Have you ever wondered: Whether you,
drink too much? Whether alcohol is harming you or putting you at risk? How
heavy drinking affects your health? How much is too much?
Drinking alcohol is certainly common in our society. About
two-thirds of American adults have a drink at least occasionally, while the
other one-third don't drink at all. Of those who do drink, the vast majority
use alcohol very moderately, and will never have serious problems with it. For
them, alcohol beverages are simply that; beverages to be enjoyed now and
then as part of a meal or a social occasion. '
Yet it is important to remember that alcohol is also a drug, and a
potentially dangerous one. People who use it beyond moderate levels have a much
greater risk for a wide variety of illnesses and problems. Overdrinking results
in up to 200,000 deaths each year in the United States alone --- about 550
every day -and many more people than that are ill or injured because of their
drinking.
Drinking is such a serious health problem in our country, in part, because many
people who drink too much don't think of themselves as problem drinkers, or
even heavy drinkers. They see themselves as normal, moderate drinkers. Although
they may realize that their drinking has negative consequences now and then,
they also enjoy drinking, and aren't sure they need to make a change. Heavy
drinking can seem quite normal if one has friends who drink just as much, or
even more.
This booklet explains some of the risks associated with heavy drinking, based
on current scientific knowledge. Of course no one person will experience all,
or even most of the risks and problems discussed here. Some are relatively
rare, while others happen to many people who drink too much.
The point is that it is important to know about alcohol, just as a
doctor or pharmacist informs you about the effects of drugs that are
prescribed. When you know the facts, you can make better choices. What you
decide to do with this information, of course, is up to you.
How much is too much? It is difficult to say exactly. Studies
suggest that people who have no more than 1 or 2 drinks per day have no higher
risk in general than non-drinkers. ("One drink" here means a 10-ounce
glass of beer, or a 4-ounce glass of wine, or one ounce of 100 proof
spirits.) Only 8% of American adults (and only 4% of women) average 3 drinks or
more per day, and those who do so suffer many more diseases, injuries, and problems
than do light drinkers or nondrinkers.
Surprisingly few Americans are aware of the risks of heavier drinking.
Most know that drunk driving is dangerous, and that alcoholics may get liver
disease. Yet few really understand how many areas of life and health can be
harmed by alcohol, and how quickly and easily this can happen. Over time, heavy
drinking can damage one's relationships, job, intelligence, and emotional and
physical health. Often the damage is gradual, occurring slowly over a period of
years, so that one may not even notice that it is happening. Other kinds of
alcohol-related damage and problems happen suddenly.
What kinds of problems can happen because of overdrinking? Health risks will be
considered first; then social and psychological risks will be discussed.
Heart and
Fitness
Is alcohol good for the heart? Although light drinkers (no more than 1-2 drinks
per day) seem to be at least as healthy as absfainers, heavier drinkers can do
serious damage to their health and fitness. Alcohol weakens heart muscle,
decreasing cardiovascular fitness, and heavy drinkers have much higher risk of
heart disease. Heavy drinking also increases blood pressure, and can contribute
to hypertension. The electrical control patterns of the heart can be disrupted
by an episode of heavy drinking, which can cause the heart to race or skip
beats, even in young people with no previous history of heart disease.
The Brain and Nervous System
The human brain is sometimes the first organ to be damaged by heavy drinking.
Alcohol kills nerve cells, and many heavy-drinkers show evidence of brain
damage. (f this process continues for a period of years, the brain literally
shrinks in size, due to the destruction of so many brain cells. Such shrinkage
can be observed (by special X-rays known as a "CAT scan") in about
half of people in treatment for alcohol problems.
It is not surprising, then, that heavy drinkers also show significant decreases
in their mental abilities. Alcohol damages the ability to learn and remember
new material, to think abstractly, and to adjust flexibly to changes. One
recent study found a strong relationship between amount of drinking and grades
in college students: the more they drank, the lower their grade point average.
After years of heavy drinking, a disease known as Wernicke-Korsakoff syndrome
can occur, permanently damaging the person's ability to remember things from
one day to the next. The damaging effects of alcohol have been likened to a
premature aging of the brain. The mental abilities of a 30-year-old heavy
drinker may resemble those I
of an 80-year-old nondrinker.
Nerve cells
outside the brain are also damaged by heavy drinking. Usually the first effects
are experienced in the legs and feet, or arms and hands. The signs include
muscle weakness, pain, tingling, or numbness. These result from
"peripheral neuropathy," the dying off of nerve channels that serve
the legs and arms.
The good news is that the nervous system,' including the brain, can repair
itself to some extent if a heavy drinker stops drinking. Although once dead,
brain cells are not replaced, the brain has a remarkable ability to make new
connections, and former drinkers often show significant improvement in their
mental abilities during their first year or so without alcohol.
The Digestive System
Alcohol can irritate-and damage the sensitive tissue of the digestive system.
Perhaps the most direct experience of this is to take a drink of straight liquor.
It burns - all the way down. It irritates the lining of the lips, mouth,
throat and stomach. Alcohol also releases digestive acid in the stomach, which
adds to the irritating effect of the alcohol itself. Heavy drinkers experience
higher rates of gastritis, ulcers, and bleeding of the digestive system.
Pancreatitis, an extremely painful and sometimes fatal inflammation of the
pancreas, also occurs at higher rates in heavy drinkers.
Cancers of the digestive system are much more common in heavy drinkers - some
occurring at more than 40 times the normal rate. Heavy drinkers account for a
majority of head and neck cancers: those in the mouth, tongue, throat, and
esophagus.
Because alcohol contains a high level of empty calories -- those with no
nutritional value - heavy drinkers also tend not to eat properly. They may
drink up to half of their daily calories. This can result in both weight gain
and nutritional deficits. To make matters worse, alcohol prevents the body from
fully absorbing and using even those vitamins and other nutrients that are
available.
The Liver
The liver is the body's main defense against poisons and impurities in the
blood, It is also important in manufacturing energy for the whole body,
including the brain, muscles, and heart. Because alcohol is a toxic chemical,
it is the liver's job to remove it from the bloodstream. When alcohol is
present, the liver gives priority to getting rid of it, and in the process does
not perform some of its normal work, such as getting rid of fats and body waste
products.
As a result, heavy drinkers tend to pile up fat in the liver and bloodstream.
The liver itself becomes fatty and enlarges, contributing to the "beer
belly" appearance.
This condition is reversible, but if the heavy drinking continues a different
kind of damage occurs. Liver cells begin to die off, and are replaced by
scar tissue. The beginnings of this irreversible process can be seen long
before it reaches the disease stage known as cirrhosis. As living liver tissue
is replaced by scars, the liver is less and less able to produce energy and
filter impurities (including alcohol) from the bloodstream.
The
Immune System
Alcohol decreases the body's
ability to fight off diseases and infections. The immune system --- the body's
defense -- works less efficiently whenever a person drinks, and over a period
of heavy drinking the body's defenses can be greatly weakened. As a result, the
person becomes more vulnerable to infections, cancers, and other illnesses. The
risk of cancers in general among heavy drinkers is twice that of other people.
Sores and injuries tend to heal more slowly, and it becomes harder to shake off
sickness.
The
Reproductive System
Alcohol has clear negative
effects on the reproductive system. In men, drinking decreases the body
level of testosterone, the primary male hormone, If a man drinks heavily
for a period of time, this loss of testosterone can result in a
"feminization" of his body---the loss of body hair, enlargement of
fatty tissue in the breasts, and a shrinking of the testicles. Heavy drinking
can also contribute to sexual problems such as impotence.
In women, heavy drinking has been linked to increased rates of sexual,
menstrual and other gynecological problems. Alcohol also changes sex hormone
balances in women, and can promote a loss of feminine body characteristics.
Heavy drinking during pregnancy has been clearly linked to increased rates of
miscarriage and stillbirth, and to birth defects, behavior problems, and mental
retardation of children exposed to alcohol in the womb. Alcohol consumed by a
pregnant woman directly affects the fetus, and there is no known safe level of
drinking during pregnancy.
Summary
In short, once alcohol is
consumed, it is rapidly distributed throughout the body, where it affects
virtually every organ system. There are no proven beneficial health effects of
drinking, but there are many proven harmful effects of heavy drinking. Many of
these damaging effects can be reversed, at feast partly, when a heavy drinker
stops drinking. In general, the longer the period of heavy drinking, the less
reversible the damage, but quitting usually results in improved health and
fitness, even after many years of excess.
The damaging physical
effects of heavy drinking are only part of the picture. Heavy drinkers are
also at risk for many other kinds of problems.
Risk-Taking and Accidents
Alcohol-related accidents and violence are the leading cause of death
among Americans under the age of Howcan this be? There are several reasons. First, as many
people know, drinking makes a person less in control. Alcohol, even at levels
well under the "legal limit" can cause dangerous changes in a
person's ability to react, to control muscles, and to perceive the world
accurately.
These changes are made all the more dangerous by something else that happens
when a person drinks. Among the first things to be changed by alcohol is a
person's judgment. Experienced race drivers, for example, become much
poorer drivers after even a few drinks, but may actually perceive themselves to
be better drivers under the influence of alcohol. In short, a person
cannot tell how much he or she is being affected. You can't judge when your
judgment is affected!
These judgment changes, in turn, often make a person overconfident, and more
likely to take foolish risks. After a few drinks, people are less able to make
good decisions, and are more likely to do things they would never do while
sober. Sometimes the result is only embarrassment, but other times it is much
more serious. A majority of people in prison, for example, committed their
crimes while under the influence of alcohol. When drinking, people are more
likely to misjudge others as threatening or challenging them, and to react
impulsively, aggressively, even violently. Other misjudgments can be disastrous
as well. Tens of thousands of deaths and hundreds of thousands of injuries
happen each year because people drink before driving vehicles, using power
tools or firearms, or engaging in fun but hazardous sports such as swimming,
boating, or skiing - activities where even a small misjudgment can be very
dangerous.
Mood
Drinking also affects mood. After one or two drinks, some people feel happier,
more relaxed, less tense and anxious. Interestingly, these same changes happen
when people believe they are drinking alcohol, even if they are not. Alcohol
itself is a depressant drug, and its effects, in heavier doses at least,
are to turn good feelings bad, and to make bad feelings worse. After several
drinks, mood tends to take a turn for the worse. It is around this same point,
however, that alcohol also affects memory, so people tend not to remember the
depressing
effects of drinking - only the seemingly positive effects of the first drink or
two.
Among heavy drinkers, depression is common. There are many possible reasons for
this. Yet when heavy drinkers get treatment and quit, usually their depression
goes away after a few weeks. Alcohol is not a stimulant or an upper. It is a
downer.
Relationships
Heavy drinking can damage close relationships. "You always hurt the one
you love" seems to be especially true for people who drink too much. Heavy
drinkers have, on average, more problems in their marriages and other relationships,
and. higher rates of separation and divorce, One's ability to be a good parent
can also be harmed by overdrinking, resulting in family problems. Child abuse
and neglect are more common among heavy drinking parents.
Problems and Coping
One reason why heavy drinkers' relationships may get into trouble is that the
person begins to drink alcohol as a solution to problems, as a way of trying to
cope. Drinking takes the place of talking and working out difficulties in other
ways. It can be a tempting trap. Alcohol dulls memory, and makes the problems
seem to go away -- at least for the time being.
Yet while people are drinking to ease cares and worries, the troubles aren't
really going away. In fact, they often get worse, because the drinker makes
little or no attempt to find better ways to handle things. It's just easier to
let things go, to take a break, to forget. So things begin to fall apart --
sometimes a little at a time, sometimes in bigger shocks - and it happens in
different ways for different people:
· Friends pull back or drift away
· Problems start showing up on the job or
at school: coming in late, missing days, not working up to your abilities,
making more mistakes, missing opportunities, having, accidents, putting off
responsibilities
· Tension builds up in the family: more
complaints, problems, and arguments, less fun and closeness
· Health and fitness begin to be affected
'
-'Money problems increase: too much is
spent on alcohol, and on paying for problems or poor decisions related to
drinking
Because alcohol can make it hard to see what is really happening, heavy
drinkers often feel misunderstood, unfairly treated, harassed, or just unlucky.
And as things pet worse. the temptation is - to drink.
Many
people drink alcohol moderately without ever experiencing significant
problems. Why is it that some people have trouble with alcohol while others I
do not?
Part of the answer, of course, lies in how much a person drinks. The more,
one drinks, the greater the risk of suffering the negative health,
psychological and
social consequences. Yet that is not the whole picture. Certain people have a
greater risk than others. Here are a few factors that have been shown to increase
a person's danger for overdrinking and running into significant problems with
alcohol:
· Having a family history of relatives with alcohol or other drug problems
· Drinking to get drunk
· Being able to "hold your liquor"-seeming to be less affected by
alcohol than
most people
· Having one or more memory "blackouts" due to drinking
· Drinking to relieve bad feelings or to escape from problems
· Thinking of alcohol as a positive life influence, which helps
people be more r
friendly, happy, relaxed, successful, etc.
· Using other drugs which, when combined with alcohol, increase the effects
and dangers of drinking E.
Probably most of the things mentioned
earlier have not happened to you. Even heavier drinkers can sometimes go for
many years without piling up too many of these problems. Yet maybe you do see
yourself in some of these descriptions, or perhaps you see what might happen to
you if your drinking continues as it is.
Is it time for you to make a change? That is your choice. In fact, no one else
can decide about your drinking, or change your drinking for you, not even if
they want to. To be sure, other people may be able to help quite a bit if you
let them, but still in the end it's your decision.
If
you want to change your drinking, there are many ways to do it. Some people
just decide, and go ahead. Others find that it's easier with some help from
friends, professionals, or other people who have been through it. There's no
one approach that is best for all. The truth is that there are many different
ways, and you keep trying until you find what works for you. If one approach
isn't working, try something else. There are books, self-help groups, skilled
counselors and psychologists and physicians, spiritual approaches, medications,
clinics, and hospitals. Theres no one magic answer far everybody, but there are
many helpful people and approaches to try.
And in the long run, the chances for change are very good. If you do try to
change your drinking and you're like most people, you may not succeed the very
first time. It is common to have some setbacks, and it can be tough to make an
important change in your life. One try may not do it. Or two, or five. Yet each
try brings you closer to getting free, to succeeding in change. Studies show
that most people who have problems with alcohol do get better in the long run.
For those who decide to do something about their drinking, there is
hope.
Prepared for Project MATCH by
The Center on
Alcoholism, Substance Abuse, and Addictions (CASAA)
The University Of New
Mexico, Albuquerque, NM 8131
