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One of the most problematic, licit drugs in our society is alcohol. The simple process of fermenting sugar from a variety of naturally occurring fruits and grains has been ubiquitous across cultures and societies since the beginning of civilization. It is so pervasive within our society as to also seem to be a seamless part of it. One cannot easily characterize a particular type of person or group that is likely to be alcohol dependent; the affliction cuts across all imaginable demographics of society. Some people are able to drink on occasion for pleasure, whether alone or with friends. Others drink on a daily basis; others periodically binge.
Here’s a quick, 9-minute history of the science, creation and use of alcohol across cultures, courtesy of SciShow.com:
At present, it has been estimated that approximately 18 million Americans have a serious problem related to the use of alcohol. These 30% of all consumers of alcohol account for about 80% of all alcohol consumed. Men outnumber women in heavy alcohol use by a ratio of around three to one.
The heaviest users of alcohol, in turn, directly or indirectly impact an even larger percentage of the population with their subsequent behaviors while intoxicated. The costs of alcohol abuse and dependence are significant: this drug is the third leading cause of death and is implicated in over half of all deaths and injuries in car accidents and half of all physical assaults and homicides. Further, it has been estimated that at least four family members are directly affected from the maladaptive behaviors that follow from the alcohol-abusing individual; you can quickly begin to see extensive the social, familial, occupational, and emotional impact of this disorder.
What’s the difference between alcohol abuse and alcohol dependence?
The initial psychiatric diagnosis that could be made for an individual that habitually uses alcohol to excess would be alcohol abuse. This diagnosis is characterized by the continued use of alcohol for at least a period of one month, despite having a recurrent physical problem or some serious personal problem in one’s social or occupational functioning because of the excessive drinking or the repeated use of alcohol in situations (e.g., driving) when consumption is physically hazardous.
The diagnosis of alcohol dependence reflects an even greater degree of impairment in individuals compared to alcohol abuse. Alcohol dependence typically involves at least three of the following serious circumstances: (1) drinking alcohol in greater amounts and over a longer period of time than intended by the individual; (2) a strong desire by the individual to reduce consumption and several unsuccessful attempts to do so; (3) spending a great deal of time drinking or recovering from the negative effects of excessive drinking; (4) continued drinking even though physical and/or psychological problems are apparent and problematic in the individual’s life; (5) social, work, or recreational activities have been significantly reduced or abandoned because of excessive drinking; (6) the development of marked tolerance for alcohol; and (7) consumption of alcohol specifically to avoid the symptoms of withdrawal. About 15 percent of men and 10 percent of women in the United States have met the diagnostic criteria for alcohol dependence during their lifetime.
How does alcohol affect the brain?
Alcohol, as a drug, acts as a depressant on the individual’s central nervous system. It is a small molecule and is quickly absorbed in the bloodstream. Alcohol is linked to inhibiting receptors for the neurotransmitter GABA. In low doses, alcohol depresses the inhibitory functions of the brain, including those areas of the brain that typically adhere to the social controls and inhibitory rules that people typically follow in society. As the alcohol concentration increases in the bloodstream, the depressive function of alcohol extends from the cerebral cortex to areas of functioning that are further (and deeper) into the brain’s primitive and reflexive areas of functioning. In extreme dosing, inhibition of respiratory and motor centers can occur with other symptoms that include stupor or unconsciousness, cool or damp skin, a weak rapid pulse, and shallow breathing. It should be noted that alcohol can only be metabolized and leave the body at a specific rate, regardless of how quickly (or how much) alcohol has been taken in by the individual, so attempts to quickly “sober up” an individual will be unsuccessful.
For more illustration of the science and physical problems associated with habitual alcohol consumption, check out this 4-minute SciShow.com video:
What are the behavioral effects of using alcohol?
Individuals experiencing alcohol intoxication will exhibit a variety of maladaptive changes in their behavior and psychological functioning. Examples include inappropriate sexual or aggressive behaviors, impaired judgment, quickly changing moods, incoordination, impaired gait, slurred speech, impaired attention and memory (sometimes to the point of blackout), stupor, and unconsciousness. The degree of symptoms is dose dependent with more pronounced symptoms occurring as the alcohol blood-level increases.
Withdrawing from alcohol intoxication (i.e., a hangover) is also dependent on recent dosing, history of chronic abuse, and involves a variety of symptoms which can include autonomic hyperactivity in the form of profuse sweating and rapid heartbeat, hand tremors, nausea or vomiting, fleeting illusions or hallucinations, psychomotor agitation, anxiety. At worst, grand mal seizures can occur following periods of prolonged and heavy use. Another significant withdrawal phenomenon that chronic, prolonged abusers of alcohol can experience is delirium tremens that is characterized by disturbances in cognitive functions (especially consciousness), autonomic hyperactivity, vivid hallucinations, delusions, and agitation.