What alcohol does to your body in the short and long term
September 1, 2019
Most Australian adults will have at least an occasional drink and about half of us are regular drinkers.
But it's easy to underestimate the health impacts, and experts believe there is too much risky drinking.
What is alcohol?
The alcohol in drinks is called ethanol (also known as ethyl alcohol). It is made from sugars in grains, fruits and vegetables.
It can be produced in various strengths:
- 5 per cent (full-strength beer and cider)
- 12-14 per cent (wine)
- 18 per cent (fortified wines like port or sherry)
- 37-40 per cent (spirits like vodka, whisky and gin)
In recent years, the strength of both white and red wines has increased.
What is a standard drink?
A standard drink is one that contains 10 grams of alcohol.
The size will vary, depending on what you're drinking.
How many drinks in a bottle?
- 1 stubby (375ml) of mid-strength (3.5%) beer is 1 standard drink
- 1 stubby (375ml) of full-strength (4.8%) beer is 1.4 standard drinks
- 1 bottle (750ml) of red wine (13.5%) contains 8 standard drinks
- 1 bottle (750ml) of white wine (11.5%) contains 6.8 standard drinks
- 1 bottle (750ml) of champagne (12%) contains 7.1 standard drinks
- 1 bottle (700ml) of spirits (40%) contains 22 standard drinks
- 1 bottle (330ml) of full-strength (5%), ready-to-drink spirits is 1.2 standard drinks
- 1 bottle (330ml) of high-strength (7%), ready-to-drink spirits is 1.8 standard drinks
Source: Australian Government
Many people underestimate how many standard drinks they've had because typical servings are generally larger than standard drink size.
What does alcohol do to your body?
When you drink alcohol, it enters the bloodstream within minutes and almost 90 per cent is absorbed within an hour.
Because women's bodies are generally smaller than men's and contain less fluid, a given amount of alcohol produces a higher blood alcohol level in females. For similar reasons, adolescents and elderly people tend to have higher blood alcohol levels than young and middle-aged adults, after consuming a given amount of alcohol.
Once in the bloodstream, alcohol begins to be broken down by the liver at the rate of about one standard drink an hour. You can't speed this up by having coffee, cold showers or anything else.
A small amount of alcohol is eliminated though the breath, tears, saliva and perspiration.
The experience of intoxication can be affected by individual and cultural expectations, the context, and factors such as whether other drugs are used. So the way you feel when you are drunk may not match another person's experience.
Drinking large amounts of alcohol causes slowed mental function, loss of memory, poor judgment, dizziness, poor coordination, slurring of speech, blurred vision, vomiting, and eventually unconsciousness and even death.
Low-risk drinking levels
While a lot of attention is paid to the ill-effects of heavy alcohol consumption, moderate alcohol consumption can also affect your health.
Regular alcohol consumption even at low to moderate levels has been linked to an increase in a range of cancers, including mouth, pharynx, larynx, oesophagus, bowel in men and breast in women, and liver cancer.
To help avoid the serious complications of drinking alcohol, Australia's peak medical authority, the National Health and Medical Research Council (NHMRC) has set recommendations for low-risk drinking levels.
For those who choose to drink, they recommend:
- No more than two standard drinks per day for women and men, to reduce the risk of health consequences of drinking. (Following these guidelines means you drop your lifetime risk of alcohol-related disease — such as cancer or liver disease — and injury — car accident, violence or self-harm — to less than one in a hundred, says the NHMRC.)
- No more than four standard drinks for both women and men in any single drinking occasion, to reduce the risk of injury related to that drinking event. (The risk of injury goes up a lot faster once you have more than four standard drinks.)
- Not drinking at all is the safest option for women who are pregnant or planning a pregnancy, or who are breastfeeding. (This is because we do not know at what levels any risk commences. We do know the risk increases the more alcohol is consumed.)
- Not drinking at all is the safest option for those under the age of 18.
- Seeking advice on whether or not it is safe to drink for people who are on medication. (Alcohol can interact with many prescribed and over-the-counter medications, altering the effects of the alcohol and/or the medication. Some herbal preparations also interact with alcohol. You need to take special care if you are taking benzodiazepines, some pain medication, heroin or methadone, as the additional effects of alcohol may cause an overdose, coma and death.)
- Not drinking while carrying out certain activities where alcohol can dramatically increase risk — such as operating machinery.
The NHMRC guidelines are currently under review.
People who have family members with severe alcohol problems might need to think carefully about drinking.
People who have ill health — such as those who have experienced cancer — are advised to seek medical advice about drinking.
A range of factors might contribute to hangovers, including:
Dehydration. Alcohol is a diuretic, increasing urine output and depleting the body of fluid.
Congeners. These chemical by-products of fermentation are thought to contribute to hangovers, at least in some people. Darker drinks generally have more congeners than lighter-coloured drinks. Thus, red wine, brandy and bourbon have more congeners than drinks such as gin and vodka.
cetaldehyde. This is a toxic by-product of alcohol metabolism. People's bodies vary in how efficiently they break this down into less-harmful products. This can influence how we feel after drinking and our experience of hangover.
Sleep impairment. While alcohol might cause you to fall asleep quickly, you are less likely to get the most restful (REM) sleep. You might also be disturbed by frequent trips to the bathroom.
You can try to reduce your risk of getting a hangover by:
- Setting your consumption limits and sticking to them
- Making sure you don't drink on an empty stomach
- Ensuring you are hydrated before and during drinking
- Not using alcohol to slake your thirst
But remember, a hangover is your body's way of telling you you've drunk too much.
Although some people swear by the remedy known as a "hair of the dog" — having an alcoholic drink the following morning — if there is any perceived benefit, it is only temporary.
The hangover will return when the effects of the drink wear off. You may well be increasing the risk of experiencing health harms because you are drinking more, and increasing the risk of becoming alcohol dependent.
Some people recommend a variety of vitamins and/or herbal preparations, but there's no scientific evidence they work.
Experts agree that, in large amounts, alcohol is toxic, damages a wide range of different organs, and is a significant factor in many dangerous and fatal accidents. In Australia, it's thought to be directly responsible for just under 6,000 deaths (2015) and 144,000 hospital admissions (2013) a year, clocking up an annual health bill of about $8 billion.
Some of the major conditions alcohol can cause include:
Alcoholic hepatitis and cirrhosis of the liver. Alcohol in large amounts irritates and inflames the liver. It may cause acute (sudden) hepatitis, or chronic (ongoing) inflammation and cirrhosis of the liver, which can end in liver failure and death.
Neurological damage (that is, to the brain and nerves). Heavy drinking can damage memory, thinking abilities and physical coordination. It can cause several brain syndromes, such as:
- Wernicke's encephalopathy (a disorder linked to a severe deficiency of vitamin B1 and which causes poor coordination, confusion and problems with vision)
- Korsakoff's syndrome (permanent damage to the brain, affecting short-term memory)
- Ataxia (damage to the cerebellum, the brain's centre for balance and coordination)
- Regular heavy alcohol use also damages nerves in the arms and legs, which can result in numbness, weakness, paralysis and leg ulcers
Injuries, such as road trauma, violence, falls, accidental death — including drowning — and suicide. Young adults have the highest injury risk.
Cancers. Alcohol is known to contribute to cancers of the lips, mouth, throat, larynx, oesophagus and liver. It also plays a role in causing breast and bowel cancers.
Damage to the gastrointestinal tract, including:
- Gastritis (inflammation in the lining of the stomach)
- Pancreatitis (inflammation of the pancreas, an organ in the abdomen that makes enzymes for digestion). Pancreatitis is a very serious condition.
Heart disease. Heavy alcohol use can cause cardiomyopathy — a disease of the heart muscle — which may result in dangerous heart rhythms and heart failure.
Some people drink alcohol not because it makes them feel pleasant or social but because they are depressed, anxious or have unresolved conflicts in their lives. They use alcohol as a means of coping.
If someone drinks regularly for long periods of time they can become physically dependent on alcohol.
Some experts believe there may be an inherited predisposition to alcoholism because it tends to run in families; this might be due to genetic or environmental factors, or some combined influence. Familial risk, easy access to alcohol, increasing use and increasing tolerance all contribute.
It is clear alcohol dependence can develop even in the absence of obvious familial factors.
Alcohol dependence may disrupt a person's relationships, destroy their livelihood and seriously damage their health. Those who become severely dependent often need to give up drinking.
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Withdrawing from alcohol
When a severely dependent person stops drinking, they might experience withdrawal symptoms, such as anxiety, sweating and shaking, as well as possible life-threatening symptoms that require medical assessment and management.
There are several ways a person can withdraw from alcohol. Some people do it at home by themselves or with supervision (from a specialised clinic for example). Others see their GP during this period. Or they can do it as an in-patient in a private or public hospital, clinic or therapeutic community, either with medications to help relieve the withdrawal symptoms, or without medications.
The more severe the dependence, the more likely they will need medical assistance in managing withdrawal. Some people will need to undergo the process as an in-patient in medically managed facilities.
Withdrawal isn't the same thing as a cure. The factors and stresses that contributed to heavy drinking will still be there and may trigger a return to heavy drinking.
After detoxification a person will need support, counselling and therapy — preferably from counsellors experienced in drug and alcohol treatment — using techniques like behavioural modification, motivational programs, and self-help groups.
Counselling can take place on a regular basis as a day visitor to a rehabilitation centre, or in a residential rehabilitation centre (sometimes called a therapeutic community) for periods of up to a year or longer.
The latter involves the person living away from their home and entering a structured program of group and individual therapy sessions. They also receive training in life, work and social skills. People in a therapeutic community usually do better because it helps break their drinking routines.
Another approach is run by Alcoholics Anonymous (AA) — an association of recovering alcoholics who meet regularly, exchange support and share their experiences of recovering from alcoholism.
SMART Recovery is a similar program based on Cognitive Behavioural Therapy (CBT).
This is general information only. For detailed personal advice, you should see a qualified medical practitioner who knows your medical history.
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