Alcohol and Health

TN : Before we start, I’d like to check some information about alcohol addiction and its impact on health, the risky behavior and the markers of alcohol intake, and also about patient and family education. So, what should we start with ?

PS : The first thing to say would be to tell them what alcohol is and how it works, namely that it’s a psychoactive substance, and that the minute you take your first sip, it starts impacting brain chemicals and altering mood, self-consciousness, reflexes, balance, memory and behavior, and impairing judgement.

TN : So, if we’d have to rank alcohol misuse or abuse, what would we begin with ?

PS : We should not underestimate any risk of alcohol. But we can say that there’s a great difference between social drinking and addictive behavior. In all cases, things would start by social events, peer pressure, and the fear of being isolated from a group of people. This usually happens to teenagers.

TN : But what about addictive behavior then ?

PS : Usually, this is linked to a negative traumatic past experience, anxiety, employment and financial stress and family history – and for teenagers perhaps as an act of rebellion – which would incite some people to have a risky behavior towards alcohol intake.

TN : As I can understand, alcohol abuse can come from psychosocial and environmental problems. But then again what are the risks on health ?

PS : They can be very serious, going from inability to sleep, inciting a person to drink more and more until being as if anesthetized, which would trigger nightmares and hallucinations. And as the brain tends to shrink from heavy drinking, the person would be unable to control body movements, learn and remember things, which, with time, can lead to Korsakoff symptoms that are known as alcohol dementia, namely that the person would have amnesia combined with dysexecutive signs more often associated to distorted reality and fabulations.

TN : And on the physical level ?

PS : Physically, the person would have more acid reflux, heartburn and diarrhea as alcohol irritates the lining of the stomach, the small intestine and the colon. Nausea and vomiting would follow, and in the long run ulcers. The person would also be unable to hold feces. Also, alcohol prevents the brain signals to the kidney from making too much urine, so the person can have difficulty regulating waterworks, which can lead to dehydration. The problems get worse when renal disorders, cirrhosis, pancreas damage, diabetes and cardiac conditions appear. Weaker immune system would make people more likely to get pulmonary infections. And lastly, alcohol abuse is associated to hormone imbalance, weaker bones, lower muscle mass, less strength, trembling and hearing loss.

TN : Last thing, how can we detect a person who is abusing alcohol and what care plan can we propose ?

PS : Unless the person, or his entourage, addresses the issue, it is hard to intervene. But usually, behavioral therapy can be a good start, up to hospitalization and psychotherapy if addiction has built up to a point where the person’s physical and mental health are impaired.