Drug abuse and addiction / Category / Emile Du Toit / May 5th 2014
Alcoholism is an addiction just like any other. It is a disease that involves a reduction in ability to stop drinking after the first drink.
Alcohol consumption causes a number of physiological and behavioural problems. Even low doses of alcohol can significantly impair the judgment and coordination required to drive a car safely. Low to moderate doses of alcohol can increase the incidence of a variety of aggressive acts, including spouse and child abuse. In moderate to high doses alcohol ingestion cam cause marked impairments in higher mental functions, severely altering a person’s ability to learn and remember information. Very high doses cause respiratory problems and death.
Continued use of alcohol can lead to physiological dependence on the substance. Sudden cessation of alcohol intake is likely to produce withdrawal symptoms, including severe anxiety, tremors, hallucinations and convulsions. In fact, an alcoholic who has been imbibing significant quantities of alcohol and suddenly stops can experience seizures and indeed die!
Long-term effects of consuming large quantities of alcohol, especially when combined with poor nutrition, can lead to permanent damage to vital organs such as the brain and liver. In addition, mothers who drink alcohol during pregnancy may give birth to infants with foetal alcohol syndrome. These infants may suffer from mental retardation and other irreversible physical abnormalities. Research also indicates that children of alcoholic parents are at greater risk than other children of becoming alcoholics.
Short-term effects of alcohol consumption can include:
Long-term effects of alcohol use can include damage to the following:
Alcoholics often eat poorly, limiting their supply of essential nutrients and affecting both energy supply and structure maintenance. Furthermore, alcohol interferes with the nutritional process by affecting digestion, storage, utilisation and excretion of nutrients.
Once ingested, food must be digested (broken down into small components) so it is available for energy and maintenance of body structure and function. Digestion begins in the mouth and continues in the stomach and intestines, with help from the pancreas. The nutrients from digested food are absorbed from the intestines into the blood and carried to the liver. The liver prepares nutrients either for immediate use or for storage and future use.
Alcohol inhibits the breakdown of nutrients into usable molecules by decreasing secretion of digestive enzymes from the pancreas. Alcohol impairs nutrient absorption by damaging the cells lining the stomach and intestines and disabling transport of some nutrients into the blood. In addition, nutritional deficiencies themselves may lead to further absorption problems. For example folate deficiency alters the cells lining the small intestine, which in turn impairs absorption of water and nutrients like glucose, sodium, and additional folate.
Even if nutrients are digested and absorbed, alcohol can prevent them from being fully utilised by altering their transport, storage and excretion. Decreased liver stores of vitamins such as vitamin A, and increased excretion of nutrients such as fat, indicate impaired utilisation of nutrients by alcoholics.
The three basic nutritional components found in food – carbohydrates, proteins and fats – are used as energy after being converted to simpler products. Some alcoholics ingest as much as 50 percent of their total daily calories from alcohol, often neglecting important foods. Even when food intake is adequate, alcohol can impair the mechanisms by which the body controls blood-glucose levels, resulting in either increased or decreased blood glucose.
In non-diabetic alcoholics, increased blood sugar, or hyperglycemia – caused by impaired insulin secretion – is usually temporary and without consequence. Decreased blood sugar, or hypoglycemia, can cause serious injury even if this condition is short lived. Hypoglycemia can occur when a fasting or malnourished person consumes alcohol. When there is no food to supply energy, stored sugar is depleted, and the products of alcohol metabolism inhibit the formation of glucose from other compounds such as amino acids. As a result, alcohol causes the brain and other body tissue to be deprived of glucose needed for energy and function.
Although alcohol is an energy source, how the body processes and uses the energy from alcohol is more complex than can be explained by a simple calorie-conversion value. For example, alcohol provides an average of 20 percent of the calories in the diet of the upper third of drinking Americans, and we might expect many drinkers who consume such amounts to be obese. Instead, national data indicate that, despite higher caloric intake, heavy drinkers are no more obese than non-drinkers. Equally, when alcohol is substituted for carbohydrates, calorie for calorie, subjects tend to lose weight. This indicates that they derive less energy from alcohol than from food.
The mechanisms accounting for the apparent inefficiency in converting alcohol to energy are complex and incompletely understood, but several mechanisms have been proposed. For example, chronic drinking triggers an inefficient system of alcohol metabolism, the microsomal ethanol-oxidising system (MEOS). Much of the energy from MEOS-driven alcohol metabolism is lost as heat rather than used to supply the body with energy.
Because cells are made mostly of protein a diet with enough protein in it is important for maintaining cell structure, especially if cells are being damaged. Alcohol affects protein nutrition by causing impaired digestion of proteins to amino acids, impaired processing of amino acids by the small intestine and liver, impaired synthesis of proteins from amino acids, and impaired protein secretion by the liver.
Nutrients are essential for proper body function; proteins, vitamins, and minerals provide the tools that the body needs to perform properly. Alcohol can disrupt body function by causing nutrient deficiencies and by usurping the machinery needed to metabolise nutrients.
Vitamins are essential to maintaining growth and normal metabolism because they regulate many physiological processes. Chronic heavy drinking is associated with deficiencies in many vitamins because of decreased food ingestion and, in some cases, impaired absorption, metabolism and utilisation.
As an example of this, alcohol inhibits fat absorption and thereby impairs absorption of the vitamins A, E, and D, which are normally absorbed along with dietary fats. Vitamin A deficiency can be associated with night blindness, and vitamin D deficiency is associated with softening of the bones.
Vitamins A, C, D, E, K, and the B vitamins can all be deficient in some alcoholics, and yet these vitamins are vitally involved in wound healing and cell maintenance. In particular, because vitamin K is necessary for blood clotting, deficiencies of that vitamin can cause delayed clotting and result in excess bleeding. Deficiencies of other vitamins involved in brain function can cause severe neurological damage.
Deficiencies of minerals such as calcium, magnesium, iron and zinc are common in alcoholics, although alcohol itself doe s not seem to affect the absorption of these minerals. These deficiencies can cause a variety of medical consequences from calcium-related bone disease to zinc-related night blindness and skin lesions.
Mineral deficiencies appear to occur secondary to other alcohol-related problems:
Here are some statistics from the USA that will give you an idea of the serious impact of alcohol on America: One-quarter of all emergency-room admissions, one-third of all suicides, and more than half of all homicides and incidents of domestic violence are alcohol-related.
Research shows conclusively that successful prevention and treatment of alcohol abuse leads to reductions in traffic fatalities, crime, unwanted pregnancy, child abuse, HIV, cancer and heart disease. Treatment reduces drug use, improves health, improves job performance, reduces involvement with the criminal justice system, reduces family dysfunction and improves quality of life.
The Comprehensive Assessment Treatment Outcomes Registry Data in Ohio in the USA has documented dramatic results in productivity after treatment for alcohol abuse:
Additionally, a California study found that after treatment health care costs reduced significantly:
Evidence demonstrates that treatment for alcohol and other drug abuse works. Treatment not only saves lives, it also saves money that could otherwise be spent in other areas of medical care and social services. In the USA for every dollar spent on addiction treatment seven dollars is saved in reduced health-care costs.
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