Alcoholism: symptoms, consequences and therapy for alcohol addiction

Alcoholism: symptoms, consequences and therapy for alcohol addiction

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Alcoholism - ways out of alcohol addiction

Alcohol is a hard drug, and the aftermath of it alcoholism are often worse than many illegal drugs if we exclude side effects such as procurement crime, forced prostitution and social neglect. It not only makes you mentally dependent, such as cannabis, but also physically.

Addiction is not a weakness in character, but an illness, more precisely, a chronic and recurring illness, characterized by a compulsive search for the substance and its consumption, although the patient knows about the catastrophic consequences.

Alcohol addiction destroys social relationships, damages the brain with symptoms that resemble mental illnesses and causes serious organic diseases that lead to premature death.

7.4% of premature deaths in Europe are the result of alcohol. Alcoholic disease is the third leading cause of premature death after tobacco and high blood pressure. Alcohol is even the leading cause of death for young men in the EU.

Alcohol abuse

We differentiate between addiction and abuse. Abuse refers to the harmful consumption of alcohol, which is not yet dependent, but which has massive social consequences for the consumer: he loses his job because he does not hang over to work, he spends money in a frenzy that he does not have; he insults friends, parents and siblings until they turn away from him; he endangers others because he drives a car while drunk; he no longer dares to leave the apartment because he has done so many things that are soberly embarrassing to him; he reveals secrets.

His apartment turns into a garbage dump; he provokes fights and is banned from bars; he either doubts about himself or the world without realizing that the bad moods are the result of alcohol abuse; he forgets or represses positive goals in life; he looks for an environment in which his behavior is considered normal and surrounds himself with people who have the same problem.

He increasingly uses alcohol to forget about the problems that arise from his abuse, he increasingly plans the regular disasters in relationships and at work through the intoxication; he is squandering his potential; he experiences mood swings as they are known to bipolar people and develops delusions similar to those of paranoid schizophrenics.

If these symptoms persist for a year or more, we speak in the clinical sense of alcohol abuse.

Psychological addiction - an example

Let's call him Karl. Karl grew up in a village near Bremen. The first time he drank alcohol was at the age of 13 on a birthday; for the peasant sons from his class that was part of it. Firefighters, rifle and soccer clubs were the alternatives in their free time. Karl had little to do with it, but entered everyone to be there.

The firefighters poured the beer into their bodies, everyone at the rifle club drank more and more from round to round, after football they went to the "Thirsty Man". Easter fire, shooting festival or firefighting ball, there was always an occasion to drink. The village youth were too simple for him, but when he drank he broke the distance.

He followed the rules: Karl never drank during the day and he did not go to the two bars in the village, where the local alcoholic scene met. Firstly, he felt uncomfortable there, secondly, his parents had warned him: a former large-scale farmer who had drunk his yard and a former soldier who had beaten his neighbors halfway to death met.

Karl went to the high school in the nearby small town. In a free hour he drank a bottle of grain with two friends as a test of courage. At school festivals, they smuggled whiskey in their jacket pockets into the auditorium. In the evening they now met in a bar; his parents warned him that drugs were circulating there, some of the older ones smoked hashish, others took ecstasy. Karl stuck to beer, wine and whiskey.

After graduating from high school, he saw great freedom; Karl enrolled in engineering studies and moved to Berlin-Kreuzberg. The first months passed like a frenzy; he drank here too, drunk, dared to speak to strangers, and kept himself awake all night.

At first, he enjoyed doing whatever he wanted to do, but soon he lacked familiarity. He met new people every night and drunk endlessly talking to them, but when he woke up he was alone.

He felt lonely especially in winter. He went to the bar around the corner, drank and discussed with people he knew by sight. Or he bought the ration for the evening when buying it late, chips, cigarettes and beer. At night he drank a gin to warm up there, a whiskey, and in the mornings, when the shops closed, he took the subway home alone, in the bag a few cans of school hot.

He got used to the addicts at Cottbuser Tor; once he saw one who opened his pants on the subway and peed between the waiting people. "How deep can a person sink," he thought as he sipped his beer.

He watched the snowflakes and drank red wine. Then his heart warmed, and being alone didn't bother him. He got used to walking the streets alone, buying some beers at this kiosk, drinking them, and he repeated that at that one.

But he felt just as "outside" as with the farmers in the village, alcohol increasingly replaced the lack of feeling of security. When his parents visited him, he put away the bottles that were stacked on the kitchen table.

He had to go to court because he drunk insulted a police officer, he now worked in a bar, and the team got drunk after hours. A contract with a construction company broke because he didn't get out of bed drunk and didn't take care of a health certificate.

He sat down with the unemployed at Cottbuser Tor, it was easy: he got a few beers from the kiosk and was one of them. Jobs and his studies moved far away; one day he would take care of it, he kept saying, and his new buddies encouraged him as they fantasized about the good life and waited for someone to supply them with beer.

In Karl's diary there were now entries about his alcohol excesses. Sometimes there was only one word across the page: "Idiot." He cursed himself for drinking and not having his life under control - and when self-reproaches exploded, he drank.

His paths in the big Berlin ended on the park bench and as before he dreamed of real life, a job, a harmonious relationship, but there was an invisible wall between his life and such dreams. Then he picked up the bottle.

He was now planning non-alcoholic weekends, once he did not drink anything for six weeks; he started with taek-won-do, went there twice, then rewarded himself with a beer, and two, and three.

He got used to the morning headache, he got used to the irritation in the stomach, he got used to the cravings that drove him to devour fatty currywurst at night. He got used to the stains on his jacket, the holes in his pants and the warnings from his landlord. He no longer invited his parents.

He was suffering. His pores widened, his eyes became small and red, his belly fatter and fatter. The mirror in the bathroom showed the truth, so he stopped looking in it and stopped counting the bottles.

One night, after several beers and whiskeys, he collapsed in the pub; the emergency doctor came and they pumped his stomach out at the clinic. At least that was what the doctors told him later.

He came back to his apartment, pondered when everything had started, read his old diaries, and again and again encountered the same problem: alcohol.

He researched the phases of alcoholism on the Internet and was amazed to find that alcoholics wrote of the same bad moods as he - and he had always blamed Berlin, society or his life for it.

Then he read clearly for the first time about the consequences of alcohol abuse: problems with the judiciary, loss of social contacts, problems with studies and work, increasing indifference, depression. Everything included. And psychological dependence, the second stage of alcohol addiction: the search for alcohol becomes a compulsion and increasingly determines life; control over the amount, time and duration of alcohol consumption disappears, hobbies no longer play a role, addictive behavior is denied, alcohol consumption rises and rises; the personality changes.

His hands didn't shake when he woke up in the morning, but he needed more and more beer and schnapps to get drunk. Karl was an alcoholic.

Karl's story is fictional, and yet it is true because it combines biographies of alcoholics. Karl had crossed the line from abuse to psychological addiction.

Alcoholism Symptoms: When Do You Consider Alcohol Addiction?

We speak of alcohol addiction when all or most of the following symptoms are present:

  • Strong demand: The person concerned extremely craves alcohol.
  • Loss of control: Loss of control over the amount, the start and the end of drinking.
  • he always drinks more than planned, but at the same time he wants to drink less without succeeding in the long run.

  • Film cracks: Frequent loss of memories of the time of intoxication.
  • Withdrawal symptoms: With physical addiction, sufferers experience withdrawal symptoms if alcohol is not used.
  • Loss of interest: The addict develops a tunnel vision: all other interests are behind procurement and consumption, hobbies as well as social norms, money and life planning.
  • Destructive behavior: Those affected continue to consume alcohol even though their health suffers and social relationships are damaged. Slopes are often aware of this damage, but they suppress it. Despite the loss of a driver's license, a failed partnership, a break in friendships or a loss of job, people continue to drink.

Alcoholism test

Alcoholism does not run in strictly delimitable stages, as medicine used to assume, light or severe addiction, physical addiction or habit drinking are not a domino effect that progresses linearly. The Munich alcoholism test is much more meaningful than the assignment of certain “drinker types”. It consists of only four questions:

  1. "Have you tried (unsuccessfully) to limit your consumption?"
  2. "Have other people criticized your drinking behavior and angered you with it?"
  3. "Did you already feel guilty about your consumption?"
  4. "Have you ever drunk right after getting up to get going or to calm down?"

If the person concerned answers yes to at least two questions, there is probably a dependency. If all questions are answered with a yes, acute alcohol dependence is highly likely.

Change of heart

Long-term abuse changes your personality. Motivation, performance, memory and drive are becoming increasingly restricted. The patients suffer from jealousy with delusional tendencies without "normal" recognizing a trigger; This jealousy not only applies to your love partner, but also to friends, parents, siblings, even strangers - and it can be dangerous.

Those affected injured their best friends dangerously because they were jealous of a third party who was at the table and got on well with the best friend. More than a third of all domestic violence cases result from alcohol abuse.

The jealousy craze goes hand in hand with paranoia, for example the fixed idea that two people talking at the counter conspired against the person concerned.

The addict's jealousy of madness destroys families, takes the sick to prison and their victims to the hospital - or to the cemetery.

Edgar Allan Poe, who suffered from the problem himself, skilfully sketched such a change of character in the story "The Black Cat": An honorable man who loves animals as much as his wife loves alcohol and develops a paranoid disgust for his cat. He kills the animal, but a new cat appears that looks like a copy of the old one. In his delusion, he attacks the cat with the ax, killing his wife in between.

The patient yells at the postman who wants to deliver a package for the neighbor; he sways between sky-high and saddened to death. He cries for fictional memories.

Only when he is intoxicated, and later in the phases in between, does his socially balanced behavior collapse - with relatives, friends, acquaintances as well as with strangers: for example, he falls around the neck of strangers and treats close friends as if they were air.

He neglects body and home hygiene. He goes beyond the limits that he had previously met: he drives a drunk car and urinates in public.

Psychoses and depression accompany longstanding alcohol abuse. Most of the time, those affected repress the fact that these are primarily the consequences of alcohol. In advanced alcoholism, these psychoses also characterize the "sober" state.

Finally, in Korsakov's syndrome, alcohol destroyed essential areas of the brain. The brain replaces the missing memories with inventions. Friends feel "offended" when the sick person now accuses them of things they have never done or does not recognize these friends, tells about trips to countries where he has never been and, above all, at every opportunity Controversy triggers events that only exist in his imagination.

Above all, however, the patient lies when it comes to his addiction. He develops strategies to first get the material and secondly to hide it. A bad joke is: "Guys, I'll take the dog out for a minute." "How, you don't have a dog at all."

He hides schnapps in the aftershave bottle. He projects and complains about the alleged or real addiction problem of others. He plans various stations to get the substance under all circumstances. He invites others to drink together to foster normality.

If he flies out of the job because of his problem, he invents other reasons. If he misses appointments because of the intoxication, he blames others.

Relatives and friends who keep in touch with him become co-alcoholics. If they massively confront him with his problem, he ends the relationship. If you play along, you cover his addiction. They make excuses when he is drunk in bed, buy him schnapps at the kiosk, and assert "everything is fine" when third parties ask about the condition of the patient.

Acute alcohol intoxication

An acute alcohol intoxication restricts awareness, perception and behavior. The drunk is disinhibited, his attention wanes (drowsiness), he loses his ability to assess situations, his performance drops. He instigates disputes and quickly feels provoked without a reason.

His gait is insecure (he stumbles), his speech blurred (he slaps), his eyes twitch, his face turns red, as does the conjunctiva. Alcohol poisoning also lowers blood pressure and the body becomes hypothermic.

Alcoholic types

In the past, doctors classified an abundance of alcoholic types. Instead, the biographies of individuals are in the foreground instead. Politicians, teachers and journalists suffer from the disease, as do construction workers and the unemployed, young and old, men and women.

Cloninger established two types in 1981. The Type I is characterized by the milieu. The patient grows up in an environment in which drinking is part of it, be it as evidence of masculinity, be it because the pub is the place for social gathering, or be it because the liquor bottle is on the table during a visit. A “men's place setting” for a beer and a grain at the counter, or the “construction worker breakfast”, ie a box of beer, make alcohol a social ritual.

Of the "Type-I“Drinks to be part of it. He is generally passive and depends on rewards. For example, he swears at his job, but instead of changing jobs, he drinks schnapps during lunch break.

He takes on the role of victim: the system, the boss, the parents are to blame for not leading the life he wants to lead. Instead of taking steps to make his dreams come true, he bathes in self-pity: "I couldn't take it without alcohol." Instead of working on your own goals, he makes his well-being dependent on the praise of others, and promises such a "reward" also the drug.

The more difficult the social situation, and the less recognition the person experiences, the more difficult the disease is. Genetic dispositions hardly play a role. In Type I alcoholics, psychotherapy promises success that paves the way for personal responsibility. Alcohol is a symptom for them, the core of their problem is the fear of a self-determined life.

Of the "Type II“Is almost always a man. His father was already addicted to alcohol and he starts drinking very early. The mother often has no alcohol problem. This guy needs alcohol and other stimuli to get into a euphoric mood - he often lives multi-toxic. He races by car, balances on bridge railings, he is involved in every questionable test of courage.

Most likely, these patients have a genetic predisposition. Some of these type II alcoholics have a dissocial personality disorder in the clinical sense, and psychotherapy does very little because they do not suffer from their behavior themselves.

A third group probably also has a genetic disposition to alcohol, but is not anti-social. Alcohol is also magnetically attracted to these people because it makes them euphoric.

Biological triggers

Alcohol has a relaxing effect because it inhibits the NMDA receptors and stimulates the GABA receptors. The body releases dopamine and endorphins. However, this stimulation falls asleep with long-term consumption, and more and more alcohol is needed to bring about relaxation.

The withdrawal is painful because the nerve cells previously suppressed by the substance occupy the room without being in balance. That means: fear to the point of horror, tremors, hallucinations and convulsions. The sick drink alcohol again to switch off these symptoms.

New studies suggest that addiction may be based on genetic predisposition. This sounds abstract and means that the brain of the alcohol at risk is linked to the pleasure centers.

Moral acid therapies are of no use here. Confronting the patient with the consequences of his alcohol abuse, assuming his weak will, and, to put it casually, asking him to "clench his teeth" brings the person concerned into a vicious circle. His unconscious keeps pushing him towards the drug, just as it leads unloaded people to the warm heating in winter. The unconscious cannot be influenced at will.

These patients in particular need an environment in which they do not come into contact with the alcohol trigger.

In the event of abuse and social triggers, however, psychotherapy and ways to help yourself promise success. However, the will to quit addiction must exist - and with it the awareness of the problem.

Alcoholism therapy

In order to get a grip on a socially or psychologically, but not genetically triggered, alcoholic illness, the will first decides.

Namely, new studies show that ultimately people do nothing that they don't want to do successfully. So the first question the person concerned has to ask is whether he wants to stop drinking at all.

First of all, sufferers need to be aware that they have a problem. Then it is important to fix the advantages and disadvantages of the drug in black and white. Demonizations are just as ineffective as convincing yourself to feel guilty. At the most, both lead to a "bad conscience", and a bad conscience only means doing the same thing as before and feeling even worse.

Deciding is already self-help. Alcoholics use the bottle to numb themselves, i.e. not to consciously decide for or against something, not to face challenges and to unconsciously take on a victim role.

An advertising machine that constantly suggests to us that we can have everything and be everything if we only want to prevent such clear decisions. Because a decision always means deciding against a variety of alternatives. If you decide, you pay a price, and you should make it clear from the start.

There were or were at least positive stimuli to drink. A table on which the person concerned compares the positive side of the addictive substance to the negative one is the basis for paving the way out of addiction - or drinking further.

For example, the positive side could be: I forget my problems with alcohol; I relax; I speak to people, lose my shyness; the intoxication makes cloudy days colorful; drinking is part of my life structure.

On the negative side is: drinking destroys my friendships; I am ashamed of what I do; I drink my professional potential; I am getting fat and sick; my performances decrease; I don't enjoy the day; I waste money that I could use sensibly; my character changes to a caricature of myself.

Next is an unsparing "chronicle" of positive and negative incidents that caused the addiction: Have I discovered something new while I'm alcoholic? Have I developed a perspective while I was intoxicated that I didn't otherwise have? Have I lost my driver's license, what important relationships broke up because of drinking, etc.

Based on this chronicle, the person concerned can classify his alcoholic career. When did the first film tear follow? When did he lose control? When did values ​​that he set himself no longer matter?

The rule of thumb of such a pro and counter dialog is: The more serious the illness, the more the positive stimuli of consumption disappear. For example, if the positive side says "I get to know new people more easily", but if I am so deeply addicted that the new and old people run away from me, the positive aspect has dissolved.

The person concerned now writes down what situations lead him to take up the bottle: stress or concrete fear, for example going to a club? These triggers already show the way to healing, namely to change habits.

If, according to one of those affected, he only endures the people in a certain club drunk, it could now dawn on him why he is going to a place that he dislikes.

If he overcomes his shyness with the drug, he can train it soberly by smiling or addressing strangers.

Noting this black on white also exposes the constant excuses. For example, the sick person can see that his excuse that he is constantly being seduced because there is beer and wine to be bought everywhere lapses if he runs for miles to get his dose at night.

But once the triggers have been identified, such as fear in a foreign company, loneliness or stress, there are a lot of alternatives: relaxation exercises, changing perspectives, trying something completely new, if only by cycling through previously unknown streets , or consciously do something good that doesn't mean alcohol.

The person concerned can go to groups that help - like Alcoholics Anonymous - and speak openly about his problems, call friends with whom he has not been in contact for a long time, tell his relatives that he has understood the problem. Addicts are often amazed at how much help they receive when they accept it.

Useful Habits / Positive Goals

If biological dispositions do not play a role, but rather the habit or the milieu, the person concerned can develop useful habits. The conscious will must exist, but the unconscious hangs on it like a block on the leg.

Our unconscious behaves "arch-conservatively". It saves past experiences and changes functional systems only very slowly. Habits are patterns stored in the unconscious, and unfortunately for sick people this pattern is kiosk alcohol, pub alcohol, club alcohol, supermarket alcohol.

These habits need to be changed consciously. For example, a person who "goes on the slopes" out of habit on Saturday night can cycle for one hour every Sunday morning at 7:00 in the forest (where there is no kiosk). For this he has to go to bed earlier on Saturday.

Or he keeps his old way to the kiosk, but now gets himself a chocolate bar and a bottle of cola every time. It is advisable to practice fixed rituals and charge them with (positive) symbols.

An alcohol diary provides an internal compass during this phase. The person concerned begins it on the day on which he decides to quit the addiction. He keeps it like a "normal" diary, but focuses on his alcohol behavior.

Firstly, if the urge to bottle seems overpowering, he can reach for the fountain pen and write about this urge, secondly, he also writes about everything else that goes through his head and frees himself from it by writing it down. Thirdly, he is creating a treasure of his own life, because after just a few weeks the diary shows whether, and as a rule, how it changes.

It is advisable to involve witnesses, parents or friends, and tell them: “I have recognized my problem and I (date) stop drinking alcohol. I will meet with you regularly in the near future and you will honestly tell me how you assess my condition. ”The person concerned has now made an agreement with himself and found witnesses. He can't go back.

If the patient drinks again in the first phase, he also writes it down without judging himself. On the contrary, he tries to record this state as a participating observer.

Everything, be it visiting anonymous alcoholics, psychotherapy, talking to parents, reactions from friends and promises to yourself should be written down. If the first attempts to get rid of the addiction fail, that's not a problem. Successful people differ from unsuccessful people in that they fail a hundred times before the unsuccessful try.

The diary should definitely contain positive drafts of a future without alcohol and the person concerned should note down at least ten beautiful (sober) experiences every day and write down five successes. He can also create a picture of himself as he imagines when alcohol no longer determines his life. He can also keep a daily list of how much money he saved today because he didn't spend money on alcohol and use it for meaningful projects. Or he contrasts the day's events with what he would have missed with alcohol.

Successes and experiences do not have to be grandiose: "I got up at 8:00 am, washed the dishes and transferred my rent first" is as much a success as "a chaffinch landed on the windowsill" is a wonderful experience. The trick with such records is that it refocuses our subconscious.

The unconscious only slowly breaks away from stored patterns, but when it adds new patterns, the associations bubble with them too. Those affected who develop such new and positive habits report different phases. At first the urge is extreme and the new habits such as walking in the wall seem like compulsive self-discipline to them, but then new contents of consciousness emerge, childhood wishes reappear in everyday life, the focus is on things that are not related to alcohol do have.

At best, the alcohol diary becomes a precious adventure of self-knowledge.

If you “only” suffer from alcohol abuse, you can also try controlled drinking by setting up rules such as: “I don't drive a car at parties”; "I drink three soft drinks between each glass of alcohol"; "I ask my friends to tell me when I become abusive"; "I'm looking for alternatives such as yoga, cycling or a warm bathtub when I'm overexcited or stressed." If this controlled drinking does not work after several attempts, it is advisable to stop consuming it altogether.

It is essential to solve the addiction problem not to undertake too much. First of all, it's all about alcohol. If I suffer from obesity, possibly through the drug, eat unhealthy food, smoke too much, do not exercise enough or have a Messie syndrome, then I should not want to solve everything at the same time - then failure is inevitable. As a rule, these other problems also decrease when I rearrange my life without dependency.

Addiction reminder

Ob Missbrauch, psychische oder körperliche Abhängigkeit: Wer sich von der Droge befreit, behält die Erinnerung an „Lady Whisky” ein Leben lang. Alle Lebenserfahrungen, die wir mit dem Alkohol verbinden, sind im Unbewussten gespeichert.

Gerade trockene Alkoholiker, die körperlich abhängig waren, kennen die Nostalgie bei allem, was mit dem Rausch zu tun hat. Die beste Vorbereitung auf dieses „Wehmutsgefühl“ ist, die Entscheidung für ein Leben ohne die Droge bewusst zu treffen, sich also vorher klar zu machen, dass vertraute Lebenswelten nicht mehr da sein werden.

So paradox es klingt; es geht, wie bei allen Alternativen, darum, das Leben mit der Sucht zu würdigen. Trockene Betroffene, die sich als radikale Alkoholfeinde inszenieren, sind meist keine glücklichen Menschen. Sie verleugnen, dass die Weinflasche ihnen Trost versprach und schmeißen so einen wichtigen Teil ihres eigenen Lebens weg, an das ihr Unbewusstes sie immer wieder erinnert.

Besser ist es, den Alkohol wie eine verflossene Liebschaft zu behandeln, oder wie einen alten Freund, der auf die schiefe Bahn geriet, und zu dem wir deshalb keinen Kontakt mehr haben, dessen gemeinsame Zeit wir aber nicht missen wollen – eine Beziehung, die ihren Sinn hatte, aber Vergangenheit ist. (Dr Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Anonyme Alkoholiker Interessengemeinschaft e.V.: Was ist Alkoholismus? (Abruf: 23.08.2019), anonyme-alkoholiker.de
  • Deutsche Gesellschaft für Suchtforschung und Suchttherapie e.V. (DG-Sucht): S3-Leitlinie Alkoholbezogene Störungen: Screening, Diagnose und Behandlung, Stand: Juli 2014, Leitlinien-Detailansicht
  • Bundespsychotherapeutenkammer (BPtK): Leitlinien-Info Alkoholstörungen in der psychotherapeutischen Praxis, Stand: April 2019, bptk.de
  • Deutsche Hauptstelle für Suchtfragen e.V.: Alkohol (Abruf: 23.08.2019), dhs.de
  • American Addiction Centers: What Is Alcoholism or Alcohol Use Disorder? (Abruf: 23.08.2019), alcohol.org
  • National Institute on Alcohol Abuse and Alcoholism (NIAAA): Alcohol's Effects on the Body (Abruf: 23.08.2019), niaaa.nih.gov
  • Mayo Clinic: Alcohol use disorder (Abruf: 23.08.2019), mayoclinic.org

ICD-Codes für diese Krankheit:F10ICD-Codes sind international gültige Verschlüsselungen für medizinische Diagnosen. You can find e.g. in doctor's letters or on disability certificates.

Video: Naltrexone for Alcohol Use Disorder - clip from Does Addiction Treatment Work? March 2019 (June 2022).


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