Resolutions, part V: Alcohol leaves lasting legacy in brain and heart

New Year’s often brings resolutions to quit or cut back and/or avoid relapse. Quitting or cutting back can be as life-changing as pledges to work out more in 2013 or promises to get a new job for the new year. Here are additional long-term brain and heart considerations about alcohol use disorders, quitting and staying sober. If you don’t have the following conditions now, there are provable connections to getting them years after abstinence.

Heart disease
Heart disease is a leading cause of death in the U.S. and carries a definite link to alcohol misuse despite French studies showing low amounts of red wine benefiting the circulatory system. Acetaldehyde – a byproduct of the metabolism of alcohol – causes hypertension, a.k.a. high blood pressure. In a 2007 Medical University of South Carolina study, 120 alcohol users charted lower blood pressure only 12 weeks after abstaining.

Alcohol itself raids the body of vitamin B (Thiamin) which is essential for a healthy heart. B-deficiency enlarges the heart and creates distended neck veins, narrow pulse pressure, elevated diastolic blood pressure (the second number in your BP) and peripheral edema. Acetaldehyde also physically weakens muscle, the heart being your body’s most important one. Think of how the tongue muscle is weakened from drinking (slurring) and leg muscles are weakened (wobbliness) and the same thing is happening to the heart muscle. However, with the heart, the weakening causes damage that accumulates.

Acetaldehyde also increases cholesterol, especially triglycerides. High cholesterol is a leading indicator of heart trouble on the horizon and the number one condition treated with prescription drugs in the U.S.

Brain damage/mental disease
Cadaever brains have provided conclusive evidence of a brain atrophying (shrinking) after alcohol misuse. However, Dr Ernest Noble of University of California—Irvine says, “Brain damage caused by alcohol, in relatively small quantities can affect the ability of brain cells to make proteins and RNA . . . essential for metabolism and organization of all cells as well as their ability to duplicate themselves.” A former social drinker, he quit drinking at all upon conclusion of his study.

A 2012 study similarly indicates that moderate drinking reduces the production of new brain cells by 40 percent. The November 8, 2012 journal, Neuroscience, reports the level of alcohol intake was not even enough to impair the motor skills of the rats in the study, however, the decrease in the brain’s ability to create new cells could have profound effects on learning and memory later. The area of the brain that produces the neuron cells is the hippocampus, which is associated with learning and memory. Affecting this part of the brain might not be something immediately noticeable, but over time, weekly drinking could have so dramatically reduced the neurons that learning or remembering things becomes more difficult. The study indicates that people don’t have to be alcoholic to do damage to brain structures and that social drinking may be more harmful to people than is currently perceived by the general public.

The impact on mental health and the many fingers of the mind are varied. On one hand there are those who endure years of heavy drinking with the mind’s fingers remaining as nimble as a pianist’s. Others emerge not so deft. It is believed alcohol increases the chances for Alzheimer’s and earlier onset of dementia. Stanford University research in 2010 also proved that alcohol abuse and the disease of alcoholism cause deficits in working memory and visio-spatial abilities (think: coordination) even after abstinence.

Sociologist William Anixter pointed out in 1990 before the Anxiety Disorders Association’s Washington, DC, conference that 80 percent of Alcoholics suffer from depression. The unanswered question more than two decades later is how much of that was there organically and how much was caused by the alcohol/acetaldehyde. A 2007 study does make the connection between alcoholic liver disease and the mind. The frontal cortex—responsible for reasoning and memory—is more impaired in patients when they have cirrhosis.
--Adapted from Every Silver Lining Has a Cloud


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(The usual weekly post, SUNDAY SNIPPET, will return 1/5)

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 
 
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Resolutions, part IV: Alcohol-related tissue damage lingers years after quitting

New Year’s often brings resolutions to quit or cut back and/or avoid relapse. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are additional long-term considerations about alcohol use disorders, quitting and staying sober.

Alcohol itself is toxic. It’s broken down in the body in the following sequence:
Alcohol>Acetaldehyde>Acetic Acid (vinegar)>Water+CO2
The first metabolite, acetaldehyde, is 30 times more toxic than alcohol and is responsible for damage to tissues.

The relationship between chemicals and your DNA is part of a field called epigenetics and epigenetics is now showing that the alcohol you consume and its acetaldehyde byproduct leave a biological imprint on your DNA, one that can surface in diseases later (Wall Street Journal, February 28, 2012). If the drinking doesn’t kill you immediately, it can kill you years down the road.

The weight of scientific evidence demonstrates a link between alcohol and a greater risk of mortality for diseases of the immunological, nervous, cardiovascular, and respiratory and digestive systems. This was most recently confirmed by researcher Domenico Palli, a scientist at the Cancer Research and Prevention Institute of Florence in 2012, and new links with diseases and alcohol are being reported nearly weekly. Absence of evidence is not evidence of absence. If you don’t have the following conditions now, there are provable connections to getting them years after abstinence… the longer a person waits to quit, the higher the risk.

Liver damage/disease
The alcohol user is eight times more likely to get cirrhosis, which is irreversible, incurable and fatal. Not all alcoholics will get it. One in 10 develops cirrhosis. However, it is not the only liver disease cause by alcohol/acetaldehyde.

A fatty liver occurs when alcohol consumption disrupts how the body chooses its fuel. Cell mitochondria—our body power plants—normally use fat to produce energy. As aacetaldehyde breaks down in the body it releases hydrogen, which mitochondria use before fat as fuel. The unused fat then accumulates around the liver. Even in someone who doesn’t look fat in their extremities or midsection, fat deposits choke the liver.

Alcoholic hepatitis is a third type of liver injury connected to alcohol misuse. It is a condition similar to the other hepatitis diseases, but is not the same as A, B or C hepatitis.

Liver problems are not the realm of only the hard drinker, they can be stimulated by amounts of alcohol between five to nine drinks in 24 hours. There are very few symptoms of liver injury until it becomes chronic because the liver has no pain nerves to tell you when it is hurt. If the liver had nerve endings, you’d never make it to the second drink.

Pancreatic damage
The pancreas is a long, flattened, pear-shaped organ located behind the stomach. It makes digestive enzymes and hormones including insulin. Alcohol users are 1.6 times more likely to develop pancreatic cancer, the most fatal of cancers. (Dr. Mirjam Heinen, Maastricht University, Netherlands, May 2009).

Men should be especially conscious of alcohol/acetaldehyde when it comes to the pancreas. University of Pittsburgh School of Medicine researchers isolated a gene variant in men that puts those who drink heavily at risk for pancreatitis.

Muscle disease
Acetaldehyde fragments muscle fibers, weakening them and allowing them to tear easily. Muscle atrophy or destruction can occur fairly easily. The weakness and atrophy have been known to medicine for 200 years as myopathy, but myopathy has come to be known as a common side effect of acetaldehyde and alcohol.

Nerve disease/neuropathy
Alcoholic neuropathy is identical to the neuropathy experienced as a side effect of diabetes. Neuropathy causes a tingling of burning sensation, or a loss of sensation all together. In Alcoholics, as with diabetics, it is an affliction of the limbs and especially the legs. Commonly there is a reduced sensitivity in the feet. You’re not able to feel pain. When this happens, foot injuries, like blisters, can become infected so severely because you cannot feel pain that amputation is necessary. But the fatal problem with the neuropathy is the increase in the risk of stroke it carries, covered in part five of this series.

Stomach disease
Gastritis—sharp stomach pains—and gastric ulcers are very common results of regular alcohol use and can last for years after abstinence. Alcohol slows the emptying of the stomach, which allows more acid to build up in the stomach and therefore more time for it to permanently damage the stomach lining. Cancer of the stomach is called gastric cancer. Gastric adenocarcinoma is the most common type of stomach cancer. It arises from those cells in the stomach lining.

Chronic gastritis also is a predisposing factor in developing stomach cancer (“Alcohol and stomach cancer in northern Italy,” in the Nutrition ResearchNewsletter, September 1994) The newsletter concluded, “heavy intake of total alcohol (at least eight drinks/day) or wine (six to eight or at least eight drinks/day) was associated with a small but significant increase in stomach cancer risk.”

A more recent study put the cancer risk in much more exact and troubling terms. Researchers evaluated information from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

More than 400 cases of stomach cancer were diagnosed among study participants. Heavy alcohol consumption increased the risk of stomach cancer in men. Men who consumed an average of more than four drinks per day were 65 percent more likely to develop stomach cancer than men who were very light drinkers. The link between alcohol and stomach cancer appeared to be stronger for beer than for wine or spirits.

Breast cancer
One out of eight women will have an encounter with breast cancer. Alcohol use is the ONLY dietary factor increasing the likelihood of getting breast cancer.

Breast cancer risks increase 10 percent for every 10 grams of alcohol consumed daily. That’s about one drink.) Women who consumed even “modest” alcohol (equivalent to 3-6 glasses of wine per week) were linked with a 15 percent increase of developing the disease. Researchers also found that the increased risk of breast cancer for those who drank at least 30 grams of alcohol per day on average (at least two drinks daily) was 51 percent higher compared to women who never drank alcohol.

In addition, when the researchers looked at alcohol consumption levels between the ages 18 to 40 and after the age of 40, they discovered that both were strongly linked with an increased risk of breast cancer. The connection with alcohol consumption still remained even after controlling, reducing or quitting alcohol consumption after the age of 40.

Other cancers
Dr. Palli’s 2012 research identified “significantly” higher risks for cancers of the pharynx, oral cavity and larynx and higher rates for cancers of the esophagus and rectum. “Alcohol’s role as a dietary carcinogen emerged quite clearly,” said Palli. An older study put the numbers at an estimated 75 percent of esophageal cancers in the U.S. are attributable to chronic, excessive alcohol consumption and nearly 50 percent of cancers of the mouth, pharynx, and larynx are associated with heavy drinking.

According to Annual Review of Pharmacology and Toxicology, alcohol misuse results in abnormalities in the way the body processes nutrients and may subsequently promote certain types of cancer later in life. Alcoholism also has been associated with suppression of the immune system. Immune suppression makes you more susceptible to various infectious diseases and, theoretically, to cancer.
--Adapted from Every Silver Lining Has a Cloud

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www.alcohologist.com


Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Resolutions, part III: The short-term consequences of drinking alcohol

New Year’s often brings resolutions to quit or cut back and/or to avoid relapse. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are additional considerations about alcohol use disorders, quitting and staying sober.

About eight percent of the population is has the disease of alcoholism and 35 percent are alcohol abusers, but in a 2011 ABC News/Gallup Poll, 67 percent of Americans admitted to having ever abused alcohol. The Centers for Disease Control and Prevention (CDC) puts the number at 61.2 percent currently drinking frequently and 14 percent former regular drinkers. Four percent of deaths globally – 5.5 percent in the U.S. – are linked directly to alcohol according to the University of Toronto Centre for Addiction & Mental Health 2009 study.

Here are the direct health risks for anyone who uses alcohol. The risks apply to light to moderate drinkers, not just a hard drinker. The direct impacts of alcohol are associated with getting drunk, being drunk or activity while drunk. (Parts four and five of this examiner.com series cover the long-term and indirect causes of death and illness from drinking.) The most common categories for direct causes of death documented include the following:

Alcohol poisoning
The first symptom most people experience is sudden death. There is no way of accurately gauging how close you are to a lethal dose of alcohol until you pass it. Coma and death are possible at Blood Alcohol Concentrations (BACs) above .30, however lower BACs can produce the same result depending upon tolerance and health.

Alcoholics can have an extremely high tolerance and the margin between the tolerance dose and the lethal dose is razor thin: They can die at a BAC of .50 or higher without even feeling buzzed. They also can experience sudden drops in tolerance, increasing the risk from death by alcohol poisoning.  Singer Amy Winehouse died in 2011 at a .40 BAC but twice before had been hospitalized at higher BAC levels. You just don’t know when you are not going to wake up.

Withdrawal
Absence of alcohol can and does kill alcoholics because the disease quickly alters the body’s tissues. They become dependent upon alcohol, requiring it in the bloodstream constantly or the body begins to shut down during withdrawal, much as it would without oxygen. Alcohol withdrawal is the only drug withdrawal other than benzodiazepines that can be fatal. Not heroin or meth, the alcohol you find in aisle six of the Winn-Dixie.

Researchers Glen Hanson, Peter Venturelli and Annette Fleckenstein in the book Drugs and Society found “About five percent of alcoholics in hospitals and perhaps 20-25 percent without treatment during withdrawal die” suffering from delirium tremens (DTs—high fever, heartbeat irregularities, etc.). Medically supervised detoxification is a requirement for severe alcoholics because of life support, not for the sedatives to make the other pains of withdrawal more bearable.

Accidents and violence
The number one cause of emergency room visits and 21 percent of all injuries is alcohol (Alcoholism: Clinical and Experimental Research). This includes injuries to someone who was drinking and injuries by someone who was drinking. Two hospital admissions each minute are attributable to alcohol directly, according to the North West Public Health Observatory. This was a 65 percent increase over five years.
. . . 30 percent of transportation injuries are alcohol-related
. . . 22 percent of the 12 million home-accident injuries in 2012 were alcohol-related
. . . 58 percent of fire fatalities have alcohol in their systems, which presumably kept them from fleeing safely
. . . 45 percent of drownings are alcohol-related
. . . 15.5 percent of occupational injuries are alcohol-related
. . . And 56 percent of assault victims have alcohol in their bodies . . . when you drink you are at a two-and-a-half-times greater risk of a violent death.

The media has overemphasized alcohol’s role in car wrecks but has under-reported the role of alcohol in other violent or accidental deaths. A 2012 Ohio State University study concluded that news organizations failure to report alcohol in those cases dampens public support of alcohol-control laws or abstinence.
-- Adapted from Every Silver Lining Has a Cloud



Image: Adamr
www.alcohologist.com


Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK. 

Resolutions, part II: Alcohol's a greater public health menace than tobacco

New Year’s often brings resolutions to quit or cut back and/or avoid relapse. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are additional considerations about alcohol use disorders, quitting and staying sober.

Alcohol is a mass killer in the United States and is the defining public health issue for the 21st century. Driving under the influence has statistically little to do with those conclusions.

Just under 10,000 motor vehicle deaths, 40 percent of the total, stem from alcohol-related crashes. To put that into context with other preventable deaths:
157,000 lung cancer deaths annually
50,000 people are killed in gun violence
39,520 breast cancer deaths
37,000 fatal overdoses from prescription drugs
34,000 suicides
30,000 Americans still die of the flu
18,000 people are killed in our hospitals by staph infections

Every alcohol-related car crash death is heartbreaking, but by the numbers, those deaths make up very little of the death toll from alcohol use. Even if you ended drinking and driving, alcohol is still our nation’s number one killer:
89,000 other deaths (not in cars) are directly attributed to alcohol; and,
1,000,000 more fatalities from diseases are indirectly attributed to alcohol (e.g. alcohol causes a condition leading to death).

It’s easy to be offended by drinking and driving. What’s even more offensive is the underreporting of the health effects of alcohol that prove alcohol is our defining health issue. Tobacco has at times held that mantle, but by comparison, only 473,000 die annually of smoking-related illness. Beverage
alcohol kills more than a million. A 2012 study by the German University Medicine Greifswald found that heavy drinkers are at more risk of death than those who smoke.

The way America has responded to tobacco awareness campaigns holds promise for alcohol awareness campaigns, should one be mounted. In 1967, smoking was “in.” Seventy-six percent of adult men smoked. Today smoking is “out” and health officials at the Food and Drug Administration believe by 2020 smoking will be banned in all states. This is happening within just a generation and a half because smoking’s health effects are no longer underreported or reported only in obscure medical publications. With alcohol as with smoking, people are entitled to their own opinions, but they are not entitled to their own facts. The remaining three parts of this series cover the direct and indirect causes of illness or death attributed to alcohol use.
--Adapted from chapter eleven of Every Silver Lining Has a Cloud.

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www.alcohologist.com

(The usual weekly post, SUNDAY SNIPPET, will return Feb. 2)

Details on the third literary award for Every Silver Lining Has a Cloud, plus the new radio interview replay is available at alcohologist.com... and please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.