A Kranz (wreath) of Kölsch beer.

A Kranz (wreath) of Kölsch beer. (Photo credit: Wikipedia)

No one knows when man first started using alcohol but archaeologists have found evidence that Stone Age man fermented and drank beer over 12,000 years ago. We know that for centuries people have used beer and wine in religious ceremonies and apparently were able to distill alcohol into whiskey.

MEDICAL USES

In addition to drinking it, alcohol has been used as an antiseptic to clean wounds and as an anesthetic.

BEER

Many people brew beer. Combine malt, hops, sugar and yeast, heat it and you can make beer. The amount of alcohol in beer is normally between four to six percent.

WHISKEY

When the fermented alcohol is distilled, or heated and condensed into another vessel, it becomes a distilled drink like rum, gin, vodka and whiskey.

Because of the effects created by alcohol, most alcoholic beverages contain a small amount of alcohol. The amount of alcohol in beer as noted above is normally between four to six percent, in wine between seven to fifteen percent and in hard liquor between 40% to 95%.

ALCOHOL IN THE BODY

When a person drinks alcohol, about 20% of the alcohol is absorbed through the stomach. The rate of alcohol absorption depends in part on the food in the stomach. One study in the Journal of Forensic Sciences found that subjects who drank alcohol after a meal that included fat, protein, and carbohydrates absorbed the alcohol about three times more slowly than when they consumed alcohol on an empty stomach.

One major factor is the percentage of alcohol in the drink; the higher the percentage, the faster the absorption.
Once the alcohol is in the bloodstream, it will pass through the lungs and some of the alcohol will be expelled through the lungs.

This is why a breathalyzer can measure a person’s intoxication level.

Most of the alcohol absorbed is metabolized in the liver through a series of chemical reactions which ultimately convert the alcohol into acetic acid (vinegar). If a person drinks too much, the liver cannot convert the alcohol into acetic acid and some of the chemicals formed by the enzymes escape into the bloodstream. These chemicals are more toxic than alcohol and are responsible for many hangover symptoms such as increased heart rate, headache, and nausea.

A small portion of the alcohol is metabolized through the P450 pathway and the CYP2E1 enzyme.

ALCOHOL AND THE KIDNEYS

Alcohol in the bloodstream causes the kidneys to produce more urine than usual, and the drinker loses more water than usual, causing the drinker to become dehydrated— a condition where the amount of water in the body has dropped below the level needed for normal body function.

Dehydration can lead to swelling of the brain, seizures (when the normal electrical discharges in the brain are disrupted, leading to involuntary muscle contractions and/or a lack of consciousness), kidney failure, and a severe drop in blood pressure preventing enough oxygen getting to the body tissues. These conditions can lead to a coma and death.

ALCOHOL AND THE BRAIN

Alcohol is very water soluble and it is able to pass through the blood-brain barrier where it can cause many harmful effects. Depending on the amount of alcohol and numerous other individual factors largely dictated by your DNA, the alcohol affects each brain in different ways. As alcohol is absorbed, the drinker starts to experience:
• Lowered pulse rate
• Lowered blood pressure
• Impaired vision
• Impaired hearing
• Lowered sensation and feeling
• Lessened muscle coordination

BLOOD ALCOHOL CONCENTRATION OR BAC

Blood alcohol concentration (BAC) is a measurement of the amount of alcohol in the blood. It is determined by measuring the number of milligrams of alcohol per 100 milliliters of blood. For example, a BAC of .08 percent, the level used by most states to determine if a person is guilty of drunk driving, means that eight tenths of one percent of the fluid in the blood is alcohol.
In general, after the consumption of one standard drink, the BAC peaks within 30 to 45 minutes. (A standard drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits, all of which contain the about the same amount of alcohol.)

INCREASING BAC

The average person eliminates approximately 0.015% of alcohol per hour from the body, or the equivalent amount of alcohol in a 12 ounce can of beer, five ounce glass of wine or a one ounce shot glass of vodka.

If a 160-pound person drinks six beers in an hour, the BAC would be approximately 0.141% minus 0.015% or 0.126%. If the person waited another hour and did not have another drink, the BAC would reduce by another 0.015% to 0.111%. In both cases, if the person were to drive during this time, and was stopped by a policeman and tested for BAC, they would almost certainly be found guilty of driving while intoxicated.

COMMON REACTIONS TO BAC LEVELS

0.05 Reduced inhibitions
0.10 Slurred speech
0.20 Euphoria and motor impairment
0.30 Confusion
0.40 Stupor
0.50 Coma
0.60 Respiratory paralysis and death

BINGE DRINKING

Many people consider that it’s OK to go out on the weekend and get “drunk” because it only happens “once or twice a week.” According to a study reported in Alcoholism: Clinical & Experimental Research (volume 29, p. 317), binge drinking is more damaging to most people than drinking the same amount of alcohol over several days. The report also found that binge drinkers also did worse than people who drank the same quantity of alcohol but over several days, in cognitive tests involving short term working memory and other cognitive tasks that were administered when both groups were sober.

What is binge drinking? The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as any episode of alcohol consumption that raises the BAC to 0.08% (or 80 milligrams of alcohol in every 100 milliliters of blood) or above. Other researchers define binge drinking as simply having more than five drinks on one occasion. By any definition, binge drinking on a regular basis can be very damaging to a person’s health and quality of life.

ALCOHOL INTERACTIONS WITH OTHER MEDICATIONS

Mixing alcohol and medicines puts you at risk for dangerous reactions. Protect yourself by avoiding alcohol if you are taking a medication and don’t know its effect. This chart was prepared by the National Institute on Alcohol Abuse.

Symptom/Disorders Medication (Brand name) Medication (Generic name) Some possible reactions with alcohol
Allergies/Colds/Flu Alavert® Loratadine Drowsiness, dizziness; increased risk for overdose
Allegra®, Allegra-D® Fexofenadin
Benadryl® Diphenhydramine
Clarinex®  Desloratadine
Claritin®, Claritin-D® Loratadine
Dimetapp® Cold & Allergy Brompheniramine
Sudafed® Sinus & Allergy Chlorpheniramine
Triaminic® Cold & Allergy Chlorpheniramine
Tylenol® Allergy Sinus  Chlorpheniramine
Tylenol® Cold & Flu Chlorpheniramine
Zyrtec®  Cetirizine
Angina (chest pain), coronary heart disease Isordil® Isosorbide Rapid heartbeat, sudden changes in blood pressure, dizziness, fainting
Nitroglycerin
Anxiety and epilepsy  Ativan® Lorazepam Drowsiness, dizziness; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; and memory problems
Klonopin® Clonazepam 
Librium® Chlordiazepoxide
Paxil® Paroxetine
Valium® Diazepam
Xanax® Alprazolam
Herbal preparations (Kava Kava)   Liver damage, drowsiness
Arthritis  Celebrex® Celecoxib Ulcers, stomach bleeding, liver problems
Naprosyn® Naproxen
Voltaren® Diclofenac
Blood clots Coumadin® Warfarin Occasional drinking may lead to internal bleeding; heavier drinking also may cause bleeding or may have the opposite effect, resulting in possible blood clots, strokes, or heart attacks
Cough  Delsym®, Robitussin Cough® Dextromethorpan Drowsiness, dizziness; increased risk for overdose
Robitussin A–C® Guaifenesin + codeine 
Depression Anafranil® Clomipramine Drowsiness, dizziness; increased risk for overdose; increased feelings of depression or hopelessness in adolescents (suicide)
Celexa® Citalopram
Desyrel® Trazodone 
Effexor® Venlafaxine
Elavil® Amitriptyline 
Lexapro® Escitalopram
Luvox® Fluvoxamine
Norpramin® Desipramine
Paxil® Paroxetine
Prozac® Fluoxetine 
Serzone® Nefazodone
Wellbutrin® Bupropion
Zoloft®  Sertraline
Herbal preparations (St. John’s Wort)  
Diabetes Glucophage®  Abnormally low blood sugar levels, flushing reaction (nausea, vomiting, headache, rapid heartbeat, sudden changes in blood pressure)
Micronase®  Glyburide
Orinase®  Tolbutamide
Enlarged prostate Cardura® Doxazosin Dizziness, light headedness, fainting
Flomax® Tamsulosin
Hytrin® Terazosin
Minipress® Prazosin
Heartburn, indigestion, sour stomach Axid® Nizatidine Rapid heartbeat, sudden changes in blood pressure (metoclopramide); increased alcohol effect
Reglan® Metoclopramide
Tagamet®  Cimetidine
Zantac®  Ranitidine
High blood pressure Accupril®  Quinapril Dizziness, fainting, drowsiness; heart problems such as changes in the heart’s regular heartbeat (arrhythmia) 
Capozide®  Hydrochlorothiazide
Cardura® Doxazosin
Catapres® Clonidine
Cozaar®  Losartan
Hytrin® Terazosin
Lopressor® HCT  Hydrochlorothiazide
Lotensin®  Benzapril
Minipress® Prazosin
Vaseretic®  Enalapril
High cholesterol Advicor®  Lovastatin + Niacin Liver damage (all medications); increased flushing and itching (niacin), increased stomach bleeding (pravastatin + aspirin)
Altocor® Lovastatin
Crestor® Rosuvastatin
Lipitor®  Atorvastatin
Mevacor® Lovastatin
Niaspan® Niacin
Pravachol® Pravastatin
Pravigard™ Pravastatin + Aspirin
Vytorin™ Ezetimibe + Simvastatin
Zocor®  Simvastatin
Infections Acrodantin®  Nitrofurantoin Fast heartbeat, sudden changes in blood pressure; stomach pain, upset stomach, vomiting, headache, or flushing or redness of the face; liver damage (isoniazid, ketokonazole)
Flagyl®  Metronidazole
Grisactin®  Griseofulvin
Nizoral®  Ketokonazole
Nydrazid® Isoniazid
Seromycin® Cycloserine 
Tindamax®  Tinidazole
Muscle pain Flexeril®  Cyclobenzaprine Drowsiness, dizziness; increased risk of seizures; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems
Soma®  Carisoprodol
Nausea, motion sickness Antivert®  Meclizine  Drowsiness, dizziness; increased risk for overdose
Atarax® Hydroxyzine 
Dramamine®  Dimenhydrinate
Phenergan® Promethazine
Pain (such as headache, muscle ache, minor arthritis pain), fever, inflammation Advil® Ibuprofen  Stomach upset, bleeding and ulcers; liver damage (acetaminophen); rapid heartbeat
Aleve® Naproxen
Excedrin® Aspirin, Acetaminophen
Motrin® Ibuprofen
Tylenol® Acetaminophen
Seizures  Dilantin®  Phenytoin Drowsiness, dizziness; increased risk of seizures
Klonopin® ClonazepamPhenobarbital
Severe pain from injury, postsurgical care, oral surgery, migraines Darvocet–N® Propoxyphene Drowsiness, dizziness; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems
Demerol® Merepidine
Fiorinal® with codeine Butalbital + codeine 
Percocet® •OxyContin® Oxycodone
Vicodin®  Hydrocodone
Sleep problems Ambien®  Zolpidem Drowsiness, sleepiness, dizziness; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems
Lunesta™  Eszopiclone
Prosom™  Estazolam
Restoril®  Temazepam
Sominex®  Diphenhydramine
Unisom®  Doxylamine
Herbal preparations (chamomile, valerian, lavender)   Increased drowsiness

ALCOHOLISM
A person suffering from alcoholism or alcohol dependence has:
• The inability to limit drinking
• Physical illness when drinking stops
• Tolerance to alcohol requiring the person to drink increasing amounts of alcohol

THE LIVER

• The largest organ in the body
• Metabolizes (breaks into components) most drugs
• Removes or neutralizes poisons from the blood
• Produces immune agents to control infection
• Removes germs and bacteria from the blood
• Makes proteins that regulate blood clotting
• Produces bile to help absorb fats and fat-soluble vitamins

CIRRHOSIS OF THE LIVER

Cirrhosis is from the Greek word kirrhos, meaning “tawny” (the orange-yellow color of a diseased liver) and is a condition where scar tissue replaces normal, healthy tissue.  It is the twelfth leading cause of death by disease.
The scar tissue interferes with the blood flowing through the liver and prevents it from working properly, resulting in some or all of the following:
• Jaundice—a yellowing of the skin and eyes
• Medications not being metabolized properly
Edema (abnormal accumulation of water)
• Bruising and bleeding because there are insufficient proteins needed for blood clotting
• Gallstones
• Toxin concentrations increasing to high levels in the blood or brain
• Type 2 diabetes because excessive glucose can remain in the bloodstream