Drinking and Problematic Drinking
1. Alcohol: Are all drinks created equal?
Alcohol is the most widely-consumed nonprescription drug in North America. A standard drink contains 17 ml (14 g) of pure ethyl alcohol (or ethanol). The volume of a drink does not necessarily correspond to how much alcohol is actually in the drink. Different types of beer, wine, and liquor have very different amounts (technically, percentages) of alcohol content. That’s why it’s important to know how much alcohol your drink contains. In North America, a standard drink is often described as 12 oz. (330 ml) of regular (5% alcohol) beer, 5 oz. (145 ml) of wine (typically about 12% alcohol), or 1.5 oz. (43 ml) of liquor such as vodka or scotch (which is typically 40% alcohol). Stronger and lighter drinks contain higher and lower alcoholic percentages respectively.
2. How alcohol affects the body
Here’s how alcohol can affect the body: Alcohol enters every cell in the body, disrupting chemical reactions throughout. It interferes with the brain’s communication pathways, and can affect the way the brain works in the short and longer terms. These disruptions can change mood and behavior, and make it harder to think clearly and move with coordination. In fact, alcohol’s effects on mood and behavior likely explain the large variability in drinking patterns and reactions that people exhibit. Alcohol has other physical effects as well. Drinking a lot over a long time or too much on a single occasion can damage the heart muscles, cause irregular heartbeats, and increase risk for stroke and high blood pressure. Heavy drinking also takes a toll on the liver, and can lead to a variety of problems and liver inflammations including fatty liver, hepatitis fibrosis and cirrhosis. Alcohol also can cause the pancreas to produce toxic substances that can lead to inflammation and impair digestion. Drinking too much alcohol can also increase your risk of developing certain cancers, including cancers of the head, neck and breast. Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Finally, drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.
3. Drinking Patterns: All drinkers are not created equal
People who abstain from alcohol, or who drink moderately, are less likely to develop adverse health and psychosocial effects associated with heavier drinking. Drinking for such individuals is usually governed by situational, cultural or religious norms, and is seldom problematic. What constitutes a moderate drinking level is slightly different for men than for women; this is because alcohol affects men and women differently according to genetic and constitutional factors. For men, moderate or low-risk drinking is usually described as no more than 4 standard drinks on a given day and no more than 14 drinks total per week. For women, moderate drinking is considered as no more than 3 standard drinks on any single day and no more than 7 drinks per week. Usually no adverse health effects are observed at or under such drinking levels. However, to keep the risk for immediate and long-term problems as low as possible, moderate drinkers are also encouraged to eat enough food when they are drinking and to not to consume alcohol too rapidly.
Problematic drinking comes in several forms. First, there are times when drinking any alcohol at all can be problematic. For example, alcohol is not recommended for people who plan to drive a vehicle or operate machinery, for people who take prescription medications that compound the effects of alcohol, for those who have a medical condition that alcohol can aggravate (such as liver disease) or women who are pregnant or trying to become pregnant. Drinking alcohol can be very dangerous for such individuals. Second, so-called “binge” drinking is problematic as well. Binge drinking means drinking so much within about 2 hours that blood alcohol concentration (BAC) levels reach legal intoxication (0.08g/dl). For women, this usually occurs after about 3-4 drinks, and for men, after about 4-5 drinks. Binge drinking is increased by the availability of lots of alcohol, by peer pressure and by a desire to feel the effects of alcohol intoxication. However, drinking this way can pose considerable health and safety risks, including personal injuries, motor vehicle accidents, as well as damage to the liver and other organs. Another problematic drinking pattern is sustained heavy drinking. For healthy adults in general, heavy drinking means consuming more than the single-day or the weekly amounts listed above. About 1 in 4 people who drink above these levels already has alcohol dependence or alcohol abuse problems (these are defined below). Heavy drinking may be used to self-medicate negative moods (such as anxiety, sadness or boredom), or to feel euphoric under the influence.
Alcoholism is probably the most familiar form of problematic drinking. Alcoholism usually refers to either Alcohol Abuse or Alcohol Dependence. Alcohol dependence is the more serious of the two, includes symptoms such as cravings (strong urges to drink), loss of control (being unable to stop drinking), tolerance (needing to drink greater amounts of alcohol to feel the same effect), as well as frequent withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking. People who are alcohol dependent may spend a lot of their time drinking, making sure they can get alcohol, and recovering from alcohol’s effects, often at the expense of other activities and responsibilities. Family (which may feel the effects of alcohol-induced aggression) and professional (with impaired performance) lives are usually negatively affected as well. Individuals with Alcohol Abuse are not physically or psychologically dependent. However, their drinking is problematic because it interferes with their ability to fulfill responsibilities at home, work, or school. Their drinking might also put them in harm’s way (like driving while intoxicated) or cause legal or social problems (such as run-ins with the law or arguments or violence with family members).
4. Problem drinking outcomes
People used to think that alcoholism was a life sentence. However, recent scientific research suggests that about two thirds of people who develop alcohol abuse or dependence have a single episode that lasts on average 3 to 4 years. Data also show that many people who seek formal alcoholism treatment are able to remain alcohol free, and many others recover without formal treatment.
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