Marina Kalyuzhnaya, a psychiatrist and narcologist who founded the Doctor Kalyuzhnaya Clinic, has listed the everyday signs that can point to alcohol dependence in a conversation with the Russian news outlet Lenta.ru. She said the symptoms of what she called "everyday alcoholism" often look painfully ordinary, which is part of what makes the condition easy to miss.
Why quantity is not the key sign
Kalyuzhnaya said people should not judge dependence purely by how much alcohol someone drinks. She said there are people who can drink a large amount in one sitting but do so only once every six months, and in that case dependence is not the issue. The real warning sign, she said, is someone who regularly drinks small amounts of alcohol every evening and has reached the point where they can no longer do without it.
Public health specialists more broadly define alcohol dependence as a pattern of drinking that a person struggles to control, even when it causes problems in their daily life or relationships. Kalyuzhnaya's comments reflect a similar view: that dependence has more to do with a person's relationship with alcohol than with the raw amount they consume on any single occasion.
Other signs of a developing problem
According to Kalyuzhnaya, other indicators of alcoholism include irritation and persistent, intrusive thoughts about alcohol on days a person is not drinking. She said a rising tolerance to alcohol is also a sign, along with aggression in response to comments about how much someone has had to drink, and a habit of inventing reasons or occasions to drink.
She said a person in this position begins planning their evenings around drinking, turns down invitations to events where alcohol will not be served, and becomes angry when a trip or change of plans disrupts their usual ritual. From the outside, Kalyuzhnaya said, this can look like the person's character has simply soured. In reality, she said, the person has unconsciously reorganized their entire life around alcohol without realizing it.
What a narcologist does
A narcologist is a medical specialist in Russia and several other post-Soviet countries who diagnoses and treats dependence on alcohol and drugs, broadly equivalent to an addiction medicine physician in other health systems. In Russia, treatment for alcohol dependence typically falls under narcology, a specialized branch of psychiatry separate from general addiction counseling in some other countries. Kalyuzhnaya's Moscow clinic treats patients for substance dependence, and she frequently speaks to the Russian press about the difference between occasional heavy drinking and the quieter, habitual pattern doctors describe as "everyday alcoholism", in which small, regular amounts of alcohol gradually become built into daily life.
Previous advice from Kalyuzhnaya
Kalyuzhnaya has previously said that alcohol is best not mixed with juice, explaining that the combination is dangerous because of its sugar content. Mixing alcohol with sugary drinks is a common topic in nutrition advice, as it can affect how quickly the body absorbs alcohol.
