Alcohol use is prevalent in our society. Alcohol can legally be consumed if over the age of 21. Alcohol is a chemical that acts like a drug to cause both short term and long term effects on the consumer. Although alcohol can be consumed safely I frequently see the unwanted consequences of alcohol use both in the Emergency Department and the clinic.
Alcohol accumulates in the blood stream after it is consumed. It generally is absorbed rapidly and remains in the system for hours. Alcohol causes some sedation and tends to help people unwind or “loosen up.”
Excessive consumption will cause toxic effects on several organ systems. The most noticeable is the effects on the brain causing unsteadiness, sleepiness, slurring of words, changes in behavior, and even loss of consciousness or “passing out.” The effects on the brain can affect judgment such that an intoxicated person is more likely to engage in risky activities or do things that they would not do sober. The kidneys lose the ability to concentrate urine so the kidneys start putting out excessive amounts of urine, causing frequent urination and dehydration. The dehydration is what is thought to contribute to the symptoms of a hangover the next day. The liver, stomach, and pancreas are directly poisoned by alcohol and this can cause acute abdominal pain.
How much alcohol is too much? The law defines it as a blood alcohol level of 0.08%. How much alcohol needs to be consumed to reach that level will vary depending on gender, size, how quickly the alcohol is consumed, and how frequently an individual consumes alcohol. Generally it is recommended that men limit consumption at any one time to two drinks and women to one drink. A drink is considered a 12-ounce beer, five ounces of wine, or 1.5 ounces (generally one shot) of 80 proof liquor. Any alcohol when pregnant is too much. Another measure of alcohol overuse would be more than eight drinks per week for a woman or more than 15 drinks per week for a man.
Alcohol use is reported to be responsible for 88,000 deaths a year including direct deaths and accidents. Deaths can happen after using alcohol one time associated with a fatal accident or overdose related to rapid consumption. Some alcohol related falls can be fatal. Alcohol can cause death due to long term use and the toxic effects on the liver leading to cirrhosis. Long term use also affects the brain and nerves leading to dementia and neuropathy. High blood pressure and heart failure are reported to be associated with long term alcohol use. Also long term use is reported to increase the risk of certain cancers.
Alcoholism refers to the dependence that can develop leading the alcoholic to continue to use alcohol despite the declining health, damaged relationships and inability to work effectively. Alcoholism is considered a disease. It is a terrible disease that destroys individuals, families, and careers. However, an individual does not have to be an alcoholic to have complications related to alcohol over use. Signs that alcohol may be a problem include feeling alcohol is necessary to have a good time, needing a drink to get going, drinking alone, or not being able to go more than a few days without a drink.
I often point out that alcohol is not an essential nutrient. Our body does not need alcohol to survive. Yet it is part of our culture. If alcohol is used, do it safely and responsibly to stay healthy my friends.
By: P. Michael Shattuck, M.D. – Community Health Network Family Physician
