Alcohol Addiction

A 2015 report from the National Survey on Drug Use and Health found that, 15.1 million American adults suffer from alcohol addiction. This is in addition to 623,000 adolescents who are addicted to alcohol.

These numbers were gathered from a self-reporting survey, so it is certain that the actual numbers are higher than what was found in the study. For a more objective view, the Centers for Disease Control  performed a study with data gathered between 2006 to 2010, and found that on average there were 88,129 annual deaths directly attributable to alcohol. This does not include DUI or crime related deaths involving alcohol, but strictly deaths due to the medically harmful effects of alcohol.

Alcohol has a significant impact on judgement, impulse control, coordination, and reaction time. These immediate effects, coupled with the damage alcohol can do to the body and mind through prolonged use, as well as it’s acceptance within society at large, make alcohol very dangerous.  If you have a family history of alcoholism or addiction, you are even more prone to the dangers of alcohol use as you may be genetically predisposed to have an abnormal reaction to alcohol compared to the majority of the population.

Alcohol Addiction

Alcoholism (alcohol addiction) is a facet of the disease of addiction, with alcohol being the drug of choice. Alcoholism is characterized by a mental obsession with consuming alcohol, and changing behavior to maximize the amount of time available to drink.

Drinking usually begins as a social activity. This can be the case for years, or even decades. Everyone is different in their propensity and susceptibility for alcoholism, but most alcoholics begin drinking in this manner. Over time, you may find that you are needing less of an “excuse” to drink, and that you begin drinking more through the week. If this trend continues, you find yourself drinking every day, and waking up hungover every morning. 

"That which hath made them drunk, hath made me bold; what hath quenched them, hath given me fire."

Macbeth: Act 2, Scene 2​

Next, you may find that on days you have an extremely bad hangover, you need a drink in the morning; a so-called “eye opener” drink to get going for the day. The next steps usually involve drinking at work or other activities throughout the day. This can progress to the point where you lose friends, jobs, are cut off from family, and become isolated as drinking becomes a primary fixation and dominates your life.

After drinking consistently for some months, you will begin to get alcohol withdrawal symptoms once you go without alcohol for some hours or days. This is a clear sign that you are physically addicted. This means that your brain has adapted to the prolonged and repeated presence of alcohol by adjusting the production, regulation, and sensitivity to various neurotransmitters. After compensation for the effects of alcohol has taken place, your brain and body will be unstable once it is removed, sometimes to a life threatening degree. This sense of discomfort along with anxiety and confusion will often propel many an alcoholic back into the embrace of drink.

The U.S. Department of Health and Human Services recommends that if someone is not already drinking alcohol, then they should not begin for any reason. If they are, however, it is recommended to drink in moderation. "Moderation" is defined as one drink per day for women, and 2 drinks per day for men. A drink is further defined in the United States as 14 grams of pure alcohol; the amount of alcohol found in 12 ounces of beer, 5 ounces of wine, or a 1.5 ounce shot of liquor. Heavy drinking is also codified as 4+ drinks a day for women, and 5+ drinks a day for men.

Signs of Alcohol Addiction

If you find yourself drinking every day or can’t stop thinking about drinking, then you may be in danger of alcohol addiction. Some common signs of alcoholism are listed below:

  • Frequent Blackouts
  • Lying About or Hiding Your Drinking
  • Frequently Missing Work or Social Events
  • Mood and Behavior Changes (increased irritability, anger, and anxiety)
  • Driving Drunk
  • Drinking Alone
  • Paranoia / Excessive Fear (without an apparent cause)
  • Drinking at Inappropriate Times (work, school, watching your kids, etc.)

Alcohol Withdrawal

Please note that once these symptoms begin, it is highly advised to seek medical help immediately. As mentioned, alcohol withdrawal can kill you without a proper, medically supervised alcohol detox. These symptoms of alcohol withdrawal will manifest when you haven’t had a drink for several hours and include:

  • Tremors or Shaking
  • Anxiety or Panic Attacks
  • Disorganized Thinking and Inability to Focus
  • Insomnia
  • Irregular or Fast Heartbeat
  • Diaphoresis (excessive sweating)

Alcohol Detox – Understanding The Risks

Once addicted, the alcohol detox process can be extremely unpleasant, and even deadly, if not monitored and treated properly. Some of the most serious withdrawal symptoms include:

  • Severe Anxiety: Begins hours from last drink and can last for days or weeks. Usually includes insomnia and psychomotor agitation symptoms such as pacing back and forth or incessant foot tapping.
  • Tremors: Trembling or even violent shaking which can begin hours after your last drink and can last for several days.
  • Alcohol Hallucinosis: Visual, tactile, or auditory hallucinations, which can present as voices, and typically begin within a day of your last drink and last for several days after.
  • Grand Mal Seizures: Also called tonic-clonic seizures, these are characterized by violent involuntary muscle contractions and loss of consciousness; can result in Status Epilepticus.
  • Delerium Tremens: Experienced by some very heavy drinkers, DTs include the above-mentioned anxiety, tremors, hallucinations, and seizures, but also include wild fluctuations in body temperature, blood pressure, heart rate, breathing, and produces severe disorientation and confusion.

Repeated alcohol withdrawal has been hypothesized to increase the risk of many neurological problems, in particular elevating your risk of seizures during subsequent withdrawals. Due to the havoc wrought by the withdrawal process, the brain can become maladapted to normal function (functioning without alcohol being present). This can result in anxiety disorders, depression, and an increased risk of epileptic episodes. The process by which this may occur is not very well understood, but is referred to as the "Kindling Process" hypothesis.

The Science Behind Detoxing From Alcohol

Due to the alcohol-induced increase in neuronal inhibition via GABA, your body will over time decrease global GABA production. Once alcohol is removed, the increase in inhibition is no longer present. Since GABA is an inhibitory neurotransmitter and has a signal dampening effect on neurons, the decreased global levels will produce less neural inhibition, and result in an increase in firing and greater response to signals. This process is partly to blame for the nervous system hyperactivity during alcohol withdrawal.

Likewise, because of alcohol-induced Glutamate receptor attenuation, the body will increase the production of Glutamate to compensate, as well as increase the sensitivity of the NMDA Glutamate receptor sites. Once alcohol withdrawal has commenced, the Glutamate receptors will return to full sensitivity due to the absence of alcohol, as well as have more global Glutamate to react to due to the increase in production. This double-whammy of more Glutamate, and receptors being more sensitive to Glutamate is responsible for a lower seizure threshold (greater risk of seizure), as well as an elevated risk for brain damage due to Glutamate excitotoxicity.

Finally, the levels of Serotonin and Dopamine will increase during alcohol withdrawal and will contribute in different ways to the unpleasant effects. The surge in Serotonin levels will act in a destabilizing manner with regard to mood, and can increase anxiety and precipitate wild mood swings during withdrawal and for a long period afterwords. Dopamine is an excitatory neurotransmitter which stimulates the brain and body. Excess levels of Dopamine result in hallucinations and the hyperactivity of the autonomic nervous system (blood pressure, heart rate, metabolism, etc.) and will also contribute to an increased level of stress and insomnia.

Because of the seriousness and variety of symptoms encountered during alcohol withdrawal, it is highly recommended to seek treatment or hospitalization during the detox process. Depending on the severity of withdrawal symptoms, you may either need an inpatient or outpatient alcohol treatment regime.

Alcohol Addiction Medications

There are a variety of medications which can drastically lower the risk or brain damage or death, as well as make the experience less traumatic. Some of the more common medications prescribed or used during the withdrawal process are:

  • Lorazepam (Ativan), Diazepam (Valium), Oxazepam (Serax), and Chlordiazepoxide (Librium): Themselves Benzodiazepines, these drugs will alleviate some of the nervous system hyperactivity due to withdrawal. Since they exhibit sedative-hypnotic effects, this will result in lessened anxiety, decreased tremors, lower risk of seizure, and lower likelihood to suffer Delirium Tremens. Benzos are cross-tolerant to alcohol, meaning that while withdrawing from alcohol, these drugs can act as a substitute to prevent the worst symptoms.
  • Carbamazepine (Epitol): An anti-convulsant drug used in mild to moderate withdrawal, it will greatly reduce the possibility of a seizure, lessen cravings, and can prevent the Kindling Process. This class of drugs can also treat mood disorders, and during alcohol withdrawal can result in decreased anxity, irritability, and help with depression.
  • Valproic Acid (Valproic): Also an anti-convulsant, it can lessen withdrawal symptoms and reduce the number of seizures suffered.
  • Gabapentin (Neurontin): A GABA analogue, it can be as effective as Lorazepam in mild to moderate alcohol withdrawal through stimulating GABA activity in the brain thereby acting to inhibit nervous system hyperactivity.
  • Propanolol (Inderal): A Beta-Blocker which modulates adrenergic responses and can lessen autonomic nervous system hyperactivity such as high blood pressure and elevated heart rate.
  • Clonidine (Catapres): An Alpha-Agonist, it also modulates adrenergic responses and can lessen certain autonomic nervous system hyperactivity such as high blood pressure.
  • Baclofen (Gablofen): A GABA Beta agonist, it acts as a muscle relaxant and has been used to moderate severe withdrawal symptoms and has been shown to reduce cravings.

Because of the risks involved in alcohol withdrawal, if a seizure has occurred, it is recommended to be medically monitored for 36 to 48 hours to prevent the onset of Delirium Tremens. Once medically stable, you may be discharged and given a prescription taper. This means that you will, over the course of days or weeks, take less and less medication until you are through the worst of the withdrawals. The next steps are geared more towards mental health and addiction recovery.

Alcohol Addiction Treatment

Once through withdrawals, you will need to be proactive in your recovery. This means seeking out a treatment program and support group. If you happen to be in the Atlanta, Georgia area, you can also view our Atlanta Addiction Recovery Guide for more information at the local level. There are many different types of treatment programs such as:

  • Inpatient Alcohol Treatment: You live onsite and attend counseling, therapy, and support activities daily.
  • Outpatient Alcohol Treatment: You come in daily or several times a week for counseling, therapy, and meetings.
  • Sober Living: Usually (but not always) involved in an outpatient program, you will live with others who are also in recovery.

Other than paid programs, 12 Step recovery groups have shown a very high success rate at helping people to get and stay clean. One such recovery fellowship is Alcoholics Anonymous. This fellowship has meetings in over 96 countries (as of September 2019) and you can find a meeting near you by visiting the AA Meeting Finder. The road to recovery is long, and having as many guides and friends as possible on the way will ensure that you have the best possible chance.

If you choose the 12 Step route, it is strongly recommended that you get a sponsor as soon as possible. Find someone who you can relate to and who has some of the things you want such as clarity of mind and serenity. They will be able to act as an guide and mentor throughout this process. It will also help to meet new friends who have gone, or are going, through the same things as you are now. They have been there and can advise you about what they did to get through, and be able to relate to the struggles you may be facing. You can do this, but you will need help. It is now up to you to seek it out.

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DUI & Other Legal Consequences of Alcohol Abuse

Alcohol has been around for a very, very long time. There is evidence of a deliberately fermented alcoholic drink in China which dates from ~7,000 B.C.E. but the production and consumption likely goes back even further in our species’ history. More recently in the United States, alcohol was outlawed in early 1920 under the 18th Amendment to the Constitution due in part to the temperance movement which argued for moderation or abstinence from the standpoint of morality and public health, and enforcing legislation was elucidated under the Volstead Act. This prohibition was not to last, and alcohol returned to legality with the ratification in late 1933 of the 21st Amendment to the Constitution.

Even though alcohol is no longer illegal, the legal consequences of offenses which include alcohol can range from slaps on the wrist, to mandatory jail time, and large fines coupled with license suspension if a motor vehicle was involved. Public Intoxication is one of the most common alcohol related charges and which usually mandates arrest and typically involves minor jail time. While the first such offense is a misdemeanor, repeat offenders can receive escalating sentences for each subsequent offense, including months in prison. Driving a car while drunk can be extremely dangerous to yourself and anyone around you, as piloting several tons of metal at even low speeds while intoxicated drastically increases the chances of an accident. Aside from killing or maiming someone, you have the ability to cause extensive property damage while driving under the influence.

Driving Under the Influence (DUI) is considered operating a motor vehicle with a Blood Alcohol Concentration (BAC) of more than 0.08%. In the United States today, every 50 minutes someone is killed in a car accident where at least one driver is under the influence of alcohol. In 2016, of the 51,914 people killed in car accidents, ~19% (9,885 fatalities) involved a driver having a BAC of 0.08% or greater.

"In the United States today, every 50 minutes someone is killed in a car accident where at least one driver is under the influence of alcohol."

National Highway Traffic Safety Administration

First or second offense DUI is typically a misdemeanor, provided you did not hit something or someone, but still usually requires jail time. This is most often a few hours or days at most, but will escalate with each subsequent offense. While the sentences vary greatly between states, in most cases you can expect suspension of drivers license (you may be eligible for a Hardship Permit for work, doctor, etc.), community service, requirement to attend a DUI class, and probation. The initial fine, plus any probation charges will often end up being several thousand dollars. Repeat offenders may be additionally ordered to attend DUI/Drug Court, get an Ignition Interlock Device installed in their car, wear a BAC ankle monitor, and attend recovery group meetings multiple times per week.

Aside from driving offenses, alcohol is involved in a significant percentage of violent crimes, in part due to it’s societal prevalence and ease of access as well as alcohol’s effect on behavioral inhibition suppression. A report by the National Crime Victimization Survey found that of domestic abuse crimes, 51% involved the perpetrator being under the influence of alcohol. For simple assault alcohol was involved in 65% of incidents, and for aggravated assault it was 23%.

Why is Alcohol Addictive?

Drinking usually begins as a social activity. This can be the case for years, or even decades. Everyone is different in their propensity and susceptibility for alcoholism, but most alcoholics begin drinking in this manner. Over time, you may find that you are needing less of an “excuse” to drink, and that you begin drinking more through the week. If this trend continues, you find yourself drinking every day, and waking up hungover every morning.

Once you take a drink, alcohol enters the blood by absorption through the stomach, and more readily through the intestinal walls. It then makes its way to the brain, and the small molecular size of alcohol is such that it can easily pass through the blood brain barrier and begin affecting neurotransmitter functions before being broken down by your body. The liver is where the majority of alcohol metabolism occurs and is able to break down alcohol into Acetate for elimination from the body, but this process involves alcohol first being broken down into Acetaldehyde, an extremely toxic metabolite and a known carcinogen in humans. Acetaldehyde is present wherever alcohol metabolism takes place in the body, even in tissues other than the liver such as the gastrointestinal tract, pancreas, and even the brain.

The effects of “drunkenness” are produced by several interactions on neurotransmitter function in the brain. The depressant action is achieved through two main avenues. The first is alcohols indirect agonist (activity promotion) effects on GABA (Gamma-Aminobutyric Acid) receptors, which produces the anxiolytic and drowsiness effects. In particular, the GABA Alpha receptor sites are most readily effected. GABA is a major inhibitory neurotransmitter which plays a large role in mammals as far as inhibiting neuron excitability. When alcohol is introduced, it turns GABA sensitivity up to increase the effect of inhibition. The next is through inhibiting Glutamate, a neurotransmitter responsible for exciting neurons and aiding in learning and memory. In particular, alcohol attenuates (reduces the effect) function at the NMDA Glutamate receptors. This interaction is in part responsible for the disorganized thinking, memory impairment, slowed reflexes, and ataxic effects.

The U.S. Department of Health and Human Services recommends that if someone is not already drinking alcohol, then they should not begin for any reason.

Another direct effect of alcohol is to facilitate the release of dopamine and serotonin. Dopamine is a neurotransmitter utilized by several regions of the brain, but the main focus of alcohol-induced dopamine release is in the nucleus accumbens, a part of the limbic system and sometimes referred to as a “reward center” of the brain. The increase in dopamine here produces feelings of pleasure, motivation, positive reinforcement, and behavior-related reward. This, coupled with comparatively minor dopamine release in the amygdala and hippocampus, has the effect of linking strong positive emotions and feelings of pleasure to the memory of drinking alcohol. 

Drug and alcohol-induced abnormalities, in the nucleus accumbens in particular, have been heavily implicated as a contributing factor in many types of drug and alcohol addiction, and a whole article could be written on it alone (forthcoming). Serotonin is also a neurotransmitter with various roles in the body (about 90% is stored in, and used by, the gastrointestinal tract) and in the brain it functions as a mood enhancer and stabilizer. Alcohol-induced release of serotonin is in part responsible for the euphoria and sense of ease that comes from taking a drink, and excessive or prolonged drinking can effect permanent changes in serotonin levels and efficiency of function in the brain.

What is Alcohol?

Alcohol is a general Central Nervous System depressant which acts to slow and weaken signalling across a large volume of the brain. The word “alcohol” typically refers to ethyl alcohol, also known as ethanol, which is the type of alcohol that you find in beer, wine, and liquor. There are 3 different types of alcohol: methyl, isopropyl, and ethyl. The different types have varying levels of toxicity, with ethyl alcohol being by far the least toxic (although it is still toxic) to humans, and thus the only type that is consumed.

Alcohol has a wide range of effects depending on the dose consumed. The dose-dependent effects are also determined by liver function and size, body mass, and even genetics. For the most part, small doses will produce a euphoria, excitation, increased libido, along with a mild anxiolytic (anti-anxiety) effect. Medium doses are known to produce disorganized thinking, memory impairment, drowsiness, emotional outbursts, and mild ataxia (impaired coordination and balance). Large doses will exhibit major ataxia, slurred speech, decreased libido, loss of inhibitions, and impaired judgement. Extremely large doses will result in stupor (near unconsciousness or insensibility) or total unconsciousness.

Alcohol also has many dose-dependent health implications, the delineation of which is still somewhat mysterious, and can range from possibly beneficial to absolutely catastrophic. Take the heart for example; light drinking (2-3 drinks per week) can slightly lower your risk of heart disease and stroke, whereas heavy drinking (4+ drinks per day) can have the opposite effect and directly lead to Atrial Fibrillation and many more issues (more below). Other immediate effects of a low dose include an increase of adrenaline output and hyperglycemia (high blood sugar). Effects of medium to high doses include hyperglycemia (low blood sugar).

Alcohol Addiction: Damages / Dangers

Aside from the risk of physical injury or legally/morally questionable behavior, ethyl alcohol consumption can have a variety of effects on the mind and body. Some of the main ways alcohol inflicts long-lasting damage is through Glutamate receptor disruption, oxidative stress due to alcohol metabolism, and inhibition of neurogenesis (new brain cell growth). Brain shrinkage due to chronic alcohol use can be quite severe. In several studies (A / B / C) both men and women showed significant brain shrinkage compared to control (non-alcoholic) test subjects. While there was partial recovery after a time of abstinence, on average there was still a neural deficit compared to control groups. Interestingly, while women were more prone to suffer alcohol-induced brain (particularly the hippocampus) and organ damage after a significantly shorter period of drinking, and typically drinking less, there was a marked trend for women to recover more quickly and more completely from this damage.

The cerebellum is extremely sensitive to the effects of chronic alcohol intake and can suffer long term damage. The cerebellum is a center for combining sensory information and motor coordination and function, and damage to it can result in a cascade of issues such as Wernicke-Korsakoff's Syndrome. Evaluations of autopsies have shown that up to 78% of diagnosed alcoholics show some form of brain pathology. The most commonly affected areas are the corpus callosum, cerebellum, prefrontal cortex, superior frontal cortex, and hypothalamus. These are just some of the neurological risks that result from long term exposure to alcohol, but alcohol can have more direct physical effects, both short and long term.

Short Term Damage From Alcohol Use

Excessive alcohol consumption in the short-term can manifest its own set of physical problems. Some of the more immediate effects are:

  • Pylorospasm: Painful and involuntary gagging or vomiting.
  • Gastritis: Inflammation of the stomach lining.
  • Reflux: Stomach acid leaking into your esophagus.
  • Mallory-Weiss lesion: Tear at the stomach-esophagus connection.

 Long Term Damage From Alcohol Abuse

The effects of long-term alcohol abuse on the body are just as serious, with alcohol being directly responsible for a plethora of physical issues, in large part due to Acetaldehyde produced through alcohol metabolism. By chronically abusing alcohol, you will greatly increase (2-3 times the rates of non-drinkers) your chances of developing certain cancers such as:

  • Breast Cancer
  • Colon / Rectal Cancer
  • Liver Cancer
  • Esophageal Cancer
  • Pharynx / Larynx Cancer

Also, due to the bulk of alcohol metabolism taking place in the liver, you greatly increase the chances of non-cancerous liver damage such as:

  • Fibrosis: Moderate scarring of the liver and an indicator of progression to full-blown cirrhosis; can also cause portal hypertension.
  • Cirrhosis: Significant scarring and severely reduced function of the liver due to alcohol-induced damage.
  • Hepatic Steatosis: Buildup of fatty cells in your liver due to alcoholism, can cause liver swelling and reduced function.
  • Alcoholic Hepatitis: Inflammation of the liver which can cause Jaundice, Ascites, fever, confusion, and fatigue.

Dangers of Chronic Alcohol Addiction

Aside from the presence of Acetaldehyde in the brain and body, other factors can lead to serious health complications. In particular, a deficiency of B vitamins (like Thiamine) can result in neural degeneration due to chronic alcohol abuse. An assortment of other serious health issues that are directly related to chronic alcohol abuse include:

  • Chronic Pancreatitis: Inflammation of the pancreas due to alcohol-induced tissue damage; can lead to Type 2 Diabetes.
  • Type 2 Diabetes: Insulin desensitization due to alcohol-induced blood sugar fluctuations and pancreas damage.
  • Cardiomyopathy: Toughening, weakening, and distention of the heart muscles which impedes blood flow to the rest of the body; can lead to organ damage elsewhere in the body; can progress to Congestive Heart Failure.
  • Atrial Fibrillation: Irregular heartbeat which can cause low blood pressure, fatigue, blood clots, fluid buildup in extremities, and can lead to other heart conditions or stroke.
  • Alcohol-Induced Hypertension: High blood pressure which can lead to heart attack, stroke, or aneurysm as well as kidney problems, vision loss, metabolic syndrome, memory problems and vascular dementia.
  • Ischemic or Hemorrhagic Stroke: Lack of blood flow to the brain or bleeding in the brain resulting in brain damage or death; risk increased due to induced hypertension, cerebral embolism, reduced cerebral blood flow, and an increase in blood clotting factors.
  • Peripheral Neuropathy: Loss of sensation, pain, and weakness typically in the extremities due alcohol-induced to nerve damage; can be chronic or even lifelong.
  • Alcoholic Dementia: A wide range of conditions fit under this umbrella term, but most present symptoms such as impairment of strategic or “big picture” thinking, judgement, and intricate planning.

A common neurological condition which results from chronic alcohol abuse is known as Wernicke-Korsakoff syndrome. Also referred to colloquially as Wet Brain, this is actually 2 distinct conditions which are typically lumped together, as Wernicke’s Encephalopathy is an acute (intense and sudden in onset) condition, while Korsakoff’s Psychosis is a chronic (long-onset and long-lasting) condition. They are both produced by the same deficiency, but the duration or severity of this deficiency will determine if Wernicke’s will progress to Korsakoff’s.

The acute condition of Wernicke’s Encephalopathy is a neurological disorder which is caused most often by chronic alcohol abuse. It is characterized by multiple symptoms which include nystagmus or ophthalmoplegia, ataxic gait, hyperthermia, hypotension, and altered mental states or delirium. It is caused by a lack of Thiamine, a coenzyme which is vital to cerebral metabolism. This deficiency, if left untreated, can lead to metabolic disturbances which can cause neuron death and lesions in the cerebellum, hypothalamus, and midbrain. If caught early enough, it can be reversed by repletion of B vitamins like Thiamine and through cessation of alcohol intake.

If untreated and allowed to progress, Korsakoff's Psychosis will likely be the result. This is a deepening of the damage done by Thiamine deficiency and is indicative of severe or permanent brain damage. The symptoms the person had during the Wernicke's phase will still be present, with the addition of severe memory impairment, typically of the short term memory.

This can be so severe as to practically destroy a persons ability to create new memories. Strangely enough, working memory seems to remain mostly unaffected, meaning someone can keep something in mind for a very short time, like how much change they should get back from a transaction. In some cases, the long term memory will be affected as well, with whole swathes of time being eradicated from recall. People who suffer from these long term memory gaps are prone to make up stories to fill in the gaps, sometimes believing the stories themselves; this is referred to as confabulation. Korsakoff's sufferers can also have aural or visual hallucinations. Research is sparse on recovery rates from Korsakoff's, but data suggests that about 1/4 of sufferers do recover, 1/2 improve slightly, and 1/4 remain with severe symptoms.

Alcohol Overdoses: Signs and Symptoms

Because of ethyl alcohols significant depression of physical processes, it is possible to overdose on alcohol, also known as alcohol poisoning. The average adult can process about 8 grams of pure alcohol per hour. Any excess will begin building up in your body. In this manner, you can still be getting more intoxicated even after you stop drinking. If you were to pass out while drinking, your body would continue to process the built up alcohol and your BAC would continue to rise. If too much is ingested in too short a time, you may experience:

  • Paleness or Blue Tinted Skin (due to lack of blood flow and oxygen)
  • Seizures (due to low blood sugar levels)
  • Confusion
  • Slow or Labored Breathing (less that 8 breaths per minute)
  • Vomiting
  • Hypothermia
  • Unconsciousness (with an inability to wake up)
  • Death (several of the above complications can result in death or brain damage)

More Potential Complications from Drinking Alcohol

Alcoholic drinks are also known to contain contaminants. Ethyl Carbamate, also known as Urethane, is a common contaminant which forms naturally in alcoholic drinks during the fermentation process or during storage. It is found in most alcoholic drink, but in the highest quantities in distilled liquor and fruit brandies. It is a Group 2A (Probably carcinogenic to humans) carcinogen and known to cause tumors in animal studies such as tumors of the lungs, liver, skin, mammary glands, and lymph nodes. It is broken down through metabolism into ethanol, carbon dioxide, and ammonia and then eliminated from the body through multiple routes.

Aside from disrupting an adults body, alcohol has been proven to cause a wide variety of birth defects, collectively referred to as Fetal Alcohol Syndrome. Drinking while pregnant can have numerous effects on the fetus, some of which include: distinct facial features, low birth weight, microcephaly (low brain volume and skull deformation), lower number of neurons, or improperly functioning neurons. With Fetal Alcohol Syndrome being the leading preventable birth defect in the United States, it is strongly advised to remain alcohol free during pregnancy.

Mixing Alcohol with Drugs

Alcohol is also capable of many drug-drug interactions which can amplify not only the effect of alcohol itself, but also the drug it is taken with. In this manner, even small amounts of alcohol can act in a synergistic way when combined with certain drugs to produce serious problems. Some drugs which alcohol can amplify include the following outlined below:

Mixing Benzodiazepines with Alcohol

Benzodiazepines (benzos) in particular can intensify the effect of alcohol, and vice versa, with only small amounts of both leading to total blackout, massive increase in risk-taking behavior, and potentially death due to depression of vital functions. Since Benzodiazepines interact with the brain in a similar fashion, such as through GABA Alpha agonist action, the effects of each will build upon one another rapidly. Types of Benzos: Alprazolam (Xanax), Clonazepam (Klonopin), and Diazepam (Valium).

Mixing Sleep Medications with Alcohol

Prescription sleeping pills, especially Z Drugs like Ambien and Lunesta act on some of the same GABA Alpha receptors as actual Benzo drugs. Because of this, the effects of synergy will be very similar to those experienced when mixing full fledged Benzos with alcohol. 

Mixing Opiates with Alcohol

Alcohol is thought to modify the function of certain opiate receptors and ambient opiate peptide levels in the brain, and through this it may modify the effects of opioids on the user. It has been proven that when opioids are used in tandem with alcohol, the elimination rates from the blood are slowed down for both drugs, leading to higher toxicities. Opiates have a similar effect of depression on vital functions as alcohol such as slower heart rate and depressed breathing, and in this way can dramatically increase the risk of death.

Mixing Cocaine with Alcohol

Cocaine is also capable of interacting with alcohol, although the process and effects are different as those seen above. In the case of dual cocaine and alcohol use, the liver will produce Cocaethylene. This substance has very similar psychoactive properties to Cocaine, however its blood elimination half-life is 3 to 5 times as long as Cocaine, meaning it stays in your body much longer. Cocaethylene has been linked to seizures, liver damage, and compromised immune system function as well as having an 18 to 25 times higher risk of immediate death.

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