Prof. Dzulkifli Abdul Razak
The Sun, July 11,1995
"First the man takes a drink. Then the drink takes a drink. Then the drink takes the man" - A Japanese proverb.
Alcohol has made significant inroads into our lives. Many people often start off with small quantities, gradually increasing intake, some to alarming levels.
Alcohol often functions as a social lubricant to help us get by. This is because it is an efficient physiological depressant that produces effects like relaxation, increased confidence, reduced inhibition, and in some instances facilitate social acceptance. These are the effects of alcohol that many of us are familiar with. Sometimes, it can even be a source of amusement when we casually get drunk. What we often do not realise is the fact that alcohol does all these at the expense of our health.
Alcohol in fact dampens the functions of the nervous system.
As the consumption gets heavier, the nervous system will be further impaired and may eventually collapse, a high price to pay for a little relief, or even fun.
Foremost to be affected is the brain functions that relate to inhibitions and anxiety. This generally leads to a false sense of relief and well-being, and sometimes euphoria. With continued drinking, other brain functions are affected as well.
This results in a loss of muscular coordination and impairment of vision and speech, amongst others things. Through its effects on the nervous system, it will eventually effect the circulatory system causing the small blood vessels to constrict and diverting the blood flow to the vessels of the skin (which in contrast are dilated or widened). This gives some drinkers the `flushed' appearance.
In the short term, overindulgence in alcohol typically leads to a hangover, the physical manifestations of excessive alcohol intake. This is characterised by nausea and vomitting. otehr symptoms include headache, dizziness, stomach upset, irritability and thirst.
The thirst is because of cell dehydration since the liver is overworked by the large quantities of alcohol in the blood, and is unable to process it within its normal limits. Morever, alcohol induces diuresis, resulting in water loss through the urine.
On the other hand, stomach upsets are due to the irritation caused by the excessive alcohol. Nausea and vomitting is, in part, due to this too.
Today, with increased social pressures, more and more people are turning to substances like alcohol to seek refuge from the harsh realities of life. Convinced that alcohol can offer instant relief with relative ease, many tend to continue drinking alcohol, so much so it becomes a matter of habit.
Some called this social drinking. Little do we realise that the body can gradually get tolerant to this drug. In the long run, to achieve the same level of relief, greater and greater quantities of the drink is required.
Over time, this can lead to a form of addiction, with disastrous consequences to the mind and body, and even one's family and social life. In short, one can become an alcoholic.
Alcoholism is a form of self-poisoning. It is often viewed as any repeated drinking that exceeds the normal standards for a community. This is a rather capricious definition because the norm for each community tend to vary.
In effect, alcoholism is a process of dependence. Like all drugs of abuse - nicotine included - it also produces psychological (mental) dependence, and in the extreme, physical dependence as well.
Drinking is therefore compulsive and abusive without which one is unable to function, and it causes a lot of discomfort both mentally and physically. For inveterate drinkers, deprivation of the normal intake can cause acute withdrawal symptoms.
Withdrawal symptoms observed when a seasoned drinker is deprived of alcohol include body aches, diarrhoea, vomitting, runny nose and eyes, as well as sweating. Fits and convulsions were also reported, sometimes hallucinations occurs. Delirium tremens can also be triggered following several days of deprivation. The patient suffers mental confusion, trembling ("shakes"), and a rapid irregular pulse.
This is preceded by restlessness, sleeplessness and irritability. He also experiences mental anguish and some psychological disturbance. It is the fear of all these that many hesitate giving up the drinking habit.
Alcoholism can also happen insidiously by what is called "symptomatic drinking".' This happens when someone is said to be genetically predisposed to some underlying personality disorders. It is further compounded by other factors like environment, availability of, alcohol, upbringing and so on.
In general, a number of stages have been identified in the development of alcoholism.
Social Drinking
As mentioned above the frequency and quantity of alcohol consumed eventually can mark the beginnings of alcoholism.
Early Alcoholism or Pre-alcoholic Stage
Increasing and surreptitious use of alcohol become noticeable. Memory is beginning to fade and one feels guilty about the habit, but refuse to recognise that it is a problem.
Basic Alcoholism
There is a compulsive urge to consume alcohol. Intoxication is frequent, leading to the deterioration of relationships, health and finances. Any attempt to stop using alcohol normally fails. However the patient can still recover if treatment is instituted early.
Chronic Alcoholism
There is a further deterioration of social and family life. Damages to health continue and psychotic behaviour may occur. There is a loss of self-respect and aninability to initiate any recovery by himself.
Terminal Alcoholism
This is marked by irreversible mental and physical deteriorations with little prospect of recovery. It usually leads to death. Even if he survives, his existence becomes invalid.
The point that need to be emphasised about alcoholism however, is not so much the quantity drunk but whether the person realises that his drinking habit is compulsive. This is so that treatment can be initiated as soon as possible.
Pregnant women face additional risks. Each time they drink, they are sending a dose of poison to the developing fetus. The retardation and disfigurement that can result is called Fetal Alcohol Syndrome (FAS), defined as a pattern of mental and birth defects that are the direct result of the mother's drinking habit.
FAS babies usually have narrow eyes and short upturned noses. Some have heart defects, which may require surgery. They are abnormally small at birth, especially in the size of their heads. Their mental development may not improve with age.
Thus, while it seems initially rewarding to be associated with the use of alcohol, in the long-term, it can poison your life.
What started off just as a toast to health, can end up as a toast to HELL! as aptly summerised by the Japanese proverb mentioned above.
Because of the complex nature of alcoholism, it is unlikely that a single anti-alcoholic agent will be developed to treat this disease. Instead, researchers are concentrating on developing agents to manage the specific events that occur in the clinical course of alcoholism and hasten the recovery process.
It is hoped that these new drugs can improve long-term treatment outcome when coupled with traditional verbal and behavioral therapies.
