HEALTH TALK: So you think you can hold your liquor

Those of you with good memories will remember that I have tackled this issue in all its aspects in all of the print and electronic media dating back to 1991. This time around, however, we’ll only deal with some medical issues surrounding alcohol. Matters such as the effect on the family, etcetera are best left to the Social Workers and Psychologists.

If I may, let me begin by telling you a little story, one that I remember as if it were yesterday. Working in the Emergency Room  one night, I was brought a young woman of about twenty. She had had a headache as a result of a blow inflicted on her skull with a piece of board. I ordered a skull X-Ray, which revealed a wide crack at the top of her skull. “But who did this to you?” I asked. “My father,” she replied. “I was running away from him.” “Why was that?”  “He was drunk and wanted to have interference with me.” A cracked skull to a daughter from a father, because of alcohol. Now you know there’s not much good I’m going to say about alcohol.

WHAT IS IT?

The alcohol we focus on is really ethanol or ethyl alcohol, made from fermentation of sugar. Of course there are other types, such as isopropyl alcohol or rubbing alcohol and methyl alcohol which is often produced by amateurs in ethanol’s illegal production, and which is quite poisonous.

WHAT IS ALCOHOLISM?

Alcoholism is a chronic illness of unknown cause with a gradual onset, showing recognizable symptoms and signs according to its severity. So an alcoholic is identified by severe dependence on or addiction to alcohol and a cumulative pattern of behaviors associated with drinking. Note that I mentioned the words ‘illnesses’ and ‘dependence.’
These are important, and we’ll come back to them in a while. By the way, there’s a simple test you can use to determine if a person is alcoholic. It is called ‘the CAGE questions?’ Do you ever feel the need to Cut down on your alcohol consumption? Do you get Annoyed when people complain about your drinking? Do you ever feel Guilty about your drinking?  Do you use alcohol as an Eye opener in the morning? A yes answer to three or four of these questions means there is something like an 85% chance the person is alcoholic. Try it on someone you know.

WHAT CAUSES ALCOHOLISM?

As part of this question, you may also ask, ‘well, everybody drinks alcohol, why do some become alcoholic and some don’t? The best answer we have is that it is thought to be hereditary, that is, can be passed on from parent to child. In fact, a gene for alcoholism has been discovered on chromosome 11. But it has also been noted that persons with certain personality traits are more susceptible. These are for example; (1) schizoid type persons (isolated, lonely, and shy), (2) depressed persons, (3) dependent types, (4) hostile and self- destructive, and (5) sexually immature individuals. To lend some support to the heredity theory, one should note that alcoholism is very prevalent among certain ethnic groups and races. Orientals   are susceptible because they lack a certain enzyme needed to metabolize alcohol; East Indians have a high prevalence relatives to blacks, just check  Trinidad and Guyana; American Indians have a high number of alcoholics; and I believe relative to the rest of the Dominican population, the native Caribs have a huge number.

SO WHY DO PEOPLE DRINK IN THE FIRST PLACE?

Some persons pick up the habit from their parents. Some yield to peer-pressure. Others just want to experiment, just like with any other drug and let me just point out here emphatically, that alcohol is a drug, albeit a legal one. In fact, any substance which has the effect of altering the way the body functions, is a drug. Of course, there are the other reasons we use like drowning our problems, freeing us up, making us more bold and having a good time easier. Why is this last part the case? Alcohol is the great disinhibitor. That is, the things you would normally feel inhibited from doing, alcohol changes that. You feel free. You can converse, you can dance, you can have a good time, and you are no longer timid.

SO WHAT’S SO BAD ABOUT ALCOHOL?

Now we’re getting started. A lot of us think, everybody drinks, what’s the big deal? As I stated earlier, I won’t even touch on the effects on marriage, family, work, kids. Alcohol is absorbed in the blood from the small intestine. It accumulates in the blood because absorption is more rapid than oxidation and elimination. Alcohol is a Central Nervous System depressant. At a certain concentration in your blood it causes sedation and tranquility; with higher concentrations come lack of co-ordination; higher, intoxication; higher still, unconsciousness then comes coma and death. There’s a common misconception that if you stick to beer or stout, you’re O.K., because they are mild. THIS IS NOT SO. One beer or stout is the equivalent of a shoot of the hard stuff or a mixed drink. All along this continuum, from lack of co- ordination to coma, we know the things that happen; the car accidents, the falls, which by themselves can lead to subdural haematomas (clots on your brain), and death.

Alcohol induces tolerance, that is you will need more and more of it to achieve the desired effect. Today, you’re disinhibited by one beer, next week it’s three, and before long you’re a bona fide alcoholic. The person who drinks the most without seemingly getting drunk is the true alcoholic. So you brag that you can hold your liquor better than the other guy, you are the alcoholic.

Alcohol induces physical dependence and psychological dependence. When you have drunk alcohol for a long time, or a large amount for a short time and just stop abruptly, you experience withdrawal symptoms 12 to 48 hours later. This includes anything from tremors to seeing snakes on the wall to getting a couple of short fits. Sometimes it gets worse and can be life-threatening. This is because you’re physically dependent, addicted, can’t do without it. It also induces psychological dependence, which means that the drug is so central to one’s being and functioning that there is always a craving for it. Can’t do without it. In these cases, you’ve lost control, and so you are said to have an illness. This does not absolve you of responsibility for all that may occur from your drinking, there is only mitigation. You need help.

WHAT DOES IT DO TO MY PHYSICAL BODY?

Brain damage is well known. This is obvious, I would think, and this can include dementia. Heart disease, because of the direct effect of alcohol and because of the deficiency of vitamin B1 it causes.This deficiency also leads to nerve damage in your limbs. Alcohol causes gastritis and pancreatitis (inflammation of the pancreas) and may even cause cancers of the gastro- intestinal tract. Its major adverse effect is on the liver which it eventually destroys. Because the liver is so vital in so many ways, a man may get large breasts; anyone can get bleeding and blood vessel problems. A man’s sperm count is reduced. His sexual desire may be increased but his performance will definitely be decreased. As an aside, can you believe people can be so ill, so addicted, that even on their dying bed with cirrhosis of the liver, they will reach for the bottle of Alcolado on their night stand their relatives brought them?
Alcoholics are more susceptible to suicide, don’t forget? Depression is very common among them.

WHAT’S GOOD ABOUT IT?

It is claimed that a little Brandy now and then is a good thing. I don’t know of studies that back this up, so I won’t advocate it. Studies have shown that an ingredient in red wine is beneficial to the heart, but there are other things which do this job, and since I don’t know who might become alcoholic by starting to drink, I’d rather recommend a good diet, exercise and cholesterol control.

HOW TO GET HELP?

ADMIT THERE’S A PROBLEM. Attend Alcoholics Anonymous. Get counseling. Get motivated to take drugs. Pray.

See you next week.