Wednesday, October 21, 2020
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Death and alcohol

Text and Photos by Henrylito D. Tacio

Alcohol kills more than the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), violence and road accidents combined, according to the recent report released by the World Health Organization (WHO).

The report said HIV/AIDS is responsible for 1.8% of global deaths, road injuries for 2.5% and violence for 0.8%.  In comparison, the harmful use of alcohol kills more than 3 million people each year.

That’s about one in 20 deaths and most of them belong to the male species.  According to the WHO Global status report on alcohol and health 2018, “more than three quarters of these deaths were among men.”

The WHO report represents a comprehensive picture of alcohol consumption and the disease burden attributable to alcohol around the world. “Overall, the harmful use of alcohol causes more than 5% of the global disease burden,” the report revealed.

The United Nations health agency said that alcohol consumption causes death and disability relatively early in life.  In the age group 20-39 years, for instance, approximately 13.5% of the total deaths can be attributed to alcohol.

CAUSAL FACTOR

The report said that the harmful use of alcohol is a causal factor in more than 200 disease and injury conditions.

“Drinking alcohol is associated with a risk of developing health problems such as mental and behavioral disorders, including alcohol dependence, major noncommunicable diseases such as liver cirrhosis, some cancers and cardiovascular diseases, as well as injuries resulting from violence and road clashes and collisions,” the WHO explained.

It added: “A significant proportion of the disease burden attributable to alcohol consumption arises from unintentional and intentional injuries, including those due to road traffic crashes, violence, and suicides, and fatal alcohol-related injuries tend to occur in relatively younger age groups.”

Of all deaths attributable to alcohol, 28% were due to injuries, such as those from traffic crashes, self-harm and interpersonal violence; 21% due to digestive disorders; 19% due to cardiovascular diseases, and the remainder due to infectious diseases, cancers, mental disorders and other health conditions.

DANGEROUS BUT LEGAL

An estimated 2.3 billion people are current drinkers.  The average daily consumption of people who drink alcohol is 33 grams of pure alcohol a day, roughly equivalent to 2 glasses (each of 150 ml) of wine, a large (750 ml) bottle of beer or two shots (each of 40 ml) of spirits.

Parents should take note: “Worldwide, more than a quarter (27%) of all 15–19-year-olds are current drinkers,” the nearly 500-page report said, adding that alcohol use starts before the age of 15 with very small differences between boys and girls, based on school surveys conducted in various parts of the world.

Unknowingly, alcohol is a dangerous drug – and yet it is not illegal.  “Alcohol is the most dangerous drug known to mankind,” wrote Dr. Mark S. Gold, author of The Facts About Drugs and Alcohol.  And yet, alcohol, like the addictive tobacco, is legal.

“Alcohol is the most frequently abused drug in the world,” says Dr. Gary Hopkins, director of the Institute for Prevention of Addictions at Andrews University in Michigan.

Hopkins added: “It is a substance that has been discussed frequently in scientific literature and has been the focus of a large amount of research.  Many of those who read media reports regarding the effects of alcohol are confused.  Is this a dangerous drug, or is it a miracle potion that reduces the rates of heart attack, a frequent cause of disability and death throughout much of the world?”

FERMENTATION, DISTILLATION

An alcoholic beverage, by definition, is any drink that contains alcohol, in the form of ethanol.  For most canned or bottled beverages, the ethanol content written on the label as the percentage of alcohol by volume (abv).  Other times, it is considered as alcohol proof, which is twice the percentage of abv.

Ethanol is the natural excreta of the fermenting yeast.  Sugar is in fruit, grains, sap, and nectar of all plants.  Yeasts are ubiquitous.  The Babylonians and Egyptians found that if they crushed grapes or warmed and moistened grains, the covered mush would bubble and become a “drink with a kick.”

French microbiologist and chemist Louis Pasteur discovered that yeasts are single-cell, living fungi and that fermentation is their act of survival.  Yeasts can’t get directly until brewers first “malt” their barley: that is, moisten and warm it so that it germinates just enough to release enzymes that convert starches into simple sugar.

As alcohol is a toxin, fermentation is self-limiting.  Once alcohol concentration reaches about 14% (or the sugar runs out), the multiplying yeasts die and fermentation ends.  A stronger drink requires distillation, in which substances are vaporized and then condensed by cooling.

The origins of distillation are ambiguous.  The Arabs get credit not so much for the process, but for the word.  Al-kohl is Arabic for finely ground antimony used as eye liner, and it came to mean any exotic essence.

CONSUMPTION

Historically, people drank alcohol when they could get it: as food, in place of fetid water, as relief from the misery of life, to chase after pleasure – at births, weddings and festivals.  Dionysian and Bacchanalian were the gods of this merry-making.

Worldwide, 45% of total recorded alcohol is consumed in the form of spirits, according to the WHO report. Beer is the second alcoholic beverage in terms of pure alcohol consumed (34%) followed by wine (12%). Worldwide there have been only minor changes in preferences of alcoholic beverages since 2010.

Let’s take a closer look at how alcohol consumption affects our body, particularly the liver. “Our liver turns glucose into fat which it sends round the body to store for use when we need it,” explained Chris Day, professor of liver medicine at Newcastle University. “Alcohol affects the way the liver handles fat, so your liver cells just get stuffed full of it. Your liver gets larger.”

That’s fatty liver, if you care to know. If that happens, you may feel a vague discomfort in your abdomen because your liver is swollen. You might also feel sick and lose your appetite. Fortunately, your liver is likely to recover. “Fatty liver will go away again in someone who isn’t a heavy drinker because the liver will repair itself,” says Day.

But if you continue drinking, fatty liver can develop into hepatitis – that happens when your liver becomes inflamed.  In turn, it may lead to cirrhosis, the scarring of the liver from continuous hepatitis.

There are two reasons why alcohol has this effect.  First, according to health experts, when our liver tries to break down alcohol, the resulting chemical reaction can damage its cells. This damage can lead to inflammation and scarring as the liver tries to repair itself.

For another, alcohol can damage our intestine which lets toxins from our gut’s bacteria get into the liver. These toxins can also lead to inflammation and scarring. The problem is, you won’t know all this is happening. “People can spend 20 years damaging their liver and feel fine until it gets serious,” says Day.

MEDICAL TREATMENT

Dr. Willie T. Ong, who has written several books, including How to Live Longer: Practical Health Tips from a Heart Doctor, said that if you are an alcoholic, you should seek a medical treatment.  Here’s what you can do:

  1. Set a date on when you want to quit. The difficult part is the first step, which is to seek medical help. The person must be ready to accept that he or she may be dependent on alcohol. Although some people say they will cut down on their drinking, the goal should be to completely stop drinking.
  2. In severe cases of alcoholism, the patient will experience withdrawal symptoms when he stops drinking. If the symptoms are severe, the patient may need some medications like sedatives. Detoxification from alcoholis usually done in the hospital.
  3. A complete medical work-up is done to check if there are organs affected by the alcoholdrinking. Tests for the liver, heart and brain may be requested. If other medical conditions are found (like diabetes or heart disease), then these will also be treated.
  4. There are some oral and injectable medicines available to help discourage the patient from again abusing alcohol. Drugs like disulfiram (Antabuse) will produce severe reactions like nausea, vomiting and headache should the patient drink again.
  5. Counseling and therapy are important to help the patient change his behavior and cope with temptation. In more serious cases, there are residential facilities for substance abusers that offer counseling, lectures and medical treatment to make sure that they don’t revert back to their old ways. Family support plays a big role in the recovery of an alcoholic.
  6. Pray and go to church. Many alcoholics have been cured by returning to their spiritual roots. The temptation may be strong, but your faith in God can be stronger.

 

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