Let us never forget! The top three killers in America are Caffiene, Tobacco & Alcohol! The biggest problem with alcohol use is where to draw the line
with this substance which appears naturally in all fermenting liquids, and which in small to moderate doses is not only a relaxant and a social
lubricator, but also a health tonic.
Alcohol is the most widely accepted drug in the world, and is part of many social settings.It changes a person's mood, reduces inhibitions, helps us
feel more confident and less anxious.It is often a part of celebrations and can be used to drown out unpleasant feelings.
Alcohol abuse often begins when a person feels that without alcohol he or she will not be able to enjoy the occasion or will be less able to cope with
an unchanging situation. Dependency follows when the body becomes used to a certain level of blood alcohol.Withdrawal in someone who's heavily
dependent should not be undertaken without medical supervision.
What is it?
Alcohol is a carbohydrate, a relative of sugar, and is therefore a potent source of energy for drinkers, supplying up to half of a heavy drinker's
energy requirements in a day. It is created by yeasts which in the absence of oxygen get the energy they need by converting sugar to alcohol.
Alcohol is absorbed rapidly from the stomach - in five to ten minutes without food.The effects last several hours, related to body weight which is why
many women are more affected by the same dose than men.
One unit is 8 grams of alcohol - equivalent to half a pint of normal beer, cider or lager, a standard glass of wine or a pub measure of spirits. After
four or five units, most people feel relaxed and comfortable.Eight units causes slurred speech and clumsiness, with exaggerated emotions.Higher doses
cause double vision, dizziness, staggering, loss of balance, nausea, vomiting.Beyond that alcohol can cause blindness, loss of consciousness, and loss
of memory for events at the time.
The biggest danger is from injury caused by intoxication.In 1990 15% of all road accidents were alcohol related and 32% of all pedestrians killed on
the road were under the influence of alcohol.Drinkers may also choke on their own vomit while unconscious. Although such sudden deaths are uncommon,
this is a real hazard in police cells or in a side room in an emergency ward.
A hangover may follow, caused by dehydration and toxic metabolites.Mixing alcohol with other depressant drugs such as barbiturates or heroin is
particularly dangerous as the effects are additive.
Other effects
Alcohol has many other effects on the body.
· Stomach irritation - can cause ulcers
· Liver damage - alcohol is destroyed by the liver but liver cells are also casualties (see below)
· Mouth and throat - cancers are more common in heavy drinkers
· Nutritional damage caused by neglect of a proper diet
· Brain damage caused directly by alcohol in the blood - in severe cases causing Korsakoff's psychosis, a permanent memory loss
Liver cirrhosis is a serious problem
Liver cirrhosis is common and deadly.It kills more than 23,000 a year in the US.It is the third commonest cause of death in men in their fifth decade.
The commonest cause is alcohol abuse.There is probably a genetic reason why only 15% of heavy drinkers develop the problem.Once cirrhosis is diagnosed
it is often too late to prevent death and 30% die in a year.
As the liver becomes progressively damaged it is no longer able to do its job as a food store, as a maker of digestive enzymes, and as a
waste-disposal unit for toxins.The result is that the liver becomes enlarged with fatty tissue, the person becomes ill and jaundiced (yellow) and
blood pressure rises in blood vessels draining into the liver, causing for example life-threatening bleeds of veins lining the gullet.This happens in
40% of those with cirrhosis.These bleeds cause sudden, violent, catastrophic vomiting. Death follows in minutes in almost half of those who are
unfortunate enough to have one.
Defining use and abuse
Is there a safe limit?
The World Health Organisation and governments have recently revised their guidelines about so-called safe limits for alcohol consumption in both men
and women. The current accepted limits vary from expert to expert but are around 21 units for men and 14 units for women. The problem is that these
are general guides and do not tell us what the actual damage to an individual's health will be.
Alcohol can be good for you
Evidence is growing that alcohol in moderate doses increases life expectancy.This discovery was made following a series of large-scale studies
comparing, for example the health of teetotallers with moderate and heavy drinkers.One of the protective effects appears to be on the heart and blood
supply, with a reduction in strokes and heart attacks.At first the beneficial effect was attributed to some mysterious ingredients in red wine, but we
now know that the therapeutic action is related to alcohol itself, independent of the method of production.
The discovery that drinking alcohol can be good for health brought alarm calls from those concerned that the news would encourage abuse. It certainly
undermined the case for absolute abstention.
Classic features of abuse
There are two main patterns of alcohol abuse: regular and binge. The regular abuser drinks every day or most days. The binge drinker rarely sees
himself as an alcoholic because he often goes for days or weeks without touching alcohol.However once he starts, he cannot stop.
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