Is alcohol really good for you?

Alcohol is the most frequently abused drug in the world. It is a substance that has been discussed frequently in scientific literature and has been the focus of a large amount of research. Many of those who read media reports regarding the effects of alcohol are confused. Is this a dangerous drug, or is it a miracle potion that reduces the rates of heart attack, a frequent cause of disability and death in the United States and throughout much of the world?

What are the issues surrounding the alcohol controversy? How can you make an intelligent decision regarding your future use of alcoholic beverages?

The French Paradox

Citizens of France, like Americans, like their alcohol. Actually, the French consume much more alcohol per capita than Americans. What is interesting about the French is that they eat diets that are higher in fats when compared to Americans, yet they suffer less atherosclerosis (narrowing of the of the arteries of the heart, which leads to "heart attacks") than in the U.S. In fact, the French have the second lowest rate of heart disease in the industrial world, second only to the Japanese. So, you say, how could that be? We are constantly reminded to eat low-fat diets in order to prevent this form of heart disease. Yet the French seem to get away with high-fat diets. This high level of fat intake with low risk for atherosclerosis is termed "the French paradox."

Researchers have studied this situation, attempting to learn why, It appears, from volumes of excellent research, that the very moderate consumption of alcohol is associated with an increase in a person's high-density lipoprotein (HDL). We alt want to have lots of HDL. When we do we tend to have less arterial disease. What appears to happen is that the alcohol somehow increases our HDL, which then removes cholesterol from the blood, which is then removed from the body by the liver. Sounds pretty neat, doesn't it? In fact, some researchers suggest that we can decrease our risk of having a heart attack by 40 percent if we just use alcohol in moderation!

The Other Side of Alcohol

But what about alcohol's negative effects? When used as a social drug, alcohol is a sedative. When introduced into the stomach, alcohol goes rapidly into the bloodstream. From the intestines it enters the blood even faster. When it is consumed with food, it is absorbed into the blood more slowly. After entering the blood, it passes easily into the brain, where it exerts its effects on behavior.

The body has a special substance called alcohol dehydrogenase, an enzyme whose function is to convert alcohol from its active form into a second chemical called acetaldehyde. As this process of conversion takes place, the person feels less of the effects of alcohol on the brain. If a person is drunk, they will remain intoxicated until the body converts much of the alcohol into acetaldehyde.

Your liver and Stomach make alcohol dehydrogenase. Men and women both produce alcohol dehydrogenase in their livers, but women have very little of this enzyme in their stomachs. This means that if a man and a woman who weigh the same consume equal amounts of alcohol until they are intoxicated, the woman will suffer drunkenness sooner than the man will. In other words, women are at a disadvantage to men when it comes to alcohol consumption.

Along with alcohol's effect on the brain causing sedation or drunkenness, it causes a general loss of brain tissue. There is a specific condition of the brain called alcoholic dementia, in which individuals develop difficulty swallowing, suffer impaired problem-solving skills, and have difficulty in manipulating objects.

The liver uses fatty acids as fuel. When alcohol is present, the liver prefers to use the alcohol as its fuel source, and the fatty acids (lipids) then build up, causing small droplets to be stored in liver cells. Cirrhosis of the liver is a condition that alcohol is known to cause and is the sixth leading cause of death in the United States. When the liver is diseased with cirrhosis, it is unable to function normally.

Heart disease is another concern for individuals who drink. Isn't it interesting that on one hand alcohol is protective for disease of the coronary arteries, while on the other hand it causes disease of the muscle of the heart wall? Those who drink have an increased risk of developing high blood pressure, which can then go on to cause strokes or further heart problems.

Alcohol is associated with cancers of the mouth, tongue, throat, esophagus, stomach, liver, lung, pancreas, colon (large intestine), and rectum. These cancers may result from alcohol's irritating effects on body tissues. There is a very strong relationship between developing these cancers of the oral cavity and throat when a person drinks alcohol and smokes cigarettes. Despite the "French paradox," French men are three times more likely than American men to die of cancer of the esophagus. Also, French men and women are twice as likely to die of stomach cancer as are Americans.

Fetal alcohol syndrome is a condition in which infants born to mothers who drink during pregnancy suffer such consequences as retarded growth; malformed features such as a large face, small eyes, short nose; and brain damage.

Aside from the many physical consequences of alcohol--many resulting from alcohol consumed in large quantities over prolonged periods of time--there are the very serious social consequences of alcohol, many resulting from alcohol use in a single event.

During a research study conducted among students who attended 69 parochial schools throughout the U.S. and Canada during the school year 1994-1995, students were asked if either of their parents used alcohol and then whether or not the student had ever used alcohol. Then they were asked about their sexual habits. The results were striking. Only 3.5 percent of the students who had never used alcohol and whose parents did not use alcohol were sexually experienced. However, if the student had tried alcohol and at least one of their parents was an alcohol user, the percentage of those who were experienced sexually increased tenfold to more than 30 percent. Since unprotected sexual intercourse is a strong AIDS risk factor, we suggest that alcohol use in the home is a cofactor for these students' risk of transmitting or contracting the virus that causes AIDS.

Other data from that same research showed that if alcohol was not used by either parent, 37.6 percent of the students had tried alcohol. However, if a parent did use alcohol, the rate of alcohol use by the student jumped to 71.7 percent.

There was even a strong effect of the parents' alcohol use on the student's history of the use of many other drugs. If a parent was an alcohol user, the student's rate of tobacco use increased from 24.4 percent to 47.3 percent, marijuana use increased from 11.5 percent to 27.1 percent, cocaine use jumped from 2.2 percent to 6.7 percent, and use of other hard drugs increased from 4.9 percent to 14.6 percent. In other words, use of alcohol by a parent was significantly associated with very large increases of their children's use of other dangerous and illegal drugs.

Alcohol use and abuse not only affect individuals; society is also affected by alcohol use by other people. This is similar to the effects of "secondhand smoking." Almost one in four people say that they experienced adverse effects in two or more areas of their lives from other people's drinking in the past 12 months.

Alcohol is known to be associated with about one third of suicides. Even 75 percent of suicide attempters had been drunk at the time of their attempt to end their lives.

We know that alcohol causes drunkenness or disinhibition. One can only imagine how much alcohol factors into unintended pregnancy, marital disruption, child abuse, incest, automobile accidents, career disruptions, educational underachievement, extramarital sexual affairs, cheating, stealing, dishonesty, employment underachievement, and the transmission of sexually transmitted diseases, including AIDS. The list could go on and on.

But What About Your Arteries?

There is no doubt that the moderate consumption of alcohol can play a role in reducing disease of the arteries of the heart and subsequent heart attacks. This data is very clear. There is also no doubt that there are many other methods of decreasing the risk of these same heart conditions, including a low-fat diet, exercise, ingestion of fruits and vegetables, stress maintenance, and living a generally healthful lifestyle.

In those whose doctors recommend it, aspirin used every other day can decrease the risk of diseases of the arteries of the heart by amounts equal to or greater than the moderate use of alcohol. However, the use of aspirin has a few problems, such as upset stomach and certain types of strokes (also associated with the use of moderate amounts of alcohol).

A medical journal recently reported that the groups most likely to benefit from drinking small amounts of alcohol are older people at high absolute risk of coronary heart disease and stroke and absolute low risk of injury, cirrhosis, and other alcohol-related diseases. In fact, this same study reported that in men and women under 40 years of age, alcohol consumption is associated with an increase in what is called "all-cause mortality," or all causes of death even in low levels of consumption. In other words, drinkers under 40 die from any cause more than nondrinkers.

Alcohol is a dangerous drug. Clearly, many individuals use alcohol and suffer only minimal or unmeasurable consequences. However, what are the subtle consequences to the children of having alcohol in the home? When parents use alcohol, their children are likely to do so also. Youths are often home when their parents are at work. Think about this: most teen pregnancies occur as the result of intercourse in the girl's home between the hours of 3:00 and 6:00 in the afternoon. Since women are at a distinct disadvantage as to the disinhibiting effects of alcohol when compared to males, is it prudent for any parent to keep alcohol in the home?

Do the benefits of alcohol use outweigh the risks? We think not.

Gary Hopkins, M.D., Dr. P.H., is director of the Institute for Prevention of Addictions at Andrews University, Berrien Springs, Michigan. He was assisted in preparing this article by John V. Stevens, Jr., J.D., attorney at law, Riverside, California; Bruce Heischober, M.D., Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, California; and Mekebeb Negerie, Dr. P.H., health director, ADRA International, Silver Spring, Maryland.