From Big Medical Encyclopedia

ALCOHOLISM (alcoholismus; arabsk. alkohl — something thin).

The term «alcoholism» was included into literature for designation of set of the pathological changes arising in an organism under the influence of long, unlimited alcohol intake by analogy with the term «alcoholism» entered in 1849 by the Swedish doctor and the public figure Guus (M. of Hiiss). Studying of social aspects of unlimited consumption of alcohol by the population led to the fact that the concept «alcoholism» received broader interpretation; sociologists, social hygienists, economists and lawyers include in the concept «alcoholism» its also harmful effects for society. The concept «alcoholism» became closely eurysynusic concept «alcoholism» in life.

For a differentiation of social and uzkomeditsinsky (clinical) contents of the term «alcoholism» it was offered to designate reception of alcoholic drinks (irrespective of quantity and prevalence) the term «alcoholization», and to leave the term «alcoholism» for the clinical use. However this point of view gained distribution only in medicobiological, in particular in psychiatric, literature.

ALCOHOLISM — the complex problem including studying of historical and social psychological roots of ALCOHOLISM, character and the mechanism of effect of alcohol on a human body and the pathological processes arising at the same time, social effects of ALCOHOLISM and also development of actions for fight against ALCOHOLISM as the mass phenomenon.

Historical and social and psychological roots of alcoholism

Knowledge of the intoxicating action of some cereals and other plants go to an extreme antiquity. The archeology and ethnography have the numerous materials confirming existence of various ways of receiving and forms of the use of alcoholic drinks at primitive tribes. Reception of alcoholic drinks at that time was, apparently, collective, periodically dated for intra breeding or astronomical events: successful hunting, full moon or new moon, transition of young men and girls to an age group of adult men and women (initiation) etc. The living conditions of the tribe (unfavorable conditions of getting of food, the dangerous neighbourhood) were more difficult, the more often the tribe could resort to joint intoxication. Joint use of the intoxicating drink in the general occasion for all members of the tribe, similarity of the emotional experiences arising at the same time, apparently, was the reason that further alcohol becomes a symbol of mental relationship, «unities of blood». The ceremony of twinning made by direct mixing or drink of blood is replaced by a ceremony of addition of blood of everyone in the general bowl of wine (at Scythians) or gets a form of joint reception of one wine (e.g., a ceremony of a participle from Christians). Ritual forms of alcohol intake remained up to now: reception of alcoholic drinks on holidays, sad, joyful and gala days. So ancient source has reception of alcoholic drinks in the companies, guests. The motive (desire) to drink alcohol at a meeting of friends in joy and a grief, thus, has very deep roots, and features of effect of alcohol (see. Alcoholic intoxication ), promoting rapprochement even in the unfamiliar company, to a positive emotional reinforcement or affective mitigation of experiences, cause stability of these motives.

With development of production ways of receiving alcohol are improved, forms and reasons for its use are diversified, and also there is an estimated relation to alcohol intake.

In process of complication of social structure of society, with the advent of a private property and exploitation of the person by the person the running-down effect of alcohol begins to be used individually. The circle of occasions extends, on the Crimea individuals resort to alcohol.

The so-called social reasons of «weight» amplified. In the countries with not resolved social contradictions is first of all the economic reasons causing spread of ALCOHOLISM among lower-income strata. Severe living conditions, insufficient and uniform food, absence or unavailability of cultural entertainments, hopelessness of situation — the reason of heavy alcoholism to which people resort as to means of oblivion or (in the vinogradarsky countries) as to an available substitute of food.

However at the end of the last century by data of the German authors it was shown that growth of welfare in itself the Soviet researcher A. S does not solve a problem of ALCOHOLISM. Sholomovich (1929) about it wrote that the century durability of a household narcotism in economically well-to-do of the population, among its cultural elements allows to claim with full confidence that rise in culture and national economy in itself without social actions does not guarantee reduction of a narcotism of the population.

Distribution And. in the modern advanced capitalist countries confirms this pattern. According to Malford and Miller (N. of Mulford, D. Miller, 1961), ALCOHOLISM in the USA increases in process of an urbanization, growth of education and welfare. The exception is made by women among whom ALCOHOLISM increases in process of their involvement in production, but decreases with increase in the educational qualification. With an urbanization social contageousness, neuroemotional tension amplifies, moral control since in the conditions of the big city the behavior of the person gives in to social control less, than in the small settlement is weakened. Conclusions of Malford, Miller and other authors about increase And. in process of growth of education and welfare disperse from data of official police statistics, according to the Crimea persons with low educational and property qualification are late for emergence in public places in an ebrietas generally. Legislative Assembly, Gardner and Hart (M. of Zax, E. Gardner, W. Hart, 1964) explain these discrepancies with the fact that persons from poor families have no conditions to make the alcoholism hidden (drink on streets, in onsale, etc.). According to Glatt (M. of Glatt, 1955), in England ALCOHOLISM is evenly distributed among all segments of the population.

Also the psychological reasons of alcoholism are socially mediated. The psychological reasons are understood as set of motives, on the Crimea individuals resort to alcohol. Difficulties of adaptation, the conflict of an individual with an environment, dissatisfaction of desires and installations, loneliness, a neponyatost, exhaustion, shyness, awareness of the inferiority in any relation cause the discomfortable mental state facilitated by the running-down effect of alcohol. However not all and not always at the moments, unpleasant for themselves resort to the help of alcohol. The last is defined as individual experience and the relation to alcohol, judgment of the acceptability of its use, customs, and social control. The social situation is capable not only to create a reason and motive for reception of alcohol, but also to limit its use. This restriction can be formal (legislative) and informal (moral). Individual idea of admissibility and inadmissibility of consumption of alcoholic drinks is refraction by the identity of the group installations existing about it and public morals. In certain cases the condition of the conflict is intolerable and forces the person to break the standard norms. The less possibility of the personality to compensation, to mastering a difficult or unusual situation, that rather a person resorts to alcohol and the less probability of strong-willed break of consumption of alcohol. However the persons resorting to alcohol owing to insufficient adaptation opportunities make an insignificant part of drinking and need not so much social control how many in medical the psychiatric, in particular psychotherapeutic, help. In general it is possible to believe that than society to the facts of an alcohol abuse is more indulgent and the less individuals accept trezvennichesky installation of society, the rasprostranenny alcoholism. At uniform negative attitude of society to And. to alcoholism there are inclined persons either rejecting social control, or living out of all-social norms.

So-called alcoholism on imitation, «without the reason» extends rather, than more tolerantly people around treat it. It, according to domestic data, the most frequent motive of consumption of alcoholic drinks. The aspiration to an euphoric ebrietas, to sensual pleasure, not controlled by correlation with ethical standards and reasons about possible individual and social effects forms a psychological basis in these cases. Young mentally unripe individuals (so-called alcoholism of young people) or simply organized persons for whom the opportunities of cultural leisure given by society are inaccessible in view of the insufficient level of mental development are most subject to ALCOHOLISM. The more the gap between the level of development of the personality and the level of development of society, the is more difficult to combine persons the interests and moral representations with interests and norms of society. Distribution of alcoholism «on imitation», «without the reason» is promoted by false opinion on tonic effect of alcohol, its usefulness for an organism, force of customs and «wild drinkable habits» and the representation occurring still that the use of alcoholic drinks — an indicator of a maturity, independence, force and courage.

Many authors consider that in development of ALCOHOLISM an important role is played by influence of the immediate, direct environment (parents, friends). According to Alexander and Campbell (S. of Alexander, E. Campbell, 1966), in group of teenagers whose parents object to alcoholism and friends do not drink, abuse alcohol of 12%; in group of teenagers whose parents do not object to alcoholism and two closest friends drink, abuse alcohol of 89%; weekly 8% of teenagers who do not take alcohol with any of parents or friends, and 43% of teenagers who drink with parents and friends drink. Thus, influence of the microsocial environment considerably creating the personality creates a certain relation to alcohol. Features of the personality in turn do an individual in bigger or, on the contrary, to smaller degree subject And.

At a research of a role of a family in emergence and distribution And., carried out by Moore and Ramser (R. Moore, F. Ramseur, 1960), it was established at patients hron. And. high frequency of hereditary psychopathological and social deviations, and also deviations in development in the period of the childhood and the adolescence. So, 45% of patients came from the families which broke up when patients were children. And., mental derangements, antisocial behavior it is revealed in 45% of cases at fathers of sick willows of 17% at mothers; rejection of future patient with parents — in 35% of cases, superguardianship, hothouse conditions of education — in 28% of cases. As a rule, in these families fathers were unbalanced — are indulgent, are cruel and aggressive, causing fear in children. Bleyler (M. of Bleuler, 1955) during the studying of alcoholics noted heavy and long emotional experiences in the childhood, complex relationship in a family, early contact with alcoholics, influence of persons of a psychopathic warehouse. And., according to Bleyler, «a symptom of painful development of the personality», her low adaptation opportunities.

The imperfection of the identity of the alcoholic found by many researchers, predisposition of some persons to And. are, as a rule, not hereditary, and acquired. These imperfection and predisposition of the personality can not be shown if they korrigirutsya by education and social control.

Predisposition to ALCOHOLISM at individuals is not fatal; their behavior can be quite adequate and correct, but for this purpose they need the sparing conditions. At an adverse situation and decrease in social control inability to resist to tension is expressed at them by the need for a relaxation, edges most often is implemented by alcohol intake.

It is also necessary to consider that industrialization without carrying out certain measures of prevention can increase mental loading, complicate adaptation and by that to create premises to growth of consumption of alcoholic drinks among persons with insufficient adaptation opportunities.

Effects of alcoholism

by Numerous medicobiological and sociological researches it is proved that ALCOHOLISM is reflected in all parties of individual and public life. Not only the long, but also incidental use of alcoholic drinks does harm to health drinking, quite often leads to destruction of a family, has pernicious effect on education of children. Under the influence of alcohol of people loses sense of responsibility before society and the state, makes offenses. ALCOHOLISM causes damage to production, reduces labor productivity, leads to absences and other disturbances of labor discipline, accidents and death of people. And. leads to decrease in morality and welfare of a part of the population.

It is established that ALCOHOLISM destructively works a pas of function of all systems and bodies of an organism.

According to WHO data, ALCOHOLISM is the reason of every third death if to consider frequency among abusing alcoholic drinks cardiovascular a disease, diseases of a liver, stomach, kidneys, and also venereal diseases, traumatism in an ebrietas, especially transport, suicides.

At single-step reception of high doses of alcohol the acute drunkenness which in certain cases is coming to an end with death can develop (see. Alcoholic intoxication ).

Ability of alcohol to be dissolved preferential in the lipids which are in a large number a part of cells of a head and spinal cord determines the frequency of defeat at ALCOHOLISM of the central nervous system. The unlimited use of alcoholic drinks causes change of the mental sphere: fatigue, irritability, mood swings, frustration of a dream (asthenic syndrome). One of the hardest effects And. development of the symptom complex of narkomannchesky dependence which is expressed in emergence of a morbid attraction to alcohol, loss of sense of proportion and control of amount of the taken alcohol is abstinences (see), psychoses, the accruing decrease in the intelligence and disturbance of functions of all systems and bodies leading in the absence of timely treatment to degradation of the personality and death (see. alcoholism , Alcoholic psychoses , Alcoholic encephalopathies ). Impact of alcohol on the energy balance of an organism, oxidizing tsrotsessa, mechanisms of nervous transfer and disturbances of exchange of vitamins connected with it (especially group B and RR vitamin), cause direct toxic effect of alcohol defeat and a peripheral nervous system shown in the form of functional frustration, vegetative neuroses, neuritis, polyneurites. Alcohol makes heavier a current of a number of mental and neurologic diseases: neurosises, psychopathies, epilepsy, traumatic encephalopathy, diencephalitis, neurovasculites, neuritis and so forth.

According to WHO data, ALCOHOLISM — the reason of 1/4 cardiovascular diseases. The systematic use of alcoholic drinks leads to a dystrophic and fatty degeneration of the heart, promotes development hron. coronary heart disease, myocardial infarction. It is established that defeat of coronary vessels and vessels of a brain at the persons abusing alcohol by 4 — 5 times, and disturbance of a vascular tone by 3 — 4 times more often than at teetotal.

Impact of alcohol on a mucous membrane of a stomach and its ferruterous device is shown in disturbances of secretory, enzymatic and motor function of a stomach, and also organic changes of a mucous membrane, is more often in the form of hypertrophic Qatar with growth of polypostural outgrowths.

Especially adverse effect And. renders on a liver: at long systematic alcohol intake there is a disturbance carbohydrate, holesterinoobrazovatelny, immunological, anti-toxic and other functions of a liver to the subsequent fatty regeneration of hepatocytes and development of fatty dystrophy of a liver. Alcohol makes heavier the course of hepatitises and promotes formation of cirrhosis. It is established that 33% of patients with cirrhosis in the anamnesis had an alcohol abuse. From other bodies went. - kish. a path also the pancreas suffers. ALCOHOLISM — the frequent reason pancreatitis (see); alcohol slows down secretory activity of a pancreas, lowers release of insulin that promotes emergence of a diabetes mellitus (see. diabetes mellitus ).

Alcohol has toxic effect on hemadens, and in particular on sexual. According to a number of authors (I. V. Strelchuk, I. M. Porudominsky, etc.), decrease in sexual function is observed at 1/3 persons abusing alcohol and at all patients hron. ALCOHOLISM. «Alcoholic impotence» is taken by Men most hard owing to what they easily have various functional disturbances of c. N of page (neurosises, situational depressions etc.). At women under the influence of alcohol periods early stop, dystrophy of formative cells of ovaries is observed, ability to a child-bearing decreases, toxicoses of pregnancy and the complicated childbirth are often observed.

On big experimental and statistical material toxic effect of alcohol is installed on the genetic device and the developing fruit. At the animals subjected to alcoholic loadings, a thicket cases of a mertvorozhdennost and the birth of cubs with various defects were observed.

Children of the parents abusing alcohol and also the children conceived drunk develop physically and mentally more slowly (start walking later, to speak, etc.); to their thicket various malformations, mental retardation, epilepsy etc. are observed. So, as a result of inspection of 8196 children suffering from an idiocy, the Swiss psychiatrist Bentsan revealed that all of them were conceived by parents during the holidays connected with the use of high doses of alcohol (weddings, carnivals etc.); according to Burenvil, among the children having weak-mindedness and mental retardation, heredity is burdened And. more than in 40% of cases. Observation within 28 years of 10 families of alcoholics showed that from 57 been born children 25 died aged till 1 year, 5 have epilepsy, 5 — hydrocephaly, 12 — mentally retarded and only 10 — are healthy. L. A. Bogdanovich established the big frequency of a surdomutism and endocrinopathies at children of alcoholics; according to its data, even single easy intoxication of one of parents at the time of conception can lead to emergence in the child of a psychopathy, mental retardation or other mental diseases. Influence on posterity is especially expressed And. mothers. According to Ruzhe, at ALCOHOLISM of mother premature births and a hypotrophy at the child are observed almost twice more often than at And. the father (at And. the father premature births are noted in 17%, a hypotrophy of the child in 37% of cases; at And. mothers respectively in 32 and 66% of cases). According to V. I. Dulnev, the probability of the birth of defective children is directly proportional to duration of an alcohol abuse parents.

The ebrietas which is followed by weakening of the constraining influences, loss of feeling of bashfulness and real assessment of effects of the made acts quite often pushes people (especially youthful and young age) on thoughtless, accidental bonds which effect there are «undesirable» pregnancy, infection with venereal diseases and the related mental injuries. So, about a half of the «first abortions» made to unmarried women were result of the accidental bonds made in an ebrietas; according to V. V. Volkov (1969), 90% of infections with syphilis and 95% of infections with gonorrhea (both men, and women) occur in an ebrietas.

Alcohol considerably lowers body resistance to influence of toxicants and infectious agents p thereby promotes increase in incidence among the drinking part of the population. Against the background of ALCOHOLISM various diseases, especially hron proceed heavier. infections (tuberculosis, bronchoectatic disease, syphilis of N other). nnfektsionno-allergic (bronchial asthma, rheumatism), cardiovascular diseases etc. Mortality among abusing alcohol at somatic diseases is 3 — 5 times higher, than mortality among abstaining from alcoholic drinks.

The disturbances of balance, coordination of movements, attention, clarity of perception arising at intoxication surrounding cause the frequency of accidents among the persons abusing alcohol. According to the Central institute of traumatology and orthopedics, in Moscow apprx. 20% of household and 46% of street injuries are connected with And.; from 11 To 18% of operational injuries are connected with alcohol intake; (hard cases) hospitalized apropos «alcoholic» operational injuries make 30% coming to traumatologic departments. According to official statistical Data, in the USA 400 thousand injuries which occurred in an ebrietas annually are registered.

Arising under influence even of One-time alcohol intake of change of mentality (excitement, depression, loss of critical perception and the constraining influences) cause the frequency of the suicide committed in an ebrietas. According to official statistics, in England 70% of suicides are committed in an ebrietas. Suicides among abusing alcoholic drinks are observed by 8 — 10 times more often than among teetotal (I. V. Strelchuk).

Systematic alcohol intake leads to a presenility, disability and death. According to WHO materials, life expectancy of the alcoholic is 15 years less, than at the persons abstaining from frequent alcohol intake.

ALCOHOLISM breaks normal process of social production, the enterprises and institutions sustain considerable losses from decline in production of work, absences, traumatism, accidents etc. N. A. Vinogradov and A. K. Kachayev (1971) report that a production produktpvnost of patients hron. ALCOHOLISM is 9,6% lower than average production productivity of healthy people. The lack of coordination of movements and easing of attention developing as a result of reception even of small doses of alcohol lead to decline in production of work at the qualified industrial workers on average for 30%, and at moderate degree of intoxication — for 70%; at reception of 30 ml of vodka significant increase in mistakes at typesetters, typists, operators is noted; at reception of 150 ml of vodka reduction of an animal force p decline in production of work for 25% at navvies and bricklayers is noted.

On statistical data of the American telephone company «Bell», absence for various reasons for work among the persons who are excessively drinking by 5 times more often than among teetotal. Temporary disability from injuries, «alcoholic diseases» and an aggravation hron. the diseases connected with an alcohol abuse makes in the USA apprx. 30 million days in a year; the financial damage caused only by «alcoholic traumatism» makes 1120 million dollars. According to official statistics, the damage from alcoholism in France makes 152 billion francs a year while the income of the state from a tax on alcohol — 53 billion francs; annually French industry because of «alcoholic diseases» loses 8 million working days.

The interrelation of Ampere-second is caused by crime as the known community of social and psychological roots of these phenomena, and a possibility of formation under the influence of alcohol of violent or mercenary type of orientation of the personality. By means of alcohol criminals hire accomplices, using it as means of artificial excitement and decrease in critical moral assessment of actions that facilitates commission of criminal action.

Formation of violent type of orientation of the personality is connected with the direct effect of alcohol on a brain causing weakening of function of the highest departments of c. N of page: excitement with animosity, aggression and counterinhibition of low motives. Therefore the agressive behavior can be shown not only at systematic, but also at incidental alcohol intake and is the leading reason of commission in an ebrietas of «violent» crimes. At the same time the agressive behavior realized in hooliganism, infliction of bodily injury, murder, rape can not be means of achievement of any mercenary purposes. According to the American psychiatric association (1969), from 50 to 70 of % of the USA concluded in prisons serve sentence for the crimes connected with alcoholism; an alcohol abuse — the reason of a half of criminal offenses in France; according to S. S. Ostroumov (1969), from among the persons condemned for various offenses in an ebrietas at the time of commission of crime there were 96% of convicts for hooliganism, 68% — for deliberate murder, 67% — for rape, 57% — for infliction of bodily injury. According to V. N. Kudryavtsev (1974), 80% of murders and more than 90% of cases of hooliganism are committed in a state of intoxication.

The mercenary type of orientation of the personality forms under the influence of systematic alcohol intake therefore there is a decrease in intellectual and moral level and replacement of socially useful interests by aspiration in an euphoric ebrietas. Former social environment is replaced to more corresponding aspirations of drinking. Bonds with teetotal family friends and fellow workers (moral control of the environment) are weakened, but there are doubtful acquaintances to the persons inclined to accidental earnings, plunders, fraud, forgeries, theft and a robbery.

Receiving funds for acquisition of alcoholic drinks becomes the leading and not korrigiruyemy motive of behavior. Under the influence of this motive drinking is capable of dishonesty, ruin of own family and other antisocial acts. So, according to S. S. Stepichev (1968), apprx. 60% of convicts for a robbery and robbery committed these crimes only with the purpose to get money for binge; A. A. Gertsenzon (1968) notes that among the persons condemned for theft systematically took alcohol of 58% of among convicts for a robbery — 67%. Moreover, alcoholism can reduce moral level not only the most drinking, on and persons, related business relations that causes damage to the moral level of society in general.

Abuse of alcoholic drinks of one of spouses — the frequent reason of disintegration of a family. E.g., according to official statistical data, in 1937 — 1950 in Philadelphia (USA) And. was a proximate cause of 21,1% of stains. The provided data on communication of number of stains with And., naturally, do not consider numerous cases of its indirect impact of a pas disintegration of a family when easing of attachment, respect, a mutual inclination in connection with the changes of properties of the personality and sexual opportunities of one of spouses which developed under the influence of alcohol, the facts of marital infidelity, venereal diseases which resulted from the accidental bonds made in an ebrietas etc. are a proximate cause of divorce.

According to researches of the French sociologists, as a result of alcoholism of one of spouses the family loses from 40 to 70% of the family budget.

And. parents harmful affects education of younger generation. The immoral atmosphere and a narrow focus of interest in a family lead to loss of respect for parents, to isolation and embitternment, moral and intellectual depletion. All this is reflected further in a social position of the teenager, his views and motives of behavior, causes special exposure to third-party bad influences. Thus, And. parents quite often defines antisocial orientation of behavior of teenagers (unwillingness to study, to work, thirst for alcohol, promiscuity, commission of offenses). So, according to V. N. Kudryavtsev (1974), 70% of teenage offenders grew in families where alcoholism and frequent quarrels took place; more than 60% of persons of minor age, detainees on the street or in drunk public places and sent to a sobering-up station, were from families where one of parents abuses alcoholic drinks.

Fight against alcoholism

Aspiration to purposeful fight with And. as the public evil and a source of diseases appeared still in the ancient time as a result of formation of concepts of individual responsibility and the state needs. Already at formation of the first

states the ethical and legislative measures interfering A. V distribution China in 2286 to the item e were undertaken. it was published edikt, prescribing severe punishment for unlimited and systematic consumption of the exciting drinks; in Ancient Egypt in 2 — 3 millennium BC drunkards were subjected to humiliating punishments and derision. In Sparta in 1 millennium BC there was such reception of antialcoholic education: it napaivatsya intentionally and for a general laughing-stock was found on the city of people — an example of what shall not be the citizen of the city-state. In Athens under Solon's laws (6 century BC) sale of undiluted wine was prohibited; in Sparta under Lycurgus's laws (5 century BC) on pain of severe punishment alcohol intake, especially in the wedding day was forbidden; in Rome from 3 century BC there was prohibition to drink wine to persons to 30-year age, and in 186 according to Katon's proposal the senate prohibited a cult of bacchanalias not only in the mother country, but also in provinces.

Though legislative restrictions generally did not concern representatives of ruling class, in the historiographic works of antiquity which reached our time (e.g., in Herodotus's «History», «History» and Tacitus's «Annals», Plutarch and Svetopiya's biographies) condemnation of alcoholism of emperors and faces of patrician estate as manifestations of low depravity meets.

Also ancestors of monoteistsky religions opposed alcoholism: restriction of reception of alcoholic beverages along with an ascetic way of life — one of moral fundamentals of the Buddhism and Christianity; laws of Islam prohibit devout consumption of alcohol.

It is possible to call the period of the Middle Ages the period of blossoming And. Domination of religious dogmatism and a cult of force promoted decrease in moral level of society. At feudal dissociation, continuous intercommunity wars and absence of the centralized power temporary possession even big territories did not promote emergence at governors of responsibility for destiny and health of the population living in the territory subject to them. Therefore in medieval Europe alcoholism was almost general. As a criterion of strength of knights served ability is much and to drink much.

From the beginning of formation of the centralized national states attempts of public restriction of alcoholism are made again. In the beginning they carry purely moral, and then and legislative character. E.g., in Russia in the message of the metropolitan Photius (1410) it is forbidden to drink wine till a lunch, in domestic tyranny norms of Sylvester (16 century) it is offered to the son not to get intoxicated dead-drunk, and to the daughter-in-law — wine not to like and not to give to drink to members of household. Ivan III issues the government decree, the Crimea is forbidden «mean» alcoholism. According to this Decree the simple people were allowed to cook intoxicated only four once a year — for big church holidays and in exceptional cases — on family celebrations. It was granted permission not to all, and only respectable inhabitants; upon termination of a grace time the remained drink was sealed up till other holiday. The Decree did not extend to people of a privileged position, to them was prohibited to take alcoholic drinks only in special cases, e.g. Ivan III prohibited to drink to ambassadorial clerks at execution of responsible diplomatic missions by them. Nevertheless alcoholism in medieval Russia was eurysynusic: priests, women, children drank. Special growth of alcoholism begins with introduction of the state monopoly for trade in alcohol (at Boris Godunov) and opening of «tsarevy taverns».

Fight with And. since the end of 18 century and on a crust, time develops in process of identification of the economic damage caused by alcoholism, impacts of systematic alcohol intake on a human body and also establishment of the reasons of distribution And., its influences on work and welfare of society, communication with rise in crime etc. The essence of antialcoholic actions, irrespective of forms of their implementation, comes down to fight against consumption of alcohol by the population, distribution of alcoholic beverages and growth of their production. The beginning of creation of various antialcoholic organizations (the so-called abstentistsky movement) which forms of work throughout time change also to an owl belongs to the first quarter of 19 centuryrshenstvutsya. If the first abstentist, making the hot sermons drawing all horrors of alcoholism hired in the ranks both absolute nondrinkers, and the persons who are moderately drinking, then since the second half of 19 century propaganda activity of antialcoholic leagues and association gains character systematic educational and a dignity. - a gleam. works, especially among the youth based on results of statistical and medicobiological researches. In a number of the countries (it is especially wide in Sweden and the USA) the obligatory system of antialcoholic education at schools is entered. The modern antialcoholic organizations have character of the international associations having network of national branches, have a significant amount of own publications and use all modern mass media in the propaganda purposes.

Activity of the antialcoholic organizations is not limited to propaganda activities. Tried to obtain and try to obtain Abstentista from the governments of a number of the countries and local governments of carrying out the legislative measures directed to restriction of distribution and production of alcoholic drinks. So, in 1851 — 1856 abstentist of the USA achieved prohibition of trade in hard liquors (vodka, whisky) in the territory of 16 (from 31) states. Though in connection with difficulties of civil war this prohibition existed not for long, consumption of hard liquors in these states, according to I. D. Strashun, was not returned to the previous level; but sharply consumption of beer increased. Measures for restriction of distribution of alcoholic beverages receive also reflection in a number of statutes, such as will lock sales of alcoholic drinks to persons of minor age (up to 16 — 18 years in various countries) or in certain days and the periods (days off and holidays, pay days, a conscription, the periods of a sowing campaign and a harvesting etc.), establishment of time and the extreme number of sale of the alcoholic drinks which are released to one buyer, etc.

One of forms of restriction of distribution and production of alcoholic drinks, especially for the countries which do not have the state monopoly for trade in alcohol measures for restriction of the income of owners of the enterprises making or trading in alcoholic drinks were. In 1865 in Sweden the order was entered, according to Krom issue of alcoholic drinks was allowed only in limited quantity and only on condition of a concomitant use of hot food. The owner of a tavern or restaurant at the same time was more interested in sale of food since from the income from sale of alcoholic drinks he received only 6% (so-called. Gothenburg system). All other Income came to municipalities For carrying out antialcoholic work, and also assistance to families of alcoholics. With nek-ry changes the Gothenburg system was applied also in Norway and Finland. Originally Gothenburg system was applied only to vodka, afterwards it was extended also to sale of grape wines. Further modification of the Gothenburg system was the so-called system of Bratt providing a peculiar alcoholic ration and accepted in Sweden in 1919. According to this system of Bratt of the head of families, constantly living in this area, monthly received cards on acquisition of a certain amount of alcohol counting on each adult family member (but no more than 4 l of vodka a month). In cases of the family celebrations registered by local governments (weddings, anniversaries, a christening), the family acquired the right for one-time additional issue of alcohol.

Also the statutes concerning conditions of opening of the enterprises trading in alcoholic drinks and establishment of the right of the population and local governments to resolve issues of the acceptability of existence available and opening of new places of sale of alcohol belong to the measures directed to restriction of distribution of alcoholic drinks. So there was so-called local veto — the right of communities to impose a local ban on sale of alcoholic beverages. Such right at the beginning of our century was periodically carried out in Norway, Finland, Denmark, Holland, Germany and Switzerland. A main objective of «local veto» was fight against the private capital occupied in the field of sale of alcoholic drinks. These objectives in some countries are achieved by introduction of the state monopoly for production and trade in alcoholic drinks.

Implementation of the right of local prohibition, however, had rather propaganda character since it was entered in the limited territory and did not deprive of inhabitants of a possibility of acquisition of alcoholic drinks in the neighboring areas. Therefore the legislation on prohibition as well productions of alcoholic drinks, and in scales of large areas and even all state becomes natural continuation of the right of local prohibition. So there were prohibitive antialcoholic laws providing partial (separate hard alcoholic beverages) or the full prohibition of production and sale of alcoholic drinks entered temporarily in connection with special state needs (war, mobilization, a crop failure, etc.) or it is constant. However practical use in a number of the countries of the prohibitive antialcoholic legislation did not give due effect. The partial prohibition of alcohol extending to hard alcoholic drinks (e.g., prohibition of absinthe liqueur in Belgium and in France, drinks with a strength more than 12% in Norway), led to significant growth in consumption of less concentrated drinks, and, thus, alcoholization of the population did not decrease since the amount of the absolute alcohol entered into an organism did not change, and on a nek-eye to data even increased in connection with less careful relation of most of the population to not fortified alcoholic beverages. The total ban of production and sale of alcohol entered in connection with the state needs caused considerable rise of consumption of alcoholic drinks among the population after its cancellation. It is confirmed, in particular, by data of a number of the European countries establishing «Prohibition» during World War I. Attempts of introduction of total constant ban of alcohol in some countries failed in connection with rendering economic pressure from the countries with the developed wine-making production, import of illicit alcohol, development within the country of the black market and moonshining. Iceland was the first country which announced in 1912 a constant total ban of production, import and trade in alcoholic beverages. However under pressure of Spain which demanded resuming of import of the wines and threatening to stop purchase of the Icelandic fish, ban in 1923 was withdrawn.

In Norway after the referendum of 1919 a ban on production and sale of vodka and wines with a strength over 12% was imposed. However in 1926 in connection with threat of France, Spain and Italy to stop purchase of the Norwegian fish in case of refusal from import of wines ban was lifted especially as in the period of prohibition increased as legal consumption of alcoholic drinks (according to recipes of doctors and a pas religious practices), and import in their illicit way: in 1923 the amount only of the detained illicit alcohol increased in comparison with 1921 (year of the beginning of registration of alcoholic smuggling) almost by 30 times.

In Finland a total constant ban was imposed in 1919 (the decision of the Finnish diet on prohibition of trade in alcoholic drinks made in 1907 was cancelled by the imperial government). From 1919 to 1926 the amount of the detained illicit alcohol increased by 35 times, issue of alcohol according to recipes of doctors increased by 9 times and made 45% of the alcoholic drinks consumed by the population of Finland to prohibition.

In the USA total constant ban of production, transportation and sale of the drinks containing more than 0,5% of alcohol was continuation of military prohibition and is actually entered since December, 1917. Officially the 18th amendment to the constitution about «Prohibition» was ratified in 1919 with commissioning in 1920. Introduction of «Prohibition» was favored by conditions of wartime: requirements of army for soldiers and the defense industry for labor allowed to provide employment of the persons which were earlier working in production and trade in alcohol; the industries of agriculture working for the distilling and brewing industry were partially reoriented on the food industry, partially — on supply of the neutral and warring countries. Even before introduction of «Prohibition» almost all leading industries, especially transport, electric, metallurgical and machine-building, categorically demanded from workers and employees of failure from the use of alcoholic drinks. The first three years of action of «Prohibition» (1918 — 1920) were marked by considerable progress: «alcoholic diseases» mortality decreased almost by 6 times, the quantity of alcoholic psychoses, crimes, absences on production etc. decreased. However since 1921 wide scales are increased by illicit import of alcoholic drinks and their underground production. The smugglers financed by the companies making alcoholic beverages had steamships and the armed groups capable with fight to break through border check-points; for fight against them the government was forced to allocate submarines and airplanes. The amount of underground production and import of alcoholic beverages continued to increase continuously (tab.), and considers that the confiscated alcoholic drinks made no more than 10% of the made quantity. Penetration of smuggling and underground production of alcoholic drinks, growth of unemployment caused by the end of war and sharp reduction in production of arms led to the fact that the number of «alcoholic diseases» and cases of death from them, the crimes committed drunk increased in comparison with the years preceding introduction of «Prohibition». In December, 1932 the congress of the USA made the decision on cancellation of «Prohibition».

Failures in fight with And. in the developed countries are explained first of all by the fact that the vigorous measures undertaken even do not remove the causes of alcoholism which are covered in social contradictions of a capitalist system. Operation and lack of elementary measures of protection of a nervous system of the worker from a mad rhythm of modern production, social inequality and uncertainty in tomorrow, military hysteria, lack of original care of welfare, health, life and rest of workers — not the full list of the reasons forcing many workers (both workers, and the intellectuals) the developed capitalist countries, even on condition of external temporary material welfare, systematically to resort to alcohol as to rather available means facilitating a condition of mental discomfort and dissatisfaction with living conditions. Moral principles of capitalist society also in many respects promote development of the psychological conflict between the personality and society both in the field of the relations in collectives, and in the field of the family relations. It is impossible to dismiss also an unseemly role of the representatives of alcoholic business interfering efforts of the public and state organizations of a number of the countries in implementation of antialcoholic work. Therefore the known interest in carrying out antialcoholic work of ruling government and industrial numbers of some developed countries connected with aspiration to an intensification of work and the need for the extreme accuracy of implementation of manufacturing operations cannot be completely realized by holding propaganda, restrictive or prohibitive actions since all of them are insolvent before contradictions of a capitalist way of production.

In the USSR fight against Ampere-second of the first days of the Soviet power becomes one of the important parties of domestic policy of the state. Having received in heritage the country ruined by war and intervention and the notorious «Russian alcoholism» and understanding complexity and duration of work on elimination of this heritage, the socialist state recruited in fight with And. broad masses of workers, party, Soviet, state, trade-union, Komsomol and other organizations. V. I. Lenin specified that rise in culture in the country is not solved in one step, and is connected with long daily work throughout the entire period of construction of communistic society. Implementation of the broad social transformations directed to strengthening of national economy and a socialist system, development of socialist morals, increase in welfare, culture and education of a people at large, improvement of working conditions and life, creation of network of antialcoholic institutions, etc. — the major conditions for successful fight with And. In 1926 — 1927 in a number of acts of the Government were planned and antialcoholic actions began to be put into practice (antialcoholic education at school, restrictions on sale of alcoholic drinks, the right of local prohibition, compulsory treatment of patients chronic And., etc.). Further the Party and the Government in the resolutions repeatedly were returned to questions of fight with And., reconstructing forms of antialcoholic work according to the level of development of national economy, welfare, education and culture of the population. Growth of welfare, culture, improvement of working conditions and life, full employment of the population, reorganization on bases of socialist moral of the family and labor relations, though are a sufficient basis for elimination of the social and psychological reasons And., for the present cannot guarantee society against presence of persons who owing to limited adaptation opportunities or as a result of intellectual immaturity resort to the unlimited use of alcoholic drinks. This circumstance demands a big variety of forms of antialcoholic work.

The system of antialcoholic work to the USSR in pastes, time represents a complex of the educational, sanitary and educational, restrictive and medical actions which are combined with measures of public and state suppression concerning persons not persons interested to carry out moral installations of socialist society.

A problem of antialcoholic education of the population — to achieve change of the relation to alcohol: any abuse of alcoholic drinks shall be considered as the vicious phenomenon causing damage to interests of the state, to health, material and family interests drinking and incompatible with morals and morality of the Soviet person. The second, not less important task of antialcoholic promotion is the explanation of the actions directed to fight with And., carried out through the public and administrative authorities and public organizations; mobilization of the public and broad masses of workers on fight against alcoholism by arms their specific knowledge of influence And. on health, work, life, welfare and morality. Special attention is paid on antialcoholic education of the studying youth in the senior classes of comprehensive schools, technical training colleges, technical schools, higher educational an institution, and also young workers and employees. For antialcoholic education, except carrying out lecture work at schools and other educational institutions, at the plants, factories, buildings, in collective farms, state farms, administrative, economic and other enterprises and institutions, the press, radio, television, and also cinema and other spectacular actions is actively used.

Efficiency of fight with And., especially with alcoholism «without the reason», it is in many respects connected with the general rise in culture of the population creating the correct social and moral orientation of the personality. Development of forms of the organization of cultural leisure (expansion of network of theaters, concert halls, movie theaters, museums, show-rooms, clubs, palaces of culture, parks, recreation areas, construction of sports constructions; development of amateur performance, folk theaters, the grass-roots sports movement, etc.) considerably facilitates carrying out antialcoholic educational work.

The bases of socialist morality formulated in the Moral code of builders of communism are contradicted not only by abuse alcoholm individuals, but also indifferent attitude towards destiny of the people subject And. and the moral forces which did not find in themselves for independent strong-willed break of abuse of alcoholic drinks. Interest of society in destiny of each citizen — distinctive feature of a socialist system. In aspect of fight with And. it, in particular, is shown by a combination of forms of mass and individual work. The last is applied to the persons unstable to alcohol, and includes, except the explanatory discussions led by medics, representatives of administration and public organizations, identification of adverse circumstances in life and family life or on production which led this person to frequent alcohol intake, and also rendering the efficient help in failure from a vicious habit to alcohol. Individual forms of educational work are efficient also for early identification of the contingent drinking which are subject to obligatory treatment.

The leading role in the organization of antialcoholic education belongs to medics since they can most correctly and convincingly explain to the population harmful effects of influence of alcohol on a human body. Therefore the order of the Minister of Health of the USSR No. 694 from 24/VIII 1972 g. «About measures for strengthening of fight against alcoholism» it is offered to bodies of health care to develop widely antialcoholic promotion among the population, to provide active participation in carrying out this work of doctors and paramedical staff of all treatment and prevention facilities, and also the faculty and students of older years of the highest medical educational institutions.

Tasks of medics in fight with And. are not limited to carrying out a dignity. - a gleam. works. Their functions also include routine maintenances of special squads before work, constant overseeing by the contingent of patients with functional or organic lesions and other diseases of c. the item of page at which the pathological drinking habit (e.g., for the persons having neurosises, psychopathies, epilepsy, traumatic encephalopathy, diseases of exchange etc.), and also early detection, treatment and the subsequent overseeing by patients hron most quickly develops. A.

The taken legislative measures limit a possibility of distribution of alcoholic beverages among the population. So, Resolutions of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for strengthening of fight against alcoholism p alcoholism» (1972) provided reduction in production of vodka and strong vodka products, and especially reduction in production of the vodka containing 50% of alcohol and more. At the same time in the USSR fight against house production of hard alcoholic drinks is conducted: moonshine, chacha, etc. (e.g., on UK RSFSR criminal penalty for moonshining for up to 5 years of imprisonment is prescribed). Time of sale of alcoholic beverages (especially with a strength over 30%) and the number of the trade enterprises and catering establishments which are releasing alcoholic drinks is limited (e.g., only in Moscow in 1973 the number of shops and other outlets, and also the catering establishments trading in alcoholic drinks decreased in comparison with 1970 almost by 30%).

The Soviet legislation provided measures of the prevention of distribution And. among youth. The parents subject to alcoholism can be deprived of the parent rights (e.g., according to Art. 59 of the Code of laws on marriage and a family of RSFSR); in the territory of the USSR sale of all alcoholic beverages (including and beer) is prohibited persons of minor age; teenagers, young men and girls aged up to 18 years are not allowed in restaurants, cafe, pubs in the evening, and in the afternoon — without parents (The resolution of Council of ministers of the USSR from 16/V 1972 g). The legislation of federal republics prescribed administrative and criminal punishments of the persons guilty of bringing minors to an ebrietas. E.g., the Decree of Presidium of the Supreme Council of RSFSR from 19/VI 1972 g provides imposing of an administrative penalty in the amount up to 30 rubles on the parents and other persons guilty of bringing the minor to an ebrietas, and criminal penalty (a penalty in the amount up to 50 rubles, corrective works or imprisonment for up to one year) if brought the person to an ebrietas of the minor, from to-rogo it is in job dependency. The same Decree prohibited reception of minors for the work connected with production, storage and trade in alcoholic drinks.

Involvement of minors in alcoholism, i.e. systematic bringing to an ebrietas, irrespective of family relations of the victim with the guilty person, is considered as penal act (e.g., according to Art. 210 of UK RSFSR for involvement of the minor in alcoholism imprisonment for up to 5 years is provided).

The measures interfering emergence at drunk work are established and also to the use of alcoholic drinks in operating time or during a lunch break. According to Art. 38 of the Labour Code of RSFSR and the relevant articles of codes about work of other federal republics it is forbidden to allow to work at the enterprises and in institutions of the persons which are in a state of intoxication. According to the Decree of Presidium of the Supreme Council of RSFSR from 19/VI 1972 g and Decrees of Presidium of the Supreme Council of other federal republics «About measures for strengthening of fight against alcoholism and alcoholism» the foremen, masters, chiefs of workshops, sites, changes and other economic heads who are allowing drinking by subordinates of alcoholic drinks on production, and also not taking measures to discharge from work of the persons which are in an ebrietas are subject to administrative or criminal liability. The persons who are systematically abusing alcoholic drinks (even in time off), according to the decision of administration and public organizations can be deprived of awards and other side social benefits.

Getting injured at work and in life in an ebrietas is considered as the accident which happened because of the victim; according to the Resolution of Council of ministers of the USSR from 16/V 1972 g in these cases the leaf of temporary disability at out-patient and hospitalization is not made out and temporary disability benefit is not paid.

The Soviet criminal law establishes that the persons who committed crimes in an ebrietas are not exempted from execution of punishment (Art. 12 of UK RSFSR and the relevant articles of criminal codes of federal republics). Under the Decree of Presidium of the Supreme Council of the USSR of July 26, 1966. «About strengthening of responsibility for hooliganism» commission of crime by the person who is in an ebrietas burdens responsibility and assumes the maximum punishment for this crime. This provision is introduced by the Supreme Council of the USSR in Art. 34 of Bases of the criminal legislation of USSR and federal republics. To patients hron. And., made an offense in a condition of sanity, along with punishment compulsory treatment (Art. 62 of UK RSFSR and the relevant articles of criminal codes of federal republics) is applied.

The legislation of USSR and federal republics provides restriction of capacity with establishment of guardianship over the persons abusing alcoholic drinks and putting it the family in difficult financial position (Art. 16 of the Civil Code of the Russian Federation and the relevant articles of civil codes of federal republics). Case of recognition of the citizen is limited capable owing to abuse of alcoholic drinks can is begun by court according to the statement of members of his family, public organizations, the prosecutor, bodies of guardianship, and also mental health medical institution and is considered by court with obligatory participation of the person, in the relation to-rogo proceedings, and also the prosecutor and the representative of bodies of health care are initiated. Restriction of capacity deprives of the citizen of the right to make without the consent of the trustee of the order the property, except for small household transactions (purchase of food stuffs, payment of utilities), he has no right itself to receive the salary, pension and all other types of income, cannot get money transfers, deposits from a savings bank, prizes on a lottery and the state loans. All these sums are received by the trustee who gives them as required to members of the family of the ward, and also to the ward, strictly controlling that money was not spent for acquisition of alcoholic drinks. The term of restriction of capacity by court is not established. Restriction of capacity is cancelled by the special judgment according to the petition of bodies of guardianship, the prosecutor, public organizations in the presence of the statement of the ward and members of his family. The basis for lifting of restriction of capacity is the termination of abuse of alcoholic drinks, recovery of social and family relations. Restriction of capacity p purpose of guardianship, except protection of interests of a family, makes big moral and educational impact, forcing drinking to change a way of life, to complete a course of antialcoholic treatment, to stop the use of alcoholic drinks.

In the USSR the control of vehicles even is forbidden at the minimum reception of alcohol. Disturbance of this situation is considered as the deliberate action directed to creation of an emergency on transport, guilty persons depending on circumstances are subject administrative (a penalty, temporary or constant deprivation of the rights of a pas driving of vehicles) or to criminal penalty. Employees of transport services undergo the so-called pretrip medical examinations having one of identification of the persons which are in a state of intoxication (intoxication, a hangover), and their discharge from work is more whole. Random inspection behind sobriety of drivers of transport is exercised by employees of GAI. All medical institutions are obliged to carry out expertize of intoxication in the direction of bodies of militia or administration of institutions of N of the enterprises.

According to article 36 of «Bases of the legislation of USSR and federal republics about health care» And. along with infectious, venereal and mental diseases treats the states constituting danger to people around and demanding special measures of treatment and prevention. The legislation of federal republics (e.g., the Decree of Presidium of the Supreme Council of RSFSR from 8/IV 1967 g) compulsory treatment of patients hron is provided. And., evading from voluntary treatment, disturbing labor discipline and the public peace, and their labor re-education in activity therapy dispensaries within 1 — 2 years. The direction in these institutions is carried out by national vessels, but does not attract a criminal record.

In the Resolution of the Central Committee of the CPSU «About measures for strengthening of fight against alcoholism and alcoholism» need «stories resolute and persistent fight against alcoholism and alcoholism is emphasized, to develop specific actions for broad expansion of mass and political and cultural and educational work in collectives, among the population at the place of residence, strengthening of antialcoholic promotion, increase in efficiency of public and administrative impact on the persons abusing alcohol».

Socialism liquidated the major social factors promoting distribution of alcoholism. Socialist social production creates material values for the sake of the person and for the benefit of the person. Therefore existence And. among a nek-swarm of a part of the population of the USSR its eradication — the major national objective is incompatible with standards of socialist morals.

The bibliography

Vlassak R. Alkogolizm as a scientific and household problem, the lane with it., L., 1928; Kachayev A. K. and Borisov E. V. About a role of alcoholism in prevalence of somatopathies, in book: Alkogolizm and not alcoholic drug addiction, under the editorship of I. N. Pyatnitskaya, page 88, L., 1971; Korovin A. M. Experience of the analysis of the main factors of personal alcoholism, M., 1907, bibliogr.; Kudryavtsev V. N. Social and psychological aspects of antisocial behavior, Vopr. philosophies, No. 1, page 98, 1974; Portnov A. A. Alkogolizm, M., 1962, bibliogr.; Bleuler M. Familial and personal background of chronic alcoholics, in book: Diethelm O. Etiology of chronic alcoholism, p. 110, Springfield, 1955, bibliogr.; Block M. A. Alcoholism, N. Y., 1965; Jellinek E. M of The disease concept of alcoholism, Washington — New Haven, 1960; Moore R. A. a. Murphy T. Page of Denial of alcoholism as an obstacle to recovery, Quart. J. Stud. Alcohol, v. 22, p. 597, 1961; Mulford H. A. a. Miller D. E. The prevalence and extent of drinking in Iowa, 1961, ibid., v. 24, p. 39, 1963.

I. N. Pyatnitskaya, A. M. Grindings.