Episode 59:

 

The Effects of Alcohol

SHOW NOTES

In today’s episode, we are going to talk about Alcohol and its side effects on the human body, and the effects on us since we are chugging 3 beers on the show. 

These are a few of the topics addressed on the show

 

Fun fact: Mammals like elephants and armadillos might get drunk easily. The difference in a gene for breaking down alcohol might help. They’re among the creatures affected by 10 independent breakdowns of the ADH7 gene during the history of mammal evolution. Inheriting that dysfunctional gene might make it harder for their bodies to break down ethanol.

 

Summary of the ADH7 gene: This gene encodes class IV alcohol dehydrogenase 7 mu or sigma subunit, which is a member of the alcohol dehydrogenase family. Members of this family metabolize a wide variety of substrates, including ethanol, retinol, other aliphatic alcohols, hydroxysteroids, and lipid peroxidation products. 

 

Elephants will feast on fruit, and the new study reopens a long-running debate over whether elephants truly get tipsy gorging on marula fruit, a relative of mangoes.

 

If you have ever seen a person who has had too much to drink, you know that alcohol is a drug with widespread effects on the body, and varies between individuals. Some people might be the life of the party or they might become sad and weary, or in some instances KO’d.

Quick little facts:

  • Alcohol is a clear liquid at room temperature.
  • Alcohol is less dense and evaporates at a lower temperature than water. This is why it is able to be distilled.
  • The alcohol we drink is ethanol (C2H6O).
  • Alcohol is metabolized differently in men and women. 
  • Carbonated beverages speed up absorption and food slows it down.
  • Alcohol cannot dissolve in fat.

When alcohol is drunk 20% is broken down in the stomach and 80% in the small intestine. 

 

After absorption, alcohol enters the bloodstream, dissolves in the plasma, and carries throughout the body. The alcohol from the blood then enters and dissolves in the tissue of the body. Once inside the tissues, alcohol exerts its effects on the body. The effects depend on the blood alcohol concentration (BAC), which is related to the amount of alcohol the person has consumed. A person’s BAC can rise significantly within 20 minutes after having a drink.

 

Alcohol is excreted in 3 ways:

  • 5% through kidneys
  • 5% through lungs
  • 90% through the liver

The average person eliminates about 0.5 ounces/hr

 

“The breakdown, or oxidation, of ethanol occurs in the liver. An enzyme in the liver called alcohol dehydrogenase strips electrons from ethanol to form acetaldehyde. Another enzyme, called aldehyde dehydrogenase, converts the acetaldehyde, in the presence of oxygen, to acetic acid, the main component in vinegar. The molecular structure of acetic acid looks like this: CH3COOH.

When ethanol is oxidized to acetic acid, two protons and two electrons are also produced. The acetic acid can be used to form fatty acids or can be further broken down into carbon dioxide and water¹.

 

Euphoria (BAC = 0.03 to 0.12 percent)

  • They may become more self-confident or daring.
  • Their attention span may shorten.
  • They may look flushed.
  • Their judgment may not be as sharp and they may be more impulsive; they might say the first thought that comes to mind, rather than an appropriate comment for the given situation.
  • They may have trouble with fine movements, such as writing or signing their name.

 

Excitement (BAC = 0.09 to 0.25 percent)

  • They could become sleepy.
  • They might have trouble understanding or remembering things (even recent events).
  • They might not react to situations as quickly.
  • Their body movements may become uncoordinated.
  • They may begin to lose their balance easily.
  • Their vision could become blurry.
  • They may have trouble sensing things (hearing, tasting, feeling, etc.).

 

Confusion (BAC = 0.18 to 0.30 percent)

  • They are likely to be confused — they may not know where they are or what they are doing.
  • They may be dizzy and stagger on their feet.
  • They might be highly emotional, aggressive, withdrawn, or overly affectionate.
  • They may not see clearly.
  • They may be sleepy.
  • They likely have slurred speech.
  • They may have uncoordinated movements (trouble catching an object thrown to them).
  • They may not feel pain as readily as a sober person.

 

Stupor (BAC = 0.25 to 0.4 percent)

  • They may barely be able to move at all.
  • They may not be able to respond to stimuli.
  • They may be unable to stand or walk.
  • They may vomit.
  • They may lapse in and out of consciousness.

 

Coma (BAC = 0.35 to 0.50 percent)

  • They are unconscious.
  • Their reflexes are depressed (i.e. their pupils do not respond appropriately to changes in light).
  • Their skin feels cool to the touch (lower-than-normal body temperature).
  • Their breathing slows and becomes more shallow.
  • Their heart rate may slow.
  • Their life could be in danger.

 

Death (BAC more than 0.50 percent)

  • The person usually stops breathing and dies.

 

Cerebral cortex

  • Responsible for thinking and processing information from the five senses – the 4 lobes of the brain
    • Depresses the behavioral inhibitory centers: The person becomes more talkative, more self-confident, and less socially inhibited.
    • Slows down information processing from the senses: The person has trouble seeing, hearing, smelling, touching, and tasting; also, the threshold for pain is raised.
    • Inhibits thought processes: The person lacks judgment or the ability to think clearly.

Limbic system

  • Responsible for memory and emotion – hippocampus and amygdala. 
    • The person is subject to exaggerated states of emotion (anger, aggressiveness, withdrawal) and memory loss.

 

Cerebellum

  • Responsible for fine motor movement
    • “You can normally touch your finger to your nose in one smooth motion with your eyes closed; if your cerebellum were not functioning, the motion would be extremely shaky or jerky. As alcohol affects the cerebellum, muscle movements become uncoordinated¹.”

Hypothalamus and Pituitary Gland

  • The hypothalamus controls and influences many automatic functions of the brain through actions on the medulla, and coordinates chemical or endocrine functions (secretions of sex, thyroid and growth hormones) through chemical and nerve impulse on the pituitary gland.
    • Alcohol depresses the nerve centers in the hypothalamus that control sexual arousal and performance. Leading to an increase in sexual desire but a decrease in performance.
    • Alcohol inhibits the pituitary secretion of anti-diuretic hormone (ADH), which acts on the kidney to reabsorb water. Alcohol reduces the circulating levels of ADH. less ADH = more urination

 

“The medulla, or brain stem, controls or influences all of the bodily functions that are involuntary, like breathing, heart rate, temperature, and consciousness. As the alcohol starts to influence upper centers in the medulla, such as the reticular formation, a person will start to feel sleepy and may eventually become unconscious as BAC increases¹.”

 

Long term effects of alcohol 

 

  • Unintentional injuries such as car crash, falls, burns, drowning 
  • Intentional injuries such as firearm injuries, sexual assault, domestic violence
  • Increased on-the-job injuries and loss of productivity 
  • Increased family problems, broken relationships 
  • Alcohol poisoning 
  • High blood pressure, stroke, and other heart-related diseases 
  • Liver disease 
  • Nerve damage 
  • Sexual problems 
  • Permanent damage to the brain 
  • Vitamin B1 deficiency, which can lead to a disorder characterized by amnesia, apathy and disorientation 
  • Ulcers 
  • Gastritis (inflammation of stomach walls) 
  • Malnutrition 
  • Cancer of the mouth and throat

 

Brain: Alcohol interferes with the brain’s communication pathways, and can affect the way the brian looks and works. These distributions can change mood and behavior, and can make it grader to think clearly and move with coordination

 

Heart: Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems including:

 

  • Cardiomyopathy – Stretching and drooping of heart muscle
  • Arrhythmias – Irregular heart beat
  • Stroke
  • High blood pressure  

 

Cirrhotic Cardiomyopathy: Cirrhotic cardiomyopathy is usually clinically latent or mild, likely because the peripheral vasodilation significantly reduces the left ventricle after-load, “auto-treating” the patient and masking any severe manifestation of heart failure. In the ICU you may see these patients on a lot more pressors because it reduces the response to inotropic and chronotropic stimuli

 

Liver: Heavy drinking takes a toll on the liver, and can lead to a variety of problems and liver inflammations including:

  • Steatosis, or fatty liver
  • Alcoholic hepatitis
  • Fibrosis
  • Cirrhosis

 

Cirrhosis: According to the American Liver Foundation, between 10 and 20 percent of heavy drinkers will develop cirrhosis. Liver Cirrhosis is the most advanced form of liver disease. How is it developed? When the liver tissue starts to scar, the liver doesn’t work as well as it did before. As a result, the body can’t produce enough proteins or filter toxins out of the blood as it should.

 

Pancreas: Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion. 

 

Pancreatitis: Damage to the pancreas as a result of pancreatitis or some other issue occurs when digestive enzymes that are normally released by the pancreas are activated before they are released into the small intestine. There are two forms of pancreatitis.

 

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