Health Effects of Alcoholism

Hal is one of those “life of the party” guys, a kind of overgrown teddy bear and everybody loves him. If there’s an interesting story, it’s Hal’s. If there is a joke, it’s Hal’s.

If a group of people has gathered around one individual, who captivates their imaginations, it’s Hal. Nobody imagined Hal would be in so much trouble.

There is an old wives’ tale out there that says you can’t really get drunk on beer, or you won’t get drunk on beer because you’ll get full first. When you look at it, it’s a simple matter of understanding how much alcohol is being consumed and how long it takes the body to rid itself of it.

Alcohol is absorbed by the body in two primary places. Some is absorbed by the stomach, but the major player in this process is the small intestine. This explains why alcohol absorption takes a little longer after you’ve eaten, as it lingers in the stomach before moving to the small intestine.

Hal’s story is a good description of the common health effects of alcoholism.

Hal’s can of 12-ounce beer has about .48 ounce of alcohol, which is about the same amount of alcohol in a four-ounce glass of wine, or an ounce of 100-proof spirits, or 1.25 ounce of 125-proof spirits. You can see that a drink is a drink. Once it is absorbed and gets into the bloodstream, that’s where the liver takes over.

There was an old joke that if reincarnation were real, the worst punishment would be to come back to life as Hal’s liver, mainly because he put away a lot of drinks, and his embattled liver could only process about .25 to .30 per hour. So, a little more than half of his first beer is absorbed in an hour. Hal never has just one beer. He doesn’t worry about having too much because he weighs about 260 pounds, but little does he realize that almost everybody is going to process in that same range, give or take a few points, so it doesn’t really matter that he is a big bear of a man.

Most of the alcohol in the bloodstream is metabolized in the liver, but there is about two percent that is removed from the body through the breath, through the urine or through the skin. That’s why you can often tell the next day when old Hal has had a rough night. You can smell it. Had he just enjoyed a couple, over a couple of hours, his body would have processed the alcohol without any fuss, but that’s not what happens. Hal equates beer with soda pop. He doesn’t understand that the carbonation actually accelerates the effects of alcohol. It’s nothing for him to down five or six. At a party or social gathering, he’ll have a beer in his hand all night.

If he were to drink in moderation, Hal would not experience any mood alteration. People enjoy alcoholic drinks and get a good feeling from them. But as his blood alcohol concentration rises, Hal’s inhibitions are loosened. Fortunately for those around him, he gets very happy and funny. He lets go of the pressures of the day and buys another round.

However, as he continues to drink, Hal’s inhibitions are set free and he is certain he can drive home, even though he can’t find his car keys. Remember, he may only be processing .30 ounce per hour, so his blood alcohol concentration rises from barely evident, to over the .08 legal limit for operating a motor vehicle.

Hal never got stopped for DUI, never got into any bar fight, or was accused of any inappropriate behavior. Everything was going along fine. However, his body was telling a different story. His liver cells developed little fatty droplets. Usually the fatty acids in the liver are used as fuel, but when alcohol is there the liver uses it for fuel. These droplets form because the fatty acids are not used, but most of the time that isn’t a major problem.

In Hal’s case, he developed alcoholic hepatitis, which is serious because it causes inflammation and impairment of liver function. Cells in the liver begin to die. The fatty liver is not necessarily serious and can be reversed, until the cells begin to die. But the alcoholic hepatitis does not occur in a liver that does not have fatty deposits.

Most people have heard of cirrhosis. That happens after heavy and prolonged use of alcohol, although there are some types that are not caused by alcohol. Most cirrhosis is alcohol-related and is the seventh leading cause of death overall in the United States. In cities, it might be the fourth of fifth highest cause of death among men. When liver cells are replaced by fibrous tissue and the structure of the liver is changed. Blood flow is decreased and the liver does not function properly. Transplants are usually successful and most people who have been given a second chance do not return to drinking.

Hal is facing a struggle. He is being treated, but the most important treatment he must go through is to stop drinking. In his case, the effects of alcoholism were nearly invisible until he began to experience health problems. His attitudes towards beer, his wanting to be the life of the party, his inability to limit himself all contributed. How he is paying the price.

Ned Wicker is addictions chaplain at Waukesha Memorial Hospital Lawrence Center

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