ALCOHOL-RELATED HEALTH PROBLEMS

The relationship of chronic alcohol use to the structure and function of the body is reasonably well understood.  Heavy alcohol use causes a variety of changes to the body that lead to an increase in morbidity and mortality.

Research shows that chronic alcohol use also damages the immune system and the nervous system.  Thus chronic users are at high risk for a variety of infections and neurological complications.  Additionally, many alcoholics suffer from malnutrition, in part because they do not consume a variety of foods.  With the deterioration of the liver, stomach, and pancreas, chronic heavy drinkers also have poor absorption and metabolism of many nutrients.

Fetal Alcohol Syndrome and Fetal Alcohol Effects

A growing body scientific evidence indicates that alcohol use by pregnant women can result in birth defects in unborn children.  When alcohol crosses the placenta, it enters the fetal bloodstream in a concentration equal to that in the mother’s bloodstream.  Because of the underdeveloped nature of the fetal liver, this alcohol is oxidized much more slowly than the alcohol in the mother.  During this time of slow detoxification, the developing fetus is certain to be overexposed to the toxic effects of alcohol.  Mental retardation frequently develops.

This exposure has additional disastrous consequences for the developing fetus.  Low birth weight, facial abnormalities (e.g., small head, widely spread eyes), and heart problems are often seen in such infants.  This combination of effects is called fetal alcohol syndrome.  Recent estimates indicate that the full expression of this syndrome occurs at a rate of between 1 and 3 per 1000 births.  Partial expression (fetal alcohol effects [FAE]) can be seen in 3 to 9 per 1000 live births.  In addition, it is likely that many cases of FAE go undetected.

Is there a safe limit to the number of drinks a woman can consume during pregnancy? Since no one can accurately predict the effect of drinking even small amounts of alcohol during pregnancy, the wisest plan is to avoid alcohol altogether.

Because of the critical growth and development that occur during the first months of fetal life, women who have any reason to suspect they are pregnant should stop all alcohol consumption.  Furthermore, women who are planning to become pregnant and women who are not practicing effective contraception must also consider keeping their alcohol use to a minimum.

THE PHYSIOLOGICAL EFFECTS OF ALCOHOL

First and foremost, alcohol is classified as drug – a very strong CNS depressant.  The primary depressant effect of alcohol occurs in the brain and spinal cord.  Many people think of alcohol as a stimulant because of the way most users feel consuming a serving or two of their favorite drink.  Any temporary sensations of jubilation, boldness, or relief are attributable to alcohol’s ability as a depressant drug to release personal inhibitions and provide temporary relief from tension.

Factors That Influence the Absorption of Alcohol

The absorption of alcohol is influenced by several factors, most of which can be controlled by the individual.  These factors include the following:

·         Strength of the beverage.  The stronger the beverage, the greater the amount of alcohol that will accumulate within the digestive tract.

·         Number of drinks consumed.  As more drinks are consumed, more alcohol is absorbed.

·         Speed of consumption.  If consumed rapidly, even relatively few drinks will result in a large concentration gradient that will lead to high blood alcohol concentration.

·         Presence of food.  Food can compete with alcohol for absorption into the bloodstream, slowing the absorption of alcohol.  When alcohol absorption is slowed, the alcohol already in the bloodstream cab be removed.  Slow absorption favors better control of blood alcohol concentration.

·         Body chemistry.  Each person has an individual pattern of physiological functioning that may affect the ability to process alcohol.  For example, in some conditions, such as that marked by “dumping syndrome,” the stomach empties more rapidly than is normal, and alcohol seems to be absorbed more quickly.  The emptying time may be either slowed or quickened by anger, fear, stress, nausea, and the condition of the stomach tissues.

·         Gender.  Women produce much less alcohol dehydrogenase than men do.  This enzyme is responsible for breaking down alcohol in the stomach.  As a result, women absorb about 30% more alcohol into the bloodstream than men, despite an identical number of drinks and equal body weight.

Three other reasons help to explain why women tend to absorb alcohol more quickly than men of the same body weight: (1) women have proportionately more body fat than men.  Since alcohol is not stored easily in fat, it enters the bloodstream relatively quickly. (2) Women’s bodies have proportionately less water than men’s bodies of equal weight.  Thus alcohol consumed does not become as diluted as in men. (3) Alcohol absorption is influenced by a woman’s menstrual cycle.  Alcohol is more quickly absorbed during the premenstrual phase of a woman’s cycle.  Also, there is evidence that women using birth control pills absorb alcohol faster than usual.

With the exception of a person’s body chemistry and gender, all factors that influence absorption can be moderated by the alcohol user.

Blood Alcohol Concentration

A person’s blood alcohol concentration (BAC) rises when alcohol is consumed faster than it can be removed (oxidized) by the liver.  A fairy predictable sequence of events takes place when a person drinks alcohol at a rate faster than one drink every hour.  When the BAC reaches 0.05%, initial measurable changes in mood and behavior take place.  Inhibitions and everyday tensions appear to be released, while judgement and critical thinking are somewhat impaired.  This BAC would be achieved by a 160-pound person consuming about two drinks in an hour.

At a level of 0.10% (one part alcohol to 1000 parts blood), the drinker typically loses significant motor coordination.  Voluntary motor function becomes quite clumsy.  At this BAC, most states consider a drinker legally intoxicated and thus incapable of safely operating a vehicle.  Although physiological changes associated with this BAC do occur, certain users do not feel intoxicated or do not outwardly appear to be impaired.

As the BAC rises from 0.20% to 0.50%, the health risk of acute alcohol intoxication increases rapidly.  A BAC of 0.20% is characterized by the loud, boisterous, obnoxious drunk person who staggers.  A 0.30% BAC produces further depression and stuporous behavior, and the drinker becomes so confused that he or she may not be capable of understanding anything.  The 0.40% or 0.50% BAC produces unconsciousness.  At this level, a person can die, since the brain centers that control body temperature, heartbeat, and breathing may virtually shut down.

An important factor influencing the BAC is the individual’s blood volume.  The larger the person, the greater the amount of blood into which alcohol can be distributed.  Conversely, the smaller person has less blood into which alcohol can be distributed, and as a result, a higher BAC will develop.

Sobering Up

Alcohol is removed from the bloodstream principally through the process of oxidation.  Oxidation occurs at a constant rate (about ¼ to 1/3 ounce of pure alcohol per hour) that cannot be appreciably altered.  Since each typical drink of beer, wine, or distilled spirits contains about ½ ounce of pure alcohol, it takes about 2 hours for the body to fully oxidize one typical alcoholic drink.

Although people may try to sober up by drinking hot coffee, taking cold showers, or exercising, the oxidation rate of alcohol is unaffected by these measures.  Thus far the FDA has not approved any commercial product that can help people achieve sobriety.  Passage of time remains the only effective remedy for diminishing alcohol’s effects.

First Aid for Acute Alcohol Intoxication

Not everyone who goes to sleep, passes out, or becomes unconscious after drinking has a high BAC.  People who are already sleepy, have not eaten well, are sick, or are bored may drink a little alcohol and quickly fall asleep.  However, people who drink heavily in a rather short time may be setting themselves up for an extremely unpleasant, toxic, potentially life-threatening experience because of their high BAC.

Although responsible drinking would prevent acute alcohol intoxication (poisoning), it will never be a reality for everyone.  As a caring adult what would you know about this health emergency that may help you save a life – perhaps even a friend’s life?

The first real danger signs to recognize are the typical signs of shock.  By the time these signs are evident, a drinker will already be unconscious.  He or she will not be able to be aroused from a deep stupor.  The person will probably have a weak, rapid pulse (over 100 beats per minute).  The skin will be cool and dump, and breathing will be increased to once every 3 or 4 seconds.  These breaths may be shallow or deep but will certainly occur in an irregular pattern.  Skin will be pale or bluish.  (in the case of a person with dark skin, these color changes will be more evident in the fingernail beds or in the mucous membranes inside the mouth or under the eyelids.)  whenever any of these signs are present, seek emergency medical help immediately.

Involuntary regurgitation (vomiting) can be another potential life-threatening emergency for a person who has drunk too much alcohol.  When a drunker has consumed more alcohol than the liver can oxidize, the pyloric valve at the base of the stomach tends to close.  Additional alcohol remains in the stomach.  This alcohol irritates the lining of the stomach so much that involuntary muscle contractions force the stomach contents to flow back through the esophagus.  By removing alcohol from the stomach, vomiting may be a life-saving mechanism for conscious drinkers.

An unconscious drinker who vomits may be lying in such a position that the airway becomes obstructed by the vomitus.  This person is at great risk of dying from asphyxiation.  As a first-aid measure, unconscious drinkers should always be rolled onto their sides to minimize the chance of airway obstruction.  If you are with someone who is vomiting, make certain that his or her head is positioned lower than the rest of the body.  This position minimizes the chance that vomitus will obstruct the air passages.

It is also important to keep a close watch on anyone who passes out from heavy drinking.  Party-goers sometimes make a mistake of carrying these people to bed and then forgetting about them.  Monitoring the physical condition of anyone who becomes unconscious from heavy drinking is crucial because of the risk of death.  Observe the person at regular intervals until he or she appears to be clearly out of danger.  This may mean an evening of interrupted sleep for you, but you could save a friend’s life.  Are you aware of any recent alcohol-related death among U.S college students?

THE NATURE OF ALCOHOLIC BEVERAGES

Alcohol (also known as ethyl alcohol or ethanol) is the principle product of fermentation.  In this process, yeast cells act on the sugar content of fruits and grains to produce alcohol and carbon dioxide.

The alcohol concentration in beverages such as whiskey, gin, rum, and vodka is determined through a process called distillation.  These distilled beverages are expressed by the term proof, a number that is twice the percentage of alcohol by volume in a beverage.  Thus 70% of the fluid in a bottle of 140 proof gin is pure alcohol.  Most proofs in distilled beverages range from 80 to 160.  The familiar pure grain alcohol that is often added to fruit punches and similar beverages has a proof of almost 200.

The nutritional value of alcohol is extremely limited.  Alcohol beverages produced today through modern processing methods contain nothing but empty calories about 100 calories per fluid ounce of 100-proof distilled spirits and about 150 calories for each 12-ounce bottle or can of beer.  Clearly, alcohol consumption is significant contributor to the additional pounds that many college students accumulate.  Pure alcohol contains only simple carbohydrates; it has no vitamins and minerals and no fats or protein.

“Lite” beer and low-calorie wines have been introduced in response to concerns about the number of calories that alcoholic beverages provide.  They are not low-alcohol beverages but merely low-calorie beverages.  Only beverages marked “low alcohol” contain a lower concentration of alcohol than the usual beverages of that type.  Recently, manufacturers have introduced a new form of beer called low carbohydrate beer.

The popular new ice beers actually contain a higher percentage of alcohol than other types of beer.  This is due to a production process that chills the fermented mixture sufficiently to allow ice crystals to form.  When the ice crystals are removed, the beer contains a higher percentage of alcohol.

ALCOHOL USE PATTERNS

From magazines to billboards to television, alcohol is one of the most heavily advertised consumer products in the country.  You cannot watch television, listen to the radio, or read a newspaper without being encouraged to buy a particular brand of beer, wine, or liquor.  The advertisements create a warm aura about the nature of alcohol use.  The implications are clear: alcohol use will bring you good times, handsome men or seductive women, exotic settings, and a chance to forget the hassles of hard work and study.

With the many pressures to drink, it’s not surprising that most adults drink alcoholic beverages.  Two-thirds of all American adults are classified as drinkers.  Yet one in three adults does not drink.  In the college environment, where surveys indicate that 85% to 90% of all students drink, it’s difficult fro many students to imagine that every third adult is an abstainer.  Although many college students assume that drinking is a natural part of their social life, others are making alternative choices.

Alcohol consumption figures are reported in many different ways, depending on the researchers’ criteria.  Various sources support the contention that about one-third of adults 18 years of age and older are abstainers, about one-third are light drinkers, and one-third are moderate-to-heavy drinkers.  As single category, heavy drinkers make up about 10% of the adult drinking population.  Students who drink in college tend to classify themselves as light-to-moderate drinkers.  It comes as shock to students, though, when they read the criteria for each drinking classification.

Moderate drinking Refined

Alcohol research and health defines moderate drinking as no more than two drinks each day for most men and one drink each day for women.  A drink is defined as one 12-ounce regular beer, 5 ounce glass of wine, or 1.5 ounce 80 proof distilled spirits.  These cutoff levels are based on the amount of alcohol that can be consumed without causing problems, either for the drinker or society.  (The gender difference is due primarily to the higher percentage of body fat in women and to the lower amount of an essential stomach enzyme in women.)  elderly people are limited to no more than one drink each day, again due to a higher percentage of body fat.

These consumption levels are applicable to most people.  Indeed, people who plan to drive, women who are pregnant, people recovering from alcohol addiction, people under age 21, people taking medications, and those with existing medical concerns should not consume alcohol.  Additionally, although some studies have shown that low levels of alcohol consumption may have minor psychological and cardiovascular benefits, nondrinkers are not advised to start drinking.

Binge Drinking

Alcohol abuse by college students usually takes place through binge drinking.  This practice refers to the consumption of five drinks in a row, at least once during the previous 2-week period.  College students who fit the category of “heavy period” rarely consume small amounts of alcohol each day but instead binge on alcohol 1 or 2 nights a week.  Some students openly admit that they plan to “get really drunk” on the weekend.  They plan to binge drink.

Binge drinking can be dangerous.  Drunk driving, physical violence, property destruction, date rape, police arrest, and lowered academic performance are all closely associated with binge drinking.  The direct correlation between the amount of alcohol consumed and lowered academic performance results in impaired memory, verbal skills deficiencies, and altered perceptions.  Frequently, the social costs for binge drinking are very high, especially when intoxicated people demonstrate their level of immaturity.  How common is binge drinking on your campus?

In response to the personal dangers and campus trauma associated with the binge drinking, colleges and universities are fighting back.  Some colleges are conducting local alcohol education campaigns that feature innovative posters and materials displayed on campus.  In the future, expect to see increasing efforts to reduce binge drinking on your campus to make it a safer environment.

For many students who drink, the college years are a time when they will drink more heavily than at any other time in their life.  Some will suffer serious consequences as a result.  These years will also mark the entry into a lifetime pf problem drinking for some. 

CHOOSING TO DRINK

Clearly, people drink alcoholic beverages for many different reasons.  Most people drink alcohol because it is an effective, affordable, and legal substance for altering the brain’s chemistry.  As inhibitions are removed by the influence of alcohol, behavior that is generally held in check is expressed.  At least temporarily, drinkers become a different version of themselves more outgoing, relaxed, and adventuresome.

TAKING CONTROL OF ALCOHOL USE

The push for zero tolerance laws, the tightening of standards for determining legal intoxication, and the growing influence of national groups concerned with alcohol misuse show that our society is more sensitive than ever to the growing misuse of alcohol.

People are concerned about the consequences of drunk driving, alcohol-related crime, and lowered job productivity.  National data indicate that per capital alcohol consumption has gradually dropped in the United States since the early 1980s.  alcohol use remains the preferred form of drug use for most adults (including college students), but as a society, we are increasingly uncomfortable with the ease with which alcohol can be misused.