Alcohol use: Weighing risks and benefits
A person who can consume large quantities of alcohol without exhibiting the "normal" effects may have developed a tolerance to alcohol. Tolerance comes from chronic use of alcohol that results in physical and mental adaptation to its presence in the body. The development of tolerance is shown by an increase in alcohol needed to produce the desired effects and can indicate the onset of physical dependence.
Being able to have a few drinks without feeling any effects may seem like a good thing, but it’s a myth. If an individual needs to drink increasing amounts of alcohol to feel an effect, it could be an indication that he/she might have an underlying problem associated with alcohol.
Alcohol has no nutritional value. It holds no vitamins, minerals, or proteins. However, it does have a significant number of calories. The calories can produce an immediate source of energy which causes food that is normally used for energy production to be changed into fat and stored in the body for later use. Types of Nutrient Deficiency Caused by Heavy Drinking and the Associated Signs and Symptoms
Selected Nutrient Deficiency Signs/Symptoms
Magnesium Insulin resistance, muscle cramps
Selenium Myopathy, cardiomyopathy
Vitamin B1/Thiamine Wernicke-Korsakoff syndrome, neurologic symptoms
Vitamin B2/Riboflavin Glossitis, cheilitis, and lingual papillae atrophy
Vitamin A/Retinol Abnormal dark adaptation, rough skin
Vitamin C Scurvy with purpura and petechiae
Vitamin D Altered bone metabolism, altered gut barrier/immune function
Vitamin E Oxidative stress
Niacin Skin photosensitivity, confusion, pellagra
Folate, S-Adenosylmethionine Anemia, altered methylation, epigenetic effects
Alcohol gives you a false sense of warmth. The direct action of alcohol causes a drop in the internal body temperature by the following process.
When you drink, your blood vessels dilate, sending more blood to your skin. The blood vessels are opened (dilated) on the skin surfaces and the blood is cooled by greater exposure to the outer environment. As the cooled blood circulates, the core temperature is lowered gradually, but significantly. This process is continued as long as alcohol is present in the body.
It makes you feel warmer, but you’re losing your body heat to the outside environment faster. You’re turning on your radiator to send your heat out into the environment. You might feel warm, but it creates a dangerous situation.
While it may help prevent frostbite in your fingers, sending blood to your skin takes it away from your core, heart, vital organs, and brain. As a result, your body temperature drops. This is particularly dangerous if you have heart problems.
Alcohol produces both stimulant and sedating effects in humans. Although subjective sedative and stimulatory effects can be measured, it is not entirely clear if all motor, cognitive and behavioral effects can be unambiguously assigned to either one or the other category. Increased heart rate and aggression seem strongly associated with stimulation, but motor slowing and cognitive impairment can also show a similar time course to stimulation, making their relation to sedation problematic.
There is good agreement that alcohol’s ability to induce striatal dopamine release is the mechanism underlying alcohol’s stimulatory effects; however, the change in brain function underlying sedation is less well understood.
In general, stimulatory effects are thought to be more rewarding than sedative effects, but this may not be true for anxiolytic effects which seem more closely related to sedation than stimulation. The two major theories of how the response to alcohol predicts risk for alcoholism both postulate that individuals at high risk for alcohol use disorders have a reduced sedative response to alcohol compared to individuals not at high risk. In addition, one theory proposes that alcoholism risk is also associated with a larger stimulatory response to alcohol.
Alcohol hangover (AH) is described as an array of negative physical and mental symptoms that develop after a single episode of heavy alcohol consumption when the blood alcohol concentration (BAC) is nearing 0.00%. AH typically follows alcohol consumed to an equivalent BAC of ≥0.11%, although recent research indicates that it can also occur after relatively low doses. Common AH symptoms include headache, thirst, and nausea, as well as sleep-related complaints such as fatigue and drowsiness which are often rated as the most severe. Several studies have also found AH-induced impairments in cognitive functions including attention, memory, psychomotor speed, and executive functioning
Many physiological mechanisms contribute to the presence of AH symptoms. These include, but are not limited to, dehydration, hormonal imbalances, oxidative stress, and inflammation. Biological factors such as age, as well as beverage congeners, which are toxic substances in alcoholic beverages other than ethanol (e.g., methanol), can also contribute to the severity of AH symptoms. Another potential contributor to AH severity is the effects of alcohol intoxication on sleep architecture. Consuming alcohol before bed can have a negative influence on sleep by altering biological sleep rhythms. Specifically, at high concentrations, alcohol has sedative properties and is often still being metabolized at sleep onset.
Hangovers are caused by the amount of alcohol consumed and the rate at which it is consumed, not by the kind of alcohol consumed. While metabolizing alcohol, the liver cannot perform its normal functions, one of which is keeping the blood sugar at a normal concentration. The result of this state is called hypoglycemia, or lower than normal blood sugar. Lastly, a hangover is a "mini-withdrawal." When the central nervous system is released from the depressed state, the opposite state develops-feeling edgy and irritable. This effect is known as "rebound."
Alcoholics are of many kinds: those who drink daily; those who drink on weekends; those who drink on binges that could occur weeks, months, or even years apart. The measure of alcoholism is not when or how often one drinks, but whether one can control the drinking once it begins.
Drinking in Moderation:
According to the "Dietary Guidelines for Americans 2020-2025,” U.S. Department of Health and Human Services and U.S. Department of Agriculture, adults of legal drinking age can choose not to drink or to drink in moderation by limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women when alcohol is consumed. Drinking less is better for your health than drinking more.
• NIAAA defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 percent - or 0.08 grams of alcohol per deciliter - or higher. This pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours for a typical adult.
• The Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual National Survey on Drug Use and Health (NSDUH), defines binge drinking as 5 or more alcoholic drinks for males or 4 or more alcoholic drinks for females on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past month.
Heavy Alcohol Use: NIAAA defines heavy drinking as follows:
• For men, consuming more than 4 drinks on any day or more than 14 drinks per week
• For women, consuming more than 3 drinks on any day or more than 7 drinks per week
• SAMHSA defines heavy alcohol use as binge drinking on 5 or more days in the past month.
Patterns of Drinking Associated with Alcohol Use Disorder: Binge drinking and heavy alcohol use can increase an individual's risk of alcohol use disorder.
Certain people should avoid alcohol completely, including those who:
• Plan to drive or operate machinery, or participate in activities that require skill, coordination, and alertness
• Take certain over-the-counter or prescription medications
• Have certain medical conditions
• Are recovering from alcohol use disorder or are unable to control the amount that they drink
• Are younger than age 21
• Are pregnant or may become pregnant
For some people, alcohol is a regular or occasional drink enjoyed on social occasions that causes no apparent harm. However, even moderate alcohol use carries some risks. Some study depicts the association between alcohol and breast cancer even at low doses. Few data claim that alcohol consumption in large quantities can damage the developing fetus before a woman even knows she is pregnant and can lead to addiction and dependence in any individual.
When drunk regularly over time and/or in a pattern of heavy single drinking sessions, alcohol can cause a variety of health conditions. These include cancers and other conditions such as alcoholic liver disease, which can range from reversible to permanent liver damage due to alcohol. The risks of alcohol-related cancers and other health conditions caused by alcohol are greatest in those dependent on alcohol or who drink heavily. The risks increase with the average amount of alcohol drunk.
Black coffee and cold showers only produce wide-awake drunks. Only time will rid the body of alcohol. There is no known way of speeding the metabolic process of eliminating alcohol from the body.
If you are drunk, nothing will help make you sober except time. Your body needs time to break down the alcohol in your system. The caffeine in coffee may help you stay awake. However, it will not improve your coordination or decision-making skills. These can be impaired for several hours after you stop drinking. This is why it is never safe to drive after you have been drinking, no matter how many cups of coffee you have.
Many people with alcohol problems cannot tell when their drinking is out of control. It is important to be aware of how much you are drinking. You should also know how your alcohol use may affect your life and those around you.
One drink equals one 12-ounce (oz), or 355 milliliters (mL), can or bottle of beer, one 5-ounce (148 mL) glass of wine, 1 wine cooler, 1 cocktail, or 1 shot of hard liquor. You must question yourself/ friends about:
• How often do you have an alcoholic drink?
• How many drinks do you have when you do drink?
• How any drinking you are doing affects your life or the lives of others
• Responsible Drinking
Healthy men up to age 65 should limit themselves to:
• No more than 4 drinks in 1 day
• No more than 14 drinks in a week
Healthy women up to age 65 should limit themselves to:
• No more than 3 drinks in 1 day
• No more than 7 drinks in a week
Healthy women of all ages and healthy men over age 65 should limit themselves to:
• No more than 3 drinks in 1 day
• No more than 7 drinks in a week
Knowing When you Have a Drinking Problem:- You may have a drinking problem if you have at least 2 of the following characteristics:
• There are times when you drink more or longer than you planned to.
• You have not been able to cut down or stop drinking on your own, even though you have tried or you want to.
• You spend a lot of time drinking, being sick from drinking or getting over the effects of drinking.
• Your urge to drink is so strong, that you cannot think about anything else.
• As a result of drinking, you do not do what you are expected to do at home, work, or school. Or, you keep getting sick because of drinking.
• You continue to drink, even though alcohol is causing problems with your family or friends.
• You spend less time on or no longer take part in activities that used to be important or that you enjoyed. Instead, you use that time to drink.
• Your drinking has led to situations in that you or someone else could have been injured, such as driving while drunk or having unsafe sex.
• Your drinking makes you anxious, depressed, forgetful or causes other health problems, but you keep drinking.
• You need to drink more than you did to get the same effect from alcohol. Or the number of drinks you are used to having now has less effect than before.
• When the effects of alcohol wear off, you have symptoms of withdrawal. These include tremors, sweating, nausea, or insomnia. You may even have had a seizure or hallucinations (sensing things that are not there).
People with long-term (chronic) pain sometimes use alcohol to help manage pain. There are several reasons why this may not be a good choice.
• Alcohol and pain relievers do not mix. Drinking while taking pain relievers may increase your risk of liver problems, stomach bleeding, or other problems.
• It increases your risk for alcohol problems. Most people need to drink more than a moderate amount to relieve pain. Also, as you develop a tolerance for alcohol, you will need to drink more to get the same pain relief. Drinking at that level increases your risk for alcohol problems.
• Long-term (chronic) alcohol use can increase pain. If you have withdrawal symptoms from alcohol, you may feel more sensitive to pain. Also, heavy drinking can cause a certain type of nerve pain over a long time.
Alcohol is a toxic and psychoactive substance with dependence-producing properties. In many of today’s societies, alcoholic beverages are a routine part of the social landscape for many of the population. This is particularly true for those in social environments with high visibility and societal influence, nationally and internationally, where alcohol frequently accompanies socializing. In this context, it is easy to overlook or discount the health and social damage caused or contributed to by drinking. World Health organization’s recent report depicts alcohol consumption contributes to 3 million deaths each year globally as well as to the disabilities and poor health of millions of people. Overall, the harmful use of alcohol is responsible for 5.1% of the global burden of disease. Harmful use of alcohol is accountable for 7.1% and 2.2% of the global burden of disease for males and females respectively. Alcohol is the leading risk factor for premature mortality and disability among those aged 15 to 49 years, accounting for 10 percent of all deaths in this age group. Disadvantaged and especially vulnerable populations have higher rates of alcohol-related death and hospitalization.
Dr. Dangs lab offers a variety of laboratory tests available to assist in the diagnosis of hazardous alcohol consumption and related disorders. Don’t guess. Visit www.drdangslab.com/
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Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion.