Dear Doctor: We have a dear friend who is 46 and has alcoholism. His liver is failing, but he blames that and all of his symptoms (fatigue, burning lungs, severe stomach pain, sinus problems, confusion) on factors besides his drinking. What are the long-term effects of abusing alcohol?
Dear Reader: Alcoholism is a disorder in which an individual has lost the ability to regulate their drinking, even though the habit is clearly causing harm. A diagnosis of an alcohol use disorder means someone has met at least two of a series of criteria within a one-year period. These behaviors, which have been laid out by the American Psychiatric Association, include a need to keep drinking despite clear evidence of self-harm; increasing tolerance to the effects of alcohol; physical symptoms when alcohol is withheld; an inability to limit the amount one drinks; losing large chunks of time to planning, seeking, consuming and recovering from drinking; and withdrawal from the activities of daily life. The more criteria that are met, the more severe the problem.
Risk factors for an alcohol abuse disorder range from stress, trauma, peer pressure, ease of access, depression and other emotional issues, to genetic factors, the age at which someone starts drinking and family history. And as your letter attests, the drinker is rarely the only one harmed by an alcohol use disorder. The effects are far-reaching and can interfere with a person’s family, social, work and spiritual lives.
Regarding the variety of physical symptoms your friend has experienced, it’s not possible to know the cause without a physical exam and diagnostic tests. However, many of them do correspond to symptoms that accompany alcohol abuse. As anyone who has ever had a drink too many knows, the short-term effects of alcohol use can include slurred speech, impaired coordination, impaired judgment, changes to mood, diarrhea, vomiting, headache, dehydration and memory lapses.
Long-term alcohol abuse adversely affects virtually every part of the body. Chronic heavy drinking can weaken the heart muscles, contribute to high blood pressure, cause irregular heartbeat and raise the risk of stroke. It can also lead to serious and persistent changes to the structures and functioning of the brain. Although heavy drinking is most associated with liver damage, including the irreversible destruction and scarring of liver tissue known as cirrhosis, it also causes a range of digestive problems. These include ulcers in the stomach or esophagus, inflammation of the pancreas and inflammation of the stomach lining.
Because alcohol interferes with the release of glucose from the liver, low blood sugar becomes a risk. This makes heavy drinking particularly dangerous for anyone with diabetes. A number of studies have linked long-term alcohol abuse to increased risk of certain cancers, including liver, colon, throat, mouth, larynx and rectum. Even moderate drinking has been linked to an increase in the risk of breast cancer.
Unfortunately, the denial that you describe is also often part of alcohol use disorder. If you decide to talk to your friend about his drinking, you’ll find guidance and support from a number of well-regarded organizations, including the National Institute of Alcohol Abuse and Alcoholism (NIAAA), and Alcoholics Anonymous.
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