Alcoholism sneaks up unnoticed, but in the end, it completely takes over the human psyche. From the first to the last stage, alcoholism is unpredictable and painful. First, from the desire to “escape from reality,” a painful attraction to alcoholic beverages arises. Then the doses increase and the morning hangover begins to haunt. Later, when the body is exhausted, alcoholics do not need a significant amount of alcohol to feel drunk. At the last stage, they do not care what time of day, in what place and condition to drink; however, alcoholics tend to deny the problem. The constant exposure to alcoholic toxins destroys the psyche and undermines vital organs and body systems. The longer people drink, even if it is a “harmless” bottle of wine every evening, the easier they become dose-dependent. Chronic alcoholics urgently need timely drug treatment, which can only be provided in a specialized medical center.
It is complicated for alcoholics to admit both the fact of their illness and the need for treatment. A conversation that they need help can cause a harsh rejection on their part, denial of the problem. At the level of family scandals, such issues cannot be solved; on the contrary, the problem is only getting worse. Therefore, people who are essential to patients should speak with them tactfully and reasonably, preferably in the presence of a psychotherapist and in a friendly atmosphere. A clear presentation of current and potential problems and the addition of specific examples of the issue will have a greater effect than manipulation and threats. If an alcoholic agrees to help during a conversation, it is crucial to understand that it is fragile (Lewis, 2019). Consequently, treatment in a particular institution should be started as soon as the person has expressed readiness.
The legislation does not allow compulsory treatment for alcoholism and drug addiction; therefore, patients can only be placed in the clinic with their consent. Private drug treatment centers have a staff of trained specialists. During a conversation with a patient, they carry out the so-called psychological intervention. This allows them to find an approach to the alcoholic to obtain consent for examination and rehabilitation (Witkiewitz et al., 2019). Therapy is prescribed individually, depending on the physical and psycho-emotional state of the patient. For some of them, a day or round-the-clock hospital is more suitable; for others outpatient treatment would be better.
The diagnosis of alcoholism is based on clinical symptoms and laboratory data. At the same time, laboratory tests do not replace the clinical diagnosis, but objectify it, making it possible to separate household alcohol abuse and pathology. The World Health Organization defines chronic alcoholism as a form of drug addiction in people who regularly consume alcohol (Burlison, 2016). The main symptoms are mental and physical dependence on the constant, continuous, or periodic consumption of alcoholic beverages with a gradual increase in tolerance. There is also an abstinence syndrome upon cessation of consumption and the development of mental and somatic-neurological disorders.
The number of clinical symptoms of alcoholism is large. For example, these are the formation of pathological craving for alcohol, which is obsessive, a sign of a decrease, and then a loss of control over the amount of alcohol consumed. Symptoms also include loss of the protective gag reflex triggered in healthy people with alcohol overdose. As a result, patients get the ability to take large doses of alcohol uncontrollably. There are memory gaps when an alcoholic cannot remember specific details and events during his alcoholic intoxication. The asthenic syndrome can be noted: lethargy, weakness, fatigue, attention disorder, exhaustion of intellectual processes, and headaches.
In some cases, there is an increasing sleep disorder and withdrawal symptoms (hangover). Its manifestations include swelling, tachycardia, increased pressure, tremors of the body and limbs, dry mouth, dizziness, weakness, lack of appetite, nausea, and diarrhea (Bilevicius et al., 2020). With a severe hangover, seizures can occur. Another frequent problem is the non-stop use of large doses of alcohol for several days, leading to severe intoxication of the body. Alcoholics have signs of personality degradation: their egoism is growing, they ignore the needs of relatives and friends, and their volitional processes are disrupted. Thinking becomes monotonous and subservient to alcohol themes. People are losing their former interests, their working capacity decreases. Alcoholics morally “sink”, become indifferent to their appearance and social status, and can even commit crimes.
To relieve withdrawal symptoms, detoxification therapy is required in combination with drug support for the functions of vital organs and systems. To begin with, doctors need to remove alcohol products from the body using drip infusions. Further, symptomatic treatment is required: stabilizing the heart rate, blood pressure level, and respiratory function. Sedatives are prescribed to correct sleep and relieve anxiety (Leggio & Lee, 2016). After the patient’s condition is stabilized, it is time for more global recovery of the body, exhausted by constant alcohol intake.
Any person who abuses alcohol always has encephalopathy, toxic brain damage, to one degree or another. It is manifested by memory lapses, deterioration of attention, decreased productivity, and inability to perform complex mental activities. In severe cases, this disease can lead to progressive dementia. Thus, disorders of the nervous system and deterioration of cognitive functions are inevitable consequences of alcoholism. For mild central nervous system disorders, acupuncture and massage can be beneficial. In alcoholic polyneuropathy, when the patient complains of “wadded” legs and difficulty walking, a course of plasmapheresis is prescribed. Doctors may also prescribe drugs to activate the work of brain cells. Having fully or partially solved the somatic sphere’s problems and having received the first positive results, one can move on to the mental health of an alcoholic.
Human mental health is mostly due to the brain’s biochemical processes, which are disrupted by constant alcohol intoxication. The use of specific psychopharmacological agents contributes to the more successful conduct of psychotherapy. They make the patient more resistant to possible subsequent traumas that can provoke a breakdown. The controlled intake of psychotropic drugs removes psychogenic and psychotic reactions characteristic of patients with alcoholism (aggression, irritability, lethargy).
The psychotherapeutic methods include both drug and non-drug coding, aimed at forming a persistent aversion to alcohol intake. In addition to coding, which is not the most effective method, complex psychotherapy with drug support is also offered. It reduces the craving for alcohol and forms a complex of more adaptive and healthy ways to respond to traumatic situations. It teaches people to have a good rest and instills the skills of successful problem-solving. This stage of treatment aims to stabilize the patients’ mental state and prepare for a reasonable dialogue about correcting their lifestyle in general.
As a rule, alcoholics have broken family relationships, reduced authority at work, and lost professional qualifications. The task of the rehabilitation period is to return the recovering alcoholic to society. At this time, it is crucial to re-create an adequate system of relationships and help a person adapt to life, taking into account the impossibility of drinking alcohol. One of the critical factors in the provision of care for alcoholism is identifying codependency in the patient’s inner circle of communication. Codependent people (friends, relatives, colleagues) consciously or unconsciously support the partner’s alcoholism, indulge in weaknesses, and aggravate the situation.
Prevention of alcohol dependence after rehabilitation is comprehensive psychological support aimed at preventing breakdowns and related problems. On the one hand, prevention includes psychotherapeutic counseling and work in groups of Alcoholics Anonymous. On the other hand, the patient needs to maintain newly built work, friendships, family relationships, move to a healthy lifestyle, and find new hobbies. This will require the care and understanding of family and friends. The prophylactic period is just as crucial for the alcoholic patient as the treatment program itself.
Long-term remission in chronic alcoholism does not necessarily means complete recovery. Even after decades, alcoholism can regain its pathological character. Therefore, remission in chronic alcoholism is a particular condition that must be constantly prolonged. It includes the correct psychotherapy, favorable social conditions, and drug treatment under a doctor’s supervision. As remissions get longer and more frequent, the chances of abstinence from alcohol increase.
Professional narcologists and psychologists’ experience in combination with modern drugs can help patients overcome severe alcohol dependence. It is essential not to be limited to one-time conclusions from the hard-drinking and not close eyes to the existing problem. In this case, dramatic and sometimes tragic consequences for alcoholics and their families can be avoided. Even though it requires significant efforts, it will contribute to the creation of a healthier society.
References
Bilevicius, E., Clark, C. C., Johnson, E. A., & Keough, M. (2020). Ashamed and alone – Risk factors for alcohol craving among depressed emerging adults. Alcohol and Alcoholism, 55(5), 540-546.
Burlison, L. (2016). Understanding alcoholism as a brain disease. Addiction Publishing.
Leggio, L., & Lee, M. R. (2016). Treatment of alcohol use disorder in patients with alcoholic liver disease. The American Journal of Medicine.
Lewis, D. (2019). Alcohol recovery: The complete problem drinking solution. Independently Published.
Witkiewitz, K., Litten, R. Z., & Leggio, L. (2019). Advances in the science and treatment of alcohol use disorder. Science Advances, 5(9).