Alcohol – that social lubricant

Dear Dr. Mo: I want to know some basic facts about alcohol and what it does to me when I drink. Is there a safe amount that’s actually good for health?

Don’t drink and drive!

Dear reader: Sometimes you might hear from a doctor that moderate alcohol consumption is good for health.

The peril lies in the word “moderate” for it is arbitrary; it is not the same for everyone and one could easily slip from moderation to amounts that are not at all useful to health. We could certainly argue if alcohol is useful in any amount because while it may be beneficial to one part of the body, it is damaging to another.

We don’t really need alcohol as far as maintaining our health is concerned so if you’ve never drank, don’t start as risks outweigh potential benefits.

Some positive effects of moderate alcohol drinking

It could reduce your risk of heart disease and heart attack.

It would probably reduce your risk of stroke, especially ischemic ones (ischemia means tissue deprivation of blood supply and oxygen that blood carries).

It would probably reduce your risk of diabetes and gull bladder stones.

In spite of such an attractive list of benefits, evidence to support such claims are still uncertain so it may turn out in the end that alcohol consumption, even moderate one, brings absolutely no benefit to the drinker, except for maybe some social lubrication.

Moderate alcohol consumption would probably bring most benefits to older population or to those with existing risk factors for heart disease – elevated blood cholesterol levels for example.

If you are middle aged adult or younger, evidence show that alcohol in any amount does more damage than it brings good.

Women who are drinking alcohol should speak to their doctors about taking some extra folates to reduce risks for breast cancer associated with drinking alcohol.

To get the alleged benefits alcohol brings to the cardio-vascular system, you don’t actually need alcohol – you can do it by having at least 150 minutes of moderate exercise a week and by having a healthy diet.

What does this “moderate” consumption really mean?

Being drunk and subsequently hung over with memory lapses form a previous night out certainly do NOT qualify as moderate drinking.

Being moderately drunk also does not mean you’ve had moderate amounts of alcohol.

Moderate means one drink a day for women and 2 drinks a day for men.

This amounts to one beer, one glass of wine, on shot of something strong and the liver always requires about one hour to process one drink (except cocktails which contain several doses at once). Liver processes alcohol at a constant rate and nothing you do will ever change that.

When to absolutely avoid alcohol no matter what?

  • Don’t drink and drive – this goes without saying although I know for fact that as obvious as it is, it is often times disregarded – what would people read about in the newspapers otherwise?
  • Again – don’t drink and drive, pretty please!

Other situations include:

  • Pregnancy or when you are trying to conceive (to get pregnant)
  • Previous strokes
  • Taking medication that could interact with alcohol or be affected by liver’s interaction with alcohol – speak to your doctor about this!
  • Liver and pancreatic disease
  • If you’ve been diagnosed with alcoholism
  • Failing heart, weakened heart or cardiomyopathy

Speak to your doctor about the following as well:

  • If you are under treatment for any health issue
  • If you know about the family history of alcoholism
  • If you know about the family history of breast cancer
  • If you have any health problem with mouth, throat, esophagus or stomach

So, how much is too much?

Alcohol is absorbed quickly into the blood. If food is present in the stomach, this process is slowed down a bit, but not a lot. On the other hand, it takes far longer for our body to get rid of the alcohol we’ve consumed.

The total speed at which we process alcohol varies from person to person and could depend on many factors besides the liver capacity to process it, which is constant for all and never changes (for a healthy liver). Other factors include our constitution and sex (weight, body mass, muscle to fat ratio, blood volume etc.) If you have more fat, you will absorb alcohol at a slower rate and will be slower to feel its effects but the rate at which you will process it and get rid of it will remain the same as in other people.

More than one drink an hour sends more alcohol to liver than it’s able to process meaning that if we binge drink/quickly down 5 or more drinks in a row, we may be consuming a lethal dose of alcohol before we pass out.

Adolescents without prior drinking experience are at a higher risk – besides classic alcohol poisoning these young people could develop an acute (sudden) alcoholic inflammation of their livers resulting in massive damage to this vital organ. In such cases, the only treatment is liver transplantation.

What happens when we drink?

It is said that alcohol inhibits our inhibitions.

This is true and for this effect, most people drink alcohol. I call it a social lubricant because it inhibits various social barriers to human relations, established in our brains by the society and upbringing. When this initial inhibition happens, people ‘loosen up’, they break free and become more relaxed which ‘lubes up’ social interactions.

Alcohol is a depressant – it is not a stimulant of any kind! Do not forget this.

It depresses brain functions and centers one by one and by depressing regions in the brain in charge for social patterns and learned behaviors (inhibitions) we tend to become “stimulated” and appear as more talkative and energized but this is false as it is a consequence of the initial depression of certain parts of our brain. As we continue to drink, this depression deepens and we may become aggressive, our centers for coordination become impaired (we stumble and trip over), and finally centers for breathing, heart function and swallowing are shut down.

Alcohol lowers our body temperature leading us into hypothermia, which could also stop the heart and it lowers blood sugar levels (creates hypoglycemia), which is one of the most dangerous metabolic conditions in medicine.

This sugar-lowering effect is especially dangerous for people with diabetes who should never drink alcohol!

Particularly bad combo is sadly a very popular one – energy drinks and strong alcohol. Former sends powerful stimulating signals and latter sends powerful depressing signals to the brain, which may wreak havoc on a body and sometimes result in a sudden death.

Alcohol inhibits our body’s ability to conserve water and the more we drink it the more it dehydrates us – this is one of the main reasons for headaches the morning after. If you must drink, always drink water too, especially before going or stumbling to bed.

Alcohol is mostly metabolized as heat – this is why you will often see drunken people (or perhaps see yourself in posted photos to your horror and disbelief) in short sleeves or half naked outside where it’s cold or even freezing.

This means that alcohol will not likely make you gain some monstrous weight – what it will do is inhibit your control and your appetite will surge so you will be eating/overeating more and more often – this will make your weight go up. So, alcohol is not a culprit but it is an accomplice.

Drink moderately or don’t drink at all

This is a general advice used and spoken so much that it has become almost corny but nonetheless worth mentioning.

To end this somewhat controversial post with an important doctor’s order:

Don’t drink and drive! Driving under influence of alcohol puts your life and lives of others at risk, a risk not worth taking.

Yours in health,

Dr. Mo

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