我該如何停止成為酒鬼？我發(fā)現(xiàn)自己每天都在喝酒，并期待著回家后喝上5-7 杯，現(xiàn)在看來我需要喝上幾杯才能入睡。這好嗎？如果這不好，我該如何停下來？

Jeanette Huston
Alcohol is an addictive substance. And your body develops a tolerance over time, so you need more to get the desired effects. It’s a depressant too and stays in your system, giving you cravings or withdrawals for up to 10 days.
The weird thing is, alcohol does not make you happy, it makes the time in your life when you’re not drinking unhappy. This is why you crave a drink- to feel normal. This keeps going downhill. The brain can’t take that much poison and you’ll have blackouts, feel in a fog, and just overall be kinda grumpy.
First step is to know that alcohol is not your friend. Second step is get help- treatment of some sort helps. Alan Carr or Annie Grace both have great books for how to kick alcohol by changing your mindset.
I did and I haven’t looked back. It’s worth stopping and getting your life back on track. Quitting alcohol made me truly happy.

酒精是一種令人上癮的物質(zhì)。隨著時間的推移，您的身體會產(chǎn)生耐受性，因此您需要喝更多才能滿足酒癮。它也是一種抑制劑，會留在你的系統(tǒng)中，讓你渴望它長達(dá)10天。
奇怪的是，酒精并不會讓你快樂，但它會讓你在不喝酒的時候感到懊惱。這就是為什么你渴望喝一杯——讓你自我感到正常。于是開始走下坡路。大腦并不能承受那么多的毒素，你會昏昏沉沉，感覺自己在霧里，脾氣也開始變的暴躁。
第一步是要知道酒精不是你的朋友。第二步是獲得幫助——某種幫助性治療。Alan Carr 或 Annie Grace 都有關(guān)于如何通過改變心態(tài)來戒酒的好書。
我做到了，沒有回頭。這值得停下來讓你的生活回到正軌。戒酒讓我真的很開心。

Jim Kamanski
Hi Jeff. That’s a good, direct question, and I can see where you’d have some concern.
I won’t sugarcoat my response. If you’re drinking that much each day and you feel a need for alcohol to sleep, you probably already have moderate Alcohol Use Disorder.
Though I’m not a physician or a psychotherapist in a position to make such a diagnosis, nor would any health care provider try to make a diagnosis in an online forum like Quora, generally once you feel a craving or strong desire for alcohol it’s a key indicator of Alcohol Use Disorder and if left unchecked it’s likely going to get worse.
If you’ve tried to stop and the craving or strong desire just rises as you force yourself not to drink, say for a few days, weeks or months, that’s also a telltale sign and refers to the Alcohol Deprivation Effect in the medical literature. The pattern for people trying to stop drinking often resembles a “yo-yo” diet, where the dieter wills himself or herself not to eat for a while and then “pops” and engages in spiked intake—food in the case of a dieter and alcohol in the case of a drinker. That’s a relapse.

嗨，杰夫。這是一個很好的、很直接的問題，我可以看出你有什么憂慮。
我不會粉飾我的回答。如果您每天都喝那么多酒并且覺得需要喝酒才能入睡，那么您可能已經(jīng)患有中度酒精中毒癥。
雖然我不是能夠做出這樣診斷的醫(yī)生或心理醫(yī)生，也沒有任何醫(yī)療保健知識提供者試圖在像 Quora 這樣的在線論壇上做出診斷，但通常一旦你對酒精產(chǎn)生渴望或強(qiáng)烈的渴望，這是一個酒精中毒癥的關(guān)鍵指標(biāo)，如果不加以控制，它可能會變得更糟。
如果您試圖停止，而當(dāng)您強(qiáng)迫自己不喝酒時，渴望或強(qiáng)烈的欲望就會上升，比如說幾天、幾周或幾個月，這也是一個明顯的跡象，指的是醫(yī)學(xué)文獻(xiàn)中的酒精剝奪效應(yīng)。人們試圖戒酒的模式通常類似于“溜溜球”飲食，節(jié)食者愿意自己暫時不吃東西，然后“突然”并增加攝入量——節(jié)食者的食物和飲酒者的酒精。那是復(fù)發(fā)。
原創(chuàng)翻譯：龍騰網(wǎng) http://top-shui.cn 轉(zhuǎn)載請注明出處

The good news is you can reverse it if you want now. And not through AA or willpower based methods, which don’t really work too well for most people. As supported by the medical literature, self-restraint methods only work in about 1 in 4 cases where the person goes in for treatment. According to the National Institute on Alcohol Abuse and Alcoholism, approximately 90% of people with Alcohol Use Disorder will relapse within four years after completing conventional treatments.
The reason for that is because alcohol consumption will cause a small release of endorphins with each sip. It's a barely noticeable effect, but endorphins are a primary biological reinforcer of behavior.
Endorphins act just like a common opioid drug but are produced inside the body naturally. So, each sip of alcohol causes the equivalent of a micro-hit of something like morphine. With enough repetition in drinking addiction sets in. Of course, each person is different based on genetic and environmental factors, but the perfect storm of events can cause anyone to develop Alcohol Use Disorder.
You can think of it as an autoimmune type disorder since it's your own endorphins reinforcing the addiction. The release of endorphins had been hypothesized and later shown in animal models for some time, but it was finally proven in humans using a special medical imaging technique called Positron Emission Tomography in 2012. Here’s a lix to the study, which was done at the University of California San Francisco School of Medicine. Alcohol Consumption Induces Endogenous Opioid Release in the Human Orbitofrontal Cortex and Nucleus Accumbens

好消息是，如果您愿意，現(xiàn)在可以逆轉(zhuǎn)它。而不是通過基于意志力的方法，這些方法對大多數(shù)人來說并不是很好。正如醫(yī)學(xué)文獻(xiàn)所支持的那樣，自我約束方法僅對四分之一左右接受治療的患者起作用。根據(jù)美國國家酒精濫用和酒精中毒研究所的數(shù)據(jù)，大約 90% 的酒精使用障礙患者在完成常規(guī)治療后的四年內(nèi)會復(fù)發(fā)。
這樣做的原因是因?yàn)轱嬀茣?dǎo)致每喝一口內(nèi)啡肽的少量釋放。這是一個幾乎不明顯的影響，但內(nèi)啡肽是行為的主要生物強(qiáng)化劑。
內(nèi)啡肽的作用就像一種常見的阿片類藥物，但在體內(nèi)自然產(chǎn)生。因此，每喝一口酒精都會引起相當(dāng)于嗎啡之類的微量打擊。隨著飲酒成癮的重復(fù)出現(xiàn)。當(dāng)然，每個人因遺傳和環(huán)境因素而異，但事件的完美風(fēng)暴可能導(dǎo)致任何人患上酒精使用障礙。
您可以將其視為一種自身免疫性疾病，因?yàn)樗悄约旱膬?nèi)啡肽增強(qiáng)了成癮性。內(nèi)啡肽的釋放已經(jīng)被假設(shè)并隨后在動物模型中展示了一段時間，但最終在 2012 年使用一種稱為正電子發(fā)射斷層掃描的特殊醫(yī)學(xué)成像技術(shù)在人類身上得到了證實(shí)。 這是該研究的鏈接，該研究是在大學(xué)完成的加州舊金山醫(yī)學(xué)院。酒精消耗誘導(dǎo)人眼眶額葉皮層和伏隔核中的內(nèi)源性阿片類藥物得以釋放。

“Endogenous Opioid” is med-speak for endorphins.
What’s emerged in the U.S. recently and originated in Europe, Finland to be precise, is a treatment method called Pharmacological Extinction. Here’s how it works:
The patient takes a medication, a tablet, called an opioid-antagonist. That’s med-speak for what’s called an opioid-blocker. These drugs are nonaddictive and safe, and do one very narrow thing very well—they block opioids from binding to our neuronal receptor sites for a period of time (naltrexone is the most commonly used and works for about 24 hours). They block regular opioids, such as morphine, heroin, Vicodin, etc., and they also block our own endorphins which bind to the same neuronal receptors and work very similar to common opioids.
The medication is taken “as-needed”, meaning you take a tablet 1–2 hours before a “drinking session” and then, when you drink, the endorphins your body produces are blocked while drinking. This produces what’s called, medically, “extinction.”
Practically speaking, the patient is breaking down the reinforcement loop that was built up from many, many times of drinking. Patients report an increasing indifference to alcohol, and the amount you drink, and the frequency of drinking, taper down.
In turn, patients can restore control over drinking and end up not really enjoying alcohol. Alcohol becomes essentially neutral, on par with a glass of water.
The published success rate is 78%, and that accounts for about a 10% noncompliance rate with the medication dosing protocol—which is a low noncompliance rate.

“內(nèi)源性阿片類藥物”是內(nèi)啡肽的醫(yī)學(xué)術(shù)語。
最近在美國興起的，確切地說是起源于歐洲的芬蘭，是一種叫做藥理學(xué)消退的治療方法。這是它的工作原理：
患者服用一種藥物，一種稱為阿片類拮抗劑的藥片。這就是所謂的阿片類藥物阻滯劑。這些藥物不會使人上癮且安全，并且在一件非常狹窄的事情上做得很好——它們會在一段時間內(nèi)阻止阿片類藥物與我們的神經(jīng)元受體位點(diǎn)結(jié)合（納曲酮是最常用的，作用時間約為 24 小時）。它們阻斷常規(guī)阿片類藥物，如嗎啡、海洛因、維柯丁等，它們還阻斷我們自己的內(nèi)啡肽，這些內(nèi)啡肽與相同的神經(jīng)元受體結(jié)合，其作用與普通阿片類藥物非常相似。
藥物是“按需”服用的，這意味著您在“飲酒”前 1-2 小時服用一片藥片，然后當(dāng)您飲酒時，您身體產(chǎn)生的內(nèi)啡肽會在飲酒時被阻斷。這產(chǎn)生了醫(yī)學(xué)上所謂的“滅絕”。
實(shí)際上，患者正在打破由多次飲酒建立的強(qiáng)化循環(huán)?；颊邎蟾鎸凭絹碓嚼淠?，飲酒量和飲酒頻率逐漸減少。
反過來，患者可以恢復(fù)對飲酒的控制，最終不會真正享受酒精。酒精變得基本上中性，相當(dāng)于一杯水。
公布的成功率為 78%，這說明藥物劑量方案的不依從率約為 10%——這是一個低的不依從率。

It’s not a painful process either, and virtually everyone will tolerate the medication without much if any issue. Most people don’t notice much if any difference in the drinking experience. It’s because the endorphin release is just a subtle aspect of the drinking experience, but it’s primarily responsible for reinforcing the behavior. Remove the endorphins from the equation and you can pave an easy pathway back to recovery. Pharmacological Extinction is also called the Sinclair Method after the scientist that invented the method.
I’ve been a part of the Sinclair Method community for a while and can tell you that it’s gone from being barely on anyone’s radar in the U.S. to growing 300–500% in awareness in the last three years, and it’s gaining more in popularity. Give it some thought.
While the problem may seem big, the solution is now there to fix it and it’s not hard. Here’s a video that explains the process in more detail. Good luck. Team Alcure.

這也不是一個痛苦的過程，幾乎每個人都會容忍這種藥物，如果有任何問題的話。大多數(shù)人不會注意到飲酒體驗(yàn)的任何差異。這是因?yàn)閮?nèi)啡肽的釋放只是飲酒體驗(yàn)的一個微妙方面，但它主要負(fù)責(zé)強(qiáng)化行為。從方程式中去除內(nèi)啡肽，您可以為恢復(fù)恢復(fù)鋪平道路。在發(fā)明該方法的科學(xué)家之后，藥理學(xué)滅絕也被稱為辛克萊方法。
我加入 Sinclair Method 社區(qū)已有一段時間了，我可以告訴你，在過去的三年里，它在美國從幾乎沒人關(guān)注到它的知名度增長了 300-500%，而且越來越受歡迎. 考慮一下。
雖然問題可能看起來很大，但現(xiàn)在已經(jīng)有了解決方案，而且并不難。這是一個視頻，更詳細(xì)地解釋了該過程。祝你好運(yùn)。阿爾庫爾團(tuán)隊(duì)。

Andrew Francis
I would strongly suggest you make it a rule that you don’t drink at home. I did and was sober for 2–3 years. I would allow myself occasional drinking if I was out, which was very rare. Friend’s dinner parties, and just once or twice a year to a bar on a special occasion (like a sports grand final day). But the golden rule I stuck rigourously to was no drinking at home.
Go home in the evenings after work but try to develop new interests and routines which drinking are not or should not ideally be a part of, and for me that was lots of reading, playing chess, cooking, and gym work outs. Avoid passive activities like watching TV. You can find good ways to fill in the time.
(Honestly drinking is not all it’s cracked up to be. I actually find it incredibly boring these days. Your life will be far more interesting without it… Good luck).

我強(qiáng)烈建議你制定一個在家不喝酒的規(guī)則。我做到了并且已經(jīng)清醒了 2-3 年。如果我離開家，我會允許自己偶爾喝酒，這是非常罕見的。朋友的晚宴、每年只有一次或兩次在特殊場合去酒吧（比如體育賽事的最后一天）。但我嚴(yán)格遵守的黃金法則是不在家喝酒。
晚上下班后回家，但嘗試培養(yǎng)新的興趣和習(xí)慣，而喝酒不是或不應(yīng)該成為理想的一部分，對我來說，這就是大量的閱讀、下棋、烹飪和健身房鍛煉。避免被動活動，如看電視。你可以找到填補(bǔ)時間的好方法。
（老實(shí)說，喝酒并不是人們想說的全部。實(shí)際上，這些天我發(fā)現(xiàn)它非常無聊。沒有它，你的生活會有趣得多……祝你好運(yùn)）。

Claire Valentine
Speak to your doctor asap and please please be wary of treatments masquerading as caring advice online; I know 2 people who’ve been suckered in by dodgy sites-one has spent thousands of pounds and is still drinking so heavily her kids are really suffering, the other is now dead. Do not embark on any scheme until you’ve spoken honestly with your doctor and had a thorough health check. Be safe.

盡快與您的醫(yī)生聯(lián)系，請警惕偽裝成在線護(hù)理建議的治療方法；我知道有兩個人被狡猾的網(wǎng)站吸引了 - 一個已經(jīng)花了數(shù)千英鎊并且仍在酗酒，她的孩子真的很痛苦，另一個現(xiàn)在已經(jīng)死了。在您誠實(shí)地與您的醫(yī)生交談并進(jìn)行徹底的健康檢查之前，不要開始任何計(jì)劃。注意安全。

David Zigterman
You can go see your doctor and tell them what’s going on. They can give you something to help you sleep as well. I am a bad alcoholic. I have also been sober for almost 5 years. I would have DT’s and seizures when I tried to stop drinking. But it wasn’t always that way. The very first physical symptom I noticed with my increasing alcohol intake was actually my sleep. I couldn’t sleep without it. I would wake up in the middle of the night and have to drink more to fall back asleep. If I were you I would stop now, and get some medical help to manage the sleep problem. Look into some type of support group as well.

你可以去看醫(yī)生，告訴他們發(fā)生了什么。他們也可以給你一些東西來幫助你入睡。我是個壞酒鬼。我也清醒了將近5年。當(dāng)我試圖停止飲酒時，我會出現(xiàn) DT（譯注：酒精中毒引起的震顫性譫妄癥） 和癲癇發(fā)作。但并非總是如此。隨著酒精攝入量的增加，我注意到的第一個身體癥狀實(shí)際上是我的睡眠。沒有它我睡不著。我會在半夜醒來，不得不喝更多酒才能重新入睡。如果我是你，我現(xiàn)在就停下來，尋求醫(yī)療幫助來解決睡眠問題。您也看看各種類型的支持小組。

Kal Breadmore
There is a condition called alcohol use disorder, which is a health problem you may or may not have: a couple of important indicators are whether drinking is causing you significant difficulty in your daily life, or significant personal distress.
From the fact you asked the question, the distress seems to be there. The fact you say drinking has become necessary to sleep suggests that the daily difficulty is also present. The amount you are drinking is also sufficient to be damaging to your health. So well done for asking the question: I would think you have already realised that you need to rein it in!
There are a number of goals that you could legitimately choose. They include both abstinence and moderation. Moderation is, perhaps, the more challenging since alcohol tends to lower inhibitions - and the first inhibition to go is often the one about how many drinks you are going to have!

有一種叫做酒精使用障礙的疾病（譯注：酒精障礙AUD是指人對酒精有強(qiáng)烈的欲望，很難控制酒精的攝入量，即使酒精導(dǎo)致其承受重大痛苦和損害，也會持續(xù)攝入。），這是您可能有也可能沒有的健康問題：幾個重要指標(biāo)是飲酒是否給您的日常生活帶來了重大困難，或者是否給您帶來了嚴(yán)重的個人困擾。
從你問這個問題的事實(shí)來看，痛苦似乎就在那里。你說飲酒已成為睡眠的必要條件，這表明日常困難也存在。您飲用的量也足以損害您的健康。問這個問題做得很好：我認(rèn)為你已經(jīng)意識到你需要控制它！
您可以合理地選擇許多目標(biāo)。它們包括禁欲和節(jié)制。節(jié)制也許更具挑戰(zhàn)性，因?yàn)榫凭鶗档鸵种谱饔谩谝粋€抑制作用通常是關(guān)于你要喝多少酒！
原創(chuàng)翻譯：龍騰網(wǎng) http://top-shui.cn 轉(zhuǎn)載請注明出處

For that reason, I would suggest that you start with a period of abstinence. This need not be long - somewhere between two weeks and three months would be a reasonable target. If you drink during a period you intended to be abstinent, start the count again.
If it is possible, seek medical supervision for stopping drinking. Withdrawal can be very unpleasant, but they can also be life threatening, since people can have seizure, get permanent brain damage or even die during them. A doctor can prescribe thiamine for neuroprotection and a short course of benzodiazepines to guard against fitting. Good nutrition and hydration are also important. During the early days, you are likely to feel low in energy, irritable and have sleep problems and mood swings. Expect them. Plan for them. They will pass.
Drinking has been taking a lot of your time, and you may find you need to change your habits quite a lot, and seek out new interests and a new social life if you are to maintain a lifestyle that is healthier. This is not the work of a moment, and most people would find it a major challenge. I tried lots of different thing in trying to establish a new lifestyle that didn’t centre on drinking. If some didn’t work out, I just tried something else.

如果可能，請尋求醫(yī)療監(jiān)督以戒酒。戒斷可能非常令人不快，但也可能危及生命，因?yàn)槿藗兛赡軙d癇發(fā)作、永久性腦損傷甚至死亡。醫(yī)生可以開硫胺素來保護(hù)神經(jīng)，并開短程苯二氮卓類藥物以防止擬合。良好的營養(yǎng)和水分也很重要。在早期，您可能會感到精力不足、易怒、有睡眠問題和情緒波動。期待他們。為他們計(jì)劃。他們會過去的。
喝酒占用了您很多時間，您可能會發(fā)現(xiàn)需要大量改變習(xí)慣，并尋找新的興趣和新的社交生活，才能保持更健康的生活方式。這不是一蹴而就的工作，大多數(shù)人會發(fā)現(xiàn)這是一個重大挑戰(zhàn)。我嘗試了很多不同的方法來嘗試建立一種不以飲酒為中心的新生活方式。如果有些沒有奏效，我只是嘗試了其他方法。

There are lots of different groups who can offer you help and support: SMART recovery, LifeRing and SOS are freely available. You may find counselling or therapy helpful in addressing underlying issues and learning things about how to cope - CBT, DBT, motivational interviewing, medication assisted treatment, community reinforcement, the Sinclair Method and various family interventions are all backed by good evidence of efficacy.
You will find many people suggest 12 Step groups. You should be aware that these groups are religious (they prefer the term “spiritual”) in nature, their approach is abstinence based, and they encourage people to label themselves and hand their will over to the care of a Higher Power. This approach is not effective for the vast majority of those who try it, and some of the doctrines and labelling may be incompatible with good mental health. Try it for yourself by all means if you have a lifelong abstinence goal!

因此，我建議您從禁欲期開始。這不需要很長時間 - 兩周到三個月之間的某個時間將是一個合理的目標(biāo)。如果您在打算戒酒的期間飲酒，請重新開始計(jì)數(shù)。
有許多不同的團(tuán)體可以為您提供幫助和支持：SMART recovery、LifeRing 和 SOS 都是免費(fèi)提供的。您可能會發(fā)現(xiàn)咨詢或治療有助于解決潛在問題并學(xué)習(xí)如何應(yīng)對——CBT、DBT、動機(jī)訪談、藥物輔助治療、社區(qū)強(qiáng)化、辛克萊方法和各種家庭干預(yù)措施都得到了良好的療效證據(jù)的支持。
您會發(fā)現(xiàn)很多人建議使用 12 Step 組。你應(yīng)該知道這些團(tuán)體本質(zhì)上是宗教的（他們更喜歡“精神”這個詞），他們的方法是基于禁欲的，他們鼓勵人們給自己貼上標(biāo)簽并將他們的意志交給更高權(quán)力的照顧。這種方法對絕大多數(shù)嘗試它的人無效，并且一些教義和標(biāo)簽可能與良好的心理健康不相容。如果你有一個終生禁欲的目標(biāo)，一定要自己試試！

Denis Thompson
That you don't drink to oblivion means you're not a slave to alcohol. If you drank every second day, and recognized the off days as proof that you are the boss (and alcohol is not), and cherished the money saved, you might set up a reward structure that can sustain sobriety. I have taken 10mg of mirtazapine (a benign, non-narcotic antidepressant) every night since 2005 and deep sleep is almost automatic.

你還沒有喝到忘卻一切的地步意味著你還沒有成為酒精的奴隸。如果你每隔一天喝一次酒，并承認(rèn)在節(jié)假日里你是自己的主宰者（而酒精不是），并且珍惜省下的錢，你可以建立一個維持清醒的獎勵機(jī)制。自 2005 年以來，我每晚服用 10 毫克米氮平（一種良性、非麻醉性抗抑郁藥），深度睡眠幾乎是自動的。

Nidhi P
People face problem in sleeping because they are having stress and unhealthy eating habits in their life. First you have to change your habit of eating and start doing exercise on regular basis. Only 20 min exercise will give you energy for whole day and it will also help in fitness.
Drinking too much will give you losses and you will not recover this if you are tied with this addiction. So we can say that to stop this habit just visit doctor and get consultation. In this your friends and family will also play a good role. Take support from them. You know it is never too late when you decide to bring change in your and others life you can easily do that.
Nature will support you when you really want to quit the bad habit. Not even you think about drink any more. Just replace this habit with good one. Changes are huge and the potential in your body are unexceptional. There is no limit and you are never late. Just Start doing this now and think about new and good habits choose any hobby and world will support you.

人們面臨睡眠問題，因?yàn)樗麄冊谏钪谐惺軌毫筒唤】档娘嬍沉?xí)慣。首先，你必須改變你的飲食習(xí)慣，并開始定期鍛煉。只需 20 分鐘的運(yùn)動就能為您提供一整天的能量，也有助于健身。
飲酒過多會給您帶來損失，如果您與這種成癮聯(lián)系在一起，您將無法恢復(fù)。所以我們可以說，要停止這種習(xí)慣，只需去看醫(yī)生并咨詢。在這方面，您的朋友和家人也會起到很好的作用。得到他們的支持。您知道，當(dāng)您決定為您和他人的生活帶來改變時，永遠(yuǎn)不會太晚，您可以輕松地做到這一點(diǎn)。
當(dāng)你真的想戒掉壞習(xí)慣時，大自然會支持你。甚至你都不再考慮喝酒了。只需用一個好的習(xí)慣來代替這個習(xí)慣。變化是巨大的，你身體的潛力是非凡的。沒有限制，你永遠(yuǎn)不會遲到?，F(xiàn)在就開始這樣做，想想新的好習(xí)慣，選擇任何愛好，世界都會支持你。

原創(chuàng)翻譯：龍騰網(wǎng) http://top-shui.cn 轉(zhuǎn)載請注明出處