Whether born of fun, situation-bred, or acquaintance-led exposure, and regardless of the age of initiation, alcoholism is an uncontrolled, debilitating chronic disease of the mind. Having become the go-to source of relief and leisure, a financially expensive habit, alcohol casts a pall of gloom over normal life. It affects people variously. In fact, five impact categories have been identified. Regardless, in the worst case scenario [9.2% of alcoholics; 38 years average age; started drinking at 16 years of age and became full-fledged dependent by 29 years; 248 days of drinking in a year while binging on 172 of them with at most 15 drinks], in its grip, having lost sharpness of mind, a person’s physical capacity becomes sluggish, situational awareness compromised, and sense of responsibility as well as risk-aversion diminished.
An alcoholic is identified by chronic blood alcohol concentration (BAC) level of 0.08 g/dL causing DUI conviction. This is arrived through repeated binge drinking in a fixed period of time, i.e., drinking at one sitting. For a 240 lb. heavy man, this BAC level is arrived through imbibing 5 drinks [one drink constitutes 1.25 oz. of 80% proof liquor, 12 oz. of beer, or 5 oz. of wine] in 2 hours. For a 240 lb. heavy woman, it is 4 drinks in the same time frame.
When a person has resorted to binge drinking 5 or more days in the past month, then one is considered to have been a heavy drinker. So, when binge drinking is not a passing event, but a compulsive, recurrent lifestyle defining theme, a person inevitably descends to the status of an alcoholic!
According to the NIAAA (National Institute of Alcohol Abuse and Alcoholism), based on 4-criteria identification [family history, age of onset of AD, endorsement under DSM-IV AUD criteria, and the presence of comorbid psychiatric and substance use disorder], about 8m adult Americans could be considered alcohol dependent. Constituting them were: male - 68%; white - 71%; and never married - 49%. Thus, 10% of men and 5% of women suffer from AUD. Unfortunately, children of adults with AUD are 4 times more likely to have AUD in one point in their lives.
Alcohol passes rapidly through the body following the bloodstream and starts acting on it immediately. Chemically in the brain alcohol takes two paths to impact the body and the mind. One, by increasing signaling by the primary inhibitory neurotransmitter, GABA (gamma-aminobutyric acid), it depresses the central nervous system and overall brain function. It is used in drugs meant to sedate, unknot muscles and relieve anxiety. So, GABA reduces fear, anxiety, inhibitions, etc. The relaxation is felt as are its various consequences – speech slurring, walking problem, blanking out and blacking out. Second, alcohol leads to increased release of an opiate receptor, Endorphin. This chemical brings about a feeling of relaxation and euphoria in the mind as opposed to relaxation of muscles. The former effect causes the addiction. With chronic drinking, the brain will respond by injecting a third chemical – glutamate. It produces excitatory signaling to counteract GABA’s inhibitory signaling. This counteractivity causes tolerance to increase in a heavy drinker. So, increasingly more often and greater amount have to be drunk so as to get the same high. Thus, dependence and addiction take a firm root.
The short run and long run negative psychological and physical ramifications are many. Psychologically one begins to feel that without the calming and relaxing effects of alcohol nothing small or big can be attempted. Physically, for some using it to relax before going to sleep will likely lead one to drink regularly at bed time; resorting to it at various other moments in a day as in a gathering, meeting, or difficult negotiations makes it a nuisance tool for it can easily cause palpitation, slurred speech, walking difficulty, loss of memory and focus and sometimes even consciousness. On long haul, one could compromise the physical safety of self and others, having lost inhibition become carefree, irresponsible and generally unpresentable, and suffer unanticipated mood swings and become aggressive or volatile. Women may run into pregnancy related health risk for themselves and their unborn. Other potentially fatal health risks like liver cirrhosis, heart disease, brain damage and incapacitation and inflammation of the pancreas begin to eventually crowd about.
AUD has both physical and psychological impact on a person. It causes a psychological attitude of being dependent on it in a wide variety of situations. Other methods of seeking wellness: physical exercise, hobbies, family time, home keeping, etc. are marginalized. Physically, staying awake, paying attention, talking clearly, writing legibly, remembering facts, even maintaining consciousness, etc. becomes a drag. Ultimately, the prized relaxing effect of drinking becomes a bit too much.
Behaviorally, the signs of having turned an alcoholic are co-occurring many: Obsessing about it. Gravitating to it whenever possible. Finding spurious justification for resorting to it. Sneaking away to have a ‘sip’. Drinking at odd hours. Drinking as the first act of the morning. Hiding one’s drinks. Over time, increasing the number of drinks, the volume per drink as well as its stiffness. Physically, the signs are: speech slurring, forgetfulness, inability to walk normally, lying, tremor, sweating, thirstiness, frequent urination, etc.
No, it is not safe for a chronic heavy drinker to halt drinking abruptly. Detox must be carefully calibrated under professional care with appropriate medication [e.g., Naltrexone - Vivitrol, Naloxone, Disulfiram - Antabuse, Acamprosate – Campral, Benzodiazepines – Librium or Valium, etc.] for it is a truly severe episode that is potentially fatal. The reason for this is the presence of glutamate in the brain. It is an excitatory neuro-transmitter (upper) released to counteract the inhibitory (downer) neurotransmitter, GAMA. Thus, with any sudden stoppage, hallucination, tremors and seizure may result as withdrawal symptoms because the brain is hyper excited. Its cells have been firing abnormally, and without the balancing action of GAMA released in response to alcohol consumption, the resulting cellular hyperactivity proves intolerable. Severe shaking, total confusion, hallucination, arrhythmia, high fever, depression, anxiety, insomnia, restlessness, etc. are signs of DT or delirium tremens. It can start as early as 8 hours after the last drink. It is better to be watchful for the first 5 days following the last drink for the onset of DT. Recommended time frame for the medicinal intervention to remain sober is minimally 3 months.
It depends on what category of drinker you are. That is determined by answering a whole series of questions. How old are you? How heavy are you? What is your gender? How long have you been drinking? How much have you been drinking? How often have you been drinking? Do you have other associated chemical dependencies? Broadly speaking, there are 5 categories of alcoholics. The nature of the turnaround process adopted will depend on the alcohol consumption profile of the individual drinker. What is common among efforts of all categories to get better is the acknowledgment of the futility of drinking, the helplessness of the situation faced, and taking comfort in knowing that there is a wide variety of help available. Also, accepting one’s own culpability in the matter, and forming personal intent and desire to turn a leaf are critical to adopting a successful recovery strategy.
Gradually. Focusing less on drinking and how enjoyable and out there it will be perceived as (if youngish). Making up one’s mind to change for the better, of course. Looking to do regularly small acts of goodness. Trying to be fair toward others. Spending time with a different, more wholesome crowd. Taking up a gentle sport and/or hobby. At the same time, artfully grabbing the beast by its throat by: Getting a medical evaluation first. Maybe getting a medication while reducing the number of drinks in a day, reducing the number of days spent drinking in any month and reducing the strength of the alcohol consumed.
Detox is generally the first phase of treatment. It may involve medication to counteract various withdrawal symptoms. The body’s ability to metabolize alcohol has a bearing on the duration of detox. Also, the greater the tolerance level achieved the longer it will take to detox because that is an indicator of the severity of the problem. So, it depends on the stage of AUD of a patient. Broadly speaking, following last drink or detox the withdrawal experience starts as early as 8 hours and lasts as long as 7 days.
Yes, of course. With the first case, more variables are involved. The source and nature of dependency are two-folds. Addressing them simultaneously is a far greater challenge. Lack of understanding and following up with appropriate response may be difficult to come by under the second situation. Whether the mental situation is alcohol induced would be a key determinant in any treatment plan with such a problem-mix. If that is the case, then the precursors will have to be first addressed.
The tptChoice Way foreshadows or anticipates modern integrative method toward curbing alcohol abuse and addiction. It has a broader life perspective brought on by a rich spiritual methodology and the success of its adherents is rooted in adopting a logically motivated behavior modification action plan. Modern approach takes the original American remediation methodology, the 12 Step Program, and integrates it with medically evolved Cognitive Behavior Therapy (CBT). The tptChoice Way first revisits the existing 12 Steps and imbues it with structural spiritualism that provides meaningful behavioral choices bringing order and discipline while giving a non-existential, non-individualistic meaning to life. Then it incorporates today’s knowledge base about causes of AUD, its nature, its triggers, and means to technically managing and reversing its devastating impact. That is the short run or tactical aspect of the recovery program (not cure, mind you).
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