Alcoholism (including alcohol dependence, ethylism, dipsomania, potomania, alcoholism, drunkenness, alcoholism or alcohol abuse disorder) is the addiction to the psychotropic substance ethanol, The mental and / or physical dependence of alcohol is mostly a social and human problem of the individual, but experience has a negative effect on his environment such as family and work. In the course of history there have been and still are repeated prohibitions on alcohol in various forms in individual countries or even in entire cultural areas such as Islam, alcohol abuse or even in principle the alcohol consumption for various reasons by strict prohibition to stop. A significant example of the dubious success of alcohol bans is the prohibition in the United States from 1920 to 1933.
The border is fluid - there is no measurable no / yes point. After Prof. dr. Wilhelm Feuerlein (Head of the Psychiatric Polyclinic, Max Planck Institute for Psychiatry in Munich and author of recognized standard works) there are five definition criteria from a clinical point of view. These include 1. abnormal drinking behavior, 2. somatic alcohol-related harm, 3. psychosocial alcohol-related harm, 4. development of tolerance and withdrawal syndrome (physical alcohol dependency), and finally 5. development of "withdrawal syndromes on the subjective level" in extreme cases total loss of control, as well as the centering of the thinking and pursuit of alcohol (mental Alhohol dependence).
If only the first four criteria are fulfilled, one speaks of alcohol abuse (alcohol abuse), with the fifth criterion of alcohol dependency. According to estimates by the German National Center Against Addiction Dangers, around eight million Germans (10%) are considered to be in danger of alcohol, of which 2.5 million are alcoholics. 20% of occupational accidents and 20% of traffic deaths are due to alcohol. These data can be proportionately converted to the number of inhabitants of Austria (almost 9 million).
A typological classification is by Professor EM Jellinek. The US psychiatrist is considered the "pope" of alcoholism research; his major work "The disease concept of alcoholism" from 1940 led to the general recognition of alcoholism as a disease, the typology of alcoholism was published in 1960. Jellinkek assumes four or five types, which he describes as follows:
Alpha and beta alcoholics
These are "non-alcoholics", where the alpha type is the conflict drinker who drinks for relaxation and relief, but at any time can stop it. The beta guy is the casual and social drinker to which virtually everyone does not abstain. As "addicted alcoholics" the groups of gamma, delta and epsilon alcoholics are classified. Addiction develops slowly via the prodromal phase (precursor phase, period between increased alcohol consumption to loss of control, duration is several months to several years) to the critical phase, combined with loss of control.
In order to preserve the appearance of an intact family, the partner's alcohol problem is very often ignored, downplayed or hidden. As a result, ever larger amounts of drink are consumed. The onset of this phase is characterized by the occurrence of regular memory gaps and irritable reactions when the environment addresses the topic of alcohol as a result of the onset of guilt from the self-awareness that one's own drinking behavior is not normal. In the further course it comes slowly with the progressive disturbance of the metabolic processes to the physical and mental addiction education, connected with loss of control.
In a pre-alcoholic phase, the drinking behavior is inconspicuous and socially motivated, it takes place in society. There is increasing relief in drinking, alcohol is increasingly drunk for mood balance, with ever higher dosages are required. There are memory gaps. It is drunk alone and secretly, with which social isolation begins. In the following critical phase loss of control occurs. Smallest amounts of alcohol increase the urge for more alcohol. The attempt to stop drinking is characterized by physical withdrawal symptoms (sweats, restlessness, trembling). Self-esteem is increasingly lost. In the chronic phase, excessive drinking is carried on for days, with the consequence of ever-increasing emotional, physical and social degradation.
Also colloquially referred to as a mirror drinker - mostly (still) without loss of control. In order to avoid physical withdrawal syndromes, a permanent blood alcohol level must be maintained. This can often be hidden from the environment through non-regular consumption.
This type of drinker (also quarter drinker) can live without alcohol for weeks, but in crises or depressions there is a loss of control and often several days of excessive alcohol consumption. This is followed by a more or less long abstinence, which can extend over several months (quarter).
The cause of the physical damage caused by alcohol abuse is mainly the primary metabolite acetaldehyde, a biologically very reactive cytotoxin. Damage is fatty liver, liver cirrhosis, alcoholic hepatitis, gastric mucosal inflammation, gastric and intestinal ulcers, chronic pancreatitis (see also under diabetics wine ), neurological damage and epileptic seizures. This leads in extremis to the alcoholic hallucinosis "delirium tremens" (drunkenness), the most severe form of alcohol withdrawal, in which it comes to visual and acoustic sensory illusions, disorientation and tremor of the hands (tremor), as well as the "Korsakov" Syndrome "(according to the Russian psychiatrist Sergei Sergeyevich Korsakov), the heaviest, irreversible form of brain damage from alcohol, with extensive loss of memory and orientation due to the death of entire brain cell regions.
Successful therapy is not possible without the patient's admission of being alcoholic. Following inpatient or outpatient physical withdrawal, which is partly drug-supported, weaning is followed by psychological and social-therapeutic treatment, in which self-help groups have a high share. The chances of success of a therapy are very good with about 50% (every second). The big difference between a moderate Weingenuss and dangerous alcohol abuse describes very well an essay by the Austrian poet Peter Rosegger (1843-1918). This wrote, so to speak, a prosaic declaration of love to the wine, but preaches moderate dealing with it.
An often asked question is whether alcoholics / addicts are alcohol free beer or Wine (up to 0.5%) or low-alcohol wine (up to 5.0%). That's not just a matter of alcohol content but also dependent on the mental state of alcoholics. There is no limit generally valid for all people, from which it becomes "dangerous". These alcoholic or low-alcohol Alcoholic beverages (which are defined under wine law) differ with respect to odor. taste and colour hardly of the alcoholic ones.
The danger here is that a abstinent or "dry" alcoholics again by the enjoyment "on the taste" and starts again to consume higher-percentage drinks. This means that even a beer / wine with 0.0% can be dangerous - because the taste and smell can (not necessarily) have an animating effect. Incidentally, as stated above, a beer up to 0.5% is considered "non-alcoholic" (although, strictly speaking, it is not alcohol-free); only one 0.0% beverage may be declared as "without alcohol".
Which quantities of wine or alcohol are acceptable for health reasons or which are probably not harmful to health when used regularly is mentioned under the keyword health explained. The subject alcohol abuse of the antiquity to the modern age with bizarre stories and prominent protagonists can be found under the keywords intoxication and drinking culture, See under this topic complex also under ADH (Alcohol degradation) ADI (Acceptable Daily Intake = acceptable levels), alcohol ban. allergy. Blood Alcohol Concentration (BAK = calculation of alcohol level), hangover. a headache. prohibition. Vinotherapie and To drink,