Hard drinking – alcohol intake within a day and more at development of the expressed alcoholic intoxication. Develops at alcoholism. The average duration of hard drinking makes 3-10 days, hard drinkings by duration about one month and more are sometimes observed. Reception of alcoholic drinks is followed by denial of a problem and development of a depression. The refusal of work, decrease or loss of appetite, neglect as rules of hygiene etc. is possible. The exacerbation of somatic pathology and the general fatigue of an organism becomes the reason of the termination of alcohol intake at late stages of alcoholism. At sharp cancellation psychoses quite often develop.
Hard drinking – the use of a large amount of alcohol within a day and more. Single short hard drinkings can arise at the people who do not have alcoholism or being in a stage of a prodrom. Holidays or attempt to remove stress which arose owing to a heavy or long stress can become the reason. However in most cases hard drinkings are observed at alcoholics. In process of deepening of alcoholism increase in duration and weight of hard drinkings is traced, the probability of development alcoholic a deliriya and exacerbations of chronic diseases increases.
Hard drinkings – one of the most characteristic symptoms of alcoholism. They are a part of a vicious circle of which it is very difficult to get out without the assistance of the narcologist. These states are followed by heavy intoxication of an organism. They often become the reason of truancies, the subsequent dismissal and loss of the social status which the accelerating degradation follows. Treatment is carried out by experts in the field of narcology. Home visiting service, therapy in out-patient or stationary conditions is possible.
Classification of hard drinkings
In domestic medical literature the concepts "false hard drinking" (pseudo-hard drinking) and "true hard drinking" often meet. Mean cases when duration of reception of alcohol does not exceed 7-10 days by pseudo-hard drinking. The patient usually stops alcohol intake in connection with external circumstances (need to come to work or to solve the collected household problems, obligations in relation to family members etc.). Besides, the fatigue which is not reaching exhaustion degree can become the exit reason from false hard drinking.
True hard drinking usually lasts not less than 2 weeks, sometimes its duration makes several months. The patient stops alcohol intake because of the expressed organism poisoning (a situation when the person physically cannot drink more). Other reasons, including need to go to work, to be engaged in life, to fulfill any obligations in relation to people around and even to respect the elementary hygienic rules during this period become insignificant. All interests of the alcoholic concentrate around reception of alcohol.
Despite some distinctions between false and true hard drinkings there is now a point of view according to which it is necessary to recognize such division illegal. First, polar options of true and false hard drinkings meet rather seldom. Usually at the same patient mixture of two types of hard drinkings with prevalence of one option is observed. Secondly, both kinds of hard drinkings are caused by the same mechanism – they arise owing to the increased emission of catecholamines which action the patient neutralizes, taking alcoholic drinks.
From this position all hard drinkings, regardless of their duration, are considered as the same pathological state. Safety of natural protective and compensatory mechanisms is the reason of short duration of hard drinkings at the II stage of alcoholism. In process of progressing of alcoholism these mechanisms gradually weaken, and duration of hard drinkings increases. Gradual change of a clinical picture is also connected with decrease in tolerance to alcohol, the progressing mental degradation and change of the identity of the patient.
Both for short-term, and insuperable thirst for alcohol is characteristic of long-term hard drinkings. At emergence of the first signs of sobering up the patient feels requirement not simply "a little to drink", and to accept the intoxicating amount of alcohol. Thirst for alcohol impetuous, uncontrollable. Episodes of relative sobering up are so short that this period of time is enough only for search of a new portion of alcohol. As a result the abstinence syndrome does not manage to develop, abstinency symptoms practically do not disturb the patient before the termination of reception of alcohol.
Short-term hard drinkings
Short-term hard drinkings can arise incidentally in the period of a prodrom and at the I stage of alcoholism. At the II stage they become regular. Their duration usually does not exceed 2-3 days, hard drinkings lasting 5-7 days are less often observed. As a rule, the beginning of the use of alcohol (at least formally) is connected with some event as the patient still needs justifications of the alcoholism. The holiday, a meeting of friends, a trip on rest, a stress at work or in a family etc. can become an occasion.
Widespread option is alcoholism on days off. On Friday the patient drinks, motivating alcohol intake with need to relax after difficult working week. On Saturday and Sunday he tries to help with wineache to get rid of displays of an abstinence syndrome, however uncontrollable thirst for alcohol pushes it on the use of a high dose of alcohol. On Sunday evening the patient forcedly stops drinking, on Monday suffers from abstinency.
So can proceed for years, at the same time patients do not consider themselves alcoholics as they manage to keep work and the habitual social status. They consider ability to stop drinking before work how confirmation of an opportunity to control alcohol intake. Meanwhile, alcoholism gradually progresses. After a while duration of hard drinkings increases, the patient begins to take alcohol not only during week-end, but also on weekdays. Sooner or later there comes the moment when because of long hard drinking he simply does not come to work.
Short-term hard drinking can be interrupted rather easily. Except appearance at work scandal with the wife, complaints of neighbors, shortage of money for alcohol, the district police officer's visit etc. can become the reason of the termination of alcohol intake. For the patient such intervention looks as attempt "to spoil a holiday". Alcohol cancellation usually is followed by sharp deterioration in mood. The patient splashes out the discontent on people around (usually on family members), however quickly enough cools down.
Short-term hard drinkings alternate with episodes of the single use of alcohol with an opokhmeleniye or without opokhmeleniye (depending on external conditions). The abstinence syndrome is expressed moderately, for elimination of the main manifestations it is enough to patients to freshen the nip a small amount of alcohol. The amount of the alcohol drunk in the course of hard drinkings and one-day excesses can significantly vary. Duration of the periods of sobriety is defined by living conditions of the patient: quantity of cash, schedule of work etc.
Long hard drinkings
At the II stage of alcoholism tolerance to alcohol increases and over time reaches "plateau". At this stage the amount of alcohol gradually increases, hard drinkings become longer and 1-3 weeks proceed. Reduction of duration of "the sober periods" is noted, frequency of hard drinkings becomes more expressed. Each reception of alcoholic drinks passes into hard drinking, single excesses and usual alcoholism with an opokhmeleniye the next morning disappear. During hard drinking the patient takes alcohol rather evenly.
The quantity drunk per day usually fluctuates within 0,8-1,5 liters of vodka, in certain cases patients daily drink up to 2-3 liters. Thirst for alcohol is so strong that forces the patient to wake up at night to accept a new dose. Quality of alcohol becomes unimportant, patients are ready to use "everything that burns", including cologne, technical liquids, any spirit tinctures for medical (including external) applications.
All the rest becomes insignificant. Patients cease to go to work, do not leave the house while in it there is an alcohol, do not wash, have not a shave, can sleep, without undressing etc. They not only spend for alcohol the money saved on food, payment of the apartment or need of children but also sell things and jewelry to get still a portion of alcohol. Patients do not need to look for reasons for a justification of own actions any more – the need for alcohol becomes so significant that other requirements in comparison with it seem unimportant or at all far-fetched.
If at a stage of short-term hard drinkings patients drank "for pleasure", then now to the forefront there is a physical dependence. Patients do not consider the use of alcohol as a holiday any more. On the contrary, they can be oppressed, suppressed and slowed down. The phenomena of an abstinence syndrome become more and more bright and finally are not eliminated even at reception of a large amount of alcohol. Patients drink not for achievement of a condition of euphoria, and for relief of physical and mental sufferings.
Organism intoxication alcohol disintegration products gradually amplifies. The quantity of drunk decreases. Sleep disorders progress. In the beginning the dream becomes superficial, unstable, the patient manages to fall asleep only after the use of a high dose of alcohol. By the end of hard drinking sleeplessness develops. Even in state of intoxication of the patient only for a while "fails" in the short-term dream accompanied with nightmares. At the time of falling asleep and awakening there are hallucinations in the form of sketchy phrases, automobile beeps, calls and other noise.
Vestibular violations in the form of feeling of fall or falling are possible. Affective frustration are observed. The patient feels concern, alarm and fear, suffers from fault and repentance. Quite often alcoholic depressions develop. Mental violations are combined with the progressing motive and somatovegetativny frustration. Nausea, lack of appetite, vomiting and violations of a chair is observed. There can be pains in epigastralny area and the right podreberye and also surrounding pains in the top part of a stomach.
Motive violations come to light: instability of gait, static ataxy, trembling of extremities, century and language. Violations from cardiovascular system are noted: increase of pulse and unstable arterial pressure with a tendency to increase. Some patients have an arrhythmia and heartaches. Because of decrease in tolerance of alcohol the patient takes alcohol in small amounts and gradually leaves hard drinking through "nursing". Within several days the adynamy remains, the patient can have disgust for alcohol. At sharp cancellation the probability of development alcoholic a deliriya increases.
Gradually disgust dies away, thirst for alcohol becomes more and more intolerable. The patient tries to abstain from the use as he knows that even a small amount of alcohol will become the beginning of new hard drinking. After a while there occurs failure, and the cycle is repeated. Duration of the mezhzapoyny period fluctuates from several days to several months. Neither the patient, nor people surrounding it can precisely predict the moment of the next failure. It is only possible to consider circumstances which it is for certain pushed the patient to alcohol intake, and whenever possible to try to prevent them, however it is the temporary measure which is not solving an alcoholism problem.
Sometimes patients during all hard drinking keep rather high resistance to alcohol. Displays of an abstinence syndrome do not accrue. Patients take alcohol several times a day and at the same time keep working capacity. This form of hard drinkings reminds continuous alcoholism, but differs from it in a certain frequency. In several months somatovegetativny frustration appear. The progressing adynamy is noted, there is a depression. As a result patients stop reception of alcohol for some time.
Treatment of hard drinking
Depending on a condition of the patient perhaps both removal from hard drinking at home, and hospitalization. Removal from hard drinking in house conditions is allowed at the II stage of alcoholism, short-term hard drinking and lack of signs of gross violations of activity of internals. At the long continuous use of alcohol, a heavy abstinence syndrome and rough somatovegetativny frustration hospitalization in a narcological hospital is shown. There are several schemes of treatment: standard clarification of an organism, double clarification of an organism, deep clarification of an organism and bystry sobering. The choice of the scheme of treatment is carried out by the narcologist.
For restoration of water-salt exchange and acid-base balance intravenously kapelno enter salt solutions. Apply glucose solution to improvement of food of a brain. Orally appoint enterosorbents – medicines which connect to alcohol in intestines and interfere with ethanol absorption. Use B1 and B6 vitamins, ascorbic acid, nootropa, somnolent and soothing medicines. If necessary carry out treatment of somatic pathology.
The forecast at hard drinkings
The forecast depends on duration and weight of hard drinking, a stage of alcoholism, a mental and physical condition of the patient. Exacerbations of chronic somatic diseases are possible. During the termination of the use of alcohol the probability of development of strokes and heart attacks increases. Alcoholic depressions are quite often observed. One of the most serious complications is alcoholic deliriya at which the lethal outcome, harming itself or to people around is possible.
Treatment of hard drinking is an emergency measure. It is necessary to fight against the problem prime cause – alcoholism, otherwise hard drinkings will be aggravated, doing more and more harm to the patient's organism. There is a set of techniques of treatment of alcoholism: installation of the coding implant, gipnosuggestivny therapy, drug treatment with provocation, coding across Dovzhenko etc. After elimination of the phenomena of an abstinence syndrome it is necessary to address the narcologist who will pick up the scheme of therapy best suitable for the specific patient.