Alcohol & Your Health

April Is Alcohol Awareness Month

April is Alcohol Awareness Month.  Here are some resource links from a variety of sources highlighting alcohol and health:

Oprah - Mind and Body:  Spotlight on Health in April: Alcohol Awareness

US Dept. of Health and Human Services:  Alcohol and Drug Information

US Dept. of Labor:  Employers Encouraged to Recognize April as Alcohol Awarness Month

National Council on Alcoholism and Drug Dependence:  2oth Annual Alcohol Awareness Month

Older Women Should Severely Limit Alcohol to Avoid Multiple Risks

Mayo Clinic advises postmenopausal women to drink less than one drink a day

March 4, 2006 – New research has led Mayo Clinic to recommend that older women (postmenopausal) limit their consumption of alcohol to less than one drink a day to avoid serious consequences with heart disease, cirrhosis, cancer and their appearance. Until recently, most studies on alcohol and its effect on health have been conducted only in men. But new research that included women has highlighted some differences.

Two new studies released last year raised red flags about dangers of even moderate alcohol consumption for older women. One found that postmenopausal women who consume even moderate amounts of alcohol may face an increased risk of breast cancer and, the second said women develop alcohol-related brain damage more readily than men.

Read entire article here

Alcohol and Women's Health Links

Alcohol: A Women's Health Issue

http://www.athealth.com/Consumer/disorders/womenalcohol.html

 

Women and Drinking - NIAAA of the National Institutes of Health

http://pubs.niaaa.nih.gov/publications/brochurewomen/women.htm

 

Women and Alcohol Fact Sheet

http://www.cspinet.org/booze/women.htm

 

Drinking Water with Alcohol

Dear Dr. Ken,

How much water should one drink in a night where one is drinking a lot of alcohol?

Thanks!

H20

Dear H20,

As much as possible!  I order an ice-water chaser with every drink. The more water you drink, the less likely you are to experience alcohol-related dehydration. Also, you will urinate more, causing you to get rid of more blood ethanol and acetaldehyde that can cause a hangover.

- Dr. Ken Krul

Alcohol and Memory

Does alcohol affect memory?

Let me get another beer --- now, what was that question? Yes, yes and yes. That's for transient memory, short-term memory and long-term memory. In fact, early use of alcohol --- in children and teenagers --- has been shown to result in developmental problems that manifest themselves as poor memory and learning problems. So, the party guy who sat next to you in chemistry may have failed his exams not only because he was hung over, but also because he was partially brain-dead.

Alcohol and Heart Health

I have heard that alcohol is good for your heart. Is this true?

Some research has shown that MODERATE amounts of alcohol -- two glasses of wine per day -- may have beneficial effects in terms of reducing the potential for arteriosclerosis -- hardening of the coronary arteries that result in arterial blockage and heart attack. The jury is still out on this. Other researchers feel the evidence is not strong enough to support claims for any benefits.

- Dr. Ken Krul

Do I have a problem with alcohol?

How can I recognize an alcohol problem?

This reminds me of the old joke:

"Drinking problem? I have no drinking problem. I drink; get drunk; fall down; pass out --- NO PROBLEM!"

In my experience, alcoholics never realize that they have a problem until the bottom out. They always think they are in control of their alcohol consumption. Moreover, when loved ones confront them about their drinking, they become resentful and confrontational. Any attempt to correct their behavior will be met with a wall of lies. Alcoholics are the best liars in the world.

If you are concerned that you may have a drinking problem, you probably don't because true alcoholics never see their condition as a problem. If you think you're drinking too much, it may be due to some stress factors that you think you can't control and the alcohol provides an escape, a release. Here, if you define the problem and move to do something about it, it is likely that, with positive results, the drinking will subside.

To me, however, there are certain signs of potential alcoholism, although others may have different lists.

1. Is there a problem of alcoholism and/or drug addiction with anyone in your immediate family, especially father, mother, grandparents?
2. Do you drink when you are alone --- and more than just a glass of wine with a good book?
3. Is drinking a ritual? Do you come home every evening, walk in the door, and pour your first martini of the evening --- followed by a line of others (possibly two more martinis, wine with dinner, and a couple of night-caps) until bedtime?
4. Do you feel you really NEED a drink? Not just as a matter of expression (Boy! Do I need a drink.), but as a real matter of need --- that you can't survive the next minute without one? And do you feel sick if you don't get one?
5. When you're out drinking socially, do you know when to quit or is it always "just one more" until you're drunk and headed for one hell of a hangover the next morning?
6. Do you need alcoholic beverages to have a good time? (And for the wise-guys out there who say, "No, I can have just as much fun on pot," you've got a bigger problem.)
7. Over time, has it become necessary to drink more to fell the same "buzz?"

If you really want to see what a drinking problem is all about, go buy or rent the old movie, "Lost Weekend," starring Ray Milland. It is VERY REAL.

- Dr. Ken Krul

 

Alcohol and Women

Does alcohol affect women differently?

Frankly, I've never understood women. However, some researchers (probably other women) believe that women do metabolize alcohol differently from men.

Research has confirmed the observation that women become more impaired than men after drinking similar quantities of alcohol. In addition, women appear to be more susceptible than men to alcohol's long-term health effects (e.g., alcoholic liver disease).  The prevalence of chronic alcohol-related problems is significantly lower among women, however, perhaps in part because only 2% of American women are heavy drinkers, compared with 9% of men. Studies report adverse effects in men and women at even moderate drinking levels.  Among those effects are disturbances of sensory information processing, short-term memory, reaction time, and eye-hand coordination.  These deficits can impair the ability to drive a motor vehicle and may persist to the following day, impeding one's performance at work.  The potential influence of gender on the acute effects of alcohol is therefore of importance for the large number of women who are social drinkers.

 

Women have proportionally more body fat and less water than do men of the same body weights. Because alcohol is dispersed in body water, women reach higher peak body alcohol concentrations (BACs) than men after consuming equivalent doses of alcohol, even when doses are adjusted for body weight. In one study, gender differences in BAC disappeared when equivalent doses were administered based on total body water.

 

As a possible explanation for gender differences in the way alcohol is processed in the body, researchers have suggested that the physiological responsiveness of women to alcohol may vary throughout the menstrual cycle as a result of changes in levels of sex steroid hormones. The mechanism for such a possible effect is unclear. Researchers have speculated that estrogens and progesterone may influence liver alcohol dehydrogenase (the enzyme that breaks down ethanol) activity or other stages of alcohol metabolism. Critical review of the current literature, however, implies that the menstrual cycle is unlikely to affect the bodily processing of alcohol and has little biological significance with respect to alcohol's effects on performance.

 

Overall, women achieve higher BACs than do men after drinking equivalent amounts of alcohol, even when doses are adjusted for body weight. Women may be more susceptible than men to alcohol's effects on cognitive functions (e.g., divided attention and memory). In contrast, impairment of psychomotor performance (e.g., eye-brain-hand coordination and body sway) does not seem to be affected by gender. Evidence suggests that men and women eliminate approximately the same total amount of alcohol per unit body weight per hour (i.e., same alcohol elimination rate), but that women eliminate significantly more alcohol per unit of lean body mass per hour (i.e., higher alcohol disappearance rate) than do men. Research has not determined whether this specific difference in disappearance rate may lead to faster recovery of alcohol-induced cognitive performance impairment in women. Additional studies might shed further light on this matter by testing subjects under heavy workload conditions (e.g., in-flight simulators) to increase the chance of identifying slight gender differences that may have escaped detection in previous studies.

- Dr. Ken Krul

Alcohol's Effects on Older People

Does alcohol affect older people differently?

When it comes to OLDER people and alcohol, I am NOT speaking from personal experience. I'll let you know when I get there.

Alcohol must be used with particular caution by older adults because they are more likely than young or middle-age adults to have health problems and to use medications that may increase the effects of alcohol. This need for caution might suggest that abstinence from alcohol would be the safest alternative for all older adults. But don't hold your breath waiting for that to happen. Many older adults do not wish to abstain completely. (Why should the young folks have all the fun?) In addition, there is at least some evidence of possible benefits of moderate alcohol consumption. Psychosocial well-being, in particular, is an important area of functioning that can be affected (both positively and negatively) by alcohol use.

Certain aspects of alcohol consumption are important and have been studied in a recent survey. In men, moderate alcohol consumption ranged from 27.2% to 38.7%, while the heavier drinking ranged from 9.2% to 10.1%. In women, moderate alcohol consumption ranged from 21.5% to 32.3%, while heavier drinking ranged from 2.2% to 2.6%. These results are consistent with previous studies showing strong gender differences in alcohol consumption by elderly persons.

In the increasingly older age groupings of men, moderate drinking remained stable, while heavier drinking decreased. Conversely, in the increasingly older age groupings of women, moderate drinking decreased, while heavier drinking remained stable. A gender differential in survival may partially explain the results. Men have a shorter life span than women. Men are more likely than women to be heavy drinkers, and heavy drinkers are more likely than those who drink lesser amounts to die at a young age. Among heavier drinking elderly persons, men may consume greater amounts of alcohol than women and may be more likely to engage in heavy episodic drinking. Data from the Established Populations for Epidemiologic Studies of the Elderly (EPESE) show that more elderly men than women consume two or more ounces of absolute (100%) alcohol per day, an amount equivalent to four or more standard drinks per day, and a recent study using other data found a greater prevalence of heavy episodic drinking in men age 55 years and older than in women in the same age group.

Some observed effects of alcohol in older individuals include:

• Elderly persons of either gender will present higher measured blood ethanol concentrations than younger persons when ethanol is taken without food. But the effective peak levels (BACs) may be significantly higher for older women than for older men and the age difference can be eliminated when ethanol is ingested with a carbohydrate meal.

• Elderly women will be exposed to significantly more ethanol when drinking without having eaten than will elderly men or younger persons of either gender.

• Elderly women drinking alcoholic beverages without attention to timing of meals and ethanol use may be more susceptible to ethanol effects solely due to greater exposure.

• Finally, food, along with age, exerts a powerful effect on ethanol processing in the body.

Alcohol problems are common among older people in medical settings. Active problem drinking is present in 4% to 15% of elderly outpatients, 14% of older emergency department (ED) patients, and 5% to 20% of geriatric inpatients. Problem drinking affects the elderly population differently than the young; it causes fewer traumatic fatalities than in young people, but is more likely to worsen seniors' coexisting illnesses. In older patients, heavy drinking may complicate health conditions through adverse alcohol-drug interactions, dietary or medication noncompliance, cognitive impairment, psychiatric illness (especially depression), or other mechanisms such as high blood pressure or bleeding ulcers. These effects of alcohol abuse increase morbidity and mortality among older people in medical settings.

The NIAAA (National Institute on Alcohol Abuse and Alcoholism) recommends that people aged 65 and older limit their consumption of alcohol to one drink per day.

-- Dr. Ken Krul

Safe Level of Drinking?

What is a safe level of drinking?

There is no "safe level of drinking" -- except not drinking alcohol at all. With each drink, you take a risk. The risk will vary from time to time, from circumstance to circumstance. The same tequila shooter you had before a big dinner will have a different level of risk than the tequila shooter you have on an empty stomach at three in the afternoon with no meal. The two beers you have on an afternoon when you're feeling well will carry a different risk from the two beers you have on an afternoon when you have a cold and have taken an antihistamine.

Risk includes emotional aspects, motor aspects, sensory aspects, memory aspects, aspects of judgement, and toxicological aspects. Even when you do not feel intoxicated, you are till subject to the toxic effects of alcohol. To the extreme, a pint of pure (100%, 200-proof) ethanol, ingested quickly, is enough to kill a 180 pound human. Translated to drinking alcohol, that's a quart of 100-proof booze. Depending on the circumstances, the same effects can be seen with more or less liquor.

Drinking responsibly really means you minimize the risks of harm to yourself and others -- you seek a "safe level of drinking." No specific volume of alcohol ingestion can be stated as "safe."

- Dr. Ken Krul