Alcoholism – A Chronicle of the Alcohol Story
By Rajgopal Nidamboor
It’s more than a twist to the famed Marquezian expression in the long-term nature of alcohol use-related disorders and dangers. Complexities, put simply, in terms of unremitting alcohol use, range from relatively asymptomatic forms to the most severe.
While the term alcoholism is widely used, there’s some ambiguity about its true meaning. However, the expression, for all practical purposes, may be applied to all individuals who cause serious harm to themselves, and others, through excessive drinking.
In the generalized sense, though, three sub-types of alcohol use are often recognized:
- Those who drink harmfully, but without being dependent on alcohol
- Those displaying a definitive pattern of alcohol dependence
- Chronic alcoholics
The first group can quite easily be recognized by their drinking pattern and evidence of social damage. The drinking “model” in them changes as life becomes more “alcohol-centric” — remember,
that early on, more time is spent in social drinking?! And, the stronger and more frequent the intake, the merrier. Thereafter, alcohol consumption is “cultivated” not so much for pleasure as to relieve
tension. In course of time, the drinker becomes preoccupied with finding alcohol, and drinking would not, in one’s belief parameters, lead to one becoming drunk.
However, the resultant effect is quite apparent — social damage, usually in the form of marital problems, declining efficiency at the workplace, financial torpor etc., Symptoms of stomach acidity may also ensue along with psychological symptoms. Example: mood swings, including depression and anxiety. The condition may further lead to heavy drinking, where symptoms get aggravated, and not calmed. Heavy drinkers may also experience memory blanks — not blackouts as is the popular belief — followed by normal behaviour when in sober state.
When excessive drinking is not checked, it can lead to addiction. Alcohol becomes a drug of dependence when there is an “impulse” to take it on a continuous basis. The condition has both psychological and physiological elements attached to it. Also, when alcohol takes priority over everything else — and, as life centers increasingly on the need to consume alcohol and avoid withdrawal symptoms — it conveys a grave signal.
As far as chronic alcoholism is concerned, the situation is nothing but grim — the chronic alcoholic’s
brain and other organs may get irreversibly damaged. What’s more, the deleterious effects may persist even after drinking has been discontinued. Paradoxically, the tolerance for alcohol also becomes significantly reduced — so much so, a small amount of alcohol may be extremely harmful for the erstwhile heavy drinker.
It may also be said that the epidemiology and genetic components of alcohol use disorders are described in the nature of medical, psychological, and behavior-related problems associated with alcohol abuse. However, the frequency of alcohol-related problems and their impact on health are not routinely detected in the primary healthcare set up. It will help, if it is done!
Causes of Alcoholism
Alcoholism, experts suggest, is not caused by a single factor, but by a host of related factors. While some researchers accept the role of genetic causes, though the mode of inheritance has not been established, alcoholism has been commonly found to be associated with certain kinds of personality — especially in those who have problems coping with the demands of life, or suffer from chronic anxiety, inferiority complex, or self-indulgence, due to a mollycoddled upbringing. Researchers also attest the possible role of certain biochemical factors that may play a part in the progression of alcohol addiction just as much as social factors, which are, of course, widely known.
Researchers also suggest that long-term alcohol consumption is likely to trigger compulsive behavior. They advise that a decision medium could be applied to inform choices regarding responsible consumption of alcohol. Needless to say, physicians often apply research evidence describing the known risks and benefits associated with alcohol [ab]use when counseling their patients on alcohol-related decisions and behavior.
Statistics report that approximately 150 million Americans, for example, may be classified as drinkers, with as many as 28 per cent of the male population, and nearly 8 per cent of women, showing a history of alcohol dependence. While males — and, most notably, whites — dominate the dependence label, particularly at higher-volume consumption levels, alcohol-related social, legal, and health problems result in annual economic costs, to society, totaling over $200 billion, in the United States alone! Perish the thought of its dangerous effects worldwide — this would be enormous, to put it mildly.
Alcohol is basically a depressant — though it is often thought to be a stimulant in the first instance.
This is mainly because the primary parts of the brain, which it depresses, “rule” our behavior.
Alcohol, consumed in any form, has the same effect on the body. This is not good news for those who believe that they would be less inebriated if they did not “mix drinks.” This holds good for “fizzy” drinks, too — e.g., champagne, or carbonated drinks — because they take effect more quickly than “still” drinks as the alcohol content in them gets into the bloodstream more swiftly.
Besides, the effect is extremely rapid if alcohol is consumed on an empty stomach rather than following a meal. Although its overall effect on the body depends on its concentration in the blood, experts report that the same amount of alcohol will affect people with a light frame more than people who are heavy torso. Not surprisingly, alcohol is said to become more concentrated in the bloodstream of people who are light-weight.
In addition, the same amount of alcohol will affect women more rapidly than men, irrespective of their body size. As a matter of fact, men have higher water content in the body — this causes alcohol to become more dilute. However this may be, children and young people are quickly intoxicated on smaller amounts of alcohol than adults, partly because their bodies are small. Also, alcohol becomes more concentrated in their body since they are not as clued-up about the after-effects of alcohol as adults “possibly” are.
Alcohol is no elixir, though popular perception would be cock-a-hoop with the expression. But, the fact is — drinking alcohol for a long period of time could lead to permanent changes in the brain. It may reduce the amount of brain tissue and increase the size of the ventricles. It may also deprive the brain cells of nutrients, like vitamins — and, the problem may also become acute because heavy drinkers often neglect their diet. As a matter of fact, thiamine — one of the B- vitamins — is most commonly missing from some diets. Thiamine shortfall, spurred on by the use of alcohol, can lead to serious mental problems.
Early Detection of Alcohol Addiciton is Advantageous
Early detection of medically unsafe drinking levels before severe complications arise may prevent late complications. The best way to achieve this objective is by means of a simple screening process after a diagnosis of the problem is established.
- The first is brief intervention therapy for at-risk and problem-drinkers.
- The second is self-help groups.
These two common approaches to management provide office-based evaluation, supervision, and referral to self-help groups; they also provide primary care physicians the basis for more intensive services to patients who meet the “norms” of alcohol abuse and dependence.
However, it must be noted that the symptoms of alcohol withdrawal can occur in alcohol-dependent persons who stop drinking alcohol, or who reduce their alcohol intake, and also patients who do not respond to brief intervention therapies. They may require referral to specialists and formal/regular alcohol treatment programs.
Prevention of a relapse is also important — this may be accomplished with medicinal therapy in conjunction with psychotherapy.
Among the most publicized health benefits of regular light-to-moderate alcohol consumption is the substance’s ability to lower myocardial infarction rates, heart failure, ischemic stroke, dementia, diabetes and also osteoporosis. Researchers explain that a number of complimentary biochemical changes have been identified for the beneficial effects of moderate alcohol consumption, although alcohol, in any form, can cause damage in the long-run.
But, the bigger problem is binge drinking — a significant “splurge” among even moderate drinkers. The pattern is associated with particularly high social and economic costs. Besides, heavy alcohol
consumption can negatively affect neurological, cardiac, gastrointestinal, blood, immune, psychiatric and musculoskeletal organ systems.
A wary, holistic approach, therefore, should be emphasized even in those individuals who drink small amounts of alcohol. This is more than half of the battle won.
Harmful Effects of Alcohol
Brain and Central Nervous System
Alcohol consumption can lead to impaired behavior, judgment, memory, concentration and co-ordination. It is not without reason that alcohol can produce mild euphoria and loss of inhibition — at the same time. However, the fact remains that alcohol affects regions of the brain controlling behavior and emotion. Hence, it can induce extreme mood swings and emotional outbursts.
Alcohol also acts as a sedative and depresses the nerve cells in the brain. It dulls responsiveness, or alternates between quick reaction time and delayed response time. Alcohol, in large doses, can enhance sleep time, induce anaesthesia, respiratory failure, coma, and death. As a matter of fact, long-term alcohol use may result in serious mental affections, and lead to permanent brain damage. Other effects may include reduced visual ability; an altered sense of time and space; failing fine motor skills; loss of pain perception; unclear hearing; slow reaction; blunted smell and taste sensation; and, weakened sexual urge and/or performance.
Long-term alcohol use can lead to distorted vision and red eyes, including the inability to adjust to lights.
Alcohol reduces the facility to distinguish between sounds and/or perceive their track, or tap source, or origin.
Alcohol can lead to garbled speech. It also dulls taste and smell, including the desire for food. It can cause mouth/throat irritation and also damage the esophagus. Besides this, it can induce severe vomiting, bleeding, pain, and difficulty in swallowing.
Blood and Heart
Research suggests that alcohol can inhibit the production of white and red blood cells. It can, in the long-run, weaken the heart muscle and its ability to pump. The condition is called cardiomyopathy [disease of the myocardium]. Besides, alcohol can cause enlargement of the heart, abnormal heart signs, and irregular heart beat. Most importantly — alcohol can increase blood pressure. It can, therefore, expand the risk of heart attack and stroke.
Long-term use of alcohol may cause clogged breathing. This can sometimes be fatal. In addition, alcohol can lead to lowered resistance to infection.
Alcohol can cause the muscles to become weak and also shrivel. The condition may also be accompanied by pain, spasm, and sensitivity to touch.
Liver and Stomach
Long-term heavy drinking may cause alcohol-induced hepatitis — in other words, inflammation and destruction of the liver cells. The end result is cirrhosis, or irreversible liver lesions, including scarring and destruction of liver cells. It may also be said that alcohol upsets the liver’s ability to eliminate bilirubin. Hence, the skin may appear sallow, indicating the onset of jaundice. Also, liver damage can cause fluids to accumulate in the extremities. This is called edema. Research indicates that alcohol decreases the production of blood-clotting factors; this may cause uncontrolled bleeding. In the course of time, fat is collected. Alcohol can cause liver failure, coma and death. Besides, it can cause irritation of the stomach lining; it can also precipitate peptic ulcers, inflammation, bleeding lesions, and cancer.
Alcohol can predispose a person to develop pancreatitis — a chronic inflammatory disorder of the pancreas. Chronic drinking may result in inflammation, ulcer and cancer of the intestines and colon. Nausea, diarrhoea, vomiting, sweating, and loss of appetite, are also common. Alcohol disturbs the ability of the small intestine to process nutrients and vitamins. This can lead to nutritional deficiency syndromes.
Alcohol interferes with our body’s ability to absorb calcium. This results in bones becoming weak, soft, brittle, and thin — especially, in conditions like osteoporosis.
Alcohol use, in the long-term, can impair sexual functioning in both males and females. This may result in impotence and infertility. While the condition is often irreversible, it is also said that women drinkers run a high risk of developing breast cancer.
Pregnancy and the Unborn Fetus
Drinking during pregnancy could be dangerous — it is certainly no fashion statement you could be proud of. Alcohol can significantly amplify the chance of one having a baby with Fetal Alcohol Syndrome. Characteristics of the syndrome include small head, possible brain damage, irregular facial features, poor muscle tone and speech, and sleep disorders, including stunted growth and development.