8. Sexual disorders in the form of weakening of potency in men (weakening of erection, the appearance of the premature ejaculation) are replaced by an increased libido observed at the initial stage of alcoholism. The decline of sexual potency often there is a strengthened sense of jealous spouses and girlfriends. Women, by contrast, is marked sexual disinhibition with promiscuity without considering possible consequences.
Main clinical features of III (final) stage of alcoholism
1. Of primary pathological attraction to alcohol is closely associated with physical dependence. In most cases, the attraction is irresistible (compulsive) character and followed by a complete loss of situational control (the desire to drink overrides all possible external constraints – work and family responsibilities, lack of funds, etc.). In some patients, a pathological attraction can be reduced, as aparisi-rific effect of alcohol is completely absent, and alcohol is the only means to mitigate withdrawal effects.
2. The syndrome of altered reactivity to alcohol is manifested by a decrease in tolerance to alcohol and is the main feature of stage III. First decreases dose – intoxication comes from small doses of alcohol, but the daily intake remains the same due to the multiple dose. Then reduced and daily alcohol consumption (50% or more), patients moving from strong to weak drinks, usually cheap wine, the alcohol substitutes. Significant diagnostic sign may be the appearance of vomiting after ingestion of alcohol, which is associated with the accession of severe somatic disease (alcoholic liver, chronic pancreatitis, and other diseases of the gastrointestinal tract).
3. The change in the pattern of intoxication is characterized by the absence of euphoria and reducing the effects of disinhibition and aggression that occurred earlier. Intoxicated patients often become lethargic, inhibited, relatively low doses of alcohol taken to induce a state of stun and Zaporozhye phenomenon. There is significant amnesia period of intoxication.
4. Withdrawal syndrome occurs after ingestion of small doses of alcohol. In the structure dominated by it is not mental (anxiety, fear, depression) and somatic vegetative, and neurological disorders. At the time of withdrawal may develop delirium or seizures.
5. The change of use of alcohol is normally expressed as a constant (systematic) drunkenness on the background of reduced tolerance or binge-drinking. The latter is in the nature of true drinking bouts, which are based on the primary attraction to alcohol. Pathological attraction actualizarea at the beginning of the binge, after binge, patients with marked aversion to alcohol, which causes interruption of the binge and the formation of spontaneous remission. The reason for the failure of such remission, in addition to external provoking factors can be “pseudoabstinence” – a condition with many signs of withdrawal symptoms (muscle tremor, sweating and chills, insomnia, anxiety and depression) that occur after long-term (weeks, months) of abstinence from alcohol. During them the craving for alcohol again becomes irresistible. The impetus for the development of pseudoabstinence can be acute somatic or infectious diseases, at least – emotional stress. Sometimes pseudoabstinence arise periodically for no apparent reason.
6. Alcoholic degradation of personality manifests the smoothing still pointed character traits and the growth of personality changes in alcohol-psychopathic type. Lost the higher emotions and affections, the circle of interests is limited. Patients become indifferent to loved ones, neglect the most basic moral and ethical principles, rules of the hostel. Uncritical attitude to their behavior. Complacency and euphoria alternating with coarse cynicism, flat, “alcoholic” humor, interspersed with dysphorias and aggressiveness. In severe cases develop chronic brain disorders: worsening memory, difficulty shifting attention, reduced intelligence (alcoholic dementia). Growing passivity, lethargy. Sick for everything but drinking, be completely indifferent. Has a rough social exclusion: patients lose their previous professional and family status, lead a parasitic way of life.
7. The occurrence of acute, protracted and chronic psychoses metacholine.
8. Somatic consequences at the final stage, there are heavy. It is often a cirrhosis, liver and pronounced cardiomyopathy. Alcoholic polyneuropathy (alcoholic polyneuritis”) are manifested by complaints of pain and discomfort in the extremities – numbness, paresthesia, seizure information. In patients with disturbed gait. May be paresis, atrophy of muscles. Statistics on the mortality of USA men of working age indicate that almost half of them killed due to alcohol consumption. With a particularly lethal factor is the use of surrogate alcohol “beverages” – Cologne, antiseptics and medicinal tinctures alcohol. Alcohol visceropathies, toxic manifestations often occur before the addiction.
Types of alcoholism
Alcoholism is a progressive disease. The progression reflects the pace of development of signs of alcohol dependence. The degree of progression varies from slowly progressive to malignant progressive. From of progression depends on the duration of the stages of alcoholism. The vast majority of patients I stage becomes apparent after 5-10 years of drunkenness, and 10% – 15 years or more. The duration of stage I is on average 3-5 years. Currently, as the criteria of progression is used the timing of the formation of alcohol withdrawal syndrome from the beginning of alcohol abuse and the peculiarities of the formation of remission. Malignant (fulminant) alcoholism is characterized by a sharp reduction all the time. 1-2 years of drinking there are signs of stage I, even after a year or two there comes a stage II. There are long binges, with short breaks, or constant drunkenness with high tolerance (up to 1 liter of vodka a day). Rapidly increasing the alcohol degradation of the individual with severe social maladjustment. Frequent variety of complications, especially alcoholic psychoses. Malignant course occurs in people with traumatic brain injury, brain infections and neurointoxication (for example, abuse of inhalants), with epileptic psychopathy and . constitutional intolerance to alcohol.
The opposite of malignant for is a slow type of flow: withdrawal syndrome is formed after 10-15 years of alcohol abuse. Marked spontaneous remission and prolonged therapeutic remission. Type of drinking short – term drinking binges with long periods of sobriety or constant drunkenness on the background of moderately increased tolerance. Marked changes in personality on alcohol type not found, exclusion does not occur.