Drug Abuse - Alcohol
- Statistics: Alcohol is the oldest and most widely used psychoactive drug and is legal in most countries. About 113 million Americans drank alcohol last month and 12-14 million Americans have a drinking problem.
- History: Grain was cultivated for bread and alcohol about 10,000 years ago. Mead (fermented honey), beer (fermented barley), wine (fermented grapes and fruit), and finally distilled spirits (usually made from grain) were discovered by succeeding generations.
- The Legal Drug: Throughout history, societies have wavered between prohibition, temperance, and unrestricted drinking in their laws and morals regarding alcoholic beverages.
Alcoholic Beverages: Alcohol is fermented from the sugar or other carbohydrates found in grapes and other fruits, vegetables, or grains. Ethyl alcohol (ethanol) is the main psychoactive component in all alcoholic beverages. Beer made from grain is about 5% alcohol, wine made from grapes and other fruits is about 12% alcohol, and distilled liquor made from grains or wines is about 40% alcohol.
Absorption, Distribution, and Metabolism: Though alcohol is absorbed by the body at different ratesdepending on weight, gender, age, and a dozen other factors, it is metabolized at a steady rate, mostly by the liver, and subsequently excreted through urine, sweat, and breath. The higher the blood alcohol concentration (BAC), the more severe the effects. A BAC of .08 to .10 signifies legal intoxication in the United States.
Bacchus, also called "Dionysus," was the ancient Greek god of wine and ecstasy. The worship of Dionysus flourished for a long time in Asia Minor by followers called "Bacchants." Lodges of Bacchus were suppressed throughout Itally in 186 B.C.
Louvre Museum, Paris, Courtesy of Simone Garlaund
Desired Effects, Side Effects, & Health Consequences: For alcohol, as with other drugs, use ranges from abstinence, experimentation, and social/recreational use, to habitual use, abuse, and addiction (alcoholism).
- Low- to Moderate-Dose Episodes: If a person is not at risk (at risk means pregnant, in recovery from addiction, or affected by mental or physical health problems), there are some health benefits from light to moderate alcohol use. In general, sedation, muscle relaxation, and lowered inhibitions accompany low-dose use. The neurotransmitter GABA is most affected by alcohol.
- High-Dose Episodes: A range of effects occurs, from decreased alertness and exaggerated emotions, up to shock, coma, and death. Effects are directly related to the amount, frequency, and duration of use. They also depend on the tolerance to alcohol developed by the user. Blackouts are common.
- Chronic High-Dose Use: Excessive chronic drinking causes tolerance and tissue dependence. Withdrawal symptoms can occur upon cessation of drinking. This type of use does major damage to the brain, liver, stomach, and other body organs.
- Classification: Historically there have been many attempts to classify alcoholism, especially as a disease. Alcohol addiction is caused by a combination of heredity, environment, and drinking alcohol or using psychoactive drugs.
- Long-Term Effects of Addiction (alcoholism): Depending on a drinker's habits and susceptibility, organ damage, particularly liver damage, cardiovascular problems, nutritional deficits, and polydrug use interations can occur. Alcohol addiction also impairs important life processes, e.g., relationships, job, self-worth, and even spiritual beliefs.
- Polydrug Abuse: Alcohol is often abused in connection with other drugs, thus aggravating the problem.
Other Problems: Self-medication for mental problems is common. There are a wide variety of diseases and traumas caused directly or indirectly by alcohol that can kill. Alcohol is also the leading cause of birth defects including fetal alcohol syndrome (FAS). One hundred and thirty thousand deaths from alcohol-related accidents, health problems, suicide, and violence, as well as 25% of hospital visits are due to alcohol.
Epidemiology: Heredity, environment, gender, age, social status, ethnic group, and culture help determine the level of alcohol use (from experimentation to addiction) in an individual.
Assessment: Tests such as the Addiction Severity Index or the Michigan Alcoholism Screening Test are used to determine levels of use, abuse, and addiction.
Conclusion: Since alcoholism can take anywhere from 3 months to 30 years to develop, it is important for drinkers to assess their susceptibility to compulsive use and their present level of use.
External guides and resources for help with alcohol problems: