Lena Savoie
Alcohol is a chemical carcinogen and even low levels of alcohol consumption can lead to health risks such as certain cancers and cardiovascular issues. Alcohol use disorder, also known as alcoholism, is a common medical condition that can be mild, moderate, or severe. People with this disorder cannot stop drinking, even when it negatively affects their health and personal relationships. Alcohol intolerance is another condition where the body cannot break down alcohol efficiently, leading to uncomfortable reactions. This is caused by a genetic condition and can be managed by avoiding alcohol.
| Characteristics | Values |
|---|---|
| Alcohol use disorder | Craving for the next drink, drinking despite damaged relationships or safety, and physical issues like withdrawal symptoms |
| Alcohol intolerance | Inherited metabolic disorder, causing unpleasant symptoms like hot flushes, nausea, and digestive issues |
| Cancer risk | Alcohol is a Group 1 carcinogen, increasing the risk of cancer, including at least seven types like bowel and breast cancer |
| Pregnancy | Alcohol consumption is not recommended for those who are pregnant or might be pregnant |
| Liver disease | Alcohol consumption can cause liver disease and other alcohol-related chronic problems |
| Medication interactions | Alcohol may interact with certain medications |
| Underage | Alcohol consumption is not recommended for those under the legal drinking age (21 or older) |
| Mental health conditions | Conditions like depression, PTSD, or ADHD may increase the risk of alcohol use disorder |
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What You'll Learn
Alcohol intolerance
The prevalence of alcohol intolerance is higher among individuals of East Asian descent, with an estimated 30%-50% of this population affected. This condition is often referred to as "Asian flush" or "Asian glow". However, it is important to note that alcohol intolerance can affect people of all races and ethnicities.
There is currently no cure or treatment for alcohol intolerance. The best way to manage the condition is to limit or avoid alcohol consumption completely. Some lifestyle adjustments that may help include choosing drinks low in sulfites and other preservatives, staying hydrated, and consuming alcohol with food to slow its absorption.
The long-term effects of alcohol intolerance can be severe, increasing the probability of developing cancers of the mouth, throat, oesophagus, stomach, and liver. Additionally, there is an elevated risk of heart disease and stroke associated with alcohol intolerance. Therefore, it is crucial for individuals experiencing the symptoms of alcohol intolerance to take precautionary measures and make necessary lifestyle changes to mitigate these risks.
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Alcohol use disorder
Symptoms
AUD symptoms focus on behavioural changes, including craving alcoholic beverages. People with AUD may drink despite the damage it causes to their relationships or plan their lives around their next drink. Additionally, alcohol exposure can alter prenatal brain development, resulting in lifelong cognitive, social, behavioural, and coordination problems.
Causes
The exact causes of AUD are not fully understood, but researchers have identified several contributing factors. Genetics play a role, as studies show that individuals with a family history of AUD have an increased risk of developing the disorder. Mental health conditions, such as depression, post-traumatic stress disorder (PTSD), or attention-deficit/hyperactivity disorder (ADHD), may also increase the risk of AUD.
Treatment
AUD treatment typically includes medication and behavioural therapy. The U.S. Food & Drug Administration has approved naltrexone and acamprosate as AUD treatments. Behavioural treatment involves counselling aimed at changing drinking behaviour, and individuals may work with addiction counsellors or psychologists.
Support Services
Individuals with AUD can seek support from various services, such as SAMHSA's National Helpline, which offers a free, confidential treatment referral and information service for those facing substance use disorders. The helpline provides referrals to local treatment facilities, support groups, and community-based organizations. Text-based services, such as the HELP4U SMS service, are also available for convenient access to information and support.
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Increased risk of cancer
Alcohol consumption is associated with an increased risk of developing cancer. The International Agency for Research on Cancer (IARC) has classified alcohol as a Group 1 carcinogen, indicating a substance that can cause cancer. This classification places alcohol in the same category as asbestos, radiation, and tobacco. Scientific evidence demonstrates a causal link between alcohol consumption and cancers of the oral cavity, pharynx, larynx, oesophagus, and liver.
The mechanism by which alcohol increases cancer risk involves multiple pathways. Firstly, alcohol is metabolised into acetaldehyde, a toxic chemical and probable human carcinogen. Acetaldehyde can damage DNA and proteins, increasing the risk of cancerous cell growth. Secondly, alcohol generates reactive oxygen species, which can further damage DNA, proteins, and lipids through oxidation. Additionally, alcohol impairs the absorption of nutrients essential for cancer prevention, such as vitamin A and B vitamins.
The risk of developing alcohol-related cancers varies based on gender and drinking patterns. Women who consume one drink per day have a higher risk of breast cancer compared to those who drink less than one drink per week. Binge drinking and heavy drinking further elevate the risk of cancer, as well as increasing the likelihood of alcohol poisoning and accidents. The combination of tobacco and alcohol use significantly increases the risk of mouth and upper throat cancers.
Certain genetic factors also influence alcohol-related cancer risk. Individuals with altered ALDH2, an enzyme involved in alcohol metabolism, have a higher risk of oesophageal and head and neck cancers, even with moderate alcohol consumption. This risk is particularly pronounced in individuals of East Asian descent, with an estimated 36% carrying gene variants that disrupt alcohol metabolism, leading to a buildup of toxic acetaldehyde.
While some studies suggest a link between moderate red wine consumption and a decreased risk of prostate and colorectal cancer, the overall evidence indicates that any level of alcohol consumption increases the risk of cancer. The World Health Organization (WHO) has stated that there is no safe amount of alcohol consumption when it comes to health. The risk of cancer is present from the first drop of alcohol consumed, and the more one drinks, the higher the cancer risk becomes.
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Liver disease
Alcohol is known to harm multiple organs and body systems, contributing to over 200 health conditions. One of the most common alcohol-related diseases is liver disease, which can manifest in several ways.
Fatty Liver Disease
The most common alcohol-induced liver problem is a steatotic (fatty) liver, which is the build-up of fat inside liver cells. This can lead to an enlarged liver, which may cause upper abdominal pain on the right side. Fatty liver disease is reversible, and abstaining from alcohol for several months or years can allow the liver to return to normal.
Alcoholic Hepatitis
Alcoholic hepatitis is a condition marked by inflammation, swelling, and the killing of liver cells, which can lead to permanent scarring (fibrosis) of the liver. It is usually caused by alcohol misuse over a long period, although it can also occur after a short period of binge drinking. Alcoholic hepatitis can be mild or severe, with mild cases usually being reversible if the individual stops drinking permanently. However, severe alcoholic hepatitis is a serious and life-threatening condition that causes many deaths in the UK each year.
Cirrhosis
Alcohol-associated cirrhosis is the destruction of normal liver tissue, leaving scar tissue in place of functioning liver tissue. This can cause the liver to stop working correctly. Up to 70% of people with alcoholic hepatitis will go on to develop cirrhosis, and in many cases, the damage is irreversible.
Treatment
Abstinence from alcohol is the most critical step following a diagnosis of alcohol-associated liver disease. Even a single drink can be detrimental. In some cases, a liver transplant may be required if the liver has stopped functioning and does not improve with alcohol avoidance.
It is important to note that not everyone who drinks heavily will develop liver disease. However, the risk increases with the amount and duration of alcohol consumption. Other factors that influence the development of liver disease include obesity, malnutrition, and genetic factors.
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Hypertension, diabetes, COPD
Hypertension and Alcohol
People with high blood pressure, or hypertension, are often advised by healthcare professionals to reduce their alcohol intake. This is because drinking alcohol can cause a rise in blood pressure. The American Heart Association recommends no more than two drinks per day for men and one drink per day for women.
Diabetes and Alcohol
Alcohol consumption can be particularly challenging for people with diabetes. While moderate alcohol consumption (one to three drinks per day) may improve blood glucose management and insulin sensitivity, leading to lower A1C levels, drinking more than three drinks daily can have the opposite effect, increasing blood glucose and A1C levels. Additionally, combining alcohol with diabetes medications, especially insulin and sulfonylureas, can lead to hypoglycemia (low blood glucose). The symptoms of hypoglycemia, such as slurred speech and confusion, can be difficult to distinguish from the signs of drunkenness. Therefore, people with diabetes who drink alcohol should be cautious and consider snacking while drinking to avoid hypoglycemia.
COPD and Alcohol
For individuals with COPD (Chronic Obstructive Pulmonary Disease), alcohol consumption can have several negative effects. Firstly, alcohol increases the risk of respiratory infections by interfering with respiratory clearance mechanisms, specifically by paralysing the cilia, short fibres that help clear mucus from the lungs. Secondly, alcohol can cause COPD symptoms to flare up due to its impact on lowering glutathione levels, an antioxidant in the lungs that provides protection. Furthermore, drinking alcohol can interfere with medications commonly used to treat COPD, such as antibiotics and steroids. While there isn't a definitive answer regarding alcohol consumption for people with COPD, it is generally recommended to follow a treatment plan, quit smoking, and be mindful of any signs of alcohol intolerance, such as stuffiness, a runny nose, or breathing difficulties.
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Frequently asked questions
Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It is considered a brain disorder and can be mild, moderate, or severe.
Alcohol intolerance is an inherited metabolic disorder that causes uncomfortable symptoms after drinking a small amount of alcohol. Symptoms can include hot flushes, digestive issues, nausea, and an increased risk of cancer and other serious diseases.
People with these conditions are more likely to engage in unhealthful alcohol use, which can worsen their symptoms and cause side effects from medication. Alcohol can also contribute to more than 200 health conditions and is one of the leading causes of preventable death.
