First you take a drink, then the drink takes a drink, then the drink takes you.
— Francis Scott Key Fitzgerald.
According to the World Health Organisation, every year about 2.5 million people die from alcohol-related diseases all over the world, accounting for 3.8 per cent of total deaths. Alcohol-related heart disease, cancer, accidents and suicides contribute to these deaths.
Further, alcohol causes loss of 69.4 million disability adjusted life years (DALYs) annually in the world. (One DALY is “one lost year of healthy life”) Alcohol abuse is more or less a universal problem. There is hardly any effort to discourage the consumption all over the world. Neither are there any statutory warnings.
Alcohol (ethanol) is a drug and may be classified as a sedative, tranquilliser, hypnotic or anaesthetic depending upon the quantity consumed. It is the only drug whose self-induced intoxication is socially acceptable. Consumption of alcohol is legal in many societies and its abuse is a societal problem.
Alcoholism is characterised by compulsive swallow despite clear, deleterious social and medical consequences. Every organ/system of the human body gets affected.
Daily consumption of alcohol in large amounts leads to cardiac problems, viz., arrhythmia (irregular heart beats), cardiomyopathy (enlarged heart), etc. Heavy alcohol consumption can raise the blood pressure, leading to alcohol-induced hypertension.
A progressive illness
Alcoholism is a progressive illness and damages the central nerves system (CNS), resulting in varying degrees of dysfunction — deficit cognitive functioning, dementia, etc. People given to prolonged binge drinking are prone to strokes — a condition of haemorrhage or deficient blood supply to brain.
Alcoholic abuse is also responsible for a variety of psychiatric symptoms, viz. anxiety, depression, confusion, panic disorders, bipolar disorders and narcissism. Chronic alcoholics develop polyneuropathy — a disorder of peripheral nerves.
Chronic, heavy and daily drinking alcoholics develop skeletal myopathy which is irreversible even on practising abstinence.
Alcohol ingestion causes a feeling of early warmth, then increased sweating, then lowered body temperature — hypothermia (cold damage) and, finally, death.
Alcohol is responsible for cancer of the oesophagus and chronic gastritis. Heavy consumers develop chronic pancreatitis. Due to mal-absorption of food, alcoholics develop frequent diarrhoeal episodes.
Ten to 20 per cent of alcoholics develop liver problems, viz., fatty infiltration, hepatitis and cirrhosis. They suffer from jaundice, abdominal pain, edema in different parts of the body, gynaecomastia (enlarged breast in men), and atrophy of the testes. Women with alcoholic liver disease may develop menstrual problems and signs or virilisation (male features). The prognosis in alcoholic liver disease is dismal. Long-term consumption leads to impotence in men and other sexual complications.
Children born to alcoholic women suffer from the fetal alcoholic syndrome (FAS). They suffer from a triad of abnormality — a cluster of craniofacial abnormalities, dysfunction of the central nervous system and stunting of growth. As the child ages, there is a manifestation of hearing, language and speech problems.
A sudden decrease in alcohol consumption leads to anxiety, fits, sleep problems and life threatening problems like delirium tremens (DT).
There are studies stating that moderate consumption of alcohol is beneficial to heart. This is controversial. Then should we promote alcohol consumption for cardiac protection? The answer is ‘no.' It is inappropriate for physicians to advocate alcohol ingestion solely to prevent heart diseases. The safer ways are changes in diet, exercise of mind management and positive living.
Programmes
There are de-addiction programmes run by organisations like Alcoholics Anonymous. But, unfortunately, there are no non-addiction programmes anywhere. Finally, the question that haunts is — why should anybody consume anything that causes harm? Why should several States in our country sell alcohol for revenue generation and spend the money to treat alcohol-related diseases?
( The writer is a former Additional Director of Health, Andhra Pradesh )
