Drinking alcoholic beverages is an accepted social activity. Consumed in moderate amounts, alcohol relaxes you, stimulates your appetite, and produces mild euphoria. It also loosens inhibitions, making you feel more friendly and outgoing. While moderate drinking is not detrimental to your health, excessive drinking (defined as four drinks or more per day) or binge drinking (defined as four drinks at one sitting) can eventually lead to alcoholism and other serious health problems. There is evidence that some people have an inherited predisposition toward alcoholism. The disorders produced by alcoholism are very costly in terms of human suffering and economic hardship. According to scientific research, the incidence of heart disease in men whoconsume a moderate amount of alcohol (two drinks a day or less) is lower than in men who do not drink. But there is not much difference between moderate drinking and heavy drinking. A typical drink is 5 ounces of wine, 11⁄2 ounces of 80- proof distilled spirits, 12 ounces of wine cooler, or 12 ounces of beer (see page
24). Although moderate drinking may reduce your risk of heart disease, doctors do not recommend drinking alcohol because it carries many health risks, including cancer of the liver, mouth, throat, and esophagus. Excessive alcohol consumption also increases your chances of having an accident, makes you more
prone to violence, and makes you more apt to engage in risky behaviors such as illicit drug use or unsafe sex (see page 111). Nutritional deficiencies and even malnutrition also can result from over consumption of alcohol. Alcohol affects every organ in your body, even in moderate amounts, but over consumption takes its most serious toll on the liver, heart, and brain. When you drink alcohol, some of the alcohol is absorbed in your stomach, but most enters the small intestine, where it passes into the bloodstream, which carries it throughout your body. As alcohol enters your brain, it numbs nerve cells, slowing down their ability to send messages to your body. If you continue to drink, the nerve centers in the brain may lose control over speech, vision, balance, and judgment, and you may have a blackout. Alcohol depresses the activity of your heart muscle; the heart compensates by quickening your pulse. Enzymes in the liver break down alcohol, but the alcohol interferes with the natural breakdown of fats in the liver. When you drink excessively, fats accumulate in the liver, resulting in a condition known as fatty liver, the first step—and the only reversible one—in the continuum of alcoholic liver disease. The next phase, early fibrosis, happens when fibrous scar tissue appears around the central veins in the liver and impairs liver function. Continued heavy drinking rapidly produces the final two stages of liver disease: alcoholic hepatitis and cirrhosis. Alcoholic hepatitis produces jaundice (a yellowing of the skin and eyes), appetite and weight loss, fever, an enlarged and inflamed liver, and accumulation of fluid in the abdomen. Permanent abstinence from alcohol is the
only cure for alcoholic hepatitis. The hallmark feature of cirrhosis of the liver is the presence of scar tissue that destroys the normal structure of the liver. The liver can no longer remove toxins from the blood, and the toxins accumulate in the bloodstream. Cirrhosis usually leads to liver failure or liver cancer. Other long-term effects of excessive drinking include inflammation of the pancreas, bleeding in the stomach and intestinal tract, obstruction of blood flow to the liver, varicose veins in the esophagus (the muscular passage that leads
from the mouth to the stomach), and heart failure. Alcohol is not the only drug that is easy to abuse. Men use a number of other recreational drugs—marijuana, cocaine, amphetamines, inhalants, hallucinogens, tranquilizers, designer drugs such as ecstasy, and heroin and other opiates. All carry certain risks, some deadly. Marijuana has received much publicity for its alleged medical uses, but that fact does not mean that marijuana is risk-free. Marijuana affects short-term memory, impairs the ability to concentrate, inhibits
alertness and reaction time (making driving dangerous), and reduces athletic performance. Prolonged use can irritate the upper respiratory system, making you more susceptible to respiratory infections. Marijuana smoke also contains some of the same cancer-causing chemicals found in cigarettes. Cocaine is a dangerous stimulant that boosts the heart rate while constricting the blood vessels, increasing your chances of having a heart attack, stroke, seizure, or an abnormal heart rhythm. While usually inhaled as a powder, cocaine is sometimes injected. In another form known as crack, cocaine can be smoked. Another class of stimulants, amphetamines (also known as speed or uppers), are prescription drugs taken in pill form that may boost energy and alertness, but also produce rapid heartbeat and can raise the blood pressure so dangerously high that a stroke can occur. Habitual use of amphetamines can cause addiction. In general, stimulants can cause agitation, dilation of the pupils of the eye, visual and auditory hallucinations, seizures, and depression of the
respiratory system. Young boys may be tempted to inhale the fumes of glue, typewriter correction fluid, nail polish remover, or household cleaning products because of the availability of an easy “high.” Sniffing such highly toxic fumes produces euphoria but also can damage the nerves that control breathing and can cause the heart to stop suddenly, leading to coma or death, even in first-time users. Hallucinogens such as lysergic acid diethylamide (LSD) and mescaline create dreamlike visual hallucinations and unexplained bizarre behavior that may mimic psychosis. These drugs can foster psychological dependence. Hallucinogenic
plants such as peyote have similar effects. The most common opiates, including heroin, morphine, and codeine, are highly addictive compounds taken to acquire a feeling of profound well-being. Undesirable effects include depression of the respiratory system and swelling of the brain. When injected, these drugs increase the risk for blood clots, inflamed veins, and transmission of blood-borne infections, such as hepatitis
(see page 191) and the human immunodeficiency virus (HIV). Overdoses of these drugs may lead to seizures, coma, and death from the sudden stopping of the heart or the inhalation of vomit, which can cause suffocation. Withdrawal from these substances produces serious effects such as anxiety, severe diarrhea,
vomiting, cramps, and seizures. It is also possible to become addicted to prescription drugs that you may have received for a medical purpose. Drugs that may become habit-forming include narcotic painkillers prescribed for conditions such as chronic back pain or taken after surgery, or sedatives or tranquilizers prescribed for chronic insomnia or anxiety. Ask your doctor about the potential for addiction when he or she prescribes any medication. Always take medication according to your doctor’s instructions and only for the period of time specified on the prescription. Any type of drug, including alcohol, has the potential to alter your judgment and perception and increase your chances of having a motor vehicle collision or other type of accident. Alcohol and other drug use also is linked with higher incidences of homicide and suicide in men. Moderation is the key when it comes to the use of alcohol (see previous page). Experimentation with other recreational drugs is a risky behavior that can increase your chances of continued substance abuse, accidental injury, and death.
