Intoxication has a predominantly negative social and legal significance, although medical attention is often required. The degree of intoxication is determined by several indicators: the general somatic and mental state, behavioral reactions, and the concentration of alcohol in the blood. This is due to the fact that the dose of alcohol, mental and somatic reactions to it can be different not only in individuals, but also in the same person, depending on certain circumstances. There are intoxication of mild, moderate and severe. By the concentration of alcohol in the blood, cases of mild intoxication are tentatively attributed to cases when it does not exceed 2 to medium, up to 3% o, severe – more than 3% o, fatal – more than 5% o (I.N. Pyatnitskaya, V.A. Balyakin, 1974).
Mild intoxication occurs, as a rule, after drinking a small dose of alcohol. Most people in this state feel more determined, relaxed. However, drinking alcohol in a state of overwork, feeling unwell often causes drowsiness, and with irritability and situational decrease in mood – an increase in these phenomena. Mild hyperemia of the face, increased talkativeness and confidence in behavior are noted. This condition is dangerous for people at the workplace, since they objectively decrease the speed and accuracy of sensorimotor and mental reactions, increase exhaustion of various functions, as a result of which emergency situations often arise. Persons in a state of mild intoxication do not need medical assistance.
With moderate intoxication, marked changes in the mental and somatoneurological fields are noted. Characteristic hyperemia of the face, unsteady gait, loud and entangled speech. Mood can be elevated – to euphoric or lowered – to depressive, characterized by its instability, dependence on the situation, the behavior of others and emerging in the experiences of past grievances, troubles. A random cue or memory can cause a flash of anger, rage with aggression. The disinhibition of instinctual drives and the reduction of control create favorable conditions for committing rash acts, hooligan acts, sexual offenses, suicides, or attempted suicide. This is facilitated by the lack of thought processes (analysis, synthesis, speed and adequacy of the assessment of the situation, the consequences of their behavior), an affective narrowing of consciousness. The day after intoxication, as a rule, signs of asthenic syndrome appear: headache, lethargy, weakness, decreased mental and physical performance. References to amnesia are unconvincing, and in expert practice they should not be taken seriously.
The need for medical assistance is not excluded both during intoxication of moderate severity and after it, especially to persons with cardiovascular pathology. The severity of alcohol intoxication can be reduced by gastric lavage. Some people with a hangover are prescribed heart remedies. With psychomotor agitation, 2-3 ml of a 2.5% solution of chlorpromazine or tisercin and 1-2 ml of cordiamine can be administered.
Severe intoxication is a danger mainly for the drunk himself, although sometimes it can be a source of negative consequences for others. In this state, the situation is perceived fragmentarily, coordination of movements is sharply disturbed, speech is incoherent, stupor can turn into deep sleep and coma. In the absence of help, a person may die from alcohol intoxication. After sobering, amnesia is noted for events preceding loss of consciousness.
Medical care for severe intoxication should include resuscitation measures carried out with intoxication coma: gastric lavage, intravenous administration of glucose with ascorbic acid and B vitamins, fructose, 0.25% potassium permanganate solution, 1% methylene blue solution, inhalation of oxygen, administration heart remedies (cordiamine), cytitone.
Expert practice shows that adverse consequences, up to a fatal outcome, arise not only due to the insufficiency of resuscitation, but also due to the superficial attitude to somatoneurological examination of patients in an unconscious state and persons with signs of intoxication. This sometimes hides a head injury, stroke, myocardial infarction and other life-threatening conditions.
Atypical forms of intoxication are often observed, the occurrence of which is promoted by residual sawing of an organic brain lesion, psychopathic features and character accentuations, somatic diseases, overwork, lack of sleep, psychotraimiruinz experiences, drinking on an empty stomach or as a mixture of alcoholic drinks (for example, beer with vodka, champagne with champagne alcohol) and alcohol with medications (sleeping pills, tranquilizers). E.S. Feldman (1963) described the following altered forms of simple alcoholic intoxication: euphoric, psychopathic with a predominance of hysterical behavior, agitated (maniac-like), dysphoric, perseveration and with disinhibition of sexual drives. G.V. Morozov (1983) identifies a number of variants of altered (atypical, complicated, heavier) simple alcohol intoxication: explosive, dysphoric, hysterical, depressive, with impulsive actions (in the form of aggression, perverted sexual acts, pyromania), with a predominance of somnolsncin, manic, epileptoid (with severe excitement, destructive actions and aggression), paranoid (with overvalued ideas, excitement and aggression). However, there is no deep pathological disturbance of consciousness or feelings of alienation and violence of the experienced.
Drinking is a frequent, systematic and excessive use of alcohol with intoxication of varying severity, not always having the nature of a painful addiction. Fast drinking should be distinguished from alcoholism in the medical sense of the term, that is, from illness. The psychophysiological and socio-psychological essence of drunkenness is that a person begins to drink alcohol in toxic doses under the pressure of certain circumstances, internal and external factors, not finding the means to resist them and resolve them in another way. In our opinion, household drinking is a part of alcoholism. The frequent use of alcoholic beverages in high doses each time causes a state of intoxication with stress functions of various body systems, primarily the central nervous system, followed by asthenic syndrome. At first, metabolic functional overloads lead, but to general biological patterns of adaptation, to the restructuring of the body with an increase in its resistance to alcohol, but this is accompanied by a depletion of reserve capabilities. As a result of this, mental and physical performance decreases, and the occurrence of socially reprehensible alcoholic excesses increases. Household drunkenness, in the absence of manifestations of physical and mental dependence, is characterized not only by general asthenization, but also by a decrease in the level of the most subtle psychological properties of a person: criticality in assessing the environment and self-esteem, breadth and depth of interests, differentiated emotions, moral principles. However, a sense of responsibility for their actions, remorse for inappropriate behavior while intoxicated remains. As a result, some people stop drinking. It should be noted that domestic drinking can be repeated (at weddings, multi-day holidays), daily, evening, in the form of a drink before a meal. In any case, the threat of turning it into alcoholism is gradually increasing. A person gets used to this lifestyle, he has a need for alcohol with an increase in dose. Drunken behavior becomes rude and vulgar, aggressive acts, palimpsests, severe forms of intoxication are noted, which are often used in expert practice to suggest pathological intoxication. We consider household drinking as a stage of alcohol abuse, as a result of which alcoholism can develop. Therefore, decisive intervention by relatives, colleagues, public organizations and the administration is necessary to suppress it. During this period, explanatory and enforcement measures are of great importance.