Bizarre and Scary Facts about Alcohol

(Note: in this article "alcohol" refers to ethyl alcohol, also known as ethanol, which is the type of alcohol used as an intoxicant in beverages)

Scary numbers

More than half of all trauma patients are intoxicated with alcohol at the time of arrival to the trauma center. In addition, alcohol is often used in suicide attempts. Alcohol also brings on suicide attempts due to the lowered inhibition and impaired ability to reason that it brings on.

Alcohol is a leading cause of trauma.

Alcohol use is the fourth leading cause of preventable death in the United States (after smoking, high blood pressure, and obesity).

According to the Centers for Disease Control (CDC), excessive alcohol use led to about 88,000 deaths (62,000 men and 26,000 women) and 2.5 million years of potential life lost each year in the United States from 2006 – 2010. The economic costs of excessive alcohol consumption in 2010 alone was $249 billion, or $2.05 a drink.

Based on the U.S. National Longitudinal Alcohol Epidemiologic Study, the following statistics apply to the U.S. adult population:

• Current drinkers - 44%
• Former drinkers - 22%
• Lifetime abstainers - 34%
• Abuse and dependency in the past year - 7.5-9.5%
• Lifetime prevalence - 13.5-23.5%

Male / Female differences

Alcoholism is more than twice as prevalent in men as it is in women.

The typical onset of problem drinking in females occurs later than in males. However, progression is more rapid, and females usually enter treatment earlier than males.

Women are more likely to combine alcohol with prescription drugs of abuse than are males. Women living with substance-abusing men are at especially high risk for this.

Alcohol problems are less likely to be recognized in women, and women are less likely to be treated.

Women don't metabolize alcohol as well as do men.

Women do not metabolize alcohol as efficiently as men; they take longer to sober up.

This gender difference is due to variations in the amount and activity of alcohol dehydrogenase (ADH), the enzyme responsible for metabolizing alcohol. Males have highly active forms of ADH in their stomach and their liver. The presence of ADH in the stomach of males can reduce the absorption of alcohol by 30%. By contrast, females have almost no ADH in their stomach and they therefor absorb more alcohol into their bloodstream. Additionally, the ADH in the liver of females is much less active than in the male liver. These gender differences result in increased blood alcohol concentrations for females compared to males if they both consume the same amount of alcohol.

Hazardous drinking (not alcoholism) is greater than 1 drink daily for women and greater than 2 drinks daily for men.

 

Legal Drinking Age

Minimum legal drinking ages around the world vary quite a bit. Most such laws apply only to drinking alcoholic beverages in public locations. The only country with a minimum legal age for consuming alcohol at home is the United Kingdom, which prohibits drinking below the age of six.

The average minimum legal drinking age around the world is 15.9. The majority of countries have a drinking age of 18. In fifty countries the minimum age is lower than 18... in 12 countries it is higher than 18... 19 countries have no age limit for drinking. France has no legal drinking age limit for drinking in private, Burundi has none for drinking with parents.

The enforcement of minimum legal drinking ages also varies widely between countries and often within countries. In many nations the law isn’t generally enforced unless alcohol is abused.

Many high school cafeterias in Europe serve alcohol to the students.

Internationally, the average age at which drinking alcohol first occurs is 12 years. According to the World Health Organization (WHO), about 80% of young people begin drinking alcohol regularly at age 15 or younger.

Many of the states in the U.S. that have chosen to prohibit alcohol consumption by those under age 21 have a variety of exceptions.

In the U.S. some states allow underage drinking if a family member consents and/or is present. In some states those under 21 may drink in any private location. A majority of states permit under 21 drinking... 30 states allow parents to provide their children with alcohol in their own home. In the remaining 20, parents are barred from providing their children with alcohol until the child's 21st birthday.

Alcohol and Children

Alcohol is the most commonly used drug by children and adolescents in the United States.

Trauma is the leading cause of death in children, and alcohol use is linked to a 300 to 700% increased risk of trauma. Alcohol use is also strongly linked to other risk-taking behaviors that can lead to trauma, assault, other drug use, and teenage pregnancy. About 40% of the 10,000 annual non-automotive child deaths (usually drownings and falls) are associated with alcohol.

More than three quarters of all foster children in the United States are children of alcohol- or drug-dependent parents. From 60-70% of reported domestic violence incidents involve alcohol. Half of all violent crime is alcohol or drug related.

Children of parents with alcoholism have a 2-fold to 4-fold increased risk of alcoholism.


Whether reared by biologic or adoptive parents, sons of males with alcoholic problems are 4 times more likely to have problems with alcohol than sons of persons who are not. Data from adoption studies on daughters of persons with alcohol problems are less clear. Daughters might be at increased risk if the biological mother has alcoholism.

Young children often present to the ER after drinking discarded alcoholic beverages left within their reach during and after parties or after ingesting a fluid that contains alcohol (cough syrop, gripe water, etc.). This occurs most often when they drink a liquid not meant for consumption, such as perfume or cleaning agents. Frequently, other chemicals in the ingested substance are more toxic than the alcohol.

Compare the alcohol concentrations in these common household substances to that of alcoholic beverages:

• Liquid cold remedies, 2-25%
• Mouthwashes, 7-27%
• Rubbing alcohol, 70% (contains isopropanol)
• Aftershave lotions, 15-80%
• Perfumes and colognes, 25-95%
• Alcohol concentrations in some common alcoholic beverages are:
  • Whiskey, 40-60%
  • Liqueurs, 22-50%
  • Wine, 8-16%
  • Beer, 3-7%

 

Infants and toddlers react differently to alcohol than do adolescents and adults. Alcohol ingestion - even very small amounts - can lead to marked hypoglycemia (dangerously low blood sugar) in infants and young children. Alcohol can also lead to respiratory depression and hypoxia (dangerously low oxygen levels) in the very young, much like opiates do in older people. Alcohol's sedating effect can make it look like the child is simply tired or asleep, and it may not be evident when they go into a coma from low blood sugar and low oxygen. If this happens the child will likely never wake up again.

In children, the classic triad of signs of alcohol ingestion are: 1) coma, 2) hypoglycemia, and 3)hypothermia (very low body temperature). They may have seizures from the low blood sugar, which is a different cause from the alcohol withdrawal seizures seen in adults.

In children, alcohol is cleared by the liver more rapidly than it is in adults.

Adolescents may ingest alcohol as a response to peer pressure or a stressful home environment, as a way to assert their autonomy, as an escape from their daily life, or as an imitation of the habits of adults. Alcohol use in adolescents is also commonly seen as "self-medication" for mental health issues, particularly depression or anxiety.

Research has confirmed that intense brain development occurs not only in the fetus, but also during adolescence. Because of this, heavy drinking in adolescents may lead to chronic brain damage similar to that seen in fetal alcohol syndrome.

In the 2011 Youth Risk Behavior Survey (U.S.), 21% of high school students admitted to drinking alcohol before age 13. The survey also found that 71% drank alcohol and 39% had at least one drink in the 30 days prior to the survey. Even more alarmingly, 24% rode in a vehicle with a driver who was drinking alcohol and 8% drove a vehicle themselves after drinking alcohol.

With regard to pregnancy, fetal alcohol syndrome is the leading cause of mental deficiencies (1 in 1000 births). More than 2000 infants annually are born with this condition in the United States. Alcohol-related birth defects and other developmental problems are estimated to be 3 times higher.

Even small amounts of alcohol consumption may be risky in pregnancy. One study demonstrated that children whose mothers consumed even small amounts of alcohol in pregnancy had more behavioral problems. Another study showed that moderate alcohol consumption while pregnant resulted in a higher incidence of problem drinking in the child by age 21 years, even after controlling for family history and other factors. All women who are pregnant or planning to become pregnant should avoid alcohol.

Race

Worldwide, alcohol is responsible for a percentage of a number of conditions, as follows:

• Cirrhosis - 32%
• Motor vehicle accidents - 20%
• Mouth and oropharyngeal (upper throat) cancers - 19%
• Esophageal (throat) cancer - 29%
• Liver cancer - 25%
• Breast cancer - 7%
• Homicide - 24%
• Suicide - 11%
• Hemorrhagic stroke (bleeding into the brain) - 10%

Of men aged 18-25 years, 60% binge drink. (Binge drinking is defined as 5 alcoholic drinks for men [4 for women] in a row.) Binge drinking significantly increases the risk of injury and contracting sexually transmitted diseases. Women who binge drink at this age are at higher risk of becoming pregnant and potentially harming an unborn child.

Brain cells killed by alcohol are never replaced.

Regular drinking causes shrinking of the brain. The shrinkage is probably due to a loss of neurons (grey matter) and glial cells (white matter), the two major types of brain cells. The shrinkage happens especially in areas of the brain that are important in learning and memory, such as the cerebral cortex and the hippocampus.

Alcohol-related sickness and death are related strongly to smoking. People who begin smoking early are more likely to develop problems with alcohol. Conversely, people who drink heavily are less likely to quit smoking.

Alcohol is primarily metabolized in the liver. Approximately 90% is broken down in the liver; the remainder is eliminated by the kidneys and lungs.

The primary route of absorption of alcohol is oral, although it can be absorbed by inhalation and even percutaneously (through the skin). Anybody who has tried to put on aftershave while taking Antabuse has found this out the hard way!

Alcohol is metabolized at a fixed rate in an individual; however, alcohol metabolism rates widely vary, and predicting an individual's metabolism rate is impossible. One cannot predict whether an individual would be intoxicated at a given blood-alcohol level without knowing the person's tolerance to alcohol.

When a person drinks alcohol repeatedly, it takes more alcohol to become intoxicated... an effect known as tolerance. Tolerance is a consequence of two changes in the body: 1) the brain receptors for alcohol adapt by decreasing their number, making it harder for alcohol to produce its effects, and 2) liver cells respond by making more enzymes to metabolize alcohol, so the body gets rid of alcohol a lot more quickly. Because of these changes, the person has to drink more alcohol to achieve the original effect. For some reason, many people take great pride in their tolerance to alcohol.

Returning to controlled drinking from alcohol abuse is uncommon, no more than 10%; however, this figure is likely to be high because it was obtained from self-reported data.

Even Dr. Evil can't go back to responsible drinking.

Alcohol in history

In ancient Egypt, “bread and beer” was a common greeting, like saying "hi."

We know from jugs that have been excavated that people were making alcoholic beverages in the Stone Age, about 10,000 years ago.

The world’s oldest known recipe is for beer.

 

When the government poisoned the alcohol

(Excerpted in part from "The Chemist's War" by Deborah Blum (see reference list below).

Although mostly forgotten today, the "chemist's war of Prohibition" remains one of the strangest and most deadly decisions in American law-enforcement history. As one of its most outspoken opponents, Charles Norris, the chief medical examiner of New York City during the 1920s, liked to say, it was "our national experiment in extermination." Poisonous alcohol still kills—16 people died just this month after drinking lethal booze in Indonesia, where bootleggers make their own brews to avoid steep taxes—but that's due to unscrupulous businessmen rather than government order.

During prohibition, rigorous enforcement had managed to slow the smuggling of alcohol from Canada and other countries. But crime syndicates responded by stealing massive quantities of industrial alcohol—used in paints and solvents, fuels and medical supplies—and redistilling it to make it drinkable.

Useless but cool facts

In some European countries McDonald’s serves alcohol.

The world's strongest beer is Scotland's Brewmeister "Snake Venom." It's alcohol content is 67.5%, compared to most beers at about 5%.

Belgium has over 400 brands of beer.

 67.5% alcohol in beer is a good thing... right?

Beer is the second most popular beverage in the world. Tea is the most popular. But beer is the most popular beverage in England and Ireland.

The strongest that any alcohol beverage can be is about 190 proof. That’s about 95% alcohol. At higher proof, the alcohol draws moisture from the air and self-dilutes. Anyone who tells you they have 100% alcohol is not telling the truth.

Beer is available in vending machines and by street vendors in Japan.

There is (supposedly) a medical diagnosis known as "Auto-Brewery Syndrome," where yeast in the digestive system ferment enough alcohol to make the person intoxicated. Hmmm. They never mentioned that one when I was in medical school.

Cocktails became popular during prohibition, when mixed drinks were used to hide the awful taste of really bad alcohol.

Cambodia's "Tarantula Brandy" contains rice alcohol and dead tarantula spiders. Yum!

  To learn more about the science and psychology of addiction and recovery, and to understand why alcoholics and addicts behave the way they do, see the author's book The Alcoholic / Addict Within.

Available in print and e-book editions from amazon.com (Click Here).

References:

Blum, Deborah. (2010, Feb 19). The chemist's war. Slate Medical Examiner. Retrieved from: http://www.slate.com/articles/health_and_science/medical_examiner/2010/02/the_chemists_war.single.html

Duke University. (n.d.). The Alcohol Education Pharmocology Partnership. Retrieved from https://sites.duke.edu/apep/

Levine, Michael D., Taylor, Jay, & Barker, Tobias. (2016, Dec 15). Alcohol toxicity clinical presentation. Medscape. Retrieved from: https://emedicine.medscape.com/article/812411-clinical#showall

Nasa.gov. (2015, Oct 25). Researchers catch comet Lovejoy giving away alcohol [Log post]. Retrieved from: https://www.nasa.gov/feature/goddard/researchers-catch-comet-lovejoy-giving-away-alcohol

Sinod, Richard H. (2017, Sept 29). Fats five quiz: Are you prepared to confront alcohol intoxication and poisoning? Medscape. Retrieved from: https://reference.medscape.com/viewarticle/886163

Thompson, Warren. (2017, Sept 12). Alcoholism. Medscape. Retrieved from: https://emedicine.medscape.com/article/285913-overview