Friday, for many, is the day to have a beer with friends or another drink to relax from everyday activities. More than half of the Brazilian population, 55%, have the habit, shows a survey carried out by the Brazilian Liver Institute (Ibrafig), with 17.2% declaring an increase in consumption during the covid-19 pandemic, associated with severe anxiety. because of social isolation.
Today, February 18, is National Day to Combat Alcoholism, a date designed to raise awareness of the damage and diseases that excessive consumption of alcoholic beverages can cause, both in men and women.
According to the Ibrafig survey, one in three people in the country consumes alcohol at least once a week. Abusive consumption of alcoholic beverages was reported by 18.8% of Brazilians interviewed in the survey. The data were collected based on the response of 1,900 people in the five regions of the country. The study also shows that, on average, Brazilians ingest three doses of alcohol per occasion, which represents 450 ml of wine or three cans of beer.
Several factors can trigger alcohol dependence, says psychiatrist Rafael Maksud, from Clínica Ame.C. “Factors that can trigger alcohol dependence are genetic predisposition, early onset of use, preexisting mental illnesses, cultural conditions such as associating alcohol with fun, history of sexual abuse, domestic violence, curiosity, insecurity, among others”.
Maksud is from the Brazilian Association of Psychiatry (ABP) and a specialist in Public Health, Chemical Dependence and Integrative Psychiatry by the Psychosocial Care Center (Caps) and by the Expanded Nucleus of Family Health and Primary Care (Nasf-AB).
He recalls that the long-term consequences of alcoholism are negative on physical and psychological health and, in most cases, cause serious damage in all areas of life – work, family or social. “As an example, we can mention hepatitis, cirrhosis, hypertension, increased risk of ischemic stroke, various sexual disorders, dementia, severe withdrawals, depression, anxiety and alcohol-induced psychoses”.
Drinking on weekends, which usually starts on Friday and ends on Sunday, leads many people to believe that they are not dependent on alcohol, but the habit can also be harmful to health, warned the doctor.
“In this case, initially it is not characterized as an alcoholic dependence, but it can be understood as the harmful use of alcoholic beverages. Harmful use is a pattern of consumption that causes damage to health, whether physical (such as alcoholic hepatitis) or mental (such as worsening anxiety and depression). Harmful patterns of use are often criticized by others and are associated with adverse social consequences of various kinds.”
damage
The psychiatrist explained how alcohol works on the brain. “When you drink, you feel relaxed, as your perception decreases. However, regular consumption reduces the levels of serotonin in the brain, one of the neurotransmitters responsible for the feeling of pleasure and well-being. Thus, alcohol aggravates anxiety and, especially, depression”.
Psychologist Monica Machado, graduated from the University of São Paulo, founder of Clínica Ame.C, reinforces that frequent consumption of alcoholic beverages controls the regular release of brain substances responsible for emotional control, which increases vulnerability to anxiety attacks”.
Therefore, he adds, “understanding the relationship between anxiety and alcohol helps in the search for more concrete answers to reduce the consequences of excessive consumption of alcoholic beverages and anxiety disorder”.
The reverse can also happen, that is, those who do not have disorders can develop them with excessive alcohol consumption. “Alcohol dependence can be one of the reasons for the development of disorders, such as anxiety, but this situation is complex, since anxiety can also lead to alcohol dependence”, says Mônica.
In addition to psychological and physical damage, alcoholism can impair thinking even when a person is sober. “Even sober, alcohol-dependent patients, especially after several years of substance use, tend to present several cognitive deficits that can even become permanent. For example, memory difficulties, consolidation of new learning, reduced ability to abstract and solve problems, important elements for the construction of reasoning”, warns Maksud.
women and alcohol
Alcoholism affects men and women, but for them, health problems occur more quickly, says the doctor. “Researchers have found that women have greater physiological vulnerability to alcohol. According to scientists, women produce smaller amounts of the enzyme alcohol dehydrogenase (ADH), which is released by the liver and used to metabolize alcohol. In addition, the fat retains the alcohol, while the water helps to disperse it. So, thanks to their naturally higher levels of fat and lower body water, women have an even more complicated physiological response.”
Therefore, he adds, “women who consume alcohol in excess also tend to develop dependence and other health problems more quickly than men. They usually start drinking later than men, but it takes much less time to become dependent and develop liver or heart disease, for example.
Treatment
According to the psychiatrist, treatment for alcoholism is usually done with medical and therapeutic follow-up and some medications can help. “When properly evaluated and diagnosed, medications are good adjuvants in the treatment of alcoholism, as they help in the process of abstinence and in the prevention of relapses. Alcohol indirectly stimulates endogenous opioid activity by promoting the release of endogenous peptides into the synaptic cleft. There is a type of medication that acts as a competitive antagonist at opioid receptors. Thus, the administration of opioid antagonists would reduce alcohol consumption through postsynaptic blockade of some receptors.”
free treatment
Alcoholics Anonymous (AA): the mutual aid group is a reference in supporting alcoholics who want to stop drinking. Participation is free and one of the main principles is confidentiality. Present in Brazil for 80 years, Alcoholics Anonymous has meetings in almost every city in Brazil.
Caps – AD: Psychosocial Care Centers – Alcohol and Drugs are health units designed to provide free care to those who need to treat alcoholism. Monitoring is done by doctors, psychologists and therapists. There is also an opening for family participation.
When the dependent lives in a city that does not have Caps – AD, he can look for a traditional unit (which takes care of mental health) or a basic health unit in his municipality to do the treatment. If there is a need for hospitalization, it is the Caps itself that makes the request and refers the patient to one of the associated institutions.
Prevention
For those who do not want to be dependent, some attitudes can help to inhibit excessive alcohol consumption, observes Monica Machado.
“First, it is necessary to know how to identify people with a greater tendency to addictions and, for this, seek the help of a trained professional. There are some tips for people who consume alcohol in excess and would like to stop drinking: don’t have alcoholic beverages at home; avoid situations where you think you will lose control of use; learn to say no or ask for help while you don’t have that control; choose a day to stop drinking and confine alcohol consumption to specific situations. And again, the main thing: seek proper professional help.”
Another attitude, reinforces the psychiatrist, is to avoid contact with alcohol during adolescence. “The later the contact with alcoholic beverages, the lower the risk of dependence. Some studies show that teenagers who start drinking before age 15 are four times more likely to develop alcohol abuse than those who start later, after age 21. It has also been reported in the medical literature that the risks for problematic alcohol use decrease by about 14% each year that the start of consumption is delayed. This is due to the vulnerability that age-related neurological immaturity entails”, says Maksud.
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