Have you ever wondered how we started drinking alcohol and even why? Besides feeling cool when you did it when you were younger. You know, sneaking out to the fig orchards (Bullard High), the flats of the Dominion before there were houses there, and even the sawmill that used to be on Maple and Shepard over the train tracks when there used to be train tracks (Clovis West High) and the dikes on Shepard and Tollhouse (Clovis High). I’m sure other small towns like Dos Palos, Firebaugh (I will check with my friend Shawn because I know he was an expert back then) 🙂 and even Tulare had their special places as well. Whenever someone’s parents left, if you wanted to “be cool”, your friends would convince you to throw a party. There is no way anything bad could happen with that idea. Yeah right. There would be flyers handed out on Friday at school or we would meet at the 7-11 at Palm and Shaw (Bullard) or the Carl’s Jr on Herndon and First (Clovis West)and find out where the parties were going to be. It was a rite of passage for most of us in high school. I’m sure that was not the reason someone decided to make alcohol to drink as far back as 13,000 years ago but there was something about it that continues to make it a part of our lives even to this day.
Alcohol was initially discovered from the accidental fermentation of fruits, honey or grains during the neolithic period. (Probably some lazy slave forgot to clean the pot and became a hero for the world). It originated out of the middle east in Israel when an ancient vessel was discovered to have 13,000 year old beer residue. The original “He-Brew” so to speak. Get it? Okay, corny joke but it was too easy to let that go by. How about this factoid? The oldest know recipe on record is not for a food or a bread but for how to make beer. Evidence of alcohol production was also seen in China ~7000 years ago. The creation of wine was not until it emerged from the Zagros mountains of Iran in 5400 BCE. In ancient Egypt and Sumeria, beer and wine were considered essential, often considered as a gift from God and safer to drink than water. (That may not be much of a stretch because I bet the sanitation systems, or lack thereof, made drinking community water a game of Russian roulette.). In the Mediterranean wine became a staple of Greek and Roman culture and was integrated into religious rituals and trade. In the Modern Era (16th century to the present) colonialism from European nations introduced alcoholic beverages to the Americas and the Pacific. Which continues to be problematic in certain cultures today. (I swear I should have know I was Native American before I did my 23 and Me DNA analysis based on my reaction to whiskey which I now know why it is referred to as “firewater”.)
The industrialization of the 18th century saw a massive increase in the production of cheap spirits. I’ve, always been curious as to why hard liquors were referred as spirits? Any guesses? The term originated from the process of distillation which was developed by Arab chemists in the middle ages. Distillation allowed for higher alcohol concentrations. It involves heating and fermenting liquid so the alcohol vaporizes before the water and the vapor was viewed as the “spirit” or the essential life force of the original substance. It is derived from the Latin “spiritus” meaning “breath or breathing” or the “soul” or purest essence of the drink. As for the term “cocktail”, I will leave it up to you to figure that one out 🙂 The long and short of alcohol is that it has been around awhile and is currently the most widely used psychoactive around the world today ahead of nicotine and caffeine. We may be at the beginning of a downward trend because of some of the risks we are now discovering, or actually paying attention to. What was once thought as a medicine or substance that has health benefits is actually revealing to be quite the opposite.
Alcohol and when I say alcohol I mean all forms. Beer, seltzers, wine and hard liquors. For some reason some of my relatives as well as many others feel that beer does not count. (Denial is not a river in Egypt.) 🙂 . All alcohol use come with risks that can be divided into short-term risks and long term risks.
SHORT-TERM RISKS OF ALCOHOL: Even small amounts can pose various health risks that affect us not only physically but mentally as well. It affects us mentally by impairing our judgement. It effects our frontal lobe which lowers our inhibition threshold. It’s why after a few drinks you are more inclined to go to someone and ask them to dance or go out on a date. Or sing that song on karaoke night even though the DJ never had anyone ask to sing “Paradise by the Dashboard Light” by Meatloaf in Kona Hawaii (True story and the individual will remain unnamed-Michael). Or for someone to say “Yeah that sounds like a cool idea, lets climb the water tower in Pinedale on a foggy night and drink beer under the tank as our friend touches the ball on top” (Again, true story and those involved will remain unnamed-Doug et al). 🙂 You get the point. It makes us a little stupid which can result in bad things and ultimately death. It impairs our coordination which in turn decreases our reaction time leading to a high risk of falls, motor vehicle accidents and burns. Here is another scary fact. Driving after 11 p.m. significantly increases the likelihood of encountering alcohol impaired drivers. In 2023, 51% of fatally injured passenger vehicle drivers between 9 p.m. and 6 a.m. had (BACs) Blood Alcohol Concentrations at or above 0.08%, compared to 20% during other hours. The highest percentage of fatalities occurred between midnight and 3 a.m. with 62% of drivers having BACs at or above 0.08%.
Another short-term effect is alcohol poisoning. This occurs when the blood alcohol levels are between .25% and .4%. These results can cause irreversible brain damage, coma and even death. I have had a few individuals who have been >.4 in my practice and when asked they said they “really didn’t drink that much”. Like I said, it can result in brain damage!! Acutely, it can cause physical distress in the form of nausea, vomiting and diarrhea. It can cause headaches, blackout periods and aspiration pneumonia when you vomit blacked out and the stomach contents fall into your lungs. Just ask Jimi Hendrix, John Bonham (the drummer from Led Zeppelin and Amy Winehouse) to name a few. Oh wait, you can’t because they died! It also increases risky behaviors which result in increased violence, rape, risky sexual activity including unprotected sex.
LONG TERM EFFECTS OF ALCOHOL: These are the ones that are now being brought into focus. Previously we were told that if we drank alcohol in moderation (Women <1 drink a day or men <2 per day, and you cannot save them all up and drink them all at once which would be considered binge drinking defined as >4 for women and >5 for men per day), it suggested that it may protect against heart disease and stroke by increasing your HDL (Good) cholesterol. The assumed reasoning behind this was the benefits of resveratrol which are seen with supplemented resveratrol at doses of 500mg to 1000mg in the supplemental form. Resveratrol is a natural polyphenol food found in grapes, red wine, berries and, believe it or not, peanuts. The cardiovascular benefits are due to its ability to lower blood pressure by promoting nitric oxide production, which relaxes blood vessels. It also promotes heart health by reducing inflammation, improving blood flow and protecting against oxidative stress that can lead to heart disease. There is also brain health benefits protecting brain cells from damage, slowing age related cognitive decline and benefits against conditions such as Alzheimer’s through its anti-inflammatory effects as well. Some studies indicate that it may reduce beta-amyloid plaque progression in Alzheimer’s patients. It has also been found to have anti-cancer effects, lowers blood sugar by improving insulin sensitivity and supporting lipid metabolism. Resveratrol even activates certain genes, such as SIRT1 which has been found to potentially extend lifespan in animals and providing anti-aging benefits by reducing cellular damage from free radicals. So why not drink more wine because look at all the benefits this resveratrol is giving us? The problem is that a glass of wine has anywhere from 0.2 to 5 mg of resveretrol per glass. So if we take the higher value your would have to drink 100 to 200 glasses a day!! Although many have tried, that is not going to happen and would be no bueno to quote a friend.
The long term effects and risks of alcohol use have been found to increase you risk of cancer, cardiovascular disease, liver disease, neurologic and psychologic disease as well as a weakend immune system, type 2 diabetes and osteoporosis.
CANCER: The word that no one wants to hear when they go to their doctor’s office. Alcohol is in the Group 1 carcinogen class by the WHO (World Health Organization). It is the third leading cause of cancers world-wide, only behind tobacco and obesity. Yes, seriously! I do not remember being told this in medical school so many moons ago. The risk of cancer goes up as high as 5-15% depending on the studies you are looking at and that is just with 1 drink a day!! The more you drink the greater the risk!!
The most common cancers caused by alcohol include oral, esophageal, stomach, liver colon and breast. Essentially any thing that alcohol can directly touch (the entire gastrointestinal tract) and indirectly through the organs that help break it down and process it-pancreas and liver. Breast cancer is increased by the estrogen promoting effects that are not beneficial for breast cancers and it is also why alcoholic men get gynecomastia (man-boobs).
LIVER DISEASE: This is the main organ that processes alcohol and as a result develops chronic inflammation ultimately leading to, first, fatty deposition which results in the chronic inflammation then scarring (cirrhosis) and eventually liver failure. Previously cirrhosis was considered rare because the liver is a very resilient organ. As a rule of thumb we used to say that you would have to drink more than a bottle of wine per day or more than a pint (16 ounces) of hard liquor or greater than eight beers a day for greater than 20 years and even if you did do that, only 20% of individuals would develop cirrhosis. That meant 4 out 5 individuals would not! That is how freaking resilient our liver is!! But now that we live in the land of excess (carbs, sugars, fats and obesity) which results in MALD (Metabloic Associated Liver Disease-previously referred to as NASH (Non-Alcoholic Steatohepatitis) this entire process is accelerated. Think of it as putting more gas on the fire. Therefore the process to cirrhosis is shorter. That is why you can see individuals who have liver failure in as little as 10 years.
CARDIOVASCULAR DISEASE: Alcohol results in elevated blood pressure which increases your risk of strokes, arrhythmias, and heart failure caused by hypertension or directly resulting in an alcohol induced cardiomyopathy. I have had patients with difficult to treat hypertension, requiring 3 or more medications to just keep the blood pressure on the higher side of normal who quit drinking and they are no longer on ANY medication for blood pressure. Have you heard the term “Holiday Heart”? It is the increased occurrence of atrial fibrillation that occurs around the holidays because that is when individuals are celebrating the holidays with alcohol. It does not have to be Thanksgiving or Christmas to develop this problem. For some people everyday is a holiday if you know what I am saying. I remember in residency, getting a 21 year old who was celebrating his 21st birthday (actually more like a college hazing) ultimately being dumped at the doors of the ER because of passing out and having a racing heart. What are friends for? At least someone in the group was smart enough to dump him at the hospital. Most of you know what I am talking about. 🙂
NEUROLOGIC DISEASE: Alcohol is known to increase ones risk of dementia, not only Alzheimer’s but vascular dementia as well. It is well known to be associated with depression and anxiety, even though it is the number one treatment for depression and anxiety. Show me a family member or friend who is a alcoholic and I will say there is a 95% chance that family member or friend is depressed. Alcohol also results in brain damage especially when the consumption of alcohol is in excess or chronic amounts. This damage occurs through a combination of direct and indirect mechanisms. The effects range from temporary impairments during intoxication to permanent structural and functional changes over time. Alcohol acts as a direct neurotoxin, directly harming neurons and disrupting brain function. It interferes with communication pathways between brain cells, altering how the brain processes information. This can result in reduced neuron size, cerebral atrophy (shrinking of the brain) and damage to the gray and white matter. It also suppresses the formation of new neurons (neurogenesis) in areas like the hippocampus, which is vital for learning and memory.
OTHER: Alcohol results in a decreased immunity predisposing to infections compared to those who do not drink. It can cause pancreatitis resulting in pain, malabsorption and diabetes. It causes osteoporosis (bone thinning) resulting in a high fracture risk which is especially common with intoxication when one loses balance and is predisposed to falling. I have found that is severely affects my sleep quality resulting in restless sleep with decreased deep sleep and REM sleep. It also affects my resting heart rate when I sleep taking it from the low 40’s without alcohol and increasing to mid 50’s to 60’s when I have more than 2 glasses of wine. Those of you who really know me know how much I LOVE my sleep so this fact alone has caused me to decrease my intake.
So what does all of this mean? I think you have to look at alcohol as not being as healthy as we once did and view it as anything else that we know is harmful. You know if you eat cake, ice cream, cinnamon toast crunch or potato chips on a regular basis this is not good for you, but occasionally is not bad. You know if you eat biscuits and gravy, chicken fried steak for breakfast every morning, particularly from the Sea Shanty in Cayucos, this is not good for you. Your know if you smoke daily it is not good for you but if you had one cigarette or cigar with friends while on a trip to Vegas or at a poker party a couple times a year that may not be so bad.
I used to say alcohol in moderation may not be so bad but now I am saying that it is. Does this mean that I will not have a beer or a nice glass or two of wine on occasion? Absolutely not!! I think the social benefits are very rewarding. Being with friends and family, but again, keep it in moderation. A lot of times people think you need alcohol to have a good time but sometimes just being out is a great time, even without alcohol. A weekend, a night out with friends, a celebration, a holiday but not on a daily basis. It should be no more that 1-2 nights a week, not 1-2 drinks a night. I will leave you with a few quotes to help ease the pain a bit. “Alcohol may be man’s worst enemy but the bible says love you enemy.” “I feel sorry for those who don’t drink because when they wake up that’s the best they will feel for the rest of the day.’-Frank Sinatra. “When I read about the evils of drinking, I gave up reading.” –Henny Youngman. Stay healthy my friends.
Doug
