Alcohol addiction (alcohol dependence)

How can alcohol addiction be recognized? What are the symptoms of alcohol abuse? Information on diagnosis and therapy of alcoholic disease

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Alcohol addiction - in a nutshell

Alcohol addiction can be extremely harmful to health. If you find yourself having problems with alcohol, you should definitely talk to your doctor. Self-tests such as the CAGE or AUDIT test can reveal critical use of alcohol. The family doctor, addiction counseling centers, psychiatrists and psychologists, appropriate specialist clinics or self-help groups can also help those affected to clarify to what extent they have harmful alcohol consumption and which steps are sensible to bring about a change.

What does alcohol addiction mean?

Alcohol addiction is a slang term for addiction to alcohol. It is characterized by physical, psychological and social problems and leads to a number of consequential damages. Around 1.6 million people in Germany are dependent on alcohol. There are certain criteria for diagnosing alcohol addiction. If an affected person fulfills a certain number of these criteria, he is considered dependent (see diagnosis).

The transitions from "normal" to high-risk or harmful consumption and dependence are fluid.

How does alcohol work?

Most of the alcohol consumed is absorbed into the body or the bloodstream through the mucous membranes of the gastrointestinal tract. How quickly this happens depends, among other things, on what was eaten. On an empty stomach, absorption occurs very quickly, whereas high-fat food delays the process. The highest blood alcohol level occurs on average around 45 to 90 minutes after consuming an alcoholic drink.

With the same amount of alcohol, the blood alcohol concentration is higher in women than in men. The reason: even with the same weight, men have more muscle mass than women. Muscles are supplied with more blood than adipose tissue, so the alcohol supplied is distributed in more fluid. Alcohol is mostly broken down in the liver.

The effects of alcohol depend on the amount consumed as well as on the individual physical and mental state. With regular consumption there is also a certain habituation effect, which is also known as tolerance. As you get used to it, your body becomes less sensitive to alcohol. The alcohol value alone does not necessarily say anything about how severely the individual is already impaired in his physical and mental abilities by the intoxication.

Examples of physical reactions to alcohol consumption are:

  • Coordination and movement disorders (for example, swaying)
  • slurred pronunciation
  • Widening of the blood vessels (flushed face)
  • increased sweating
  • increased urine production ...

Psychological reactions to alcohol consumption are for example:

  • Disinhibition (reduction of shyness or increased aggressiveness)
  • Urge to talk
  • upscale mood
  • Concentration and memory disorders
  • Disorientation
  • partly aggressive behavior that is harmful to others or oneself
  • sometimes anxiety or depressed mood

But the following always applies: Regardless of whether someone "tolerates a lot" or gets drunk more quickly, alcohol causes damage to their body. Because alcohol is a cell poison. This means that even small amounts of alcohol damage the cells and organs of the body, such as the liver or the nervous system. This cell-damaging effect always unfolds, the extent basically and exclusively depends on the amount of pure alcohol - regardless of whether it is consumed in the form of schnapps, beer or wine.

When is alcohol consumption dangerous?

Experts agree: there is no such thing as risk-free alcohol consumption. Even small amounts of alcohol are harmful, but the risk of secondary diseases increases with the amount consumed. The amount of alcohol at which it is harmful is controversial in specialist circles. The following division into "consumption patterns" (in grams of pure alcohol per day) is common in Germany:

Low-risk consumption: women up to 12 g / men up to 24 g on a maximum of five days per week.

Anything beyond that is risky use, which means that if you continue to use it, the risk of harmful consequences increases. Women who regularly consume more than 40 or even 80 grams of alcohol or men who consume more than 60 or 120 grams a day have a high probability of significantly harming their bodies sooner or later.

For orientation: A 0.33 liter glass of beer corresponds to about 13 g of alcohol. A glass of about 0.2 liters of wine corresponds to about 16 g.

If there are fewer than two consumption-free days per week, alcohol consumption is always considered to be risky. The above classification only applies to healthy adults and especially not to pregnant or breastfeeding women.

How much alcohol does a glass contain?

© W & B / Ulrike Möhle

TO THE PICTURE GALLERY

© W & B / Ulrike Möhle

Beer, 0.33 liters: 13 grams of alcohol

© W & B / Ulrike Möhle

Wine, 0.2 liters: 16 grams

© W & B / Ulrike Möhle

Sherry, 0.1 liter: 16 grams

© W & B / Ulrike Möhle

Liqueur, 0.02 liters: 5 grams

© W & B / Ulrike Möhle

Whiskey, 0.02 liters: 7 grams

© W & B / Ulrike Möhle

Grain, 0.02 liters: 7 grams

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Symptoms

Alcohol consumption has a direct and immediate effect on the body that occurs shortly after consumption. Excessive alcohol consumption over a long period of time can also cause damage that only becomes apparent after months or years.

Immediate physical and mental symptoms after consuming alcohol

These include those under "How does alcohol work?" mentioned symptoms such as dilation of the vessels, coordination and movement disorders, ...

Physical and psychological consequences of alcohol addiction

This includes, for example, decreased appetite and malnutrition as well as withdrawal symptoms such as restlessness or nausea, tremors, increased irritability, ...

Consequences of alcohol consumption and alcohol dependence

High alcohol consumption significantly increases the risk of many diseases. These include:

  • Inflammation of the liver,
  • Cirrhosis of the liver
  • Inflammation of the pancreas
  • Injuries, accidents
  • Cancer, especially tumors of the oral cavity, throat, liver and female breast
  • Disease of the esophagus and stomach (inflammation, ulcer, cancer)
  • Diseases of the cardiovascular system (cardiac arrhythmias, enlarged heart, ...), high blood pressure
  • Folic acid deficiency and the resulting anemia
  • Erectile dysfunction
  • Immune disorders
  • Damage to the nervous system
  • prenatal damage to the embryo, such as short stature, intellectual disability or heart defects

Social consequences often include family and work problems, loss of friends and acquaintances, driving license disqualifications, or conflict with the law. In many cases, alcohol addiction also leads to social decline and causes enormous social consequential costs.

The stages of alcohol addiction

Alcohol addiction often runs in certain phases, each with characteristic behavior. Although the individual forms of the disease often differ greatly, the following course is therefore typical:

1) First of all, people drink more and more often in order to cope with problems and to make certain situations more bearable. Daily alcohol consumption can be the result. It does not have to lead to an intoxication.

2) In the next stage, alcohol becomes more and more important, thoughts revolve almost exclusively around the topic of drinking and getting alcohol and hiding one's own drinking habits from friends, family and colleagues. In addition, there is a progressive loss of control: those affected compulsively reach for the bottle, later at any time of the day. Other duties, interests and social contacts are neglected because of the alcohol consumption. If less alcohol is drunk than usual, physical and psychological withdrawal symptoms occur.

3) After all, alcohol addiction largely dominates the daily routine and behavior of those affected. Mental abilities such as the ability to criticize and judge often decline. In many cases, then at the latest there will be rapid social decline.

Diagnosis: Recognize alcohol dependence

There are a number of signs that you may be addicted to alcohol. These include:

  • A strong desire or some kind of compulsion to drink alcohol
  • Decreased ability to control when and how much is consumed
  • Withdrawal symptoms when consumption is reduced or stopped
  • Drink to ease the withdrawal symptoms
  • Tolerance development, that is, in order to achieve the desired effect, those affected have to consume ever larger amounts of alcohol
  • Restricted behavioral patterns: For example, people drink without observing the usual social rules
  • Other interests are increasingly neglected in favor of alcohol consumption. Obtaining and consuming alcohol takes more time
  • Persistent consumption against better knowledge, i.e. although the harmful consequences in the physical and psychological area are already becoming clear. This also includes problems in the family, at work and in the social environment

Not all of these symptoms have to be true to be addicted! There are alcohol addicts who do not drink daily or who do not experience any withdrawal symptoms, but who accept other disadvantages.

The doctor makes the diagnosis on the basis of a detailed discussion and physical examination. Conspicuous behaviors, physical and psychological symptoms of the patient are taken into account. The doctor tries to get an idea of ​​the life situation of the person concerned and the development of his alcohol consumption. Changes in certain blood values ​​can give the doctor an indication that there may be increased alcohol consumption.

Test: Are you addicted to alcohol?

There are also questionnaires that can help assess whether there is an addiction. These include the AUDIT or the CAGE questionnaire: