Alcohol is an extremely powerful substance that can be abused very easily.

For some, alcohol is a drink that adults have occasionally at a social event or in moderation in their own home. Alcohol abuse is a disease that is characterized by the sufferer having a pattern of drinking excessively despite the negative effects of alcohol on the individual's work, medical, legal, educational, and/or social life (Marks). Unfortunately, many families everyday are affected negatively by alcoholism. Why do people get consumed by alcohol and why is the habit so hard to quit? Stressors in life cause many people to turn to alcohol or drugs just to escape for a while. Alcohol is a psychologically addictive drug (House). Alcohol has the dangerous tendency to make one feel at ease and free. Any normal situation a person would feel stressed out or embarrassed is now less threatening. A drink or two can affect the body by relieving tension, fatigue, and pain (Ryan). The addiction is mostly in ones mind and the way they feel until the poison takes over. Soon after a persons body then depends on a drink or more to get through the day. Underneath the way alcohol makes one feel, it is a poison to the human body. The way the alcohol makes a person feel and when the disease of alcoholism takes over, this is when a person is consumed by alcohol. Excessive drinking causes the brain and the liver to work very hard. However, and eventually, if enough alcohol is consumed over time, they will succumb to the toxins found in the alcohol (House). When the disease has done damage to the body that is irreversible or in repairable, death will eventually ensue. A main reason why I found it was hard for many alcoholics to stay sober is because it is in their genes. Caroline Ryan gave an example explaining that someone whose parents had a problem with alcohol have a 10-fold chance of having a problem themselves compared to someone whose parents did not have a problem (Ryan). Also it is not know exactly what gene this is, but has to do with addictive personalities. This doesnt mean that this happens to all children who have parents with a problem the chance is just greater. Dr.Ball from the same article also brought up a very valid point. The fact that alcohol is now more available means genetic predispositions to addiction and the biological effects of drinking too much are triggered more often.(Ryan). An example of a situation like this would be alcohol in the home of teens and it being in reach or close to them that they can consume it or even friends who have alcohol in their home. Alcohol being the psychologically addictive drug that it is, makes life a lot easier for many people. Those who use alcohol as a crutch usually do this to forget their troubles. This makes it harder for people to stop their addiction. Alcohol abuse is a very serious and scary thing. In the wrong hands alcohol can ruin many lives all at the same time. Drinking too much alcohol is also extremely dangerous to ones health and should not be taken lightly. Alcoholism is the result of extreme cases of alcohol abuse. Fortunately, for those who suffer from this disease, there are many support groups .One being alcoholics anonymous. Support groups for families of those who are alcoholics are also available and is called Al-Anon Family Groups.

Alcohol abuse among older adults is a more serious problem than many people realize. Anyone at any age can have a drinking problem. Alcohol abuse in later life is often hidden or overlooked by families, doctors, and the public. For example, many older adults drink in the privacy of their homes and are less likely to be disruptive in public or arrested for driving while intoxicated (Rohleader,W (1999). Even when family, friends, and professionals recognize that an alcohol problem exists, they are reluctant to confront an older person. This reluctance may be related to fear of making the older person angry, lack of knowledge about alcohol problems in later life, or the older persons denial of drinking behavior (Goldberg, 2003). Alcohol slows down brain activity. Drinking increases the risk of falls and accidents because alcohol affects alertness, judgment, coordination, and reaction time. Some research has shown that it takes less alcohol to affect older people than younger ones (Clark, 2003). Over time, heavy drinking permanently damages the brain and central nervous system, as well as the liver, heart, kidneys, and stomach. Alcohols effects can make some medical problems hard to diagnose. For example, alcohol causes changes in the heart and blood vessels that can dull pain that might be a warning sign of a heart attack. It also can cause forgetfulness and confusion, which can seem like Alzheimers disease (Goldberg, 2003). Alcohol is often harmful if mixed with prescription or over the counter medicines. This is a special problem for people over 65, because they are often heavy users of prescription medicines and over the counter drugs (Goldberg, 2003). As people age, the bodys ability to absorb and dispose of alcohol and other drugs changes. Mixing alcohol with other drugs such as tranquilizers, sleeping pills, painkillers, and antihistamines can be very dangerous, even fatal. For example, aspirin can cause bleeding in the stomach and intestines; when it is combined with alcohol, the risk of bleeding is much higher (Goldberg, 2003). Each older person who develops an alcohol problem has a unique set of circumstances. It is often is difficult to identify one event that led to the problem. However, excessive use of alcohol in later life often is triggered by changes in work status, family relationships, and health. To the older person, these changes typically represent a loss that produces emotional and/or physical pain. People of all ages experience losses, but for older people, losses often are irretrievable and tend to build up (Rohleader, 1999). Many people welcome retirement but for some individuals, work has been a primary source of identity. Work has given life purpose, structure, and meaning. For people who have not developed other interests and relationships, retirement can usher in many losses. Those losses are often lack of routine, activity, income, and feelings of productivity. Some older people drink in reaction to the loss of self-worth and responsibility following retirement. Others cant adjust to the lack of structured activity and drink out of boredom. Still others may find themselves in new leisure situations where social drinking is expected (Clark, 2003). The circle of relationships grows smaller as children leave home, a spouse dies, and friends move away or die. Physical problems may limit mobility. Soon the sense of loneliness and isolation may become unbearable. Unlike younger people, who often begin drinking with friends, the older person drinks because they feel alone. People often are devastated by the loss of a spouse and sometimes turn to alcohol to block the pain of their bereavement. Widowers appear to be the most vulnerable (Clark, 2003). Loss of physical health can be very stressful, limit mobility, and lead to a negative self-image for some older adults. Alcohol may be used to block the emotional pain caused by the loss of

physical capabilities. Other older people experience serious and chronic pain and sometimes use alcohol as a sedative to lessen the physical pain (Alcohol Alert, 1998). Alcoholism often is called a family disease because it affects the entire family. It can be as damaging to the family as it is to the alcoholic. Members of a family depend on one another for mutual love, care, support, and respect. An older person with an alcohol problem who exhibits forgetfulness, irritability, or increased physical problems will disturb the normal, healthy emotional relationships within a family (Rohleader, 1999). Alcoholism triggers strong feelings in people. Helping an older person who has a drinking problem means being honest with yourself and with him or her. How you feel will determine how you interact with the older person and how helpful you can be. Misconceptions about alcohol can be destructive and prevent getting help for the person who has the problem with drinking (Clark, 2003). The right time to do something is when you suspect alcohol is a problem. It may take time to confirm this, to convince other family members, and to convince the older person that a problem exists and to accept treatment. The sooner treatment starts, the sooner life can begin to improve. Its not easy to approach a loved one about an alcohol problem. You likely feel uncomfortable. You may fear the person will become angry, hostile, and will reject you (Alcohol Alert, 1988). Treatment programs include long-term residential centers, short-term in-patient programs, outpatient programs, and support groups. They are run by hospitals, mental health clinics, and private rehabilitation centers, and self help support groups (Goldberg, 2003). Some studies suggest that alcohol problems in the elderly are as likely to benefit from treatment as younger people. Other studies believe treatment outcomes may be improved if the older adults are treated in age-segregated settings (Alcohol Alert, 1998). Sometimes relapses occur, even when a person is committed to recovery. A person may take a drink after being sober for several months, thinking that he or she is cured or can now handle alcohol. The person will need support and encouragement more than ever. Condemning the person or feeling responsible for a relapse will not help. Although its discouraging to see a person return to drinking, such relapses are not necessarily repeated. They often serve as a valuable lesson and frequently help a person to accept that abstinence is necessary because of their powerlessness over alcohol (Alcohol Alert, 1998). Continued support is essential and may be easy to provide if the older person is willing to enter a treatment program. If a person strongly denies a problem exists and resists seeking help and returns to previous drinking patterns, do not give up and do not ignore the problem. Support is still very important. Continue to present facts in a caring, concerned way. Tell the person how you think the situation is affecting them and how it affects you. Let the older adult weigh the evidence.

"Alcohol Abuse is a Serious Problem for Teenagers," was written by the Center for Science in the Public Interest. The article states, "Nearly four million young people suffer from alcohol dependence," and the average age at which children begin to drink is as early as 13. The article goes on to say that the number of children who experiment with alcohol has been rising steadily over the years. The article points out the unfortunate effects of drinking which range from an array of physical illnesses like liver problems and cancer. From the article we learn that because teenagers tend to indulge in binge drinking, they are at higher risk to suffer the consequences of alcohol consumption. According to the article these consequences include developmental problems like lack of growth, a reduced ability to learn, and to psychological problems like depression and suicidal tendencies. Alcohol abuse in turn leads to social problems which include dropping out of school, robbery, and "risky sexual behavior." We learn that alcohol serves as a "gateway-drug," leading to more addictive drugs like cocaine. The article substantiates this claim by citing a study conducted by the Center on Addiction and Substance Abuse at Columbia University. The article also touches on the problem of alcohol used by parents though the primary focus of this piece is about teenage drinking. The purpose of the article is to jolt readers into an awareness of the magnitude of the problem of teenage drinkiing. Most people know that teenagers like to experiment, try the new and forbidden, but the Center assumes that no one is fully aware of how serious this problem can be if it is not addressed. Although this article does show the magnitude of the problem of teenage drinking, it doers not touch many people or clarify what we can do about it and the lack of clarity is an important factor that limits its impact. To make its point the article uses facts and statistics to prove that teenage drinking is a huge problem in the United States. We learn, "Beer is the alcoholic beverage of choice for kids, preferred by 27% of all children," and, "1.1 billion cans of beer and 300 million bottles of wine coolers were consumed by junior and senior high school students." The article also uses statistics to prove the unfortunate consequences of drinking and states, "In 1997, 3,336 drivers 15 to 20years old died, an additional 365,000 were injured in motor vehicle crashes. Almost 30% of those drivers had been drinking. The estimated economic cost of those crashes totaled $31.9 billion." According to the article almost 25-30% of 6th graders said it would not be difficult to find hard liquor whereas only 6% said they could find marijuana. The article confirms our worst fears that as children get older it may become easier to find drugs but alcohol remains the most accessible and therefore a more serious problem for children. I felt the article would have a wider appeal if it was made more attractive for teenagers and parents alike. Although the statistics do grab the readers attention they will not hold the reader's interest for very long unless they are backed up by anecdotes, real life examples or happenings the reader can identify with. A teenager reading this article will get bored by statistics and begin to tune out adults preaching to them about dire consequences of things teenagers see as new and exciting. Parents who read this article may not read for very long because numbers are dry, and no one wants to feel guilty about a problem that can be easily dismissed by saying, "everybody does it," and close the book. This is an unexpected impact this article can have unless it is made more interesting. If the article is about a teenage problem, it should be made more interesting to teenagers and parents so they will be tempted to look past the statistics into real life case reports or anecdotal references. This article has no real life stories; nothing a teenager can identify with or relate to. It is merely a dry narration of facts that are the same kind found in text books that can be rather boring. If we tell people, "Alcohol is the most widely used and abused

drug among youth. It kills more teenagers than all other drugs combined, and is a factor in the three leading causes of death among 15-24 year olds; accidents, homicides and suicides," we may get their attention--but teenagers and adults both need something more concrete than generalized statements such as the one above. How about a case report" The article states, "In 1998, 44% of 8th graders, 63% of 10th graders, and 74% of 12th graders experimented with alcohol. This compares to the 17% of 8th graders, 31% of 10th graders and 38% of 12th graders who experimented with marijuana." The article continues to give numbers from a survey of 4.390 high school seniors and dropouts and reports, "approximately 80% of them reported getting drunk, binge drinking, or drinking and driving within the preceding year." Numbers alone do not have the desired impact. Teenagers feel they are invincible and nothing bad can happen to them. Parents sometimes have a "head-in-the-sand" attitude thinking nothing bad can possible happen to their child. A good way to jolt them out of their complacency is to give real life stories of real people with normal backgrounds who had an alcohol problem. Another way to target a wider readership for this article and to attract more widespread attention is to establish a better cause and effect relationship between drinking and disease. The listing of various illnesses caused by alcohol consumption is very general and simply states that people who drink have "higher death rates from cirrhosis of the liver, cancers of the mouth, larynx, pharynx, and also breast cancer. The problem with this argument is that people who do not drink sometimes end up with breast cancer and an assortment of other problems. There has to be a clearer attempt to establish the cause and effect relationship. An examination of life styles versus genetic or environmental influences could be a starting point for a discussion followed by a number of case reports of real people in real situations. The article states, "research suggests..." rather than saying conclusively that research proves a direct cause and effect relationship between alcohol intake and its consequences. The article focuses on the obvious--tells the readers that drinking is bad. What is the solution? The article does not offer any. What do children do when there is peer pressure to drink? Who will hear their cry for help? Perhaps that is outside the realm of this article. Is its focus then, only to state the obvious--that drinking is bad and hope that everyone will decide to abstain? The purpose of the article would be greatly enhanced if it encouraged the reader--people of all ages and genders, with some positive information. A youth center help line where youngsters can talk about their problems, a listing of sports programs and recreational activities in the community. A parents' helpline, or even just a reference to a source that would teach parents how to talk to their youngsters about alcohol abuse would be helpful. The article touches on adult drinking and talks about CASA reports where, "7 out of 10 cases of child abuse and neglect are caused or exacerbated by alcohol or other drug abuse." The link between adult alcohol abuse and teenage drinking should be shown more clearly. The statistics in this article are an eye opener, but their purpose is only served if they are backed up by one-onone personal accounts that would make the article more interesting for both teenagers and adults and help them work together with welfare agencies to address the problem.

One of the major problems in society today is alcohol abuse, which needs to be fixed desperately. Nearly 17.6 million adults in the United States are alcoholics or have alcohol problems. The statistics on alcoholism are mind blowing. It is extremely important that the public, including the large groups of users and abusers of alcohol, gain as much knowledge as possible about the symptoms and effects of alcoholism if we ever want to see the reduction of statistics involving fatalities, injuries and diseases caused from the use and abuse of alcohol. Education and realization of the effects alcohol abuse can have on the different aspects of a person's life are the best ways that we can help lower the number of individuals who are addicted to alcohol. The effects of this disease are very dangerous and serious. It can cause many problems in a persons life without the person even knowing. In trying to understand alcohol abuse, its nature, and the possible effects that it can have on the human body, we will discuss the physical, psychological and emotional effects of alcoholism and finally, some contributors as to what causes it to happen. The first and possibly most detrimental effects of alcohol abuse are of a physical nature. The effects alcohol can have on the body are numerous. For example, alcoholism causes cancer in the stomach, kidneys, and liver. Alcohol alters the digestion of nutrients that the body needs to stay healthy. It increases the workload of the heart, causing high blood pressure and an irregular heartbeat. It poisons the liver, causing extensive damage and failure. Additionally, it can stop the kidneys from maintaining a proper balance of body fluids and minerals. Alcoholism also causes severe damage in the neurons, so it causes alterations in the body movements, loss of appetite, and even depression. It can also affect the brain, causing unclear thinking which can endanger not only the person drinking, but those around them. Some people start being exposed to alcohol during their fetal development and therefore suffer throughout their whole lives sometimes not even having a small hope to find their places in the world and not being even comparatively independent. They cannot concentrate or complete small tasks. They may talk too much and are often incapable of making proper decisions. Such people are completely helpless and unprotected. The disabilities caused by alcohol can last a lifetime and can therefore completely change the life of any person and those people who will take care of them. The outcomes of alcohol abuse for the body are severe and can ultimately lead to death. The second, yet no less important effects caused by alcoholism are psychological. At the beginning, alcohol makes you feel good. It is often the companion of any significant event occurring in the life of modern people or even an everyday way to unwind and get away from all the difficulties of life. People relax and forget that they are supposed to think not only about their health but also about the health and well being of the people around them. However, drinking in excess can actually increase anxiety and cause depression. Alcohol is very powerful and alters all your normal behaviors. Many people believe that they can handle their drinking and that it wont affect them at all. For some this may be true, but for others it is a cover up for what can really happen. For example, alcohol use, if not in moderation can lead to family and legal problems, violence, changes of behavior, and even suicide among others. Since alcohol alters the perception of most people, they make decisions that could change the rest of their lives. One of the most common is drinking and driving. Every year approximately 75,000 lives are lost due to alcohol related driving incidents. This can mean jail time, fines, suspensions, and even worse, the loss of life, your own, or someone elses. Furthermore, alcohol abuse affects families all over America, and some families are even divided because of it. Alcohol abuse can definitely take a toll on a person when it causes them to lose their family, their job, and even their sense of well-being. It can lead to depression and the down

fall of their life. One might ask, Why risk everything you have for a drink? The answer often times is that it simply becomes a habit, taking over your life that one day you wont be able to control. Some might get help, while others lose faith and it drives them to the end. It isnt worth losing everything you love. Provided the previously stated, and setting aside risk factors for a moment, looking at what causes this disease is of extreme importance if we are ever to fully understand it and ultimately reduce the number of people affected by it. An interesting commonality among those suffering from the disease is their journey from just taking a drink to enjoy the effects of alcohol, to losing control over their drinking. Alcohol addiction, physical dependence on alcohol occurs gradually. Over time, drinking in excess changes the balance of chemicals in your brain associated with the pleasurable aspects of drinking alcohol. Excessive, long-term drinking can affect the balance of these chemicals, causing your body to crave alcohol to restore good feelings or to avoid negative feelings. There are several possible risk factors for the disease. The individual is the determining factor when assessing risk of contracting the disease. One or more of the following causes/risk factors can indicate the presence of alcohol abuse or alcohol use disorder: Genetic Predisposition: If your parents or grandparents were addicted to alcohol, the chances are strong that you will be vulnerable to the disease. Healthcare professionals will take a family history to look for risk factors for many diseases. Alcoholism is no different. Children of alcoholics will not necessarily become alcoholics themselves, but the medical history indicates a possibility. Psychological: People suffering from depression or low self esteem may be more likely to develop a drinking problem. They are more likely to try to fit in with their friends, who enable the problem to continue. Emotional Makeup: People may use alcohol to block the pain in the life. Alcohol is used as a coping device and there are certain stress hormones that may contribute to the progression of the disease. Gender: Men are more likely to develop the disease than women. Age: Young people are at greater risk of developing alcoholism, especially if they start drinking by age 16 or sooner. If one waits until age 21, the probability goes down dramatically. Social: Alcohol is legal, readily available and drinking is socially acceptable. Alcohol is promoted heavily in the media, and having a few beers before, during and after a sporting event is part of American culture. There is a peer pressure to drink, to be a part of the crowd. Frequency of consumption: Drinking alcohol regularly can cause alcoholism. People who drink regularly over time may be at risk of developing a physical dependence on alcohol. Studies actually show that one/two drinks per day for the average person (15 per week for men, 12 per week for women) is within safe limits, then it follows that going beyond that limit can produce problems. The probability is that one in nine will develop the disease. In conclusion, the effects of alcoholism which are physical, psychological, and emotional can cause many problems that affect ones life in all aspects. Alcohol alters your brain, internal organ functionality, and other disorders that affect your overall health. It also can cause depression or changes in behavior that result in problems with family, friends, and with ones self. These factors prevent people from proper social adaptation and therefore make their life incomplete. Most people do not understand the consequences alcohol abuse can have on their health. Nevertheless, the abuse occurs primarily because people do not know the destructive power of alcohol. The consequences of alcohol abuse dont decrease with time, though it can change when

amounts of drinking become smaller. Treatment for alcoholism has been shown to reduce criminal activity up to 80% among chronic offenders, has increased their rate of employment, decreases homelessness and reduces all health care costs. Unfortunately, some people still make bad and dangerous choices when it comes to alcohol.. There is no cure better than alcohol abstention. So before you drink, ask yourself, Is it really worth it?

Alcohol abuse is a pattern of drinking that result in harm to ones health, interpersonal relationships, or ability to work. According to Gelder, Mayou & Geddes (2005) alcohol abuse is linked with suicide. They state the risk of suicide is high in older men who have a history of drinking, also if a person is suffering from depression. Certain manifestations of alcohol abuse include failure to fulfill responsibilities at work, school or home; drinking in dangerous situations, such as while driving; legal problems associated with alcohol use; and continued drinking despite problems that are caused or worsened by drinking. Alcohol abuse can lead to alcohol dependence. Alcohol abuse has both short-term and long-term risks. If a person has driven while drunk or regularly binge drinks (more than 5 or 6 standard drinks in one drinking session), they are considered to have been involved in alcohol abuse. Short-term abuses of alcohol include, but are not limited to, violence, injuries, unprotected sexual activities and additionally social and financial problems. Symptoms & Signs Symptoms are the defining characteristic of alcohol abuse and are reviewed above in Definitions. Patient will often complain of difficulty with interpersonal relationships, problems at work or school, and legal problems. Additionally patients do complain of irritability and insomnia. Signs of alcohol abuse are related to alcohol's effects on organ systems. However, while these findings are often present, they are not necessary to make a diagnosis of alcohol abuse. Signs of alcohol's effects on the central nervous system acutely include inebriation and poor judgment; chronic anxiety, irritability, and insomnia often feature. Alcohol's effects on the liver include elevated liver function tests (classically AST is at least twice as high as ALT). Prolonged use leads to cirrhosis and failure of the liver. With cirrhosis patients develop an inability to process hormones and toxins. The skin of a patient with alcoholic cirrhosis can feature cherry angiomas, palmar erythema and - in fulminent liver failure - jaundice and ascities. The derangements of the endocrine system lead to gynecomastia. Inability to process toxins leads to hepatic encephalopathy. Binge Drinking Binge drinking is associated with individuals reporting fair to poor health compared to non-binge drinking individuals and which may progressively worsen over time.[4] Binge drinking is associated with alcohol poisoning, unintentional injuries, suicide, hypertension, pancreatitis, sexually transmitted diseases, and meningitis, among other disorders. Other negative consequences include social costs (including interpersonal violence), drunk driving, and lost economic productivity. Impairments in neurophysiological and neurocognitive function can result from binge drinking. A substantial proportion of alcohol-related deaths are due to binge drinking. Causes Peer pressure influences individuals to abuse alcohol; however most of the influence of peers is due to inaccurate perceptions of the risks of alcohol abuse. According to Gelder, Mayou and Geddes (2005) easy accessibility of alcohol is one of the reasons people engage in alcohol abuse as this substance is easily obtained in shops. Prevention Preventing or reducing the harm has been called for via increased taxation of alcohol, stricter regulation of alcohol advertising and the provision of brief Interventions. Brief Interventions for alcohol abuse reduce the incidence of unsafe sex, sexual violence, unplanned pregnancy and,

likely, HIV transmission. Information and education on social norms and the harms associated with alcohol abuse delivered either via the internet or face to face has been found to result in a decrease in harmful drinking behaviors in young people. Epidemiology Alcohol abuse is most common in people aged between 15 and 24 years. The long term effects of alcohol range from possible health benefits for low levels of alcohol consumption to severe detrimental effects in cases of chronic alcohol abuse. High levels of alcohol consumption are correlated with an increased risk of developing alcoholism, cardiovascular disease, malabsorption, chronic pancreatitis, alcoholic liver disease, and cancer. Damage to the central nervous system and peripheral nervous system can occur from sustained alcohol consumption. Long-term use of alcohol in excessive quantities is capable of damaging nearly every organ and system in the body. The developing adolescent brain is particularly vulnerable to the toxic effects of alcohol. Historically doctors have promoted alcohol for its perceived health benefits and most recently for protection against coronary heart disease. There is evidence of cardiovascular benefits from drinking 1 - 2 drinks per day; however, the health benefits from moderate intake of alcohol are controversial. Concerns have been raised that, similarly to the pharmaceutical industry, the alcohol industry has been involved in exaggerating the health benefits of alcohol. Alcohol should be regarded as a recreational drug with potentially serious adverse effects on health and it is not recommended for cardio-protection in the place of safer and proved traditional methods such as a balanced diet, exercise and pharmacotherapy. Some experts argue that the benefits of moderate alcohol consumption may be outweighed by other increased risks, including those of injuries, violence, fetal damage, certain forms of cancer, liver disease and hypertension. As the apparent health benefits of moderate alcohol consumption are limited for populations at low risk of heart disease, other experts urge caution because of the possibility that recommending moderate alcohol consumption may lead to an increased risk of alcohol abuse, particularly among the young. The benefits of moderate alcohol consumption may be outweighed by the risks of moderate alcohol consumption. Background The adverse effects of long-term excessive use of alcohol are similar to those seen with other sedative-hypnotics (apart from organ toxicity which is much more problematic with alcohol). Withdrawal effects and dependence are also almost identical. Alcohol at moderate levels has some positive and negative effects on health. The negative effects include increased risk of liver diseases, or pharyngeal cancer, esophageal cancer and pancreatitis. Conversely moderate intake of alcohol may have some beneficial effects on gastritis and cholelithiasis. Chronic alcohol misuse and abuse has serious effects on physical and mental health. Alcohol Dependence Chronic excess alcohol intake, or alcohol dependence, can lead to a wide range of neuropsychiatric or neurological impairment, cardiovascular disease, liver disease, and malignant neoplasm. The psychiatric disorders which are associated with alcoholism include major depression, dysthymia, mania, hypomania, panic disorder, phobias, generalized anxiety disorder, personality disorders, schizophrenia, suicide, neurologic deficits (e.g. impairments of working memory, emotions, executive functions, visuospatial abilities and gait and balance) and brain damage. Alcohol dependence is associated with hypertension, coronary heart disease, and ischemic stroke, cancer of the respiratory system, but also cancers of the digestive system, liver, breast and ovaries.

Heavy drinking is associated with liver disease, such as cirrhosis. Studies have focused on both men and women, various age groups, and people of many ethnic groups. Published papers now total in the many hundreds, with studies having shown correlation between moderate alcohol use and health that may instead have been due to the beneficial effects of socialization that is often accompanied by alcohol consumption. Some of the specific ways alcohol affects cardiovascular health has been studied. Cardiovascular system A meta-analysis of 34 studies found a reduced risk of mortality from coronary heart disease in men who drank 2 - 4 drinks per day and women who drank 1 - 2 drinks per day. A meta-analysis of randomized trials found that alcohol consumption in moderation decreases serum levels of fibrinogen, a protein that promotes clot formation and increases levels of tissue type plasminogen activator, an enzyme that helps dissolve clots. The serum levels of C-reactive protein (CRP), a marker of inflammation and predictor of CHD (coronary heart disease) risk, are lower in people who drink moderately than those who abstain from alcohol suggesting that alcohol consumption in moderation might have anti-inflammatory effects. In addition to its psychotropic properties, alcohol has anticoagulation properties similar to warfare. Additionally, thrombosis is lower among moderate drinkers than teetotalers. Despite epidemiological evidence, some criticize the idea of recommending alcohol for health benefits. A doctor at the World Health Organization stated that recommending moderate alcohol consumption for health benefits is "ridiculous and dangerous". There have been no randomized controlled trials to demonstrate the cardio benefits of alcohol. Due to the risks of abuse, dependence, adverse effects, alcohol should never be recommended for cardio benefits as a substitute to well-proven measures, such as a good diet, exercise or pharmaceutical drugs. It has been argued that the health benefits from alcohol are at best debatable and may have been exaggerated by the alcohol industry. Alcohol should be regarded as a recreational drug with potentially serious adverse effects on health and should not be promoted for cardio-protection. Peripheral Arterial Disease Moderate alcohol consumption appears to decrease the risk of PAD in apparently healthy men. In this large population-based study, moderate alcohol consumption was inversely associated with peripheral arterial disease in women but not in men. Residual confounding by smoking may have influenced the results. Among nonsmokers an inverse association was found between alcohol consumption and peripheral arterial disease in both men and women." Intermittent Claudicating A study found that moderate consumption of alcohol had a protective effect against intermittent claudicating. The lowest risk was seen in men who drank 1 to 2 drinks per day and in women who drank half to 1 drink per day. Heart attack and stroke Drinking in moderation has been found to help those who have suffered a heart attack survive it. However, excessive alcohol consumption leads to an increased risk of heart failure. A review of the literature found that half a drink of alcohol offered the best level of protection. However, they noted that at present there have been no randomized trials to confirm the evidence which suggests a protective role of low doses of alcohol against heart attacks. However, moderate alcohol consumption is associated with hypertension. There is an increased risk of hypertriglyceridemia, cardiomyopathy, hypertension, and stroke if 3 or more standard drinks of alcohol are taken per day. Cardiomyopathy

Large amount of alcohol over the long term can lead to alcoholic cardiomyopathy. Alcoholic cardiomyopathy presents in a manner clinically identical to idiopathic dilated cardiomyopathy, involving hypertrophy of the musculature of the heart that can lead to congestive heart failure. Hematologic diseases Alcoholics may have anemia from several causes; they may also develop thrombocytopenia from direct toxic effect on megakaryocytes, or from hypersplenism. Nervous system Chronic heavy alcohol consumption impairs brain development, causes brain shrinkage, dementia, physical dependence, increases neuropsychiatric and cognitive disorders and causes distortion of the brain chemistry. Some studies however have shown that moderate alcohol consumption may decrease risk of dementia, including Alzheimer disease, although there are studies which find the opposite. At present due to poor study design and methodology the literature is inconclusive on whether moderate alcohol consumptions increases the risk of dementia or decreases it. Evidence for a protective effect of low to moderate alcohol consumption on age related cognitive decline and dementia has been suggested by some research, however, other research has not found a protective effect of low to moderate alcohol consumption. Some evidence suggests that low to moderate alcohol consumption may speed up brain volume loss. Strokes Epidemiological studies of middle-aged populations generally find the relationship between alcohol intake and the risk of stroke to be either U- or J-shaped. The consistency in the vascular benefit associated with moderate drinking, compared with nondrinking, observed across different studies, together with the existence of credible biological pathways, strongly suggests that at least some of this benefit is real. However, because of biases introduced by: choice of reference categories; reverse causality bias; variations in alcohol intake over time; and confounding, some of it is likely to be an artifact." Drinking lots of alcohol has been negatively linked to stroke. According to the National Stroke Association, more than 2 drinks per day (one drink is ~5 ounces of wine) may increase stroke risk by 50% and lead to other medical problems. Because of this and other known harmful effects of heavy drinking, care should be taken when considering safe amounts of alcohol intake. Brain Alcohol abuse is associated with wide spread and significant brain lesions. Alcohol related brain damage is due not only to the direct toxic effects of alcohol; alcohol withdrawal, nutritional deficiency, electrolyte disturbances, and liver damage are also believed to contribute to alcohol related brain damage. Brain development Consuming large amounts of alcohol over a period of time can impair normal brain development in humans. Deficits in retrieval of verbal and nonverbal information and in visuospatial functioning were evident in youths with histories of heavy drinking during early and middle adolescence. During adolescence critical stages of neurodevelopment occur. Binge drinking, which is common among adolescents, interferes with this important stage of development. Heavy alcohol consumption inhibits new brain cell development. Nearly half of chronic alcoholics may have myopathy. Proximal muscle groups are especially

affected. Twenty-five percent of alcoholics may have peripheral neuropathy, including autonomic.