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При развитии алкогольной зависимости исчезает защитный рвотный рефлекс, и регулярное употребление спиртных напитков приводит к тому, что человек постепенно повышает дозы, продолжая непрерывное питьё несколько дней подряд. На поздней стадии алкоголизма удовольствие от алкоголя часто перестает быть главной причиной употребления: спиртное принимается уже для уменьшения ломки, тревоги, дрожи и других проявлений абстиненции.
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Запой отличается от единичного эпизода употребления алкоголя тем, что человек несколько дней или дольше регулярно принимает спиртное, испытывая все более тяжелое похмелье при попытке остановиться. Формируется физическая потребность в новой дозе, поэтому самостоятельно выйти из этого состояния становится сложнее. Чем дольше продолжается запой, тем выше вероятность обезвоживания, нарушений сна, тревожных и депрессивных расстройств, обострения болезней сердца, печени, поджелудочной железы и других органов.
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Абстинентный синдром возникает после снижения дозы или прекращения приема спиртного у человека с сформированной алкогольной зависимостью. Его проявления могут заметно отличаться: у одних преобладают слабость, тошнота и тремор, у других появляются сильные страхи, бессонница, раздражительность, панические атаки и выраженная тревога. Врач оценивает комплекс признаков, поскольку обычное похмелье и тяжелый абстинентный синдром требуют разного объема медицинской помощи.
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Первый этап лечения начинается с беседы и медицинской оценки. Нарколог выясняет, сколько лет существует проблема, как часто человек употребляет алкоголь или наркотические вещества, когда был последний прием, присутствуют ли симптомы интоксикации, бессонницы, тревоги или психических расстройств. При необходимости назначаются анализы и дополнительная диагностика. Врач также учитывает документы и выписки, если ранее лечение проводилось в другой организации. Такой подход позволяет подобрать безопасные методы лечения пациента и определить, может ли помощь оказываться на дому либо необходима госпитализация в стационар.
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