Alcohol – the Body & Health Effects A brief overview 23 3 Contents 5 Introduction 21 Mental health conditions 5 What is alcohol? 22 Alcohol and drug interactions 6 Body effects of alcohol 23 Effects of alcohol on other people 9 Overall body effects 23 The unborn child 9 Blood and immune system 23 Children and families 9 Bones and muscles 24 Effects of alcohol on population groups 9 Brain and nervous system 24 Women 10 Breasts – women 24 Men 10 Eyes 25 Young people 10 Heart and blood pressure 25 Older people 11 Intestines 26 Low-risk alcohol drinking advice 11 Kidneys and fluid balance 26 How much? 11 Liver 27 Advice for parents of children and young people under 18 years 12 Lungs 27 What is a standard drink? 12 Mental health 28 When not to drink 12 Mouth and throat 28 Tips for low-risk drinking 13 Pancreas and digestion of sugar 28 Background to drinking advice Acknowledgements 13 Sexual health – men 29 Where to find support and further information 13 Sexual health – women The Alcohol Advisory Council of New Zealand (ALAC) would like to thank Dr Fiona Imlach Gunasekara, Public 30 Glossary Health Medicine Specialist, for preparing the summaries of the health and body effects of alcohol in this resource. 14 Skin and fat 32 References ISBN 978–1–927138–41–0 (print) 14 Stomach and food pipe (oesophagus) 978–1–927138–42–7 (online) 15 Health effects of acute alcohol use TABLES 15 Alcohol poisoning 7 Table 1: Symptoms of drunkenness at different 17 Hangover levels of blood alcohol concentration (BAC) Alcohol Advisory Council of New Zealand 18 Health conditions related to chronic alcohol use 16 Table 2: Potential symptoms and complications Kaunihera Whakatupato Waipiro o Aotearoa of acute intoxication or alcohol poisoning, by 20 Cancers body part affected PO Box 5023 20 Cardiovascular disease Wellington 19 Table 3: Potential conditions and complications New Zealand 6145 21 Existing health conditions – impact of alcohol of chronic and/or heavy episodic alcohol use, by body part affected alac.org.nz | waipiro.org.nz | June 2012 21 Diabetes mellitus 5 Introduction Introduction Introduction Support & Information Effects Health & Conditions Impact of Alcohol Drinking Advice Body This resource provides a brief What is alcohol? overview of the health and body Alcohol (ethanol or ethyl alcohol) is the ingredient effects of alcohol. It is a series found in beer, wine and spirits which causes of short summaries based on drunkenness. Alcohol is formed when yeast ferments available evidence rather than (breaks down without oxygen) the sugars in different foods; for example wine is made from the sugar in a comprehensive literature grapes, beer from the sugar in malted barley (a type of review. Areas covered include grain), cider from the sugar in apples, and vodka from the effects of alcohol on body the sugar in potatoes, beets or other plants.[1] parts, the health effects of acute alcohol use, the health conditions related to chronic alcohol use, and the effects of alcohol on other people and populations. Low-risk drinking advice is also outlined in this resource along with information about where to find support and further information. 6 7 Introduction Body effects of alcohol Effects Body Health Effects & Conditions Impact of Alcohol Effects of Alcohol Drinking Advice Support & Information Health Effects & Conditions Impact of Alcohol Drinking Advice Alcohol is classed as a ‘sedative The BAC rises, and the feeling of drunkenness occurs, when alcohol is drunk faster than the liver can break hypnotic’ drug,[2] which means Table 1: Symptoms of drunkenness at different levels of blood alcohol concentration (BAC) it acts to depress the central it down. Table 1 shows the relationship between BAC and symptoms of drunkenness – the higher the BAC, nervous system at high doses. the greater the effects on the body. However, BAC does BAC Symptoms not correlate exactly with symptoms of drunkenness <50 mg/dL Some impairment in motor coordination and thinking ability At lower doses, alcohol can act as a stimulant,[3] and different people have different symptoms even Talkativeness inducing feelings of euphoria and talkativeness, after drinking the same amount of alcohol. The BAC Relaxation but drinking too much alcohol at one session can level, and every individual’s reaction to alcohol, is lead to drowsiness, respiratory depression (where influenced by: [1,2,7] breathing becomes slow, shallow or stops entirely), 50-150 mg/dL Altered mood (increased well-being or unhappiness) coma or even death.[4–6] • the ability of the liver to metabolise alcohol (which Friendliness, shyness or argumentativeness varies due to genetic differences in the liver enzymes Impaired concentration and judgement As well as its acute and potentially lethal sedative that break down alcohol)[7] Sexual disinhibition effect at high doses, alcohol has effects on every • the presence or absence of food in the stomach organ in the body, and these effects depend on 150-250 mg/dL Slurred speech (food dilutes the alcohol and dramatically slows the blood alcohol concentration (BAC) over time.[7] Unsteady walking its absorption into the bloodstream by preventing Nausea After a drink is swallowed, the alcohol is rapidly it from passing quickly into the small intestine) Double vision absorbed into the blood (20 percent through the • the concentration of alcohol in the beverage Increased heart rate stomach and 80 percent through the small intestine), (highly concentrated beverages such as spirits Drowsiness with effects felt within 5 to 10 minutes after drinking.[6] are more quickly absorbed) Mood, personality and behaviour changes which may be It usually peaks in the blood after 30 to 90 minutes,[6] sudden, angry and antisocial and thus is carried through all the organs of the body. • how quickly alcohol is drunk • body type (heavier and more muscular people have 300 mg/dL Unresponsive/extremely drowsy Most (90 percent) of the metabolism, or breaking more fat and muscle to absorb the alcohol)[2] Speech incoherent/confused down, of alcohol from a toxic substance to water Memory loss • age, sex, ethnicity (e.g. women have a higher BAC and carbon dioxide is performed by the liver,[6] Vomiting after drinking the same amount of alcohol than men with the rest excreted through the lungs (allowing Heavy breathing alcohol breath tests), through the kidneys (into urine) due to differences in metabolism and absorption – and in sweat.[8] since men have on average more fluid in their body >400 mg/dL Breathing slowed, shallow or stopped to distribute alcohol around than women do; some Coma The liver can break down only a certain amount ethnic groups have different levels of a liver enzyme Death of alcohol per hour, which for an average person responsible for the breakdown of alcohol) is around one standard drink (which raises the • how frequently a person drinks alcohol (someone BAC about 15 to 20 mg/dL[8] – the current limit who drinks often can tolerate the sedating effects for driving in New Zealand is 80 mg/dL). of alcohol more than someone who does not regularly drink).[6] Adapted from: Table 163.1 in Brust, J. C. M. (2005). Alcoholism. In L. P. Rowland (Ed.), Merritt’s neurology (11th ed.). Philadelphia: Lippincott Williams & Wilkins.[4] and Table 1 in Vonghia, L., Leggio, L., Ferrulli, A., Bertini, M., Gasbarrini, G., Addolorato, G., et al. (2008). Acute alcohol intoxication. European Journal of Internal Medicine, 19(8), 561–567.[5] 9 Overall body effects cells that fight infections), making it more difficult for Introduction Body effects of alcohol the body to fight off both viral and bacterial infections. > Alcohol affects all parts of the body including: People who drink heavily over a long time are more likely to suffer from infections after surgery, burns, Summary of main effects • blood and immune system trauma, hepatitis C infection, HIV/AIDS, meningitis, • bones and muscles blood Effects Body Alcohol affects all parts tuberculosis and pneumonia (acute inflammation Alcohol is absorbed into the • brain and nervous system of the body including: bloodstream and can have of the lung, usually due to infection).[4,14,15] some long-term effects. • breasts (in women) • eyes brain and Support & Information Health Effects & Conditions Impact of Alcohol Drinking Advice mental health nervous system • heart and blood pressure Bones and muscles Alcohol can be used to Alcohol impairs judgement • intestines relax but it is also addictive and concentration. Long-term ImmedIate effects of aLcohoL use and can lead to dependency. alcohol use can damage the • kidneys and fluid balance Alcohol use causes many different types of injuries, brain and nerves. • liver eyes including injuries from road traffic accidents, assaults Being drunk can • lungs and falls.[9] This is usually because high levels of blood cause blurred vision. lungs Being drunk and chronic • mental health alcohol impair the brain’s thought processes and skin heavy alcohol use can • mouth and throat the coordination of muscles, causing clumsiness and Alcohol use can have direct and increase the risk of difficulty walking.[16] Common injuries seen at the infections of the lungs. • pancreas and digestion of sugar indirect effects on the skin. emergency department include cuts, bruises, sprains • sexual and reproductive system – men and broken bones.[17,18] The risk of injury in the six mouth and throat heart • sexual and reproductive system – women hours after drinking doubles with four standard drinks Being drunk can cause Alcohol use at low levels may slurred speech. be beneficial for the heart in • skin and fat and increases rapidly the more alcohol is drunk on some people but is harmful for • stomach and food pipe (oesophagus). a single occasion.[19] breasts everyone at high levels. (in women) As well as potentially affecting the physical and mental Long-term effects of aLcohoL use Long-term alcohol liver health of individuals in many ways, chronic and heavy Moderate alcohol use may protect against osteoporosis use increases the Long-term alcohol use alcohol use can increase the risk of death[9] either (thinning of the bones, which makes the bones more risk of breast cancer.