functional accidences are particular or utter. Those damages issue by toxically alcohol effects or of not enough introducing vitamin B in organism, and those introduced are hardly absorbed because stomach mucous membrane are damaged. Drinkers loosing concentrate, attention, have hardly memory and reproduction of learnt materials. By the time brain age faster than what would be normal by his age.

It is important to say that is often came and to epileptic attack, by the less alcohol level in blood and most frequently is introduce for delirium.

Damaging of periphery nerves give a symptoms through rubbing hands and legs, especially in the morning, but which passing taking new quality of alcohol. Patient walk is recognized by the little or more outspreading legs. Those are all clinical signs of alcoholic poly-neuropathies.

Psychiatric consequences

Psychiatric consequences of alcoholism are deliriums, and the most frequent ones are:

  • Delirium tremens, with visible hallucinations (“hearing the wall”, “seeing the air”), with expressed fear and visible psychomotor disturbance. It penetrates through medicament therapy in hospital conditions, and very rarely have deadly epilogue. Alcoholic jealousy, when drinker in alcoholically state does a jealous scene and starts to follow his partner, checks him and psychically and physically abuse him/her.
  • Especially there has to be noticed consequences which are sighed as alcoholically behavior, with repercussion on family and wider social surroundings. In the period of alcoholic probation or disease development, there is changing of entire mental functions – some psychical function (memory, opinion, notion, attention, will) so as and integrative possibility. Towards life's happenings they are passive. Insight of consequences is insufficient or almost does not exist, as and possibility of separation deeply disturbances at himself and interpersonally relation.
  • At drinkers is noticed deficit in functioning of super-ego, so that is control of interval feelings weak, than here not exist control under vexation, rage. Very often they transmit guilt on somebody else and have wide diapason of behavior, especially toward close person and emotionally needs, interval conflicts and mechanism of defend somebody else. Drinkers are manipulators, chameleons. They are system controllers (family, work area and widely socially area) who support them with their own behavior. Their manipulations, aggressions, promises, remorse are attacks on the other tries to change existing relations and conditions in system functioning. He with himself manipulative techniques press any try of changing, because only that kind of system giving him opportunity to drink.

Character changing which are visible at drinkers:

  • Mendacity.
  • Irresponsibility toward himself and the others. No one can expect liability. Love to promises but not to accomplish them, by which he makes feeling at himself of self-confidence.
  • Discrepancy, not have attitude for anything, can not be coherent for his decision, yet change it by situation and in dependence of psychoactive state.
  • Missing self-discipline, can not to go to the end of his work, very often pass up, respite “for some another time”, and often can not to reduce himself to start a job, when he uses a role of rationalizations (it rains, women angry me, has headache).
  • Egoism, when he is occupied only with his needs (which are on the least level) and doesn't have any sensibility for needs of his family members. He is central person when drinks and not, and with different techniques he successfully receives attention from the others, and when he wants that they live him alone.
  • Duplicity, drinker often introduces himself like another person, as he thinks that the other expect. He have behavior with manners, with a lot of phrases, but inside himself he is empty (emotionally and cognitive).