With the media focus on alcoholism making people rethink their drinking habits, Emma Gregson looks at the implications alcohol misuse and dependence has on premium ratings
Alcohol is water soluble so it can be carried around the blood stream, therefore, getting into every cell causing many different types of harm throughout the body. The physical side effects can vary significantly in terms of the types of illness, symptoms, time of onset, progression and severity. Behaviour plays a part and the types of physical harm seem to depend on the individual behaviour. Findings suggest young men are more susceptible to certain alcohol-related harm such as assault, suicide, accidents and mental health problems than women and greater tendency to engage in risk-taking.
Alcohol abuse is defined as the pattern of heavy alcohol intake with the likelihood of social dysfunction and health being affected. Alcoholism is when the consumer has cravings and/or physical dependence plus a lack of control/restraint despite the associated implications.
How is it measured?
One unit is 8g or about 10ml, of pure alcohol - regardless of how diluted it is. Below is a list of some common drinks and how many units of alcohol they contain:
n One pint of strong lager (alcohol 5% vol) = three units;
n One pint of standard strength lager (alcohol 3% to 3.5% vol) = two units;
n One 275ml bottle of alcopop (alcohol 5.5% vol) = one and a half units;
n One standard (175ml) glass of wine (alcohol 12% vol) = two units;
n One measure (25ml) of a spirit strength drink = one unit;
The Government guidelines for alcohol intake are as follows:
Women: two to three units a day; men: three to four units a day. "Binge drinking" is when on one occasion men drink more than eight units and women drink more than six. Men who regularly drink four or more units and women who regularly drink three or more units are putting their health at risk.
The liver is the main organ for breaking down alcohol. It metabolises about 90% of the alcohol and about 10% is excreted through the urine or breath.
The liver needs water to get rid of toxins, but, as the alcohol acts as a diuretic, there will not be sufficient amounts so the body is forced to divert water from other organs including the brain.
The liver produces more toxins as a by-product of breaking down alcohol. When it is metabolising alcohol it produces acetaldehyde, which has toxic affects on the liver, brain and stomach lining.
There is an enzyme in the stomach called alcohol dehydrogenase (AD) that should process alcohol into a safer substance. When a person drinks alcohol, about 20% of the alcohol is absorbed into the stomach and 80% is absorbed into the small intestine. The AD is 70% to 80% more effective in younger men than women or men over 50. Heavy drinkers have severely reduced levels of AD. The longer the body has to work on the alcohol, the less harm it does to the body. A meal consumed with alcohol prevents the alcohol from passing quickly into the small intestine, therefore, giving AD longer to process it.
While alcohol is waiting to be processed by the liver, it travels in the blood through the heart to all other organs of the body, including the brain. Alcohol is both a stimulant and a depressant. It can make people feel "revved" up by closing down different circuits in the brain. At low levels alcohol increases the electrical activity in the brain, affecting pleasure and euphoria (in a similar way to cocaine and amphetamines). It also works on the circuits targeted by drugs like valium - calming and easing anxiety. Alcohol also acts on the serotonin system, which (like prozac) increases self-confidence and reduces depression. Unfortunately, this is short-lived. In large amounts, the alcohol interferes with some of the chemical messages in the brain - it can make a person clumsy, affect co-ordination and slur the speech. It also dramatically reduces the ability to learn and form memories. Regular drinking sessions will make it very difficult to learn new skills or retain new knowledge.
Some of the conditions and indicators are:
n Liver: fatty liver, alcoholic hepatitis, cirrhosis, jaundice, liver cancers
n Gastro-intestinal: cancers all the way through the gastro-intestinal tract, pancreatitis, dyspepsia and ulcers, persistent vomiting and diarrhoea, other gastric and bowel problems
n Brain and central nervous system: delirium tremens (shakes, shaking delirium), dementia, cerebral degeneration/brain lesions, stupor/coma, withdrawl seizures and epiform fitting, tremor, strokes/haemorrhages, peripheral neuropathy
n Heart and circulatory: high or low blood pressure, anaemia, blood loss from external or internal injury, heart failure, impaired blood clotting, weakened heart muscles, tachycardia (fast heart rate)
n Physical appearance: ruddy complexion, malnutrition, poor personal hygiene, sweats, cuts and bruises, tired/puffy eyes, finger clubbing, pitted nose, weight gain, weight loss in chronic cases (due to deficient diet)
n Sexual indicators: impotence, loss of libido, infertility, shrinkage of sexual organs, risk to foetus
Drinking can also cause osteoporosis, affect the respiratory system and lead to kidney problems, including cancers and renal failure. Various studies have examined breast cancer rates and alcohol consumption. There appears to be a link between even light-to-moderate drinking and an increased risk of breast cancer in pre-menopausal women. There is definitely an increased risk for heavy drinkers.
Withdrawal of alcohol can cause various symptoms including shakes and sweats, peripheral neuropathy, anxiety and/or panic attacks, hallucinations and delusions, mood swings and irritability, graphic nightmares/disturbed sleep, delirium tremens, seizures, strokes and heart attacks.
Emma Gregson is life and disability underwriter at Aegon Scottish Equitable
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