Bad habits and how to deal with them
How smoking, alcohol and drugs destroy the body
Alexey Utin, Post-science
According to the World Health Organization, on average every year more than 3 million people die from alcohol consumption, more than 8 million – due to smoking and second-hand exposure to tobacco smoke. Although heavy narcotic substances have less influence on the global picture, in each individual case they lead to severe forms of addiction, which are extremely difficult to get rid of. PostNauka asked Dr. Alexey Utin to talk about bad habits, the mechanisms of action of toxic substances on the body and health, as well as the fight against addiction.
What is harmful in habits?
At first glance, it is difficult to define bad habits, because everyone can have their own understanding of what exactly can be considered harmful. However, there is a key factor, the value of which almost no one questions, is human life. Therefore, substances that can affect life expectancy in a negative way can definitely be considered "harmful". Smoking, alcohol and drug use fall under this definition, because they cause long-term and inevitable damage to our health.
Are sweets, salt and coffee harmful?
It's a matter of measure. WHO says that sugar is actually a necessary part of the diet. We are talking about free sugars: monosaccharides (for example, glucose and fructose), disaccharides (sucrose or table sugar) and sugar, which is in honey and fruit juices. But the daily rate of their consumption should be no more than 10% of all calories consumed. Similarly, if a person likes salty food and he does not have any contraindications - hypertension or the risk of developing stomach ulcers – then there will usually be no negative consequences from eating salty food, although excessive consumption can lead to an increase in blood pressure. Therefore, salt should be taken no more than 5 grams per day. It's the same with coffee. Studies show that moderate consumption of caffeinated foods (3-5 cups of 240 ml per day) reduces the risk of developing cardiovascular diseases and diabetes. Harmful effects from drinking coffee can occur only at doses above 500 micrograms of caffeine per day, that is, more than 5 cups. There are studies showing that for men this norm is slightly lower – about 3 cups per day.
The study of the beneficial and harmful properties of caffeine, sugar and salt has no direct relation to bad habits. We will focus on the negative consequences of using cigarettes, alcohol and narcotic substances.
Smoking
The addiction to smoking is based on dependence on nicotine. Its molecules are similar to acetylcholine, a neurotransmitter that stimulates the production of dopamine, which is necessary for a person to consolidate a positive experience. Acetylcholine decomposes quickly enough and ceases to affect the receptors. Nicotine is excreted from the body much longer. When dopamine begins to be lacking, acetylcholine receptors send a special signal to start the production of acetylcholine. But with prolonged exposure to nicotine, this does not happen, the chain is broken and nicotine becomes necessary for the body to start the process of dopamine production. This is how excessive reinforcement of smoking occurs in the body, which is why addiction occurs.
In fact, nicotine is contained in minimal amounts in tomatoes, potatoes and even tea, but the dosage is calculated in tens and hundreds of nanograms. Nicotine, of course, is harmful in itself, but cigarette burning products are much more dangerous, which are very quickly absorbed into the bloodstream from the lungs.Gorenje That is why one of the most vulnerable organ systems affected by smoking is the circulatory system. Carbon monoxide and about 30 other toxic components of tobacco (benzpyrene, benzidine, prussic acid and others) injure the vascular wall, damaging its inner shell (endothelium). Through these microtrauma of the vascular wall, "bad" cholesterol (low-density lipoprotein molecules) begins to penetrate, which is then deposited under the inner lining of the vessels. Deposits are most often not uniform, but are formed in the places of branching of the arteries, where laminar blood flow turns into turbulent, which further contributes to the effect on the inner shell of the vessel. This is how atherosclerotic plaques begin to form, resembling a pimple in the lumen of the vessel. The plaque has a shell and a liquid content consisting of cholesterol, its esters and dead immune cells. The plaque shell may rupture, and then the "filling" will come out into the lumen of the artery. This substance provokes blood clotting on the surface of the ruptured plaque, as a result of which a blood clot may form. The process, if it occurs in the brain, is called an ischemic stroke, and in the heart – a myocardial infarction. This mechanism underlies the death of almost half of the inhabitants of our country.
When did people start smoking tobacco?
The practice of smoking tobacco first originated in America long before Europeans got there. After the beginning of colonization , tobacco began to spread in The Old World, where it quickly began to gain popularity. For a long time, European doctors considered it very useful: tobacco was considered as an effective antidote to poisoning and plague diseases, stopping the spread of miasma. Only in 1828, when nicotine was isolated from tobacco, an increasing number of scientists began to perceive smoking as a bad habit. However, serious shifts in smoking began to occur only in the middle of the XX century. An important role in this was played by the works of Richard Doll and Austin Hill, who demonstrated the relationship between tobacco smoking and the risk of lung cancer. Despite the widespread lobby of cigarette manufacturers, since the 1960s in the USA and Western European countries, measures have gradually begun to be taken to legally restrict the sale of tobacco products: regulation of advertising, restriction of the age of sales, placement on packages of minimum warnings about potential harm to health. Finally, in 2005, the World Health Organization Framework Convention on Tobacco Control entered into force, to which 168 countries have joined. The signatories of this agreement pledged to raise tobacco prices, prohibit all types of advertising of tobacco products and their sale to minors, and introduce measures protecting against passive smoking.
There is no doubt about the harm that smoking causes to the human respiratory system. It is reliably known that lung cancer in 90% of cases is observed in smokers and is associated with the effects of resins and carcinogens contained in the cigarette. Carbon monoxide (II) CO, a colorless and odorless gas, is present in high concentrations in cigarette smoke. Its ability to combine with hemoglobin is 200 times higher than that of oxygen, which is why it greatly reduces the ability of the blood to carry oxygen. This affects the functioning of all body tissues. Acrolein and formaldehyde belong to the group of substances that provoke the development of asthma. Many other cancers are also directly related to smoking, primarily oral cancer, throat cancer, and respiratory tract cancer.
Cigarette manufacturers, understanding the resistance of the state and society, are now inventing alternatives. The scientific consensus is that there are no safe forms of smoking. Thin cigarettes, which are considered lighter, are actually just manipulation. Technically, of course, they may contain less nicotine or other harmful substances, but from such cigarettes the feeling of "saturation" is weaker, which means that a person will simply smoke more.
The fundamental property of any addiction is that it can develop. If a person smokes one cigarette a day, but does not consider himself a smoker, there is always a risk that in difficult life situations, problems in the family, at work, he will suddenly start smoking a pack daily.
Alas, alternative forms of smoking are also harmful. Hookah smoke, as well as cigarette smoke, contains harmful gorenje products. Hookah emits a lot of carbon monoxide, which is why a 45-minute smoking session is equated to smoking a whole pack of cigarettes: 179 mg of CO in one hookah versus 11.66 mg of CO in one cigarette. Electronic cigarettes, vaping and tobacco heating systems will not reduce the harm either. In the composition of substances for evaporative systems there are carcinogens, acrolein, acetaldehyde, also arising in the gorenje process. The risks, albeit somewhat in a limited format, remain with passive smoking.
When a person completely gives up smoking, the body recovers quickly enough from the negative consequences. On average, the risk of heart attacks and strokes in former smokers decreases significantly within two years after quitting smoking. If the smoking experience was short-lived, then five years after giving up tobacco, all the consequences come to naught. But if a person has smoked for a long time and a lot, for example, a pack a day for thirty years, then he still has high risks of developing lung cancer. Therefore, after 50-55 years, he will be recommended to do a CT scan of the lungs annually.
Nevertheless, quitting smoking makes sense. On average, smokers live 10 years less than non-smokers. Even if you give up smoking at a late age, there is every chance to increase life expectancy by an average of 7 years. If you do it on time, at the age of 30 to 40 years, then you can practically nullify the effects of smoking. The later a person quits smoking, the worse it will affect his health.
Alcohol
Unlike cigarettes, the danger of alcohol consumption is directly related to its main component – ethanol. Getting into the stomach and liver, ethanol is absorbed into the blood. Passing through the liver, it is partially broken down by enzymes and spreads throughout the body, reaching the brain. There, ethanol easily penetrates through the membranes of nerve cells and changes the functioning of several neurotransmitters at once, primarily gamma–aminobutyric acid (GABA), glutamate and dopamine.
The initial stimulating effect of alcohol is associated with its ability to inhibit the centers that control our behavior, as well as its effect on the dopamine and glutamate systems. GABA receptors are responsible for the processes of inhibition, so a drunk person relaxes, feels drowsy, his tongue slurs, speech becomes slurred. Alcohol also activates the opioid system, so there is a sense of pleasure and self-confidence. However, those who drink regularly have a decrease in endorphin synthesis over time. This is how alcohol addiction arises, and a person loses the sensations that he seeks to experience.
If such a load on the brain becomes constant, then the prerequisites for long-term functional disorders begin to form in it over time. With chronic alcohol use in the brain, the number of GABA receptors (inhibitory neurotransmitter) decreases, while the number of excitatory receptors increases. This leads to excessive arousal of the brain with a sudden refusal of alcohol. A patient with alcoholism may develop alcoholic delirium, known as delirium tremens, after stopping drinking. It is accompanied by convulsions, hallucinations, excessive excitement and insomnia. This condition is extremely dangerous.
How did people start drinking alcohol?
Mankind has been familiar with alcohol for a very long time. Researchers from Stanford in 2018 found traces of brewing in the caves of Israel, the age of which was 13 thousand years. The oldest samples of wine found at the excavations of ancient settlements near Tbilisi are at least 6 thousand years old. Alcohol - based beverages were distributed almost throughout the Old World and in Pre-Columbian America. Most recently, people have learned to create strong alcoholic beverages based on ethyl alcohol. Distillation of alcohol became possible for the first time in China and in Alexandria approximately in the I–II centuries, but drinks based on it began to spread widely only in the XIV–XVI centuries.
Unlike tobacco products, alcohol was not considered an exceptionally useful product due to the serious social consequences of drunkenness. The term alcoholism was first proposed by the Swedish physician Magnus Huss in 1849. He was one of the first to study alcoholic beverages in terms of their direct harm to the human body. The first, however, to actively fight against alcohol were not doctors, but states that have repeatedly tried to pursue a policy of prohibition. The most famous example of the first half of the XX century is the 18th Amendment to The US Constitution, which prohibited the production, sale, transportation, export and import of any intoxicating alcoholic beverages. In practice, this measure proved ineffective, led to clandestine production and even served to promote Al Capone in the hierarchy of the criminal world. Therefore, modern practices of combating alcoholism are quite similar to measures against tobacco addiction: restrictions on advertising, prohibition of sales to certain groups of persons, temporary restrictions on trade.
Due to long-term alcohol consumption, convulsive syndrome may also develop, coordination may be disrupted up to the loss of the ability to move, as well as encephalopathy (mass death of brain cells).
Alcohol harms many organs. Its use provokes the development of oncological diseases of the gastrointestinal tract - from oral cancer to liver cancer. Arterial hypertension, stomach ulcer may develop. Alcoholism causes paroxysm and atrial fibrillation, leading to ischemic strokes and cardiovascular diseases.
Some ethnic groups are characterized by innate intolerance to alcohol. Their body is genetically predisposed to the formation of elevated concentrations of acetaldehyde from alcohol – an organic compound with toxic properties. This substance is formed quickly, but is slowly broken down, so it causes a serious condition in a person during a hangover. Because of it, a person's face or body turns red, becomes covered with spots, skin temperature rises, and in general, well-being deteriorates greatly.
Because of its effect on the nervous system, alcohol is not only an individual's problem. According to statistics, at least 30% of injuries, poisonings, murders, suicides, cases of domestic violence, accidents occurred with the participation of alcohol.
Russia is far from being in the first place in terms of total alcohol consumption. In some European countries, for example, in Germany, Ireland and Portugal, this indicator per capita is higher, but there are no such severe consequences for society there. The reason is simple: in such countries, they drink lighter alcohol in general. The use of strong drinks leads to a very rapid development of pathological dependence. However , gradually in In Russia, the population is beginning to change their habits, increasingly preferring light alcohol to strong drinks.
Drawings by Ekaterina Zolotareva
But do not think that there is a benefit from a small amount of alcohol. It is generally believed that a glass of red wine in the morning stimulates digestion, and some scientists have hypothesized about reducing the risk of diabetes and diseases of the cardiovascular system. This is not so: the benefits of resveratrol – an antioxidant contained in wine – have not been confirmed in clinical studies.
And yet some amount of alcohol is relatively safe for the body. We are talking about the so–called "drinks" - 50 ml of strong, 150 ml of wine or 330 ml of beer per day. The permissible number of drinks is no more than 2 for men and no more than 1 for women at a time. Of course, these daily indicators do not add up. It makes no sense to endure the whole month, and then at once drink all these drinks that have accumulated over 30 days.
The effects of stopping alcohol consumption occur within a few weeks. In severe cases, you will need the help of a psychologist, both for a person with alcohol addiction and for codependent people in his environment.
Drugs
Probably, drugs cannot be called just a "bad habit", given the destructive effect they have on the human body. However, this exactly corresponds to our definition of bad habits: drugs shorten people's lives like nothing else. Strictly speaking, cigarettes and alcohol are also drugs that make a key negative contribution to the health of society. A completely separate question is why exactly these substances have historically been allowed.
When did people find out about drugs?
Some narcotic substances have been known to mankind for a very long time. Coca leaves, from which cocaine was subsequently obtained, grew on the territory of Pre-Columbian Peru and Bolivia, and the locals knew about their effect. Before the arrival of the Spaniards, the entire coca crop was owned by the Inca emperor, and only after colonization it began to be consumed more massively by the Indians. Opium has also been common in Europe and Asia since ancient times. The first mention of it was found on Sumerian clay tablets dated to the middle of the third millennium BC. In the ancient Egyptian "Ebers Papyrus" there are mentions of recipes that include sleeping poppies. Opium had a wide cultural and medical significance in Ancient Greece: there are lines about it in The Odyssey, and Hippocrates himself used it as an analgesic and hypnotic.
In its modern form, drugs began to appear together with the achievements of chemistry and for a long time were considered as important and useful medicines. In 1803, morphine was obtained, which throughout the XIX century and the beginning of the XX century was used as an analgesic and a means to combat addiction to alcohol and opium (it was believed that morphine was much less harmful). Heroin was synthesized from morphine in 1874, which was used as a cough medicine for adults and children at the turn of the XIX and XX centuries. Cocaine was isolated from coca leaves in 1860, and Sigmund Freud was actively interested in this substance. He believed that cocaine could serve as a cure for depression, sexual disorders and other forms of addiction. Psychoactive substances, such as amphetamine and LSD, attracted attention already in the XX century. They actively tried to use them to combat opioid addiction and alcoholism. Amphetamine has also been used as a treatment for narcolepsy, Parkinson's disease, depression and weight loss, and LSD has been tried as an auxiliary drug for psychotherapy in various forms of schizophrenia and neurosis. On January 23 , 1912 , the International Opium Convention was signed in The Hague on January 23, 1912 – the first international agreement on the control of drug trafficking. And in 1920, a similar act was signed in the UK.
The mechanism of action of heavy narcotic substances on the body from a physiological point of view is somewhat similar. Their action either resembles the action of neurotransmitters, or significantly stimulates their production in the body. Opium-based substances such as morphine, heroin, methadone are close to endorphins in their effects. They slow down the vital activity of the body: thoughts become confused, breathing and blood circulation slow down. Amphetamine, cocaine and other psychoactive substances, on the contrary, activate the production of dopamine, norepinephrine and serotonin. All processes accelerate, pressure increases, concentration of attention increases, there are rapid mood swings and bursts of sociability.
Very quickly, the body gets used to the increased content of these substances and can no longer fully work without them. At the same time, the human brain, receiving neurotransmitters (or their analogues) from the outside, ceases to produce them independently. Therefore, when giving up drugs, withdrawal syndrome appears – a physiological "withdrawal", which is very hard experienced by the body. Depending on the type of addiction, the specific withdrawal symptoms may vary. In case of refusal of some narcotic substances, abstinence can lead to a fatal outcome.
The scale of harmfulness of chronic recreational drug use. Based on data from a 2013 study by Dutch experts "Physical harm due to chronic substance use".
Tolerance to narcotic substances is one of the most harmful consequences of taking drugs. The minimum dose capable of producing an initial effect is constantly increasing. At the same time, the specific load on the body that the narcotic substance creates does not change much. Because of this, there is a very high risk of overdoses that can lead to death. The most dangerous consequences of excessive use of opioids, especially heroin. This substance has a powerful sedative effect, and its overdose can lead to a lack of oxygen due to slowing breathing. In addition, nausea and vomiting often appear, which block the respiratory tract and in fact lead to the same effect. An overdose of amphetamine and other psychostimulants causes a sharp increase in blood pressure, which is fraught with brain hemorrhages, serotonin syndrome (anxiety, anxiety and related tachycardia and elevated body temperature) and kidney failure.
Impurities multiply the harm. The drug gets to the consumer through a long chain of people. Raw materials of questionable origin are transported and stored in such conditions that they often get particles that should not be there. The substances themselves are also very often diluted with other components without special knowledge of biochemistry, which can lead to poisoning, overdoses and other negative consequences.
The main problem with heavy narcotic substances is that remission during treatment, unfortunately, is quite low due to the strong degree of dependence. An extremely small number of people completely refuse to use them in a short time – only about 5 percent. In such a situation, it is problematic to talk about healing as such.
Can dependence on drugs be formed?
Physiological dependence can also be formed from the use of certain drugs. However, this problem cannot be included in the list of bad habits: it is extremely rare to talk about reducing life time. Most medications do not cause physical and mental dependence. They rather disrupt the natural course of the organs, making it difficult for a person to live without using drugs. Examples of this kind of dependence are nasal drops containing adrenomimetics that constrict the vessels in the nose or some types of hormones. You can get rid of these problems with medications prescribed by ENT or simply by refusal.
However, there are more serious pharmacological dependencies. So, addiction is caused by phenobarbital, which is part of corvalol. This problem is especially characteristic of Russia, since the country does not have a very well-developed system of high-quality psychiatric and psychological care for the treatment of depression, anxiety disorders and panic attacks. Because of this, many people go to see cardiologists, believing that they have problems with the cardiovascular system. Some are beginning to try to treat panic attacks with beta-blockers, someone with phenobarbital, originally intended as a medicine against epilepsy. This can really help reduce anxiety, but at the same time cause serious physiological dependence.
The fight against smoking and alcoholism
Fortunately, a lot of time has passed since people realized all the negative consequences of bad habits. Therefore, today there are a number of proven medications to combat addictions.
Nicotine replacement therapy works quite successfully in the field of anti-smoking. Nicotine patch reduces the basic craving for nicotine, and nicotine gum helps with acute momentary cravings. Another technique involves the use of drugs that work on the principle of blocking receptors in the brain so that a person stops enjoying nicotine. This is how the process of smoking and getting pleasure from it are separated. Tablets are taken simultaneously with a cigarette for two weeks. At some point, a person loses the feeling of anticipation of pleasure, which each time reinforced the addiction.
A person can quit smoking by himself, but in some cases may need the help of a doctor and support from the family. They must work together to determine what behavior is acceptable in relation to a person struggling with nicotine addiction. It makes sense to communicate with someone more harshly and persistently, or vice versa - to create a calm environment and not to push. In the fight against alcoholism, these recommendations are doubly relevant, since addiction is much more serious. Unfortunately, it is impossible to force a person to give up any addiction, so he must make a decision on his own. Today, drugs that can significantly reduce cravings for alcohol and opioids have been clinically tested. Some of them have a prolonged (up to a month) validity period.
However, it is absolutely necessary to finally eradicate the practice of coding. From the point of view of evidence-based narcology, this practice is nothing more than shamanism, which has nothing to do with medicine and patient care. Practice works like a horror story. It developed in Soviet medicine under the influence of Ivan Pavlov's specially perceived ideas about unconditional reflexes. In the eyes of some specialists, these discoveries served only as a way to legitimize the practices of suggestion, hypnosis and intimidation. It was believed that in this way it was possible to develop a conditioned reflex in a patient. To consolidate the effect, disulfiram was used, which actually caused a person to be intolerant of alcohol. It caused unpleasant sensations that were supposed to be associated with alcohol, thus forming a negative reinforcement. This can work with impressionable people, but the practices of world narcology have already advanced far in comparison with such methods. The effects of coding were, as a rule, very short-lived, and quite quickly the craving for alcohol overcame the effect of suggestion.
Unfortunately, many rehabilitation centers operate in accordance with these outdated norms. There are frequent stories when violence and humiliation of patients are widespread in such institutions. That is why it is necessary to study rehabilitation centers very carefully before applying there.
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