Alcoholism is one of the most serious problems of our time. According to a study conducted by the Public Opinion Foundation, alcoholism is one of Russia's top three problems. Only high tariffs for housing and communal services and rising prices are ahead of this indicator. Every third Russian (32%) identified alcoholism as a problem that worries and hinders living.
And a completely new phenomenon for Russia today is child alcoholism. Child alcoholism is a very relative concept. A description of what it is that you most likely will not find in medical directories published before 1991; what can I say - even in the new medical directories there is practically no information on the topic of child alcoholism. However, despite this, the problem continues to exist and, as it does not sadly, begins to progress and develop as a chronic disease. The lack of knowledge of adults and medical specialists, the inadequacy of their knowledge from this area, paves the way for the development of this problem.
The age of minors drinking alcohol is rapidly declining in Russia. The problem of child alcoholism is especially acute in dysfunctional families.
As soon as a teenager learned to hold toys in his hands, he learned to hold a spoon, a mug, and then he was taught to hold a bottle. As a rule, parents in such families suffer from alcoholism. Children quickly earn alcoholism. There are cases when, during six months of systematic use, the first stage was formed. The child already ceases to worry when they say to him: “We will be expelled from the house, we will not give money,” and so on. He is ready to leave home. Because the main dominant in his head is drinking already.
To poison a child, just drink a can of beer or gin. If the necessary help is not provided on time, then a fatal outcome is possible.
Often minors who are intoxicated - become the perpetrators of the most serious crimes; or even find themselves in a hospital bed in a crane in serious condition.
Of course, according to the laws of the Russian Federation, all responsibility for their children should be borne by parents, however, in those cases when these same children are in the hospital or in the police, it is very difficult for parents to get there because they are in a binge. If they come, they often come drunk. They demand that they immediately give them a child. To give the drunk child to the drunk parents. Another category of parents - people are more prosperous. They are simply shocked by what happened to their child. They never thought such a thing could happen. They said: “Well, I went for a walk with the company. It seems that all the guys are good, but they took and got drunk. ”
The concept and characteristics of child alcoholism
The concept of "Child alcoholism"
Children’s alcoholism is spoken of when its symptoms first appear before the child reaches the age of 18. In children, alcoholism, unlike adults, has a number of characteristic features:
- quick addiction to alcoholic beverages (this is due to the anatomical and physiological structure of the child's body);
- malignant course of the disease (in adolescence, the body is in the formation stage and the resistance of the central nervous system to the action of alcohol is reduced, as a result of which deep and irreversible processes of its destruction occur);
- the adoption of large doses of alcohol by the child (the adoption of alcohol by children is not approved by society, therefore adolescents usually drink in secret, usually without a snack, taking the entire dose at the same time);
- the rapid development of drunken drunkenness (for teenagers it becomes the norm to drink for any reason, while in a state of mild intoxication they begin to feel insecure);
- low treatment effectiveness.
Drunkenness among minors is closely related to their deviant behavior. At the heart of this connection is the most dangerous danger of alcoholism for adolescents - it dramatically weakens self-control.
Most often, while intoxicated, violent crimes are committed. Introduction to alcoholic beverages of children and adolescents occurs most intensively in three age periods: early childhood, preschool and primary school age, children and adolescents.
The first period is early childhood, in which alcoholization of children is unconscious, involuntary. The following main reasons contribute to this: drunken conception, drinking alcohol during pregnancy and breastfeeding, which leads to abnormalities in the physical and mental development of the child.
The second period is preschool and primary school age. During this period, the most significant reasons are two - pedagogical illiteracy of parents, which leads to alcohol poisoning of the body, and family alcohol traditions, which lead to the formation of interest in alcohol.
Pedagogical illiteracy of parents is manifested in the existing prejudices and misconceptions about the healing effects of alcohol: alcohol enhances appetite, cures anemia, improves sleep, and teething. Parents pay for their illiteracy with alcohol poisoning of children, which can even lead to death.
Alcoholization of children and adolescents contributes to the alcoholic environment, which is made up of drinkers by the next of kin.
Biological studies have shown that alcoholism itself is not genetically transmitted, only the tendency to it is transmitted, resulting from the characteristics of the character received from parents. In the development of drunkenness in children, the decisive role is played by bad examples of parents and the situation of drunkenness in the family.
The third period is adolescence and youth. The following seven can be named as the main reasons: family dysfunction; positive advertising in the media; unemployment of free time; lack of knowledge about the consequences of alcoholism; avoiding problems; psychological characteristics of personality; self-affirmation. During this period, the formation of an attraction to alcohol occurs, which develops into a habit, leading in most cases to the child's alcohol dependence.
Alcoholism, which forms in adolescence and youth (13 to 18 years), is usually called early alcoholism. It is believed that at this age the clinical manifestations of alcoholism develop faster than in adults, and the disease is more malignant.
The anatomical and physiological characteristics of the body during the period of age crises, the puberty are a kind of favorable soil on which alcohol can cause the rapid development of the disease. Of great importance is the degree of alcoholization and the form of drinking, in particular, the frequency, dose, concentration of alcohol, the reaction of the body to its intake [Babayan E. A., Gonopolsky M. Kh., 1987].
In the body of a child or adolescent, alcohol primarily penetrates the blood, liver, and brain. Due to the immaturity of the central nervous system, it is most vulnerable to the action of ethanol. The result of this action is a violation of the differentiation and maturation of neurons, as a result of which the adolescent's personality suffers, logical abstract thinking, intelligence, memory, and emotional response are disrupted. When exposed to alcohol, almost all systems of the adolescent's body are affected. According to statistics, 5-7% of poisoning in children accounts for alcohol intoxication. The effects of intoxication in children and adolescents develop rapidly and can result in stupor and even coma. Blood pressure and body temperature increase, blood glucose level, white blood cell count decreases. Short-term excitement caused by the intake of alcohol quickly turns into a deep intoxication sleep, convulsions are frequent, even death. Sometimes mental disorders with delusions and hallucinations are recorded.
The main psychological mechanisms of drinking alcohol in childhood, adolescence and youth are considered to be psychological imitation, reduction or removal of asthenic manifestations (conditions), and personality deformation with a tendency to drink alcohol.
There are several stages in the development of alcoholism in these age groups.
At the first, initial, stage, a kind of adaptation (addiction) to alcohol occurs. In this case, the microsocial environment, especially the family, school, and peers, is of great importance. The duration of this period is up to 3-6 months.
The second stage is characterized by a relatively regular intake of alcoholic beverages. The dose is increasing, the rate of alcohol intake. The behavior of a teenager is changing. This period lasts up to 1 year. It is believed that cessation of alcohol consumption during this period can give a good therapeutic result.
At the third stage, mental dependence develops, which can last for several months or years. The teenager himself is an active promoter of the intake of alcoholic beverages at any time, in any quantity and of any quality. Quantitative and situational control is lost. Ethanol tolerance increases 3-4 times. There are multi-day, weekly, sometimes constant drinking, this is the initial stage of chronic alcoholism.
The fourth stage is defined as the chronic stage of the disease. Formed withdrawal syndrome, mainly with a predominance of the mental component. Sometimes withdrawal syndrome is weakly expressed in the form of autonomic-somatic disorders. Withdrawal is less prolonged than in adults, occurs after taking large doses of alcohol.
Further, at the fifth stage, the development of alcoholism corresponds to the patterns described for adults. A significant difference is the rapid formation of dementia (dementia). Children with alcoholism quickly descend, become asocial, rude, dysphoric, sexually disinhibited, intellectually degraded, with gross impaired memory and emotions.
Alcoholism in adolescents is formed on average within 3-4 years. Withdrawal syndrome occurs 1-3 years after the start of constant drinking. A distinctive feature of early alcoholism is its great dependence on premorbid characteristics, in particular on the type of character accentuation [Lichko A.E., 1988]. With the epileptoid type, explosiveness, viciousness, a tendency to combine alcohol with other intoxicating agents (acetone, glue), and use surrogates quickly increase. Often joined hashishism, barbitura.
Alcoholism often develops in adolescents, youths after a brain injury, organic damage to the central nervous system, and neuroinfections that cause personality changes. In these cases, the disease develops more intensively, proceeds more malignant, quickly leads to a loss of quantitative control, the appearance of a pathological attraction to alcohol, and the development of withdrawal symptoms. The pathological character traits of the adolescent are getting heavier. Psychopathies are a particularly unfavorable background for the development of early alcoholism, which is facilitated by such traumatic factors as early loss of mother, parental alcoholism, neglect, family conflicts, pedagogical and social neglect. In excitable psychopaths, alcohol use is most often associated with a desire to get rid of a bad mood. Braking psychopaths drink alcohol to improve their adaptation to the environment. Hysterical psychopaths correct alcohol with excitability and instability. Psychasthenic psychopaths are often depressed with suicidal attempts. Alcoholism in young psychopathic personalities develops early, proceeds harder, more often progressively, early leads to primary psychotic phenomena, dementia. Clinically, alcoholism is characterized by severe intoxication with amnesia, a significant decrease in tolerance, the rapid formation of withdrawal symptoms, a change in the pattern of intoxication, the early appearance of true binges. In this case, social degradation is rapidly developing.
The results of a study of the problem of child alcoholism in different countries of the world
Here I would like to give some results of studies conducted by different countries of the world and republics of the former USSR.
Back in 1931, the Ukrainian Psychoneurological Institute, using a special questionnaire, conducted an extramural survey of doctors and educators in several countries of Europe and America about alcohol consumption by children. According to the answers received, a bleak picture of the spread of teenage drinking in a number of capitalist countries was revealed. For example, in France there were even cases of drunk children coming to school. In many families, children are not forbidden to drink champagne, wine, and liquor here.
In Italy, in a number of provinces, up to 70% of schoolchildren were familiar with the taste of wine. A completely different situation existed then in our country, where schoolchildren, as a rule, did not even have a clue about drinking. Unfortunately, much has changed for the worse since then ...
What caused the wide distribution of alcohol in the modern world? They say that a lot of bars and restaurants, cafes and discos "introduce" drinking among young people. The West German magazine Spiegel recently published an article with a noteworthy headline: "Alcoholism among young people is a new disease."
In the editorial preface, the problem of alcoholism in the Federal Republic of Germany is described as follows: at least 100,000 West German boys and girls, often children aged 10-12, are alcoholics. The bottle “walks in circles in schools and on the streets”, the generation of alcoholics is growing up, which will bring much more trouble to the nation. The health of many children and youth is in serious danger. For example, the first adolescents with delirium tremens are already entering the psychiatric clinic of Frankfurt University.
According to the data on the Federal Republic of Germany, 8% of 12-14 year olds, 20% of 15-17 year olds, 31% of 18-20 year olds and 41% of 21-24 year olds drink alcoholic beverages in this country daily.
Statistical studies in the USA show that 63% of boys and 30% of girls who are in seventh grade have an early introduction to intoxication. For the 10th grade, the corresponding numbers are even larger; 95 and 90%. On this occasion, the director of the National Institute on Alcoholism of the USA M. Cefeto said: “Excited about the fact that our children may be among 250 thousand drug addicts considered hopeless, we turn a blind eye to the more real danger that they will be among 9 million registered alcoholics. Of this number, 5% are teenagers aged 10 to 16 years. ”
Both abroad and in our country, the vast majority of minors, until recent years, did not have a proper understanding of the dangerous consequences of drinking alcohol, and indeed the properties of alcohol. So, among the teenagers and young men surveyed by Professor B. M. Levin who were in the detoxification center, only 10% more or less clearly understood the properties of alcohol, and 90% did not know anything about the harmful effects of its use.
When examining a large group of people suffering from alcoholism, it was found that about 95% of them first became involved in alcohol before the age of 15 years. By the age of 19, almost 90% of those surveyed had independently and systematically consumed alcohol. By the age of 20–25, alcohol use, which began in adolescence and youth, became a habit among them.
L. Nikolaev tells how doctors from one of the districts of Moscow, together with teachers, conducted an examination of several schools. Students were offered a questionnaire, which contained several questions: when was the first time you drank alcohol? What exactly: beer, wine, vodka? At will or at the insistence or request of others? Who exactly? etc.
The survey results were disappointing. In particular, it turned out that in 67% of cases, children got acquainted with alcohol at home, in the family.
Usually this happens, so to speak, an “innocent” glass in honor of a birthday or other celebration. And although this happens with the consent of the parents, in the family circle, nevertheless, such a familiarization of children with wine can in no way be justified. After all, once you touch the alcohol, the psychological barrier has already been removed and the teenager feels right to drink with friends, if the opportunity arises.
No wonder people say: "Rivers begin with a brook, and drunkenness - with a glass." In many cases, the introduction to alcohol begins with beer, the use of which was written by psychologists B. S. Brattsev and P. I. Sidorov in the book “Psychology, Clinic and Prevention of Early Alcoholism”, published in 1984 by the Moscow State University.
Early introduction to alcohol then leads to the systematic use of alcoholic beverages in adolescence and youth and the development of alcohol abuse in young people.
Among the circumstances contributing to this, the leading role belongs to a number of social and socio-psychological factors: alcoholic traditions in the family, low cultural level of parents and poor family education, negative attitude to education, lack of social activity and socially significant attitudes, uncertainty in issues of professional orientation etc. Thus, statistical data show that 75% of students in grades 8-10 drink alcohol in the family on holidays and family celebrations. The first introduction to alcohol in 78% of cases occurs under the influence of parents and relatives of adolescents. In families where adolescents "often drank alcohol, 68% of fathers and 64% of mothers had only primary or eight-year education.
The overwhelming majority of such adolescents (75%) had low academic performance, they were characterized by the empty spending of free time: idle walking along the streets in the company of friends, gambling, visiting bars, etc.
The above facts indicate the need for the formation of a sobering attitude in the younger generation of an extremely wide range of activities in many areas.
Ways of the course of child alcoholism, the effect of alcohol on the child’s body and psychotherapy as a method of treatment for child alcohol addiction
Alcohol poisoning in children
Curiosity pushes children to drink intoxicated drinks. But the opportunities for this are “provided” by adults. Psychologically, Jack London writes about this in the novel John Barley Grain:
“The first time I got drunk when I was five years old. The day was hot; my father drove into the field half a mile from home. I was sent to bring him a beer. “Yes, look, do not spill on the road!” - Punished me goodbye. Beer was, I remember, in a wooden bucket, with a wide top and without a lid. I carried it and splashed to my feet.
I walked and thought: why is beer considered such a jewel? Probably delicious! Otherwise, why am I not told to drink it? After all, everything that parents forbid is always very tasty. Means, and beer too. I put my nose in a bucket and began to lap up a thick liquid. Well, rubbish!
Still, I drank. It cannot be that adults are so wrong. It is hard to say how much I drank then: I was a toddler, the bucket seemed huge, but I kept sipping, not looking up, plunging my face to the ears in foam. But I swallowed, to admit, as a medicine: I was sick, and I wanted to quickly end this torment.
... I overslept under the trees until evening. At sunset my father woke me, and, having hardly got up, I wandered after him. I was barely alive: my legs seemed leaden, cut in my stomach, nausea came to my throat. I felt poisoned. As a matter of fact, this was the real poisoning. ”
And now there are modern stories.
On holiday, adults arranged a table in a separate room for five children from four to eight years old and for the sake of fun they gave glasses to which they offered to pour lemonade. However, the older boy managed to quietly pour port wine into glasses for children from adults. The children did not understand and drank in one gulp - the first glass. Some choked, but after a while the wine revived the children's company, and they drank two more glasses. Adults discovered this only when the youngest girl screamed in cramps and she started vomiting. The children urgently had to be sent to the hospital ...
Alcohol, getting into the child’s body, is quickly spread by blood and is concentrated in the brain. Even small doses of alcohol cause a violent reaction in children, severe symptoms of poisoning. With the systematic intake of alcohol in the child's body, not only the nervous system suffers, but also the digestive tract, eyesight, heart. The liver does not cope with the alcohol load, and its degeneration occurs.
The organs of internal secretion also suffer, especially the thyroid gland, the pituitary gland, and the adrenal glands. As a result, against the background of alcohol intoxication, adolescents who are addicted to alcoholic beverages can develop diabetes mellitus, impaired sexual function, etc.
Special mention should be made of acute alcohol poisoning in children. It poses a great danger to children whose body is highly sensitive to toxic substances. Their nervous system and brain are especially vulnerable. Intoxication in children of preschool and early school age develops so rapidly that it is difficult to save a child. He can die from just a glass of vodka. A dose of 250 grams of vodka can be fatal for a teenager.
It must be said that deaths of children from alcohol are not so rare. According to Bulgarian doctors, alcohol poisoning of children makes up about 7% of all types of poisoning in childhood.
As you know, alcohol has the ability to evaporate, so its use in children's practice requires some caution. In the literature, there is a case when a four-month-old baby mother applied alcohol compresses to her stomach to calm colic! The child dozed off, but after an hour and a half, he suddenly became very pale and lost consciousness. There was a pungent smell of alcohol from his mouth. The child, poisoned by alcoholic fumes, was difficult to save.
A similar story happened with a six-month-old girl suffering from pneumonia, who was given wine compresses on her chest three times a day, which they held for three to five hours. On the third day of the “treatment”, the child lost consciousness, he had a cold sweat, and his temperature rose. For a long time the girl was in a state of unconsciousness and only on the third day regained consciousness.
But the case ended tragically. A nine-year-old boy was fishing with adults. During lunch, he was given 1/3 cup of vodka, which he drank in two divided by the cheers of adults. After the ear was eaten and the vodka drunk, the adults again went to the river, and the boy stayed by the fire. Soon he lost consciousness and in this state was taken to the nearest hospital. He observed inhibition of vital functions: cardiac activity, respiration, metabolism. Without regaining consciousness, the child died two hours later.
Irreparable damage is caused to the child by the drunkenness of the parents during breastfeeding. Many cases of alcohol poisoning of infants due to the fact that mothers drank wine and beer have been described. Why did they do this? In most cases, the mothers of the affected children answered this question: to have more milk.
Such a “stimulation” of milk production ended very deplorably: the kids had convulsive seizures, and sometimes even real bouts of epilepsy developed. This was found, for example, in Normandy, where lactating women did not refuse wine. Such children were called "breast alcoholics."
One Swiss pediatrician described a case in point from his practice. He was invited to a six-month-old baby who, on certain days of the week — Mondays and Thursdays — developed convulsive seizures after each feeding. The rest of the days there were no seizures. Nursing him, a completely healthy woman. It turned out that twice a week the nurse had days off (on Wednesdays and Sundays). These days, she drank a solid portion of alcohol, and the next day, alcohol along with breast milk entered the baby's body. The cramps stopped as soon as the baby was ceased to be fed with such milk.
If a nursing mother consumes alcohol, then she causes a peculiar alcohol addiction in her child to infants, since the adopted alcohol penetrates into the body of the child and poisons it. As a result, he begins to have disorders of the gastrointestinal tract and nervous system. Children are restless, screaming, sleeping badly, they have convulsive twitching, and then convulsive seizures.
With further alcoholization in children already in infancy there are signs of alcoholism, addiction, and then craving for alcohol. A nursing mother, drinking alcohol, solders her child literally from the first day of his birth.
But even before his birth, the child, if his parents drink often, can be exposed to harmful effects. It should be noted that in these cases, alcohol can cause serious consequences not only on its own, but also facilitating the action of any other pathogenic factors. For example, many inherited diseases may not occur under favorable conditions for the development of the fetus and, on the contrary, appear in the presence of additional harmful effects, among which alcohol is one of the first places.
Getting into the blood of the fetus, alcohol causes characteristic defects of its development, which are called the fetal alcohol syndrome in the medical literature. It is characterized by a lag in the development of the child, a reduced head size, mental underdevelopment, a typical face with a short upturned nose, a small chin, a narrow red border of the lips, there may be congenital shorts of the upper lip and palate and other malformations.
Numerous studies have shown that alcohol is most dangerous in the first 12 weeks of pregnancy. Based on a survey of 1,529 mothers and their children at a state university.
Washington, deviations from the norm (extra fingers on the hands, folds of skin on the palms, irregular eye shape, congenital heart defects, etc.) were observed in 74% of children born to mothers with alcoholism.
If the future mother does not drink alcohol, but the father abuses it, the normal development of the fetus may also be at risk. This is due in particular; with those experiences, mental injuries that fall to the lot of the wife of an alcoholic.
Mental trauma, stressful state of a pregnant woman can have undesirable consequences. The negative emotional stress of a pregnant woman changes her biochemical composition of the liquid medium, which adversely affects the development of the child’s nervous system.
In the following sections of the second chapter of my work, I will talk about the features of the effect of alcohol on the child’s body and try to analyze the motives for drinking alcohol in adolescence. I will try to pay special attention to family and behavioral factors that contribute to the use of alcohol by minors.
Alcohol and a developing organism
The transition from childhood to adulthood is characterized by the rapid growth of both individual organs and the whole organism as a whole, the improvement of their functions, the beginning and completion of puberty.
In adolescence, intensively develop internal organs. The heart mass is almost doubled, in the lungs they are manifested in an increase in external respiration, and the respiratory rate is equaled.
At the very beginning of the adolescence period, the morphological and functional changes in the digestive organs are completed, the replacement of milk teeth, the development of the esophagus, salivary glands and stomach are completed.
Of particular note is the development of the psyche in adolescence. Promising thinking is being formed, which, in particular, is manifested in philosophizing typical of a growing person about the meaning of life, a person’s place in the world, etc. This period is also characterized by emancipation reactions, grouping with peers, various hobbies (frequent hobbies) and etc.
In general, the activity of organs and systems of the body in the puberty is characterized by functional instability, and in this regard, increased tissue reactivity to many environmental factors, especially harmful ones. It is no coincidence that therefore the child’s body is easily vulnerable to alcohol.
Absorption of alcohol into the blood mainly occurs in the stomach (20%) and the small intestine (80%). Alcohol penetrates the mucous membrane of the stomach and small intestines by diffusion, and most of it enters the blood stream unchanged.
The rate of absorption of alcohol is largely determined by the filling of the stomach and intestines. When drinking alcohol on an empty stomach, its maximum content in the blood can be established after 30-40 minutes, and in some cases even earlier. Alcohol absorption slows down if the stomach is full of food, while intoxication develops more slowly.
Immediately after the alcohol enters the bloodstream, its oxidation and excretion begin. According to numerous data, about 90-95% of alcohol absorbed into the blood is oxidized in the body by enzymes to carbon dioxide and water, and 5-10% is excreted unchanged by the kidneys, lungs, and skin.
It is generally accepted that the oxidation and excretion of alcohol always occur at the same rate, regardless of the concentration of alcohol in the body. The volume of blood ejected by the heart in one contraction increases. Changes in the average structure, according to many researchers, the rate of alcohol oxidation is 6-10 grams per hour. For example, after taking 100 milliliters of vodka, which is about 40 grams of pure alcohol, the latter is found in human tissues within four to seven hours.
After taking alcohol in large quantities, the release of alcohol from the body can last up to two to three days.
Alcohol in the blood, along with it, washes all the organs and tissues of the body and penetrates into them. The concentration of alcohol in organs and tissues is largely determined by the liquid content in them: the richer the tissue or organ in water, the more alcohol is contained in them. A large amount of alcohol, in particular, is retained in the tissues of the human brain.
Modern research allows us to reasonably argue that the body does not have such structural elements that would not be affected by the toxic effects of alcohol. Alcohol "interferes" in the synthesis of proteins, carbohydrates, fats, disrupts enzyme metabolism, it affects mitochondria, disrupts the permeability of membranes, changes the conductivity of nerve impulses, etc.
The toxic effects of alcohol primarily affect the activity of the nervous system. If the blood alcohol content is taken as 1, then in the liver it will be 1.45, and in the brain 1.75. Even small doses of alcohol disrupt the metabolism in the nervous tissue, the transmission of nerve impulses. Small doses of alcohol pathologically accelerate the process of transmission of excitation, moderate - complicate it. At the same time, the work of the vessels of the brain is disturbed: their expansion, increase in permeability, hemorrhage in the brain tissue are observed. All this contributes to an increase in the influx of alcohol to nerve cells and leads to an even greater disruption of their activity.
The large German psychiatrist E. Kraepelin (1856-1926) found that mental workability from small doses can cause noticeable disturbances in subtle mental functions: under its influence, the clarity of thinking decreases, and a critical assessment of one’s activity.
Modern psychiatrists have revealed that the alcohol contained in one glass of vodka is enough to reduce the ability of the basic functional systems of the body, providing accurate orientation in space, performing accurate movements, work operations.
Needless to say, a tipsy teenager driving a bicycle, moped or motorcycle is a dangerous enemy both for himself and for everyone who may meet on his way; French scientists Chardon, Bautin and Bogar, having carried out a number of experiments on volunteers, have convincingly shown that with light intoxication with a blood alcohol concentration of 0.15-0.25 grams per 1 kilogram of body weight, visual and auditory reactions are observed. For every fifth of the subjects, this reaction was late, and for every sixth, deep vision was impaired, that is, the ability to distinguish distant objects, to determine at what distance this or that object was affected. At the same time, light perception, the ability to distinguish colors (especially red) worsened.
The effect of alcohol on other organs and systems is no less pronounced.
When it enters the liver, alcohol acts as a solvent for the biological membranes of the liver cells, causing structural changes with the accumulation of fat and subsequent replacement of liver cells with connective tissue. In adolescence, alcohol acts on the liver especially destructively, since this organ is in the formation stage in a teenager. Toxic damage to liver cells leads to a violation of protein and carbohydrate metabolism, the synthesis of vitamins and enzymes.
Alcohol has a pronounced effect on the epithelium lining the esophagus, stomach, disrupts the secretion and composition of the gastric juice, which, in turn, leads to an upset digestive ability of the stomach and various dyspeptic phenomena.
Along with alcohol and rapidly growing lungs at puberty. After all, about 10% of the alcohol taken is removed from the body through the lungs, and passing through them, it leaves pathologically altered cells.
It is sensitive to the presence of alcohol and the heart of a growing person. The rhythm, heart rate, metabolic processes in the heart muscle change. Naturally, in such conditions there cannot be a correct and full-fledged formation of both the muscular and nervous apparatus of the heart of a teenager.
Finally, the toxic effects of alcohol affect blood. The activity of leukocytes, which play an important role in protecting the body, decreases, the movement of red blood cells that carry oxygen to tissues slows down, platelet function, which is of great importance for blood coagulation, changes pathologically.
Thus, alcohol has a profound detrimental effect on a growing organism during adolescence. It weakens, inhibits and inhibits the proper development and maturation of all literally organs and systems.
And at the same time, the younger the body, the more destructive is the effect of alcohol on it. This is due to the anatomical and physiological and socio-psychological characteristics of childhood and adolescence. In particular, the rapidly occurring changes in the central nervous system, internal organs, endocrine system, associated with the growth and maturation of the body, contribute to an increase in its reactivity, and therefore alcohol can lead to the rapid development of a pathological process.
Speaking about the peculiarities of adolescence, one cannot but touch upon such an important socio-hygienic problem as acceleration, which sometimes reduces the acceleration of physical and sexual development. However, the essence of the phenomenon is not only this. Modern living conditions have a more intense effect on the nervous system of a child than half a century ago.
At the same time, adolescents retain children's interests, emotional instability, immaturity of civic ideas, etc. A disproportion arises between physical development and social status. And in the presence of such a disproportion, the use of alcoholic beverages in adolescence often contributes to the sharpening of character traits such as irritability, aggressiveness, isolation, and alienation.
So, the anatomical, physiological and psychological characteristics of childhood and adolescence, consisting in enhanced body development, endocrine shifts, puberty, personality and psyche formation, increase the young person's susceptibility to various negative influences, including alcoholic beverages.
The Psychology of Introducing Alcohol to Minors
The first drink is almost always accompanied by unpleasant subjective sensations.
However, over time, with an increase in the “experience” of drinking, the subjective assessment of intoxication changes dramatically. More than 90% of adolescents with a two-year and long “alcoholic experience” believe that intoxication causes them to feel a surge of strength, a sense of contentment, comfort, mood improvement, etc.
Where is the gradually appearing and capable of increasing the attractiveness of alcohol intoxication? It lies mainly in that - for the most part unconscious - psychological motivation for turning to wine, in those desires and needs that a person is trying to satisfy with his help. The first and most frequent is the desire to have fun, to create high spirits at a wedding, birthday, meeting friends, that is, in cases in which the traditions of wine drinking are especially strong.
Usually they wait for the holiday, prepare for it in advance, set themselves up in a certain way, dress up, which in itself creates that special atmosphere, which even without wine makes a person excited, upbeat, joyful. Subsequent intake of alcohol, changing the state of the body and nervous system, creates only a special, unusual psychophysiological background, onto which psychological expectations, all the previous psychological preparation for this event are projected. For the man himself, this mechanism remains unconscious, hidden, which gives rise to the generally accepted idea of the special properties of alcohol.
There are ideas about other "indispensable" properties and functions of alcoholic beverages. So, alcohol is consumed not only in connection with joyful, but also sad events, for example, at a wake. Moreover, it is characteristic that in the latter case, no matter how much intoxication, people for whom the loss is really hard, are sad, and not laugh; the euphoria of a drunken man at a wake is estimated as disrespect for the deceased and references to intoxication are not taken into account. Over time, the range of subjective reasons for drinking alcohol becomes wider - they drink both “for courage” and “with resentment”, and “to talk heart to heart”, and in order to “relax” or “cheer up”, etc.
All this can be called illusory-compensatory alcoholic activities aimed at creating and maintaining the desired emotional state, a special “alcoholic”, that is, an illusory, satisfaction of one or another urgent need.
In order to understand the specifics of this activity, it is enough to compare it (especially in people already sick with alcoholism) with the activity of a healthy person. Let us take, for example, the need for self-esteem satisfying him that is so important to everyone. A healthy person usually tries to set himself goals and objectives, the achievement of which will be highly appreciated by those around him and himself, which will lead to the maintenance and increase of his self-esteem.
A completely different way of organizing activities aimed at maintaining self-esteem, self-esteem, is typical for people who abuse alcohol and are sick with alcoholism. As noted by the Soviet scientist K. G. Surnov, who specifically investigated this issue in 1982, the most important feature of the alcoholic way of satisfying needs is the substitution of objective results of realistically carried out actions with subjective experiences.
It should also be noted that the sought-after subjective states are usually not achieved by the drinker alone. Illusory-compensatory activity requires a sufficiently detailed "acting out" of these states, for which a company, interlocutor, listener, and spectator are needed.
A person is looking for much more in guilt than a state of simple euphoria. The psychological reasons are deeper here: they lie in the illusory possibilities of satisfying desires and resolving conflicts that are given by a state of intoxication.
Why is it that far from all, but only a small part of minors who are familiar with the taste of alcohol and who are somehow involved in drinking, embark on the path of regular drinking? Why not all, but only a few quickly and firmly learn the simple "psychotechnics" of illusory-compensatory alcoholic activity? Why do they, and not others, become early alcoholics?
It is known that already a senior student is revealed as a person. However, this person is still deeply immature, in many ways disharmonious. Consciousness so far is largely divorced from reality, ideas about human relationships, evaluations of one's and others' actions are disproportionate to the real relationships of people. Children are often judged by the principle of "all or nothing," their inner vision is as if in contrast, not even distinguishing the complexity of the world, its midtones. With all the desire for independence and adulthood, with all the external obstinacy, a teenager often himself does not exactly know what he wants, what specific life and moral goals he would like to achieve.
A greater or lesser severity of all these psychological characteristics can affect, to some extent, the teenager’s propensity to absorb an illusory-compensatory alcohol orientation.
The next youthful age then largely aligns the manifestations of traits characteristic of a teenager - both external (the angularity of movements, sharpness of manners, fragility of voice) and internal. It's time to choose a profession.
If the child is easily captivated by the outward brilliance, ostentatious bravado, an act in itself without taking into account its consequences, then the young man already sees the weaknesses of many heroes attractive to adolescence and can easily debunk them. He no longer cuts off his shoulder: the good is bad, the coward is brave, but preliminarily thinks, compares and only then puts this or that act in a system of moral coordinates that is much more complicated than that of a teenager.
In almost all cases of youthful alcoholism, we encounter a disadvantaged environment: an incomplete family, a drunkard father, homelessness, etc. A characteristic feature is in most cases “drunken life”, a child’s visual perception from the early years of the traditions of drunkenness, the type and behavior of drunkards as habitual, everyday attribute.
The second thing that psychologists pay attention to (B.S.Bratus et al.) Is a very common brain failure, often expressed in a worn out form and caused by head injuries, unfavorable pregnancy, burdened childbirth, etc.
These two points constitute the most important prerequisites for youthful alcoholism: the first determines the content and early assimilation of alcoholic customs, microenvironment settings, and the second determines the special circumstances burdened by the norm in which mental processes unfold and form.
However, there are adolescent alcoholics in whom even mild cerebral insufficiency is not detected and there is no "family burden." But in all these cases, as a rule, what is called pedagogical neglect is observed, parental supervision and help are absent, upbringing is replaced by punishment, etc.
It would be a mistake to think that a teenager, because of his mental burden for one reason or another, chooses alcohol as his primary need. As a rule, it is not alcohol that is chosen, but a company in which a mandatory element of communication, pastime is drinking. This company, which is called "street", "yard", can be uniform in age or, more often, heterogeneous, with two three senior "ringleaders". What attract these teenagers to adolescents?
The main thing is that in a “street” microenvironment, a child with the background examined above finds a group of his own “outcasts”. It is in these groups that future alcoholics find a real field of self-affirmation, can finally acquire a "high status", imbued with self-esteem, which they were not able to do either at school or in their family.
The group, especially at first; It seems to a beginner full of democracy, warmth, cohesion. And the use of alcohol here occupies a special position. It is booze that often plays the role of a kind of initiation into group members. The ability to drink symbolizes adulthood in the group, is perceived as a sign of special strength and masculinity.
Soviet psychologists B. S. Bratus and P. I. Sidorov describe the process of introducing young people to drinking. Sometimes it all starts with attempts to "cultivate" the euphoria of intoxication, which is achieved by special emotional infectivity, anticipation, recovery during the preparation and waiting for a drink, collective mutual induction in the process of taking alcohol. For these purposes, loud rhythmic music is used, and sometimes even medications that enhance stunning.
The style of alcoholization adopted by the "alcohol company" begins to be gradually perceived as natural and normal, finally forming a psychological readiness for an uncritical perception of the alcoholic customs existing here. Alcoholization is becoming more frequent. The usual, self-evident norm of behavior is drinking alcohol before dancing, on weekends, when meeting friends, etc.
In many such groups, a fairly rigid internal structure is also found with the presence of group leaders, among which there are often people registered with the police, the juvenile inspection, and previously convicted. A newly admitted group member is often “doomed” to undergo a “compulsory program”, starting with hooligan actions while intoxicated and ending with serious offenses.
With the onset of alcohol abuse in minors, conflicts immediately arise in the educational institution, at work, in the family. However, as a rule, this opposition is limited either to measures of a repressive nature (teenagers are reprimanded, blamed), or they are “scared” by the consequences of alcoholism, the harmful prospects of connection with a “bad company”.
Such measures, being negative, cannot protect the teenager from the "alcohol company", because they are not able to satisfy emotional needs and expectations, the need for intimate and personal communication, a sense of self-worth, strength, etc.
The "alcoholic" company, albeit in a perverted form, but offers him all this. In such a situation, resistance, and especially repression, only increases the internal cohesion of the company, cutting off or, in any case, making it extremely difficult to return its members to a happy childhood.
The deepening of conflict situations leads to the fact that adolescents most often easily and without regret interrupt their studies at school, vocational school, technical school. They do not stay for a long time and in one place of work, motivating their departure (usually scandalous) by the fact that they do not like the previously attracted specialty. However, when applying for another job, the story repeats.
Not only certainty in matters is lost.
Vocational guidance, but the very attitude to work. Work begins to be seen only as a means of obtaining money for alcohol, and the circle of active social life is limited to the problems and interests of the "alcohol company".
With the development of alcoholization, the “external” customs of alcohol consumption seem to become “internal” alcohol systems, which, in turn, actively affirm the once-accepted customs and facilitate their transmission to future generations - a vicious circle closes. And the younger the age of the onset of abuse, the faster this circle closes.
In connection with the complexity of the questions being analyzed, it makes sense to say briefly about the psychology of bad habits in general.
Why do people go to theaters, stadiums, cinema, clubs, restaurants? “To relax, have fun,” you answer. What is pleasure? Anything you like that causes positive emotions. However, for the sake of pleasure, some people are willing to sacrifice their health, official, marital status.
Belarusian psychologist Yu.A. Merzlyakov proposes to conditionally divide all pleasures into pleasures of making up for lack and pleasures of excess.
Imagine that you are very hungry or thirsty. If you are offered food or spring water at this moment, will you enjoy it? Of course yes. But until when? Until you are full or drunk. After that, you are in the zone of physiological comfort, but you need more. Do you want to meet friends, go to the stadium or just listen to your favorite record, in a word, relax in comfort. This is the pleasure of excess.
Among the latter there are many useful ones (visiting museums, communication with nature, collecting, etc.), but there are also harmful ones. The most common of them and the most detrimental to health are smoking and drinking alcohol.
In confirmation of this, Yu.A. Merzlyakov gives such an example.
Imagine that two friends - a smoker and a non-smoker - went fishing. A non-smoker, while admiring nature, catches fish, inhaling clean air with pleasure. The smoker forgot cigarettes at home. A sucking, unpleasant feeling prevents him from enjoying nature; he is no longer interested in nibble. He will suffer all day until he returns home to the coveted pack of cigarettes. So he lit a cigarette, puffed on smoke and ... became a non-smoker, that is, at that moment he could already admire nature and enjoy his nibble.
What happened? What did he get compared to a non-smoker? The pleasure associated with great harm to health. So is it worth inventing artificial torments and worries for yourself?
And is it a pleasure? Think about who smokes, where did it start? Was there a desire like hunger, thirst? Did the body require a cigarette? This need arose later, when the body got used to it, when something began to be broken in it. Read the list of smoking-related illnesses: lung cancer, angina pectoris, myocardial infarction, hypertension, endarteritis, gastritis and stomach ulcers, impotence in men and menstrual irregularities in women, pulmonary emphysema, bronchial asthma. This is not a complete list.
Often, a doctor is approached with complaints of necrosis of the toes and hands. But this happens from the narrowing of blood vessels, which often leads to gangrene. Vessels narrow at the first puff. Remember how dizzy when you started smoking? This was also associated with vasoconstriction. But smoking is especially dangerous for the psyche and the entire nervous system as a whole. A person becomes irritable, his sleep is disturbed, his appetite worsens.
Or another case. You walk around the city. Next to you is a nice person. You wanted to drink, entered the cafe, took the juice. It is cold, pleasant, you enjoy filling the deficiency. "Would you take a cocktail?" - asks your friend. “Really, let's try,” you reply. And now a straw in his mouth: the pleasure of excess!
Did you really need this cocktail? Were you thirsty? Did your body need alcohol? You didn’t even think about it, although it doesn’t taste the juice much nicer.
The next time I again wanted to see myself from the side looking like a movie star - with a straw in his mouth. Then - a glass of champagne, then a glass of brandy, and later, when there is not enough money for good drinks, you agree to ... "chat" ... You did not notice when the body was used to getting a certain dose of alcohol. How scary it is especially for teenagers and youth. At this age, addiction is very fast. Addiction and at the same time gradual poisoning.
... And now, like an intelligent, even pleasant young man, sitting in his office, and so far only the doctor has noticed a restless anguish in his eyes, fussiness of movements, a slight trembling of his fingers. Later, others will notice this. But the trouble is not in the external manifestation. The tragedy is different: the personality is destroyed, and this destruction occurs at the age when the process of formation should go: the search for oneself in life, the creation of a family, the joy of the child’s first steps, the joy of his first words. The drinker will not have any of this, because in any solemn and joyful case for others, he needs only a glass ...
Intoxication is a substitute for natural joys, natural pleasures.
So, the use of alcohol in the beginning is in the nature of the pleasure of excess. As you get used to it, a period of chronic domestic drunkenness begins, and drinking alcohol becomes the pleasure of making up for a deficiency in which a comfort zone is never achieved.
But when a bad habit has developed, then the body itself prevents the defeat of harmful addictions ...
Understanding the problem was helped by observing the brain using implanted electrodes and analyzing the role of biological rhythms.
Using microelectrodes, scientists discovered brain regions with opposite properties. When a current was supplied to one of them, the animals experienced pain and suffering. When applying current to others, they immediately calmed down and enjoyed it immensely. Such sites, respectively, were called “hell” and “heaven” zones. Similar zones were found in the human brain.
Let's say a person experiences hunger, physical suffering, then hell amplifies his signals. If he gets pleasure from something, the zone of paradise already amplifies the signals. Zones are connected by negative feedback. When, for example, pleasure begins to exceed acceptable limits, a danger signal arrives in the “hell” zone, and pleasure becomes displeasure, the process stops (say, the child has played enough, is tired).
When smoking and drinking alcohol, rhythms and communication are disturbed. Nicotine and alcohol, manifesting their narcotic properties, saturate the "paradise" and quench displeasure. There is a temporary relief. But "paradise" begins to require constant feeding.
Accustomed to smoking or drinking wine, we take the pendulum to the side of "paradise".
The more a person smokes, the more the pendulum of Paradise deviates. When you try to quit smoking, “hell” begins to signal ... The same goes for alcohol.
Yes, you can’t joke with the body, any attempt to whip it due to the rhythmic nature of biological processes can lead to irreversible consequences. So, the desire to temporarily relieve well-being (a state of discomfort) turns into a violation of vital processes in the body.
Features of psychotherapy in the treatment of alcohol dependence in adolescence and childhood
In adults, psychotherapy has now become regarded as the main method of treatment for alcoholism, without which drug therapy in most cases has a very unstable effect. In the action of the medicinal substances themselves (apomorphine, teturama, etc.), the leading psychotherapeutic (conditioned reflex, behavioral) component is rightly seen.
Although the need for psychotherapy for alcohol dependence in adolescence is not disputed by anyone, nevertheless there are certain indications of low effectiveness of both individual rational and group psychotherapy. When a teenager is forced to be treated, the treatment itself, including communication with a therapist, is considered by him as a form of punishment and causes only protest. In these conditions, the success of psychotherapy, like the entire treatment, is difficult to count on.
According to our observations, individual rational psychotherapy is indeed ineffective in chronic alcoholism if it develops against the background of unstable psychopathy and character accentuation. The main influence of the doctor - an explanation of the dangers of alcohol to health and social status in the present and future - of an unstable teenager leaves you indifferent. However, for an adolescent of the epileptoid type, caring for their own health, their future, the danger of suffering or being persecuted in a helpless state of “disconnection” can be quite exciting problems. But this requires not only an “approach” to the teenager, his “trust in the doctor”, but also the confidence of the teenager himself in the high competence and special attention of the doctor. Information about the dangers of alcohol "in general", presented in a form that personally does not affect it, is of little significance for such a patient. It can be useful for an epileptoid teenager to show the results of his examinations - for example, an electroencephalogram, an electrocardiogram, blood tests, gastric juice, etc. and compare them with the standards given in the manuals, with similar studies by his peers, so that obvious deviations of his indicators become obvious (electroencephalogram is especially convenient for this purpose). Stories about the grave consequences of actions committed in a state of “disconnection” are sometimes also impressive.
The goal of individual psychotherapy is to ensure that the teenager decides to be treated and stop alcohol abuse.
In hyperthymic and hysteroid-type adolescents, the task of psychotherapy is different - to try to find a field of activity that is more attractive than drinking, and able to satisfy the thirst for communication with friends, open the possibility of a prestigious position in their midst. With the layering of instability traits on the hyperthymic, hysteroid, or other nucleus (including enileptoid), psychotherapy becomes as ineffective as in adolescent unstable type.
With a labile and schizoid accentuation, psychotherapy should be not so much “anti-alcoholic” as it should be aimed at overcoming the difficulties and life problems that prompted alcoholization. An emotionally labile teenager often suffers from emotional rejection in the family (which, for example, worries little about the unstable); he is looking for emotional contacts in the alcohol company, needs a "friend psychotherapist," "a friend's guardian."
If alcohol serves as a “communicative dope” for a schizoid teenager, then you should try to persuade him to take part in group psychotherapy, the task of which is to teach verbal and non-verbal methods of contact with peers.
Group psychotherapy can be not only useless, but also harmful if the group is composed of adolescents who abuse alcohol and do not have a sincere intention to stop drinking. Such a group only rallies the assembled teenagers in an alcohol company, and they will react to group discussions of the dangers of alcohol indifferently or ironically.
Group psychotherapy may make sense for adolescents of the hyperthymic, hysteroid and labile types, if they are included in a non-alcoholic group (but not boasting of their sobriety); where the process of group communication is attractive to them because of their common interests, the ability to express themselves, find emotional attachments, etc. In general, group psychotherapy is usually successful if it does not set direct anti-alcohol goals, but serves as a way to distract from alcohol.
All other psychotherapeutic methods (suggestive therapy, emotional stress therapy, etc.) in adolescents can be effective only with one precondition - the desire to be treated.
Today in Russia, after the collapse of the USSR, the problem of child alcoholism became noticeably aggravated, the reason for this was: the emergence of commercial outlets selling alcoholic beverages to even adults, the desire to imitate adults and try to look like them, and in the end imitation their peers who already drink alcohol or they smoke, so as not to appear among them a “black sheep”. Another important factor is the media and mass media of Western culture (music, cinema). For example, seeing in the film an inflated hero who saves the world from a terrible catastrophe and, moreover, gulps drinking a glass of whiskey, modern youth is trying to be like those they see on the screen. As for music, the areas of punk, metal and rock music are of great importance, for example, in the songs of such musical directions, alcoholism, drunkenness and drug addiction are directly promoted.
The task of the comprehensive and harmonious development of the younger generation is inextricably linked with the upbringing of positive moral attitudes, including a negative attitude to the manifestations of drunkenness.
The need to strengthen anti-alcohol work with adolescents is due primarily to the prevalence of alcohol consumption among the population. It is known that drunkenness of parents creates extremely unfavorable conditions for moral education and intellectual development of children and contributes to their early involvement in alcoholic beverages.
Especially fraught with the consequences of drinking alcohol in adolescence at the age of ten sixteen, when in the developing organism there is a differentiation and improvement of functions and systems, is puberty. Alcohol consumption at this age can delay or completely stop the physical and mental development, the formation of ethical and moral categories, higher forms of thinking, aesthetic concepts.
The comparative novelty of the problem creates certain difficulties in the ways of its solution. The main ways to solve this problem are: preventive methods: anti-alcohol campaigning, trainings, classroom hours devoted to the problem of alcoholism; emergency methods: psychotherapy, chemotherapy (drug), shock therapy.