Alcoholism is a serious, chronic (can be curbed or regulated but cannot be cured), potentially fatal condition in which a person has an uncontrollable urge to drink alcoholic beverages. Alcoholism can be seen in both the rich and the poor, the young and the old, and males and females. It is estimated that 75 percent of alcoholics are male and 25 percent are female.
Biological, psychological, social, and cultural factors all seem to play a role in the development of alcoholism. Children with a biological parent who is an alcoholic are more likely to become alcoholics than are children who do not have an alcoholic parent. Peer pressure, the social acceptability of drinking, and a desire to escape from emotional stress and anxiety can all set the stage for a person's descent into alcohol addiction.
Alcohol is a depressant that acts as a numbing agent on the central nervous system. Some adults can drink alcohol-containing beverages in moderate amounts without experiencing significant side effects. The ability to tolerate alcohol differs from person to person. Alcohol affects women more easily because women lack a stomach enzyme present in men that breaks down some of the alcohol before it reaches the intestines. Thus, if a man and a woman both drink a glass of wine, more alcohol will enter the woman's bloodstream than the man's.
Alcohol affects every cell in the body, especially those of the liver, heart, and brain. Excessive use can lead to permanent brain damage, heart disease, and cirrhosis (hardening; destruction) of the liver. Alcohol provides calories but no nourishment to the body. It also robs the body of vitamins and minerals necessary to maintain proper cell function.
When alcohol is ingested, it is absorbed from the intestines directly into the bloodstream, where it is carried to all organs of the body. Most of the alcohol consumed is passed to the liver, which detoxifies the alcohol by first converting it to a chemical called acetaldehyde (pronounced a-suh-TAL-duh-hide). Acetaldehyde is then changed to acetic acid, which is converted to carbon dioxide and water or to fat, according to the body's energy needs. If alcohol is consumed faster than the liver can process it, a sufficient amount is carried by the blood to the brain, affecting mental functioning.
In alcoholics, the conversion of acetaldehyde to acetic acid is slow to occur because of impaired liver function from previous alcohol abuse. Acetaldehyde thus accumulates in other organs of the body, causing symptoms such as staggering gait, shaking hands, blinding headaches, and hallucinations. High levels of acetaldehyde can result in pain, which can be eased temporarily by further drinking.
The stages of alcoholism. In the first stage of alcoholism, a person may drink heavily and remain functional. Withdrawal symptoms are absent other than the standard hangover that follows excessive drinking. The body's cells adapt to large quantities of alcohol and use the energy it provides to continue functioning. However, alcohol eventually begins to attack cell structures, erode cell membranes, and alter cellular chemical balances. Fatty deposits accumulate in the liver cells, causing the "fatty liver" common in heavy drinkers.
Alcohol withdrawal delirium: The set of physical and psychological symptoms that occur when alcohol intake is stopped suddenly following excessive use.
Cirrhosis: A chronic disease of the liver in which scar tissue replaces normal cells, impairing blood flow.
Detoxify: To remove a poison or toxin from the body.
Metabolism: The physical and chemical processes that produce and maintain a living organism, including the breakdown of substances to provide energy for the organism.
No definite signpost marks the border between the early and middle stages of alcoholism, and the change may take years. Eventually, however, the alcoholic drinks to counteract the symptoms of alcoholism, not to get high or to be able to function better. Deterioration of cells in all parts of the body produce symptoms such as severe headaches, trembling, chills, and nausea when the level of alcohol in the blood falls.
As cellular metabolism becomes more and more dependent upon alcohol, an alcohol-dependent person shows signs of alcohol withdrawal delirium when intake is stopped abruptly. He may experience loss of appetite and uncontrollable bodily shaking, become frightened and shrink into a corner, or become dangerous as he lashes out to protect himself from an imaginary attack. The person may also manipulate his hands as if playing a game of cards, throwing dice, or whittling. These symptoms require immediate medical attention as they can be precursors to a heart attack, stroke, or respiratory failure.
Fetal alcohol syndrome (FAS) is a group of birth defects found in some children whose mothers drank alcohol during pregnancy. Since a fetus or unborn baby receives its nourishment directly from the blood stream of its mother, alcohol easily enters the fetus's body. The level of alcohol in a fetus's blood is the same as that of its mother's within just a few short minutes after the mother has begun drinking.
The effects of FAS range from mild to severe, depending on the amount and frequency of alcohol consumed by a mother during her pregnancy. The weight and height of newborns suffering from FAS is lower than average. They also have physical disabilities such as low muscle tone, a smaller than normal skull, and irregularities of the face including small eye sockets. After infancy, children suffering from FAS display nervous system disorders such as hyperactivity, learning deficiencies, temper tantrums, short attention span, inability to concentrate, and seizures.
FAS results in more babies being born mentally retarded than any other known factor. Yet it is completely preventable if a pregnant mother stops drinking alcohol during her entire pregnancy.
In the final stage of alcoholism, the cellular demand for alcohol is so great that the alcoholic must drink constantly to avoid his painful symptoms. The heart, pancreas, digestive, respiratory, and nervous systems all show characteristic changes. The liver suffers the most extensive damage. About 10 percent of persons in this stage die from liver failure as a result of cirrhosis, a disease in which scar tissue forms in the liver and affects its ability to function properly. Perhaps a third die from accidents such as falling down stairs or drowning, or by committing suicide.
There is no cure for alcoholism. Treatment consists of total avoidance of alcohol. Therapeutic programs lasting about four weeks are recommended to support the patient through withdrawal, medically treat physical problems brought on by alcohol abuse, and educate the patient about his condition and the need to abstain from alcohol. Individual, group, and family therapy are also usually included in the recovery process. To discourage alcoholics from drinking, they are sometimes given medication that causes a severe, unpleasant reaction if mixed with alcohol.
Continued support through participation in a group such as Alcoholics Anonymous can help the alcoholic adjust to life without alcohol. Many will need this type of support for the rest of their lives. An alcoholic has about a 50 percent chance of successful recovery from addiction.