Drug Abuse: Alcohol

I would like to start with this: ALCOHOL IS A PSYCHOACTIVE DRUG. It’s often considered a harmless social beverage with some dependency cases, while in reality it a highly addictive psychoactive social drug.

Alcohol has been around since before 8000 BC. Since then we’ve developed all kinds of types of alcohol, such as APA beer, whiskey, gin, Jaegermeister, and more. Whichever is your preferable way of getting wasted, I can guarantee it’s bad for you. See a list of different beverages below.

To understand how much alcohol is consumed in the USA, we can look at the picture below “A Tale of 10 Beers and 10 People”. If we take 10 people to represent the entire US population and give them 10 bottles of beer this is how it would be distributed. 3 people would not drink any, that’s 30% of the population. 5 people would share 2 beers, representing that 50% of the population that drink 20% of the total alcohol supply. Then the ninth person has 2 beers, meaning 10% of the population that drinks 20% of the total supply. So we are left with one person, 10%, who drinks 60% of the entire alcohol supply. The numbers are pretty shocking, especially that 10% which is most likely already dependent on alcohol.

So then, what happens when alcohol enters our bodies?

The fact that alcohol is so easily absorbed by the gastrointestinal tract is due its small molecular structure in liquid form. It’s moderately soluble in fat and highly soluble in water. About 20% is absorbed directly into the bloodstream by the stomach, and 80% from the upper portion of the small intestine. Once it enters the stomach, alcohol acts as an irritant, increasing the flow of hydrochloric acid and small pepsin, chemicals that aid digestion. The higher the percentage of alcohol is in a beverage the faster it will work. If the alcoholic beverage is carbonated, such as champagne, the stomach will empty its contents faster and effects will be felt sooner. The more you drink, the drunker you get, the faster you drink, the drunker you get. But it also depends on the size of the consumer, the larger the body the longer it takes for the effect to take place.

The body recognizes alcohol as a visitor with no biological purpose. It has calories but no vitamins, minerals, or other components that have any nutritional value. Thus the body is just trying to break it down to remove it through a process called oxidation. This process consists of two steps. First, an enzyme, alcohol dehydrogenase, breaks down alcohol into acetaldehyde. Second, another enzyme, acetaldehyde dehydrogenase, breaks down acetaldehyde in the liver into acetic acid. Then further oxidation results in oxygen, carbon dioxide, and calories of energy.

Contrary to popular belief, alcohol doesn’t make you fat. It does though, reduce the breakdown of fat, so dietary fat has a higher chance of being stored rather than expended. Thus a person who consumes alcohol with a healthy diet doesn’t gain fat, only a bad diet will induce a “beer belly”.

The reason alcohol is often viewed as a stimulant instead of a depressant is due to the chemical effects in the brain. Alcohol first releases the cerebral cortex from its inhibitory control over subcortical systems in the brain. This means that alcohol is depressing an area of the brain that normally would be an inhibitor, thus leaving the illusion of stimulation. Impairment in judgment and thinking comes from loosening of social inhibitions that allow us to be civil and well behaved.

Physiological Effects:

  • Toxic Reactions – Very often people get toxic reactions to large amounts of alcohol. Luckily our bodies developed two ways to protect us to a certain degree. First, since alcohol is a gastric irritant we often end up vomiting. Second, we might simply pass out due to over-intoxication. Of course the danger still persists, since if one throws up while unconscious they might end up blocking their airways.
  • Heat Loss – Don’t believe when someone tells you that drinking helps your body get warm. What happens in reality is that alcohol acts as a peripheral dilator, meaning that blood vessels near the skin surface enlarge leading to redness and warmth. Studies show that men and women have high heat loss after consumption of alcohol, so if you are stranded in the mountains and a St. Bernard runs to you with whiskey don’t drink it, instead hug the puppy.
  • Diuretic Effects – As alcohol concentration rises in blood, antidiuretic hormone, a hormone which starts to reabsorb water in the kidneys prior to elimination in the urine, starts to get affected. Thus urine becomes more dilute, and more urine is released. But when concentrations levels peak, the opposite starts to occur. Water is now retained in a condition called antidiuresis, which results in swollen fingers, hands, and feet. The more salty food you eat with your alcohol, the more pronounced this effect is.
  • Cardiovascular Effects – Constant consumption of alcohol, which could be binge drinking or alcoholism, raises chances of a heart attack. If binge drinking lasts for more than two days, the likelihood of cardiac arrhythmia rises owing to the lowered threshold for ventricular fibrillation and the scarring of heart muscle.
  • Effects on Sleep – Drinking before sleep is the worst idea, even though it could seem harmless. Alcohol reduced the duration of sleep called rapid eye movement, which results in nightmares and poor sleep quality.
  • Effects on Pregnancy – The risks of retardation greatly increase if the mother consumes alcohol during pregnancy. In short, if the mother takes a drink, so does the fetus. Characteristics of children of alcoholic women are referred to as fetal alcoholic syndrome. A newborn with a FAS could have a post-natal growth retardation where its weight and length is below the 10th percentile, CNS abnormalities or mental retardation, a characteristic skull and facial appearance with a smaller than normal head, small wide-set eyes, drooping eyelids, a flattening of the vertical groove between the mouth and the nose, a thin upper lip, and a short upturned nose. The incidence of FAS is approximately 0.5 to 3 cases per thousand live births in the USA.
  • Interactions With Other Drugs – Combining alcohol with other drugs already sounds like a bad idea, but it’s a pretty common practice. Prescribed medications are never to be taken with alcohol. But what’s more common is to take opiates and opiate-like drugs, like marijuana, which results in a combination of the two effects, sometimes even greater than the sum of the parts. Meaning you will be high and drunk at the same time, or even worse.
  • Hangovers – Headache, nausea, fatigue, thirst. Sounds familiar? Does it sound like a regular Sunday morning? Then, my friend, you have experienced a hangover. About four to twelve hours after alcohol consumption we tend to feel these symptoms, even though it’s not fully clear why. Of course it depends on the type of alcohol, but depending on the amount of congeners in the liquor, your symptoms might be more or less severe. Headache and thirst usually persist due to dehydration from last night, nausea is due to the stomach feeling poisoned from the night before, and well fatigue is due to your organism taking a hit.

Behavioral Effects:

  • The obvious ones – exhilaration and excitement, talkativeness, slurred speech, and irritability.
  • Blackouts – Have you ever had a gap in your memory from the night before? Well that’s a blackout. The faster you drink, the higher the chance of a blackout.
  • Driving Skills – There’s no question that alcohol consumption significantly impairs the ability to drive or deal with traffic. You don’t need to be over the state identified BAC levels for it to cause impairment in driving, even a small amount of alcohol could get in the way. DO NOT DRINK AND DRIVE UNDER ANY CIRCUMSTANCES.
  • Aggression and Violence – Disinhibition theory holds that alcohol impairs normal cortical mechanisms responsible for inhibiting the expression of innate or suppressed aggressive inclinations. Cognitive-expectation theory teaches that violence is induced by virtue of the act of drinking combined with the person’s expectation to how he’s supposed to respond to being drunk.
  • Sexual Desire – to quote Macbeth, alcohol “provokes the desire, but it takes away from the performance.” This is true for both men and women, who might have very high sexual desires due to intoxication, but can’t perform physically.

There are some health benefits to drinking alcohol, though. But they’re very small compared to the dangers of alcohol. One plus is that it increases the high-density lipoprotein cholesterol (aka the good cholesterol) levels in the blood, which acts as protective mechanism against possible restriction of blood flow through arteries. Moderate alcohol intake also reduces the risk of diabetes mellitus, reduces the risk of stroke, and reduces the risk of dementia.

It’s impossible to cut out alcohol from our lives. The perfect example would be the period of the prohibition. It has become such a normal part of our lives that the society probably won’t be able to live without it.

It’s important though, to know what alcohol does to you, and to always drink responsibly. As long as you drink in moderation, you should be fine! Stay hydrated, don’t drink and drive, and drink for the sake of fun. Enjoy!


Graphs and Citations:

Levinthal, Charles F. Drugs, Society, and Criminal Justice. Pearson, 2016.

U.S. Department of Health and Human Services (1994). Alcohol and Health. Betherda, MD: National Institute on Alcohol Abuse and Alcoholism.

Shakespeare, William, et al. Macbeth. Noble and Noble, 1965.

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