Alcoholism Health Article

Definition

Alcoholism is the popular term for alcohol abuse and alcohol dependence. The hallmarks of both of these disorders involve repeated life problems that can be directly tied to a person's abuse of alcohol. Alcoholism has serious consequences, affecting an individual's health and personal life, as well as having a negative impact on society at large. Alcoholism is the use of alcohol in any harmful way.

Description

The effects of alcoholism are quite far reaching. Alcohol affects every body system, causing a wide range of health problems. Such problems include poor nutrition, memory disorders, difficulty with balance and walking, liver disease (including cirrhosis and hepatitis), high blood pressure, weakness of muscles (including the heart), disturbances of heart rhythm, anemia, clotting disorders, weak immunity to infections, inflammation and irritation along the entire gastrointestinal system, acute and chronic problems with the pancreas, low blood sugar, high blood fat content, interference with reproductive fertility, and weak bones.

On a personal level, alcohol can be responsible for marital and other relationship difficulties, depression, unemployment, child abuse, and general family dysfunction.

Alcoholism causes or contributes to a variety of severe social problems: homelessness, murder, suicide, injury, and violent crime. Alcohol is a contributing factor in 50% of all deaths due to motor vehicle accidents. In fact, more than 100,000 deaths occur each year due to the effects of alcohol, of which 50% are due to injuries of some sort. In the United States, the annual economic cost of alcoholism and alcohol abuse is estimated at more than $160 billion.

Causes and symptoms

There are probably a number of factors that work together to cause a person to become an alcoholic. Genetic studies have demonstrated that close relatives of an alcoholic are more likely to become alcoholics themselves. This risk appears to hold true even for the child adopted away from his or her biological family at birth and raised in a non-alcoholic adoptive family—with no knowledge of the biological family's difficulties with alcohol. More research is being conducted to determine whether genetic factors can account for differences in alcohol metabolism, thereby increasing the risk of an individual becoming an alcoholic—or whether the involvement of genetics is less direct, perhaps producing personality traits that render people susceptible to alcoholism. Many investigators believe that environmental factors, such as availability and acceptance of alcohol, peer pressure, or stressful lifestyle are at least as important as genetic factors. At the time of this writing in early 2001, researchers were seeking the location of specific genes that affect susceptibility to alcoholism.

The symptoms of alcoholism can be broken down into two major categories, symptoms of acute alcohol abuse and symptoms of long-term alcohol abuse.

Immediate (acute) effects of alcohol abuse

Alcohol exerts a depressive effect on the brain. The blood-brain barrier does not prevent alcohol from entering the brain, so the brain-alcohol level will quickly become equivalent to the blood-alcohol level. Alcohol's depressive effects result in difficulty walking, poor balance, slurred speech, and generally poor coordination(i.e., accounting, in part, for the increased likelihood of injury). At higher alcohol levels, a person's breathing and heart rates will be slowed, and vomiting may occur, with a high risk of the vomit being inspired (breathed) into the lungs; this can result pneumonia, or in choking and death (especially if the person is unconscious). Extremely high blood alcohol levels may result in coma and death.

Effects of long-term (chronic) alcoholism

Long-term abuse of alcohol affects virtually every organ system of the body:

• Nervous system. An estimated 30-40% of all men in their teens and twenties have experienced alcoholic blackouts, which occur when drinking a large quantity of alcohol. This can also result in loss of memory of the time surrounding the episode of drinking. Alcohol is well known to cause sleep disturbances, so that overall sleep quality is affected. Numbness and tingling may occur in the arms and legs. Two syndromes, which can occur together or separately, are known as Wernicke's and Korsakoff's syndromes. Both are due to the low thiamin levels found in the blood of alcoholics. Wernicke's syndrome results in disordered eye movements, very poor balance and difficulty walking; Korsakoff's syndrome severely affects memory, preventing new learning from taking place.
• Gastrointestinal system. Alcohol causes loosening of the muscular ring that prevents the stomach's contents from re-entering the esophagus. Therefore, the acid from the stomach can flow backwards into the esophagus, thereby burning those tissues and causing pain and bleeding. Inflammation of the stomach can also result in bleeding and pain, and decrease the appetite. A major cause of severe, uncontrollable bleeding (hemorrhage) in an alcoholic is the development of enlarged (dilated) blood vessels within the esophagus, called esophageal varices. These varices are actually developed in response to liver disease, and are extremely prone to bursting and hemorrhaging. Diarrhea is also a common affect of alcohol abuse due to alcohol's effect on the pancreas. Another condition, inflammation of the pancreas (pancreatitis) can be a serious and painful consequence of alcoholism. Throughout the intestinal tract, alcohol interferes with the absorption of nutrients, creating a malnourished state. Alcohol is broken down (metabolized) in the liver, which is profoundly affected by consistently high alcohol levels. Alcohol interferes with a number of important chemical processes that also occur in the liver. As a result, the liver begins to enlarge and fill with fat (i.e., fatty liver), fibrous scar tissue interferes with the liver's normal structure and function (cirrhosis), and the liver may become inflamed (hepatitis).
• Blood alcohol can cause changes to all types of blood cells. Red blood cells become abnormally large. The number of white blood cells (WBCs) (important for fighting infections) decreases, resulting in a weakened immune system. This places alcoholics at increased risk for infections; it is thought to account, in part, for the increased risk of cancer in alcoholics (i.e., ten times the normal risk). Platelets and blood clotting factors are negatively affected, causing an increased risk of hemorrhage.
• Heart. Small amounts of alcohol can cause a drop in blood pressure. With increased use, however, alcohol begins to move blood pressure into a dangerously high range. High levels of fats circulating in the bloodstream increase the risk of heart disease. Heavy drinking results in an increase in heart size, weakening of the heart muscle, abnormal heart rhythms, and risk of the formation of blood clots within the chambers of the heart. These factors greatly increase the risk of stroke, which can occur if a blood clot from the heart enters the circulatory system, goes to the brain, and blocks one of its blood vessels.
• Reproductive system. Heavy drinking has a negative effect on fertility in both men and women. It decreases testicle and ovary size, thereby interfering with both sperm and egg production. When an alcoholic woman becomes pregnant, she assumes the great risk of giving birth to a baby who has fetal alcohol syndrome. This causes distinctive facial defects, lowered IQ, and behavioral problems.