Alcohol

In short

In Bulgaria the alcohol is the most frequently used legal drug. It is the active substance in a variety of beverages including beer, wine but also mixed drinks and shots (spirits, hard liquor). The consumption and sale of alcoholic beverages is legal. A minimum age of 18 years holds for the sale of alcoholic beverages.

Description of alcochol, effects, risks, manners of use, dependence

Addictive? In cases of light — typically social — consumption, one can speak of minor psychological dependence; in cases of intensive consumption, one can speak of major psychological and physical dependence.
Increasingly more needed for the same effect? Yes.
Short-term effects: Numbing and disinhibitory, impaired judgement, delayed response speed, sentimentality, aggression, self-overestimation, speech and motor dysfunction.
Long-term effects: Severe damage to the liver, brain, heart and stomach in cases of excessive use.
Important: Dangerous in combination with other substances (sedatives and opiates).

What is alcohol?

Alcohol is a substance with a numbing effect. Due to the number of effects of alcohol and the risks of alcohol use, alcohol use is considered comparable to drug use. There is alcohol in beer, wine and spirits such as gin but also in mixed drinks. Alcoholic beverages can be purchased at off-licences, supermarkets, restaurants, hotel and catering establishments and from bars or clubs with a catering permit.

Where does it come from?

Alcohol is the product of the fermentation of fructose or grains. Wine and beer have been made in such a manner for centuries. Fermented beverages have an alcohol percentage of 15% at most. In the middle ages, the technique of distillation was developed. In such a manner, beverages with a much higher percentage of alcohol can be made such as vodka and whiskey. In the nineteenth century, the production of alcoholic beverages became more wide scale. The production of beer, wine and spirits is now a worldwide industry.

Who uses it?

Most alcohol is consumed within the home; it is also consumed in restaurants and pubs but also in the canteens of sport clubs. Many people drink alcohol because they enjoy it and like the taste of it or because they want to go along with the rest. While the one individual may drink daily, the other my only drink on the weekend but then considerably. The consumption of large amounts of alcohol can also be a part of the behaviour of a group. Students, for example, are known to get drunk in certain group situations. The same holds for young people on vacation. Large amounts of alcohol may also be consumed in the nightlife circuit.

According to the statistics, the alcohol use by the people at the age of 16 to 69 in Bulgaria is constantly increasing. Considerable part of these people is using at least one glass of wine or one bottle of 500 ml beer every evening. Most of them are man. The data from a national representative research on the questions of the drugs, conducted among the nation, is pointing that the “once in a while” use of alcohol is not perceived as a serious risk for the health. In 2005 there are 12407 children, who’ve passed through the Child Pedagogic Rooms for criminal acts. 6,5 % of them have been punished for using alcohol. 2 % of them are at the age of 8 to 14. 3% of them are girls. In 2006 there is a 18,7% decrease of the number of children, punished for alcohol use (802 children in 2005, 652 children in 2006).

How does alcohol work?

Alcohol is absorbed into the blood via the stomach and intestines. Via the bloodstream, alcohol enters all parts of the body. Alcohol anaesthetizes. Alcohol influences the transmission of signals in the brain and nerves in particular.

Alcohol leaves the body largely via its break down in the liver. The breakdown of one alcoholic beverage takes about 1.5 hours. The breakdown process cannot be speeded, neither via the drinking of coffee nor via the eating of a snack. It does not matter if the person has consumed a beer or, for instance, a shot of gin. The percentage of alcohol in gin is indeed higher, but the volume of a shot of gin is much less than the volume of a glass of beer. Every standard glass contains about 10 grams of pure alcohol.

The more alcohol consumed within a short period of time, the higher the concentration of alcohol in the blood and the greater the effects. The effects of spirits are felt more quickly and more strongly because the alcohol enters the bloodstream more quickly. This is because hard liquor has a higher percentage of alcohol to start with (35%). There are beers with a higher percentage of alcohol as well (5%). The drinking of this type of beer thus produces a relatively quicker effect.

When alcohol is consumed on an empty stomach, it enters the bloodstream more rapidly and directly than when it is consumed on a full stomach. The concentration of alcohol in the blood also rises more quickly when alcohol is consumed on an empty stomach.

The effects of alcohol are not the same for all people. This has to do with body weight and the amount of fluid in the body among other things. The less fluid in the body, the greater the effects of alcohol. The concentration of alcohol in the blood rises more rapidly when there is less fluid in the body. The individual who weighs 50 kilos has less fluid than the individual who weighs 100 kilos and the former thus experiences the effects of alcohol more quickly than the latter. For the same reason, alcohol tends to affect women more quickly than men; women weigh less than men, on average, and therefore have less body fluid as well. Yet another difference in the effects of alcohol can be seen for people who drink regularly. The human body quickly grows accustomed to alcohol and, for this reason, more alcohol may quickly be needed to attain the same effects. The body does not, however, grow accustomed to all of the effects of alcohol; the negative effect on reaction time remains the same, for example.

What does the user feel?

After 1 or 2 glasses, alcohol appears to work as a stimulant. This is in fact because the anaesthetizing effect of alcohol removes certain inhibitions. The drinker relaxes more easily, feels better and behaves more loosely. People can also become more depressed, more anxious or more aggressive following the consumption of alcohol as well.
The disinhibitory effects of alcohol are greater when it is consumed in combination with drugs which are stimulants because these substances counteract the subduing effects of alcohol. The combination of alcohol and drugs nevertheless produces unpredictable effects and is therefore risky.
After 1 or 2 glasses of alcohol, physical reactions are already present. Fine motor skills are impaired, reaction times decline and the individual sees, hears and tastes less.
After 3 to 5 glasses of alcohol, perceptions of one’s own behaviour are impaired and self-criticism also declines. This is why people who have been drinking often think that they are still in a position to drive really well while this is actually not the case.
When someone continues to drink, he or she is clearly under the influence. The individual can get emotional, self-critique declines further, he or she can get red in the face and the individual can have difficulties speaking.
When a person still continues to drink, intoxication is the result. The person has considerable difficulties with his or her balance, can become unconscious and may not know on the next day what he or she did the evening before. After an often restless and brief sleep, the hangover awaits in the form of headache, heartburn, queasiness and a dry mouth.

Is alcohol addictive?

A substance is addictive when it causes dependency and tolerance. A distinction can be made between physical versus psychological dependence. In cases of physical dependence, the body protests when use of the substance is stopped (symptoms of withdrawal). Psychological dependence means that the user craves the substance to an increased extent and no longer feels really good without it. One can speak of tolerance when the user requires increased amounts of the substance to experience the same effect.

The use of alcohol can lead to tolerance and both physical and psychological dependence. Most users are very familiar with the risks but think that they will never affect them. As a result of more frequently drinking increasingly greater amounts of alcohol, however, it is possible to become dependent on alcohol.

By drinking no alcohol for an extended period of time, one can determine if one can speak of physical or psychological dependence. Those who have difficulties with this or feel miserable are in the danger zone.

What are the risks?

The consumption of alcohol in moderation does not damage one’s health. A daily consumption of 1 or 2 glasses for women and 2 or 3 for men is not unhealthy. One standard glass contains 10 g alcohol ( beer – 5% alc., 250 ml; wine – 12% alc., 100 ml; spirits – 35% alc., 40 – 50 ml). Daily consumption increases the likelihood of tolerance and, for this reason, it is good not to consummate alcohol on at least two days out of the week.

Excessive use can lead to various problems.

Excessive alcohol use can damage the stomach lining, liver and brain.
When someone has consumed a lot of alcohol, the probability of accidents increases. People can also become more aggressive more quickly when they have consumed excessive amounts of alcohol.
People who regularly drink large amounts of alcohol run the risk of liver disorders in the long run and various forms of cancer affecting the mouth, throat, esophagus, stomach, liver and intestines.
Excessive alcohol consumption can lead to social problems. Totally uninhibited behaviour towards one’s partner, friends or colleagues can lead to irritations and disagreements with relational splits and the loss of one’s home or work as a consequence.
Short-term memory can be damaged, which leads to Korsakov’s Syndrome or alcohol dementia.

Other risks are as follows.

Drinking while pregnant can lead to a smaller brain mass and lower birth weights for babies. In cases of heavy drinking during pregnancy, severe birth defects with lifelong consequences can occur.
The combination of alcohol and anaesthetics, stimulants or sedatives and tranquillizers is dangerous because the alcohol and drugs augment each other’s effects.

How do you recognize problematic use?

Alcohol addiction and tolerance can gradually emerge. It starts out with occasionally drinking too much and shifts to regularly getting drunk. The gradual nature of the process makes it difficult to recognize problematic use. One can speak of abuse when someone, no matter what the circumstances, continuously uses alcohol and this use leads to or worsens problems. If someone continually places not only him/herself but also others at danger by driving under the influence of alcohol, for instance, one can speak of abuse.

Important signs of problematic use are:

alcohol needed to relax, to get into another mood, to overcome fears or to calm one’s nerves;
finding 1 or 2 glasses to not be enough, drinking more on a daily basis and frequently seeking out situations for the consumption of alcohol;
a desire to stop drinking altogether or an attempt to stop drinking during the day but without success;
guzzling or drinking fast, drinking in secret, frequently smelling of alcohol and chewing gum to hide the smell of alcohol on one’s breath;
appearance of such withdrawal symptoms as trembling hands, perspiration and problems sleeping when without alcohol;
frequent arguments with the partner and/or other members of the family with regard to alcohol;
frequent mistakes at work or regular absence from work;
driving more frequently under the influence of alcohol.

How to handle problematic use on the part of another?

People with alcohol problems show a tendency to deny this. Trying to prohibit or forbid alcohol does not work. Panic or threats can actually, at times, produce the opposite of the desired effect.

An open exchange of thoughts on the basis of sufficient background information and no prejudices is thus called for. In doing this, the following points should be kept in mind.

Set clear boundaries.
Try to identify what the underlying problem(s) may be together with the person and whether something can be done about them or not.
See that you are sufficiently informed. The latest and most important information is presented here.
The following holds for both the problem user and the environment: Do not hesitate to ask for advice or to seek help.