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酗酒:喝多少才算多?

Alcoholism: How much is too much?

[片头]
[♪ INTRO ]
酒精会导致很多问题
Alcohol can cause a lot of problems.
仅仅是过量饮酒就能让你中毒 或是丧命
Just drinking too much can poison and kill you,
开车时 它也会损害你的判断力
but so can the impaired judgment while driving,
或增大你患病的风险
or the diseases it puts you at greater risk for.
但是很多人每天规律饮酒 也没出什么问题
Lots of people drink fairly regularly without any of these problems, though.
也不是所有隔三差五喝多了的都是酒鬼
And not everyone who has a little too much once in a while is an alcoholic.
那么 你怎么知道你喝多了?
So how do you know when drinking becomes a problem?
这主要与上瘾的症状
It mostly has to do with symptoms of addiction,
比如 忍受折磨和戒断症状
like tolerance and withdrawal,
以及你的人际关系和责任有关
along with how your drinking affects your relationships and responsibilities.
即使你喝的量就其本身而言是一个巨型健康风险
Even though the amount you drink is a big health risk on its own
也是问题中最重要的一部分
and a super important part of the problem,
使用酒精使用障碍――酒精中毒的临床术语诊断大量饮酒
diagnosing alcohol use disorder — the clinical term for alcoholism
――并不确切
— isn’t really about hard numbers.
为此 多数精神病学家转向
For that, most psychiatrists turn to
《精神疾病诊断和统计手册》(DSM)
the Diagnostic and Statistical Manual of Mental Disorders, or DSM,
它列出了两类主要症状
which lists two main types of symptoms.
首先 有迹象表明 与身体依赖方面有关的
First, there are the signs that have to do with the physical aspects of dependence,
比如上瘾 忍受折磨和戒断症状
like addition, tolerance, and withdrawal.
例如 如果你发现自己需要更多的酒精以达到相同的效果
For example, if you find yourself needing more alcohol to get the same effect,
比预计的量喝得多很多
drinking a lot more than you intended,
尝试戒酒却没成功
or failing to cut back on drinking when you’ve tried.
其他症状更多的是和饮酒如何影响
Other symptoms are more about how your drinking
你的家庭生活和责任有关
affects your home life and responsibilities.
比如 如果饮酒已经妨碍了你工作或家庭的人际关系与责任
Like if your drinking has interfered with your relationships or responsibilities
或者已经让你或其他人处于危险之中 但你仍继续饮酒
at work or at home, or has put you or others at risk, but you still don’t stop.
《精神疾病诊断和统计手册》总共列出了11种症状
The DSM lists 11 symptoms in all,
而且如果你符合其中的任意两种
and if you have any two of them,
就足以被诊断为酒精使用障碍了
that’s enough to be diagnosed with alcohol use disorder.
一个人符合的症状越多 他的状况就越严重
The more symptoms someone has, the more severe it gets.
无论他们的症状多严重
But no matter where they fall on the spectrum,
患有酒精使用障碍的人都会大量饮酒
people with alcohol use disorder are drinking so much
以至于让他们的人际关系 责任
that it puts their relationships, responsibilities,
甚至他们的生命都处于危险当中
and maybe even their life at risk.
要得出这个结论有上千种不同的方法
There are a thousand different ways to get to that point,
但它们最终都归结为一点:
but they all come down to one thing:
酒精有镇静效果 它能减轻焦虑 让你更放松
alcohol has a sedative effect, which makes you less anxious and more relaxed.
而且在饮酒时 你越放松
And the more you associate drinking alcohol with that relaxed feeling,
大脑越能介入奖励系统
the more your brain’s reward system gets involved.
如果饮酒让你的大脑释放许多多巴胺
If thinking about a drink makes your brain release a lot of dopamine,
即一种参与寻求奖励的神经递质
the neurotransmitter that’s involved in the motivation to seek rewards,
你将拥有一种很强烈的欲望想要满足那种想法
you’re going to have a very strong urge to satisfy that thought.
这是驱动多数上瘾的相同的基本过程
It’s the same basic process that drives most addictions.
酒精影响人的方式并不完全相同
But alcohol doesn’t affect everyone in exactly the same way.
从研究和统计学中
From studies and statistics,
我们知道类似你的遗传和经验这样的事
we know that things like your genetics and experiences
使你有或多或少的患上一种障碍的可能性
can make you more or less likely to develop a disorder.
例如 某些基因似乎
For example, certain genes seem to
改变了酶对于酒精的新陈代谢方式
change how enzymes that metabolize alcohol work,
这将改变它影响你大脑的方式
which changes how it affects your brain.
每个人的肝脏中都有醇脱氢酶
Everyone has enzymes in their liver called alcohol dehydrogenases,
它将酒精转化成乙醛
which convert alcohol into acetaldehyde,
一种不会以相同方式影响大脑的化学物质
a chemical that won’t affect the brain the same way.
但相比于其他变异性基因
But some people have genes that make those enzymes faster at their job,
有人的基因可以提高那些酶的工作效率
compared to other variants of those genes.
拥有那种基因的人
People with the genes that make the enzymes faster
不会喝多 而且酒精中毒的风险也很低
tend not to drink as much and are at a lower risk of alcoholism,
可能因为少量酒精有机会干扰其神经传导物质
probably because less alcohol gets a chance to interfere with their neurotransmitters.
但有的人 他拥有能让酶降低工作效率的基因
But people with genes that make the enzyme slower
他患上障碍的几率也更高
have a higher chance of developing a disorder.
那些基因差异有助于解释研究人员多年来所知的:
Those genetic differences help explain what researchers have known for years:
酒精中毒的家族史使人们面临更高的风险
that a family history of alcoholism puts people at higher risk.
但照例 基因不能说明全部问题
But as usual, genes aren’t the whole story.
研究人员还发现 仅和酗酒者一起生活
Researchers have also found that just living with alcoholics
就能提高患病几率 这是通过额外的压力
can put people at a greater risk, both through additional stresses
和接触那种饮酒行为所引起的
and being exposed to that kind of drinking behavior.
例如 在1991年 《变态心理学》杂志上出版了
For example, a study published in the Journal of Abnormal Psychology in 1991
一项针对454位青少年的研究
looked at 454 adolescents since that’s a stage of life
因为这一生命阶段是你
when you’re at a high risk for starting to
与酒精建立不健康关系的高发期
develop an unhealthy relationship with alcohol.
在这项研究中 有酗酒的父母让人们
In the study, having alcoholic parents made people more likely to
更有可能报告自己自我依赖
report dependence themselves.
但重点是他们父母的酗酒是否在缓解期
But it mattered whether their parents’ alcoholism
――我的意思是 他们是否清醒
was in remission or not — meaning, whether they got sober.
总的来说 与那些父母仍在酗酒的孩子相比
Children of sober alcoholics drank less overall,
保持清醒者的孩子喝的更少
and were less likely to report negative consequences or dependence
而且最不可能报告负面结果或依赖
than those whose parents stilldrank.
即使这样 遗传危险因素仍然存在
Even though, the genetic risk factors were still there,
他们的环境也会产生影响
their environment made a difference, too.
但风险因素只是――风险因素
But risk factors are just that — risk factors.
它们不会决定你的命运
They don’t determine your fate.
对于许多患有酒精使用障碍的人来说
For a lot of people with alcohol use disorder,
认识并承认他们有问题是很难的
recognizing and admitting that they have a problem is incredibly difficult,
而获得帮助似乎更加困难
and getting help can seem even harder.
部分原因是因为障碍对大脑的影响 它带走了你的控制权
That’s part of what the disorder does to your brain — it takes away your control.
但你仍然可以选择获得帮助来重获控制权
But you can still choose to get help to regain that control.
最普通的治疗是互助小组 像匿名戒酒互助社
The most common treatments are mutual-help groups, like Alcoholics Anonymous.
这些项目是有帮助的
These programs can be helpful
因为在最需要它时 你能得到同龄人的支持
because you have peer support available when you need it the most.
而且研究发现第一次加入匿名戒酒互助社的人
And research has found that people participating in AA
喝酒的天数会减少
for the first time have more days where they don’t drink.
康复治疗也趋向有效化
Rehab also tends to work well,
部分原因是 它旨在
partly because it’s designed to remove the triggers
消除鼓励你饮酒的诱因
that might encourage you to drink.
调查住院康复治疗项目的人报道
People who check into inpatient rehab programs
戒酒周期越长
report longer periods of abstinence,
坚持的时间就越长 似乎就越有用
and the longer they stay, the more helpful it seems to be.
特别是当人们需要摆脱酒精时
Some medications can help too,
一些药物治疗也很有帮助
especially when people just need to get alcohol out of their system,
这样他们就能开始进行长期治疗了
so they can start on long-term treatments.
例如 一种叫做环丙甲羟二羟吗啡酮的药物
A drug called Naltrexone,
它能降低对酒精的渴望
for example, can reduce cravings for alcohol,
而且研究发现服用这种药物的人会减少酗酒
and studies have found that people who take the drug end up drinking less,
与安慰剂相比 它的时间更短
and on fewer days, compared to a placebo.
另一项证据表明认知行为疗法可能是有效的
There’s also evidence that cognitive behavioral therapy can be effective.
你要和治疗师一起协作
That’s where you work with a therapist
确定激发你喝酒的诱因并找到更健康的处理方式
to identify things that trigger you to drink and find healthier ways to cope.
不是每个人都会对每种治疗起反应的
Not everyone will respond to every kind of treatment,
但在医生和心理学家的兵工场里有很多工具 因此
but doctors and psychologists have so many tools in their arsenal that
如果你意识到你需要帮助 你总会发现一种适合你的工具
if you realize you want help, odds are you’ll find one that makes sense for you.
感谢观看本集《心理科学秀》
Thanks for watching this episode of SciShow Psych,
本期节目是由Patreon赞助的
which was brought to you by our patrons on Patreon.
如果你想了解更多有关《什么让我们神奇的人类大脑工作》
If you want to learn more about what makes our weird human brains do all the things they do,
可以到“youtube.com/scishowpsych”点击订阅哦
you can go to youtube.com/scishowpsych to subscribe.
[片尾]
[♪ OUTRO ]

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饮酒,酒精中毒,酗酒,好可怕,那我们喝多少才算多?在这里,我们将带你了解有关酒的一切,快来吧!

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