Living Skillfully: Your Mind and Health

Alcohol is in the news at the moment here for a couple of reasons. First is the fatal shooting of liquor store owner Navtej Singh, which is focussing attention on the high density of liquor outlets in some areas – most commonly, low-income areas. The other is the controversial decision in Australia to redefine binge drinking with a lower limit, as part of the Government’s campaign against youth binge drinking.

photo credit: Don Fulano

So what are the specifics of the harm that alcohol does? I recently learned some things about it that I didn’t previously know (as part of the nutrition studies I’m doing), so I thought I would pass them on.

Alcohol is, basically, a poison, though in small amounts it’s one that our bodies can usually deal with without permanent harm. It’s also a drug, affecting the operation of the brain. So much is well known. However, what I didn’t realize about alcohol is exactly what it does inside the body.

Firstly, alcohol, unlike food, is immediately absorbed across the stomach wall and into the bloodstream, quickly reaching the brain. Food in the stomach slows this process, which is why some people – young women, particularly – are using the risky maneuver known as “alcorexia”, skipping meals before drinking in order to become drunk more quickly and cheaply. It saves money and reduces calorie intake (alcohol is high in calories, by the way), but it’s bad for the stomach and liver, and also for judgment and reasoning – the first mental functions that alcohol affects. This is likely to lead to more drinking, with toxic effects.

photo credit: styleserver

Women also have less of the alcohol dehydrogenase enzyme in their stomachs than men, so they break down less alcohol (and so absorb more) per kilo of body weight than men do. Add to this the fact that women are usually smaller than men in any case, and you see why the recommended moderate intake for women is about half of that for men.

The liver is the body’s main way of getting rid of alcohol. Alcohol, when present, receives priority over other things the liver should be taking care of, because it’s toxic and can’t be safely stored in the body. You know what happens when urgent jobs take priority over routine tasks – the routine tasks stack up. Heavy drinkers end up with fat stockpiled in their livers for processing that it never receives. Even one day’s heavy drinking can increase fat stores in the liver.

The liver also is essential to several different parts of the metabolic processes which produce energy for the body, and if it is busy dealing with the alcohol these processes get neglected. Acid builds up in the body, blood glucose – essential fuel for the brain and nervous system – can drop, synthesis of proteins needed by the immune system slows down, and the liver’s processing of other drugs is hindered.

The liver can only handle so much alcohol in a given time period, about one standard drink (or half a fluid ounce, 15ml, of pure alcohol) per hour. The alcohol that isn’t yet processed will keep circulating in the bloodstream, and affecting the brain, until the liver is able to process it. This is why drinking a lot in a short amount of time is dangerous.

photo credit: Simczuk

It’s dangerous because alcohol is a narcotic – it interferes with the functioning of parts of the brain, effectively “puts it to sleep”. Having parts of your brain asleep is generally not a good thing in a changing environment, which is why drinking and driving is such a stupid thing to do.

The first part of your brain to be sedated is the frontal lobe, where your judgment and reasoning functions are carried out (as I mentioned above). If you drink fast enough that the alcohol level in your blood continues to rise because the liver can’t process it all out as it comes in, speech and vision centres in the midbrain are affected next.

At higher concentrations still, voluntary muscular control (as in speech, hand-eye coordination and limb movements) is affected. At this point the drinker may stagger, weave and fall down, or their speech may be slurred. Finally, consciousness is lost; the drinker passes out.

photo credit: kamshots

At least, we hope that that’s the final thing that happens, because if a person has been drinking really quickly, they may have enough alcohol in their system to actually stop their breathing and heartbeat by sedating the deep parts of the brain which control those functions. Even unconsciousness, of course, can be dangerous, especially if the body decides to get rid of some of the poison by vomiting, and you choke on your own vomit.

Alcohol is involved in a quarter of emergency-room admissions, a third of suicides, half of all homicides, half of domestic violence incidents, half of traffic fatalities and half of fire fatalities. It is the second largest public health issue after smoking.

Moderate drinking is usually defined as up to one standard drink (containing 15ml of pure ethanol) per day for women, and up to two for men. Binge drinking is defined as four drinks in a row for women and five in a row for men (though Australia is moving to change the definition to simply four drinks in a row). The definition, note, doesn’t consider the amount of time elapsed – although this is significant for the specific effects of the alcohol, as noted above, four drinks in a row is always a problem.

photo credit: Tambako the Jaguar

You can be a problem drinker without being an alcoholic. Alcoholism has a specific definition, involving the presence of three or more of the following:

• Increasing tolerance (needing higher and higher doses of alcohol to get the same effect)
• Withdrawal symptoms if drinking is stopped
• Impaired control of drinking behavior
• Neglect of important life commitments because of drinking
• Much time invested in obtaining alcohol, drinking, and/or recovering
• Intoxication or withdrawal symptoms interfering with work, school or home
• Continued drinking despite physical hazards or problems with illness, the law, employment, mental health, family life etc. which are caused by alcohol.

Someone who’s simply uncomfortable with the amount that they’re drinking and wants to be able to drink moderately, but is not an alcoholic, is usually easy to work with. All that’s required is a cognitive shift. I have worked successfully with such a client, and it’s a similar process to working with someone who wants to overcome any excessive but straightforward desire, such as the desire for sugary foods.

Alcoholics, on the other hand, have a complex physical and mental health condition which needs specialist treatment. It is generally not possible for alcoholics to drink moderately. They need to give up alcohol completely and for life.

photo credit: {dpade1337}

Next post, a (probably much shorter) look at the health benefits associated with drinking alcohol in moderation.

Source for much of the above: Understanding Nutrition, eleventh edition, by Ellie Whitney and Sharon Rady Rolfes (Thomson, 2008).

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