Dr. Sadaqat Ali:
Unlike anything else we eat, alcohol is absorbed differently, is eliminated differently, and affects us all in a different way as well. More information on all of these issues means better decisions when it comes to drinking.
We all drink water and it is important to us. We know its significance, but hardly does anyone know much about it. Some of us love to drink alcohol but are completely unaware of the basic information about this unique beverage. There are a lot of myths around alcohol and alcoholism and how it affects our lives and the lives of our dear ones.
Dr. Sadaqat Ali, a graduate of Dow Medical College, Karachi is a renowned professional in the field of addiction psychiatry. He has a background of getting trained at “HAZELDEN” and “Vital Smarts”, USA. Dr. Sadaqat Ali is the Project Director of Willing Ways (Pvt.) Limited and Sadaqat Clinic (Pvt.) limited. He is a sought-after speaker who promotes new scientific solutions for persistent and profound problems.
Every year, Willing Ways conducts a major survey in Pakistan. Recently, we asked people which subject was of great interest to them and a great majority of all respondents wanted to know about the effects of alcohol on the human body. Honoring that request, Willing Ways is pleased to add this informative article to its “Drinking Shrinking” series. Its purpose is to provide information and influence behavior using simple, easy-to-understand language. Willing Ways believes strongly that one way to prevent alcohol abuse is to make sure that people know exactly what happens to the drink in their bodies and what goes wrong that messes up their lives and the lives of those around them. People who are equipped with accurate information are more likely to be aware of the dangers of abusive drinking and understand even more clearly the importance of responsible drinking. When it comes to the consumption of alcohol, there are a few hard and fast rules that hold true for everyone. However, each one of us must take our specific differences into account as we make our choices. Rest assured, the path that alcohol travels through the body is not the same for everyone. There are exceptional inherent difficulties that some people go through and need to sacrifice their love of life for them. And it remains true that excessive, abusive drinking and intoxication will always be unacceptable – socially, culturally, and medically. In other words, irresponsible and mindless drinking is always in bad taste.
ALCOHOL IS UNLIKE ANYTHING ELSE; IT’S UNIQUE
More than 10 million people in Pakistan drink alcohol regularly and most of them are only moderate drinkers. Anyone who drinks should be aware of the fact that alcohol is not like any other food and they should also know the psychological effects of drinking: how the alcohol is absorbed, how it is eliminated, and the impact it has as it travels through our body.
Molecules of alcohol are quite tiny, so they are absorbed very quickly by the blood. They are not broken down like food items that get infused in the blood easily. Alcohol molecules dissolve easily in water and fat, the main ingredients the human body is made of.
When you consume alcohol, it quickly moves down into the intestines due to gravity. A little amount is absorbed in the mouth, esophagus, and stomach, while larger portions of alcohol are absorbed by the small intestine. If you have an empty stomach, the alcohol moves easily and quickly passing on into the blood and one drink is likely to be absorbed in thirty minutes. With the stomach full of a fatty meal, having a high content of protein, the alcohol absorption will be delayed to up to 90 minutes.
Contrary to popular thinking, stronger alcohol is absorbed very slowly. Beverages that have more than 20% alcohol content in them irritate the mucous membrane lining of the stomach and shrink the opening of the stomach into the small intestine. Gulping down shots of spirits, hoping to get the buzz quickly, may actually be counter-productive.
Alcohol goes to your head very quickly when it is in the blood circulation and spreads to all the tissues of the body containing water. As alcohol travels along with the blood, it is delivered to the brain, lungs, and liver because of the abundant blood supply, which these organs enjoy.
It is eliminated from the body in different ways. Some amount of alcohol (about 10%) is eliminated through urine and some through the breath and sweat since it passes along the lungs as well. This is why a breathalyzer effectively measures your BAL. The concentration of alcohol in breast milk is slightly higher than in the blood and the nursing mothers should know this concerning fact as it means that the infant may be subjected to great difficulties.
WHY THE ROLE OF THE LIVER IS VERY CRUCIAL IN ALCOHOL METABOLISM?
The liver is primarily responsible for metabolizing alcohol. In the liver, an enzyme breaks down the alcohol into aldehyde, a toxin that instantly activates another enzyme which in turn transforms aldehyde into harmless molecules of acetic acid. This is how alcohol is managed in everyone, but the speed of these two stages of metabolism varies greatly.
No matter how much you drink, the liver can only effectively deal with a limited amount. Our liver is accustomed to metabolizing about 15 cc of alcohol every hour. Any more of the drink consumed, for example, 30 cc in an hour, the pending amount (15 cc) left to be metabolized after that hour would affect the body a great deal. The speed at which the liver deals with alcohol depends mainly on the availability of the enzymes, which vary from person to person. This capability to metabolize alcohol effectively and precisely is generically determined, but there are various factors that might influence the process, qualitatively as well as quantitatively.
FOOD: FULL STOMACH OR EMPTY?
The speed at which the alcohol is absorbed depends on the amount and the kind of food present in the gastrointestinal system. During the process of digestion, the stomach’s contents are passed into the small intestine, a process known as gastric emptying. The fatty foods in the stomach require more time for gastric emptying which slows down the process of alcohol absorption. Studies have shown that people, who drink after a heavy meal, absorb alcohol more slowly in comparison to those who drink on an empty stomach.
Gender differences matter a great deal when it comes to drinking. All other things being equal, if both men and women consume the same amount of alcohol, women would have a higher blood-alcohol level. That’s because men, in general, are heavier and their bodies have a lower fat content. Higher body weight means higher water content, so the alcohol is dissolved in a large amount of liquid. This means a higher concentration of alcohol in women because they are generally much smaller than men, with less amount of enzyme that breaks down alcohol, to begin with. So, the alcohol women drink keeps circulating in their blood relatively longer than men.
AGE MATTERS TOO: TEENS AND SENIORS BEWARE!
Teens and older people cannot tolerate alcohol well, mostly because of their generally lower body weight and the fact that alcohol is dissolved in a smaller volume of liquid. Also, teenagers have fewer alcohol-eliminated enzymes in their liver than adults and the BAL in them is relatively more.
There are unpredictable reactions between alcohol and other drugs. Some medications can retard alcohol elimination, heighten or mask its effects or provoke abnormal reactions. Paradoxically, alcohol can reduce the general effectiveness of some medications or hinder their elimination.
Alcohol affects different organs differently as well. It has a great affinity for the brain and greatly influences its functions, especially mood and creativity. Before it is dealt with by the liver, alcohol affects certain vital organs, especially those that contain a lot of water and require a great volume of blood in order to function. Almost an instant effect can be observed in the brain. Alcohol restricts certain functions of the brain by encouraging and pampering the brain’s reward centers. The effects are pleasurable, to begin with: the stress is reduced and there is an obvious dis-inhibition and a sensation of either being calm or tipsy. How you feel depends on your prior mood, but afterward, you may go back to your original state and may feel even more angry and sad than you were at the starting point.
Alcohol often promotes sociability, conversation, pleasure, and a sense of wellbeing. Some people also report an increase in creativity. Alcohol also has a slight therapeutic value as a means to reduce stress. While it does relieve stress in the short term, it does not do anything to treat the actual source causing the stress. Rather the opposite is true, that alcohol disables you to take positive actions to solve problems. So, over the longer term, alcohol increases the anxiety levels and when the anxiety persists, the desire to self-medicate with more alcohol leads to alcohol dependency.
There is a myth. People commonly believe that alcohol helps you sleep. Certainly, it sure can help you ‘fall’ asleep but it also interrupts normal sleep cycles and you may find yourself feeling tired and unwell, even if you have slept a long time. What’s worse is that alcohol can also cause insomnia in addition to making existing sleep problems worse.
Alcohol can cause or aggravate sexual problems as well. Abusive drinking, for example, can make it difficult for men to achieve an erection and for women to attain an orgasm.
With a rise in your BAL, the brain’s centers are affected. There is a difficulty with coordination and physical movement and an obvious increase in reaction time and these effects depend on how much you drink. But generally, it looks like your body is on the “Go Slow” policy. If you have a BAL of 80 mg of alcohol/100 cc of blood, your reaction time will be 40% slower on average than with no alcohol in your blood. No wonder driving and drinking make it difficult to hit the break when suddenly needed.
With intoxication, your thought processes, speech and senses are also adversely affected. Since verbal skills allow you to resolve problems, there is a greater likelihood of aggression and violence.
The alcohol and the toxic acetaldehyde in your blood cause nausea and there is a tendency to vomit. Alcohol also affects the anti-diuretic hormone that maintains hydration level, so in a way, alcohol also works as a diuretic. The kidneys no longer reabsorb sufficient water from your urine and you end up eliminating more water. Dehydration also contributes to the symptoms of a hangover to a great deal.
The brain is not really completely developed until after the age of twenty; therefore the brains of adolescents are more vulnerable to alcohol-related damage than adults. Studies highlight the effects of alcohol on the ability to learn and make decisions. The earlier children begin to drink, the greater the risk that they will develop alcoholism soon.
If you drink regularly, you tend to ignore the immediate effects of alcohol on the brain as you would have developed a tolerance for it. As a result, you may often drink without realizing the ill effects as alcohol does not let you know. Such tolerance is metabolic – the liver breaks down the alcohol quickly and “efficiently” – and the person unconsciously learns to make good for the deficits caused by alcohol. However, harmful drinking will be obvious in the long term. Habituation generally means that drinking has long been established and that you have started behaving as if you are not under the influence.
Just a little amount of alcohol can affect the heart rate, blood pressure, and the heart’s ability to pump to maintain blood circulation. These reactions can be serious if there is existing heart disease. However, as of a certain age, regular and moderate drinking in a perfectly healthy person can provide some protection against cardiovascular disease. But these benefits can be achieved with simple efforts and you don’t need to kill the mosquito with a gun. There are much easier and safer alternatives.
Alcohol causes the small blood vessels under the skin to dilate, among other things. This explains the pink complexion in heavy drinkers and as a result this dilation also causes heat loss. Contrary to the popular belief, it is dangerous to drink to ‘warm up’ when exposed to cold, just because you feel energized after drinking. Fact remains that you are losing heat, continuously. The intestines begin to secrete acid after drinking. As the BAL rises, the digestive enzyme pepsin is reduced which leads to irritation of the intestinal walls. Drinking causes a sudden increase in blood sugar and the pancreas reacts with a rapid drop in blood sugar. This in turn causes symptoms of low blood sugar levels like dizziness, headaches, difficulty concentrating, anxiety, trembling, and cold sweats to begin to appear.
More information means better decisions. Understanding the effects of alcohol can help you estimate your BAL, considering the various factors that affect the rate of alcohol absorption into the blood circulation. This information is vital for those who have a demanding job like a pilot or a surgeon. Of course, it is certainly good to know how much alcohol you have absorbed before you drive, but there are better reasons for understanding how alcohol affects the various organs and systems in your body. More information helps you make better choices and when you have more knowledge, you tend to make more enlightened decisions. Ultimately, we hope that people who know more about the subject will understand the very real impact alcohol has on the human body. Well-informed people will be more conscious of the unpleasant and dangerous side-effects of abusive drinking. We hope you will be more aware than ever that irresponsible and mindless drinking is always in bad taste.