Beer alcoholism – the kind of alcoholism which is followed by pathological addiction to beer. It is shown by the constant use of high doses of this drink, increase in tolerance to alcohol, inability to control time of the reception and quantity drunk, the abstinence syndrome and other symptoms characteristic of alcoholic dependence. Distinctive features are insignificant expressiveness of "fight of motives" and late development of psychopathological symptoms. The diagnosis "beer alcoholism" is established by the narcologist on the basis of a conversation with the patient and his relatives. Treatment – medicamentous or non-drug coding, psychotherapy, symptomatic therapy.
Beer alcoholism – the informal term. This category is absent in MKB-10, does not admit most of foreign narcologists and cannot be considered as the official diagnosis. Nevertheless, some Russian experts insist that addiction to beer should be considered as the separate form of alcoholism having a number of differences from other types of alcoholic dependence. Availability, low content of alcohol, preservation of working capacity and lack of rough changes of behavior after reception of drink lead to the fact that a considerable part of the population does not take possible negative consequences of abuse into consideration. As a result early stages of beer alcoholism remain unnoticed for the patient and his relatives. Beer teenagers abuse more often that becomes the reason of bystry formation of dependence with the subsequent transition to more hard liquors. Exact prevalence of pathology is unknown.
Reasons of beer alcoholism
In general the etiology of this kind of alcoholism is similar to the reasons of development of other types of alcoholic dependence. At the same time, there are differences connected with seeming "safety" of beer, in particular – the frequent beginning of the use at early age (sometimes – from approval or with the connivance of parents), tolerance from society and advertizing influence. The Russian narcologists specializing in this problem allocate the following leading etiofaktor of developing of beer alcoholism:
- Family predisposition. Presence of the relatives having alcoholism or mental diseases creates an adverse situation in a family, promotes development of pathological patterns of behavior. Influence of the hereditary features of a metabolism promoting bystry accustoming to alcohol is not excluded.
- Defects of education. Beer alcoholism arises more often at people who were brought up by the despotic or hyper sponsoring parents, suffered from the sharp or chronic psychoinjuring influences. Dissatisfaction with close relations, violations of adaptation in society, the staticized traumatic experiences becomes the reason of the use.
- Personal features. A disease persons with hysterical, unstable and excitable traits of character or aktsentuation have more often. Especially adverse course of beer alcoholism is noted at a combination of these lines that is caused by more expressed self-control violations.
- Asteniziruyushchy factors. Dependence on beer quite often arises in the period of prolonged stresses and is long not allowed psychoinjuring situations. The risk of development of alcoholism increases at chronic somatic diseases, at a stage of recovering from injuries and infectious diseases, in the presence of not alcoholic intoxications (for example, toxicomanias).
- Features of microsociety. The approving relation to the use of beer in a family, group of friends or labor collective involves increase in frequency and doses of alcohol intake, especially – at psychological infantility, tendency to the conducted and dependent behavior.
Violation of regulation of neurotransmitters in a brain is the cornerstone of the mechanism of development of beer alcoholism. Alcohol intake provokes the forced emission of dopamine and noradrenaline which is characterized by some arousing, emergence of pleasant emotions, feeling of pleasure. The constant use of high doses of beer becomes the reason of exhaustion of regulatory mechanisms, permanent decrease in level of noradrenaline and dopamine which is followed by deterioration in working capacity and mood. Reception of alcoholic drink only for a short time stimulates increase in level of neurotransmitters that induces the patient to increase a dose drunk and the frequency of reception. There is a vicious circle involving progressing of a disease. Patients long do not attach significance to increase in a dose of alcohol therefore beer alcoholism often comes to light only at late stages.
The majority of classifications of alcoholic dependence includes three stages, however modern narcologists specify that such division insufficiently fully reflects dynamics of changes at this pathology. In this regard the leading Russian experts in the field of studying of beer alcoholism (A. A. Kovalyov, A.S. Okhapkin) in the works use expanded classification of N. N. Ivants which consists of the following stages:
- I – increase in frequency of reception and increase of a single dose of alcohol is noted. Duration of alcoholic excesses usually does not exceed one day.
- Transitional I-II – observe decrease in control over quantity of drunk. A push to start an alcoholic excess is the external reason (birthday, a pay and so forth). Pseudo-hard drinkings prevail.
- II – the use of beer becomes daily or almost daily. Significant increase in tolerance comes to light.
- Transitional II-III – against the background of the constant use arise true hard drinkings. There are first signs of alcoholic degradation.
- III – note prevalence of a zapoyny form of beer alcoholism. Degradation accrues, the patopsikhologichesky symptomatology joins.
Taking into account a progrediyentnost distinguish three options of alcoholism: slowly progressing, moderately progressing and fast-progressing. Depending on prevalence of this or that form of the use allocate a constant (the daily use prevails), periodic (false and true hard drinkings are observed) and mixed (hard drinkings are replaced by daily alcohol intake) disease forms.
Symptoms of beer alcoholism
Typical lines of dependence are the early beginning, expressiveness and constant character of a pathological inclination to alcohol at insignificant intensity or total absence of "fight of motives". The first reception of drink often happens aged up to 15 years. Many patients begin to abuse beer during study in the highest or average educational institution (for comparison – beer alcoholism among students meets by 8 times more often of the dependence caused by reception of hard alcoholic drinks).
At an initial stage motive for the use usually is desire to reduce stress level, to improve mood, to eliminate psychological discomfort. The special relation to beer, as to the drink capable to regulate psychological state is quickly formed. Patients become initiators of feasts. Intoxication is followed by relaxation and some euphoria. At frequent reception the dose increases quickly, noted decrease in situational and quantitative control. Upon transition from I to the II stage beer alcoholism there are first unsharply expressed changes of the personality which are characterized by a point of premorbidny lines.
At the II stage decrease in resistance to various irritants is observed, the pathological inclination appears at any discomfort, duration of the continuous use increases up to several days. Because of loss of control of the quantity drunk and time of reception the conflicts in a family and at work develop. In a condition of sobriety affective and vegetative violations are formed. The melancholy, uneasiness, irritability, a dysphoria, frustration of a dream, the increased perspiration, unpleasant feelings in a stomach can come to light. Working capacity decreases. The abstinence syndrome with prevalence of vegetative, neurologic and somatic symptomatology is found. The amount of beer necessary for achievement of state of intoxication increases at 5-10 times in comparison with initial figures.
Long safety of memory, intellectual and moral and ethical personal features is considered characteristic feature of beer alcoholism. Strong indications of degradation are found only at the III stage. Pseudo-hard drinkings are replaced by true hard drinkings. The clinical picture of an abstinence syndrome is supplemented with psychopathological manifestations, at some patients ipokhondrichesky, fobichesky, obsessivny frustration develop. Ability of strong-willed control over time of alcohol intake is completely lost, as the only limiter ipokhondrichesky experiences in combination with the real somatic pathology which is followed by burdensome feelings from vitals act.
For beer alcoholism typically early development of somatic violations, including – fatty dystrophy of a liver and increase HELL, in the subsequent replaced by a persistent arterial hypertension. Expansion of borders and a thickening of walls of heart, reduction of mitochondrions and formation of sites of a necrosis in a myocardium is observed. Various sexual frustration, endocrine violations, muscular dystrophy, increase or (more rare) decrease in body weight are noted. The risk of developing of varicosity of veins of the lower extremities, formations of teleangiektaziya increases. Dependence between regular reception of considerable doses of beer, mental and neurologic violations is confirmed. Patients complain of headaches, a tremor, an insomniya, according to MRT damage of tissues of brain in the form of the central miyelinoliz (death of myelin covers of nervous cages) is found.
The diagnosis is established by the expert in the field of narcology on the basis of symptoms and results of laboratory analyses, at the same time a basis for detection of beer alcoholism are always clinical symptoms of a disease, and additional researches are considered only as auxiliary techniques. Dependence is stated at detection of the following signs: high subjective importance of beer in the patient's life, loss of quantitative and situational control, emergence of a syndrome of cancellation at the use termination is more unseemly. In the course of diagnostics the following methods are applied:
- Conversation with the narcologist. The doctor finds out complaints, specifies the abuse duration, habitual doses of alcohol, a circumstance and duration of alcoholic excesses, existence of characteristic somatic diseases, family and social problems. Poll can individually be carried out or with participation of relatives of the patient.
- Special tests. Are addition to poll and collecting the anamnesis of patients with beer alcoholism. Include "The Michigan test for alcoholism" and the standardized poll for preliminary detection of alcoholic dependence.
- Laboratory researches. In biochemical blood test increase in level of enzymes (alcohol dehydrogenase, nuclear heating plant, ALT, GGT), changes of exchange of lipids (cholesterol, triglycerides, LPVP) and deficiency of minerals comes to light. In the general blood test anemia, thrombocytopenia, change of morphological properties of erythrocytes is found. There are techniques based on assessment of level of immunoglobulins and autoantitet to glutamate receptors.
According to indications consultations of experts of various profile are appointed: therapist, neurologist, cardiologist, gastroenterologist, hepatologist, endocrinologist. The list of tool procedures is defined by the revealed therapeutic pathology, can include ultrasonography of abdominal organs, the ECG, an echocardiography, brain MRT, functional techniques for assessment of a condition of nervous system, etc.
Treatment of beer alcoholism
Treatment of dependence on beer is carried out in the state and private narcological clinics, carried out in a planned or emergency order. During the emergency procedures (a detoxication, removal from hard drinking) perform infusional therapy, enter vitamins, minerals, means for correction of work of internals. When holding planned actions use:
- Medicamentous therapy. There is a set of the medicines causing intolerance of alcohol. Medicines are entered parenterally or sewed under skin, provide sharply expressed negative reaction of an organism to reception of beer and other alcoholic drinks during certain time (from several months to several years).
- Non-drug coding. Along with medicamentous influence in treatment of beer alcoholism apply non-drug (across Dovzhenko, with use gipnosuggestivny the technician). The combination of medicamentous and non-drug techniques is possible.
- Psychotherapy. Use cognitive and behavioral psychotherapy, psychoanalytic and other methods. Reveal and study the problems which are the cornerstone of beer alcoholism, make correction of beliefs, help to resolve family difficulties. Both individual work, and family or group therapy is possible.
Taking into account disease severity treatment is carried out on an outpatient basis or in stationary conditions. The listed techniques if necessary supplement with the actions directed to improvement of work of various bodies and systems. After a basic course carry out social rehabilitation. The good effect renders participation in groups of the anonymous alcoholics based on the principles of mutual aid.
Forecast and prevention
The forecast at beer alcoholism is defined by duration and features of reception of beer, and also personal lines of the patient. At the initial stages chances of treatment are rather high. In the subsequent the probability of recovery decreases, especially – at the intensive use, bystry increase in a dose, existence of unstable or excitable traits of character. On average the pathological inclination remains within 3-4 months after completion of therapy. For a year the adynamy phenomena can be observed. Prevention consists in formation of the correct installations in children's and teenage age, creation of the favorable family atmosphere reasonable for the organization of a work-rest schedule, the timely address to the psychologist at emergence of signs of psychological trouble.