Issues of Alcohol Misuse Essay

Ethyl alcohol, also known as ethanol, is a chemical, liquid, colorless, flammable compound used industrially for the manufacture of medicines, perfumes, sprays and spirits as well as wine, beer, whiskey and others.There are two main methods for their production by the fermentation of sugars, the most common, or from the ethylene by a synthetic method. The production by fermentation of sugars is from macerated grain, fruit juices, honey, milk, potatoes or molasses, using yeast that create an enzymatic reaction that converts complex sugars into simple and then in alcohol.⁹⁴

History

There is evidence that consumption of intoxicating substances has been around since the Paleolithic era, although the purpose of its use is unknown, and the frequency of use in the Neolithic born an alcoholic beer-like product, which was obtained from barley fermentation.Issues of Alcohol Misuse Essay.  Wine was used almost exclusively by Roman settlers of origin and citizenship and this part of the imperial refined cuisine.⁹⁵

Pharmacodynamics

Alcoholis consumed by the oral route, after being ingested 20% of it is absorbed in the stomach and 80% in the small intestine, the absorption process is completed in an average of 30 to 60 minutes, even if a food intake simultaneously may be delayed up to 3 hours.Alcohol circulate freely in plasma, its metabolism occurs in the liver at a rate of between 7 to 10 grams per hour, this is removed from the body in small amounts so as respiratory renally.⁹⁶

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Metabolism

The alcohol is oxidized to acetaldehyde by alcohol dehydrogenase (ADH), which is saturated with low levels of blood alcohol concentration, then acetaldehyde is converted to acetate by aldehyde dehydrogenase.Under normal situations acetaldehyde is metabolized rapidly and fails to accumulate normally, however when large amounts of alcohol consumed, the accumulation of acetaldehyde can cause symptoms such as headaches, nausea, dizziness and gastritis, which is a possible hangover.⁹⁷

Types of alcoholic beverages

Alcohol is industrialized in different presentations of the same, varying in taste, odor and color each time, the proportion of use of each type of alcohol varies between different social groups, both age and sex, as with social class the person.In this research the types of alcohol used in the university’s population. Cervezabe defined, is the product of fermentation of malted barley, is one of the oldest alcoholic beverages.The basic elements of beer are malted barley, hops, yeast and water.The beer is known for being a little bitter and foamy and usually, except in special beers, it looks bright and clear. Whiskey and Vodka are distillated starch, distilled Vodka is produced from the fermentation broth of starch.Whiskey is distilled from the broth produced by fermenting grain and aged in wooden casks. Ron, is an alcoholic beverage obtained from the distillation of molasses and cane juice sugar and is colored with caramel. Came, we obtain fermentation of grape juice, wine to distill methanol, aldehydes, esters, acids and higher alcohols is obtained.The obtained ethyl alcohol, also called “heart”, is essentially wine.⁹⁸

Effects on the body

Alcohol is part of our lives and culture, but the overuse of this can trigger serious health problems. Issues of Alcohol Misuse Essay. Alcohol can not only lead to accidents or dependency, but alcohol abuse can cause organ damage, weaken the immune system and promote the development of neoplasms.⁹⁹

Because alcohol potentially affects physical and mental health, chronic use both as a high intake at one time may increase the risk of death, directly, in the case of alcohol poisoning, or indirectly by altering behavior and induces violence.¹⁰⁰

• Immune and bloodsystem,the alcohol in excessive amounts can suppress the immune system making this way harder fight both viral and bacterial infections.Chronic use of large amounts of alcohol can also develop anemia and low platelets in the user.
• Bones andmuscles,Moderate use of some types of alcohol can prevent the development of osteoporosis, however when used excessively, this interferes with the absorption of calcium and contrary then develop into finalinstance osteoporosis.A great use alcohol chronically has also been associated with muscle weakness.

• Brain and nervoussystem,being under the influence of alcohol impairment involves judgment and concentration, lethargy involve extremely high amounts and in worst cases, coma.It is equally common temporary memory loss in those drinkers high rate of consumption.Brain tissue damage in people who use large amounts of alcohol, thiamine deficiency (vitamin B1), which can be caused by poor dietary intake or associates because alcohol reduces absorption and interferes with the use of this in the body, thiamine deficiency can evolve in a severe condition called Wernicke encephalopathy.Chronic alcohol use can likewise alter the cerebellum, which is responsible for balance and coordination of movement.Furthermore,peripheral nerves are also affected, causing pain and weakness.
• Heart and bloodpressure,excessive alcohol use increases the risk of coronary artery disease.Have been recorded cases of sudden cardiac death in patients with a history of heavy alcohol consumption, irregular heartbeat and chronic disease of the heart muscle.A high alcohol intake is linked to high blood pressure more frequently in men.
• Intestines,alcohol can lead to developing malnutrition because it blocks the absorption of many important vitamins and nutrients. Issues of Alcohol Misuse Essay.
• Kidneys,alcohol intake leads to fluid loss since this acts as a diuretic, which can cause dehydration.Similarly von lost fluids can escape minerals and salts from the body, such as magnesium, phosphorus, sodium and potassium.
• Liver,chronic use of alcohol can damage the liver, with conditions ranging from fatty liver to alcoholic hepatitis and eventually cirrhosis.It is very common in fatty liver drinkers large amounts of alcohol, although this is reversible when the alcohol intake ceases.Alcoholic hepatitis is developed by a 10 to 35% and leads to symptoms such as fatigue and malaise, death from liver failure may occur in severe cases.Cirrhosis becomes suffered by 5 to 15% of you large consumers of alcohol, at this stage the liver has suffered irreparable harm where the affected cells are replaced by fibrous tissue.
• Lungs,drunkenness increases the risk of pneumonia, since high concentrations of alcohol in the blood are sedative and relax the mouth and throat, suppressing reflections and reduces the ability of the lungs to clear mucus and foreign bodies.Chronic alcohol use has also been associated with an increased risk of pneumonia, tuberculosis and acute respiratory distress syndrome (ARDS).
• Mentalhealth,alcohol affects mood in different ways, leading the person to feel happy, sad or aggressive.There is a risk of dependence when alcohol intake is given by anxiety or stress relief.Because alcohol increases aggressiveness and affects judgment, is often associated with people who have attempted or completed suicide.In people who drink large amounts of alcohol, mood disorders, including depression, anxiety and psychosis, alcohol abuse and dependence develop is also common in people with pre-existing mental condition.¹⁰⁰

Reasons for use

Young, the reasons why young people use alcohol involve several factors such as the environment in which the person was raised during his childhood, peer pressure, social activities, and inadequate parental control.Children born in an environment where the sale of alcohol is part of the family economy are more likely to use it when they grow up, as well as children whose parents abused alcohol.The abundance of spirit with which society has today, also plays an important role in the development of the habit of using alcohol. Adults, there are similarities between the reasons that young people and adults consume alcohol, social and therapeutic reasons , stress, need for stimulation, pressure from peers.Adults report that alcohol offers relaxation after a busy day at work.¹⁰¹

Consumption patterns in university

In universities there are students who are not consumers of alcohol, and sometimes consumers and consumers of high amounts of alcohol, there are predisposing reasons for students to consume alcohol or not, including the influence of family and friends.The fact that a student has consumed alcohol at some point in your life does not make an active consumer, however those who consume alcohol regularly, consumers can be classified into low-risk and high-risk consumers.Studies say that about 20.9% of adolescents report being regular drinkers.¹⁰²

Toxic Dose

It is established that the lethal dose of pure ethanol is 300 to 400ml in less than an hour in adults being potentially lethal dose of 10 ml / kg in children and 5ml / kg, as children are highly sensitive to ethyl alcohol.The clinical manifestations of alcohol intoxication will be related to blood alcohol concentration of10 to 50mgis still in a state of sobriety, so the stage is asymptomatic;30to120mg,produces euphoria, covering motor incoordination, emotional instability, restlessness, inattention and association of ideas;90to 250mgexcitability appears where irritability, dysarthria, muscular incoordination, hypoglycemia, lactic acidosis and visual disturbances seen;180to 300mgcomes the confusion, including sleep, drowsiness, marked incoordination, hypothermia and temporary amnesia;270 to 450mgof the patient falls into a coma, expressed punctate miosis, respiratory depression, areflexia, superficial and profound analgesia, metabolic acidosis, hypoglycemia and seizures;increased to450mg,death occurs from paralysis of Cardiorespiratory Centre.¹⁰³

Alcohol Dependence

When the individual has used his body to chronic alcohol intake, this begins to develop addiction and dependency, worsening by more consumed, inadequate intake of alcohol causes malaise, called withdrawal. Issues of Alcohol Misuse Essay.WHO defines alcohol dependence as “a mental and physical state usually also resulting from the ingestion of alcohol, characterized by responsesbehaviorand others, which always include a compulsion to drink alcohol continuously or periodically to experience its psychic effects and sometimes way to avoid the discomfort of withdrawal;tolerance may have or may not be present.^“104

Alcohol tolerance

When high amounts of alcohol are ingested for prolonged periods, the body tends to develop a series of adaptive responses due to the constant presence of ethanol in the bloodstream.Studies demonstrated that continuous exposure to ethanol, results in a significant loss of activity of membrane in neurons besides adaptive changes in electrophysiological responses from them.¹⁰⁵

Abuse in young

The percentage of college students who ate five or more alcoholic beverages for a period of one month is 41.7% to 45.2% according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).Of those university students who inferred alcohol, 26.1% to 29.2% driving under the effects of alcoholic beverages.¹⁰⁶

The age with the highest incidence of alcohol use are those being 21 and 23 years of age, the percentages being 49.9% at 21, 46.6% at 22 and 47.7% at 23, the fact that the highest percentage is at 21, it may be that in the most populous countries the legal age to consume alcohol is 21 years, the freedom to consume alcohol upon reaching the required age encourages young people to get alcohol as a sign that they are already adults.Anyway as young people themselves is easy to get alcohol even when you are under 21 years of age, this being expressed by 87% of students.¹⁰⁶

Diagnostic criteria for alcohol abuse.

There are four criteria according to DSM-IV avalúan if the consumer is within the range of alcohol, then it is enunciated identically to DSM-IV:

a) Recurrent use of alcohol, which leads to the violation of obligations at work, school or at home (eg, repeated absences or poor work performance related to substance use,.. Substance related absences, suspensions or expulsions school, neglect of children or household duties).

b) Recurrent alcohol use in situations in which it is physically hazardous (p. Example., Driving an automobile or operating a machine when impaired by substance use).

c) Repeated legal problems related to alcohol (p. Example., Arrests for alcohol-related disorderly conduct).

d) Continued alcohol use despite having persistent or recurrent social problems caused or exacerbated by the effects of alcohol interpersonal problems (p. Example., Arguments with spouse about consequences of intoxication, physical fights).¹⁰⁷

Legality

Across America the use of alcohol is allowed, however it is restricted to certain ages depending on the country.Some countries do not have regulationsfor the age at which it is allowed to use alcohol, this representing a risk for young people to develop negative behaviors on the use of alcohol.¹⁰⁸

Alcohol and energy drinks

The use of alcohol and energy drinks with high caffeine content has become popular in recent times.Previously the use of caffeine to maintain sobriety after having ingested alcohol was known for a large proportion of frequent drinkers today, because of this trend, there are drinks energy properties included in its composition, ie, according to studies allows the user not feel drunk even if you are at a stage where the alcohol in your system is categorized as intoxicated.¹⁰⁹

Alcohol is addictive in a large proportion of people have used these once your palate to this, just as energy drinks with addictive substances like caffeine, alcohol and energy drinks use sum the probability that the individual will develop addiction to this such substances.Another property that has this binding substance is to increase the desire to continue taking more alcohol, increasing the risk of over-consumption and worsening the caudate damage by alcohol, since with increasing alcohol consumption people show less inhibitions.¹¹⁰

Due to the large increase in the simultaneous use of these substances the FDA (U.S. Food and Drug administration) issued notices care about inconsiderate alcoholic and energy drinks. Issues of Alcohol Misuse Essay.Since the population is currently the most affected population is mostly young university, the FDA called the authorities to consider studies to understand clearly and precisely as these substances affect both together and individually, to college students in health and academic activity.¹¹¹

There are many risks that bring the use of these substances from the increased likelihood of developing dependence to a greater chance of developing alcohol poisoning.The use of energy drinks during the same period in which they are drinking alcohol keeps an alert position and gives the perception of a lesser degree of intoxication which leads people to consume greater quantities of alcohol.Drinking alcohol and energy drinks together is associated with a decline in the notion of deteriorating mental and physical health caused by alcohol.¹¹²

The use of energy drinks is associated in many cases people who have a problem with alcohol.Studies show that in people where a problem is reported in the consumption of energy drinks, usually a high frequency of episodes of high alcohol intake, and problems resulting from consumption of alcohol and increased symptoms of alcohol dependence were reported.¹¹³

Regarding susceptibility possessing people ingest energy drinks tend to develop alcohol dependence, studies show that people who used energy drinks with high frequency had begun to consume alcohol and become intoxicated at a younger age than those who do not frequently consumed energy drinks, like having drunk more alcohol in the past year and more drinks on a typical night of drinking alcohol, plus they were more likely to meet diagnostic criteria for alcohol dependence.¹¹⁴

There are several reasons that motivate young people to consume alcohol with energy drinks, in fact these are the drinks consumed while on holiday and that adding some kind of energy drink alcohol improves the taste of the beverage.Observations indicate that college students who visited a bar reported greater use of alcohol in those who had consumed energy drinks, these students also had a threefold increased risk was after leaving the bar highly intoxicated by alcohol.¹¹⁵

Among the factors that influence the use of alcohol with energy drinks among young people is equally the fact that these young people mostly believe in the idea thatwill look better in front of others if they consume these types of drinks, associating greater popularity with the same classmates. College students report that if they are seen with some energy drink while consuming alcohol, they feel somehow more striking and interesting manner.¹¹⁶

According to Alcohol Concern Organisation (2015) more than 9 million people in England consume alcoholic beverages more than the recommended daily limits. In relation to this, the National Health Service (2015) actually recommends no more than 3 to 4 units of alcohol a day for men and 2 to 3 units a day for women. The large number of people consuming alcohol more than the recommended limits, highlights the reality that alcoholism is a major health concern in the UK which can lead to a multitude of serious health problems. Moss (2013) states that alcoholism and chronic use of alcohol are linked to various medical, psychiatric, social and family problems. To add to this, the Health and Social Care Information Centre (2014) reported that between 2012 and 2013, a total of 1,008,850 admissions related to alcohol consumption where an alcohol-related disease, injury or condition was the primary cause for hospital admission or a secondary diagnosis.Issues of Alcohol Misuse Essay.  This shows the detrimental impact of alcoholism on the health and overall wellbeing of millions of people in the UK. It is therefore vital to examine the aetiology of alcoholism in order to understand why so many people end up consuming excessive alcohol. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) (n.d.) supports this by stating that learning the natural history of a disorder will provide information essential for assessment and intervention and for the development of effective preventive measures. This essay will also look into the different public health policies that address the problem of alcoholism in the UK. A brief description of what alcoholism is will first be provided.

What is Alcoholism?

It is safe to declare that alcoholism is a lay term that simply means excessive intake of alcohol. It can be divided into two forms namely; alcohol misuse or abuse and alcohol dependence. Alcohol misuse simply means excessive intake of alcohol more than the recommended limits (National Health Service Choices 2013). A good example of this is binge drinking.

Alcohol dependence is worse because according to the National Institute for Health and Care Excellence (2011, n.p.) it “indicates craving, tolerance, a preoccupation with alcohol and continued drinking regardless of harmful consequences” (e.g. liver disease). Under the Diagnostic Statistical Manual of Mental Disorders (DSM)- 5, these two have been joined as one disorder called alcohol use disorder or AUD with mild, moderate and severe sub-classifications (NIAAA 2015).

Genetic Aetiologic Factor of Alcoholism

Alcoholism is a complex disorder with several factors leading to its development (NIAAA 2005). Genetics and other biological aspects can be considered as one factor involved in the development of alcohol abuse and dependence (NIAAA 2005). Other factors include cognitive, behavioural, temperament, psychological and sociocultural (NIAAA 2005).

According to Goodwin (1985) as far as the era of Aristotle and the Bible, alcoholism was believed to run in the families and thus could be inherited. To some extent, there is some basis that supports this ancient belief because in reality, alcoholic parents have about four to five times higher probability of having alcoholic children (Goodwin 1985). Today, this belief seems to lack substantially clear and direct research-based evidence. On the other hand, studies also do not deny the role of genetics in alcoholism. With this view, it is therefore safe to argue that genetics is considered still as an important aetiologic factor in alcoholism.

The current consensus simply indicates that there is more to a simple gene or two that triggers the predisposition of an individual to become an alcoholic. Scutti (2014) reports that although scientists have known for some time that genetics take an active role in alcoholism, they also propose that an individual’s inclination to be dependent on alcohol is more complicated than the simple presence or absence of any one gene. The National Institute on Alcohol Abuse and Alcoholism (2008) states that there is no one single gene that fully controls a person’s predisposition to alcoholism rather multiple genes play different roles in a person’s susceptibility in becoming an alcoholic. Issues of Alcohol Misuse Essay. The NIAAA (2005) further claims that the evidence for a genetic factor in alcoholism lies mainly with studies that involve extended pedigree, those that involve identical and fraternal twins and those that include adopted individuals raised apart from their alcoholic parents.

For pedigree studies, it is believed that the risk of suffering from alcoholism is increased four to seven fold among first-degree relatives of an alcoholic (Cotton 1979; Merikangas 1990 cited in NIAAA, 2005.). First degree relatives naturally refer to parent-child relationships; hence, a child is therefore four to seven times at higher risk of becoming an alcoholic, if one or both of their parents are alcoholics. Moss (2013) supports this by stating that children whose parents are alcoholic are at higher risk of becoming alcoholics themselves when compared to children whose parents are non-alcoholics.

A study conducted by McGue, Pickens and Svikis (1992 cited in NIAAA 2005) revealed that identical twins generally have a higher concordance rate of alcoholism compared to fraternal twins or non-twin siblings. This basically means that a person who has an alcoholic identical twin, will have a higher risk of becoming an alcoholic himself when compared to if his alcoholic twin is merely a fraternal twin or a non-twin sibling. This study further proves the role of genetics in alcoholism because identical twins are genetically the same; hence, if one is alcoholic, the other must therefore also carry the alcoholic gene.

The genetic factor in alcoholism is further bolstered by studies conducted by Cloninger, Bohman and Sigvardsson 1981 cited in NIAAA 2005 and Cadoret, Cain and Grove (1980 cited in NIAAA 2005) involving adopted children wherein the aim was to separate the genetic factor from the environmental factor of alcoholism. In these studies, children of alcoholic parents were adopted and raised away from their alcoholic parents but despite this, some of these children still develop alcoholism as adults at a higher rate than those adopted children who did not have an alcoholic biological parent (Cloninger et al., 1981 cited in NIAAA 2005 and Cadoret et al., 1980 cited in NIAAA 2005).

One interesting fact about aetiologic genetic factor is that although there are genes that indeed increase the risk of alcoholism, there are also genes that protect an individual from becoming an alcoholic (NIAAA 2008). For example, some people of Asian ancestry carry a gene that modifies their rate of alcohol metabolism which causes them to manifest symptoms such as flushing, nausea and tachycardia and these generally lead them to avoid alcohol; thus, it can be said that this gene actually helps protect those who possess it from becoming alcoholic (NIAAA 2008). Issues of Alcohol Misuse Essay.

Environment as an Aetiologic Factor of Alcoholism

Another clearly identifiable factor is environment, which involves the way an individual is raised and his or her exposure to different kinds of activities and opportunities. The National Institute on Alcohol Abuse and Alcoholism (2005) relates that the genetic factor and the environmental factor have a close relationship in triggering alcoholism in an individual. This can be explained by the simple fact that even if an individual is genetically predisposed to becoming an alcoholic, if he is not exposed to a particular kind of environment which triggers activities that lead to alcohol intake, the likelihood of his becoming an alcoholic will be remote.

There are certain aspects within the environment that makes it an important aetiologic factor. According to Alcohol Policy MD (2005) these aspects include acceptance by society, availability and public policies and enforcement.

Acceptance in this case refers to the idea that drinking alcoholic drinks even those that should be deemed excessive is somewhat encouraged through mass media, peer attitudes and behaviours, role models, and the overall view of society. Television series, films and music videos glorify drinking sprees and even drunken behaviour (Alcohol Policy MD 2005). TV and film actors and sports figures, peers and local role models also encourage a positive attitude towards alcohol consumption which overshadows the reality of what alcohol drinking can lead to (Alcohol Policy MD 2005). In relation to this, a review of different studies conducted by Grube (2004) revealed that mass media in the form of television shows for instance has an immense influence on the youth (age 11 to 18) when it comes to alcohol consumption. In films, portrayals regarding the negative impact of alcohol drinking are rare and often highlight the idea that alcohol drinking has no negative impact on a person’s overall wellbeing (Grube 2004). In support of these findings, a systematic review of longitudinal studies conducted by Anderson et al. (2009) revealed that the constant alcohol advertising in mass media can lead adolescents to start drinking or to increase their consumption for those who are already into it. Issues of Alcohol Misuse Essay.

Availability of alcoholic drinks is another important environmental aetiologic factor of alcoholism simply because of the reality that no matter how predisposed an individual is to become an alcoholic, the risk for alcoholism will still be low if alcoholic drinks are not available. On the other hand, if alcoholic beverages are readily available as often are today, then the risk for alcoholism is increased not only for those who are genetically predisposed to alcoholism but even for those who do not carry the “alcoholic genes”. The more licensed liquor stores in an area, the more likely people are to drink (Alcohol Policy MD 2005). The cheaper its price, the more affordable it is for people to buy and consume it in excess (Alcohol Policy MD 2005).

Another crucial environmental aetiologic factor is the presence or absence of policies that regulate alcohol consumption and its strict or lax enforcement. It includes restricting alcohol consumption in specified areas, enacting stricter statutes concerning drunk driving and providing for penalties for those who sell to, buy for or serve to underage individuals (Alcohol Policy MD 2005). It is worthy to point out that in the UK, the drinking age is 18 and a person can be stopped, fined or even arrested by police if he or she is below this age and is seen drinking alcohol in public (Government UK 2015a). It is also against the law for someone to sell alcohol to an individual below 18; however, an individual age 16 or 17 when accompanied by an adult can actually drink but not buy alcohol in a pub or drink beer, wine or cider with a meal (Government UK 2015a).

Policies to Combat Alcoholism

One public health policy that can help address the problem on alcoholism is the mandatory code of practice for alcohol retailers which banned irresponsible alcohol promotions and competitions, and obliged retailers to provide free drinking water, compelled them to offer smaller measures and required them to have proof of age protocol. It can be argued that this policy addresses the problem of alcoholism by restricting the acceptance, availability and advertising of alcohol (Royal College of Nursing 2012). Another is the Police Reform and Social Responsibility Act 2011 which is a statute that enables local authorities to take a tougher stance on establishments which break licensing rules about alcohol sale (Royal Collage of Nursing 2012). Issues of Alcohol Misuse Essay.

There is also the policy paper on harmful drinking which provides different strategies in addressing the problem of alcoholism. One such strategy is the advancement of the Change4Life campaign which promotes healthy lifestyle and therefore emphasises the recommended daily limit of alcohol intake for men and women (Government UK 2015b). Another strategy within this policy is the alcohol risk assessment as part of the NHS health check for adults ages 40 to 75 (Government UK 2015b). This policy aims to prevent rather than cure alcoholism which seems to be logical for after all, an ounce of prevention is better than a pound of cure.

Conclusion

Alcoholism which includes both alcohol misuse and alcohol dependence is a serious health problem which affects millions in the UK. Its aetiology is actually a combination of different factors. One vital factor is genetics wherein it can be argued that some people are predisposed to becoming an alcoholic. For example, an individual is at higher risk of becoming an alcoholic if he or she has a parent who is also alcoholic. When coupled with environmental factors, the risk of suffering from alcoholism becomes even greater. Environment refers to the acceptability and availability of alcohol and the presence or absence of policies that regulate alcohol sale and consumption. Vital health policies such as Harmful Drinking Policy Paper advocated by the government, are important preventive measures in reducing the incidence and prevalence of alcoholism in the UK.

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References

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