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                     Alcoholic beverage

 

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n alcoholic beverage is a drink containing ethanol, commonly known as alcohol. Alcoholic beverages are divided into three general classes: beers, wines, and spirits. They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption In particular, such laws specify the minimum age at which a person may legally buy or drink them. This minimum age varies between 16 and 25 years, depending upon the country and the type of drink. Most nations set it at 18 years of age.

Alcohol is a psychoactive drug that has a depressant effect. A high blood alcohol content is usually considered to be legal drunkenness because it reduces attention and slows reaction speed. Alcohol can be addictive; addiction to alcohol is known as alcoholism.

List of alcoholic beverages

Fermented beverages

·         Beer

·          Ale

·         Barleywine

·         Bitter ale

·         Mild ale

·         Pale ale

·         Porter (dark beer made from brown malt)

·         Stout (strong Porter)

·         Cask ale

·         Stock ale

·         Fruit Beer

·         Lager

Distilled beverages

Alcoholism and alcohol abuse

 

Alcoholism (alcohol dependence) and alcohol abuse are two different forms of problem drinking.

  • Alcoholism is when you have signs of physical addiction to alcohol and continues to drink, despite problems with physical health, mental health, and social, family, or job responsibilities. Alcohol may control your life and relationships.
  • Alcohol abuse is when your drinking leads to problems, but not physical addiction.

Causes, incidence, and risk factors

There is no known cause of alcohol abuse or alcoholism. Research suggests that certain genes may increase the risk of alcoholism, but which genes and how they work are not known.

How much you drink can influence your chances of becoming dependent. Those at risk for developing alcoholism include:

  • Men who have 15 or more drinks a week
  • Women who have 12 or more drinks a week
  • Anyone who has five or more drinks per occasion at least once a week

One drink is defined as a 12-ounce bottle of beer, a 5-ounce glass of wine, or a 1 1/2-ounce shot of liquor.

You have an increased risk for alcohol abuse and dependence if you have a parent with alcoholism.

You may also be more likely to abuse alcohol or become dependent if you:

  • Are a young adult under peer pressure
  • Have depression, bipolar disorder, anxiety disorders, or schizophrenia
  • Have easy access to alcohol
  • Have low self-esteem
  • Have problems with relationships
  • Live a stressful lifestyle
  • Live in a culture alcohol use is more common and accepted

Alcohol abuse is rising. Around 1 out of 6 people in the United States have a drinking problem.

Symptoms

People who have alcoholism or alcohol abuse often:

  • Continue to drink, even when health, work, or family are being harmed
  • Drink alone
  • Become violent when drinking
  • Become hostile when asked about drinking
  • Are not able to control drinking -- being unable to stop or reduce alcohol intake
  • Make excuses to drink
  • Miss work or school, or have a decrease in performance because of drinking
  • Stop taking part in activities because of alcohol
  • Need to use alcohol on most days to get through the day
  • Neglect to eat or eat poorly
  • Do not care about or ignore how they dress or whether they are clean
  • Try to hide alcohol use
  • Shake in the morning or after periods when they have not a drink

Symptoms of alcohol dependence include:

Signs and tests

Tests that may be done include:

Complications

Alcoholism and alcohol abuse can increase your risk of many health problems, including:

  • Bleeding in the digestive tract
  • Brain cell damage
  • Brain disorder called Wernicke-Korsakoff syndrome
  • Cancer of the esophagus, liver, colon, and other areas
  • Changes in the menstrual cycle (period)
  • Delirium tremens (DT's)
  • Dementia and memory loss
  • Depression and suicide
  • Erectile dysfunction
  • Heart damage
  • High blood pressure
  • Inflammation of the pancreas (pancreatitis)
  • Liver disease, including cirrhosis
  • Nerve damage
  • Poor nutrition
  • Sleeping problems (insomnia)

Medications

A variety of medications may be prescribed as part of treatment for alcoholism.

  • Disulfiram (Antabuse) prevents the elimination of acetaldehyde, a chemical the body produces when breaking down ethanol. Acetaldehyde itself is the cause of many hangover symptoms from alcohol use. The overall effect is severe discomfort when alcohol is ingested: an extremely fast-acting and long-lasting uncomfortable hangover. This discourages an alcoholic from drinking in significant amounts while they take the medicine. A recent nine-year study found that incorporation of supervised disulfiram and the related compound carbimide into a comprehensive treatment program resulted in an abstinence rate of over 50 percent.[112]
  • Calcium carbimide (Temposil) works in the same way as disulfiram; it has an advantage in that the occasional adverse effects of disulfiram, hepatotoxicity and drowsiness, do not occur with calcium carbimide.[112][113]
  • Naltrexone is a competitive antagonist for opioid receptors, effectively blocking the effects of endorphins and opiates. Naltrexone is used to decrease cravings for alcohol and encourage abstinence. Alcohol causes the body to release endorphins, which in turn release dopamine and activate the reward pathways; hence when naltrexone is in the body there is a reduction in the pleasurable effects from consuming alcohol.[114] Naltrexone is also used in an alcoholism treatment method called the Sinclair Method, which treats patients through a combination of Naltrexone and continued drinking.[115]
  • Odansetron, a 5HT3 antagonist, is effective in the treatment of alcoholism; the combination of odansetron and naltrexone is superior than either treatment alone.[116]
  • Acamprosate (Campral) stabilises the brain chemistry that is altered due to alcohol dependence via antagonising the actions of glutamate, a neurotransmitter which is hyperactive in the post-withdrawal phase.[117] By reducing excessive NMDA activity which occurs at the onset of alcohol withdrawal, acamprosate can reduce or prevent alcohol withdrawal related neurotoxicity.[118] A 2010 review of medical studies found that acamprosate reduces the incidence of relapse amongst alcohol dependent persons.[119]
  • Benzodiazepines, while useful in the management of acute alcohol withdrawal, if used long-term can cause a worse outcome in alcoholism. Alcoholics on chronic benzodiazepines have a lower rate of achieving abstinence from alcohol than those not taking benzodiazepines. This class of drugs is commonly prescribed to alcoholics for insomnia or anxiety management.[120] Initiating prescriptions of benzodiazepines or sedative-hypnotics in individuals in recovery has a high rate of relapse with one author reporting more than a quarter of people relapsed after being prescribed sedative-hypnotics. Those who are long-term users of benzodiazepines should not be withdrawn rapidly, as severe anxiety and panic may develop, which are known risk factors for relapse into alcohol abuse. Taper regimes of 6–12 months have been found to be the most successful, with reduced intensity of withdrawal.[121][122]

Dual addictions

Alcoholics may also require treatment for other psychotropic drug addictions. The most common dual addiction in alcohol dependence is benzodiazepine dependence, with studies showing 10–20 percent of alcohol-dependent individuals had problems of dependence and/or misuse problems of benzodiazepines. Benzodiazepines increase cravings for alcohol and the volume of alcohol consumed by problem drinkers.[123] Benzodiazepine dependency requires careful reduction in dosage to avoid benzodiazepine withdrawal syndrome and other health consequences.

Dependence on other sedative hypnotics such as zolpidem and zopiclone as well as opiates and illegal drugs is common in alcoholics.

Alcohol itself is a sedative-hypnotic and is cross-tolerant with other sedative-hypnotics such as barbiturates, benzodiazepines and nonbenzodiazepines. Dependence upon and withdrawal from sedative hypnotics can be medically severe and, as with alcohol withdrawal, there is a risk of psychosis or seizures if not managed properly.[15]

 



 

Alcohol Facts:

  • The alcohol contents of a regular beer, glass of dinner wine and shot of whiskey or other distilled spirit (80 proof) are all the same. This is alcohol equivalence.
  • The U.S. government reports that moderate consumption of alcohol (beer, wine or distilled spirits) improves health and increases longevity.
  • Parents have great influence over the choices their children make about alcohol now and in the future.
  • Drinking alcohol by students in U.S. middle and high schools has declined to its lowest level in the 36 years that the federal government has surveyed the subject.
  • Distilled spirits (whiskey, brandy, rum, tequila, gin, etc.) contain no carbohydrates, no fats of any kind, and no cholesterol. Get the nutrition facts.

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Complications of alcoholism and alcohol abuse

Eventually, regular heavy drinking may cause at least one of the following problems:

  • Fatigue - the patient is tired most of the time.
  • Memory loss - especially the patient's short-term memory.
  • Eye muscles - the eye muscles can become significantly weaker.
  • Liver diseases - the patient has a considerably higher chance of developing hepatitis, and cirrhosis. Cirrhosis of the liver is an irreversible and progressive condition.
  • Gastrointestinal complications - the patient can develop gastritis, or pancreas damage. These problems also seriously undermine the body's ability to digest food, absorb certain vitamins, and produce hormones which regulate metabolism.
  • Hypertension - regular heavy drinking invariably raises the person's blood pressure.
  • Heart problems - regular heaving drinking can lead to cardiomyopathy (damaged heart muscle), heart failure, and stroke.
  • Diabetes - alcoholics have a very high risk of developing diabetes type 2. Patients who have diabetes will invariably have serious complications if they are regular heavy drinkers of alcohol. Alcohol prevents the release of glucose from the liver, causing hypoglycemia. A person with diabetes is already taking insulin to lower his/her blood sugar levels - hypoglycemia could be devastating.
  • Menstruation - alcoholism will usually stop menstruation or disrupt it.
  • Erectile dysfunction - alcoholic men are much more likely to have problems getting an erection, or sustaining one.
  • Fetal alcohol syndrome - women who abuse alcohol during their pregnancy are much more likely to have babies with birth defects, including a small head, heart problems, shortened eyelids, as well as developmental and cognitive problems.
  • Thinning bones - alcoholics invariably suffer from thinning of the bones because alcohol interferes with the production of new bone. This means an increased risk of fractures.
  • Nervous system problems - alcoholism often causes numbness in the extremities, dementia and confused/disordered thinking.
  • Cancer - alcoholics have a much higher risk of developing several cancers, including cancer of the mouth, esophagus, liver, colon, rectum, breast, prostate and pharynx.

    An international study found that the key causes of bowel cancer are alcohol and smoking.

    In fact, even moderate alcohol consumption is linked to a higher incidence of cancer among women, a study found. Another study found that consuming just two or more drinks per day could increase a person's risk of pancreatic cancer by about 22%.
  • Accidents - alcoholics are vulnerable to injuries from falls, car crashes, being run over, etc. The NIH says that over half of all American traffic deaths are alcohol-related.
  • Domestic abuse - alcohol is a major factor in spouse beating, child abuse, and conflicts with neighbors.
  • Work (school) problems - employment problems, unemployment, school problems, are often alcohol-related.
  • Suicide - suicide rates among people who are alcohol-dependent or who abuse alcohol are much higher than among other people.
  • Mental illness - alcohol abuse can cause mental illness and make existing mental illnesses worse.
  • Problems with the law - the percentage of alcoholics who end up in court or in prison is significantly higher compared to the rest of the population.
  • effects on the reward system are reduced. It is an important discovery that could lead to new therapies for addictions such as alcohol dependence.
  • Detoxification - the patient takes some medication to prevent withdrawal symptoms (delirium tremens) which many alcoholics experience when they give up drinking. Treatment usually lasts from four to seven days. Chlordiazepoxide, a benzodiazepine medication, is frequently used for detoxification (detox). Doses will be initially high, and will then taper off. It is important that the patient abstains completely from alcohol during the detox.
  • Staying on the wagon (remaining abstinent) - some patients find the detox acheivable, but start drinking again soon after, or some time later. It is important to remember Samuel Johnson's phrase "If at first you don't succeed. Try, try, and try again." Success rates are significantly improved if the patient has access to counseling or some support group. Family support is crucial. Sometimes a good GP can provide vital support. A study found that genetics is a factor in predicting the risk of relapse among alcohol-dependent patients.


In small quantities, the following benefits can result from alcohol:

- It decreases the risk of cardiovascular problems
- Decreases the possibility of lethal heart attack
- Sometimes, alcohol reduces the possibility of ischemic or other kind of strokes
- Diminishes the possibility of gallstone
- It may reduce the diabetes danger

In large quantities, or in excess, the consequences may be terrible:

- The pancreas, the mouth, pharynx, esophageal, breast and liver are more likely to be affected by cancer
- Pancreatitis may appear, especially in youth
- Stroke
- Atrophy of the brain
- Cirrhosis
- Pregnancy problems, like spontaneous abortion
- Possible malformations and other birth problems of the fetus
- Car accidents
- Suicidal tendencies
- Sudden death in case of cardiovascular problems
- Cardiophaty generated by alcohol

There are certain diseases that forbid the affected person to drink at all, such as:

- Conditions of the liver
- Affection of the pancreas
- Precancerous stages affecting the digestive system
- A record including a previous hemorrhagic stroke

Pregnant women or people whose family has an alcohol related background must be extremely cautious and, if possible, not to drink at all.

One drink each day is permitted to persons over 65 years, because in their case, a higher consume is more dangerous; the process of absorption needs more time, the effects are stronger, and the risk of intoxication is a real one.

Alcohol must not be used during the following medications' administration:

- Anticoagulants
- Medication for diabetes
- Beta blockers
- Antihistamines
- Antibiotics
- Antidepressants
- Pain relievers
- Sleeping pills


 
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