Alcohol Abuse - Alcohol and general health

It is known that alcohol has harmful effects when consumed in large quantities, but studies in the 1990s showed that alcohol may provide some health benefits. Moderate consumption—no more than one drink a day for women or two for men—has been associated with a lower risk of heart disease in some individuals. Some people, however, should not drink at all; for example, children and adolescents, people who cannot control their consumption, women who are pregnant or trying to become pregnant, and anyone taking medication. No one should drink before driving. The adverse effects of alcohol are detailed below.

Tissue Impairment

Habitual drinking of straight whisky can irritate the membranes that line the mouth and throat. The hoarse voice of some heavy drinkers is the result of a thickening of vocal cord tissue. As for the effect on the stomach, alcohol doesn't cause ulcers, but it does aggravate them.

There is no evidence to support the belief that port wine or any other alcoholic beverage taken in moderation will cause gout. Studies have shown that as many as 60 percent of all patients with this disease had never drunk any wine at all.

Brain Damage

Alcohol abuse continued over many years has been found to contribute to cognitive defects. These may, in turn, indicate brain impairment. Researchers do not know what the defects represent—whether greater susceptibility to the problems of aging or an actual, alcohol-caused “premature aging” effect. Whatever the case, long-term chronic alcohol abuse leads to more rapid aging of the brain. Neuropsychologically, the alcoholic's brain resembles that of an older nonalcoholic.

Long-term abuse can have many other effects. These include withdrawal symptoms beginning 12 to 48 hours after a person stops drinking, sometimes followed by delirium tremens (DTs), which brings hallucinations and can be fatal; the Werner-Korsakoff syndrome, a type of beriberi characterized by a lack of the B vitamins; alcoholic peripheral neuropathy, involving damage to the nerve tissue outside the brain and spinal cord; and liver damage, including alcoholic hepatitis and cirrhosis. In the latter the liver becomes hard and yellowed.

Alcohol and Immunity to Infection

Moderate drinkers who maintain proper health habits are no more likely to catch viral or bacterial diseases than nondrinkers. But heavy drinkers, who often suffer from malnutrition, have conspicuously lower resistance to infection. Even well-nourished heavy drinkers have a generally lower immunity to infection than normal. When the blood-alcohol level is 0.15 percent or higher, the alcohol appears to weaken the disease-fighting white blood cells.

Alcohol and Stroke

Studies have shown that heavy drinkers face nearly three times the teetotaler's risk of hemorrhagic stroke. Light drinkers face twice the risk. About one stroke in four occurring in the United States is hemorrhagic, but these strokes are more likely to be fatal than those caused by blood clots.

Alcohol and Life Expectancy

It is difficult to isolate drinking in itself as a factor in longevity. One study reported the shortest life span for heavy drinkers, a somewhat longer one for those who don't drink at all, and the longest for moderate drinkers. But other factors, such as general health and heredity, play important roles.

Alcohol and Sex Activity

Alcohol in sufficient quantity depresses the part of the brain that controls inhibitions. This liberating effect has led some people to believe that alcohol is an aphrodisiac, in men. This is a conclusion that is far from the truth. At the same time that alcohol increases the sexual appetite, it reduces the ability to perform.

Alcohol as an Irritant

Many otherwise healthy people cannot tolerate alcoholic beverages of any kind, or of a particular kind, without getting sick. In some cases, the negative reaction may be psychological in origin—connected with a disastrous experience with drunkenness in the early years or with an early hatred for a drinker in the family. Some people can drink one type of beverage but not another because of a particular congener, or because of an allergy to a specific grain or fruit. People suffering from such diseases as peptic ulcers, kidney and liver infections, and epilepsy should never drink any alcoholic beverages unless allowed to do so by a physician.

Uses and Hazards

At practically all times and in many parts of the world today, alcoholic beverages of various kinds have been and are still used for medicinal purposes. This should not be taken to mean that Aunt Sally is right about the curative powers of her elderberry wine, or that grandpa knows best when he says brandy is the best cure for hiccups. Today an American physician may recommend a particular alcoholic beverage as a tranquilizer, a sleep-inducer, or an appetite stimulant.

Use of Alcohol with Other Drugs

Alcoholic beverages should be avoided by anyone taking barbiturates or other sedatives. See “Drug Use and Abuse” later in this chapter for a discussion of barbiturates.

Alcohol and Driving

For many people, coordination, alertness, and general driving skills are impaired at blood-alcohol levels below the legal limit (0.1 percent). There are some people who become dangerous drivers after only one drink. Attempts are constantly being made, but so far with less than perfect success, to educate the public about the very real dangers of drunken driving.

Possible Causes of Alcohol Abuse

A popular myth holds that alcohol causes alcohol abuse. It doesn't—any more than sugar causes diabetes. Various theories have been evolved to explain what does cause alcohol abuse.

Physiological Causes

Although several physiological factors seem to be involved in the progression of alcohol abuse, no single one can be pinpointed as the cause of the disease. Among the theories that have come under investigation are the following: abnormal sugar metabolism, disorders of the endocrine glands, and dietary deficiencies.

Psychological Causes

Recent studies have pointed to a possible relationship between personality and alcohol abuse. Researchers indicate that one definable segment of the alcoholic population has the character disorder known as antisocial personality . Once called a sociopath , the person with an antisocial personality is usually charming in a social sense, manipulative, impulsive and rebellious, and egocentric. An estimated 25 percent of the alcoholic population falls in this category; in the general population the prevalence of antisocial personalities is about 3 percent.

Sociological Factors

Practically all studies of alcohol abuse in the United States indicate that ethnic groups vary dramatically in their rates of problem drinkers. A great deal of attention has therefore been focused on learned attitudes toward alcoholic beverages and how they are used or abused. Generally, in the low-incidence groups attitudes toward drinking are clearly defined and understood by all the members of the group. Drunkenness is consistently frowned upon. In the high-incidence groups, researchers have found extensive conflict over alcohol. The basic rules aren't clearly defined, and there are no clear-cut standards for acceptable and unacceptable drinking behavior.

Genetic Factors

Research into the genetics of alcohol abuse has led to a theory of “familial abuse.” The theory holds that the person with a close relative who is alcoholic is at far greater risk of succumbing to the disease than are others without such connections. Familial abuse or “familial alcoholism” characterizes as many as three in four of all abusers. Therapy has thus begun to focus on the families of alcohol abusers—particularly young sons—as the ones most susceptible to the disease.