Ukuphuza Ngokweqile Kanye Nempilo

“Santé!” “Salute!” “Za vashe zdorovye!” “Chuc suc khoe!” Kunga-khathaliseki ukuthi useFrance, e-Italy, eRussia noma eVietnam, kuzwakala izilokotho ezifanayo ngaphambi kokuba abangane baphuze ndawonye, bethi: “Mpilo-nhle!” Kodwa kuyadida ukuthi izigidi zabantu emhlabeni wonke zizibulala ngotshwala.

UKUPHUZA ngokweqile kuyinkinga enezici eziyinkimbinkimbi ezihlanganisa ukuphuza okuyingozi, ukweqisa kanye nokulutheka. Ukuphuza okuyingozi, ngokwendlela i-World Health Organization ekuchaza ngayo, “kuwumkhuba wokuphuza utshwala ohambisana nemiphumela eyingozi,” emzimbeni, engqondweni noma emphakathini. Kuhlanganisa ukuphuza izilinganiso ezingaphezu kwalezo ezituswa abezempilo noma ezibekwe umthetho. Ukweqisa ophuzweni kuhilela ukuphuza osekudala umonakalo kakade emzimbeni noma engqondweni kodwa okungakabi ukulutheka. Ukulutheka kuye kwachazwa ngokuthi “ukuhluleka ukuzithiba otshwaleni.” Umuntu owumlutha wotshwala uhlala ebunxanela, uyaqhubeka ebuphuza naphezu kwezinkinga ezihlukahlukene obumbangela zona, futhi uba nezimpawu zokulutheka uma engabuthintanga.

Kungakhathaliseki ubudala bakho, ubulili noma ubuzwe, awugonyiwe ezingozini zokuphuza okuyingozi. Benzani ngempela utshwala emzimbeni wakho? Ziyini izingozi zokuphuza ngokweqile empilweni yakho? Futhi lingakanani izinga lokuphuza abantu abalibheka njengeliphephile?

Buyingozi Engqondweni

I-ethanol, ikhemikhali etholakala eziphuzweni eziningi ezidakayo, iyi-neurotoxin—ikhemikhali enobuthi engalimaza noma engabulala isimiso sezinzwa. Empeleni, umuntu odakiwe usuke enobuthi emzimbeni ngandlela-thile. Uma iphuzwa ngobuningi i-ethanol yenza umuntu aquleke futhi imbulale. Ngokwesibonelo, abafundi baseJapane banomkhuba okuthiwa i-ikkinomi, noma ukuminya utshwala, obabulala minyaka yonke. Umzimba uyakwazi ukuguqula i-ethanol ibe ikhemikhali engeyona ingozi, kodwa lokho akwenzeki ngokushesha. Uma umuntu ephuza utshwala obuningi ngokushesha kunalokho umzimba ongakusingatha, i-ethanol iyanqwabelana emzimbeni bese iqala ukuba yisiphazamiso esikhulu ekusebenzeni kobuchopho. Kanjani?

Ikhono lokukhuluma, lokubona, lokusebenzelana kwamalungu omzimba, ukucabanga nokuziphatha konke kuhlobene nengxube eyinkimbinkimbi yamakhemikhali kuma-neuron, noma amangqamuzana obuchopho ayinhloko. I-ethanol iguqula leyo ngxube yamakhemikhali, inciphise noma yandise indima efezwa ama-neurotransmitter athile—okungamakhemikhali adlulisa imiyalezo phakathi kwamangqamuzana obuchopho. Kanjalo ukudluliswa kwemiyalezo ebuchosheni kuyathikamezeka, kwenze ubuchopho bungasebenzi ngendlela efanele. Yingakho uma umuntu ephuze kakhulu, eqala ukuba nenkinga yokukhuluma, angaboni kahle, adiyazele futhi angakwazi ukuzithiba—konke okuyizimpawu ezivamile zokudakwa.

Uma umuntu eqhubeka ephuza utshwala, amakhemikhali asebuchosheni azivumelanisa nesimo ukuze alwe nobuthi be-ethanol futhi alondoloze ukusebenza kahle kwezinzwa. Lokhu kuholela ekumelaneni komzimba notshwala, okwenza umthamo ofanayo wotshwala ungabe usaba namandla njengakuqala. Ukulutheka kwenzeka lapho ubuchopho sebuzivumelanise nokuba khona kotshwala kakhulu kangangokuba bungabe busakwazi ukusebenza kahle ngaphandle kwabo. Umzimba ufisa utshwala ukuze ukwazi ukulinganisa amakhemikhali. Uma umuntu engabuthintanga utshwala, izinga lamakhemikhali asebuchosheni liba bucayi abese eqala ukuba nezimpawu zokulutheka ezinjengokukhathazeka, ukuthuthumela, noma ngisho nokuquleka imbala.

Ngaphandle kokushintsha amakhemikhali asebuchosheni, ukuphuza ngokweqile kungawohloza futhi kubulale amangqamuzana, kushintshe ukwakheka kobuchopho ngokwabo. Nakuba umuntu engase alulame ngezinga elithile uma ebuyeka, kubonakala sengathi omunye walo monakalo awulungiseki, okuphazamisa inkumbulo neminye imisebenzi yobuchopho. Ukulimala kobuchopho akubangelwa nje ukuphuza utshwala isikhathi eside. Ucwaningo lubonisa ukuthi ngisho nokweqisa isikhashana nje otshwaleni kungaba yingozi.

Isifo Sesibindi Nomdlavuza

Isibindi sifeza indima ebalulekile ekugayeni ukudla, ekulweni nezifo, ekulawuleni ukugeleza kwegazi nasekukhipheni emzimbeni izinto ezinobuthi, ezihlanganisa notshwala. Uma umuntu ephuza utshwala isikhathi eside lokhu kulimaza isibindi ngezigaba ezintathu. Esigabeni sokuqala, ukugayeka kwe-ethanol kubambezela ukugayeka kwamafutha, okuwenza anqwabelane esibindini. Lokhu kuthiwa i-steatohepatitis, noma isibindi esinamafutha. Ngokuhamba kwesikhathi, isibindi siqala ukuvuvukala njalo. Nakuba utshwala bungasenza sivuvukale ngokuqondile isibindi, kubonakala sengathi bunciphisa nekhono lomzimba lokulwa namagciwane esifo somdlavuza sohlobo B no-C.a Uma kungadambi, ukuvuvukala kwenza amangqamuzana aqhume futhi afe. Okwenza le nkinga ibe yimbi nakakhulu ukuthi kubonakala sengathi utshwala buqala inqubo engokwemvelo yokufa kwamangqamuzana ebizwa ngokuthi i-apoptosis.

Isigaba sokugcina salesi sifo ukoma kwesibindi. Ukuqhubeka kwesibindi sivuvukele nokufa kwamangqamuzana kubangela umonakalo ongalungiseki. Ngokuhamba kwesikhathi, isibindi siyoma, esikhundleni sokuhlala sithambile. Ekugcineni, izicubu ezomile zenza igazi lingagelezi kahle, okubulala isibindi kanye nomuntu.

Umonakalo odalwa utshwala esibindini unomunye umphumela ocashile—isibindi siyehluleka ukufeza indima yaso yokulwa nezinto ezibanga umdlavuza. Ngaphandle kokukhuthaza ukwakheka komdlavuza wesibindi, utshwala buyandisa kakhulu ingozi yokuba nomdlavuza womlomo, wamankanka, wegilo kanye nowomminzo. Ngaphezu kwalokho, utshwala benza ulwelwesi lomlomo luhlaselwe kalula yizinto ezibanga umdlavuza ezitholakala kugwayi, okwenza abantu ababhemayo babe sengozini enkulu nakakhulu. Abesifazane abaphuza nsuku zonke basengozini enkulu yokuba nomdlavuza wamabele. Ucwaningo oluthile lubonisa ukuthi ingozi kulabo abaphuza izingilazi ezintathu noma ngaphezulu ngosuku iphakeme ngamaphesenti angu-69 kunakulabo abangaphuzi.

Izinsana Ezizalwa Zinobuthi Emzimbeni

Umphumela odabukisa nakakhulu wokuphuza ngokweqile ubonakala ezinsaneni ezingakazalwa. I-International Herald Tribune iyabika: “Utshwala buyingozi kakhulu embungwini osakhula kunanoma isiphi esinye isidakamizwa esisetshenziswa kabi.” Lapho owesifazane okhulelwe ephuza, umntwana okhula ngaphakathi kuye naye uyaphuza, futhi ubuthi botshwala buyingozi kakhulu ikakhulukazi kulesi sigaba sokwakheka kombungu. Utshwala bubangela umonakalo ongalungiseki esimisweni sezinzwa sosana. Amangqamuzana obuchopho awakheki kahle. Amangqamuzana omzimba ayafa. Amanye amangqamuzana agcina esezindaweni ezingafanele.

Umphumela, owukukhinyabezeka kombungu ngenxa yotshwala (fetal alcohol syndrome [FAS]), uyimbangela eyinhloko yokuphazamiseka kwezinsana ngengqondo. Izinkinga zabantwana abane-FAS zihlanganisa ukungakhuli kwengqondo, izinkinga zolimi, ukungabi nesimilo, ukukhula kancane komzimba, ukungalawuleki nokuphazamiseka kwekhono lokuzwa nelokubona. Izinsana eziningi ezine-FAS zivame ukuzalwa zinokukhubazeka okuthile ebusweni.

Ngaphezu kwalokho, izingane zomama ababephuza ngisho nengcosana yotshwala lapho besakhulelwe zingaphazamiseka nangezinye izindlela, kuhlanganise ukuba nezinkinga zokuziphatha nokuhluleka ukufunda. UProfesa Ann Streissguth, womnyango ocwaninga ngomphumela wotshwala nezidakamizwa embungwini e-University of Washington, uthi: “Akudingeki ukuba ube umlutha wotshwala ukuze ulimaze umntanakho, umonakalo ubangelwa ukuphuza kukodwa nje lapho ukhulelwe.” Umbiko we-French National Institute of Health and Medical Research othi Alcool—Effets sur la santé uthi: “Ukuphuza utshwala kuyingozi ngendlela enganakeki phakathi naso sonke isikhathi sokukhulelwa, futhi asikho isilinganiso esiphephile esake sabekwa esingeyona ingozi.” Ngenxa yalokho, inkambo yokuhlakanipha ngabesifazane abakhulelwe noma abafuna ukukhulelwa iwukuba bangabuthinti ngisho nakancane utshwala.b

Ukuphuza Ngezinga Eliphephile

Uhlu olungenhla olubala izingozi zempilo aluphelele neze. Ngo-2004 isihloko sikamagazini i-Nature saphawula ukuthi “ngisho nengcosana yotshwala yandisa ithuba lokulimala nengozi yokungenwa yizifo ezingaba ngu-60.” Ngenxa yalokho, kuyini ngempela ukuphuza ngezinga eliphephile? Namuhla izigidi zabantu emhlabeni wonke ziyakujabulela ukuphuza ngezinga eliphephile ngezikhathi ezithile. Isihluthulelo sempilo enhle ukulinganisela. Kodwa kuyini ngempela ukulinganisela? Abantu abaningi bangase bathi bayalinganisela ophuzweni, mhlawumbe becabanga ukuthi uma nje bengadakwa noma bengeyona imilutha yotshwala, akunankinga. Nokho, indoda eyodwa kwamane eYurophu iphuza utshwala ngezinga elibhekwa njengeliyingozi.

Imithombo ehlukahlukene ithi ukulinganisela ophuzweni kuwukuphuza amagremu angu-20 e-alcohol engahluziwe ngosuku, noma izingilazi ezimbili ezivamile uma uyindoda, kanye namagremu ayishumi, noma ingilazi eyodwa, uma ungumuntu wesifazane. Izikhulu zezempilo zaseBrithani naseFrance zisikisela “isilinganiso esifanele” sezingilazi ezintathu ngosuku uma uyindoda, nezimbili uma ungowesifazane. I-U.S. National Institute on Alcohol Abuse and Alcoholism yona itusa ukuthi “abantu abaneminyaka engu-65 nangaphezulu baphuze ingilazini eyodwa vo ngosuku.”c Nokho, sonke utshwala busiphatha ngezindlela ezingafani. Kwezinye izimo, ngisho nalezi zilinganiso eziphansi zingase zibe ukweqisa. Ngokwesibonelo, “ukuphuza ngesilinganiso esifanele kungaba ingozi kubantu abanezinkinga zokukhathazeka nokuguquguquka kwemizwa,” kusho i-10th Special Report to the U.S. Congress on Alcohol and Health. Kufanele kucatshangelwe ubudala bomuntu, umlando wakhe wempilo nobukhulu bomzimba wakhe.—Bheka ibhokisi elithi “Ukunciphisa Izingozi.”

Yiluphi usizo olunganikezwa labo abeqisayo ophuzweni? Isihloko esilandelayo sizophendula lo mbuzo.

[Imibhalo yaphansi]

[Ibhokisi/Izithombe ekhasini 5]

INGABE KUFANELE UPHUZE NGAPHAMBI KOKUSHAYELA?

Imithetho yokuba ungashayeli uphuzile yaqala ukuba khona cishe ngesikhathi ezaqala ukuba khona ngazo izimoto. Izwe lokuqala elashaya umthetho onjalo kwakuyiDenmark ngo-1903.

Uma uphuza ungadlile, utshwala obusesiswini buqala ukukudaka kungakapheli nesigamu sehora ubuphuzile. Ngokuphambene nalokho abantu abaningi abakukholelwayo, ukuphuza ikhofi, ukushaywa umoya nokuvivinya umzimba akukwenzi ukuba uhlaphuke. Amandla otshwala emzimbeni aphela ngokuhamba kwesikhathi kuphela. Futhi, ungakhohlwa ukuthi “utshwala buwutshwala.” Ngalokho sisho ukuthi uma uphuza ingilazi evamile yewayini, kabhiya, noma kagologolo, lob’ otshwala bunamandla afanayo.d

Ngisho nengcosana yotshwala ingaliphazamisa ikhono lakho lokushayela. Utshwala buthikameza amehlo. Izimpawu zomgwaqo zibonakala zizincane. Ukubuka emaceleni kanye nekhono lakho lokunquma ubude bebanga kanye nokugxilisa amehlo ezintweni eziqhelile kuyancipha. Ikhono lokuhlaziya izinto ezenzekayo, ukusabela komzimba nokusebenzelana kwamalungu awo kuyancipha.

Uma wehlelwa ingozi ngemva kokuphuza ngokweqile, cishe ungalimala kabi kakhulu kunalapho ungaphuzile. Ngaphezu kwalokho, amathuba okusinda lapho uhlinzwa ngokuphuthumayo ayancipha ngenxa yendlela utshwala obuyithinta ngayo inhliziyo nokujikeleza kwegazi. “Ngakho, ngokuphambene nalokho abantu abaningi abakukholelwayo, abantu abaningi abafa ezingozini ezihlobene notshwala yibo kanye abashayeli abadakiwe,” kusho umbiko we-French National Institute of Health and Medical Research. Ngenxa yezingozi, lo mbiko utusa okulandelayo:

◼ Ungaphuzi bese uyashayela.

◼ Ungangeni emotweni eshayelwa umuntu ophuzile.

◼ Ungabavumeli abangane noma abazali bashayele uma bephuzile.

[Umbhalo waphansi]

[Izithombe]

Lezi ziphuzo ziqukethe cishe isilinganaso esifanayo se-alcohol

Ibhodlela elivamile likabhiya (Amamililitha angu-330 aqukethe amaphesenti amahlanu e-alcohol)

Isiphuzo esisodwa sikagologo (i-whiskey, i-gin, noma i-vodka) (Amamililitha angu-40 aqukethe amaphesenti angu-40 e-alcohol)

Ingilazi yewayini (Amamililitha angu-140 aqukethe amaphesenti angu-12 e-alcohol)

Ingilazi encane ye-liqueur (Amamililitha angu-70 aqukethe amaphesenti angu-25 e-alcohol)

[Ibhokisi ekhasini 6]

UKULUTHWA UTSHWALA—INGABE KUBANGELWA UFUZO?

Njengoba bemagange befuna ikhambi lokwelapha ukuluthwa utshwala, ososayesi baye bazama ukuqonda indima yofuzo ekuqaleni nasekuqhubekeni kwalo mkhuba. Ososayensi baye bathola izakhi eziningana zofuzo okubonakala sengathi zithonya indlela umzimba womuntu obusingatha ngayo utshwala. Nokho, ukuluthwa utshwala akubangelwa ufuzo kuphela. Ngisho noma abanye abantu benokuthambekela okuthile kofuzo, lokho akusho ukuthi abanakukugwema ukuluthwa utshwala. Isimo sendawo umuntu akhulela kuyo sihilelekile. Ukungakhuliswa kahle abazali, ukweqisa ophuzweni ekhaya noma phakathi kontanga, izingxabano, izinkinga ezingokomzwelo, ukucindezeleka, ukuba nolaka, ukufuna ukwesasa, ukumelana komzimba notshwala, noma ukuluthwa enye into konke kuye kwabalwa phakathi kwezinto ezandisa ingozi. Lezi zici kanye nezinye zingaholela ekuluthweni utshwala.

[Ibhokisi/Isithombe ekhasini 6]

EFRANCE:

Ucwaningo lubonisa ukuthi abantu abaphuza ngokweqile bangaba yizigidi ezinhlanu, kanti abayizigidi ezi- mbili kuya kwezintathu kulelo nani bayimilutha yotshwala

ENIGERIA:

Ngokwephephandaba laseLagos i-Daily Champion, “abantu baseNigeria abangaphezu kwezigidi ezingu-15 bayimilutha yotshwala”—lokho kucishe kulingane namaphesenti angu-12 enani lezakhamuzi

EPORTUGAL:

Leli zwe lingelinye lamazwe anamanani aphakame kakhulu emhlabeni abantu abaphuza ugologo. Iphephandaba laseLisbon i-Público libika ukuthi amaphesenti ayishumi ezakhamuzi anenkinga “yokuthikamezeka okukhulu okubangelwa utshwala”

E-UNITED STATES:

Ngokwe-10th Special Report to the U.S. Congress on Alcohol and Health, “amaMelika angaba yizigidi ezingu-14—okungamaphesenti angu-7,4 ezakhamuzi—angachazwa ngokufanele ngokuthi aphuza ngokweqile noma ayimilutha yotshwala”

[Ibhokisi ekhasini 8]

UKUNCIPHISA IZINGOZI

Izincazelo ezilandelayo zezilinganiso ezidingekayo zokunciphisa izingozi zanyatheliswa umnyango we-World Health Organization okuthiwa i-Department of Mental Health and Substance Dependence. Ukunciphisa ingozi akusho ukuthi ayikho ingozi. Abantu basabela ngezindlela ezihlukahlukene otshwaleni.

◼ Ungaphuzi iziphuzo ezivamile ezingaphezu kwezimbili ngosukue

◼ Ungaphuzi okungenani izinsuku ezimbili ngesonto

Ezimweni ezilandelayo, ngisho nesiphuzo esisodwa noma ezimbili zingaba ingozi:

◼ Uma ushayela noma usebenza ngomshini

◼ Uma ukhulelwe noma uncelisa

◼ Uma kunemithi ethile oyiphuzayo

◼ Uma unezinkinga ezithile zempilo

◼ Uma uhluleka ukulawula izinga ophuza ngalo

[Umbhalo waphansi]

[Umthombo]

Source: Brief Intervention for Hazardous and Harmful Drinking

[Ibhokisi/Isithombe ekhasini 9]

UTSHWALA—INGABE BUYILUNGELE INHLIZIYO?

Ososayensi bakholelwa ukuthi amakhemikhali asewayinini elibomvu (ama-polyphenol) avimba ikhemikhali eyenza imithambo yegazi ivaleke.

Ngaphezu kwalokho, ngokuvamile utshwala buye bahlotshaniswa nokwenyuka kwamazinga alokho okuthiwa i-cholesterol enhle. Bunciphisa nezinto ezingabangela amahlule.

Kubonakala sengathi utshwala buyinzuzo uma umuntu ephuza ingcosana phakathi nalo lonke isonto, kunokuphuza sonke leso silinganiso ngasikhathi sinye ngobusuku obubodwa. Ukuphuza izingilazi ezingaphezu kwezimbili ngosuku kuthiwa kubangela ukwenyuka komfutho wegazi, futhi ukuphuza ngokweqile kwandisa ingozi yokushaywa unhlangothi kanti kungenza inhliziyo ivuvukale futhi ingashayi kahle. Ukuphuza ngokweqile kubangela lezi zingozi kanye nezinye izingozi zempilo, bese kuyenza ingabonakali yonke eminye imiphumela emihle utshwala obunayo enhliziyweni nasemithanjeni yayo. Ukweqisa entweni enhle kuyingozi.

[Umdwebo/Isithombe ekhasini 7]

INDLELA UTSHWALA OBUNGAKULIMAZA NGAYO

Ubuchopho

Ukuwohloka kwamangqamuzana, ukulahlekelwa inkumbulo, ukucindezeleka, ukuba nolaka

Ukuphazamiseka kwe-khono lokubona, lokukhu-luma nokusebenzelana kwamalungu omzimba

Umdlavuza womminzo, womlomo, wamabele nowesibindi

Inhliziyo

Ukuba buthaka kwezicubu, ingozi yokumelwa yinhliziyo

Isibindi

Isibindi siba namafutha bese sivuvukala, sigcine sesomile (i-cirrhosis)

Ezinye izingozi

Isimiso sokuzivikela esibuthaka, izilonda esiswini, ukuvuvukala kwamanyikwe

Abesifazane abakhulelwe

Bazifaka engozini yokuzala abantwana abakhubazekile noma abagulayo ngengqondo

[Isithombe ekhasini 8]

“Utshwala buyingozi kakhulu embungwini osakhula kuna-noma isiphi esinye isidaka-mizwa esisetshenziswa kabi”