“Is wine really healthy and beer not really alcohol?” Experts share signs of alcohol use disorder – Times of India

Reports suggest that for many people alcohol consumption increased during the pandemic, especially because most of us were ripped from a structured way of life. We did not have to rush anywhere, there was no one who could tell you were suffering from a hangover and alcohol became the thing many looked forward to. But sometimes the line blurs between drinking for a reason and getting dependent on alcohol. We spoke to doctors to know the difference

According to Dr. Dinika Anand, Clinical Psychologist, BLK-Max Super Speciality Hospital, “In terms of substance use disorders, dependence and addiction, in terms of substance use disorders are terms that are associated with a lot of confusion. Simply speaking, dependence is associated with aspects of tolerance and withdrawal and addiction is when continuous consumption alters biochemical changes in the brain. In terms of intake and consumption, acceptable is the occasional 1-2 glasses which translates to mindful, moderate consumption.”

Excessive consumption of alcohol will impact a person’s life in every way – from the number of days/week they drink to the amount of alcohol consumed. Poor sleep, frequent headaches, putting on weight, blackout drinking episodes, inability to socialize in the absence of alcohol can all be signs of a developing problem.”

Is beer or wine better than other drinks?

People who are classifying beer or wine as “good alcohol” or “not alcohol” are definitively walking a slippery slope. Wine may be the secret to longevity but so is a healthy diet, exercise and good sleep. Consuming either wine or beer in excess is a recipe for gloom, after all both have alcohol and therefore rules of moderation apply there as well, adds Dr Anand.

Red wine is touted as a ‘healthy heart drink’, owing to which people feel it’s a safer drink to have. “Consumption of red wine was once considered as one of the possible reasons of the “French Paradox” nearly 3 decades earlier where French people were seen to have a relatively low incidence of coronary heart disease, while having a diet relatively rich in saturated fats.
A natural polyphenol (reveratrol) in red wine has been considered to carry some possible health benefits. This is obtained from the skin of grapes and is also present in other natural foods like blueberries and cranberries. Similar benefits may be available by consuming these in a natural form. A study conducted across 195 countries which was published in The Lancet in 2016 observed that even very small amounts of alcohol raise a drinker’s risk for cancer and early death,” adds Dr Gopalakrishna.

Dr Dwivedi further adds, “Wine per se is another alcoholic drink, while you drink wine, it is also necessary to understand that it is a part of a culturally acceptable Mediterranean diet. How much of that diet contributes to one’s health is anyone’s guess. Also, flavonoid, antioxidant, and cardioprotective compounds in red wine have been talked about without any actual proven support. So, the message of responsible drinking needs to be propagated.”

How much is safe to drink?

Talking about signs of alcoholism, Dr. Rajesh Gopalakrishna, Clinical Professor, Gastroenterology and Hepatology, Amrita Hospital, Kochi shares, “If the person feels that he is using too much alcohol and needs to cut down on use or feels annoyed when others criticize his drinking or he may feel guilty about his drinking. Urge to drink immediately after waking up is also a sign. Frequent binge drinkers are usually dependent. Sleep disturbances, irritability, palpitations, excess sweating, behavioral changes sometimes may be the indicators too.”

The doctor further elaborates, “There is no threshold for acceptable use of alcohol. If you do not drink alcohol, there is no need to start drinking it. Moderation in alcohol use means the drinking is not getting you intoxicated (or drunk) and you are drinking no more than 1 drink per day if you are a woman and no more than 2 if you are a man.
A drink is defined as 12 ounces (350 milliliters) of beer, 5 ounces (150 milliliters) of wine, or 1.5 ounces (45 milliliters) of liquor.”

Dr. Puneet Dwevedi, Chief- Mental Health and Behavioural Science, Artemis Hospital Gurugram further adds, “
Although various dietary recommendations might be there ranging from one to two drinks per day, the problem is that over a period of time the same one to two drinks will not suffice, so the person will have to increase the amount of alcohol to get the same amount of pleasure. That is where this standard dosage of recommended drinking will not be the right way of understanding whether it is allowed or not allowed.”

We all know the ill effects of alcohol on one’s liver. Dr Gopalakrishna shares, “Early effects of liver may be fatty liver which can progress to liver cirrhosis. It can affect other organs of the body also. Drinkers also may experience a range of social harms including family disruption, problems at the workplace, and financial problems.”

Signs of alcoholism

Dr Dwevedi shares definite diagnostic criteria for alcohol use disorder

1) Alcohol is taken in larger amounts or over a longer period than was intended,

2) Persistent desire or unsuccessful effort to cut down or control the alcohol use

3) Great deal of time is spent in activities necessary to obtain alcohol or use alcohol or recover from its effect

4) Carving or a strong urge, desire to use alcohol

5) Recurrent alcohol use resulting in failure to fulfill major roles/ obligation to work

6) Continued alcohol usage might be happening irrespective of social and interpersonal problems that the person might be going through

7) Social, occupational, recreational activities are given up because the person is taking alcohol

8) Specifically taking alcohol in situation, which is physically hazardous, like driving while being drunk

9) Alcohol use is continued despite the knowledge that recurrent physical and/or psychological problems are happening, which are directly increased by alcohol intake. Alcohol can cause anxiety, depression, and other neurological issues

10) Tolerance. If the same amount of alcohol does not give the same amount of pleasure, then the person keeps on increasing the amount of alcohol required to give that same pleasure, which means that tolerance has developed in the body

11) Withdrawal. All those physical and psychological withdrawal symptoms that happen to a person when the person does not take alcohol is also one of the criteria for diagnosing a person to be suffering from alcohol use disorder

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