Aim. To suggest a new perspective on chronic alcohol intoxication by means of investigating the associated severe multiple organ pathology, which frequently becomes the cause of lethal outcome in patients suffering from drunkenness and alcoholism.Key points. The empirical basis of the study consisted in the analysis of autopsy results obtained from 1,115 corpses of persons having abused alcohol during their lifetime. In addition, 800 experiments on rats were carried out.  As a result, a concept of alcoholic disease (AD) is proposed. AD is defined as a condition, in which chronic ethanol intoxication leads to the development of morphological changes in organs and systems: from minimal injuries of the microcirculatory pathway to a multiple organ pathology showing signs of alcoholism. AD pathogenesis is demonstrated to undergo 3 major stages, from (1) episodic alcohol intoxication, through (2) drunkenness and to (3) alcoholism. It is noted that, while the morphological changes are considered to be reversible during the first two stages, they become irreversible at the stage of alcoholism.Conclusion. It is concluded that the forms of the disease that involve the described morphological changes in organs and systems should be primarily treated by physicians, not by psychiatrists and narcology practitioners who are only capable of dealing with the psychological aspect of the problem.

Aim. To reveal the patho- and morphogenesis of microvascular injury, cardiac and vascular changes in individuals with alcohol use disorder (AUD) and the role of cardiovascular pathology in the thanatogenesis of patients with chronic alcohol intoxication.Material and methods. The study was carried out using the data of 1118 autopsies of patients with AUD. We used histological, immunohistochemical, electron microscopic and biochemical methods, as well as morphometrics with statistical processing of the results.Results. Most patients with binge drinking developed alcoholic cardiomyopathy, cardiac hypertrophy, myocardial fatty degeneration, microvascular arteriolosclerosis and hyalinosis, diffuse focal sclerosis, as well as mitochondrial swelling and fragmentation of cristae in cardiomyocytes (CMC). The proportion of damaged CMC was 30,9±0,6%. Sclerosis affected 20,1±0,9% of the stroma. If alcohol was abandoned or consumed within the basal metabolic rate, these changes were reversible. With alcoholism, alcoholic cardiomyopathy, arteriosclerosis and arteriolosclerosis progressed. Compared with the binge drinking, the proportion of damaged CMC (44,8±1,1%) and the cardiosclerosis area (28,1±0,5%) significantly increased. Mallory bodies with autoantigen properties were detected. Morphological changes became irreversible.Conclusion. The data obtained identified the need for AUD isolation as an independent nosological entity with stage-by-stage pathogenesis. In the stage of binge drinking, the compensatory and adaptive capabilities of the body are preserved. With appropriate treatment, this stage of AUD is treatable. In the stage of alcoholism, changes in organs and tissues are irreversible, and it is more advisable for addiction medicine physicians to deal with palliative treatment of such patients.