What is alcohol? What Is alcohol abuse? What is moderate drinking? Who is alcoholic?Friday, February 17, 2023 - 12:32
John J Schwab MD
Steven Lippmann MD
Guy Slowik FRCS
Alcohol is a colorless, volatile, flammable fluid made from certain plants (corn, barley, rye, grains) or fruits It is made by mixing these plants or fruits with yeast. The yeast feeds on the various sugars (starches) in these plants or fruits. The sugars are then converted into alcohol (and carbon dioxide). The process of alcohol production is called fermentation.
The alcohol people drink is called ethanol or ethyl alcohol. The chemical formula for ethyl alcohol is C2H5OH.
Alcohol is quickly absorbed into the bloodstream after it has been swallowed. It then gets metabolised (broken down) in the liver. The problem is that the liver is unable to quickly metabolise large amounts of alcohol; it breaks down only a little alcohol at a time. So the excess alcohol continues to accumulate in the bloodstream.
The level of alcohol in the blood may be affected by gender (male or female), age, physical health, the amount of food recently eaten, and whether the person has taken certain medications or drugs. Thats why alcohol affects different people in different ways.
Depending on these factors a person's reaction may range from being slightly tipsy to being drunk.
Many people drink a small or moderate amount of alcohol to relax and enhance their social activities. Using alcohol in this way is not harmful for most adults.
People are said to have an alcohol problem when their use of alcohol has negative effects on any aspect of their lives including their health, relationships, work or school and money. These problems can range from mild to severe. The type of alcohol a person drinks, how much he or she drinks, and how long he or she has been drinking are also considered when determining whether a person has an alcohol problem.
Categories of Drinking:
Experts divide levels of alcohol use and abuse into the following categories in terms of risk for developing problems (considered below):
1. Moderate drinking
2. At-risk drinking
3. Alcohol abuse
4. Alcohol dependence, also called alcoholism
1. What Is Moderate Drinking?
Moderate drinking is drinking that does not usually cause problems for the drinker or society and is considered low risk. In the United States, moderate drinking is usually defined as:
- men: no more than two drinks per day.
- women: no more than one drink per day.
- over age 65: no more than one drink per day.
A standard drink is considered to be:
- 12 ounces of beer or wine cooler;
- 5 ounces of wine; or
- 1.5 ounces of 80-proof distilled spirits.
The limit for women and all people over age 65 is lower because they have smaller amounts of water in their bodies than men age 65 and under. As a result, they reach the same concentration of alcohol in their blood after drinking a smaller amount of alcohol. In addition, more older people have medical conditions that can be worsened by alcohol and take medicines that can have harmful effects when mixed with alcohol.
These guidelines for moderate drinking do not apply to the following people, who should not drink alcohol at all:
- women who are pregnant or trying to get pregnant;
- people who are driving or operating machines;
- people who are taking medicine that interacts with alcohol;
- people who are recovering from alcohol dependence (alcoholism);
- people with certain medical conditions where alcohol use would be harmful, such as ulcer and liver disease; and
- children and adolescents (under age 21).
Although moderate drinking is generally considered low risk in terms of causing problems, some level of impairment can begin with the first drink. One example is decreased ability to concentrate and slower reflexes, which can lead to problems when driving or operating machines. Other health problems normally associated with heavier drinking can sometimes occur with low levels of alcohol use.
In recent years, there have been many media reports about possible benefits to the heart from moderate drinking. Evidence from research does show that moderate drinking (as opposed to not drinking or drinking larger amounts) is associated with decreased risk of death from heart disease. However, because drinking involves possible risks, people who drink little or no alcohol are not advised to drink more just to reduce their chance of developing heart disease. In addition, similar protective effects can be gained from a healthy diet and regular exercise.
2. What Is At-Risk Drinking?
At-risk drinking is drinking that poses a risk of developing problems. A persons drinking habits are such that he is at risk of becoming addicted to alcohol.
It is considered to be:
- men: more than 14 drinks per week or more than 4 drinks per sitting.
- women: more than 7 drinks per week or more than 3 drinks per sitting.
3. What Is Alcohol Abuse?
Alcohol abuse does not mean that a person is addicted to alcohol. It means that a person abuses the use of alcohol, drinking dangerously (such as to cause danger), can cause problems to his or her health, and harm relationships with family, friends and co-workers.. Continued alcohol abuse can lead to alcohol dependence.
Alcohol abuse is defined as a pattern of drinking that involves one or more of the following problems within a one-year period:
- Continued drinking despite ongoing problems in relationships with other people that are related to alcohol use.
- Drinking in physically dangerous situations, such as while driving
- Failure to carry out major responsibilities at work, school, or home
- Legal problems related to using alcohol
Alcohol abuse is different from alcohol dependence (where someone is addicted to alcohol - an alcoholic) because alcoholics are physically dependent on alcohol and do not have control over their drinking. However, sometimes it is hard to draw a clear line between them because alcohol abusers may experience many of the same effects that alcoholics do.
4. What Is Alcohol Dependence?
Alcohol dependence, also called "alcoholism," is a where a person is addicted to alcohol. It can be considered as a chronic disease. It may be difficult to cure. It can be successfully controlled.
Alcohol dependence is characterized by three or more of the following occurring in a one-year period:
- Tolerance: increasing amounts of alcohol needed to get the same effect.
- Withdrawal symptoms, such as shakiness, sweating, nausea, anxiety, and depression, when alcohol use is stopped after heavy drinking. Also, use of alcohol to relieve or avoid withdrawal symptoms.
- Drinking larger amounts and for longer than you intended.
- Inability to cut down or quit drinking.
- Spending a lot of time getting and drinking alcohol or recovering from its effects.
- Reducing or giving up important work or leisure activities.
- Continued use despite the physical or emotional problems it causes to the drinker or other people.
Facts About Alcohol Use And Abuse
- Almost 14 million Americans (1 in 13 adults) have problems with drinking alcohol. About 8 million of these people are alcoholic.
- Several million more Americans drink in ways that could lead to alcohol problems.
- About 50 percent of American adults have been affected by alcohol abuse or dependence in their family.
- Alcohol abuse and dependence occurs about two to three times more often in males than females.
- Alcohol problems are most common in the early adult years and lowest among people ages 65 and older, but they can occur at any age.
- About 1 in 4 American children (19 million) is exposed at some time before age 18 to alcohol abuse or dependence in their family.
- First experiences with getting drunk often occur in adolescence. The earlier people start drinking heavily, the higher the chance they will develop serious medical problems later.
- People with alcoholism in their family are more likely to start drinking before age 20 and become dependent on alcohol.
- Alcohol abuse and dependence can occur in all racial, cultural, and socioeconomic backgrounds, but some groups are at higher risk than others.