Alcoholism is a wide-ranging and complex disease that heavily plagues society. Drinking is defined as the consumption of a liquid, and/or the act of drinking alcoholic beverages especially to excess. Every year alcohol is responsible for 1/2 of all murders, accidental deaths, and suicides; 1/3 of all drowning, boating, and aviation deaths; 1/2 of all crimes; and almost 1/2 of all fatal automobile accidents (Overview 1).
Alcohol is a potent nonprescription drug sold to anyone over the national legal drinking age, 21. Unlike carbohydrates, fats, and proteins, which can be manufactured by the body, alcohol is a substance that is not made within the body. It is a food, because it supplies a concentrated number of calories, but is not nourishing and does not supply a significant amount of needed nutrients, vitamins, or minerals. These are empty calories that result in an unattractive beer belly. Most foods are prepared for digestion by the stomach so that their nutrients can be absorbed by the large intestine. However, 95% of alcohol is absorbed directly through the stomach walls or the walls of the duodenum (part of the small intestine nearest the stomach)and small intestine (Overview 2).
Various factors effect the speed of alcohols absorption into the body.
- Watery drinks such as beer is absorbed more slowly.
- Foods (especially fatty foods) delay absorption
- Carbonated beverages speed up the emptying of the stomach into the small intestine where alcohol is absorbed more quickly.
- The drinkers physical and emotional state (fatigue, stress), and individual body chemistry affect absorption.
- Gender: Women have less dehydrogenates (a chemical that breaks down alcohol in the stomach, so more alcohol is absorbed in the bloodstream.
Within moments of ingestion, alcohol moves from the blood stream into every part of the body that contains water, including major organs like the brain, lungs, kidneys, and heart. Alcohol stimulates and agitates, depresses and sedates, produces calmness and tranquility, and begins a hypnotic state of drowsiness and sleep. Alcohol impairs your judgement, and strongly affects motor skills, muscle function, reaction time, eyesight, depth perception, and night vision. As a drinker continues to drink, alcohol depresses lung and heart function, slowing breathing and circulation. Death can occur if alcohol completely paralyzes breathing.
However, this state is seldom reached because the body rejects alcohol by vomiting. Acute alcohol overdose leading to death occurs in colleges where individuals are encouraged to drink large amounts of alcohol rapidly. Relatively speaking, the twelve million U.S. College students drink over 430 million gallons of alcohol a year- that is 3,500 Olympic sized swimming pools filled with alcohol. Binge drinking is the number one public health hazard for more than six million college students in America (MADD 2). Only five percent of alcohol is eliminated from the body through the breath, urine, or sweat; the rest is broken down in the liver.
In the Liver: -Alcohol is broken down in steps by enzymes until only carbon dioxide remain as by-products. -Alcohol is processed at the rate of three tenths of an ounce of pure ethanol per hour (less than one ounce of whiskey) and unprocessed alcohol circulates in the body. (The alcohol from two cocktails, each about 1.5 ounces, drank before dinner is still present in the body three to four hours later) (Overview 2).
The livers fixed rate of alcohol breakdown means that drinking coffee or taking a cold shower does not speed the sobering process. Therefore, giving coffee to a person who is drunk may make a wide-awake drunk, who thinks he/she is sober enough to drive a car. Occasional users of alcohol, who are healthy, do not appear to suffer negative affects from use of alcohol.
In moderate doses, alcohol has beneficial effects: relaxation, appetite stimulation. However, consumed in large amounts, alcohol is a toxin. The short-term result of the toxin is a hangover.
A hangover has a combination of physical symptoms:
- Headache: Blood vessels in the head, dilated by alcohol, painfully stretch as they return to their normal state.
- Upset stomach: Alcohol irritates gastric lining.
- Dehydration: Alcohol stimulates the kidneys to process and pass more water than is ingested. A hangover is a withdrawal state.
The best hangover cure is aspirin, liquids, sleep, and time. Bland foods, especially liquids, may also help. The best prevention for hangover is moderation or abstinence from alcohol at all. The long-term results may develop into alcoholism and alcohol-related diseases. Alcohol has a direct toxic as well as sedative affects on the body, and failure to take care of nutritional and other physical needs during prolonged periods of excessive drinking may further complicate matters.
Advanced cases often require hospitalization. The physical effects of alcohol abuse are wide ranging and complex. They include a wide range of digestive-system disorders such as ulcers, inflammation of the pancreas, and several liver diseases. The liver breaks down alcohol in the body and is therefore the major area for alcohol damage.
Liver damage may occur in three irreversible stages:
- Fatty Liver: Liver cells are worked in with abnormal fatty tissue, enlarging the liver.
- Alcoholic Hepatitis: Liver cells swell, become inflamed, and die, causing blockage.
- Cirrhosis: Fibrous scar tissue forms in place of healthy cells, obstructing the flow of blood through the liver. Various functions of the liver deteriorate with often fatal results.
A diseased Liver:
- Cannot convert stored glycogen into glucose, thus lowering blood sugars and producing hypoglycemia (an abnormally low level of glucose in the blood).
- Inefficiently detoxifies the bloodstream and inadequately removes drugs, alcohol, and dead red blood cells.
Cannot manufacture bile (for fat digestion), prothrombin (for blood clotting and bruise prevention), and albumin (for maintaining healthy cells) (Overview 4).
Alcohol in the liver also alters the production of digestive enzymes, preventing the absorption of fats and proteins and decreasing the absorption of the vitamins A, D, E, and K. The decreased production of these enzymes also causes diarrhea (Overview 4).
Alcohol strongly disturbs the structure and function of the central nervous system, interrupting the ability to retrieve and integrate information. Even small amounts if alcohol affect the brains retrieving and processing abilities, while larger amounts interfere with the oxygen supply to the brain. Blackouts, hallucinations, and extreme tremors may occur (LeClair 1).
Alcohol abuse destroys brain cells and whether the damage can be reversed is unknown. Alcoholics who do not quit drinking decrease their life expectancy ten to fifteen years (Overview 3). Large amounts of alcohol may irritate the mouth, esophagus, and stomach. Alcohol increases the stomachs digestive enzymes, which can irritate the stomach wall, producing heartburn, nausea, gastritis, and ulcers. The stomach of a chronic drinker loses the ability to adequately move food and expel it into the duodenum, leaving some food always in the stomach, causing sluggish digestion and vomiting. Alcohol may also inflame the small and large intestine (Overview 4).
Moderate daily drinking may be good for the heart, but for many the risks outweigh the benefits. Even one binge may produce irregular heartbeats, and an alcohol abuser experience increased risk of high blood pressure, heart attacks, heart arrhythmia, and heart disease. Alcohol may cause cardiomyopathy (a disease of the heart muscle) (Overview 4). Quitting drinking aids in recovery from this condition.
Growing evidence supports the theory, that alcoholism is a hereditary disease. Alcoholism, as appeased to merely excessive or irresponsible drinking, has been variously thought of as a symptom of psychological or social stress or as poor coping behavior. More recently, and probably more accurately, it has come to be viewed as a complex disease entity in its own right (LeClair 1). With the acceptance of alcoholism as a disease, we have been able to develop new treatments, an understanding, and a way to recover.
A vast majority of this research has focused on mutations in the enzymes that metabolize (The sum of the processes of life support and especially the processes by which a substance is assimilated or eliminated by the body) alcohol and may effect the bodys ability to excrete this toxin (Overview 1). Evidence shows there may be genetic factors that help determine whether a person will become and alcoholic. A child of an alcoholic has four times the risk of becoming an alcoholic compared with a child of nonalcoholic parents (Overview 6).
There are two types of genetic alcoholics:
- Male-limited susceptibility: Found mostly in males, this condition is passed on frequently and occurs at an early age. This type is associated with most criminal cases and often requires extensive therapy.
- Milieu (environmental)-limited susceptibility: More common, this condition is found in both males and females. Although inherited, this type of alcoholism must be stimulated by environmental factors (Overview 1).
Alcoholism usually develops over a period of years. Early and subtle symptoms include placing excessive importance on the availability of alcohol. Ensuring this availability strongly influences the persons choice of associates or activities. Alcohol becomes a staple in the abusers daily life. Initially, the alcoholic may demonstrate a high tolerance to alcohol, consuming more and showing less adverse effects than others may.
Subsequently, however, the person begins to drink against his or her own best interests, as alcohol becomes more important than personal relationships, work, reputation, or even physical health. The person commonly loses control over drinking and is increasingly unable to predict how much alcohol will be consumed on a given occasion or, if the person currently abstaining, when the drinking will resume again. Physical addiction to the drug may occur, sometimes eventually leading to drinking around the clock to avoid withdrawal symptoms.
In some cases the diagnosis of alcoholism is made by the courts, when a judge issues a drunk driving sentence that requires the offender to attend Alcoholics Anonymous (AA), or enter a rehabilitation program. As the public becomes more aware of the nature of alcoholism, the social attractiveness attached to it decreases, alcoholics and their families tend to conceal it less, and diagnosis is not delayed long. Alcoholism has a good recovery rate once the alcoholic stops drinking.
Treatment is provided in many different forms because there are many kinds of alcoholics. Treatment sources include hospitals, alcoholism units within hospitals, private clinics designed specifically for the care of alcoholics, residential alcoholic rehabilitation facilities, self-help groups such as Alcoholic Anonymous, and private practitioners such as alcoholism counselors, psychologists, psychiatric social workers, and psychiatrists. In addition to managing physical complications and withdrawal states, treatment involves individual counseling and group therapy techniques aimed at complete and comfortable abstinence from alcohol.
Alcoholics Anonymous, a support group commonly used for those undergoing treatment, in many cases helps alcoholics to recover without extensive formal treatment. This organization of men and women help each other solve their common problem of alcoholism.
They also offer to share their recovery experiences with others that have a drinking problem and want to do something about it. Such abstinence, according to the best current evidence, is the desired goal, despite some highly controversial suggestions that a safe return to social drinking is possible (LeClair 2). Despite these encouraging signs, estimates of the annual number of deaths related to excessive drinking exceed 97,000 in the United States alone. Economic costs related to alcoholism are at least 100 billion a year (LeClair 2).
The National Institute on Alcohol Abuse and Alcoholism defines moderate drinking as an average of not more than two drinks per day, and estimates that fifteen million adults (fifteen percent of the drinkers in the United States) consume more than that amount. The fifteen percent of men and three percent of women who ingest more than four drinks a day risk a serious drinking problem. Most problem drinkers are not presently receiving formal treatment apart from what Alcoholics Anonymous offers. The available treatments are most effective for socially stable, middle-class alcoholics and least effective for the homeless without families. The need to provide increasing services of better quality to those with alcoholism is urgent.
The major burden of coping with this complex drug problem continues to fall on the individuals and families most directly affected. A further enlightened public policy on alcoholism addressing legal drinking ages, liquor labeling, laws governing drunk drivers, and public education is still necessary.
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