Dr. Lucian Vasilescu - Director of the Disintoxication Unit of “Alexandru Obregia” Hospital

All medical doctors nowadays agree that the term alcoholic (or drunkard to put it more colloquially) is too general and inaccurate. It actually includes an unnatural set of relations with drinking, marked by excesses, as well as a whole series of consequences. There are a lot of partial definitions which insist, as the case may be, on the sociological dimension, on the impact of abuse upon the body, mental health or society or on its various consequences.

The current definition of alcoholism refers to repeated alcohol-related conditions affecting multiple functionalities of the human being (biologic, psychological and social), which do not however deter that person from continuing (relapsing into) the consumption of alcoholic drinks.

Although the term “alcoholism” does not describe a specific mental disease, the disorders associated with it can generally be classified into 3 groups:

  • Disorders related to the direct effects of alcohol upon the brain – acute intoxication, withdrawal, delirium tremens, alcoholic hallucination;
  • Behavioral disorders – alcohol abuse and addiction;
  • Persistent disorders (which last in time) – dementia, various forms of encephalopathy, amnesia.

Alcohol addiction – the encounter between a certain mentally active substance (alcohol) with certain physical-chemical properties and a specific action with a person, having a certain genetic background and personality, in a specific social context.

What do we mean by abuse, addiction, withdrawal?

Many of us consume alcohol, which could be a sign of social integration and in no way a sign of disease. Neither the quantity nor the frequency of consumption is a criterion for diagnosis, alcohol tolerance varying greatly from one individual to another. When does consumption become an issue? What is the limit? According to the American Psychiatric Association in “Diagnostic and Statistical of Manual of Mental Disorders”, abuse means: maladaptive use of alcohol, which leads to clinically significant degradation or suffering, manifested by one or more of the following signs:

1)  Recurrent use of alcohol, which results in failure to fulfill major obligations at work, school or home (for example repeated absences or improper performance at work, low conduct mark at school, absenteeism or expulsion from school, neglect of children or household);
2)  Recurrent use of alcohol in situations when it is physically dangerous (e.g. driving or operating a machine after having drunk);
3)  Recurrent legal problems related to alcohol (fines, arrest for troubling public order);
4)  Continued use of the substance despite recurrent social or interpersonal problems, caused or exacerbated by alcohol (quarrels with family members, beating).

It can be noticed that the negative consequences of repeated alcohol consumption are the most important. Abuse conducts vary from heavy drinking to “weekend” drinking or consumption periods followed by longer or shorter periods of abstinence. More often than not, alcohol abuse evolves into alcohol addiction.

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