The A-Files, Alcohol A-Z for Alcohol Awareness Month: Life Expectancy

(See online article)

Alcohol consumption of two or more drinks a day shaves 10 to 12 years off life expectancy. That's from the A.D.A.M. Medical Encyclopedia. More moderate use, cuts at least 12 months from how long you'll live. A.D.A.M.'s 10-12 years is the conservative estimate by the way: A study conducted by the Centers for Disease Control and Prevention in 2005 found that alcohol use shortens lives by at least 30 years.

Alcohol use will affect the body in so many ways that researchers have a hard time specifying exactly what the life expectancy consequences are from drinking. Drinking is associated with earlier death. However, it is not just from a higher risk of the more common serious health problems, such as heart attack, heart failure, diabetes, lung disease, or stroke. Other ways alcohol cuts life expectancy:

• People who drink regularly have a higher rate of death from violence. Half of all murders are alcohol-related.
• Alcohol overdose can lead to death and can interaction with other medications. Alcohol overdose doesn't just stem from any one heavy drinking incident, but also may occur from a constant infusion of alcohol into the bloodstream.
• Severe withdrawal and delirium tremens (DTs). Delirium tremens occurs in about five percent of alcoholics attempting to quit. It includes progressively severe withdrawal symptoms and altered mental states. In some cases, it can be fatal. Alcohol withdrawal is one of only two drug withdrawals that can kill you. The other drug class is benzodiazepines. Heroin addicts may think their withdrawal is going to kill them, but alcohol withdrawal will.
• Alcohol use directly harms many areas in the body to produce dangerous health conditions related to liver damage, heart damage, pancreatitis, anemia, upper gastrointestinal bleeding, nerve damage, and visible brain damage.
• Alcohol users who need surgery have an increased risk of postoperative complications, including infections, bleeding, insufficient heart and lung functions, and problems with wound healing. Alcohol withdrawal symptoms after surgery may also delay recuperation.

Alcohol also plays a huge role in household accidents, drownings, a third of car-crash fatalities, and half of all suicides. It's the third-leading cause of preventable death… not in some depressed and undereducated locale, but here, in the U.S., taking one life every 10 seconds.
The entire 26 episode HD series is available on disc, along with fact sheets, for helping professions. See the preorder special at tr.im/AFiles

Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com 

National Kidney Month: Alcohol damages kidneys, can cause failure

A single drink affects the normal function of a person's kidneys in a chain of events that begins with alcohol displacing water in the body. March is National Kidney Month, and the National Kidney Foundation (NKF) reports that alcohol use – from a single binge to constant use with the disease of alcoholism – is one of the more complex ways kidneys are damaged from the body's delicate balance of water.

Alcohol alters the filtering ability of the kidneys. The organs filter about 200 quarts (189 liters) of blood daily. The body gets rid of cellular waste through them, ultimately in urine, and the organs also regulate the concentrations of sodium, potassium, magnesium, chloride and phosphate.

Sodium and potassium are needed within the body to maintain water concentrations within the cells. Magnesium is used for enzyme activity. Chloride is needed for nerves. Phosphate ions help to maintain a stable pH and sugar in the blood. All are thrown into imbalance with a single drink. Ironically, low potassium increases thirst... and what beverage is nearby? More alcohol.

Even though alcohol displaces water, the drug at the same time signals the brain to stop releasing a certain hormone (vasopressin or ADH) which in turn makes a person urinate more, getting rid of the water.

Urination can be induced 20 minutes after a person consumes alcohol, according to the National Institutes of Health (NIH) publication on kidney damage and alcohol, More water leaving the body affects all the concentrations of the chemicals ions in the body. Research indicates that older people overcome this suppression of ADH more quickly than younger people do. So younger drinkers can lose more water in their urine than older people do.

The kind of alcohol consumed can either increase or decrease the concentrations of nutrients in the blood stream. When a person drinks beer, large amounts of water enter the body. That lowers the nutrient concentration. When a person drinks hard alcohol, it has less water and has a more severe drying effect and the nutrient concentrations can increase. This drying effect also can harm the normal function of cells and other organs.

Alcohol impacts muscle cells, too, causing them to release phosphate.

According to the NKF, there are more than 26 million Americans who already have kidney disease, and most don’t know it because there are often no symptoms until the disease has progressed. Kidney disease is the 9th leading cause of death in the country. (Alcohol is the third leading cause of death, see related examiner.com article.) Today there are more than 95,000 people waiting for kidney transplants and more than 590,000 people have diagnosed kidney failure in the U.S.
--from examiner.com, see full article
www.alcohologist.com

Scroll down for the replay of the Dr. Jeanette Gallagher show feature with Scott Stevens. Lucy Pireel's "All That's Written" included a feature on Every Silver Lining Has a Cloud called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud can be found on www.alcohologist.com, plus the interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.  
 

SAVE THE DATE:  Scott Stevens will be part of the opening night symposium for the REEL Recovery Film Festival San Francisco.

10,000 deaths, 100 percent preventable

Bookended by Thanksgiving and New Year's Day – the two deadliest days on the road – is National Impaired Driving Awareness Month. During the entire year, an average of 25 people are killed each day by intoxicated motorists. During the holidays, the average jumps to 45 per day. All are preventable with existing technology.

National Highway Traffic Safety Administration (NHTSA) is a sponsor of the campaign, along with Mothers Against Drunk Drivers (MADD) and the Governors’ Highway Safety Association. In the United States the NHTSA estimates the nearly 10,000 people killed in alcohol-related collisions, represented a third of total traffic deaths. One out of every 10 arrests for all crimes in the U.S. were for Operating While Impaired (OWI), accounting for 1 out of every 80 licensed drivers. The death toll is higher than the previous year, despite tougher penalties and more enforcement.

Most addiction professionals prefer the term “Operating While Impaired” over “Drunk Driving” because often “drunk” is a subjective term, but there's an objective legal standard for impairment. No distinction is ever assessed whether the driver is an alcohol abuser or has the disease of alcoholism: If you are impaired, you are under arrest.

Drunk or buzzed driving is the act of operating or driving a motor vehicle while under the influence of alcohol or drugs while motor skills are impaired. In the United States, the point of impairment is pegged at .08 Blood Alcohol Concentration (BAC). However, studies have demonstrated that motor-skill impairment begins at much lower BACs. Reaction time is 1/5 of a second for an unimpaired driver. With alcohol in the system, reaction time is slowed to 4/5 of a second at .06 BAC. At 60 mph, a second means 88 feet. A fifth of a second is 17.5 feet, 4/5 of a second is 70.4 feet. The Jetta slamming on the brakes in front of an impaired driver is 53 feet closer, reaction-time wise, compared to an unimpaired driver.

The specific criminal offense is usually called driving under the influence (DUI), and in some states driving while intoxicated (DWI), operating while impaired (OWI), or operating a vehicle under the influence (OVI). The first jurisdiction in the U.S.to adopt laws against drunk driving was New York in 1910, with California and others following. Early laws simply prohibited driving while intoxicated, requiring proof of a state of intoxication with no specific definition of what level of intoxication qualified.

The first generally-accepted legal BAC limit was .15. In the US, most of the laws and penalties were greatly enhanced starting in the late 1970s, and through the 1990s, largely due to pressure from groups like MADD, leading to a national standard of .08 as the definition of impairment.

A May 2013 hearing by the National Transportation Safety Board (NTSB) produced ideas for reducing drinking and driving deaths, among the ideas, lowering the limit legal for driving from .08 to .05 BAC. One hundred other countries have lower BAC limits for driving than the U.S. The idea is being debated around the country because the board has no authority to make the recommendation a law.

The last time the NTSB recommended a BAC change, from .10 to .08, it took two decades and the threat of Congress withholding highway funds for the idea to become law in all 50 states. An Indiana state legislator, Senator Michael Crider, R-Greenfield, predicts that is what it will take again. "If you look at the percentile drops, it's a pretty significant drop in the legal driving limit for drunk driving. It's going to be something not necessarily real popular, based on what I saw last time."

MADD, an expected ally of the proposed lower limit, is not behind it, instead focusing on its own three-pronged agenda for reducing impaired driving. The NHTSA also opposes the change to .05. Republican leaders on Capitol Hill say, "Leave it to the states to decide."

The states so far have voiced resistance. The Governors Highway Safety Association, which represents state highway safety offices, says expect push back because, “It was very difficult to get .08 in most states so lowering it again won’t be popular,” according to Jonathan Adkins, an official with the states' group. “The focus in the states is on high content offenders as well as repeat offenders. We expect industry will also be very vocal about keeping the limit at .08.”

The industry, via the American Beverage Institute, expectedly called the proposal "ludicrous."

Wyoming Gov. Matt Mead told the Associated Press he would prefer to increase penalties for drunken drivers, but he is willing to study the recommendation. However, Mike Moser, of the State Liquor Association, said the change could criminalize social drinking. Moser said it makes more sense to crack down on heavy drinkers who are more dangerous behind the wheel, an idea that does not register with a Chicago trauma surgeon who notes impairment begins far earlier than severe intoxication. Dr. Thomas Esposito, chief of the Division of Trauma, Surgical Critical Care and Burns in the Department of Surgery at Loyola University Medical Center, says, "The rationalization by critics that it penalizes the person who only occasionally has 'one too many' or who only drinks 'socially' makes no sense. One too many is just that; it's about impairment, not the number of drinks."

Lab research indicates at 0.02 to 0.05 BAC, the ability to see or locate moving lights correctly is reduced as is reaction time and the ability to judge distance. Even if not obviously impaired, at 0.05 BAC drivers are twice as likely to have a crash as before they started drinking...At 0.08 BAC drivers are five times more likely to have a crash than before they started drinking. Over .08, the crash likelihood jumps to 10 times that of a sober driver.

Highway alcohol-related deaths are 100 percent preventable. Passive alcohol detectors can measure a driver's BAC before starting the vehicle and render it unable to start. If the driver is intoxicated, he isn't driving. Critics claim the technology has not been perfected. However, the technology already exists for the non-invasive technique (see related examiner article), although the public appetite for the device does not.

Mandating these in-car alcohol detectors – the way seatbelts and airbags are required in U.S. cars – was among the 20 ideas the NTSB proposed at the same time as lowering the BAC threshold for drinking and driving. Detroit automakers have been testing in-dash systems since June 2012. The idea was suggested three years ago in the book What the Early Worm Gets as the way to conclusively eliminate all drinking and driving accidents.

“Our goal is to get to zero deaths because each alcohol-impaired death is preventable,” NTSB Chairman Deborah Hersman said. “They can and should be prevented. The tools exist. What is needed is the will.”

In 2011, 9,858 people were killed, 350,000 injured and $132 billion spent as a result of "alcohol-related" crashes. To Esposito's point, such classification does not mean the driver was over the .08 BAC limit, although usually that is the case, only that alcohol was present at the scene or detected on the breath or blood. No determination has to be made regarding level of intoxication, alcohol abuse or the disease of alcoholism but 4 million motorists admit to driving while impaired, according to NTSB estimates.
--from examiner.com (See full article)
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. 

World Stroke Day: New Finnish study ties alcohol use and hangovers to stroke risk

World Stroke Day  is Oct. 29, bringing attention to how to spot a stroke and how to prevent one. On the prevention front, a new University of Eastern Finland study shows excessive alcohol consumption increases the progression of atherosclerosis and the risk of stroke in middle-aged men. The findings were reported as part of the FinnDrink Study Oct. 21 and mirror earlier data showing an increased stroke risk for drinkers of both genders regardless of age, even with only moderate consumption.

The Finnish research found that progression of atherosclerosis over an 11-year follow-up was increased among men who consumed six or more drinks on one occasion. Stroke risk also increased among men who had at least one hangover per year. Drinking large quantities of alcohol more than twice a week also increased the risk of stroke death in men.

And strokes aren't only a concern for older adults. Early in 2013, a separate study at the University of California at San Francisco (UCSF) concluded that one of every five strokes occurs in people between 18 and 44 years of age. That's men and women.

"When a young person has a stroke, it is probably much more likely that the cause of their stroke is something other than traditional risk factors," such as hypertension and obesity, according to one of the lead researchers in the study. (See the entire examiner.com article)

The UCSF researchers say long-term changes in the heart as a result of alcohol abuse or the disease of alcoholism may put younger users at higher-than-average risk earlier in life. "Substance abuse is common in young adults experiencing a stroke,” according to the research team. "Patients aged younger than 55 years who experience a stroke should be routinely screened and counseled regarding substance abuse.”

Neither study offers evidence that patients' drug or alcohol use directly caused the strokes. It's possible, for example, that people who abuse alcohol or have the disease of alcoholism also see their doctors less often or engage in other risky behaviors that increase the chance of stroke.

Stroke disables more people in the United States than breast cancer or the war in Afghanistan. According to the Centers for Disease Control and Prevention (CDC), nearly 800,000 people in the United States have a stroke every year. Strokes (either ischemic or hemorrhagic) are the most common causes of serious long-term disability. Ninety percent of strokes are ischemic, where a clot blocks blood flow to the brain.

Additional statistics from the National Stroke Association reveal:

• Stroke kills almost 130,000 Americans each year—that’s 1 in every 19 deaths.
• On average, one American dies from stroke every 4 minutes.
• Fewer than 20 percent of hospitals are stroke certified.
• One fourth of strokes are recurrent strokes.
• Stroke costs the United States an estimated $38.6 billion each year.

Stroke risk is heightened by even a small amount of alcohol according to an Oct. 26 study posted on Canadian medical news website Tele-Management. Just one drink of alcohol was found to double stroke risk immediately after consuming the beverage. After two hours, the risk of stroke is increased 1.6 times when compared to the risk before having the drink.

The research was not based on any specific type of alcoholic beverage.

The World Stroke Day campaign emphasizes the importance of seeing a physician regularly and quickly recognizing the signs of a stroke. The American Stroke Association and American Heart Association use the acronym FAST, encouraging people to be on the lookout for weakness in one side of the Face or Arm weakness or Speech difficulty as signs it is Time to call 9-1-1. Some stroke treatments can only be used during a short "window of opportunity" after the stroke, just like has been commonly accepted as a window of opportunity for getting help to someone who’s had a heart attack.

-- from examiner.com (see complete article)
www.alcohologist.com



Please read the new interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.    

SATURDAY REWIND: Other organs risked by binge drinking, not just the liver

The following article from the alcohol research news archive takes a look at other organs at risk from episodes of heavy drinking.


Alcoholic liver disease (ALD) covers a range of diseases such as fatty liver, hepatitis and cirrhosis. All are commonly linked to alcohol abuse or the disease of alcoholism. A January 22 review of studies addressing the effects of binge drinking on the liver underscores the complex interactions among various damages done to the liver by binge drinking.

Results published in the April 2013 issue of Alcoholism: Clinical & Experimental Research and are part of the first review that highlights the changes at the molecular level that occur in the liver from excessive alcohol use.

Binge drinking is defined by the U.S. Centers for Disease Control and Prevention (CDC) as four or more drinks in an episode for women, five or more in an episode for men.

Binge drinking is on the rise worldwide, and is particularly common in the U.S. A recent study, reported on examiner.com in early 2012, shows it is a rising – and risky – problem for women, but men are statistically more prone to binge drinking and are also at risk. Teen and young adult binge drinking is also a statistical headache for those in the alcohol abuse prevention profession.

"The liver is the main metabolic site in the body," said Shivendra D. Shukla, Margaret Proctor Mulligan Professor at the University of Missouri, School of Medicine and lead author for the study. "It is involved in the physiological functions of organs such as the heart, kidney, blood vessels and brain. ALD-affected liver chemicals can also influence immunity, cardiovascular health and coagulation. Thus, ALD can have a 'domino effect' on many organs."

The liver is also the major organ for alcohol metabolism, and as such, is the first line of defense against excessive alcohol consumption.

New studies from both experimental animals and humans indicate that binge drinking has profound effects on the liver. This is in addition to the known dangers of acute levels of alcohol. "Chronic alcohol consumption renders the liver highly susceptible to binge-induced liver damage," said Shukla. "Binge-induced liver injury impacts other organs as well, a view rather poorly appreciated by the public."

Shukla said, "This review also sets the stage for additional investigations in this field. The cross-organ implications of binge-induced liver damage must be explored."

Binge drinking can cause changes at the cellular level, in the mitochondria – the power-plant of all living cells. It can result in cell death as a result, and otherwise has a snowball effect in other organs because of the liver’s role in removing toxins from the body. Added Zakhari. "Therefore, people should not binge drink, especially on an empty stomach, and if they are chronic heavy drinkers, binge drinking will exacerbate liver injury, especially if (conditions) such as obesity, Hepatitis C or HIV infection exist."

"We hope this will encourage research and development of newer approaches and tools to control and ameliorate binge-induced health effects,” said the researchers.

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

“Lest you think these three liver problems are the realm of only the hard drinker, they can be stimulated by amounts of alcohol between seven and 13 ounces of whiskey – five to nine shots or mixed drinks – in 24 hours,” according to the book, Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety. “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.”
-- from examiner.com (full article)

www.alcohologist.com

Alcohol's health benefits 'wishful thinking,' not evidence-based

The evidence of the harmful effects of alcohol outweighs data on the benefits of drinking, a physician writes in the current online issue of the journal Addiction. In a critical analysis of the health-boosting, disease-preventing characteristics of alcohol, Norwegian psychiatrist and addiction researcher, Hans Olav Fekjær, notes in the journal, “Altogether, the evidence for alcohol's ability to prevent diseases is considerably weaker than that for alcohol causing several kinds of harm.”

According to Fekjær, claims that alcohol has health benefits are observational, not evidence-based considering all the characteristics of the drinkers. This means that the claims do not take into account other lifestyle choices such as diet, nor do they consider the “dosage” of alcohol or pre-existing conditions, not the least of which is the disease of alcoholism.

Various observational studies have concluded that drinking moderate amounts of alcohol may help prevent:
Alzheimer's disease/dementia
Asthma
Colorectal cancer
Common cold
Coronary heart disease
Diabetes (type 2)
Gallstones
Hearing loss
Low birth weight, prematurity
Lower urinary tract symptoms (in men)
Osteoporosis
Overweight
Psychiatric disorders
Renal cell cancer
Rheumatoid arthritis
Stroke (ischaemic)
And total mortality

According to the journal, these studies all vary widely on the lifestyle factors taken into account. “Altogether, there is ample evidence that groups with different drinking habits differ in several other ways than their drinking, making it difficult to separate the effects of drinking habits from other factors” contributing to illness. For example, people who don't drink at all, as a group, "have a less healthy diet and exercise less than moderate drinkers to begin with," Fekjær said. An earlier study also concluded that abstainers have more of several other risk factors tied to the same diseases, such as having low education and passive lifestyles or being unmarried, disabled or depressed.

Fekjær also noted claims that moderate wine drinking has health benefits. “Wine drinkers generally had more formal education, better dietary and exercise habits and more favorable health status indicators. Altogether, there is ample evidence that groups with different drinking habits differ in several other ways than their drinking, making it difficult to separate the effects of drinking habits from other factors.”

Other evidence-based studies on the same diseases listed above demonstrate increased risk with alcohol consumption. On the list, alcohol is claimed to help with low birth weight in observational studies, but in evidence-based studies, drinking has been proven to cause fetal alcohol spectrum disorder (FAS) and lower the child's IQ by age eight. Observational studies mention alcohol as reducing risk of some cancers, but evidence-based studies by Boston University earlier this year (see related examiner.com article) concluded “No amount of alcohol is safe."

While there is observational data that light or moderate drinkers have a reduced risk of several diseases which are influenced by lifestyle factors, whether or not the lower risk is due to alcohol is a more complicated issue. “Taken together, the existing evidence does not seem to meet the criteria for inferring causality. For almost all the diseases, we do not know of any plausible biological mechanism explaining a preventive role for alcohol. Alcohol's possible ability to prevent diseases should probably not be considered as an established fact.

“The absence of definite knowledge leaves plenty of room for wishful thinking, which we observe frequently on this topic,” Fekjær concluded.


There are 79,000 U.S. deaths annually attributed directly to alcohol use (accidents, cirrhosis, etc.) and as many as 900,000 additional deaths indirectly attributed to alcohol use (cancers, Alzheimer's, etc.).  While it may be comforting to justify alcohol use as "good for my heart" or by using some other observational data, the CDC reports alcohol as the nation's #3 cause of death.


Scroll down for the replay of the Dr. Jeanette Gallagher show feature with Scott Stevens. Lucy Pireel's "All That's Written" included a feature on Every Silver Lining Has a Cloud called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud can be found on www.alcohologist.com, plus the interview with Scott Stevens at Christoph Fisher Books.  Mr. Fisher is an acclaimed international historical fiction novelist from the UK.  

SAVE THE DATE:  Scott Stevens will be part of the opening night symposium for the REEL Recovery Film Festival San Francisco.