Alcohol is the most abused substance in many countries. Alcohol consumption is linked to so many forms of morbidity. Alcoholic beverages may be very cheap, in many African countries, it come in sachets, and small plastic bottles making it easily to carry without notice. Also, it is grain-based opaque beers, whether commercial or home-brewed, in Nigeria locally known as (sapele water, ogogoro, kaikai etc.) which are drunk without previous filtration.
Alcoholism which is also known as alcohol dependence is a syndrome that consists of two phases:
- At-risk drinking: this is the repetitive use of alcohol, often to alleviate anxiety or solve other emotional problems. The American national institute on alcohol abuse defines at risk-drinking as more than 4 drinks per day or 14 drinks per week for men or more than 3 drinks per day of 7 drinks per week for women.
- Alcohol addiction: is a true addiction, similar to that which occurs following the repeated use of other sedative-hypnotics, and is characterized by recurrent use of alcohol despite disruption in social roles (family and work), alcohol-related legal problems and taking safety risks by oneself and with others.
ALCOHOL EFFECT IN THE BRAIN
The principal pharmacological action of alcohol is depression of the central nervous system (CNS). The CNS effects vary depending on the blood alcohol concentration, from (1) euphoria and decreased inhibitions (less than or equal to 50mg/dL) to (2) increased disorientation and loss of voluntary muscle control resulting in irregular movements (100 to 300 mg/dL) then (3) coma and death (greater than 400mg/dL). It is a known fact that not all individuals experience the same degree of CNS dysfunction at similar blood alcohol concentration. The CNS actions of alcohol are more evident when the blood alcohol concentration is increasing (absorptive phase) than when it is declining (elimination phase), partly because of the phenomenon of acute tolerance.
When alcohol is consumed with other CNS depressant drugs, it gives rise to a potentiation or synergistic depressant effect. This has been known to occur at relatively low alcohol concentration, and a number of deaths have resulted from combined alcohol and drug ingestion.
STAGES OF ALCOHOL INFLUENCE/INTOXICATION
| Blood alcohol
Concentration (g/100mL)     Stage of Alcohol Influence     Clinical signs/symptoms                                      |
||
| 0.01 – 0.05 | subclinical | Influence/effects not apparent or obvious
Behavior nearly normal by ordinary observation Impairment detectable by special tests |
| 0.03 – 0.12 | Euphoria | Mild euphoria, sociability, talkativeness
Increased self-confidence; decreased inhibitions Diminution of attention, judgement, and control Some sensory-motor impairment Slowed information processing Loss of efficiency in finer performance tests |
| 0.09 – 0.25 | Excitement | Emotional instability; loss of critical judgment
Impairment of perception, memory, and comprehension Decreased sensory response; increased reaction time Reduced visual acuity, peripheral vision, and glare recovery Sensory-motor incoordination; impaired balance Drowsiness |
| 0.18 – 0.30 | Confusion | Disorientation, mental confusion, dizziness
Exaggerated emotional states (fear, rage, grief, etc.) Disturbances of vision (diplopia, etc.) and of perception of color, form, motion, dimensions Increased pain threshold Increased muscular incoordination; staggering gait; slurred speech Apathy, lethargy |
| 0.25 – 0.40 | Stupor | General inertia; approaching loss of motor functions
Greatly decreased response to stimuli Notable muscular incoordination; inability to stand or walk Vomiting; incontinence of urine and feces Impaired consciousness; sleep or stupor |
| 0.35 – 0.50 | Coma | Complete unconsciousness; coma; anesthesia
Depressed or abolished reflexes Subnormal temperature Impairment of circulation and respiration Possible death |
| 0.45+ | Death | Death from respiratory arrest |
ALCOHOL CONSUMPTION AND PREGNANCY
Alcohol is a teratogen, and alcohol consumption during pregnancy has been known to cause a baby to be born with fetal alcohol spectrum disorders (FASD). These effects include but not limited to physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. Other conditions of alcohol abuse in pregnancy are alcohol-related neurodevelopmental disorders, (ARND) and alcohol-related birth defects (ARBD). Numerous infants are born annually with FASD, ARND and ARBD. These conditions affect more children than Down syndrome, cystic fibrosis, spina bifida, and sudden infant death syndrome combined. FASD, ARND, and ARBD are 100% preventable when a woman completely avoid alcohol during pregnancy.
References
CURRENT Medical Diagnosis and Treatment 2013 Papadakis et. al.
TIETZ Fundamentals of Clinical Chemistry Burtis et. al.
MANSON’S TROPICAL DISEASES 22ND EDITION
