Death by Ounces

America's no. 1 drug problem

Allan R. Magie, Ph.D., M.P.H., is an associate professor of environmental health, School of Health, Loma Linda University, Loma Linda, California.

 

ALCOHOLISM IS America's No. I drug problem, yet it seldom gets the recognition it deserves. In fact, the majority of Americans consider alcohol a beverage, and most unthinkingly accept it as part of their daily life. Through an intensive "If you choose to drink drink sensibly" advertising campaign, the Licensed Beverage Industry has lured many into a life style that includes alcohol.

Beverage alcohol consumption has reached an all-time high. Nevada usually leads the States in yearly volume of alcoholic drinks consumed—more than 55 gallons for every person more than 14 years old. More alarming is the almost-universal use of alcoholic beverages by this country's youth. Of all age groups studied, the youngest (those 18 to 20 years old) had the largest proportion of problem drinkers.

Alcohol's human toll is enormous. Of approximately 100 million drinking Americans, 9 million are alcoholics or problem drinkers. If you care for statistics, that's one chance in fourteen of a drinker becoming an alcoholic. One in five adults has a family member who drinks too much. And there's no way to predict who will become an alcoholic. Twenty-eight thousand who die each year on highways have alcohol in their blood at the time of the accident, and alcohol is the cause in at least half of the fatal accidents.

No one needs alcohol. There's no proof that anyone's health is improved by using it. It has no nutritive value. Al though it does supply calories, alcohol contains no protein, minerals, or vitamins.

Unlike most other foods, which must be digested and changed before the human body can use their nutrients, alcohol enters the bloodstream directly in the same form in which it is imbibed. It travels rapidly, first to the liver, then throughout the entire body, including the brain. Within moments after it is swallowed, alcohol can be detected in all tissues, organs, and secretions of the body.

A low level of alcohol in the blood, such as that resulting from one drink (one ounce of pure alcohol) has a mild tranquilizing effect. This is because alcohol depresses the central nervous system. The first areas of the brain to be affected are those where learned behavior patterns such as self-control are stored. After a drink or two, the typical controls temporarily disappear and the drinker may lose his inhibitions—acting strangely, talking freely, he becomes the "life of the party." Others become aggressive or depressed.

Additional drinking raises the blood alcohol to a level that depresses brain activity further, temporarily impairing memory, muscular coordination, and balance. Still larger alcohol intake, within a short period of time, depresses deeper parts of the brain, which results in a state of loss of control—dulling the sensory perceptions and severely affecting judgment. If regular heavy drinking continues, deeper levels of the brain are anesthetized by the alcohol, and loss of consciousness and death may result.

To the occasional partaker of beer, wine, or whiskey, it would be reassuring to know that, scientifically and medically, a few drinks will never hurt and might, just might, do some good. No such reality exists. The fact is that a few drinks might harm a person's body and will never do it any good.

Myths about the so-called good that alcohol can do have been increasingly discredited in recent years. A jolt of hard liquor will not make the body warmer on a freezing day. Alcohol is not an antidote for frostbite. There is no evidence that would indicate alcohol helps the heart perform its work. It is not a cardiac stimulant. Other traditional "helpful" effects of alcohol have been similarly disproved.

Of primary concern over the effect of alcohol on the body is the sludging of blood. This is brought about by a mate rial that coats the red blood cells, causing them to stick together in clumps. Recent evidence indicates that a wide variety of diseased conditions result from such clumping. When the clumped red cells reach the tiny threadlike capillaries, they may block the passage way and cause a deficit of oxygen in one part of or an entire body organ. Sludging is most easily detected in the network of capillaries underneath the eyeball's transparent surface. Heavy drinkers may suffer tiny hemorrhages of eye tissue because of this.

While the incidence of other major diseases has recently shown some decline, cancer has not. Along with a number of other environmental factors, alcohol is involved in the increase of some human cancers at various sites in the body—the mouth and throat, tongue, esophagus (food tube), upper throat, and the mouth cavity. And the more a person drinks, the greater his risk of developing such cancers. Other cancers thought to be connected with the consumption of alcoholic beverages include cancers of the liver (hepatoma), pancreas, large bowel, and upper portions of the stomach.

Cirrhosis of the liver is a major cause of debilitating illness and premature death in alcoholics. In urban areas it is the fourth-largest cause of death be tween the ages of 25 and 45. In New York City it ranks as the third leading cause of death between the ages of 25 and 65.

The first change in the liver after consuming alcoholic beverages is the accumulation of fat in varying portions of the liver cells. This condition is known as fatty liver. Although the exact sequence or progression of symptoms is not universal for all heavy drinkers, alcoholic hepatitis may follow. The liver becomes inflamed, the structure and function of various cells change, portions die, and fiberlike strands are formed throughout the organ.

The most serious change in liver structure is cirrhosis. This degenerative disease results in the drastic reshaping of the liver tissue, loss of function, and eventual shrinking and thickening of the organ. At this point death is inevitable.

As early as the eighteenth century there were medical warnings that maternal drinking could damage the developing fetus. The developmental changes associated with the mother's drinking include low birth weight, small height, slow growth and development, and abnormalities of the heart, face, and structure of the bones of the head. A number of other congenital abnormalities of unknown origin are suspected of being caused by the mother's use of alcohol during pregnancy.

When alcohol is drunk, every tissue and every organ is affected in one way or another for, since it is carried in the bloodstream, it can reach practically every tissue and cell of the body.

The alcohol-addicted person has lower resistance to numerous infections.

Malnutrition is commonly observed among alcoholics. It usually results from a lowered intake of nutritious food. But even in a person consuming a good diet, heavy alcohol consumption can result in malnutrition by interfering with the normal processes of food digestion and absorption. As a result, there is insufficient digestion of the food actually consumed. Alcohol also appears to affect the ability of the intestines to absorb various nutrients, including vitamins and amino acids.

It was formerly believed that as long as a person was well-nourished he could drink any amount of alcohol without injury. This is now recognized as erroneous. Significant recent studies demonstrate that sufficient alcohol intake can severely damage the liver no matter how well-nourished an individual may be.

One of the most obvious effects of alcohol on human existence is its influence on the drinking driver. During any two of recent years more people have died on our nation's highways in alcohol-related accidents than were killed in combat during all the many years of war in Vietnam. The drinking driver cannot accurately determine how much or how little alcohol in his own bloodstream is "safe." Alcohol interferes with learned movements, while its users judge themselves to be more skilled. Muscular powers are diminished, yet the drinker considers himself stronger. His reaction time is slowed, but he speeds up. The menace of the drinking driver is that he thinks himself keener, stronger, and quicker, when he is actually duller, weaker, and slower! One drink slows a person's reflexes. This includes even a small quantity of wine, which has been shown to retard eye action to a point where it is even unsafe for a person who has drunk wine to drive an automobile.

Blood levels of alcohol judged "safe" even by law-enforcement agencies are really not applicable to all. Legally defined blood-alcohol levels in many States (one at which lack of coordination is present) are twice or more as high as required to impair seriously the driving skill of certain persons.

Alcohol never should be assumed safe. It is a drug—and a killer! No one who uses it can be certain it will never control them.


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Allan R. Magie, Ph.D., M.P.H., is an associate professor of environmental health, School of Health, Loma Linda University, Loma Linda, California.

July 1977

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