Difficulty walking, blurred vision, slurred speech, slowed reaction times, impaired memory: Clearly, alcohol affects the brain. Some of these impairments are detectable after only one or two drinks and quickly resolve when drinking stops. On the other hand, a person who drinks heavily over a long period of time may have brain deficits that persist well after he or she achieves sobriety. Exactly how alcohol affects the brain and the likelihood of reversing the impact of heavy drinking on the brain remain hot topics in alcohol research today.
We do know that heavy drinking may have extensive and far–reaching effects on the brain, ranging from simple “slips” in memory to permanent and debilitating conditions that require lifetime custodial care. And even moderate drinking leads to short–term impairment, as shown by extensive research on the impact of drinking on driving.
A number of factors influence how and to what extent alcohol affects the brain (1), including how much and how often a person drinks; the age at which he or she first began drinking, and how long he or she has been drinking; the person’s age, level of education, gender, genetic background, and family history of alcoholism; whether he or she is at risk as a result of prenatal alcohol exposure; and his or her general health status.
This Alcohol Alert reviews some common disorders associated with alcohol–related brain damage and the people at greatest risk for impairment. It looks at traditional as well as emerging therapies for the treatment and prevention of alcohol–related disorders and includes a brief look at the high–tech tools that are helping scientists to better understand the effects of alcohol on the brain.
BLACKOUTS AND MEMORY LAPSES
Alcohol can produce detectable impairments in memory after only a few drinks and, as the amount of alcohol increases, so does the degree of impairment. Large quantities of alcohol, especially when consumed quickly and on an empty stomach, can produce a blackout, or an interval of time for which the intoxicated person cannot recall key details of events, or even entire events.
Blackouts are much more common among social drinkers than previously assumed and should be viewed as a potential consequence of acute intoxication regardless of age or whether the drinker is clinically dependent on alcohol (2). White and colleagues (3) surveyed 772 college undergraduates about their experiences with blackouts and asked, “Have you ever awoken after a night of drinking not able to remember things that you did or places that you went?” Of the students who had ever consumed alcohol, 51 percent reported blacking out at some point in their lives, and 40 percent reported experiencing a blackout in the year before the survey. Of those who reported drinking in the 2 weeks before the survey, 9.4 percent said they blacked out during that time. The students reported learning later that they had participated in a wide range of potentially dangerous events they could not remember, including vandalism, unprotected sex, and driving.
Binge Drinking and Blackouts
• Drinkers who experience blackouts typically drink too much and too quickly, which causes their blood alcohol levels to rise very rapidly. College students may be at particular risk for experiencing a blackout, as an alarming number of college students engage in binge drinking. Binge drinking, for a typical adult, is defined as consuming five or more drinks in about 2 hours for men, or four or more drinks for women.
Equal numbers of men and women reported experiencing blackouts, despite the fact that the men drank significantly more often and more heavily than the women. This outcome suggests that regardless of the amount of alcohol consumption, females—a group infrequently studied in the literature on blackouts—are at greater risk than males for experiencing blackouts. A woman’s tendency to black out more easily probably results from differences in how men and women metabolize alcohol. Females also may be more susceptible than males to milder forms of alcohol–induced memory impairments, even when men and women consume comparable amounts of alcohol (4).
ARE WOMEN MORE VULNERABLE TO ALCOHOL’S EFFECTS ON THE BRAIN?
Women are more vulnerable than men to many of the medical consequences of alcohol use. For example, alcoholic women develop cirrhosis (5), alcohol–induced damage of the heart muscle (i.e., cardiomyopathy) (6), and nerve damage (i.e., peripheral neuropathy) (7) after fewer years of heavy drinking than do alcoholic men. Studies comparing men and women’s sensitivity to alcohol–induced brain damage, however, have not been as conclusive.
Using imaging with computerized tomography, two studies (8,9) compared brain shrinkage, a common indicator of brain damage, in alcoholic men and women and reported that male and female alcoholics both showed significantly greater brain shrinkage than control subjects. Studies also showed that both men and women have similar learning and memory problems as a result of heavy drinking (10). The difference is that alcoholic women reported that they had been drinking excessively for only about half as long as the alcoholic men in these studies. This indicates that women’s brains, like their other organs, are more vulnerable to alcohol–induced damage than men’s (11).
Yet other studies have not shown such definitive findings. In fact, two reports appearing side by side in the American Journal of Psychiatry contradicted each other on the question of gender–related vulnerability to brain shrinkage in alcoholism (12,13). Clearly, more research is needed on this topic, especially because alcoholic women have received less research attention than alcoholic men despite good evidence that women may be particularly vulnerable to alcohol’s effects on many key organ systems
Source-US Dept of Health. URL: HERE.
A fellow veteran who sometimes exhibits these symptoms was not only “diagnosed” as being an alcoholic, he had both his VA “primary care provider” and another VA specialist try to coerce him into confessing that he is such. As it happens, I know, as a point of absolute certainty, that he is actually a life-long NON drinker.
These experts have thus executed a perfect Catch-22:
Having generated a faux “diagnosis,” they now no longer need to actually determine what is wrong with him. But... since he refuses to confess his (imaginary) alcoholism, he can be branded as recalcitrant, in denial, delusional, and/or a liar. Since he refuses to be “treated” for a condition he could not possibly have, they can merely sit back (metaphorically) and watch him slowly turn into a vegetable (or corpse). But, it is worse than that. His Primary Care Provider is now free to carp at him because he cannot do things which she pretends he CAN do, after all, he isn't really sick, just an alcoholic. Further, She is free to ignore anything he tries to say, since he is a “known” liar.
I believe that the vast majority of the people who work for the VA Medical system are good, kind hearted people, who try to do the best they are allowed to do for veterans. Nevertheless, there are far too many who are like the above Primary Care Provider; those for whom veterans are not fully human persons, who have anything of value to say, except to provide (under interrogation) fodder for another carping session. ...Not fully human. More like no-longer-useful draft animals, cluttering up her examining room, and sucking up resources which should be used on humans.
Little wonder some call it “Veteran-arian's Hospital.”*
DG
p.s. *with apologies to the Muppet Show, especially Doctor Bob.