Alcohol Addiction – Not the Way to Cope With Grief, Trauma or Fear
Alcohol is the world’s third largest risk factor for disease burden. Worldwide, the harmful use of alcohol results in 2.5 million deaths each year. (WHO 2007)
In 2003, alcohol was the second largest cause of drug-related deaths and hospitalisations in Australia after tobacco.
Alcohol is an integral part of our social life and culture, as it has been for centuries. It relaxes the body, loosens our inhibitions, and helps us feel less tense and more open to our emotions.
Many people can safely enjoy alcohol in moderate amounts. Moderate drinking is generally defined as no more than one drink per day for women, and no more than two drinks a day for men.
In moderate amounts alcohol can stimulate the appetite, improve digestion, enhance cardiovascular function, improve circulation, and reduce the risk of heart attack.
But don’t consider this as an endorsement for drinking.
For many of us, the risks inherent to drinking far outweigh any benefits.
High alcohol consumption increases the risk of heart, stroke and vascular diseases, liver cirrhosis and some cancers. It also contributes to disability and death through accidents, violence, suicide and homicide (WHO 2004).
Effects of Alcohol on the Body
Alcohol affects everyone differently. Some become intoxicated with the first drink, others may be able to consume four or five drinks before showing any effects. In alcoholics, each drink triggers a craving for another.
Alcoholism is a progressive disease that usually starts with acceptable social drinking. This leads to a drink for every mood: one to calm down, one to celebrate, one to perk up, and so on.
The alcoholic soon needs no excuse to drink and in time becomes completely controlled by his or her dependance on alcohol. Alcoholics often become ashamed and angry at their compulsive behaviour, leading them to further alcohol abuse.
Women are physiologically more sensitive to alcohol than men are. Because of their bodies’ lower water content and higher fat content, alcohol becomes more concentrated in the bloodstream and is also retained in their bodies longer.
Also, women produce less of the alcohol dehydrogenase, the enzyme in the stomach that breaks down alcohol before it reaches the bloodstream.
Alcohol usually starts to affect the brain within five minutes of being swallowed. It generally takes about an hour for the body to clear one standard drink, although this varies from person to person.
The rate of this metabolism depends on several factor including liver size, body mass and composition, alcohol tolerance, and individual variation in the genes that control expression of alcohol-metabolising enzymes in the liver.
Food in the stomach reduces the speed at which alcohol is absorbed into the bloodstream.
Alcohol Effect On The Liver
Alcohol affects every organ of the body, but most dramatically – the liver. Alcohol metabolism permanently changes liver cell structure, which impairs the liver’s ability to metabolise fats. This explains why heavy drinkers develop fatty liver.
A liver clogged with fat cannot function properly and this impairs person’s nutritional health. Fat accumulation can be seen in the liver after single night of heavy drinking.
Fatty liver, the first stage of liver deterioration seen in heavy drinkers, interferes with the distribution of nutrients and oxygen to the liver cells. If the condition lasts long enough the liver cells will die and form fibrosis.
Some liver cells can regenerate with good nutrition and abstinence from alcohol, but in the most advanced stage, cirrhosis, damage is the least reversible.
Alcohol and Brain Function
The most immediate effects of alcohol are on the brain, beginning with feeling of relaxation and loss of inhibitions. As the intake of alcohol increases, these effects are counterbalanced by less pleasant effects, such as drowsiness, loss of balance, nausea and vomiting.
With excessive alcohol consumption brain cells die and some heavy drinkers suffer permanent brain damage.
The Effects Of Alcohol On The Kidneys
People who drink alcohol may notice that they urinate more often. Alcohol depresses the production of anti-diuretic hormone (ADH), a hormone produced by the pituitary gland that retains water.
Loss of body water leads to more drinking, and the thirsty drinker may drink more alcohol instead of water.
Heavy drinkers usually consume alcohol, as a substituted energy, instead of their normal food intake and suffer malnutrition. Alcohol is rich in energy (7 kcal per gram) (3), but like sugar, these are “empty” calories.
Alcohol and Blood Sugar Levels
Hypoglycaemia may be one of the major causes of alcoholism. Consuming alcohol gives a temporary rise in blood sugar so the person feels relaxed and energised.
When the blood sugar drops the desire to drink more rises.
The liver is responsible for converting glucose to glycogen (a form of glucose that can be stored in the liver).
When the liver is persistently occupied with breaking down alcohol, it becomes less able to metabolise blood glucose and store it as glycogen.
Excess sugar accumulates in the blood. The body tries to compensate by releasing extra insulin, which lowers blood sugar. Later, when the the body is in need of more blood sugar, the liver is unable to supply it and hypoglycaemia becomes a chronic problem.
Low levels of glucose correspond to low levels of energy and impaired brain function. For temporarily relief , alcoholics use more alcohol, which contains plenty of sugar but serves only to exacerbate the problem.
Alcoholism can also cause hyperglycaemia. The constant influx of alcohol creates persistent high blood sugar levels and diabetes can occur.
Alcohol is one of the most damaging substances to the stomach and the small intestines. It reduces the absorption of nutirents, increases gastric secretions, causing exess acidity and dilutng digestive enzymes. This can lead to gastritis.
Alcohol consumed during pregnancy, especially during the first trimester, can cause complications and damage to the developing foetus, including fetal alcohol syndrome.
Alcohol alters both amino acid and protein metabolism. Synthesis of proteins important for the immune system slows down, weakening the body’s defences against infection. Protein deficiency can develop, both from a diminished synthesis of protein and from poor diet.
Causes and Risk Factors for Alcohol Addiction
The exact cause of alcoholism is unknown. People with a family history of alcohol-related problems, including alcohol dependence, are at greater risk of being unable to control their level of drinking.
Genetic factors seem to play a significant role in alcoholism and it is likely that many different genes are involved.
High levels of the D2 dopamine receptor may help inhibit behavioral responses to alcohol, and protect against alcoholism, in people with a family history of alcohol dependence.
Reduced number of D2 dopamine receptors and low dopamine activity may predispose an individual to alcohol addiction.
Abnormal serotonin levels are associated with high levels of tolerance for alcohol.
After long-term use of alcohol neurotransmitters in the brain seem to be affected.
As a sedative hypnotic, alcohol alters multiple neurotransmitters in the brain including dopamine, GABA,serotonin, glutamate and opioid peptides. Opioid enhancement contribute to the sensation of being rewarded. Low serotonin levels may increase aggressiveness and impulsive behaviour.
Chronic alcohol consumption leads to decreased GABA and increased glutamate in the brain, and this may be responsible for the withdrawal symptoms.
Alcohol blocks out emotional pain and is often perceived as a loyal friend when human relationships fail.
Additional risk factors include having a psychiatric condition such as schizophrenia, depression, or anxiety disorders.
Signs and Symptoms of Alcohol Abuse and Alcoholics:
- Drinking alone or in secret
- Not remembering conversations or commitments-blacking outs.
- Making a ritual of having drinks at certain times and becoming annoyed when this ritual is disturbed or questioned
- Feeling an overwhelming need or for a drink
- Being unable to limit the amount of alcohol you drink
- Getting intoxicated to feel normal
- Developing tolerance to alcohol so that you need an increasing amounts to feel its effects
- Having problems with finances, social interactions, relationships, or employment.
- Experiencing physical withdrawal symptoms — such as nausea, sweating and shaking — when you can’t drink
- Losing interest in activities and hobbies that used to bring you pleasure
- Irritability when your usual drinking time nears, especially if alcohol isn't available
- Hiding alcohol in unlikely places at home, at work or in the car
- Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel “normal”
Treatment of Alcoholism
Alcoholism is a very difficult disease to treat. Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalise drinking, even when the consequences are obvious.
Some may think that it’s just a matter of having the will to stop drinking, but alcoholism is more complicated than that and the majority of alcoholics need assistance to stop drinking.
Depending on the individual, treatment may involve detoxification and withdrawal. This usually takes four to seven days and involves medication to prevent delirium tremens or withdrwal seizers.
Alcoholics who stop drinking often experience withdrawal symptoms, especially during the first week of abstinance.
Extreme insomnia, headache, anxiety, hand tremors, sweating, racing pulse, nausea and vomiting, irritability, loss of appetite, are some of the symptoms. In severe cases, withdrawal from alcohol can also involve hallucinations, confusion, fever, and agitation.
Counselling and therapy to get at the underlying problems that may have led to alcohol abuse are also used.
One of the key nutrients involved in metabolism of alcohol is zinc. Low zinc levels are associated with impaired alcohol metabolism, predisposition to cirrhosis, and impaired testicular function. Zinc supplementation, particularly when combined with Vitamin C, greatly increases detoxification.
Vitamin A and C deficiency is also common in alcoholics and goes hand in hand with zinc deficiency. Reduced concentrations of vitamin A and zinc and abnormal enzyme activity, lead to common disorders of alcoholism, including, night blindness, reduced skin healing and skin disorders, impaired immune function, decreased testicular function and cirrhosis.
Most dramatic is alcohol’s effect on B vitamins. Thiamine deficiency is both the most common and the most serious and can be a predisposing factor for alcoholism.Severe thiamin deficiency called Wernicke-Korsakoff syndrome is characterised by paralysis of the eye muscle, poor muscle coordination, impaired memory, and damaged nerves and is treated with thiamine supplementation.
Supplementation with folate, Vitamin B6 and B12 can reduce homocysteine levels and the risk of seizers during the withdrawal phase
Magnesium deficiency due to reduced intake and increased kidney excretion is present in 60 % of alcoholics and is strongly linked to delirium tremens. It is thought to be the major reason for the increased cardiovascular disease in alcoholics.(4)
The intestinal microflora is severely unbalanced in alcoholics. Colonisation of the small intestine by endotoxin producing bacteria may lead to malabsorption of fats, carbohydrates, protein, folic acid and B12.
Lactobacilllus acidophilus supplementation may assist in the decolonisation with healthy bacteria, improving immunity, digestion and absorption of nutrients.
St Mary’s Thistle has been shown to be effective in the treatment of alcohol related liver disease.
Glutathione is essential to liver detoxification reactions as well as functioning as a powerful antioxidant.
Dietary and Lifestyle Changes
• Avoid all alcohol. Total absistance is an absolute requirentment for regaining control over your life.
• Drink plenty of water, which will help cleanse the body and diminish cravings.
• When at social gatherings, enjoy the conversation, eat the food, and drink nonalcoholic beverages.
• Eliminate all simple sugars, processed carbohydrates, and increase complex carbohydrates.
• Exercise 5-7 times a week for at least 20-30 minutes.
• Eat small frequent meals to keep the body’ blood sugar levels stable.
• Avoid stressful situations as much as possible.
• Avoid places, people, and things associated with drinking.
• Avoid all tea, coffee,and cigarette smoking.
1. “Alcohol Consumption More Detrimental To Women”, 2007, www.sciencedaily.com
2. The Encyclopaedia of clinical Nutrition vol.1, Henry Osieki, Fiona Meeke, Jenny Smith, 2004, BioConcept Publishing
3. Understanding Nutrition, 11th edition, By Ellie Whitney, Eleanor Noss Whitney, Sharon Rady Rolfes, Thomson and Wadsworth
4. “Textbook of Natural Medicine”, 2nd ed., vol 2, Pizzorno and Murray, Churchill Livingstone, Sydney