The 5 types of alcoholism (and associated disorders)

Alcohol. This word refers to one of the most popular and widely used legal psychoactive substances in the world. This substance acts as a central nervous system depressant, disrupting neuronal membranes and increasing the mobility of molecules present in the brain.

Taking small amounts daily improves health and protects against heart disease, further producing a feeling of excitement, lowering anxiety levels and lower heart and respiratory rates. However, at higher doses, the level of consciousness and psychomotor coordination decrease, among other effects, and continued use can lead to addiction to this substance, also known as alcoholismWhat to maintain over a period of at least twelve months can cause damage to various areas of the brain.

What is addiction?

By dependence is meant this table characterized by the existence of the acquisition of a remarkable tolerance requiring an increase in the quantity of substance to obtain the desired effects, the presence of withdrawal symptoms, the prolonged use of the substance at- beyond what the consumer wanted, the persistent desire to suppress or control the behavior, the deterioration of other activities due to the continued performance of activities to achieve the substance and the taking of the substance despite the knowledge of the impact it causes on the person himself.

In case of alcohol dependence, this dynamic of constant consumption of alcoholic beverages tends to lead to a series of injuries at the neurological level.

These injuries occur in the corpus callosum, bulge and limbic system, which explains the existence of memory problems and intense emotional reactions. It also decreases the density of neural dendrite connections and the number of dendrites in the cerebellum and hippocampus, which affects the ability of motor coordination and learning.

Types of alcoholism according to the Jellinek classification

There are a large number of causes and patterns of alcohol consumption in people with addiction.

In this sense, a large number of classifications have been established, highlighting Jellinek’s proposal. This author classifies drinkers and alcoholics into five different groups, in order to indicate the social and therapeutic problems specific to each group.

1. Alpha-type drinkers

This type of drinker engages in binge and binge drinking in an attempt to lessen the effects of a mental illness. or medical. In these drinkers there is no real dependence, so in reality this classification would not fit into the concept of alcoholism.

2. Beta drinkers

In this type of drinker, there is also no real dependence on alcohol.. Social drinkers are included in this classification, consuming excessively which can lead to somatic damage.

3. Gamma-type alcoholism

These types of individuals have a real addiction, showing a clear loss of control over alcohol consumption., Craving or excessive desire to access it, tolerance to alcohol and adaptation to its metabolites. Within this group would be chronic alcoholics.

4. Delta-type alcoholism

Subjects included in this category are also addicted to alcohol, Presenting inability to maintain abstinence but without showing loss of control over alcohol consumption. In other words, they should drink regularly, but without getting drunk.

5. Epsilon-type alcoholism

So-called periodic alcoholism occurs in people who have lost control over alcohol consumption and behavioral problems., But consuming sporadically, spending long periods between prey and prey.

Disorders resulting from alcoholism

Alcohol abuse it can cause serious physical and mental health problems of consumers.

alcohol poisoning

Among them is alcohol poisoning, It is caused by the recent ingestion of a large amount of alcohol (or consumed at an excessive speed) and is characterized by the presence of mental and behavioral changes such as aggressiveness, euphoria, poor muscle control, mental and physical slowing down. , farfulleo, alterations in memory, perception and attention. It can range from simple poisoning to alcoholic coma and death.

Withdrawal syndrome

Another of the disorders associated with alcohol consumption is withdrawal syndrome. This syndrome, which occurs after sudden cessation or interruption in chronic users, usually begins with tremors between seven and forty-eight hours of the last consumption.

Anxiety, restlessness, tremors, sleeplessness, nausea, and even hallucinations are common. The alterations of this syndrome depend largely on the time and amount of frequent consumption, and can present with convulsions and convulsions, alcoholic hallucinosis or even delirium tremens as one of the more serious manifestations of the abstinence.

In the case of delirium tremens, it is very important to seek emergency medical help, because 20% of cases are fatal if you do not go to the hospital, and even with the intervention of specialists, 5% of cases are fatal. people die. This clinical picture appears in 3 phases:

  • First phase: anxiety, tachycardia, insomnia and dizziness.
  • Second phase: 24 hours later, the above symptoms worsen and appear tremors and profuse sweating.
  • Third phase: hallucinations, disorientation, tachycardia, delusions and stupor.

Alcohol-induced amnesia

There is also known fainting, or partial amnesia, which can be classified as state-dependent amnesia (in which actions performed during intoxication are forgotten and only remembered in a state of intoxication), fragmentary (amnesia of what happened during the intoxication preserved moments) or en bloc (total forgetting of what happened during the intoxication).

Habitual alcohol abuse leads to the death of many neurons in the hippocampus, and as a result, problems arise in creating memories of what happens when the blood alcohol level is high. At a time, declarative memory problems they can stay long term.

Sleep disorders

There are also difficulty sleeping, a decrease in REM sleep, and an increase in phases 2 and 3 of non-REM sleep to occur in the second half of the night, an increase in REM sleep that can wake the individual up.

chronic disorders

In addition to these acute disorders, chronic disorders such as Wernicke-Korsakoff syndrome, cognitive impairment (memory loss, decreased judgment and planning, or impaired attention may also occur). Others) or sexual dysfunctions, personality (including pathological jealousy in relationships) and other neurological and hepatic disorders.

Established effective treatments

At the pharmacological level, different drugs are used to treat alcohol dependence. Demonstrates the use of disulfiram to produce an aversive response to alcohol consumption and naltrexone to curb the urge or desire to consume.

As for psychological treatment, over time, multiple programs and treatments have been created to combat alcoholism. Among these, some of the most effective today are the community strengthening approach, cognitive behavioral therapy, and family and couple therapy.

1. Community strengthening approach (CRA)

Program designed taking into account the importance of family and society in strengthening alcoholic sobriety. Motivation and positive reinforcement techniques are used there. The main objective of the program is to reduce consumption and increase behavior functional.

Disulfiram, communication skills training, job search skills training, non-alcoholic recreational activities, and contingency management training are used to resist social pressure to drink through secret awareness. it is the program with the highest level of proven effectiveness.

2. Cognitive-behavioral therapy

Includes training in social skills and coping and relapse prevention.

The first step aims to produce an increase in the ability to handle situations that trigger the desire to drink, to prepare for change, to teach coping skills and to generalize to everyday life.

In terms of relapse prevention, it affects the possibility of the subject drinking again on one occasion (fall), differentiating it from relapse (Restoration of the habit) so that there is no effect of the violation of abstinence (creating cognitive dissonance and personal attribution of addiction, which in the long run causes guilt that facilitates relapse) .

3. Family and couple therapy

Essential component of treatment programs. Pgold alone is also very effective. Besides the problem itself, it focuses on how it affects the relationship and strengthens communication, negotiation, and activities that make it easier to maintain the relationship properly.

in conclusion

Although alcoholism is a chronic problem, in a large number of cases the prognosis once behavior is normal is positive: it was observed that in more than 65% of the treated cases, abstinence was controlled. However, it is necessary to detect the problem in time and start treatment as soon as possible to prevent serious damage to the nervous system.

In some cases, furthermore, withdrawal from alcohol consumption should be carried out in a controlled and supervised manner by doctors, as withdrawal syndrome can lead to many problems and even lead to death.

Bibliographical references:

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Hunt, GM and Azrin, NH (1973). A community approach to reinforce alcoholism. Research and Behavioral Therapy, 11, 91-104
  • Jellinek, EM (1960). The concept of the disease of alcoholism. New Brunswick: Hillhouse Press
  • Kopelman, MD (1991). Short-term nonverbal forgetfulness of Korsakoff alcohol syndrome and Alzheimer’s dementia. Neuropsychology, 29, 737-747.
  • Marlatt, GA (1993). Prevention of relapses in addictive behaviors: a cognitive-behavioral treatment approach. In Gossop, M., Houses, M. (eds.), Relapse and rechute prevention. Barcelona: Ed.Neurociencias.
  • Sants, JL; Garcia, LI; Calderon, MA; Sanz, LJ; of rivers, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Lladre, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR preparation manual, 02. CEDE. Madrid.

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