alcoholism

Alcohol can easily become a luxury drug to a highly dangerous drug. The transition to an addiction is not a one-way street. Decisive are a strict withdrawal and the right relapse prevention.

Quick Overview

• signs: Strong desire for alcohol, loss of control, increase in volume, withdrawal symptoms, neglect of interests and contacts, continued consumption despite negative consequences
• Consequences: Damage to liver, pancreas, stomach and intestine, cardiovascular system, cognitive deficits, anxiety, depression, suicidal thoughts, job loss, destruction of social relationships
• Causes: Genetic predisposition, stress, mental stress, emotional lability, problematic handling of alcohol in family and circle of friends
• Diagnosis: Notes from related persons, questionnaire, blood test (liver values), investigation of possible typical complications of alcohol addiction
• Therapy: Inpatient or outpatient, cognitive behavior therapy, individual therapy, group therapy, mindfulness training, stress management training, therapeutic goal: abstinence
• Forecast: Addiction is lifelong, with disease insight and therapy good chances of abstinence even in isolated relapses, untreated severe sequelae, shortened lifetime

Alcoholism: signs

Alcohol dependence (also: Äthylismus, drunkenness) is not a character weakness, but a serious mental illness. It can meet anyone: people from all walks of life, young and old, women and men alike. In Germany, almost all adults consume more or less alcohol. Some drink dangerously large amounts, but are still not dependent. At what point does the addiction begin?

When are you an alcoholic?

Also for alcoholics are the six main signs of addiction. If three of them meet within one year, the person concerned is considered addicted to alcoholism.

Strong demand

The central symptom of alcohol addiction is a barely controllable craving for alcohol. It can be a permanent condition or suddenly attack the person affected.

loss of control

Alcoholics lose control over when and how much they drink. Loss of control is an important indicator of alcohol addiction. After the first glass there is no stopping for many, until they are very intoxicated. Contrary to better knowledge, they also drink in situations in which this is inappropriate or dangerous – for example during working hours or when they still have to drive.

development of tolerance

Excessive consumption causes the body to develop tolerance to alcohol over time. The affected then need ever larger amounts to feel the desired effect. An alcoholism indicator is therefore that sufferers seem to tolerate significantly more alcohol than non-dependent consumers. This does not mean that the higher amount of drinking harms your body less.

withdrawal symptoms

If an alcoholic with physical dependence drinks less or no alcohol, withdrawal symptoms appear. These include tremors, sweating, sleep disturbances, anxiety and depressive mood. Only a new dose of alcohol can then initially relieve the withdrawal symptoms. This vicious circle is difficult to break.

Dreaded in the case of withdrawal is the so-called delirium. It can be associated with hallucinations. Delirium can cause life-threatening circulatory problems.

Neglect of other interests

The constant concentration of thoughts on the procurement and consumption of alcohol and the time spent on drinking and intoxication make alcoholics neglect their tasks and interests. Friends and family are also moving further and further into the background.

Consistent consumption despite harmful consequences

Alcohol sufferers do not stop drinking even if the consumption already has harmful physical, mental or social effects. They drink despite impending job loss, separation from the partner or a sick liver.

Lack of disease insight

Alcoholics no longer drink to enjoyment, but out of an inner compulsion or even a physical need. That is why attempts to reduce consumption are failing regularly.

Nevertheless, most alcoholics are initially convinced that you could stop at any time. Often they succeed over days or weeks actually. This reinforces their belief that they are not dependent.

But as soon as they reach for the glass, the next relapse with loss of control is usually inevitable. Her failure increases her frustration and makes her drank a bit longer.

Shame, stealth

Despite their obvious problems, most alcoholics are far from being addicted to alcohol. The reason for this can be the extreme stigmatization that hits people with alcohol problems. The corresponding prejudices often share the alcoholics themselves (“I’m not a bum”).

Added to this is the fear of the necessary consequences – namely having to give up alcohol. Many people with alcoholism drink more and more secretly when the environment addresses them to the problem.

Types of alcohol addiction

Depending on your drinking habits you can differentiate between different types of alcohol addiction.

mirror drinkers

The so-called Spiegeltrinker consumes rather small amounts of alcohol, but continuously throughout the day. This type maintains a certain concentration of alcohol in the blood, in order to feel no withdrawal symptoms.

binge drinkers

In contrast, there is the intoxicating drinker, who can not control his drinking behavior and each time drowns until the strong intoxication. He gets used to an ever increasing amount of alcohol. This form of chronic alcohol abuse (chronic alcohol abuse) occurs most frequently.

conflict drinkers

Much rarer is the conflict drinker, who only drinks excessively when problems or conflicts arise. This type uses alcohol to overcome difficulties.

Episodic drinker

The episodic drinker consumes alcohol in phases excessively and then stays abstinent for a few weeks. This drinking behavior is also referred to as dipsomania.

Functional alcoholics

An alcohol disease is not always obvious. Some sufferers hide their alcoholism for years so cleverly that no one notices it. Many succeed in continuing to perform even demanding tasks.

Detect dangerous alcohol consumption

An alcohol addiction develops slowly. The following signs indicate that you are developing an alcohol addiction. Then they should seek advice so as not to slip into dependence on.

• They drink more and more often.
• They are increasingly drinking larger quantities.
• They like to drink alone.
• You are drinking more than you have planned.
• They drink so much that memory gaps occur.
• They continue drinking despite negative consequences.
• They hide how much you drink.
• They are addressed by others on their drinking behavior.

Alcoholism – the consequences

The consumption of alcohol has both acute and long-term effects. Long-term threatens serious organ damage and mental illness. In addition, every area of ​​life is affected by alcoholism: work, family, friends and leisure.

Short-term effects of alcohol

Alcohol can raise mood in the short term and reduce inhibitions. But some make him tearful, others aggressive. Depending on the amount and type of alcoholic drink as well as the body weight and drinking habits, sooner or later alcohol consumption will lead to cognitive disorders and coordination difficulties.

Alcohol quickly spreads throughout the body through the blood to the brain. Even those who tolerate a lot without being drunk harm their organs. Because the liver can only break down about 15 grams of alcohol per hour. Everything that goes beyond that initially remains in the blood. Degradation of alcohol also causes toxins that permanently affect your health.

Long-term physical effects of alcohol

Alcohol and its breakdown products are poisonous. In the long term, they damage all organs of the body.

liver damage

The liver, which has to do its heavy work with frequent drinkers, stores more fat, enlarges and converts to the so-called fatty liver. This often goes unnoticed for a long time, because the liver itself can not feel any pain. However, it is sometimes noticeable by a feeling of pressure in the upper abdomen. Pain only develops when the liver becomes inflamed.

After some time the liver cells die off: It develops a liver cirrhosis (shrinking liver). This is a steadily progressive, life-threatening disease. The risk of liver cancer is also increasing.

Effects on the brain

The brain also suffers heavily. Brain cells are lost with every sip of alcohol (brain atrophy).

Thus, risk also triples for other forms of dementia such as Alzheimer’s and vascular dementia, which also often use earlier than usual.

In severe alcoholics, brain damage can also trigger alcoholic dementia causing Korsakoff syndrome. The affected then suffer from disorientation and memory loss. Korsakoff syndrome is caused by a lack of vitamin B1. Because alcoholics often do not feed enough. Alcoholic drinks contain many calories, but not the necessary nutrients.

digestive tract

Since alcohol passes through the whole digestive tract, it causes damage everywhere. These include increased gingivitis, reflux (heartburn), gastritis and ulcers, damage to the small intestine and colon mucosa.

Gastrointestinal problems such as vomiting, diarrhea and appetite disorders are other alcoholism episodes.

pancreas

Heavy alcohol consumption can cause inflammation of the pancreas (pancreatitis). The acute form is very painful and can be life-threatening, a chronic course with diarrhea weakens the body.

Varices of the esophagus

By destroying the liver, the blood from the abdomen has to find a new way to the heart. A part is no longer passed through the portal vein, but via veins along the esophagus to the heart. These dilate morbidly (esophageal varices) and can burst. The so-called esophageal variceal bleeding into the esophagus can lead to life-threatening blood loss.

Cardiovascular damage

Long-term alcohol addiction episodes are also cardiovascular diseases. The alcohol damages the heart muscle and the vessels. High blood pressure, cardiac arrhythmias and myocardial diseases are more common in alcoholics. Vascular changes are expressed, among other things, in the typical red color of the skin of alcoholics and in the so-called drinking nose.

cancer

In the long term, alcohol also increases the risk of cancer. In addition to liver cancer also threaten tumors in the mouth, throat and esophagus and stomach. In women, there is a significantly increased risk of breast cancer.

Reduced life expectancy

The life expectancy of alcoholics is reduced by 10 to 15 years.

Long-term psychosocial effects

Problems in work and private life

The effects of alcohol affect not only the health: The described physical and emotional consequences come with environmental problems.

Alcoholics will eventually be unable to fulfill their day-to-day tasks. The deeper they slip into the alcohol addiction, the more likely is the loss of employment. This not only affects the financial but also the interpersonal situation.

For example, relationships with partners, children, or friends often break with alcoholism.

Relatives often suffer just as much as the person affected. Family, friends and hobbies are neglected. The patient becomes a burden on the part of the friend, partner and parent, and the addiction becomes a terrible focal point for everyone involved. Relatives often develop a so-called co-dependency.

What’s up with it and how to escape it, you read in the text co-dependency.

Mental Alcoholism Symptoms

Alcohol changes the personality. Under the influence of alcohol some are muted or whiny, others behave aggressively or even violently. The aggression can be directed against both strangers and one’s own family. Many crimes happen under the influence of alcohol.

Alcohol sufferers often also suffer from mood swings and depression. In severe cases hallucinations and delusions occur. Often, alcoholics suffer from sleep disorders and severe anxiety. Also feelings of guilt and inferiority accompany the alcohol addiction.

Alcohol addiction and other mental illnesses

In many cases, the alcohol addiction occurs not alone, but accompanied by another mental disorder (comorbidity). The most common are anxiety disorders, such as panic disorders or phobias. Many alcoholics also suffer from depression. Alcoholics are also common among schizophrenic patients.

It is often difficult to determine whether a mental disorder has led to alcohol addiction or alcohol has caused or exacerbated psychological problems. In combination with a mental disorder, the risk of suicide in alcoholics is increased. Therefore, both diseases must be treated as quickly as possible.

Alcohol in pregnancy

Alcohol is especially dangerous for the unborn child. Because if the mother drinks alcohol during pregnancy, it affects the physical and mental development of the fetus. The damage is irreversible and accompanies the child for a lifetime.

In Fetal Alcohol Syndrome, the children show, among other behaviors and mental and physical impairments that can be very serious.

Even small amounts of alcohol can harm the child. Women should therefore abstain completely from alcohol during pregnancy.

Read more about the effects of alcohol on the unborn child in the text Fetal Alcohol Syndrome.

Alcohol addiction: causes and risk factors

Most people in Germany drink alcohol, many also in harmful amounts. Alcohol dependent, however, is only a part of them, namely around two million.

Exactly how an alcohol dependency arises is not yet completely explained. But there are always several factors together. Both genetic and psychosocial influences play an important role.

Genetic influences

Is alcoholism inheritable? Studies in family and twin research show that there is a genetic risk for alcohol addiction. Identical twins have a significantly increased risk of getting alcoholic if a twin is affected. If both parents are addicted to alcohol, about 30 percent of the children develop alcohol addiction later as well.

Consumer behavior in the family

In addition to the genes of parents, their relationship to alcohol also plays a role. When children learn that drinking a lot is funny, or even admiration, or that alcohol is used to tackle problems, they soon make it a bad role model. If later in your own circle of friends much is drunk, the effect is amplified.

Roots in childhood

Traumatic or stressful experiences often form the basis for the development of addiction. Most vulnerable are people who have experienced abuse or loss in childhood, such as the death of a parent. Decisive for the further development of the child is also the attachment to the mother. Children whose mothers do not respond to their needs or children without a permanent caregiver are more susceptible to alcoholism later.

Alcohol among friends

Especially during puberty, another factor is added: peer pressure. Puberty is a complicated period in which the youngsters try to develop personality and self-image and find peer-to-peer relationships. Peer pressure can be the trigger for drinking. Who does not drink, risks being excluded from the group.

Teenagers often rate the alcohol positively. Being “drinking” is considered a sign of strength. However, persons who bring along this property and who tolerate alcohol well are even more at risk of becoming addicted to alcohol than those who tolerate little. Because the latter automatically drink less.

Alcohol as a life coach

Another risk for alcohol abuse is the initially beneficial effects of consumption. Under the influence of alcohol inhibitions and fears are reduced in the short term. For more insecure people or people in difficult life stages, therefore, the risk of alcohol abuse increases.

Alcohol as a fortune drug

The processes in the brain also play an important role in the development of alcohol addiction. Because alcohol increases the release of the neutron dopamine, which activates the reward system in the brain. Dopamine creates happiness. For example, it is also distributed when we eat something.

But alcohol activates the dopamine receptors even more than food. Drinking alcohol is rewarded with happiness. People who use it too often become less susceptible to dopamine – they need larger amounts. When they drink less or no alcohol, they develop a craving. This is also called craving.

Alcohol addiction: examinations and diagnosis

Harmful use or alcohol addiction? Based on certain criteria, the doctor or therapist can decide what applies to a person and accordingly plan further treatment. The first contact person will help you with the family doctor.

Investigations in alcohol addiction

If an alcohol addiction is suspected, the doctor will first have a detailed conversation with the person concerned. The family doctor could ask the following questions in a first interview:

• Do you often feel the need to drink alcohol?
• How much alcohol do you drink a day / a week?
• Do you have the impression that you often have to think about alcohol?
• Have you ever tried to reduce your alcohol intake?
• What positive or negative effects does alcohol have on you?

External withdrawal symptoms, such as sweating, shivering or redness, can be an alcohol addiction sign. Using a blood test, the doctor can find more evidence of increased alcohol consumption. The blood count also provides information about the condition of the liver. In addition, the doctor will perform a comprehensive physical examination to determine any further possible damage.

Diagnosis: abuse or alcohol dependence (ICD-10)

If the suspicion of alcohol addiction becomes apparent, the family doctor will refer you to outpatient specialists or a clinic. These perform an accurate diagnosis and create an individualized treatment plan to combat alcohol addiction.

Diagnostic criteria for alcoholism

As a rule, the criteria of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) are used to diagnose alcohol addiction.

A distinction is made between the harmful use of alcohol, which is referred to as alcohol abuse or alcohol abuse, and alcohol dependence. According to the ICD-10 for Alcohol Addiction, at least three of the following criteria must occur at the same time in one year:

• There is a strong desire to drink alcohol.
• Those affected have no control over when or how much they drink.
• If alcohol intake is reduced or stopped, withdrawal symptoms (such as sweating or shivering) are the result.
• It creates a tolerance to the alcohol, so that the amount must be increased more and more to feel an effect.
• Dealing with alcohol takes a lot of time and leads to the neglect of other interests.
• Although alcohol consumption has negative consequences, those affected do not stop drinking.

Alcohol addiction: alcohol withdrawal

In the case of physical dependence, a detoxification must be carried out first. Before the actual alcoholism therapy, those affected must do a medically monitored alcohol withdrawal, a so-called detoxification. The withdrawal of alcohol can be accompanied by mild to severe physical withdrawal symptoms. With heavy addiction withdrawal can even be life-threatening. Therefore, he should always take care of a doctor. Only after the physical withdrawal then follows the actual weaning therapy.

Outpatient withdrawal

In easier cases, this is possible on an outpatient basis. The patient then appears daily for breath control for alcohol over a period of time. In addition, a doctor checks the withdrawal symptoms such as tremors, sweating, concentration problems and high blood pressure. It may also be the end of a urine test made, the alcohol can prove much longer.

Inpatient withdrawal

In more severe cases, you must be detoxified in hospital. On the one hand, patients who do not manage to renounce alcohol on their own do not come here for alcohol. On the other hand, the dreaded delirium tremens can also occur during withdrawal. It can be associated with anxiety, confusion and hallucinations.

The dangerous physical symptoms such as epileptic seizures, increased blood pressure, pulse turf can be better controlled here. Under inpatient medical supervision delirium can be intercepted and treated in time.

Read more about this topic in the article Alcohol withdrawal.

Alcohol addiction: treatment

Even though dependent people can no longer suppress their alcoholism, few people seek help with alcohol addiction. For one, the shame is very big. On the other hand, the idea of ​​having to give up alcohol is unthinkable for many.

But alcoholism is a life-threatening disease. It can only rarely be mastered alone. Therefore, do not hesitate to seek help with alcohol addiction if you are afraid to drink too much.

Abstinence or reduced drinking?

Those who are not yet dependent on alcohol have a good chance to reduce their consumption again – preferably under supervision.

But once the addiction has developed, it becomes a lifelong companion. The aim of a weaning therapy is usually a complete abstinence from alcohol. However, many alcoholics can not imagine a complete renunciation of alcohol (at least initially). In the past, they usually fell out of the grid of help offers.

In the meantime, search experts have changed their attitude. Since 2015, the guidelines on alcohol therapy have also recommended reduced drinking as a possible treatment target for alcoholics who fail to achieve abstinence.

In some circumstances, over time, the patient may be able to do without – or even easier than drinking. Because the constant self-control of the amount of drinking is not easy. The urge for more remains.

However, for most alcohol cessation offers, abstinence is still the basic requirement.

Focal points in alcoholism

First contact is usually the family doctor. Further help with alcohol addiction is provided by psychiatrists and therapists, as well as public organizations, associations and counseling centers dealing with alcoholism.

Psychological weaning therapy

To find out from the alcohol addiction, you have to set up from scratch. It is important to discard old habits, discover the causes of addiction and find new ways to deal with problems and stress or to create positive feelings.

A weaning therapy is always made up of different building blocks that address the different aspects of addiction and its enhancers: combined with individual discussions and group therapy. In addition, elements such as stress management, mindfulness training are added.

individual therapy

An addiction treatment is usually based on a cognitive behavioral therapy. In the individual therapy, the therapist worked intensively with the patient to develop new patterns of thinking and behavior.

The essential step is to uncover the personal reasons for slipping into alcohol. To stay abstinent, the patient must work with the therapist to develop new coping strategies for the addictive situations. He learns to get away from the automated grip on the bottle and find new sources of positive emotions.

group therapy

Group therapy is the second key component of addiction treatment. The experience of meeting others, people who have experienced the addiction on their own body, helps to reduce feelings of shame. In mutual exchange, patients can benefit from others’ tips and coping strategies and encourage and support each other.

The senior therapist often also addresses central life issues that play a role in addiction: life goals, relationships, relationships with parents, losses or fears.

Family or Systemic Therapy

Often the addiction has already damaged the relationship with friends and family. Often, there is a so-called co-dependency in alcoholism: the relative allegedly helps the patient, for example, by covering him with outsiders or tolerating his behavior.

But it can also have family problems contributed to alcohol addiction. Both can be dealt with as part of a family therapy.

The focus is usually an open, respectful communication behavior without blame. This makes it easier for both sides to approach each other again. The relatives learn how to support the patient, but also to isolate themselves.

mindfulness training

In mindfulness exercises like the “body scan”, the patient pays full attention to the here and now. He learns to perceive his feelings, both positive and negative, clearly, but also to accept them as something temporary. In this way, for example, an imminent relapse can be detected early, so that the patient can counteract in time. With the techniques but can also cope with a strong addiction pressure.

stress reduction

Stress is a central cause in most alcoholics – and again and again a trigger of relapses. In therapy, the patient learns how to stress less or to be stressed externally. Also helpful is the learning of a relaxation method such as autogenic training or progressive muscle tension according to Jacobson.

Medicines against the desire

For people who can not achieve abstinence with psychotherapy alone, additional drugs for alcohol addiction can help:

• The active ingredient naltrexone reduces the positive effects of alcohol. In alcoholic addicts, these tablets are often used against alcohol addiction as a relapse prophylaxis.
• The active substance disulfiram causes a strong intolerance of alcohol. The victim then suffers from drinking alcohol, headache, shortness of breath, redness on the face, nausea and vomiting.

Inpatient or outpatient?

Inpatient treatment: Getting rid of alcohol is difficult. Often this works better in a clinic specializing in addiction. For one thing, one is not confronted with drinking fellow human beings and it is difficult to get alcohol at all.

However, for many patients, it is important to get out of their usual environment and focus on themselves and overcoming the disease.

In addition, patients who are seriously ill and who have been suffering from illness for many years often no longer have a job and, apart from their drinking routines, barely have a daily structure. At the clinic, they have the opportunity to get used to a regular routine, to develop new interests and to learn to take on responsibility for smaller tasks. Inpatient treatment usually lasts between three and six months.

Ambulatory weaning: For patients who are less seriously ill, for example, still have a job and are socially well involved, outpatient treatment may be useful. This can, but does not have to be extra-occupational.

The advantage is that patients practice life without alcohol right in the wild. They learn to refuse alcoholic drinks in convivial rounds, do not be tempted by the beer, schnapps or wine offer when shopping or to cope with stressful situations without alcohol. Outpatient treatment usually takes nine to twelve months.

Reimbursement

Since 1968, alcoholism has been recognized as a disease. Therefore, the treatment is also taken over by the health insurance, later by the pension provider, for example, the Federal Insurance Institution for white-collar workers. Private health insurance companies do not always or not always cover the costs completely. The refund depends on the contract.

To deal with relapses

Alcoholism can not be “erased”. Anyone who was once dependent on alcohol, must also decide after successful completion of alcoholism therapy again and again against the alcohol. Each glass can cause a serious relapse. Even if the first alcoholic beverage seems to have no consequences after a long time, the consumption is usually back to its old level within a very short time.

The way out of alcohol addiction is long and difficult. Der Patient wird daher auf den Umgang mit möglichen Rückfällen vorbereitet. Rückfälle sind häufig und es ist wichtig, dass die Betroffenen diese nicht als persönliches Versagen, sondern als Teil des Lernprozesses betrachten. Wichtig ist es, dann zu erkennen, welche Auslöser es für den Rückfall gab, um diese künftig rechtzeitig abzuwenden.

Selbsthilfegruppen

Selbsthilfegruppen leisten im Anschluss an die Therapie einen wesentlichen Beitrag, stabil zu bleiben. Durch die regelmäßigen Treffen bleibt das Thema Alkoholabhängigkeit präsent. Das schützt vor Rückfällen. In der Gruppe findet der Betroffenen Rückhalt und ein Verständnis, das Nichtbetroffene nicht aufbringen können. Manche vereinbaren persönliche Mentoren, die sie im Notfall kontaktieren können.

Kontrolliertes Trinken

Für die klassischen Therapieformen ist der Wille zur Abstinenz noch immer die Grundvoraussetzung. Einen anderen Ansatz verfolgt das sogenannte „kontrollierte Trinken“. Angedacht ist es nur für Betroffene, die noch nicht zu tief und nicht allzu lange in der Sucht stecken.

Das 10-Schritte-Programm wurde bereits vor Jahren von dem Psychologen Joachim Körkel entwickelt. Unter anderem soll der Kranke erkennen, zu welchen Gelegenheiten er trinkt, ein Trinktagebuch führen und feste Trinkziele festlegen und einhalten lernen.

Die Regeln sind jedoch strikt: Er muss vorab Zeit, Ort, Umstände und Trinkmenge festlegen. Letztere sollte so niedrig angesetzt sein, dass sich kaum eine Wirkung entfaltet. Experten kritisieren, dass der Kontrollverlust Teil der Erkrankung ist und kontrolliertes Trinken daher für Suchtkranke ein Widerspruch in sich sei.

Alkoholsucht: Krankheitsverlauf und Prognose

Das Trinken von Alkohol ist gesellschaftlich fest verankert. Als legale Droge ist Alkohol leicht erhältlich und jederzeit verfügbar und zudem vergleichsweise preisgünstig. Er entspannt, hebt die Stimmung und enthemmt. Die Gefahr, zu viel zu trinken, ist daher groß.

Riskanter Konsum

Der Grat zwischen Genuss und Gefahr ist schmal: Mehr als 24 Gramm reiner Alkohol für Männer (z.B. zwei Gläser Bier à 0,3l) und 12 Gramm (z.B. ein Glas Bier à 0,3l) täglich für Frauen gelten bereits als riskanter Konsum. Doch auch weniger Alkohol kann empfindliche Menschen auf Dauer schädigen.

Alkoholmissbrauch

Der Übergang von schädlichem Gebrauch zur Sucht ist fließend. Zunächst setzen die meisten Alkohol ein, um positive Gefühle zu erzeugen, Ängste und Unsicherheit zu lindern oder Probleme auszublenden. Der Konsum steigert sich zu einem schädlichen Gebrauch.

Dabei handelt es sich noch nicht um eine Abhängigkeit. Bei vielen kommt es aber schon jetzt immer wieder zu Problemen im Zusammenhang mit dem Alkoholkonsum: Ärger mit Partnern, Freunden oder am Arbeitsplatz beispielsweise.

Die Betroffenen lassen in ihrer Leistung nach, kommen häufiger ihren Verpflichtungen nicht nach oder der Betroffene verunglückt im Rausch. Anderen Alkoholkranken gelingt es, ihre Sucht lange Zeit zu verbergen.

Psychische Abhängigkeit

Es folgt die psychische Abhängigkeit. Der Betroffene vernachlässigt Sozialleben und Aufgaben zunehmend. Der Alkohol wird zum Lebensmittelpunkt. Oft kreisen die Gedanken nur noch um das nächste Glas. In diesem Stadium verheimlichen die Betroffenen das Trinken bereits häufig. Steht kein Alkohol zur Verfügung, entwickelt sich ein starkes Verlangen danach.

Körperliche Abhängigkeit

Gewöhnt sich der Körper an den Alkohol und benötigt der Betroffene größere Mengen für den gewünschten Effekt, ist das der Einstieg in die körperliche Abhängigkeit. Verzichtet der Abhängige in dieser Stufe auf Alkohol, tauchen körperliche Entzugserscheinungen auf.

Sie reichen von Schwitzen und Zittern bis hin zum lebensgefährliches Delirium mit Halluzinationen. In schweren Fällen kann ein Entzug zumindest im Alleingang tödlich enden. Er sollte daher unbedingt unter ärztlicher Aufsicht erfolgen.

Verkürzte Lebenserwartung

Ohne Therapie ist die durchschnittliche Lebenserwartung eines Alkoholikers um zwölf Jahre vermindert. Häufigste Todesursache sind Suizid, Unfälle, Leberversagen, Herzerkrankungen und Krebs.

Trotz konsequenter Nutzung aller therapeutischen Möglichkeiten sind nur 45 Prozent der ehemaligen Alkoholkranken vier Jahre nach Ende einer Therapie noch abstinent. Wer sich jedoch von Rückfällen nicht abschrecken lässt, kann auch auf lange Sicht die Alkoholsucht in den Griff kriegen.

Lebenslanges Thema

Unbehandelt bliebt Alkoholismus meist ein ständiger Lebensbegleiter bis zum – oft verfrühten Tod. Alkoholismus im Alter wird allerdings oft nicht erkannt. Stürze oder kognitive Ausfallerscheinungen werden dann schnell dem hohen Lebensalter zugeschrieben, statt der Suchterkrankung.

Additional information

Books:

• Alkoholismus: Warnsignale, Vorbeugung, Therapie (Wilhelm Feuerlein, C.H.Beck, 2008)

guidelines:

Leitlinie “Screening, Diagnose und Behandlung alkoholbezogener Störungen” der Deutsche Gesellschaft für Suchtforschung und Suchttherapie e.V. (2016)

Support Groups:

• Gemeinsames Dienstbüro Anonyme Alkoholiker Interessengemeinschaft e.V.
• Al-Anon Familiengruppen, Für Angehöroge und Freunde von Alkoholikern