|Alcohol Problems and Solutions|
by Stephen Gislason MD
Ethanol, Chemistry of Alcohol
Ethanol is a 2-carbon alcohol, responsible for the behavior-altering effects of Alcoholic Beverages, and for the devastation of the social and physical well being of alcoholics and their communities. This alcohol is a simple molecule, a carbohydrate, which is "burned" as a fuel supplying energy to cells. Ethanol in its disguise as a fuel can be considered a non-essential nutrient. But before it is metabolized as a fuel, it is an active brain-drug and an all-purpose cellular toxin.
As a brain drug, ethanol acts to depress brain function from the top down, very much in the style of an anaesthetic. With low blood concentration, the cortical depression of ethanol seems to release behaviors that are otherwise inhibited. At this low level of mind intoxication, ethanol is useful and possibly pleasant. The relaxation of inhibitions releases playful behavior and laughter, promotes chatty talk, and facilitates socialization. If the use of AB's were constrained to occasional, low-dose cortical inhibition, we would likely praise AB's as socially useful drugs.
Even low doses of alcohol interfere with memory and make it difficult for the hippocampus to process new information. "Somebody who drinks too much, the next day doesn't remember what happened during that time, but yet at the same time has the ability, unfortunately in certain cases, to drive home after drinking a lot."
With increasing doses, ethanol depresses more and more brain functions, rendering the intoxicant temporarily demented, with inappropriate behavior, incoordination, and poor judgment. The stubborn, irritable drunk often argues unreasonably; belligerent outbursts are characteristic of heavy intoxication. In many alcohol abusers, AB's release violent aggressive behaviors and result in fighting, assaults, and death by accident or murder.
The AB-intoxicated driver accounts for the majority of car accidents and road fatalities. Social attitudes are now changing, as the obvious relationship of AB and highway carnage is finally acknowledged. The belligerence and family violence of the drunk is the next level of criminal behavior which legislators will seek to better control. Women are the most vulnerable people when married to alcoholics and physical abuse of women is often related to male alcoholism. Children are the most vulnerable people when mother and/or father is an alcoholic.
Metabolism of Ethanol
The metabolism and toxicology of ethanol has been extensively studied. AB, like syphilis, are the "Great Imitators," since regular ingestion of AB in excess produces so many disease patterns involving every part of the body. Even moderate alcohol abuse distorts the personality, emotions, and intellect of the "social drinker," producing the commonest patterns of psychopathology which afflict our society. The personality distortion is a direct consequence of brain dysfunction cause by ethanol and other chemical pathogens in AB's.
Ethanol supplies cells with energy and replaces other foods at the level of basic fuel. Ethanol is metabolized to carbon dioxide and water with 2% being lost through the urine and through respiration. The rate of oxidation is about 75 mg per kilogram of body weight per hour. About half of a group of middle class alcoholics obtained 20 to 39 percent of their dietary calories from ABs while about one third of the individuals obtained between 40 and 59 percent. ABs had displaced other carbohydrates as a source of calories. The calories provided by an AB may be calculated by means of the following formula:
0.8 x proof x ounces = kilocalories.
The calorie contribution from the ethanol in wine or beer can be calculated by multiplying the percent alcohol by volume by two, and using this figure as the proof of the beverage. The oxidation of alcohol occurs in the following steps:
1. Ethanol ---> Acetaldehyde
2. Acetaldehyde ---> Acetate
3. Acetate ----> Carbon Dioxide + Water
Ethanol has a variable effect on body weight. It is ketogenic; ketones (like acetaldehyde) may produce a rapid weight loss of several pounds. Acetaldehyde is particularly toxic. The drug, disulfiram (Antabuse) impairs the enzymatic degradation of acetaldehyde. The accumulation of this chemical causes flushing of the face, shortness of breath, headache, fast and often irregular heart action, nausea, vomiting, weakness, fainting or collapse. Recovery follows in hours, after the ethanol and acetaldehyde have been metabolized. A person taking Antabuse is warned that even a small drink will make them ill. The immediate, rather than delayed, symptoms of AB ingestion are supposed to deter drinking.
Ethanol interferes with carbohydrate energy metabolism. Liver and muscle glycogen are depleted.
As cellular toxin, ethanol is catabolic and promotes structural tissue loss. The catabolic effect causes a greater loss of weight than caloric input can replace in the form of fat stores. Typically, fat distribution shifts to the belly and trunk, leaving the extremities skinny and weak. Men often grow female breasts, as estrogen accumulates in their system. Their psyches follow their body degeneration. Macho men turn to mushos and amygdaloids (people who have lost control of their rage response). There are a host of body responses to ethanol ingestion, as it acts in its drug/chemical pathogenic role.
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