​The 5 Types of Alcoholism (and Associated Disorders)

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

It has been proven that taking small amounts daily improves health and protects against heart diseases, also producing a feeling of excitement, reducing the level of anxiety and heart and respiratory rates. However, in higher doses it decreases the level of consciousness and psychomotor coordination among other effects, and Maintaining continued consumption can lead to dependence on this substance, also known as alcoholism which if maintained over a period of at least twelve months that can cause injuries to various brain areas.

What is dependency?

Dependence is understood to be that condition characterized by the existence of the acquisition of a notable tolerance requiring an increase in the amount of the substance to achieve the desired effects, the presence of withdrawal symptoms, the prolonged use of the substance beyond what the consumer intended. , the persistent desire to suppress or control the behavior, the deterioration of other activities due to the continuous performance of activities to obtain the substance and the taking of the substance despite knowing the impact it causes on the person themselves.

In the case of alcohol dependence, This dynamic of constant drinking of alcoholic beverages tends to lead to a series of neurological injuries

These lesions occur in the corpus callosum, the pons and the limbic system, which explains the existence of memory problems and intense emotional reactions. Likewise, the density of the connections of the dendrites of the neurons and the number of these in the cerebellum and hippocampus also decreases, which affects the capacity for motor coordination and learning.

Types of alcoholism according to Jellinek’s classification

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

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

1. Alpha type drinkers

This type of drinker engages in exaggerated and excessive consumption with the aim of mitigating the effects of a mental illness or medical. In these drinkers there is no true dependence, so in reality this classification would not fall within the concept of alcoholism.

2. Beta type drinkers

In this type of drinker there is no true alcohol dependence either Included in this classification are social drinkers, who consume excessively, something that can cause somatic injury.

3. Gamma type alcoholism

These types of individuals present a true addiction, manifesting a clear loss of control over drinking, craving or excessive desire to access it, tolerance to alcohol and adaptation to its metabolites. Within this group we would find chronic alcoholic subjects.

4. Delta type alcoholism

Subjects included in this category also have an addiction to alcohol, presenting an inability to maintain abstinence but without presenting a loss of control over drinking. In other words, they need to drink regularly, but without becoming drunk.

5. Epsilon type alcoholism

The so-called periodic alcoholism occurs in subjects who present loss of control over drinking and behavioral problems but consuming sporadically, spending long periods between doses.

Disorders derived from alcoholism

Abusive alcohol consumption can cause serious physical and mental health problems of consumers.

alcohol poisoning

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

Abstinence syndrome

Another disorder related to alcohol consumption is withdrawal syndrome This syndrome, which occurs when suddenly stopped or interrupted in chronic users, usually begins with tremors between seven and forty-eight hours after the last consumption.

Anxiety, agitation, tremor, insomnia, nausea and even hallucinations are common. The alterations of this syndrome depend largely on the time and amount of frequent consumption, and seizures and epileptic crises, alcoholic hallucinosis or even delirium tremens may occur as one of the most serious manifestations of withdrawal.

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

Alcohol-induced amnesia

Also known are the blackoutor partial amnesias, which can be classified as state-dependent amnesia (in which actions carried out during drunkenness are forgotten that are only remembered when intoxicated), fragmentary (amnesia of what happened during drunkenness with some intermediate moments preserved) or en bloc (total forgetfulness of what happened during the drunkenness).

Habitual alcohol abuse causes many neurons in the hippocampus to die, and as a consequence problems appear when creating memories about what happens when the level of alcohol in the blood is high. At once, declarative memory problems They can remain in the long term.

Sleep disorders

Sleep difficulties also occur, with REM sleep decreasing and phases 2 and 3 of non-REM sleep increasing to produce a surge in REM sleep in the second half of the night that can wake the individual.

Chronic disorders

Apart from these acute disorders, chronic disorders such as Wernicke-Korsakoff Syndrome, cognitive alterations (memory loss, decreased ability to judge and plan, or deterioration of attention, among others) or sexual dysfunctions may also occur. personality (including pathological jealousy in relationships) and other neurological and liver disorders.

Established effective treatments

At a pharmacological level, Different medications are used to treat alcohol dependence Highlights the use of disulfiram to produce an aversive response to drinking alcohol and naltrexone to curb the craving or desire to consume.

Regarding psychological treatment, Over time, multiple programs and treatments have been created in order to combat alcoholism Among them, some of the most effective currently are the community reinforcement approach, cognitive-behavioral therapy, and family and couples therapy.

1. Approach to community reinforcement or “Community Reinforcement Approach” (CRA)

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

Disulfiram, communication skills training, training in job search techniques, recreational activities not compatible with alcohol, and contingency management training are used to resist social pressure to drink through covert sensitization. This is the program with the highest level of proven effectiveness.

2. Cognitive-behavioral therapy

Includes social skills and coping training and relapse prevention.

The first step aims to produce an increase in the ability to manage the situations that trigger the desire to drink, preparing for change, teaching coping skills and generalizing them to everyday life.

Regarding relapse prevention, It focuses on the possibility of the subject drinking again on one occasion (relapse), differentiating it from relapse (reinstatement of the habit) so that there is no effect of the violation of abstinence (creating cognitive dissonance and personal self-attribution of the addiction, which in the long run causes guilt that facilitates relapse).

3. Family and couples therapy

Essential component in treatment programs. Qor on its own it is also highly effective Aside from the problem itself, it focuses on how it affects the couple’s relationship and reinforces communication, negotiation and activities that facilitate maintaining the relationship correctly.

In conclusion

Although alcoholism is a chronic problem, in a large number of cases the prognosis once the behavior is normalized is positive: It has been observed that in more than 65% of the treated cases it has been possible to maintain controlled abstinence However, it is necessary to detect the problem in time and start treatment as quickly as possible to prevent the nervous system from being severely damaged.

In some cases, in addition, the withdrawal of alcohol consumption must be done in a controlled manner and supervised by doctors, since the withdrawal syndrome can give rise to many problems or even lead to death.