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Last Updated on August 8, 2021

Medicine began to recognize alcoholism as a disease when doctors concluded that no one starts drinking in order to become an alcoholic. The disease is the result of processes occurring in the body that the patient is unable to control. These processes are abnormal, since not all drinkers manifest themselves. Moreover, not everyone who drinks a lot becomes an alcoholic. The alcoholic most often does not at all look like an eternally drunk drinking companion at a barrel of beer or wallowing in a ditch. In everyday life, most alcoholics –they are very active, for the time being, people in society, and they sometimes surpass their non-drinking colleagues by their qualifications. An alcoholic is not at all the one who drinks denatured alcohol. One third of alcoholics have never drank anything other than beer in their lives. An alcoholic may not drink daily, almost half of them drink periodically, but after each regular binge, periods of sobriety are periodically shortened.

This frequency of drunkenness misleads the patient, his family, and often doctors, and is for them proof of a healthy reaction to alcohol. However, in essence, a drinking break does not prove anything. Almost every alcoholic can go without drinking for a while.

As a rule, he stops drinking in order to prove that he still has control over alcohol. A person decides not to drink for 5 days, a month, six months, but during this period he is always convinced that control over alcohol is not lost. As soon as he proves to himself and to others that he is able to control the amount of drinking, he will start drinking again. Every alcoholic who believes he has control over alcohol sooner or later returns to drunkenness. – this is an undeniable rule, where there are no exceptions.

Almost every alcoholic can fulfill his promise that he will not drink a single drop of alcohol for the next few months. But no alcoholic can promise that within a month he will drink only 2 glasses and no more. An ordinary drunkard can fulfill such a promise, but an alcoholic will start drinking heavily after a few days.. 

The essence of the disease is the loss of control over alcohol. The disease consists of 2 elements: an obsessive drive, which leads to the fact that an alcoholic cannot imagine life without alcohol, and even after a long break takes a glass, and a physical need that arises immediately after drinking the first drop and causes a loss of control over alcohol (a person begins to drink without measure). He promises himself that he will drink only one glass, and he drinks until he is drunk until he is unconscious.

Despite the fact that each regular booze causes more and more serious complications with health, in family relations, in society, and often in conflict with the law, the alcoholic again goes into binge and drinks without measure. And so on endlessly. Unable to learn from his own bitter experience, he is like a man who repeatedly puts his hand on a hot stove, ignoring the increasingly severe burns. A man of a sane mind does not behave like that, an alcoholic does not have a sane mind. But that is not all. The most surprising thing is that despite the existence of easily distinguishable manifestations of the disease, an alcoholic almost does not know until the end of his life that he is sick. Alcoholism belongs to a group of special diseases, which are characterized by the denial of the disease, primarily by the patients themselves.

The main part of alcohol dependence is the mechanisms of psychological defense, constantly convincing the patient that he is not an alcoholic. The suspicion of alcoholism has an unambiguously negative effect and can seriously affect all aspects of life. No one without resistance wants to admit some mistakes and shortcomings, especially when it seems to him that he is not to blame. But an alcoholic does not drink in order to become an alcoholic; in essence, he himself does not understand why he drinks uncontrollably, and therefore tries to justify himself with the help of various tricks. He finds a variety of reasons: a difficult childhood, and stressful situations at work, and marital problems, and political events.

Looking for a solid reason for each regular binge, the addict subconsciously tries to divert attention from both his own and those around him from the problems with alcohol that have arisen.  But most often he blames his relatives for his drunkenness. At times, the alcoholic unconsciously looks for a reason for conflict, in order to find a reason to get drunk or to put himself in the role of the victim, in order to then say: «I drank because…»

Alcohol is a toxin

So, alcohol, as a toxin, is rendered harmless in the body. As in the vast majority of other cases, the liver is involved in ethanol. The cascade of transformations is two-step: first, in hepatocytes, ethanol under the action of the enzyme alcohol dehydrogenase is converted into acetaldehyde, which, under the action of the second enzyme, aldehyde dehydrogenase, is oxidized to acetic acid.

Acetic aldehyde is several times more toxic than ethyl alcohol. It is he who is responsible for the hangover, which is essentially a severe poisoning. But in people who abuse alcohol, the body has to defend itself from overdoses of alcohol. He does it quite simply – by increasing the activity of alcohol dehydrogenase. But the second enzyme cannot be accelerated.

Why is it always not enough for an alcoholic?

It turns out a paradox – the liver is trying to save the body from ethanol poisoning, but in the end we get even more pronounced poisoning, but with acetaldehyde. What to do – not everything that is done in our body is done for the better.

With systematic abundant libations, alcohol dehydrogenase ceases to cope with its duties, enzyme systems of the second echelon come into play, which further increases the concentration of acetaldehyde in the body.

In the future, taking even small doses of alcohol leads to an avalanche-like increase in the concentration of acetaldehyde. As a result – loss of control and craving for the next dose instead of instantly “burnt out”.

You can buy disulfiram (Antabuse) – one of the oldest, proven and currently not lost drugs for the treatment of alcohol addiction.

All sorts of gimmicks and tricks, excessive diligence at work, meekness at home during a period of sobriety, manipulation of people and facts, periodic breaks in drinking and many other mechanisms of self-deception create an unusually strong structure of denial, thanks to which the alcoholic protects himself from the thought that he is an alcoholic. This structure of self-deception has an intellectual character and is especially well developed in educated people. People who start drinking more and more often, over time, adjust their thinking to this need, come up with refutations of the growing role of alcohol in their lives. And when this becomes impossible, they find an explanation for their drunkenness, trying to bring logical, convincing documents: «Yes, I drank, but a little, the only trouble is that on an empty stomach…», «I drank because I could not refuse the boss», «Because my wife pissed me off». The alcoholic invents such excuses even when he is sober, in order to start a new booze, sometimes he deliberately goes into conflict in order to have, at first glance, a logical reason for drunkenness. Now in the life of an alcoholic, the most important thing is the constantly increasing drunkenness, which the alcoholic himself unusually cleverly and cunningly does not want to realize. Thus, the mechanism of self-deception and denial of reality develops and strengthens, covering over time the entire personality of an alcoholic, penetrating into all his thoughts, even those that, at first glance, are far from alcohol.

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The decline in criticism rarely becomes overwhelming. Usually, the patients are more critical to some discussed issues, and less to others. In particular, patients are fairly well aware of the damage caused by alcohol to their physical and mental health or material well-being. However, they are far less aware of the negative effects of drinking on the family or promotion at work. Patients shift responsibility for family and work troubles from themselves to others or explain them by random circumstances.

In short, the alcoholic does not want to admit that he is an alcoholic. BUT, at the same time, he is constantly in a dejected state, feels guilt and remorse, fear of the phone ringing and when meeting with a servant of the law. Increasingly frequent mood changes, aggression and anger, painful jealousy and suspicion, a tendency to feel sorry for oneself, a feeling of loneliness and longing are observed. And, worst of all, an inferiority complex develops, until every morning a person begins to wake up with fear of what the coming day may bring him, with a dream of sleeping without waking up, or getting drunk. Self-deception does not allow him to notice the true reason for this state. The alcoholic is convinced that the reason for his problems lies in the attitude of other people towards him, in the events and circumstances that take place. He decides to change these circumstances, starts doing gymnastics, running, getting divorced, leaving somewhere, changing jobs. He marries again, returns to his old place, but the desired relief does not come. Since you cannot run away from yourself and from an illness that causes significant deterioration in health, problems in family relationships, conflicts at work and with the law. In the end, all this leads to the fact that the person gives up and goes to the doctor.

But self-deception fulfills another important function. Together with the growing need for alcohol day by day, the patient subconsciously feels that he can no longer live without it. He understands that alcohol has become for him «glass barrier», separating him from those around him and guaranteeing safety and well-being. Now that the alcoholic has decided to be treated, the most important thing for him is to suppress this thought in himself. He should not admit the thought that there is something without which he could die. He should throw away feelings of powerlessness and dependence, self-deception suppresses them. The patient surrounds himself with an increasingly dense shell of self-deception, distorting the perception of reality and fencing it off from other people and from himself. The main mechanism for the formation of alcohol-dependent behavior – the desire to escape from reality by changing their mental state. The destruction of this shell becomes the initial stage of sobering up.

To stop drinking, the alcoholic must begin to behave in a completely different way than before. Instead of hopelessly fighting for the return of a strong will, he must finally capitulate and admit facts that he did not want to notice before, but which frankly indicate his powerlessness over alcohol, i.e. admit oneself to be an alcoholic, and alcoholism is a disease. But one has only to express his assumption about the illness of the interlocutor with alcoholism, as he will immediately have a defensive reaction that will block the way for further serious dialogue.

The problem of an alcoholic is the inability to control himself for a long time in a state of sobriety, without alcohol. It’s easy to understand this by asking a question «why», but not «why» alcoholic drinks.

Usually, people drink alcohol in order to enjoy the taste of alcohol, to support the company, or because a ritual or custom requires it. Others find some benefit to themselves in alcohol. They drink to improve their well-being, to get rid of stress, to reduce anxiety, to ease the state of tension, to become different for a while, to escape from oneself. They drink because they cannot cope with painful sensations, thoughts and doubts.

Sometimes they succeed. After drinking, they start to feel better. Pain and suffering disappear, shyness is easily overcome, in this state it is easier for them to express themselves, make an acquaintance, go dancing, feel unity with others, find understanding of those present, and as a result – a feeling of self-confidence appears. Alcohol helps such people to live. Moreover, it acts quickly and does not require any effort. It turns out that in order to feel good, it is enough to drink a few glasses.  Anyone who has discovered this magical power of alcohol will increasingly turn to a glass. Over time, both joys and failures will become the reason for another drunkenness for him. In general, the ability to control oneself, one’s own feelings ceases to be necessary, since it is now replaced by alcohol. A person ceases to improve himself: the processes of forming emotional resilience are delayed. And from now on, every wave of emotion – longing or fear, anger or joy – will be too much of a shock to survive without alcohol. This explains the seemingly incomprehensible fact that an alcoholic gets drunk, as a rule, at the most inopportune moment: for example, when he has to go to an exam, complete a serious task or make a responsible decision. At this moment, an alcoholic has a nervous tension, which he cannot cope with on his own, and therefore he gets drunk. It is on this, along with the special physiological susceptibility of the body, that a person’s dependence on alcohol is based..

A common trait of all alcoholics is emotional immaturity, which is more than just a personality trait. – the essence of the disease.

The child feels himself at the center of the universe. When he feels hunger, then, wanting to immediately satisfy him, cries until he receives food. By crying, and sometimes in other ways, the child imposes his will on those around him. He must do this, since he is completely dependent on them and, at the same time, is afraid. Over time, the child begins to understand that there are other people in the world, and their existence puts a barrier to his whims. He realizes that he cannot always be the center of attention and not all his desires will be fulfilled immediately. And some will never come true, and you will have to accept this, since you cannot impose your will on others. By developing the mechanism of self-control, the maturing child becomes more independent, realizes that his fate depends more on himself and not on those around him. A mature person is characterized by the ability to control himself, courage, responsibility for his actions and destiny.

The alcoholic is like a child. In the sphere of his consciousness, two concepts dominate: I and WANT. Irresponsible, he, instead of persistently solving his problems, prefers to manipulate the people around him, trying to make them fulfill his whims. In essence, he – a coward, because he is afraid to face difficulties one-on-one, he prefers that his problems be solved by someone else. Alcoholic – always egocentric, thinks and speaks exclusively about himself, and it will never occur to him that someone does not want to be interested in him and listen to his desires. Each «No» he perceives it as a personal insult.

Thus, the alcoholic gradually degrades spiritually, losing the ability to express his feelings normally, does not know what to do with them, how to express hatred and how to say the word. «I love». He drowns out feelings in himself, especially negative ones: anger, resentment and fear. And when there are too many of them – drinks, then literally explodes and throws out everything that has accumulated, while, most often, in an aggressive and destructive form.