Dr. Shyam P Lohani

Many people assume that the occasional beer or a glass of wine or a peg of whiskey on special occasions is safe and does not pose much cause for concern. However, drinking any amount of alcohol is not safe and leads to unwanted health consequences in long term. Alcohol use has been linked with physical and mental well-being over time.
There have been numerous studies showing increase in use of alcohol during the winter season. It all depends on the individual how much to drink, and how to cope with the dark winters. It is, however, important to keep in mind that the effects of alcohol can make our body more vulnerable in low temperatures.

Effects
Alcohol is responsible for a false sense of warmth and heat in the body by dilating blood vessels, thus increasing the blood flow to the limbs and periphery. Actually, a sensation of warmth is due to the increased blood flow to the limbs leading to heat loss which ultimately results in lower core body temperature. This leads to hypothermia during the cold season. Drinking alcohol also impairs the body’s ability to shiver to combat cold weather. The effects of alcohol become serious or noticeable for a regular drinker who drinks more than 1 or 2 drinks per day. The Centre for Disease Control (CDC) defines moderate drinking as one or fewer drinks for women and two or fewer drinks for men where one standard drink equals 43 ml of 40 per cent hard liquor (whisky, vodka, rum, gin, etc.), or 341 ml of 5 per cent alcoholic beer, or 142 ml glass of 12 per cent red or white wine.
Worldwide, 5.3 per cent of all deaths are attributed to harmful use of alcohol which corresponds to 3 million deaths every year and as measured by disability-adjusted life years (DALYs), responsible for 5.1 per cent of the global burden of disease and injury (WHO, 2018). By regulating drinking, one can reduce the risk of short and long-term health risks. Alcohol contributes to over 200 diseases and injury-related health conditions (WHO, 2018).

Alcohol is absorbed into the body relatively quickly; nevertheless, it takes longer to get the alcohol out of the body. It is absorbed into the bloodstream by blood vessels from the stomach and small intestine within minutes. It then reaches the brain, where it quickly produces its effects. The liver usually takes about one hour to process one drink. Therefore, consumption of several drinks in a short period results in the alcohol level increase in the body, thus putting the metabolic system under pressure. The long-term use of alcohol leads to several illnesses and in severe cases, death.

Alcohol acts as a central nervous system depressant, thereby slowing down the activity of the brain. It can change mood, behaviour, and self-control. It can cause problems with memory and think clearly and also affect our coordination and physical control. Alcohol also has effects on the other organs in our body such as raising blood pressure and heart rate. Drinking too much at once causes immediate vomiting. The short-term effects of alcohol depend on the amount consumed, rate of drinking, the weight, sex, body fat, and either food has been taken along. Consumption of alcohol with a meal slows the rate of absorption, resulting in fewer side effects and less intoxication.

Excessive alcohol use or binge drinking increases the risk of blackouts if consumed on an empty stomach. Binge drinking is defined as drinking five or more drinks for a man and four or more drinks for a woman within 2 hours. The amount of consumption differs for women and men as they metabolise alcohol differently. Binge drinking associated blackouts may lead to motor vehicle crashes, falls, drowning, and burns. Alcohol use is also linked to suicide, homicide, sexual assault, and intimate partner violence.

Alcohol use has been linked to risky sexual behaviours such as unprotected sex or sex with multiple partners that may result in unintended pregnancy or sexually transmitted diseases, including HIV. Miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs) are seen among pregnant women. Alcohol poisoning is a medical emergency that results from high blood alcohol levels following binge drinking. Since alcohol is a depressant, it can slow breathing, leading to a lack of oxygen to the brain. Confusion, vomiting, seizures, slow breathing, blue skin, low body temperature, loss of consciousness, and coma are symptoms commonly seen in alcohol poisoning.

Excessive alcohol use over a long period of time can lead to the development of chronic diseases and other serious health problems such as high blood pressure, heart disease, stroke, liver disease, and digestive problems. Cancer of the breast, mouth, throat, esophagus, larynx, liver, colon, and rectum are other chronic conditions following long-term alcohol use.
Alcohol weakens the immune system resulting in an increase in the probability to fall sick, learning and memory problems, including dementia and poor school performance. Mental health problems, including depression and anxiety, social problems, including family problems, workplace problems, and unemployment are frequently seen among heavy drinkers. Alcohol use disorders or alcohol dependence happen over a long period of time.

Prohibition
Many countries have taxed heavily on alcohol and also made availability restrictions in order to decrease consumption. Easy availability and cheaper alcohol have shown devastating effects on health. Prohibition of advertising should strictly be considered especially during winter and festival seasons. Societal and cultural changes are harder to achieve, however, increasing youth activities and programmes have had promising results in decreasing alcohol use as well as drug use behaviours. It should not be underestimated the value of rehabilitation programmes for heavy alcohol users. Lastly, it is up to us to limit our exposure to alcohol and live a healthy life.

(Prof. Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)