The World Health Organisation estimates that alcohol abuse accounts for over 3 million deaths a year across the world, lowers health standards and causes a rise in disabilities and illnesses in all of the areas where it is highly consumed. (15)
Alcohol is also the leading risk factor for premature deaths in the 15 to 50-year-old group as nearly 10% of all deaths in this group are alcohol-related.
This can have a severely limiting effect on countries’ healthcare systems across the world where alcohol forms a strong part of many people’s social routines and more significantly as a way of coping with increases in their stress and anxiety levels. (15)
Short-term effects of alcohol
Alcohol in small doses does offer many desirable effects for people which is why they look forward to enjoying a drink when unwinding.
This is because when people start drinking alcohol they may experience a decrease in anxiety and feelings of pleasure and enjoyment which means they are more relaxed and able to interact with other people confidently.
However, it is worth bearing in mind that alcohol is a psychoactive drug which means that people who drink alcohol are likely to experience a change in many aspects of their cognition and mental processing if they consume alcohol over a prolonged period.
For example, alcohol can alter our perception, mood and emotional state, consciousness, and inhibition, all of which can affect the way we behave. (5)
Toxic effects of alcohol
Alcohol has a highly toxic effect on the body and can damage cells and tissues right throughout the body.
Even though it is primarily processed in the liver, all cells and tissues throughout the body are highly efficient at metabolising alcohol.
Because of this alcohol can harm every aspect of our physical health and over time we will find that if we continue to drink daily many aspects of our appearance will change and our physical capabilities will deteriorate.
A person who drinks alcohol each day will experience the following changes:
- Skin – Alcohol has a dehydrating effect on the human body so the skin will dry up and lose its flexibility, leaving the person with a red, puffy appearance.
- Weight gain – There are a lot of calories and a high sugar content in alcohol which will lead to weight gain at some stage if alcohol is consumed every day.
- Body odour – As time passes regular alcohol intake will lead to various physiological changes leading to the person eliciting undesirable body odour if sustained for too long.
- Hair – Heavy, sustained drinking can lessen the efficiency of the pancreas which is involved in the exocrine gland system which plays a key role in keeping the hair (and skin) lubricated and in healthy condition. If the pancreas becomes less efficient then these aspects of our appearance will become less attractive.
- Fertility – Research has shown drinking a lot of alcohol can affect both men’s and women’s capability of producing healthy offspring. (5,14)
Physical dependence can develop very quickly
Research into alcohol dependence has revealed that it is possible to show signs of alcohol dependence within a week if you consume the equivalent of six pints of medium-strength beer/lager a day for that week.
So, if a drinker goes through a period of heavy drinking throughout the Christmas holiday period for example they may well be showing signs of physical dependence after that period.
If after a period of heavy drinking over a weekly or fortnightly period a person stops drinking and experiences withdrawal symptoms (insomnia, anxiety, headaches) after this then it is likely they are exhibiting signs of alcohol dependence.
People do not necessarily need to drink heavily every day to become dependent on alcohol. Even drinkers who consume a couple of glasses of wine a day can become alcohol-dependent within a few months. (5,10)
Physical dependence – Neuroadaptation
If a person consumes alcohol every day the internal physical mechanisms in their central nervous system and throughout their body will quickly adapt to the presence of alcohol which will result in the body becoming very efficient at processing alcohol.
The body is designed to minimise the effect of any psychoactive substance so that it can function at as high a level as possible, and to enable the body to do this the central nervous system needs to implement biological and chemical adjustments to cater for the continuing presence of alcohol in the body.
1. Withdrawal symptoms
However, if after adjusting to the presence of alcohol a person stops drinking they will experience strong withdrawal symptoms such as headaches, nausea, insomnia and anxiety.
These withdrawal symptoms can be alleviated instantly by drinking more alcohol which is the main reason why giving up alcohol is so difficult once you have become physically dependent on it. (5,10)
2. Psychological dependence
Within a few months of drinking alcohol every day, people may become psychologically reliant on alcohol, as alcohol may help to improve their mood, give them confidence or enable them to relax in social situations.
Anyone who needs to drink alcohol to help them achieve these states is now likely to be psychologically dependent on alcohol as they do not possess the mental resources to display confidence, exhibit a positive mindset and feel comfortable in social situations without consuming alcohol.
This means that it will become even harder for the dependent drinker to give up alcohol as their body and brain are becoming entrapped in a state of physical and psychological dependence on alcohol which can only be treated by specialist medical and psychological interventions. (10)
From dependence to addiction
The problem is that although they may not have caused significant damage to their health by this stage they are slowly becoming embroiled in the addictive process and if they do not try and curtail this very soon they will find it very difficult to stop drinking as time passes even if they want to.
Once a person becomes physically dependent on alcohol it is very easy for their life to spiral out of control and before they know it, many areas of their life can be affected, including:
- Close Relationships and family life.
- Social relationships.
- Leisure activities.
- Education and learning.
- Cognition, memory and concentration.
- Job/career.
People who drink every day and become alcohol dependent will gradually lose interest in activities and interests that they once found pleasurable and engaging.
They will give up these activities to become involved in activities that are associated with alcohol consumption. (4,5)
Alcohol addiction
If a heavy drinker develops a physical and psychological dependence on alcohol this does not necessarily mean that they are now addicted to alcohol but if they carry on drinking every day then they will develop an addiction if:
- They have steadily and gradually increased their alcohol intake over a period of months.
- Have become preoccupied with alcohol so that it interferes with their lives.
- Their lives become unmanageable.
- They give up pleasurable and engaging activities because of their alcohol use.
- They carry on drinking even when they know it is causing them physical and psychological harm.
- They have a strong desire to stop or reduce their drinking but are unable to achieve this. (4,10)
Serious physical health concerns
Due to the highly toxic effects of alcohol regular drinkers will experience various physical consequences which will gradually deteriorate further if they carry on drinking.
Heavy alcohol use will severely limit the efficiency of various internal biological mechanisms and major organs. (12)
- Cardiovascular/respiratory
Alcohol can have a very damaging effect on the cardiovascular and respiratory systems with a high degree of toxicity in the body leading to physical problems that could cause strokes, high blood pressure and cardiovascular disease.
- Diabetes (Type2)
Scientific research suggests alcohol plays a hugely significant role in the development of type 2 diabetes.
Diabetes is a chronic condition that occurs when blood sugar in the form of glucose becomes too high and causes disruption to various physiological mechanisms that can affect the heart, nerves and eyes because of problems with a hormone called insulin.
The following symptoms are common in people diagnosed with diabetes. (8)
- Increased thirst.
- A need to urinate more often than normal.
- Becoming hungry more frequently.
- Unintended weight loss.
- Fatigued more often.
- Vision becomes blurred.
- Slow-healing sores and infections.
- Suffering constant infections.
- Liver damage- cirrhosis
There is also a risk that long-term drinkers can develop cirrhosis, which is a serious condition where the liver becomes scarred.
The scarring of the surrounding tissue of the liver leads to a significant decline in the functioning of the liver which can have several health consequences. These can include:
- Becoming physically weak.
- Becoming fatigued easily.
- Loss of appetite.
- Feeling nauseous.
- Skin takes on a yellow appearance.
- Itchy skin.
- Bruising and bleeding frequently.
- Vomiting blood.
- Swollen legs and abdomen.
The liver plays a vital role in removing waste and toxic chemicals from the body, facilitating human growth by the formation of important proteins and enabling the digestive system to function effectively.
All of these processes will be significantly hampered if the liver is damaged. (4,12)
- The immune system will gradually become less effective.
The long-term alcohol intake associated with everyday drinking can drastically reduce the efficiency of the immune system.
Therefore, daily drinkers will find that they will pick up a lot of colds, infections and irritations that do not heal easily as their immune system is not protecting them as well as it previously did.
Once people are dependent on alcohol their inability to stop drinking can cause them many inconveniences.
For example, if they are on medication for illnesses and certain medical conditions and they do not halt their drinking whilst taking the medication the medication is likely to be rendered ineffective by the alcohol which will result in them being unwell for longer. (4,12)
- Pancreatitis
There is well-established scientific research suggesting that 10-15 years of consistent drinking can make a person more vulnerable to developing pancreatitis.
Pancreatitis is a very debilitating condition in which the pancreas becomes inflamed after sustained alcohol intake. Initially, prolonged drinkers will experience pain and discomfort in the abdominal area (mainly the left side) and their back area at sporadic intervals.
If this is not diagnosed and the person does not stop drinking this can develop from acute pancreatitis into chronic pancreatitis.
If the patient’s pancreatitis reaches the chronic stage the pain will never go away and they will be in danger of suffering from more severe pain and stomach complaints which will severely restrict their day-to-day living. (2)
- Mental health problems
Heavy, persistent drinking has been associated with an array of mental health difficulties. As well as alcohol addiction heavy drinking can lead to an increased likelihood of being diagnosed with anxiety, depression and several behavioural difficulties relating to anger, aggression, poor emotional control and communication difficulties. (13)
People who drink regularly are unfortunately at risk of becoming embroiled in a negative associative cycle between depression and alcohol, where high amounts of alcohol can start to interfere with a person’s brain chemistry and cause a person to experience a low mood which, paradoxically can improve by drinking more alcohol. (9,13)
- Financial difficulties
Drinking alcohol every day can prove to be a very expensive habit which can significantly eat into your income, which over a period of months can set you back hundreds if not thousands of pounds depending on what you drink, where you drink alcohol (pub prices have increased significantly in recent years) and how often you drink.
If this is not recognised and curtailed then it is likely you may find yourself without money to pay for the basics things in life such as rent, clothes and food.
This is likely to have an even greater impact on adults with young children to care for.
Unfortunately, any instability or disturbance to routine caused by poor financial management can have serious consequences for their physical, emotional and intellectual development.
Other serious brain disorders from alcohol addiction
Sustained, heavy drinking over a period of 15-20 years can eventually result in serious alcohol-related brain disorders which can have serious consequences for brain functioning and the damage can often be irreversible if it has reached this stage.
1. Delirium tremens (DT)
Delirium tremens, also known as late-stage alcohol withdrawal affects approximately one in 15 people who experience alcohol withdrawal symptoms.
Delirium tremens is a medical emergency and anyone showing symptoms of DT will die if they do not receive specialist medical treatment urgently.
DT is a very serious condition because there is a strong possibility that patients may have experienced severe disruption to their respiratory and cardiac functioning.
It is only heavy, long-term drinkers that are likely to experience DT though so anyone who has gone through a phase of drinking alcohol every day for a few weeks having previously drunk at a moderate level is highly unlikely to develop DT.
As well as experiencing a state of confusion (delirium) other symptoms of DT include:
- Abnormal perceptions.
- Increased likelihood of tremors.
- Severe agitation.
- Expressing delusional beliefs.
- Tachycardia (Fast heart rate) and Hypertension (high blood pressure)
- Feelings of fear and terror.
- Insomnia.
- Symptoms of mild fever.
- A rise in the hallucinations they experience, whether auditory or visual which will more than likely be of a threatening nature.
- Susceptible to sudden mood change.
Being diagnosed with delirium tremens should indicate to an individual that they are drinking at very high levels which could cause them harm if they do not curtail (or preferably stop) their drinking habits.
If they do not take heed of this advice then they are vulnerable to developing even more serious disorders in the future. (3)
2. Wernicke / Korsakoff syndrome
Heavy long-term drinking will eventually take its toll on the brain and cause problems with cognition including memory loss leading to frequent amnesia and confusion as well as problems with information processing and coordination.
Patients diagnosed with such advanced brain diseases also tend to develop difficulties in speaking and expressing themselves and will experience frequent hallucinations.
Once patients have reached this stage it is highly probable that they require constant medical care and will have done permanent damage to aspects of their brain functioning. (4)
What if I cannot give up Alcohol?
As a result of their deteriorating health, it may be urgent for some people to give up alcohol immediately before they cause themselves serious harm.
However, as alcoholism is an addiction associated with a lack of control over behaviour people diagnosed with the condition are unable to stop drinking, even if they have a strong desire to.
It would therefore be advisable for them to engage with treatment services for medical detox and psychosocial therapies at the earliest opportunity.
This is because heavy drinkers need expert help to help them overcome their physical dependence and emotional reliance on alcohol.
Treatment setting
To ensure they abstain from alcohol for the good of their health alcohol treatment professionals would probably refer them to a residential treatment programme (also known as inpatient rehab) instead of following an outpatient treatment programme.
This will increase their chances of giving up alcohol for a 1-2 month period and focusing on their recovery.
This is because patients on inpatient programmes are removed from their usual social and domestic living arrangements while they receive treatment and there may be tempting influences and toxic atmospheres in the patient’s social and domestic life which can limit their progress towards abstinence and potentially lead to them relapsing.
Staying for 1-2 months in a residential setting means that qualified staff are on hand 24 hours a day to help patients deal with medical emergencies and moments of psychological crisis and to enforce the strictly no alcohol policy of the treatment centre.
References
(1) Chowdhury, P., Gupta, P. (2006) Pathophysiology of alcohol pancreatitis: An overview. Available @Pathophysiology of alcoholic pancreatitis: An overview – PMC (nih.gov)
(2) Feldman, M. (2021) Acute Pancreatitis. Available@ Alcoholic Pancreatitis – an overview | ScienceDirect Topics
(3) Grover, S. & Ghosh, A. (2018) Delirium Tremens: Assessment and management. Journal of Clinical and Experimental Hepatology. 8(4) available@ Delirium Tremens: Assessment and Management – PMC (nih.gov)
(4) Heather, N. & Stockwell, T. (2004) The Essential Handbook of Treatment and Prevention of Alcohol Problems. John Wiley and Sons. Chichester.
(5) Herie, A. & Skinner, W. (ed) (2014) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada.
(6) Hoffman, R. Weinhouse, G. (2022) Management of moderate and severe alcohol withdrawal syndrome. Wolters Kluwer. Available@Management of moderate and severe alcohol withdrawal syndromes – UpToDate
(7) John Hopkins University (2022) Anatomy of the endocrine system. available@Anatomy of the Endocrine System | Johns Hopkins Medicine
(8) Kim, S.J., Kim, J.K. (2012) Alcoholism and diabetes mellitus. Diabetes and metabolism Journal. available@ Alcoholism and diabetes mellitus – PubMed (nih.gov)
(9) Kuria, M.W. et al (2012) The Association between alcohol dependence and depression before and after treatment for alcohol dependence. available@The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence – PMC (nih.gov)
(10) Moss and Dyer (2010) The psychology of addictive behaviour. Palgrave Macmillan. Basingstoke.
(11) National Institute of Care Excellence (2022) Alcohol Use Disorder: Diagnosis and management of physical complications. available@Alcohol-use disorders: diagnosis and management of physical complications DRAFT (nice.org.uk)
(12) NI Direct (2022) How alcohol affects your health. available@https://www.nidirect.gov.uk/articles/how-alcohol-affects-your-health
(13) Royal College of Psychiatrists (2022) Alcohol and Depression. Available @ Alcohol and depression | Royal College of Psychiatrists (rcpsych.ac.uk)
(14) Rusyn, I. & Bataller, R, (2013) Alcohol and toxicity. available@ALCOHOL AND TOXICITY – PMC (nih.gov)
(15) World Health Organisation (2022) Alcohol. available@Harmful use of alcohol (who.int)
