Alcohol-related Problems

Alcohol-related Problems: Overview

Alcoholism is the physical and emotional dependency on the use of alcohol, the removal of which causes physical and emotional withdrawal symptoms.

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Although two-thirds of American men and one-half of American women drink alcohol, three-fourths of drinkers experience no serious consequences from alcohol use.

Repeated studies of alcoholics have confirmed that it is almost invariably fear which drives an alcoholic to seek help; fear for his safety, health, or sanity; fear of loss of love, family, home or job.  An event ferocious enough, frightening enough, appalling enough, or humiliating enough happens to breech his denial system.  But the defenses of the mind are like those of the body; they rush to wall off, to localize and repair damage.  No sooner has the alcoholic faced the magnitude and malignancy of his drinking problem than the denial begins to build again and he begins to temporize.  As paradoxical as it seems, therefore, the first phase in any treatment approach to the alcoholic, even the alcoholic who has specifically presented himself to obtain help with his drinking problem, must center on his being confronted with the inescapable fact of his alcoholism.  He must be repeatedly reminded he is an alcoholic, that he is no different from other alcoholics in his vulnerability to alcohol, and that his feelings of imperviousness to relapse are not justified.  Even with persistent confrontations, it may take 3-6 months before the alcoholic's efforts to rebuild his denial system taper off, and this will be the time of greatest danger that he will drop back out of treatment.

Causes and Development; Contributing Risk Factors

The physical dependence element develops at different rates for different individuals and effects vary widely.  Any human who drinks enough alcohol over enough time will become alcoholic.  For some, it takes large quantities and long periods and for others, small quantities and short periods.  It is difficult to predict where any given individual may be on that scale.

Genetic predisposition to easy development of alcoholism is evidenced in differing proportions in differing ethnic groups.

Signs and Symptoms

There are many symptoms of chronic alcoholism.  The main ones include:

  • Denying the problem
  • Tremors
  • Blackouts
  • Mood swings upon ingestion
  • Protecting supply (many alcoholics can hold a job long after they have lost everything else, including their family)
  • A loved one or associate telling the patient they drink too much
  • Gulping drinks
  • Hiding supply

Prognosis

Amongst those who abuse alcohol, many reduce their drinking without formal treatment after personal reflection about negative consequences.  However, the recovery rate is often poor even among people who seek help.

Signs, symptoms & indicators of Alcohol-related Problems:

Symptoms - Food - Beverages

Symptoms - Head - Nose

An/a very enlarged nose

Rhinophyma (an enlarged nose) has been associated with several causes including the over-consumption of alcohol.  Men are 12 times more likely to have this problem than women.

Symptoms - Mind - General

Short-term memory failure

Alcoholics as well as the elderly suffer gradual loss of acetylcholine, a vital neurotransmitter.  The brain compensates for this change by heightening the sensitivity of the receptors carrying memory messages, but because of the acetylcholine shortage, the transmission cannot be completed and short-term recall is poor.

Conditions that suggest Alcohol-related Problems:

Circulation

Poor/Slow Wound Healing

Alcohol impairs wound healing and increases the likelihood of wound infection.  Alcohol impairs the early inflammatory response; it inhibits wound closure, development of new blood vessels, and collagen production; it alters the protease balance at the wound site, which is needed to remove foreign matter and dead tissue; it decreases resistance to infectious microorganisms.

Digestion

Hormones

Low Melatonin Level

One of the things that impair melatonin production is alcohol.

Infections

Yeast / Candida Infection

Alcohol kills friendly bacteria, increases toxic overload of the liver and thus allows Candida to grow.

Metabolic

Cluster Headaches

Many sufferers report that alcohol is an important trigger during a cluster period, but not during remission periods.

Edema (Water Retention)

Excessive alcohol intake can cause edema.

Insomnia

Depletion of tryptophan as a result of heavy drinking explains why alcoholics suffer from insomnia.

Hemochromatosis (Iron overload)

Use of alcohol and other hepatotoxic drugs lowers the ability of the liver to safely store iron and may accelerate the development of the liver changes seen with hemochromatosis.

Nervous System

Nervous Breakdown Tendency

Alcohol and drug abuse frequently contribute to nervous breakdowns.

Nutrients

Magnesium Requirement

People who abuse alcohol are at high risk for magnesium deficiency because alcohol increases urinary excretion of magnesium.  Low blood levels of magnesium occur in 30-60% of alcoholics, and in nearly 90% of patients experiencing alcohol withdrawal.  In addition, alcoholics who substitute alcohol for food will usually have lower magnesium intakes.  Medical doctors routinely evaluate the need for extra magnesium in this population.

Folic Acid Deficiency

Alcohol interferes with the metabolism and absorption of folic acid.

Vitamin B1 Requirement

Alcoholics are at significantly increased risk of developing a deficiency of thiamine (vitamin B1) and may develop a form of thiamine deficiency called wet beri beri.

Zinc Requirement

Zinc deficiency is frequently associated with alcoholism, due to a lower intake of food.

Multiple Vitamin Need

An interesting study showed significantly decreased levels of anxiety among a group of alcoholics treated with megavitamins.  Over a 21-day period, the group took approximately 3gm of vitamin C, 3gm of niacin, 600mg of B6, and 600 IU of vitamin E per day.  A comparison group received only inert gelatin capsules.  None of the subjects in either group took antidepressants or antianxiety drugs.  Anxiety levels among both groups were measured three times over the 21 days.  They fell dramatically only in the group on megavitamin therapy.

Organ Health

Cirrhosis of the Liver

To many people, cirrhosis of the liver is synonymous with chronic alcoholism.  It is a major cause, but nevertheless one of several.  Alcoholic cirrhosis usually develops after more than a decade of heavy drinking.  The amount of alcohol that can injure the liver varies from person to person.  In women, as few as two to three drinks per day have been linked with cirrhosis and in men, as few as three to four drinks per day.  Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats and carbohydrates.

Pancreatitis

The most common cause of chronic pancreatitis is prolonged alcohol abuse.

Respiratory

Pneumonia

Alcoholism is a risk factor for the development of pneumonia.

Symptoms - Female

Symptoms - Food - Beverages

Tumors, Malignant

Breast Cancer

Since the original recommendation regarding alcohol was published, researchers at the Harvard Medical School found that even 3 drinks a week put women at increased risk for breast cancer.  Women who had one or more drinks a day were found to be at 60% higher risk than women who did not drink.

Laryngeal Cancer

In smokers, heavy alcohol consumption increases the risk of laryngeal cancer by approximately 75%.

Risk factors for Alcohol-related Problems:

Lab Values - Chemistries

Excellent HDL cholesterol level

Elevated levels of HDL cholesterol are generally considered to have a protective effect against cardiovascular disease.  However, very elevated levels can be a result of liver disease or chronic intoxication.

Metabolic

Pyroluria

When anxiety is a factor promoting the consumption of alcohol, Pyroluria should be investigated as a possibility.  As many as one-third to one-half of alcoholics have this genetic chemical imbalance.

Nutrients

EFA (Essential Fatty Acid) Type 3 Requirement

Polyunsaturated omega-3 fatty acid deficiency may contribute to depressive symptoms in alcoholism, multiple sclerosis and postpartum depression.

Symptoms - Food - Beverages

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Alcohol-related Problems suggests the following may be present:

Addictions

Alcohol-related Problems can lead to:

Circulation

Aneurysm / Rupture

See the link between Smoke Damage and Aneurysm.

Cardiomyopathy

Cardiomyopathy occurs with greater frequency in people who drink too much alcohol.  The risk of developing DCM is greater for female than for male alcoholics [JAMA 1995;274(2): pp.149-54].  Alcoholics can develop a form of thiamine deficiency called wet beri beri or Shoshin beri beri, which frequently includes cardiomyopathy.

Digestion

Hormones

Low Melatonin Level

One of the things that impair melatonin production is alcohol.

Metabolic

Insomnia

Depletion of tryptophan as a result of heavy drinking explains why alcoholics suffer from insomnia.

Nutrients

Multiple Vitamin Need

An interesting study showed significantly decreased levels of anxiety among a group of alcoholics treated with megavitamins.  Over a 21-day period, the group took approximately 3gm of vitamin C, 3gm of niacin, 600mg of B6, and 600 IU of vitamin E per day.  A comparison group received only inert gelatin capsules.  None of the subjects in either group took antidepressants or antianxiety drugs.  Anxiety levels among both groups were measured three times over the 21 days.  They fell dramatically only in the group on megavitamin therapy.

Vitamin B1 Requirement

Alcoholics are at significantly increased risk of developing a deficiency of thiamine (vitamin B1) and may develop a form of thiamine deficiency called wet beri beri.

Zinc Requirement

Zinc deficiency is frequently associated with alcoholism, due to a lower intake of food.

Organ Health

Pancreatitis

The most common cause of chronic pancreatitis is prolonged alcohol abuse.

Tumors, Malignant

Mouth Cancer

Cancer Research UK warned in August of 2009 that growing numbers of 40-somethings are developing mouth, lip and tongue cancer because they drink too much alcohol.  Diagnoses of oral cancer have gone up by 28% among men in their 40s and 24% among women the same age since the mid-1990s.  The charity says tobacco does not explain the rise, as it takes up to 30 years to cause cancer.  Some 41% of cancers of the mouth could be prevented if no one drank, the World Cancer Research Fund estimated.

Recommendations for Alcohol-related Problems:

Botanical

Not recommended

Diet

Raw Food Diet

In a study where the average intake of uncooked food comprised 62% of calories ingested, 80% of those who drank alcohol abstained spontaneously.  [South Med J 1985 Jul;78(7): pp.841-4]

Therapeutic Fasting

Fasting makes it easier to overcome bad habits and addictions.  Many people have overcome tobacco and alcohol addictions, and even drug addictions, by fasting.  Fasting rapidly dissipates the craving for alcohol.

Drug

GHB (Gamma-Hydroxybutyrate)

GHB shows great promise in the treatment of alcoholism.  In Europe, one of its primary uses is to relieve withdrawal symptoms, cravings and anxiety among alcoholics.

In a rigorous, double-blind, placebo-controlled study conducted on alcoholics, "...nearly all withdrawal symptoms disappeared within 2-7 hours" after administration of GHB.  On a severe-moderate-mild-or-none scale, withdrawal symptoms remained below moderate during the entire period.  The only side-effect observed was slight, occasional and transient dizziness.  The researchers concluded, "...the results clearly indicated that GHB is effective for the suppression of withdrawal symptoms in alcoholics" [Gallimberti, 1989].

Conventional Drug Avoidance

It can be dangerous to drink if you are taking prescription or over-the-counter medications.  Medication that slows you down or sedates you can be very dangerous when combined with alcohol.  You might find you have difficulty breathing and a great deal of difficulty thinking clearly.  You need to be careful with the following drugs:

  • Barbiturates, which should never be taken with alcohol
  • Benzodiazepines, such as Valium or Halcion
  • Codeine
  • Anti-histamines, which are often taken for allergies and colds
  • Some painkillers, which can combine with alcohol to damage the stomach lining and cause bleeding
  • Anti-depressants, such as Prozac
Not recommended
Aspirin

Aspirin can prevent stomach enzymes from processing the alcohol.  If taking aspirin, leave more time between drinks so the liver can cope.

Not recommended
Antibiotics

Some antibiotics do not work well when combined with alcohol.

Lab Tests/Rule-Outs

Test Zinc Levels

It is clear that brain zinc content changes during disease states and that brain zinc deficiency is possibly dynamically related to alcoholism.  McLardy (1973) observed a 30% deficit in brain zinc levels amongst chronic alcoholics.

Mineral

Zinc

Low zinc status has been observed in 30% to 50% of alcoholics.  Alcohol decreases the absorption of zinc and increases loss of zinc in urine.  In addition, many alcoholics do not eat an acceptable variety or amount of food, so their dietary intake of zinc may be inadequate.

Nutrient

Alpha Lipoic Acid

Alpha-lipoic acid should not be given in high doses to patients suspected of having a thiamine deficiency unless the thiamine deficiency is also corrected.  Individuals who may be deficient in vitamin B1 (such as alcoholics) should supplement vitamin B1 along with alpha-lipoic acid.

Psychological

Alcoholics Anonymous (AA)

Alcoholics Anonymous, made up of recovering alcoholics, is as successful as any treatment program and there is no fee.

Vitamins

Vitamin B-Complex

Regular use of a quality high potency multiple vitamin may be important in alcoholism.  Alcoholics are classically deficient in most of the B vitamins.  These deficiencies result from a variety of mechanisms: low dietary intake, deactivation of the active form, impaired conversion to the active form by ethanol or acetaldehyde, impaired absorption, and decreased storage capacity.  A thiamine deficiency is both the most common and the most serious of the B-vitamin deficiencies, since a deficiency causes beriberi and the Wernicke-Korsakoff Syndrome.  A functional pyridoxine deficiency is also common in alcoholics, due not so much to inadequate intake as impaired conversion to its active form, pyridoxal-5-phosphate, and enhanced degradation.

Preventive measures against Alcohol-related Problems:

Diet

Not recommended
Caffeine/Coffee Avoidance

A study published in the journal "Archives of Internal Medicine" in 2006 indicates that coffee may greatly reduce the risk of liver damage in those who consume alcohol regularly.  Every daily cup of coffee reduced the incidence of cirrhosis, a condition that destroys liver tissue, by 22%, according to researchers at the Kaiser Permanente Medical Care Program.  However, Dr. Arthur Klatsky, the leader of the study, said the results "should not be interpreted as giving a license to drink without worry, because of all the other problems connected with drinking." adding, "the only proper advice is to drink less."

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