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What's addictive?.

Alcohol

Alcohol is often not thought of as a drug - largely because its use is common for both religious and social purposes in most parts of the world. It is an addictive drug, however, and compulsive drinking in excess has become one of modern society's most serious problems.

Beverage alcohol (scientifically known as ethyl alcohol, or ethanol) is produced by fermenting or distilling various fruits, vegetables, or grains. Ethyl alcohol itself is a clear, colorless liquid. Alcoholic beverages get their distinctive colors from the diluents, additives, and by-products of fermentation.

Beer is fermented to contain about 5% alcohol by volume (or 3.5% in light beer). Most wine is fermented to have between 10% and 14% alcohol content; however, such fortified wines as sherry, port, and vermouth contain between 14% and 20%. Distilled spirits (whisky, vodka, rum, gin) are first fermented, then distilled to raise the alcohol content. The concentration of alcohol in spirits is 40% by volume. Some liqueurs may be stronger.

The effects of drinking do not depend on the type of alcoholic beverage - but rather on the amount of alcohol consumed on a specific occasion.

How Alcohol Works

Alcohol- is rapidly absorbed into the bloodstream from the small intestine, and less rapidly from the stomach and colon. In proportion to its concentration in the bloodstream, alcohol decreases activity in parts of the brain and spinal cord. The drinker's blood alcohol concentration depends on: Once the alcohol has passed into the blood, however, no food or beverage can retard or interfere with its effects. Fruit sugar, however, in some cases can shorten the duration of alcohol's effect by speeding up its elimination from the blood.

In the average adult, the rate of metabolism is about 8.5 g of alcohol per hour (i.e. about two-thirds of a regular beer or about 30 mL of spirits an hour). This rate can vary dramatically among individuals, however, depending on such diverse factors as usual amount of drinking, physique, sex, liver size, and genetic factors.

Effects

The effects of any drug depend on several factors:
  • the amount taken at one time
  • the user's past drug experience
  • the manner in which the drug is taken
  • the circumstances under which the drug is taken (the place, the user's psychological and emotional stability, the presence of other people, the concurrent use of other drugs, etc.).

    It is the amount of alcohol in the blood that causes the effects. In the following table, the left-hand column lists the number of milligrams of alcohol in each decilitre of blood - that is, the blood alcohol concentration, or BAC. (For example, an average person may get a blood alcohol concentration of 50 mg/dL after two drinks consumed quickly.) The right-hand column describes the usual effects of these amounts on normal people - those who haven't developed a tolerance to alcohol.

    BAC (ma/dL)    Effect

    50
    Mild intoxication; Feeling of warmth, skin flushed; impaired judgment; decreased inhibitions
    100
    Obvious intoxication in most people; Increased impairment of judgment, inhibition, attention, and control; Some impairment of muscular performance; slowing of reflexes
    150
    Obvious intoxication in all normal people; Staggering gait and other muscular incoordination; slurred speech; double vision; memory and comprehension loss
    250
    Extreme intoxication or stupor; Reduced response to stimuli; inability to stand; vomiting; incontinence; sleepiness
    350
    Coma; Unconsciousness; little response to stimuli; incontinence; low body temperature; poor respiration; fall in blood pressure; clammy skin
    500
    Death likely

    Drinking heavily over a short period of time usually results in a "hangover" - headache, nausea, shakiness, and sometimes vomiting, beginning from 8 to 12 hours later. A hangover is due partly to poisoning by alcohol and other components of the drink, and partly to the body's reaction to withdrawal from alcohol. Although there are dozens of home remedies suggested for hangovers, there is currently no known effective cure.

    Combining alcohol with other drugs can make the effects of these other drugs much stronger and more dangerous. Many accidental deaths have occurred after people have used alcohol combined with other drugs.

    Long-term effects of alcohol appear after repeated use over a period of many months or years. The negative physical and psychological effects of chronic abuse are numerous; some are potentially life-threatening.

    Some of these harmful consequences are primary - that is, they result directly from prolonged exposure to alcohol's toxic effects (such as heart and liver disease or inflammation of the stomach).

    Others are secondary; indirectly related to chronic alcohol abuse, they include loss of appetite, vitamin deficiencies, infections, and sexual impotence or menstrual irregularities. The risk of serious disease increases with the amount of alcohol consumed.

    Early death rates are much higher for heavy drinkers than for light drinkers or abstainers, particularly from heart and liver disease, pneumonia, some types of cancer, acute alcohol poisoning, accident, homicide, and suicide. No precise limits of safe drinking can be recommended.

    Tolerance and Dependence

    People who drink on a regular basis become tolerant to many of the unpleasant effects of alcohol, and thus are able to drink more before suffering these effects. Yet even with increased consumption, many such drinkers don't appear intoxicated. Because they continue to work and socialize reasonably well, their deteriorating physical condition may go unrecognized by others until severe damage develops - or until they are hospitalized for other reasons and suddenly experience alcohol withdrawal symptoms.

    Psychological dependence on alcohol may occur with regular use of even relatively moderate daily amounts. It may also occur in people who consume alcohol only under certain conditions, such as before and during social occasions. This form of dependence refers to a craving for alcohol's psychological effects, although not necessarily in amounts that produce serious intoxication. For psychologically dependent drinkers, the lack of alcohol tends to make them anxious and, in some cases, panicky.

    Physical dependence occurs in consistently heavy drinkers. Since their bodies have adapted to the presence of alcohol, they suffer withdrawal symptoms if they suddenly stop drinking. Withdrawal symptoms range from jumpiness, sleeplessness, sweating, and poor appetite, to tremors (the "shakes"), convulsions. hallucinations. and sometimes death.

    Alcohol and Pregnancy

    Pregnant women who drink risk having babies with fetal alcohol effects (known as fetal alcohol syndrome or FAS). The most serious of these effects include mental retardation, growth deficiency, head and facial deformities, joint and limb abnormalities, and heart defects. While it is known that the risk of bearing an FAS-afflicted child increases with the amount of alcohol consumed, a safe level of consumption has not been determined.

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    Copyright (c) 1971 Revised January 1991 Alcoholism and Drug Addiction Research Foundation, Toronto Canada
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