The chronic alcoholism is characterized by habitual and repeated psychological difficulty to control the consumption of alcoholic beverages. A person with this addiction is highly dependent on alcohol and consumes it every day at dangerously high levels.
In general, the deterioration in the ability to control alcohol consumption can be intermittent and very slight in the early stages of the disease. When you start drinking, and even during the first years of excessive alcohol consumption, the inability to stop drinking is not usually very high.
However, as the years go by and alcohol is consumed in a pathological way, the inability to control the consumption can become continuous and intense, and lead to an absolute addiction to this substance.
Since when is it said that there is chronic alcoholism?
Obviously, saying that a person who has been drinking for a year suffers from chronic alcoholism is inappropriate, since the pattern of consumption has not yet become chronic.
This fact raises the option that the person who has been consuming alcohol for a few years is not yet an alcoholic, since they do not present a clear dependence on alcohol consumption.
Now, why does this person continue to drink alcohol? What leads you to continue consuming for so many years until you reach a state of chronic alcoholism?
These questions are difficult to answer, since there are many factors that can play an important role in the development of this phenomenon, however, the fact that there are so many cases of chronic alcoholism raises the possibility that first-time alcohol consumption already constitutes a first phase of the disease.
Likewise, when faced with a person who suffers from chronic alcoholism and who has been consuming alcohol in a pathological way for 30 years, their pathology cannot be understood as a new situation.
That is, it cannot be said that alcoholism begins at the moment that a clear dependence on the substance is observed in the person, since before this occurs, the person had already been consuming pathologically for many years.
Thus, chronic alcoholism is a disease that sets in at the time a person’s alcohol use can be diagnosed as chronic and shows signs of substance dependence, but that begins much earlier.
In order to accurately define the concept of alcoholism, it is convenient to distinguish it and relate it to other problems related to alcohol consumption.
Differences between chronic alcoholism and other types of consumption
Risk consumption of alcohol is considered to be that which exceeds the limits of prudent consumption and that increases the risk of suffering illnesses, accidents, injuries or mental or behavioral disorders.
In qualifying values, this consumption has been defined as an almost daily consumption of more than 40g of ethanol per day, that is, the equivalent of 4 Standard Beverage Units (UBEs) per day.
According to the WHO manual for the diagnosis of mental illness, harmful consumption constitutes that type of alcohol consumption that has already affected physical or mental health.
This pattern of consumption does not meet the diagnostic criteria for alcohol dependence, and is based on a regular consumption that is above 60 grams per day in men and 40 in women.
People who present this pattern of consumption can obtain a great benefit for their health if they manage to reduce their consumption, but if they do not, they have a great chance of developing a dependence on drinking and presenting alcoholism.
Alcoholism refers to those people who have already developed a serious dependence on alcohol and cannot return to moderate consumption or have the ability to reduce or eliminate their alcohol intake.
In order to reach this situation of alcoholism, several years of continuous alcohol consumption are required, presenting the patterns of intake mentioned above.
Alcohol dependence syndrome
This syndrome is characterized by the presentation of a series of physiological, behavioral and cognitive manifestations in which alcohol consumption acquires the highest priority for the individual.
In these cases, the person presents a series of symptoms when not consuming alcohol and presents a constant feeling of desire and need to drink alcohol.
The development of this syndrome is usually much slower than that of other drugs, so it appears on average after 30-40 years of use. However, changes in consumption patterns and previous or simultaneous use of other substances can motivate a more rapid development of dependence.
Symptoms of chronic alcoholism
As we have seen previously, alcoholism constitutes a dependence and physical addiction to alcohol.
This situation that a person can reach, appears after many years in which there is an inappropriate and excessive consumption of alcohol.
Likewise, in order to define the presence of chronic alcoholism, the following symptoms must be present continuously.
Strong desire to drink alcohol
The person must experience a desire interpreted as a need to consume alcohol.
Normally these sensations automatically lead to consumption, at which time the need to drink alcohol decreases.
However, at those times when alcohol is not consumed, the desire to drink alcoholic beverages progressively increases.
Lack of control over consumption
In general, a person with an inappropriate drinking pattern has some difficulties in controlling alcohol intake.
However, in chronic alcoholism there is an absolute lack of control in the consumption of alcoholic substances, referring both to the need to start drinking and the inability to suspend or reduce this consumption.
It is one of the main symptoms to determine the presence of chronic alcoholism.
In these cases, the person presents a series of annoying physical sensations, as well as behavioral and / or emotional alterations in the moments that they do not consume and that their wishes to drink alcohol cannot be fulfilled.
This symptom is not exclusive to chronic alcoholism, since a person who does not have a clear dependence on alcohol but who consumes this substance on a regular basis can also present it.
However, in chronic alcoholism there is a high tolerance to the substance, in such a way that the person needs to consume greater amounts of alcohol to achieve the same effects that they previously achieved with lower doses.
It is quite common for chronic alcoholism to appear failures in memory and cognitive functioning of the person.
Lapses, sudden forgetfulness or gaps in memory may appear, especially at times of greatest consumption.
Interference in daily life
To be able to speak of chronic alcoholism, consumption has to interfere with the normal functioning of the person.
In this way, excessive alcohol consumption can affect different areas such as social, work, academic or family.
Consequences of chronic alcoholism
Chronic alcoholism is one of the conditions that constitute the greatest risks for the person.
In this way, suffering from high alcohol consumption and dependence on these substances for a long time can lead to serious health diseases as well as mental disorders and social problems.
Regarding the physical component of the person, chronic alcoholism is a risk factor for many diseases and disorders of the body.
Probably the organ that is most affected by chronic alcohol consumption is the liver, since it is in charge of metabolizing this substance in the body.
Thus, chronic alcoholism can affect the liver in many ways, causing alterations such as alcoholic liver disease, whose damage can range from liver inflammation to the development of much more serious diseases such as cirrhosis.
Alcohol consumption is one of the main enemies of hypertension, which is why chronic alcoholism is the main risk factor for the development of this disease.
Alcohol is a highly irritable substance for the digestive system, it attacks the digestive mucosa and can cause disorders such as heartburn, vomiting or bleeding ulcers.
In this way, people who suffer from chronic alcoholism often have many digestive problems and alterations in their functioning.
Alcohol abuse decreases the absorption of many vitamins and minerals, so chronic alcoholism often leads to accelerated deterioration of the body.
People with chronic alcoholism often have megaloplastic anemia, osteoporosis, and low blood sugar levels on a regular basis.
Unlike other diseases that can be more or less predictable, chronic alcoholism always ends up translating into a decrease in the intellectual abilities of the person.
The intellectual alterations that chronic alcohol consumption can produce are usually variable, however, cases of chronic alcoholism without alterations in cognitive functioning are rarely seen.
Cognitive impairment can range from decreased memory capacity or frequent forgetfulness, to the development of frank dementia.
Alcoholism involves a series of circumstances that cause a reduction in the social circle and a progressive isolation of the person.
Many studies have shown the strong correlation between alcoholism and depression.
In general, people with chronic alcoholism become depressed and are invaded by symptoms such as feelings of sadness, apathy and decreased energy.
Central nervous system damage
Finally, alcohol causes irreparable damage to the human nervous system , which is why people who suffer from chronic alcoholism often present symptoms such as tremors, lack of coordination and parkinsonian manifestations.
The treatment of chronic alcoholism is not an easy task and requires a lot of effort on the part of the affected person to be overcome.
However, certain studies such as the one carried out by Antonio Gual from the Hospital Clínic de Barcelona, have shown how, unlike the popular belief that alcoholics relapse into consumption inexorably, if the appropriate treatment is applied, chronic alcoholism can be overcome.
The therapeutic strategies that have proven effective for the treatment of chronic alcoholism have been psychotherapy and pharmacotherapy.
With regard to drugs, the use of benzodiazepines, clomethiazole, and tetrabamate during the detoxification phase, and disulfiram and calcium cyanamide during the maintenance and cessation phase is recommended.
However, to achieve long-term effects, this treatment must be accompanied by psychotherapy, which is based on providing the individual with strategies that reduce the discomfort caused by withdrawal, avoid consumption behaviors and increase motivation for change.
- Corrao G., Bagnardi V., Zambon A., La Vecchia C. A meta-analysis of alcohol consumption and the risk of 15 diseases. Prev Med. 2004; 38: 613-19.
- Ledermann, S. Alcohol, alcoolism, alcoolisation. Take 1. Paris: Presses Universitaires de France; 1956.
- Maheswaran R., Beevers M., Beevers DG Effectiveness of advice to reduce alcohol consumption in hypertensive patients. Hypertension 1992; 19: 79-84.
- US Department of Health & human services. Helping Patients who drink too much. A clinicians Guide. Updated 2005 edition. National Institute on Alcohol Abuse and Alcoholism (NIAAA). Bethesda, MD; 2005. Taken from niaaa.nih.gov
- Vasilaki E, Hosier S., Cox Mw. The efficacy of motivational interviewing as a brief intervention for excessive drinking: A meta-analytic review.Alcohol alcohol. 2006; 41: 328-335.
- World Health Organization. Department of Mental Health and Substance Abuse. Global status report on alcohol 2004. Singapore: World Health Organization; 2004.