The effects of small quantities of alcohol

The paths we walk in life determine our ultimate destiny. Our lifestyle does affect our spiritual growth. As ministers, we also have responsibility for the spiritual welfare of others, whether they be our families or our congregations.

We need to educate our congregations concerning things that hinder Christian growth. One of these hindrances of particular interest to ministers is the effect of beverage alcohol.

Alcohol use seems to be inversely related to church attendance. An article in the January, 1986, issue of the American Journal of Public Health reports that lifelong abstainers and past drinkers attend church more frequently than other categories of drinkers. At all levels (even the lowest) of alcohol consumption, church attendance decreased as alcohol intake increased.¹

And among churchgoers who drink, there is always the specter of alcoholism. Approximately 10 percent of any population are prone to alcoholism. Most ministers have had occasion to offer spiritual support to families of alcoholics. Although the social effects are profound, the most immediate impact of alcoholism is on the user. The physical effects of alcohol play most heavily on the heart, liver, and brain, though other systems and organs are also affected. In 1955 C. B. Courville published a monograph on the study of the brains of alcoholics. Examination revealed that brains of deceased alcoholics resemble those of aged men. This is true even of alcoholics in only the third or fourth decade of life.²

Since these findings other investigators have conducted a variety of tests, including psychological tests on alcoholic subjects, ³ recording their electrical brain waves and sleep patterns. ⁴ Researchers have concluded that the brain of an alcoholic is like that of the aged in function as well as in appearance. Psychological test results of alcoholic subjects resemble those of men twenty to thirty years older.

Moral discernment

Of particular interest is the effect that alcohol has on the specific area of the brain concerned with moral discernment. This is located in the frontal lobes of the brain, directly behind the bones of the forehead. Courville (1955) found that the size of this area of the alcoholic brain was significantly decreased in proportion to the size of the rest of the brain. In other words, the frontal lobes, the center for moral judgment, were found to be atrophied or shrunken. ⁵

The apostle Paul recognized the negative effect of alcohol on Spirit-inspired morality. In his letter to the Ephesians he drew a sharp either/or contrast between the movings of alcoholic spirits and the Holy Spirit on Christians: "And be not drunk with wine, wherein is excess; but be filled with the Spirit" (Eph. 5:18).

To understand better the function of the brain's frontal lobes, consider a nineteenth-century medical case history.

On a September afternoon in 1848 in the little town of Cavendish, Vermont, Phineas P. Gage, a 25-year-old railroadgang foreman, had placed a charge of blasting powder and a fuse into a hole in some rock. He then began to gently tamp the charge and the inserted fuse with a three-foot-long tamping rod. Distracted, Gage turned his head to check his crew when the rod struck the rock, producing a spark and setting off the blasting powder. Instantly the rod shot through Gage's grip, entered his head at the jaw, tore through his brain, exited from the top of his head, just behind his forehead, and flew many yards beyond Gage.

Thrown back by the blast, Gage gave a few convulsive movements, but in a few minutes he was able to speak to the men gathered anxiously around him. Carried to an ox-drawn cart, he sat up and remained conscious throughout the ride to town. He was taken to his hotel three fourths of a mile away, where, according to the physician's report, he was able to walk with little assistance up a long flight of stairs and down a long hallway to his room. Two country doctors cared for him there until his physical recovery, which took two and one-half months.

Prior to his accident, Gage was described as a man of medium stature, athletic build, temperate habits, and considerable character. After the accident, though his body healed physically, it became apparent that Phineas Gage, the well-respected foreman, was no longer the man his crew had known. ⁶

In the words of his physician, Dr. J. M. Harlow, "the equilibrium, or balance, so to speak, between his intellectual faculties and animal propensities seems to have been destroyed. He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times . . . obstinate, yet capricious and vacillating, devising many plans of future operation, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. A child in his intellectual capacity and manifestations, he has the animal passions of a strong man. Previous to his injury, though untrained in the schools, he possessed a well-balanced mind, and was looked upon by those who knew him as a shrewd, smart businessman, very energetic and persistent in executing all his plans of operation. In this regard his mind was radically changed, so decidedly that his friends and acquaintances said he was 'no longer Gage.' " ⁷

This case history shows how important the frontal lobes are to one's moral judgment. In some respects, and far more subtly, alcohol affects moral judgment just as surely as the tamping rod affected Phineas Gage's character. Yet, unreasonable though it may be, some people believe that alcohol is beneficial to health. Over the past half decade much publicity has been given to a number of research studies suggesting that the regular ingestion of small amounts of alcohol may actually reduce the risk of coronary heart disease. This assumption was a result of the finding that moderate drinking increases the level of the good cholesterol, called high-density lipoprotein, or HDL. There are two different kinds of HDL. These are referred to as HDL2 and HDL3. Most of the early studies on alcohol and heart disease simply placed both types of HDLs into a single group. ⁸ HDL2, or good cholesterol, correlates specifically with a decrease in coronary heart disease.

Stanford researchers have found, however, that social drinking raises HDL3, not HDL2. HDL3 has no protective effects against coronary heart disease. ⁹ In a follow-up study, the results were somewhat equivocal in that both HDL2 and HDL3 were increased. ¹⁰ So the effect of alcohol on heart disease is still in question. Even if alcohol were shown to reduce heart disease, however, most authorities recognize that the risk from alcohol is greater than any benefit obtained.¹¹ This is especially true considering the recent evidence that small amounts of alcohol have detrimental effects on brain function even when a person is in the so-called sober state.

A standard drink contains about .48 ounces of pure alcohol. Thus, one shot (or jigger) of whiskey, four ounces of wine, a twelve-ounce can of beer, and three ounces of sherry all contain the same amount of alcohol (see table).

Diminished abstract thinking

Some now believe that the use of alcohol and the effects on the drinker may be a continuum. ¹² This theory suggests that small amounts do cause some damage and that large amounts accelerate the rate of damage. In an early study of the effects of social drinking on brain function, a consistent relationship existed between the quantity of alcohol consumed per occasion and poor test scores. Abilities to perform abstract thinking, to adapt, and to form concepts were decreased as the amount of alcohol consumed increased.

In a 1982 American Journal of Public Health article, E. S. Parker and associates reported the findings of a study con ducted in Detroit on 1,024 male and female social drinkers. Evaluation of the drinking habits revealed that the men drank an average of twelve times per month with an intake of two drinks (about one ounce of alcohol) per occasion. Research analysis of the data from this group after neuropsychological tests found that an average alcohol intake of 1.3 ounces per occasion (about two and one-half drinks) is sufficient to cause diminished brain function on tests to measure memory and abstract thinking. ¹³

In addition, in both men and women who drank at least once per week, abstract thinking ability decreased as alcohol intake increased. It is important to note that all testing in this study was conducted on sober individuals who had not drunk for at least twenty-four hours prior to testing. ¹⁴

Parker and colleagues in the Detroit study and in a California study were also able to calculate that the increase of only one drink per drinking occasion caused a decrease in abstract or high-order thinking performance in the sober state equivalent to the addition of 2.4 years and 3.7 years to the individual's age, respectively. ¹⁵

And the consumption of alcohol coupled with aging has an additive effect. Drs. M. K. Jones and E. S. Parker and their respective colleagues were able to show that alcohol causes greater neuropsychological deficits with greater use and that this effect becomes still greater with the increasing age of the subject. ¹⁶ Showing similar impairments in relation to alcohol use, Dr. R. Hannon commented that it is impressive that both male and female subjects who are young and bright and who have a drinking history of only a few years should show these effects of decreased high-order thinking in the sober state. ¹⁷

Although alcoholics, by definition consume more than fifty liters of pure alcohol per year and some as much as 130 liters, findings of decreased performance on mental ability tests are found in light social drinkers consuming as little as four liters per year, ¹⁸ a finding also supported by others. ¹⁹ This is roughly equivalent to one third of an ounce of alcohol per day (eight ounces of beer, three ounces of wine, or two thirds of a jigger of whiskey). As alcohol consumption increases to the heavy social drinking level, the ability to recall events and information is also impaired. ²⁰

Brain shrinkage

In Australia Dr. L. A. Gala and associates have for many years studied the effects of alcoholism on the brain and its ability to function. 21 To determine the point at which alcohol consumption begins brain damage, Cala examined heavy drinkers, using CAT scans, and found brain shrinkage already in progress. ²² Using the same CAT scan procedure, she then examined a group of individuals considered to be moderate to light drinkers. Of thirty-nine drinkers tested, thirty were found to have some brain shrinkage, with frontal lobes bear ing the first signs. ²³ Thus far the results of these studies indicate that the amount of alcohol intake to cause brain shrinkage is less than two ounces, or approximately four drinks. Research has also found an impairment of moral discernment with an intake of only one to two ounces of alcohol. ²⁴

It must be remembered that brain shrinkage and brain function impair ment occur at an alcohol-intake level of a light social drinker who may never have been intoxicated. "It was found," said one researcher, "that the progression in the degree of cerebral atrophy in the social drinkers follows the same trend line as does that in the patients with alcoholism, but that the degree of atrophy was greater in the latter group." ²⁵ In addition, after studying liver enzyme tests to determine the occurrence of liver damage, Cala concluded that it becomes apparent that with alcoholic beverage use, brain dam age occurs before clinical tests can show liver damage. ²⁶ These findings are of profound significance; the abnormalities in these subjects are not gross intellectual impairments, but subtle impairments in high-order thinking. The changes are so insidious that they can be likened to those of aging. This higher order of thinking separates us from the rest of the animal kingdom. Man was created in the image of God, with the ability to think, to discern, and to make individual decisions.

The decision-making and moral values centers of the human character reside in the frontal lobes of the brain. Interestingly, the cells of this part of the brain are among the smallest, and they appear to be the most sensitive to damage from alcohol. Anything that affects this area of the brain will also affect moral judgment as well as the individual's willpower.

There is also some good news for drinkers from this research. In their attempts to understand the effects of alcohol on the brain, researchers studied eleven social drinkers who were willing to abstain from alcohol for six months or longer. ²⁷ Though the brain does not replace dead cells, in ten of the eleven subjects in this study, not only did brain atrophy stop, but there was actually a partial reversal of the process. The alcohol-affected frontal lobes of the brain can be likened to a shriveled arm coming out of a cast. Cells that have been near death or reduced in size may be restored to their full capacity with the termination of alcohol use, much as an arm returns to its former strength and size with the return of movement and use.

These researchers found that the density of both the gray matter and white matter of the brain increased toward normal, though there was not full recovery, with the cessation of alcohol use. If with today's technology of CAT scans we are able to detect these subtle adverse effects of small quantities of alcohol, what will the technology of tomorrow re veal?

Because the consumption of alcohol is so widespread, and in light of recent research, many authorities are trying to determine if there is a safe level of consumption. So far research seems to indicate that 1.4 ounces, or 2.8 drinks, per day for men will avoid brain shrink age. For women the quantity is considered to be approximately half that amount. But note that this is only for brain shrinkage. An average of less than one drink per day is still related to brain dysfunction. Is it then logical or reason able for one to consider using alcohol as a possible means of slightly reducing his or her risk of coronary heart disease? Could it be that the old stand taken by the Protestant churches against the use of alcohol kept the church strong? Could it be that with the effects of alcohol lessening moral discernment, the present liberal stand on alcohol is part of the erosion of present-day Christian churches? Can a minister who drinks socially truly direct his flock if his moral discernment and decision-making are as impaired as the evidence indicates? These questions must be answered by the church and its leadership as well as by each minister and church member.