In chronic alcoholism, significant biochemical and immunological changes occur in the body. A violation of the ratio of protein fractions in serum was found (an increase in the content of fractions of a-globulins, slow B- and y-globulins, preilbumin, a decrease in a-microglobulins and b-lipoproteins), DNA synthesis in lymphocytes (X. Ya. Vyar et al., 1981), acid-base state, water-electrolyte balance, protein-forming function of the liver (M. G. Gulyamov, V. F. Kolomiets, 1981). N. I. Kuznetsova (1981) indicates a change in immunological reactivity in patients with chronic alcoholism.
In the pathogenesis of chronic alcoholism, the effect on the brain of acetic acetaldehyde formed during the oxidation of ethanol in the body, mainly in the liver, and its interaction with biogenic amines are of great importance (G.I. Ezrielov, 1975). G.V. Morozov and I.P. Anokhina (1981) consider the violation of catecholamine metabolism in the brain to be one of the most important pathogenetic mechanisms of alcoholism: an increase in their synthesis, a decrease in the activity of dopamip-B-hydroxylase, and an increase in the content of dopamine in the brain and blood. In the process of the systematic intake of alcohol, as shown by animal experiments (T.M. Vorobyeva et al., 1981), the bioelectric activity of the brain changes. This is confirmed by the data of electroencephalographic studies conducted in patients with alcoholism, the appearance of convulsive seizures in them.
An important place in the pathogenesis of alcoholism is occupied by disorders of the functions of internal organs at the biochemical, neurohumoral, neuroendocrine and neuroreflex levels, the gradual development of degenerative-dystrophic changes in them: liver cirrhosis, myocardial dystrophy, nephropathy. The biological component of the craving for alcohol, apparently, is due to metabolic disorders, mainly in the brain, damage to its emotiogenic structures. The psychological component, based on the physiological one, is complex in structure and very dependent on the influence of microsocial factors, characterological features of the patient’s personality, and its painful changes. This clearly appears during the period of abstinence and with the actualization of the pathological craving for alcohol during remission, when its severity is dependent on external circumstances. Increasing irritability (in excitable individuals), meeting with old friends and other situational moments (in unstable individuals), quarrels in the family, and production turmoil (in asthenic individuals; L. L. Igonin) are especially significant for actualizing the pathological attraction and resuming drinking alcohol. , 1980).
Based on a pathopsychological analysis, B. S. Bratus (1974), confirming the organic nature of the intellectual and mnemonic decline in patients with alcoholism, came to the conclusion that it is based on a complex pathological restructuring (reformation) of the personality, as a result of which there is a distortion, inadequate overestimation of self-esteem and the level of claims, the hierarchy of motives for behavior (the need for alcohol becomes the main one) with a narrowing of the circle of interests, impoverishment and primitivization of the structure of actions and all activities in general. The need for alcohol becomes the “top” in the hierarchy of motives, the most effective motivating force of the patient’s behavior. Moral values and social requirements cease to be a controlling mechanism. The requirements of others are perceived by the patient as of low value, inadequate, infringing on his freedom. With a kind of “alcohol negativity” social requirements often cause the patient a feeling of protest. As a result, patients continue to drink.