1ST CITY CLINICAL HOSPITAL

Prevention of alcoholism

11.07.2024

1.NORM? 

There is no norm! At all! People make it up themselves. People who have no problems with alcohol are very proud of the norm. People who realize that something is wrong with alcohol, as before, with the best intentions for themselves, with a persistence that irritates their loved ones, proudly talk about their norm.

All people without exception have a prerequisite to become an alcoholic. All of them! Exactly! We are sure! What prerequisite? Biological!

Alcohol, like all spirits, is poisonous! "Fortunately" in terms of toxicity, of all spirits it (ethyl alcohol) is the safest both in terms of the direct toxic effect of ethyl alcohol on the body's cells and in terms of the toxic effect of decay products (acetic aldehyde).

Alcohol is not a fracture/bruise/tumor, not a virus or a microbe - it is different, there are no antibiotics or antiviral drugs for it, and even more so, it is impossible to operate on and remove it.

The liver works constantly, cleanses the blood. Everything a person eats/drinks passes through the liver. The liver rests/recovers when a person eats healthy food. And when a person drinks alcohol, the liver works to the point of wear and tear. Only, fortunately for people, wear and tear does not occur immediately, the liver has enough strength to last at least several years (or even decades), but not everyone is lucky.

One standard glass of beer (250 ml), dry wine (100 ml) or a small shot of spirits (35 ml) contains approximately the same amount of alcohol (12 to 15 grams of pure alcohol), called a standard unit. 1 standard unit of alcohol is processed by a healthy body (read - liver) in 1 hour without consequences. The liver works and "trains" in detoxifying alcohol.

To prevent the development of addiction to alcohol, a healthy person is not recommended to drink alcohol every day, even within 1-2 units. The liver works and "trains" to break down alcohol faster.

• 2 standard units of alcohol usually do no harm, however, if you start to feel uneasy after a few days without drinking, then this is a WARNING SIGNAL.

If you drink alcohol regularly, your body gets used to it. If you stop drinking for a few days, your body starts to "protest": you feel unwell, you are restless or irritable, you may get a headache, insomnia, fear, sweating, chills or palpitations.

Addiction treatment experts call this alcohol withdrawal syndrome or abstinence syndrome.

If you constantly need to drink to feel better or to cope with certain situations, then there is a high probability that you have developed an addiction to alcohol consumption. Drinking begins to control your life. In this case, you will no longer be able to independently reduce the amount of alcohol you drink or stop drinking it completely.

SO THERE IS NO NORM!

2. WHAT IS ALCOHOL ADDICTION?

In the society we live in, the biological approach to medicine prevails - doctors continue to treat the disease, forgetting that it is necessary to treat the person.

The mentioned biological approach had a long-term success in medicine since the middle of the 20th century, when the overwhelming majority of diseases that people suffered from were caused by microbial infections. Medical drugs (antibiotics, antipyretics, painkillers) only strengthened people's belief that the disease can be treated even without the patient's participation.

Unfortunately, the attempt to transfer such ideas to the field of mental health is doomed to failure. Treating alcoholism by secretly adding drugs does not achieve the goal.

Alcohol addiction is a health disorder that affects three areas of a person’s life: social, mental (behavioral), and biological – in that order.

First, changes occur in the social sphere, this is the family and relationships with loved ones, which are manifested by emotional tension among family members, conflicts (up to divorce), neglect of children, violence and assault, spending time with people who regularly drink alcohol. Problems with employment (education) appear: absenteeism or skipping work, classes, accidents at work, sudden decline in school performance or leaving school, illegal trade, theft. The emergence of financial problems (debt and borrowing money) is discovered unexpectedly by many problem drinkers.

Almost simultaneously with changes in the social sphere, changes in the mental (behavioural) sphere of a person’s life are added: depression, anxiety, sudden unexplained mood swings, unreliability, memory loss, paranoia, and lying.

Biological changes manifest themselves in a person after six months to a year of alcohol abuse: visits to doctors about high blood pressure, abdominal pain, weakness, vague physical complaints, unexpected injuries and abrasions, nausea, headaches, insomnia, decreased potency, palpitations.

For several years, a person may not pay attention to this, but relatives see problematic relationships, difficulties at work, and changes in behavior. But a person keeps silent about physical discomfort until the very end (as practice shows - until an ambulance is called, when not even a doctor, but a paramedic of the ambulance team immediately says - "You need to drink less!").

There is a fairly simple way to determine whether a person has problems with alcohol. The test is so accessible that sometimes even doctors smile at its simplicity (the test is based on the CAGE screening questionnaire, which was adapted for Russian-speaking patients).

Here are the questions in this test:

• Have you ever tried to quit drinking?
• Does it irritate you when people ask about your drinking habits?
• Do you feel guilty about the way you drink?
• Have you ever had a hangover in the morning?

Evaluation of survey results (non-verbal reactions to questions (body language) are also taken into account):

1. A positive answer to any of these questions indicates a risk of alcohol problems; 
2. a positive answer to two or three questions indicates that the patient has problems with alcohol consumption; 
3. four positive answers indicate a high probability of alcohol dependence; 
4. all answers are negative - there are no problems with alcohol, or the person is being disingenuous.

The patient urgently needs to consult a narcologist if the answer to even one of the questions is positive.

3. WHO WILL HELP?

Consult a specialist in addiction treatment, i.e. a narcologist - in Minsk it is very easy to do: in the state healthcare institution "Minsk City Clinical Narcological Center" there is a 24-hour single telephone number for the Minsk narcological service (phones: 183, +37517 3570909, +37529 1490909, website www.gknd.by ) - call and make an appointment for a consultation with a narcologist.

The Minsk City Clinical Narcological Center has all the conditions (inpatient, semi-inpatient, outpatient) for medical prevention and staged treatment of consumers of alcohol and psychoactive substances:

• stage, diagnostic (from 1 to 5 days) - is carried out on an outpatient basis in 33 drug treatment rooms (20 for alcohol consumers, 9 for teenagers, 4 for drug users); in day care departments; in inpatient settings; 
• stage, stopping the use of psychoactive substances (detoxification, “breaking a drinking binge”) - is carried out on an outpatient basis, in day care departments, inpatiently, the stage takes from 5 days (in mild cases) to 1 month (in severe cases); 
• stage, maintenance treatment - aimed at stopping the craving ("craving") for alcohol, a psychoactive substance, is carried out on an outpatient basis and in day care departments, can last from 1 to 6 months; 
• th stage, medical rehabilitation and psychological rehabilitation - is carried out inpatient in the rehabilitation departments (the programs "Formula of Life", "Krok") and outpatient in the day care department (the long-term medical rehabilitation program - "Amethyst"). Duration of inpatient rehabilitation: a course of 28 days. Duration of long-term medical rehabilitation: 11 months. 
• stage, post-rehabilitation support - stabilization of abstinence, resocialization. Carried out on an outpatient basis. Duration: from 1 year to 3 years. It is advisable to undergo it for a year after completing stage 4.