Alcohol abuse and alcoholism can have major effects on the various systems of the body, particularly if the abuse continues for years. However, sometimes even short-term alcohol use, as with only one or more bouts of binge drinking, is extremely dangerous and can be fatal.

The Brain

Alcohol consumption over a period of years may lead to brain damage, causing such disorders as Wernicke's encephalopathy. However, experts Marlene Oscar-Berman and Ksenija Marinkovic have reported that about half of those who have alcoholism in the United States are apparently free of permanent cognitive impairments. The other half of all alcoholics have mild to severe brain impairment. As many as 2 million alcoholics need full-time care by others. Some have dementia. This situation is likely to increase as the baby boomers become elderly individuals.

The Heart and Circulatory System

Heavy and chronic alcohol consumption increases the risk of a heart attack, and this risk is exacerbated by high blood cholesterol levels. Individuals who are heavy drinkers have a much higher risk of having high blood pressure. Heavy female drinkers (Category III) have an elevated risk of having hypertensive disease compared to those who drink much less (Category I).

The risk for ischemic stroke and especially hemorrhagic stroke is much greater among heavy drinkers than light drinkers or nondrinkers; for example, among women, heavy drinkers have nearly an eight times greater risk of having a hemorrhagic stroke. This is also a higher rate than among heavy drinkers who are male, who have more than twice the risk of a stroke.

The Reproductive System

Menstruation is affected by alcoholism, and these effects can cause infertility in women. The male reproductive system may also be affected by alcoholism, not only in incidents of impotence (due to drunkenness) but also in penile dysfunction caused by alcoholic-induced neuropathy.

The Digestive System

Alcoholism may severely harm the liver and the pancreas, causing alcoholic hepatitis, pancreatitis, and even liver failure. As can be seen from Table IV, both male and female drinkers who are at levels II and III drinking have a much greater risk of development of cirrhosis of the liver than those at Level I. They have a significantly elevated risk of cirrhosis (9.54) compared to drinkers at level I, who have a risk of 1.26.

Abnormal clotting of the blood that is caused by liver damage may lead to excessive bleeding. The damaged liver may decrease the blood flow through the liver, causing swollen veins in the esophagus. These veins may rupture in response to only minor trauma. When combined with the problem of abnormal clotting, bleeding from these veins can lead to rapid death through blood loss.

The Immune System

Chronic alcoholism appears to harm the immune system, causing alcoholics to contract more infections than others. According to Elizabeth J. Kovacs and Kelly A. N. Messingham in their article in Alcohol Research & Health:

Taken together, these studies show clearly that there are dramatic suppressive effects of both acute and chronic alcohol exposure on inflammation and immunity, regardless of gender. This results in decreased ability of the immune system to fight infections and tumors. The decrease in immunity after consumption of larger quantities of alcohol is in marked contrast to the effects of very low levels of some alcoholic beverages (such as a single glass of red wine), which contain immunosuppressive antioxidants. By depressing estrogen levels, chronic or acute alcohol exposure may cause females to lose the important boost to the immune system that estrogen normally provides. This could act additively or synergistically with an elevation in immunosuppressive glucocorticoids (through activation of the HPA axis) to attenuate immune response, thus leading to a weakened ability to fight infections and tumors.

Finally, although chronic alcohol exposure causes liver damage in both males and females, it takes less alcohol and shorter periods of consumption to raise the risk of liver damage for females than for males. Like the observed gender differences in alcohol-induced immune suppression, this effect may involve the combined effect of stimulating glucocorticoid production and inhibiting estrogen production.

Cancer

Colorectal cancer, esophageal cancer, and stomach cancer are all forms of cancer that have been directly linked to alcoholism, and there also appears to be a relationship between alcohol consumption and the incidence of breast cancer. As can be seen from Table IV, heavy drinkers have an increased risk for the development of mouth cancer, esophageal cancer, liver cancer, breast cancer, and other cancers. Note that when individuals both drink and smoke, they have an even further elevated risk of the development of digestive cancers and cancer of the respiratory tract.

The Bones

Bone density is reduced by chronic alcoholism; as a result, the risk for osteoporosis among both men and women increases.

The Effects of Alcohol in Adolescents

In addition to the effects that alcohol may have on all humans, alcohol has an array of additional insidious effects on adolescents; for example, alcohol can lower the estrogen levels in girls and the testosterone levels in boys. Acute alcohol intoxication affects the growth hormones in both males and females and thus may impede growth. Increased alcohol consumption can affect the bone mineral density in adolescent males; however, it does not appear to have this effect in females.

Studies of alcohol abuse and dependence in adolescents have shown that alcohol consumption is linked to reduced hippocampal volumes in the brain as well as with subtle abnormalities in the corpus callosum of the brain.

References:

1)         Bagnardi, Vincenzo, et al. "Alcohol Consumption and the Risk of Cancer: A Meta-Analysis." Alcohol Research & Health 25, no. 4 (2001): 263-270.

2)         Emanuele, Mary Ann, M.D., Frederick Wezeman, and Nicholas V. Emanuele, M.D. "Alcohol's Effects on Female Reproductive Function." Alcohol Research & Health 26, no. 4 (2002): 274-281.

3)         Kovacs, Elizabeth J., and Kelly, A. N. Messingham. "Influence of Alcohol and Gender on Immune Response." Alcohol Research & Health 26, no. 4 (2002): 257-263.

4)         National Institute on Alcohol Abuse and Alcoholism, Alcohol Use and Alcohol Use Disorders in the United States: Main Findings from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). U.S. Alcohol Epidemiologic Data Reference Manual 8, no. 1 (January 2006), Bethesda, Md.: National Institutes of Health, January 2006.

5)         Office of Applied Studies. "Emergency Department Visits Involving Underage Drinking." The DAWN Report 1 (2006): 3.

6)         Oscar-Berman, Marlene, and Ksenija Marinkovic. "Alcoholism and the Brain: An Overview." Alcohol Research & Health 27, no. 3 (2003): 125-133.

7)         Petrakis, Ismene L., M.D., et al. "Comorbidity of Alcoholism and Psychiatric Disorders." Alcohol Research & Health 26, no. 2 (2002): 81-89.

8)         Rehm, Jurgen, et al., "Alcohol-Related Morbidity and Mortality." Alcohol Research & Health 27, no. 1 (2002): 39-51.

9)         Tapert, Susan F., Lisa Caldwell, and Christina Burke. "Alcohol and the Adolescent Brain: Human Studies." Alcohol Research & Health 28, no. 4 (2004/2005): 205-212.

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