Alcohol - When the fun stops
This is a long piece, but well worth the read...hang in there!
Alcohol has a long history; in fact, we can trace it back roughly 12000 years. It has been used in religious rituals and ideology for centuries; The Romans and the Greeks both had gods of wine! (Bacchus and Dionysus). For much of ancient history, alcohol was actually safer to drink than the water!
Of course not everyone has a history with alcohol. In Islamic and Buddhist cultures, alcohol is forbidden and in the 19th Century, the Temperance movement in Christian countries is what created the term teetotaller. In fact, even as recently as 2004, 4 billion abstainers worldwide outnumbered drinkers 2-1.
So why, now, do we find ourselves, especially in the UK, with such a dysfunctional relationship with something that has been a part of us for so long?
Well, we don’t drink it for safety; our water and the purification processes we have access to completely eliminate that need to drink alcohol. We don’t drink it to be cost effective, even though some supermarket special offers can end up charging less per unit than a litre of water. We drink because:
We find it fun
We find it relaxing and freeing
It’s part of the British culture
Its part of our family/friends/sports group culture
It's a way to escape; ourselves, our lives, our emotions, our stress.
It's a way we can be ourselves rather than what we think we have
Far too often though, it gets out of hand. I would challenge anyone to find a reason we drink that is beneficial. You see many of the reasons we drink that we listed are signs of much greater danger. If you are drinking to be yourself or to be able to relax and have fun, even to sleep or dance or connect meaningfully, there are much more important emotional issues to be addressed. In fact, if you ever pick up a drink because you NEED it.... run away from the bottle and toward someone who can help you.
You can find much more about emotional support in my other materials but for now I want to focus sharply on the intense physical impact alcohol has on our bodies and our minds. If you have read anything of mine, you will know that I believe information to be transformative; sometimes all we need is a better understanding to make a permanent change in ourselves. You see, where we feel a thrill of losing inhibitions, we are actually experiencing the death of brain cells. When we feel a warm, relaxing sensation, our body is actually becoming numb to stimuli.
Alcohol affects our health in 3 main ways:
It has a direct affect on our organs and tissues. It can damage the liver, the pancreas, our gastrointestinal system (that's the stomach and intestines), the cardiovascular system (our hearts) and our nervous system (our brains and our ability move and function).
It has multiple indirect affects:
Impairment of physical coordination
Impairment of consciousness
Impairment of cognition
Impairment of perception
Behaviour that leads to accidents or injury
3. It can create a severe state of dependence when a person loses control over their drinking; we know it
as being an alcoholic, nowadays called alcohol use disorder (AUD).
Did you know that there are 25 chronic diseases and conditions that are directly related to alcohol consumption and over 200 more associated with it? We have all heard of cirrhosis of the liver. The conditions are so wide ranging, you wouldn’t believe just alcohol could affect you in so many ways; from mental and behavioural disorders to heart disease, diabetes and cancers. It even accounted for almost 6% of all deaths on the planet in 2012 (WHO, 2012).
You may have heard that moderate alcohol consumption can be beneficial to us; this is true, but in order for us to get the benefits, we have to understand what moderate is. A massive factor in alcohol abuse and binge drinking is understanding; understanding what a unit is and how that amount relates to our health. When we don’t understand units, we can’t possibly understand how much we drink. Then, we vastly underestimate how much we drink.
Our guidelines say that drinking anymore than 60g of pure alcohol on one single occasion in a month, is a heavy drinking episode...binge drinking. Now bear in mind, just one of these heavy drinking episodes eradicates any positive effect moderate drinking has on us. So how much is 60g of pure alcohol?
I will spare you the maths involved and simply tell you this:
Binge drinking = 60g of pure alcohol = 7.6 units
A bottle of wine with 12% volume is:
o 9 units
o 71.1g of pure alcohol
A 175ml glass of wine is:
o 2 units
o 16.59g of pure alcohol
A pint of strong cider or lager (Strongbow, Stella Artois) is:
o 3 units
23.7g of pure alcohol
An alcopop is:
o 1.5 units
o 11.85g of pure alcohol
A double measure in a pub is:
o 2 units o 16.59g of pure alcohol
Are you shocked? Have you had a realisation? Binge drinking isn’t just when you get obliterated at the weekend or a wedding: When you think you have had maybe 10 drinks, but actually you’ve likely had around 30 or 40 units. Binge drinking is around 3⁄4 of a bottle of wine, 2.5 Stella’s or 5 alcopops. You could be binge drinking 4 times a week or every night and until now you had no idea. The 60g limit for binge drinking is set for a reason; health reasons. Here is the unpleasant part; understanding what your drinking is doing to your health.
First off, your pattern of drinking is more harmful than your amount. What this means is that if you spread 8 units out over a week or even a whole day, it is significantly less damaging to your health than if you drink 8 units in one short sitting. Similarly, you do less damage when you drink with food. There are some other generic factors that will affect the damage alcohol consumption does to us as individuals also:
Age: Children and older people are more vulnerable to alcohol related harm o Theearlieryoustartdrinking,themorelikelyyouaretodevelopalcoholrelatedissuesandhealth
problems; 4 times more likely to become an alcoholic. Isn’t that shocking! o Older people are less able to cope with the effects of alcohol and therefore more likely to suffer
an injury from an accident
Gender: It’s not sexist, it’s fact...women are more vulnerable due to body size and body fat (it’s just
science). o Men are more likely to suffer from alcohol related disease, and women from alcohol related
Family: Families who have a drinking culture pass that culture to their children
o Families who don’t drink are more likely to have children who drink in moderation
Socio-economic status: Interestingly the lower the status, the more likely to suffer from alcohol related
ill heath o Higher economic status tends to binge drink less
Personality: People who are more impulsive, neurotic or prone to high stress levels are more likely to self medicate with alcohol
Religion: Those with religious beliefs are less likely to drink. Obviously, some religions do not allow drinking at all.
Do you fit any of those factors? Now you understand how much you are drinking and whether or not you were more likely to drink in the first place, it’s time to understand what alcohol does in the body.
What we generically call alcohol, in its pure, consumable form, is ethanol. One of ethanol’s chemical properties, is that it is water soluble; That’s how we make a gin and tonic! What this means is that ethanol molecules (little bits of ethanol), dissolve in water. Our blood has a lot of water in it. Ethanol reaches the stomach, gets taken up from the gut and dissolves into the blood and body fluids and carried all over the body. Ethanol carried in our blood affects each organ as it passes through.
The first landing place for ethanol is the gut. Drinking with food reduces the negative impact of ethanol because it keeps the ethanol in the stomach for longer. This is important for two reasons:
1. The stomach isn’t very good at absorbing the molecules; they are absorbed slowly in the stomach and much more readily in the intestine. This means the ethanol takes longer to get into the blood.
2. There is a ‘flap’ in the stomach called the pyloric sphincter, that stops undigested food going straight into the intestine. When we eat, the pyloric sphincter is closed, keeping the stomach contents in the stomach. When we drink on an empty stomach, the pyloric sphincter is open allowing ethanol straight into the intestines and on into the blood rapidly.
As the gut is ethanol’s first stop, it is also the first place to feel the negative effects, which only get worse as we drink more.
Ethanol irritates the stomach and intestinal lining causing swelling and
Increases acid production and secretions causing abdominal pain, nausea and vomiting
Next we hit the liver.
The liver is always the first stop for harmful substances so they can be processed before going into general circulation, minimising damaging affects on other vital organs and tissues, like the brain. 90% of ethanol is converted into other chemicals in the liver and so it is most susceptible to damage from ethanol. The way the liver converts ethanol is complicated, but really all you need to know are the stages.
Stage 1: Ethanol converts to acetaldehyde Stage 2: Acetaldehyde becomes acetic acid Stage 3: Acetic acid becomes carbon dioxide and water
Acetaldehyde is more toxic than ethanol. When it builds up in the bloodstream, you get common drinking symptoms like vomiting, headache, rapid heartbeat and flushing. People have different types of the enzymes that convert ethanol to acetaldehyde, some quick and some slower. The faster you convert it, the faster you make acetaldehyde, the faster you feel very unwell.
Other common symptoms of drinking that come from ethanol’s affect on the liver are fatigue, weakness and mood disturbance. Ethanol messes with the balance of chemicals stored in the liver causing disruption in store and release signals, which can quickly result in low blood sugar. A form of sugar, glucose, is the main source of fuel for the brain. When your glucose levels are low you feel tired, weak and moody.
Next stop is the kidneys. You may have noticed that you pee more than usual when you are drinking. This is actually a by-product of an effect ethanol has on the brain that causes the kidneys to excrete more than in normal circumstances. A hormone called vasopressin is released by the brain when the body has low water levels. Ethanol inhibits vasopressin and so allows more water to be lost from the body and there is nothing to tell the kidneys to keep the water in! We are all familiar with the intense dehydration and thirst that comes with a drinking session.
It is the effect on the kidneys that cause all the familiar hangover symptoms:
• Dizziness • Light-headedness • Weakness • Thirst
All made worse by other hangover symptoms which dehydrate us even more...
Lastly, the biggest and baddest organ with the biggest baddest effects from ethanol: the brain. The chemistry of the brain is complex, so I am going to make this as understandable as possible. Ethanol binds to different things in the brain. The main effects of those things are exciting something, and inhibiting or depressing something. When ethanol binds to a GABA receptor, it enhances its inhibitory or depressive effect. You don’t need to understand what that is, but it is responsible for the sleepy feeling you get when you drink. When it binds to glutamate it stops the parts of the brain involved in memory and learning from working properly; hence the morning after amnesia.
Dopamine is a chemical that acts like the brains natural reward system. It is highly linked to addiction as it makes us feel good and rewarded, and as such, strengthens behaviours that make us feel that way. Boom...Addicted. Ethanol increases dopamine production in the brain turning up our natural reward system. Just think about how good, and how clever and how sexy you feel after a few drinks...
Generally speaking, ethanol’s affects in the brain actually change the activity of the nerves, which is the basis for the mood and behaviour changes you see when people drink. It has a stronger affect on some parts than others. The main parts ethanol affects are:
The prefrontal cortex – responsible for self control and self restraint. Goodbye inhibitions, hello A&E
The ventral tegmental area – where the dopamine releasing neurons are
The cerebellum – responsible for coordination and balance
The overriding lack of restraint we get when we drink has a proper name: Alcohol myopia Myopia means short sightedness and in this context it is a psychological short sightedness. What happens is that we become concerned only with our immediate wants and needs, and all consideration or thoughts of consequences fly out the window...some examples... Unsafe sex, sleeping with people you absolutely wouldn't if you were sober, climbing, walking home alone or through bad neighbourhoods, fights, injuries, impulsiveness... and these can lead to even more undesirable things; unplanned pregnancy, STDs, broken bones, sexual assault, even death! Provocative but true!
I see many people who clearly drink more than they like to admit, or maybe it’s not understanding the units like we talked about. The big issue for me is that they tend to have medical issues already. Some of them say that if alcohol was actually affecting their health they would stop. I have news people.... It is! If you want to heal from your medical issue, you have to give your body a chance and stop the alcohol. If that is really painful for you, you need to look into why that is. If you have any condition where nerve function, liver, kidney or stomach function is a problem; Motor neuron, Parkinsons, Fibromyalgia, IBS, etc, alcohol consumption is harming you whether you can see it or not. Let me restate that...
Just because you can’t see the damage does not mean it isn’t there!
Drinking destroys nerves, which means your brain activity diminishes and your actual brain matter diminishes too! The brain is made of nerve tissue, so your brain shrinks!!!! How can you expect symptoms of a nerve disorder to stabilise if you are continually consuming something that alters and destroys nerve function in your brain. This is why I wrote this piece, so people would understand the real affects of alcohol. You won’t see it in one session, but the affects are cumulative; they build up. So please, seriously consider what is more important to you...alcohol or your health and recovery.
All these things are predominantly physical and only applicable to the drinker. What we haven’t touched on is the damage alcohol can do psychologically and emotionally or the damage it can do to your loved ones, friends and family.
My aim with this piece is to help you. Information creates understanding and understanding can provoke real change. If all it does is make you think for a second before you order your 6th drink, wonderful. If it stops you drinking 4 out of 7 days a week, great! If it wakes you up to damage you may be doing to yourself, even better. If you are suffering with an alcohol use disorder, please don’t suffer alone, talk to someone who can help you. If you don’t know if you have an issue, ask yourself a couple of questions:
Do I hide my drinking?
Do I go out of my way to make sure I can drink?
Do I lie to people about how much I drink?
Can I get through a day without feeling like I need a drink?
Can I stop drinking once I get started?
Do I have arguments with loved ones about drinking?
Have my loved ones suggest I cut down on drinking?
Do I end up not doing things I am supposed to because of drinking?
Do I feel like I have to have alcohol to be the life of the party, or any fun at all?
Do I drink heavily in times of stress, pressure or emotional upheaval?
Do I feel guilty, remorseful or full of shame after drinking?
Have I or anyone else been injured because I was drinking?
Have I been completely unable to remember what happened the night before often?
If you have answered yes to any of those, please look for some help. Asking for help is not weakness or failure, it is the ultimate act of self empowerment and there are many people and organisations, including me, who are here to help you, completely free of judgement. Feel free to contact me or look for your local AA meeting. You can contact me on firstname.lastname@example.org and you can find your local AA meeting here
Thanks for reading...make good choices!