Alcohol addiction: stages, treatment, pills

Signs and symptoms

You can often hear the words from the mouth of a person who drinks alcohol: “I’m not an alcoholic.” This phrase is a favorite among addicts. Alcoholics very rarely admit that they are sick. They usually believe that they can stop drinking strong drinks at any time without outside help, but in reality everything is different.

There are main signs and symptoms that indicate the presence of alcohol dependence:

• Irresistible craving for alcoholic drinks. A person cannot spend a certain number of days without alcohol; with long-term addiction, this period of time becomes shorter. It doesn’t make much difference to the patient what to drink, the main thing is that the drink contains a degree. And here, in particular, the frequency of use matters rather than the quantity
• Stress and fatigue are relieved only by alcoholic drinks. The most interesting thing is that a person even drinks in case of positive stress, when a certain pleasant event occurs. A person begins to reach for alcohol in both joyful and sad moments of life. The stronger the addiction, the easier it is for an alcoholic to find a reason to drink.
• Losing the ability to refuse an offer to drink. Lack of sense of proportion when drinking alcoholic beverages
• Work, family and previous hobbies fade into the background. The addict is only interested in everything related to the opportunity to drink alcohol
• Changes in interests and social circle. It becomes simply no longer interesting to contact family and friends; people who are always ready to join in for a drink are much closer
• Memory problems. Short-term failures, after sobering up a person will not be able to remember everything that happened yesterday while intoxicated
• Loss of control over emotions and behavior. Manifestation of causeless aggression or, on the contrary, fun.
• No hangover symptoms. This symptom appears at the last stage of addiction, when the body stops fighting ethanol.

The manifestation of the above signs, even some of them, indicates the formation of addiction.

Symptoms of female alcoholism

The symptoms of alcoholism differ in women and men. Society frowns upon female drunkenness. When men openly drink at home or at holiday office parties, women do it quietly so as not to cause rumors or condemnation. Alcohol addiction sharply increases the risk of losing your job, your beloved husband, and connections with your family. Therefore, women do not even try to talk about their addiction to someone around them, for fear of encountering misunderstanding and negativity. Anonymous treatment for alcoholism is ideal for them: strangers, work colleagues or neighbors will not know about their visit to a narcologist or stay in the clinic.

Gradually, drinking a glass of vodka or wine after work is becoming the norm. And relatives do not even notice the first signs of alcoholism in a woman:

• suddenly increased interest in feasts, corporate events, meetings with friends;
• often unreasonably high spirits;
• decreased interest in personal care, appearance of disheveled hair, unkempt appearance;
• attempts to mask the smell of alcohol using chewing gum, candy, and perfume;
• change in voice (it becomes rougher);
• the appearance of nervousness, emotional imbalance.

At the first stage of alcoholism, there are no signs of pathology noticeable to others. A woman shows tolerance to drinking alcohol, drinks alone or with friends. But at the initial stage, withdrawal syndrome does not yet develop, and there are no characteristic external signs of alcoholism.

As addiction takes hold, tolerance to everything associated with alcoholism grows. A woman loses control over herself, drinks too much alcohol, loses consciousness, and forgets about everything that is happening around her. She loses her tender feelings for children, becomes sloppy, scandalous, and aggressive. Symptoms of chronic alcoholism, signs of damage to internal organs appear, and mental functions change.

Female alcoholism develops rapidly, and its symptoms can be disguised as ordinary fatigue or a desire to relieve nervous tension.

If addiction develops in men over 8-10 years, then in women this period is reduced to 5 years. The rapid development of pathological addiction is due to the anatomical as well as psychological characteristics of the body.

The enzymatic activity of the liver in women is lower, which leads to active breakdown of ethanol. The blood circulation of the protective organs is also noticeably lower than in men. These factors contribute to the rapid destruction of the liver with regular alcohol consumption. The later a woman seeks help, the more her health is destroyed, since it is possible to cleanse the body of accumulated poisons, but it takes years to fully restore impaired functions, and this is not always possible.

Ethanol has a pronounced destructive effect on brain cells and neural connections due to the reduced protective function of the blood-brain barrier. This feature leads to rapid social and mental degradation, loss of all moral guidelines, and deterioration of mental activity. While a man who regularly drinks alcohol is able to maintain his professional qualities for many years, a woman loses previously acquired skills and knowledge much faster. This happens outwardly imperceptibly, especially if she lives separately, communicates little with others, and is reserved.

The woman begins to go on a drinking binge. At first they happen rarely, and then they can occur several times a month. The characteristic symptoms of binge alcoholism appear in the last stages of the disease. But even in this state, many reject the idea of ​​​​the need for treatment and seeking help from professionals. Denial of one's own illness is one of the signs of chronic alcoholism not only in men, but also in women. This is why it is so difficult to obtain consent from an addict to undergo treatment or rehabilitation in a drug treatment clinic. Changes in the psyche do not allow one to adequately assess one’s condition or notice the pathological manifestations of addiction.

Stages of alcohol addiction

Alcoholism develops in four stages.

Read more about the stages of alcoholism

The sooner treatment is started, the greater the chance of completely restoring the patient’s health.

First stage

1. Drinking alcohol is associated with pleasant feelings, negative consequences are not yet felt
2. No hangover, headaches or other unpleasant symptoms
3. The person thinks that addiction has passed him by, and he can drink without fear for his health.
4. He thinks that he drinks just for the sake of company, or comes up with other excuses
5. At this stage, it is difficult to recognize the disease, which is why the disease successfully passes into the second stage
6. At this stage, alcohol is considered something desirable and safe, because after drinking it you feel morally good

Second stage

1. Alcohol begins to be consumed with a certain frequency. Alcohol becomes necessary for a person. For example, once a week he gets drunk to the point of “pig squealing”
2. The patient is deprived of the right to choose; he cannot decide whether to drink or not drink. Alcoholism dictates its own rules, how much and where to drink. To test yourself, you can first give up alcohol for six months
3. A person on a subconscious level comes up with a defense for his drunkenness
4. Alcohol tolerance increases. Therefore, to get drunk and feel like before, it becomes necessary to drink more alcohol. The previous dose no longer has the same effect
5. Adaptation to alcohol occurs, natural receptors for rejection of ethyl alcohol are excluded. An alcoholic is sure that alcohol will not harm him
6. Each time the patient begins to lose control over the amount of drinking

Third stage

• Alcohol begins to take priority. Drinking alcoholic beverages becomes the only way to get pleasure. The patient may still go to work, but he is always on standby
• Other addictions begin to form and intensify. It is possible to combine two addictions to obtain greater pleasure (smoking and vodka)
• Sober periods in life cause discomfort. An alcoholic often walks around irritated, restless, and is tormented by internal pain. Only after consumption, the mood improves
• Problems get worse due to the fact that a person ignores other areas of life
• Changes occur in the social sphere, and other people begin to irritate the addict. When communicating with loved ones, he becomes harsh and aggressive
• The frequency of use increases, the addict begins to drink for several days in a row

Prodromal (zero) stage of alcoholism

To know how to identify alcohol addiction in yourself or a loved one, you should pay attention to the alarm bells:

1. The frequency of drinking alcoholic beverages increases. New reasons for drinking appear.
2. There is a feeling of anticipation of a future feast or gatherings with alcohol.
3. The habit of drinking large amounts of alcohol during feasts is formed, and the need for a “supplement” appears.
4. Alcohol can sometimes be consumed alone, the reasons for this may be far-fetched.
5. Behavior changes when intoxicated - traits that were previously unfamiliar to others appear.
6. After drinking alcohol, memory lapses appear - the next morning it is difficult to restore the chronology of the events of the past day.
7. Emotional dependence appears: if earlier alcohol was consumed in order to feel good, now - so as not to feel bad.
8. Disorientation in time and space occurs when intoxicated.
9. Cases of loss of things, documents, as well as cases of injury are increasing.

The above-described signs are characteristic of the stage of pre-alcoholism, or prodromal, - this is the beginning of the formation of addiction, everyday drunkenness. The prodrome is distinguished by the following features:

• indifference to the presence or absence of alcohol (in the near future);
• the ability to stop at a certain dose;
• no use alone.

At this stage of alcoholism, a person is able to completely give up alcohol altogether without experiencing pain.

Summarizing these signs, we can draw a portrait of a person at the zero stage: he lives a normal life, is able to work, despite a slight deterioration in performance, ensures the safety of finances, from time to time resorts to friendly gatherings over strong drinks, and less often, drinks alone. In cases where the prospect of drinking is postponed indefinitely, he does not experience mental anguish and continues to go about his business.

But if drinking alcohol becomes frequent or daily, after a few months the first stage of addiction forms.

To find out how to determine the stage of alcoholism, it is necessary to characterize each of them. Their symptoms may vary depending on factors - heredity, medical history, age, gender, concomitant diseases.

Pills as a way to treat alcoholism

In narcology, alcohol addiction is increasingly treated with anti-alcoholism pills. To rid an alcoholic of pathological cravings for alcoholic beverages, pharmaceuticals are used, the active ingredient of which is disulfiram. The substance is an inhibitor of the enzyme that breaks down ethanol.

Disulfiram, while in the human body, interferes with the process of ethanol breakdown, resulting in severe intoxication. It is important to note that if a person does not drink alcohol after coding with disulfiram, the substance will not manifest itself in any way.

The disulfiram-ethanol reaction is extremely dangerous for a person; after experiencing it, the patient will be afraid on a subconscious level, drink alcohol, and develop a negative attitude towards ethanol. After all, the next use in this case can cause death.

Sometimes drug coding is performed with naltrexone-based pharmaceuticals. The substance is an opioid receptor antagonist. Naltrexone medications prevent the pleasure of drinking alcohol. As a result, the addict simply becomes uninterested in alcohol. Anti-alcohol drugs are selected individually for each client, after examination by a narcologist.

When coding medications, the following may be entered:

1. intramuscularly ("Injection" method)
2. sewing under the skin
3. orally

Hypnotherapeutic and psychotherapeutic coding

You can get rid of pathological craving for alcoholic beverages without the help of medications. Hypnosis and psychotherapy will help develop a negative attitude towards alcohol-containing drinks. In particular, Dovzhenko’s method, Ericksonian hypnosis, is especially popular. The doctor, based on the patient’s well-being, chooses a method of prohibitive therapy. Whenever possible, the doctor listens to the wishes of the alcoholic.

The psychotherapeutic effect is very safe and effective; many alcohol addicts stopped drinking thanks to them.

In modern drug treatment clinics, hardware coding techniques are often used.

These include:

• neurophysical blockade
• neurophysical blockade + laser coding
• reflexology

Coding is carried out only after the body has been cleansed of ethanol breakdown products.

brief information

1.1. Definition

Dependency syndrome (DS) is physiological, behavioral and cognitive changes that transfer the use of psychoactive substances to a leading position in the system of human values.

SZ is a brain disease manifested by a complex of behavioral disorders as a result of the interaction of factors:

• genetic,
• biological,
• psychosocial,
• environment.

Synonyms: alcoholism, alcohol dependence, alcohol dependence syndrome.

1.2. Etiology and pathogenesis

The following systems are involved in pathogenesis:

1. catecholamine (CA), dopamine (DA) in limbic structures; 2. endogenous opioid; 3. GABAergic; 4. N-methyl-D-aspartate.

Consequences of taking surfactants:

• neurotransmitter deficiency,
• compensatory enhancement of catecholamine (CA) synthesis,
• suppression of the activity of monooxidase and dopamine-β-hydroxylase, which convert dopamine (DA) into norepinephrine (NA),
• accumulation of DA in biological fluids and tissues,
• acceleration of circulation of coronary arteries—formation of withdrawal syndrome (AS),
• overexcitation of the sympathetic autonomic nervous system,
• excess production of adrenal hormones,
• damage to brain neurons,
• increased GABA activity - depression of the central nervous system and development of tolerance,
• blockade of NMDA receptors by alcohol - an increase in their number and increased glutamate synthesis,
• decreased myocardial contractility due to toxicity, arrhythmia, fibrillation and sudden death,

Correlation of DA level in the blood with the severity of AS:

• excess of 2 times - severe AS;
• exceeding 3 times - acute psychotic state;
• in AS, the level of DA increases regardless of the chemical formula of the surfactant;
• abrupt withdrawal of alcohol relieves inhibition of the central nervous system, increasing the excitatory effect of glutamate.

The main therapeutic target for all types of psychoactive substance addiction is the regulation and normalization of the functions of the mesolimbic dopamine system of the central nervous system.

Alcohol withdrawal syndrome:

• tachycardia,
• tremor,
• sweating,
• psychotic symptoms - delirium tremens and seizures.

1.3. Epidemiology

Alcohol is the most commonly used surfactant.

In 2012, 3.3 million or 5.9% of all deaths in the world (WHO).

In 2020 in the Russian Federation:

• DU consisted of 1,589,525 people;
• 1,084.7 per 100 thousand,
• 1.1% of the total population.

1.4. Coding according to ICD-10

F10 – mental and behavioral disorders due to alcohol use

F10.2хх – dependence syndrome caused by alcohol consumption

The nature of the dependence syndrome is currently specified by the fifth sign:

20 .. currently abstinent 21 .. currently abstinent, but in a non-use setting (hospital, prison, other) 22 .. currently under clinical supervision on maintenance or replacement therapy 23 .. currently under clinical observation, but on treatment with aversion or blocking drugs 24. . currently using surfactants.. constant use 25 .. occasional use

The stage of the dependence syndrome is specified by the sixth character:

2×1 ..initial (first) stage 2×2. .middle (second) stage 2×3 .. final (third) stage 2×9 .. stage unknown

1.5. Classification

According to ICD-10

Diagnosis examples:

F10.252. Alcohol dependence syndrome. Permanent form of use. Middle stage.

F 10.232. Alcohol dependence syndrome. Middle stage. Under clinical supervision, but on treatment with sensitizing drugs.

Do you need a psychologist?

Alcohol addiction does not arise just like that; unresolved psychological problems almost always lead to the disease. It is impossible to rid a person of alcoholism until the cause that led to the addiction is identified and eliminated. For many alcoholics, alcohol is a screen behind which they hide from life's problems. These people include people who have not found or lost contact with their real selves. A psychologist will help identify and eliminate problems that led to serious illness. His help will be needed at all stages of alcoholism treatment.

Diagnostics

Clinical diagnosis is of primary importance when diagnosing Alcohol Dependence Syndrome.

2.1 Complaints and anamnesis

Alcohol consumption leads to three (3) disorders within 12 months:

• taken in larger quantities or for longer than intended;
• persistent efforts/unsuccessful efforts to reduce or control use;
• increasing the time spent searching for alcohol and drinking it, despite the negative consequences;
• strong (irresistible) desire to accept;
• forgetting basic interests and responsibilities;
• continued use for persistent/recurrent social or interpersonal problems;
• formed withdrawal syndrome;
• tolerance with one of the following symptoms:
• a larger amount is required for intoxication or the desired effect,
• With constant consumption of the same amount of alcohol, it is more difficult to achieve intoxication or the desired effect.

Clinical manifestations of SZ:

• decreased mental performance,
• increased fatigue,
• sleep disorders,
• emotional lability,
• blood pressure fluctuations,
• painful sensations in the heart area,
• feeling of heaviness in the head,
• weakening of memory and attention,
• loss of interest in creative work,
• activity templates,
• decreased sense of duty,
• neglect of duties,
• dulling of higher emotions (conscientiousness, duty, care, compassion, etc.),
• strengthening of lower emotions (selfishness, irritability, hedonism, parasitism, etc.).

Components of addiction syndrome:

1. syndrome of pathological attraction to psychoactive substances, 2. withdrawal syndrome, 3. syndrome of mental degradation, 4. (tolerance).

According to ICD-10, the structure of SD is formed by 7 criteria, however, the contribution of each sign to diagnosis is unequal.

Stages of alcohol consumption:

• habitual or occasional
• systematic abuse
• harmful (or repeated) use with harmful consequences and SA fragments
• alcohol dependence syndrome.

Signs of the initial (first) stage:

1. increasing tolerance - the earliest; 2. the formation of a pathological craving for alcohol (PCA) with the loss of quantitative and situational control over consumption and the appearance of a secondary pathological craving; 3. change in the nature of intoxication with loss of memory for events during intoxication.

Signs of the advanced (second) stage:

1. alcohol withdrawal syndrome (AAS) becomes more severe and complicated (convulsive seizures, psychosis, reversible psychoorganism); 2. increase in 5-6 times the initial tolerance; 3. use without reason and the dominant motive of behavior; 4. formation of a “habitual” form of use – constant, intermittent, binge drinking; 5. personality changes (alcohol degradation) with “moral coarsening”, sharpening of premorbid character traits and intellectual-mnestic decline with deterioration of attention, memory, learning ability, “palimpsests” (loss of memory).

Signs of the final (third) stage:

1. general decrepitude, similar to premature aging; 2. a sharp decrease in alcohol tolerance; 3. severe AAS with psychopathological disorders - fear, ideas of attitude, guilt, illusory and hallucinatory disorders, epileptiform seizures; 4. high probability of psychosis; 5. somatic pathology (liver cirrhosis, myocardial dystrophy, pneumosclerosis, etc.).

2.2. Physical examination

Physical examination data:

• not specific
• help clinical diagnosis
• allow us to determine the clinical and dynamic features of the disease
• guide in determining the severity of the condition.

Characteristic for the second stage of SD:

• somatovegetative disorders - increased and unstable blood pressure, changes in heart rate and respiratory rate;
• Neurological disorders in the form of transient tremor and nystagmus are possible.

Characteristic for the third stage:

• obvious neurological disorders;
• somatic manifestations of chronic alcohol intoxication (CAI).

Physical examination:

• before starting therapy,
• during treatment to assess the dynamics of the patient’s condition.

Recommended:

• determination of the condition of the skin and sclera,
• muscle tone,
• palpation and percussion of the liver, kidneys,
• auscultation of the heart,
• measurement of blood pressure, heart rate, respiratory rate,
• determination of pupil reaction, nystagmus, tremor,
• tactile and pain sensitivity,
• static and dynamic coordination.

2.3. Laboratory diagnostics:

• if it is difficult to identify surfactants in the clinic;
• differential diagnosis;
• to confirm the state of chronic intoxication with surfactants;
• when clarifying the withdrawal state.

The manifestation of chronic intoxication and tolerance is the absence of intoxication or withdrawal syndrome with elevated levels of biomarkers.

Laboratory biomarkers:

• reflect the fact of alcohol consumption
• do not allow a diagnosis of “Addiction Syndrome” to be made
• an important objective indicator in addition to classical clinical diagnosis.

Biomarkers of intoxication or recent alcohol use:

• gamma-GT
• AsAt
• ethanol and its metabolites
• AlAt (to a lesser extent).

Marker of chronic alcohol intoxication - mean erythrocyte volume (MCV):

• does not react to alcohol excess for a month;
• with long-term daily consumption of the equivalent of 60 g of pure ethanol;
• sensitivity not less than 50%;
• specificity 90%;
• normalization of the level for at least 4 months after stopping alcohol consumption;
• single use within socially acceptable norms does not lead to high values;
• accuracy of identification of patients with alcohol dependence 96%;
• the norm is 80-100 femtoliters and depends on the age of the patient;
• identification of abuse by the ratio of AST/ALAT and MCV.

carbohydrate-deficient transferrin (CDT) concentration

• increase with daily and at least a week intake of >60 g of ethanol;
• test to determine alcohol abuse;
• for diagnosing withdrawal syndrome;
• when monitoring patients with alcohol dependence during treatment;
• to control the quality of remission.

Average CDT for Russians:

• healthy men - 17.4±1.3 U/l
• healthy women - 22.2±0.8 U/l
• patients with alcohol dependence during hospitalization - 38.6±3.8 U/l.

Screening for alcohol dependence:

• sensitivity/specificity of CDT is higher than AST, ALT, gamma-GT or MCV;
• CDT is more sensitive in men;
• the most effective combination of biomarkers AST, gamma-HT and CDT;
• Gamma-HT and CDT have higher sensitivity/specificity and a stronger correlation with actual alcohol consumption.

Before starting treatment and to assess the safety of treatment, tests:

• blood biochemical general therapeutic,
• blood general (clinical) detailed,
• urine general.

2.4. Instrumental diagnostics

According to clinical indications.

• ECG before treatment to assess the severity of the condition and the safety of treatment.
• Ultrasound of internal organs.
• EEG
• Echo-EG
• X-ray of the skull, lungs , etc.

2.5. Other diagnostic methods

Prescribed by specialists in accordance with the clinical situation.

Drugs and pills for alcohol addiction without a prescription

Many pharmaceutical drugs for the treatment of addiction, sold without a prescription, have many side effects (breathing problems, ulcers, arrhythmia, hypertension).

But there is a certain category of medications that do not cause negative effects on the body:

1. Zorex. The main components are citric acid, bicarbonate, aspirin. It is important to follow the dosage indicated in the instructions; do not use for more than 5 days.
2. Alcaprim. Has no contraindications, the main components are acetylsalicylic acid and glycine
3. Metadoxyl. Due to the high content of vitamin B in the medicine, rapid oxidation of ethanol occurs. However, it should not be taken by pregnant women. It is also contraindicated in case of severe alcohol poisoning
4. Limontar. Contains succinic and citric acids. Excellent in the fight against binge drinking, also used as a prophylactic agent. Contraindicated for ulcers and cardiac ischemia.

It must be taken according to the dosage prescribed by the doctor.

Meditation and mantras help or not

The mantra for alcoholism is sound vibrations that affect the human nervous system. Vibrations with certain frequencies, affecting the nerve endings in the brain that are responsible for the desire to drink alcohol, irritate them and create a strong charge of positive energy. As a result, the energy balance returns to normal, and alcohol addiction is eliminated.

In order for the mantras to help, it is recommended that you listen to them daily at the beginning, and the ambassador learns to reproduce them. At the same time, a positive attitude towards victory over alcoholism is very important.

Meditation in the fight against alcoholism can only be useful for alcoholics who have not yet fully experienced personality degeneration, since meditation requires concentration.

In general, meditation can help in the fight against alcoholism, since during it not only hidden problems are revealed, but also attention is drawn to a person’s physical well-being.

Meditations and mantras can be effective only if a person sincerely wants to get rid of alcoholism.

Some statistics

According to the World Health Organization, there are at least 140 million alcoholics in the world, and most of them are untreated.
Of these, approximately 2.5 million are in Russia. Scientists believe that 1 in 25 people in the world die from the consequences of drinking alcohol. Tags:

• Depression
• Psychology
• Alcohol
• Stress
• Family
• Diagnostics
• Genes
• Nadezhdin
• Addiction
• Testing

1 comment • Leave a comment

• Mivina The article is educational, in terms of consequences, only for teetotalers, and they already understand all the harm from alcohol. My alcohol clinic saved me from complete degradation. Now he regrets that he drank for so long and therefore lost it.

How to get rid of it at home

It is extremely difficult to overcome alcoholism without the help of doctors, but the patient’s sincere desire to get rid of addiction and willpower will help him begin to lead a sober lifestyle. In addition, private drug treatment clinics offer the service of calling a narcologist to your home. A doctor can provide medical assistance in a comfortable environment for you. At home, a narcologist will conduct detoxification and even coding.

Independent struggle with addiction:

• If you have a strong desire to drink a strong drink, you need to freeze, take a deep breath several times and say the phrase: “I will never drink again” (words for self-hypnosis)
• Take a contrast shower 2 times a day
• Drink 2 glasses of water before each meal
• Spends a lot of time outdoors, preferably in places where there is no chance of meeting drinking buddies

To combat addiction on your own, you will need activated charcoal and folic acid. Diuretic medications and cleansing enemas help quickly cleanse the body of toxins. In consultation with your doctor, you can also resort to traditional medicine. However, it is worth remembering that it is more advisable to treat alcoholism under the supervision of a doctor. In case of complications, only a medical professional can provide proper assistance.

SEE OTHER CLINICAL GUIDELINES

Year of approval 2018
Professional associations

• Association of Narcologists of Russia (Professional Community of Narcologists)

Table of contents

1. Brief information 2. Diagnosis 3. Treatment 4. Rehabilitation 5. Prevention 6. Organization of medical care 7. Additional information

Alcohol addiction in women: features

Alcoholism develops much faster in women than in men. All this is due to the following features:

• Hormonal background
• Physiology
• Biochemical processes
• Psychics

There is evidence that in men, persistent addiction occurs 7 years after the start of use, and in women after about 3 years. Unfortunately, alcohol addiction develops very aggressively in women. The disease destroys the liver and brain early, personality degradation also occurs earlier. Basically, treatment methods for alcohol addiction are the same for men and women.

It is very difficult to recognize female alcoholism at an early stage, since they often start drinking alone.

Third stage of alcoholism

The third stage - the chronic phase of the disease - is formed only 10-20 years after the start of alcohol consumption. It is characterized by an increase in the severity of symptoms of the 1st and 2nd stages and a sharp decrease in tolerance. To achieve a state of intoxication, a small amount of alcohol becomes sufficient.

The third stage of alcoholism can lead to death from:

• alcoholic delirium;
• diseases of the cardiovascular system;
• liver and kidney diseases.

Before this, a person undergoes physical, mental, and social degradation. The character of the patient changes - cynicism, aggressiveness, cruelty, anger become the “framework” of the addict’s personality. It is difficult for close people and acquaintances to recognize him - it’s as if the person has been replaced.

The intellectual and emotional spheres undergo the following changes:

• decreased intelligence, deterioration of thinking, primitiveness;
• misunderstanding of humor;
• refusal of intellectual stress, irritation;
• severe irritability, conflict;
• touchiness, tearfulness;
• stubbornness, selfishness;
• loss of interests.

Reactions are greatly inhibited, and severe memory lapses occur.

The severity of withdrawal syndrome in the third stage of alcoholism is more severe. Reduced tolerance to alcohol leads to rapid intoxication from small doses, and true binges appear - daily continuous drinking of alcohol. Loss of appetite and dysfunction of the gastrointestinal tract lead to weight loss.

From time to time a person tries to completely give up alcohol; a period of sobriety occurs, but its duration steadily decreases over time.

An alcoholic no longer knows how to get rid of addiction on his own. Volitional qualities deteriorate, degradation occurs, personal hygiene is neglected, the person looks unkempt.

It is in this case that the likelihood of psychosis and alcoholic delirium increases. Multiple organ failure develops.

The last stage of alcoholism has an unfavorable prognosis - a high probability of death, exhaustion of organs and systems, severe depression, and the possibility of suicide.

Choosing a clinic and doctor for treatment

Treatment for any type of addiction should preferably take place in an inpatient drug treatment clinic. The choice of a medical institution must be approached with full responsibility. The clinic's staff must include doctors of various specialties and must have modern medical equipment. It is advisable to undergo treatment in a medical facility located away from home.

It is difficult, even impossible, to cope with the disease without the help of a narcologist. Timely contact with narcologists will help save your loved one.

Rehabilitation

Rehabilitation of a patient with addiction to psychoactive substances is a set of medical, psychological, social, educational and labor measures aimed at:

• restoration of the patient’s physical and mental condition;
• formation of socially acceptable qualities and adaptation to the environment, full functioning in society without the use of surfactants.

Strategic goals:

• safe cessation of substance use and maintaining a sober lifestyle;
• achieving premorbid personal and/or social status;
• creating an adaptive social environment to prevent access to psychoactive substances and prevent relapse.

Pragmatic goals:

• formation of conscious and sustainable motivation to quit substances and participate in a treatment and rehabilitation program (TRP);
• carrying out therapeutic measures to relieve mental and behavioral disorders, prevent relapses;
• therapy of somatic and neurological disorders and diseases;
• correction of personality structure and provision of conditions for its positive development;
• correction of family relationships;
• increasing the patient's level of social functioning;
• real social employment: study, work.

Full restoration of normative personal and social status in case of damage to psychological functions:

• passing LRP;
• compensation through the development of other functions;
• formation of completely new skills and abilities.

Stages of LRP:

restorative (pre-rehabilitation); medical rehabilitation:

• adaptive,
• integration,
• stabilization;

preventive (post-rehabilitation).

Optimal LRP algorithm:

• Treatment of mental and behavioral disorders: emergency drug treatment department or drug treatment department of a dispensary.
• Inpatient rehabilitation: medical rehabilitation department of a drug treatment hospital (dispensary) or drug rehabilitation center.
• Outpatient rehabilitation: medical rehabilitation department or drug treatment department of a dispensary (hospital).
• Dispensary observation by a local psychiatrist-narcologist.

After primary inpatient drug treatment, the patient is required to be referred to rehabilitation.

Compliance with the principles of phasing and continuity of treatment and rehabilitation measures:

• sufficient duration of treatment measures;
• continuity of inpatient and outpatient care;
• transition of the patient from one stage of the LRP to another, taking into account the stages of change and change in the URP.

Directions of a multidisciplinary approach to rehabilitation:

• medical - for SZ with somatic problems, treatment of concomitant mental disorders;
• organizational - structured therapeutic environment;
• psychological and psychotherapeutic;
• working in a 12-step program;
• social and pedagogical - stimulation of physical activity, development of self-care skills, social communication, occupational therapy;
• social support.

Diagnosis of the level of rehabilitation potential is carried out in all patients.

Short-term intervention in the form of initial consultation and motivational interview upon admission.

Objectives of the short-term intervention:

• formation of motivation to begin rehabilitation using psychotherapeutic methods;
• strengthening the patient’s motivation for rehabilitation;
• increased motivation among relatives.

The goals of psychoeducational work with patients and relatives at all stages of rehabilitation:

• overcoming drug addiction illiteracy;
• change and correction of the internal picture of the disease;
• developing an understanding of the multifactorial nature of the causes of addiction to psychoactive substances;
• awareness and acceptance of the negative medical and social consequences of SZ;
• understanding the meaning of personal responsibility for the implementation of PRP and recovery.

Anti-relapse training at all stages of rehabilitation:

• strengthens the skills of coping with stressful situations and the ability to say “no” to alcohol;
• teaches the identification of precursors of exacerbation of craving for psychoactive substances;
• teaches how to overcome relapse;
• instills planning and time management skills;
• carried out during psychocorrectional and psychoeducational sessions;
• a way to copy behavior modeled by specialists.

Psychotherapy in rehabilitation:

• only using proven methods;
• person-oriented at all stages;
• forming communication and behavioral skills;
• correcting interpersonal relationships.

Objectives of person-oriented psychotherapy:

• correction of personal characteristics acquired as a result of the disease;
• personal restructuring;
• return (formation) of the lost system of values.

Main tasks of psychotherapy:

• restoration of communication and behavioral skills in a social environment;
• improving relationships with family and immediate environment;
• training in methods of effective communication and resolution of conflict situations.

Psychotherapy techniques:

• family
• cognitive-behavioral
• transaction analysis
• skills training (behavioral, communication, social).

At all stages of rehabilitation, psychotherapeutic and psychocorrectional work with the patient’s relatives.

Recommended:

• occupational therapy;
• participation in self- and mutual-help groups;
• social support for patients.