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Alcohol

Alcohol is the most commonly used drug in our Western society. The chemical name for alcohol is ethanol (C2H5OH). Alcohol is a drug that is produced by the fermentation of grains and fruits. Grapes are used to make wine, barley and wheat are used to make beer and various grains and fruits are used to make spirits. The natural fermentation process stops when the alcohol content reaches about 15%. These drinks are called weak alcoholic beverages. The heating and cooling of weak alcoholic beverages (distillation) can cause higher alcohol percentages, so the drink becomes a strong alcoholic beverage.

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What is alcohol?§

Alcohol is the most commonly used drug in our Western society. The chemical name for alcohol is ethanol (C2H5OH). Alcohol is a drug that is produced by the fermentation of grains and fruits. Grapes are used to make wine, barley and wheat are used to make beer and various grains and fruits are used to make spirits. The natural fermentation process stops when the alcohol content reaches about 15%. These drinks are called weak alcoholic beverages. The heating and cooling of weak alcoholic beverages (distillation) can cause higher alcohol percentages, so the drink becomes a strong alcoholic beverage.

Besides beer, wine and various kinds of spirits and liquors, also mixed drinks, shooters, alcopops and blasters are on the market. A mixed drink is an alcoholic beverage mixed with a soda; for example, a rum and Coke (Baco) or vodka mixed with orange juice. The alcohol percentage of these drinks is between 5 and 7%, depending on the person who pours it. Shooters are beverages with a high alcohol content (around 20%), mostly sold in small bottles of 20ml. The most famous shooter is probably Flugel.

Alcopops are produced by the fermentation of fruit juices, and often alcohol and carbon dioxide are added. An alcopop contains as much alcohol as a glass of beer, a glass of wine or an alcoholic beverage, because it is mixed with a non-alcoholic drink. Breezers are alcopops, for example. Blasters are similar to mixed drinks but they mostly contain a stimulant like caffeine or guarana. Vodka Red bull is the most famous blaster.

 

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History and the law§

History

Alcohol was probably accidentally developed in a warm spot when honey and water came in contact with yeast that was suspended in the air. Eight thousand years ago people already drank alcohol. Pieces of pottery that have been found in Iran and Iraq show that beer was known as long ago as 5400 BC. In Egypt papyrus scrolls from 3500 BC have been found that show the recipe for wine. People in the Netherlands mainly drank beer, something the Germanic tribes already knew how to make. Around 1300 AD, beer became the national drink. Because of the poor water quality, drinking beer was a safe alternative for people. Most beer was brewed in monasteries; breweries did not exist yet. Distillation became widely used in the late Middle Ages. In the late seventeenth century strong alcoholic beverages became almost as popular as beer and wine. After 1800, the use of alcohol was more and more seen as a major social problem. This led to various temperance movements and in 1881 the first licensing act was established, the precursor of today’s Licensing and Catering Act. The temperance movement was especially effective in the Netherlands; during the 1920’s almost no alcohol was consumed there.

After 1960 the use of alcohol increased and the Dutch drank three times as much as before. The main reasons for this increase in consumption are the growth in wealth while the prices of alcohol stayed the same, but also a greater knowledge of different types of alcoholic beverages due to foreign vacations and a greater acceptance of the use of alcohol by women and young people.

The law

Alcohol is legal in the Netherlands. People who want to sell or use alcohol have to stick to certain rules, however. The Licensing and Catering Act says that from 1 January 2014 it is prohibited to sell alcoholic drinks to people under 18. There used to be a distinction between weak alcoholic drinks (legal to buy from 16 years old) and strong alcoholic drinks (from 18 years old). Strong alcoholic drinks are only sold in liquor stores. Weak alcoholic drinks are also sold in the supermarket.

Someone who sells alcohol (the bartender or the shop keeper) should always ask youths for a valid ID (passport, driver’s licence, moped document). In case he sells an alcoholic beverage to someone under 18, he can lose his licence. These rules apply to any place that sells alcoholic beverages: shops, cafes, bars, canteens and so on. People who are visibly drunk are not allowed in bars. It is also not allowed to serve alcohol to people who are in “apparent state of intoxication”. And we all know: drinking and driving is very dangerous. In the Netherlands it is a criminal offence to drive with a blood alcohol level of 0.5‰. If you have a point system driving licence you can only drive with a level of 0,2‰. See also “Effects”.

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Use§

Alcohol can be found in various alcoholic beverages such as beer, wine, vodka or mixed drinks. When you drink it, it passes through the oesophagus into your stomach where it mixes with fluids, gastric juices and possibly food. Part of the alcohol (20%) is directly digested into the bloodstream.

Strong alcoholic beverages are absorbed faster than weak alcoholic beverages. Carbonated drinks and hot drinks are also absorbed faster.

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Dose§

In the Netherlands, glasses are designed to contain the same amount of alcohol for each drink. Beer contains about 5% alcohol, wine 12% and vodka 40%. A glass of beer is bigger than a glass of wine and a measure of vodka is even smaller. The bottom line is that any standard glass contains approximately the same amount of pure alcohol (10 grams). This means that it does not matter whether you drink a mixed beverage or pure vodka, but be careful: a shot of vodka is emptied much faster than a glass filled with a mixed alcoholic beverage. Therefore, you get down the 10 grams of alcohol faster and this entails higher risks. Also please note that not everyone uses standard glasses or measures.

Alcohol level

A glass of alcohol does not bring everyone’s blood alcohol content (BAC) to the same level. BAC is the amount of alcohol in a person’s body (in grams) in a litre of blood. Many individual factors can have influence on this:

Alcohol disperses in body water. This means that someone who is quite heavy, and therefore has a lot of bodily fluids, does not get drunk as fast as someone who weighs less.

Your gender does also influence the blood alcohol content. Women have less water in their bodies than men, and therefore the alcohol is less diluted. This means that on average, women are faster under the influence of alcohol than men.

The amount of food in your stomach can also be of influence. The food causes the alcohol to be absorbed into your bloodstream more slowly and evenly. In short, with a full stomach you are not as easily drunk as you would be with an empty stomach.

Your physical condition and whether or not you are taking certain medications may also have influence on your blood alcohol content.

A standard glass of alcohol contains 10 grams of alcohol and this leads on average to an alcohol level of 0.2‰ for men and 0.3‰ for women.

Strong alcoholic beverages are absorbed faster than weak alcoholic beverages. Carbonated drinks and hot drinks are also absorbed faster.

Norm

In the Netherlands, the Health Council applies a medically acceptable norm for the use of alcohol. Based on a comprehensive assessment between the positive and the negative effects of alcohol, the Health Council applies the following norm: healthy women should not drink more than one glass of alcohol per day and healthy men should not drink more than two glasses per day, with a maximum of five days a week. It is preferable to have two consecutive alcohol-free days a week. However, even for women who only drink one glass of alcohol there might be a slightly increased risk of breast cancer.

Do you drink more than the norm for responsible alcohol consumption, then you may risk low iron levels in your blood, fatty liver disease, exhaustion, depression, problems at work, cancer and high blood pressure. See also: “Risks”.

By the way, you are not immediately an alcoholic if you drink more than the norm. See the subheading “Addiction”.

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Effects§

Effects always depend on your mental and physical condition (set) and the situation/environment (setting) in which you are using. Personal factors can play a big role as well. For instance, one person can become very violent from drinking while someone else becomes mild. Every body, every person and every situation is different.

The effect strongly depends on the dose, or more precisely: on the blood alcohol content (BAC).

Blood alcohol content Number of glasses (woman) Number of glasses (man) Effect
0,0-0,5 1-2 2-3 Your pulse and breathing accelerate slightly. You have a warm feeling and talking seems to be easier than before. Your senses of taste, smell and sight deteriorate and you feel less pain. You have a bigger appetite and you have to urinate more frequently.
0,5-1,5 2-5 3-7 You can feel cheerful and carefree but sometimes rude and irritable. Your mood and behaviour change clearly. You overestimate yourself. Your memory, quickness of response and coordination worsen and assessing situations becomes difficult. You see less on your left and right (the so-called tunnel effect). You speak more loudly, also because your hearing worsens.
1,5-3 6-9 10-15 Your cheerful mood can turn into excessive emotionality, loudness and aggressiveness. It is increasingly difficult for you to follow a conversation and you don’t notice much of the things that are going on around you. Your muscle coordination continues to worsen, your face gets red and swollen and your pupils dilate. You can get confused and even get blackouts (so the next day you don’t remember what happened). Chances are that you become dizzy and nauseous, especially when you close your eyes, and you may vomit.
3-4 10-13 15-19 What you see and what you hear may not get through to you, you think very slowly, you cannot remember much and you are confused and absent-minded.
4-5 Your pulse and breathing slow down so much that you may pass out and you are in more and more danger: your breathing may stop which can cause a heart attack (risk of alcohol poisoning).

In the description above, “glass” refers to a standard size glass. “Number of glasses” refers to the number of glasses you drink within a few hours. As previously stated, the effects can vary greatly per person.

Psychological effects

  • Cheerful (alcohol temporarily suppresses feelings of depression)
  • Totally uninhibited
  • Relaxed
  • Confident
  • Talking becomes easier
  • Alcohol facilitates social contacts
  • Emotionally unstable
  • Aggressive
  • Confusion

Physical effects

  • Blood vessels dilate (warm feeling)
  • After the first couple of glasses heartbeat and breathing accelerate
  • Later on heartbeat and breathing slow down
  • Reduced reaction time
  • Impaired motor coordination
  • Senses are dulled
  • Tunnel vision
  • Red face
  • Dilated pupils
  • Black out and memory loss at high doses
  • Dizziness, nausea and possibly vomiting
  • Dehydration
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Risks§

Short-term

  • Hangover
  • Alcohol poisoning
  • Getting fat
  • Lust for sex
  • Bad night’s sleep
  • Bad breath
  • Greyout & Blackout
  • Nausea and vomiting
  • Damage to unborn child
  • Addiction

Hangover

When you drink a lot of alcohol, you get a hangover: an unpleasant and sick feeling. When you have a hangover, your body is detoxifying itself. Symptoms of a hangover include nausea, vomiting, trembling, dizziness, headache, thirst and sweating. A hangover has several causes, including lack of moisture in your body. Because of the alcohol, your kidneys excrete more fluids. This causes you to pee more often and to become dehydrated. When drinking strong beverages, you get down even less water than when you drink beer, and this causes an even worse hangover. Another reason for getting a hangover is that the alcohol in your body is converted into the toxins ADH (acetaldehyde) and ALDH (alcohol dehydrogenase). These substances are produced during the breakdown of alcohol in your body and they cause headaches and a shaky feeling. The more you drink, the more these substances are produced in your body. A third reason for a hangover is fusel oils. These toxic substances are a by-product of alcoholic fermentation and they are broken down in the body very slowly. Alcohol irritates your stomach lining which can cause you to feel nauseous and vomit. Finally, personal factors also influence your hangover. If you are tired or not feeling well, your hangover will be worse.

Alcohol poisoning

When you drink a lot of alcohol in a short amount of time, alcohol poisoning may occur. This means that the concentration of alcohol in your blood, and therefore also in your brain, becomes so high that you can get unconsciousness or in a coma. Eventually, the alcohol can affect the nervous system so strongly that your respiratory centre becomes paralyzed. In this case, your life is in danger. For adults an alcohol poisoning can occur from an alcohol level of 4‰. For young, unexperienced drinkers this is a much lower level.

Getting fat

Whether or not alcohol causes you to get fat, depends on what other things you drink and eat and how much exercise you get. Alcoholic beverages contain a lot of energy in the form of (empty) calories (7 calories per gram). That is almost as much as fat (9 kcal) and more than sugar, because 1 gram of sugar contains 4 kcal. Alcoholic beverages often contain a lot of sugar as well, which provides even more calories.

Alcohol cannot be stored in the body and it is rapidly burned, which can also cause you to get fat. This is because other energy sources, especially fat, are not burned at the same time. The remaining fat is stored in the body, especially in the abdomen.

Small amounts of alcohol can whet your appetite because they stimulate your stomach. Large amounts often make you feel full, but they do not contribute to a healthy diet. Alcohol provides a lot of calories but hardly contains important nutrients such as proteins, vitamins and minerals.

Sex

Alcohol has a depressant effect on the brain, which causes you to lose your inhibitions and it can also increase your sex drive. You may do things you would never do if you were sober, like having unsafe sex.

Additionally, alcohol lowers testosterone levels in men, which makes it harder for them to get an erection and to ejaculate. Women’s testosterone levels increase, which allows their orgasms to be more intense. When women drink large amounts of alcohol, however, their sex drive decreases.

Sleep

Alcohol relaxes you and often you fall asleep quickly. However, if you have had a lot to drink, your sleep is more restless and you wake up earlier. You don’t have enough deep sleep and you are not very well rested. Alcohol has a negative effect on your REM sleep.

Bad breath

Alcohol is transported by the blood and it passes several organs, including your lungs. Part of the alcohol transfers into the air sacs (alveoli), after which it leaves your body when you exhale. This is how the police measures the amount of alcohol in your body.

Blackout & Greyout

If you drink a lot of alcohol on one night you might get a blackout: a temporary loss of memory during which the information from the short-term memory is not transferred to the long-term memory. The next day you don’t know what you have done and where you have been.

You can also get a greyout: you still remember certain things, but they are only fragmentary memories. Here, too, an error has occurred during the transfer of information from the short- to the long-term memory.

It is harmful to the brain to often have a blackout or a greyout. Having one can also be a sign that you drink too much too often.

After a night of heavy drinking, your memory does not function as well as it normally does, even though the alcohol is completely out of your blood. Especially the long-term memory is (temporarily) affected.

The long-term memory also functions worse when you’ve been drinking a lot of alcohol.

Nausea and vomiting

Drinking alcohol irritates your stomach lining and this causes your body to produce more stomach acid. Your stomach may contract which can make you feel nauseous and maybe you will have to vomit.

Long-term

  • Heart and blood vessel disease
  • Inflamed stomach lining
  • Liver disease
  • Cancer
  • Pancreatitis
  • Brain damage
  • Psychosis
  • Weight loss

 

Heart and blood vessels

Drinking more than three glasses of alcohol a day has a negative impact on the heart; you have a higher risk of an increased blood pressure. A high blood pressure increases the risk of a heart attack. Alcohol can also lead to heart failure and cardiac arrhythmia because it prevents the heart muscle from contracting properly, and it can lead to brain haemorrhages as well.

Moderate use (up to 1 to 2 drinks per day) has a protective effect on the heart and blood vessels. It can slightly discourage clogging of the arteries due to the build-up of cholesterol. It does not matter whether you drink wine or any other alcoholic beverage. However, this beneficial effect only applies to healthy men over 40 and healthy postmenopausal women. Please keep in mind that alcohol cannot be used as a medicine because it has negative effects on your health as well, and because there is always the risk of addiction. It is much better to exercise, to eat healthy and not to smoke to prevent heart and blood vessel disease.

Stomach lining

Excessive alcohol consumption can cause the stomach lining to become infected. You may suffer from bloating, belching, stomach pain and heartburn.

Liver diseases

Alcohol is broken down by the liver. Because alcohol is a toxic substance, the liver will always break down the alcohol first. Excessive alcohol use can cause damage to the liver.

Fatty liver

Alcohol abuse disrupts the liver and it can cause the build-up of fat in the liver (fatty liver) and in the blood, which can cause the liver to swell. This can already happen after a few days of heavy drinking and it can be accompanied by pains, a poor appetite, nausea and vomiting, and sometimes jaundice. Fat accumulation can damage a liver cell, possibly even causing it to die off. When you stop drinking, the liver can recover after a few weeks, depending on the damage.

Alcoholic hepatitis and Cirrhosis

Besides fatty liver alcohol can cause two other liver diseases; alcoholic hepatitis and liver cirrhosis. Alcoholic hepatitis is an inflammation of the liver which can make you very ill and can cause severe pains, fever, a poor appetite and jaundice. Alcohol hepatitis is a serious disease with potentially fatal consequences and it can be a precursor to cirrhosis. Cirrhosis is a serious condition in which the liver cells die and are replaced by connective tissue. As a result, the blood vessels that pass through the liver are narrowed so the liver cannot function properly. The liver shrivels and becomes smaller. Cirrhosis cannot be cured, but it can stabilise when you stop drinking alcohol. When your liver is unable to purify your blood, degradation products will end up in your brain and there they can cause drowsiness, confusion and a coma with death as a result.

Cancer

Alcohol increases the risk of cancer. For instance, three glasses a day can cause an increased risk of colon cancer. Women even have an increased risk of breast cancer when they drink one glass of alcohol a day, which has probably to do with the influence of alcohol on the hormones. From four drinks a day for women and six drinks a day for men the risk of oesophageal cancer increases. For oral cavity cancer that is six drinks per day for women and eight drinks per day for men. The risk of these cancers is even bigger for those who both drink and smoke. Only with heavy alcohol use there is a risk of liver cancer and pancreatitis, which increases the risk of pancreatic cancer.

Pancreatitis

Alcoholics can suffer from pancreatitis or inflammation of the pancreas. Alcohol stimulates the pancreas to produce more digestive juices. As a result, the pancreas can become inflamed. During severe inflammation the digestive juices leave the pancreas behind the peritoneum and they can cause inflammations in several other places in the body as well. This can sometimes lead to death.

Brain damage

Drinking affects all brain functions. After drinking 1 or 2 glasses your brain already work less well. If you drink more than 25 glasses of alcohol per week on average in the long-term, you have a high risk of brain damage. Your memory deteriorates, your thinking slows down and it becomes harder to adjust to new situations. The brain does not only work less well, the brain volume of excessive drinkers can also shrink up to 15%.

Korsakoff syndrome

Drinking too much for a long period of time can lead to irreversible brain damage, especially in combination with a lack of vitamin B1. The most severe type of brain damage due to alcohol use is the Korsakoff syndrome. Korsakoff patients suffer from memory loss, loss of the ability to learn something new and a disturbed sense of time and place.

Psychosis

As a result of their excessive alcohol use, heavy drinkers can suffer from psychoses such as delirium tremens and psychotic disorders with delusions or hallucinations.

Weight loss

In the short run alcohol can cause you to gain weight, but if you drink more and more you have the chance to lose weight or become malnourished. That is because in large quantities alcohol can make you feel full, which means you’re less hungry. The alcohol does produce energy but it has no nutritional value, so when the drinker neglects his diet he may be at risk of malnutrition. Alcoholics often eat badly and the alcohol also damages their intestinal wall, which means the body is less able to absorb nutrients.

Pregnancy

Alcohol affects fertility in both men and women, even when you drink one glass a day. Drinking alcohol during pregnancy can lead to miscarriages, premature birth and mental retardation. With six or more drinks there is an increased risk of foetal alcohol syndrome (FAS). This causes the baby to be underweight and to have a smaller skull, a shorter body length and possibly facial deformities.

Addiction

Alcohol is both physically and mentally addictive. Someone who drinks 8 glasses a day for half a year, will experience withdrawal symptoms when he stops drinking, such as poor sleep, sweating, and restlessness. Withdrawal symptoms are often a reason to start drinking again. Drinking temporarily suppresses these symptoms. It also leads to tolerance or habituation. This means that if you drink regularly, the same amount of alcohol has less effect. You need to drink more to get tipsy or drunk. Regular drinkers say they can “handle alcohol better”.

If you’re wondering whether your alcohol use is becoming a problem, you could ask yourself the following questions:

  • Is it hard to get in a good mood without drinking?
  • Am I mentally preoccupied with alcohol?
  • Has the use of alcohol changed me as a person?
  • Do I have to use more and more to achieve the same effect?
  • Have I been drinking more alcohol lately? Do I drink more, in more different places and on various occasions?
  • Do I drink more than I planned beforehand?
  • Do I suffer from withdrawal symptoms when I don’t drink, such as sleeping poorly, moodiness, shaking, headaches, dizziness, nausea and sweating?
  • Do I sometimes drink to eliminate negative effects from the last time I drank, such as a hangover?
  • Does it take me a long time to recover from drinking?
  • Do I spend more and more money on alcohol?
  • Do I drink despite the fact that I have important things to do? Do I neglect hobbies and work?
  • Does drinking lead to more and more problems with people around me, for instance friends and family?
  • Do I drink constantly, even though I know it causes damage to both my body and my social life?

The more times you answer these questions with “yes”, the more dangerous your use of alcohol has become.

 

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Combinations with other drugs§

Combining different types of drugs is extra risky and unpredictable. When you combine drugs you have a higher risk of health problems. In the following paragraphs you can read about the effects and the risks of a number of combinations that occur frequently and also a about few that are extra hazardous.

Alcohol and cocaine

When you combine alcohol and cocaine, the substance cocaethylene is produced in your body. This psychoactive substance is harmful to the liver, it provides an extra burden on the heart and blood vessels and it is more addictive than alcohol or cocaine alone. The half-life for cocaethylene is 4 times as long as the half-life for cocaine (so it works 4 times longer) and therefore it takes longer to break down, causing a higher risk of toxic effects. You may also come to associate alcohol with cocaine use, so when you are drinking you want to snort and when you snort you want to drink. Plus coke may give you the feeling that you are not as drunk as you really are. Some people come to think that they are perfectly able to drive a car (which is not the case). You may also drink more alcohol than you would have done when you had not snorted cocaine.

Alcohol and GHB (and other downers)

The combination of alcohol and GHB, sleeping pills, tranquilizers (Valium, etc.) or other downers increases the risk of an overdose and is very dangerous! When you combine alcohol and GHB you have a much bigger chance to fall asleep and to pass out. This is because the two substances may numb the part of your brain where your breathing is controlled almost completely so that you stop breathing, which can lead to a coma and even death. It is therefore highly inadvisable to combine alcohol with the substances named above.

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Detection time§

Different factors influence the detection time of a substance in your blood or urine. How often and how much you use, for instance, just as your personal metabolism (how fast a substance is broken down in your body, especially by the liver). Drugs are absorbed in the blood after which they are broken down by the liver and leave the body through the kidneys in your urine. Therefore, drugs are longer traceable in urine than they are in blood.

On average, the liver needs 1.5 hours in order to remove the alcohol in one alcoholic beverage from the body. The more you drink, the longer this takes. The amount of alcohol in your blood does not only depend on how fast it is broken down in your body, but also on your gender and weight.

An alcohol calculator can calculate your blood alcohol level after a couple of hours. Alcohol is detectable in urine for about 6 to 24 hours.

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Unity tips§

  • Drink a glass a glass of water with each alcoholic beverage to prevent dehydration and a hangover
  • Do not drink alcohol to quench your thirst
  • Rest well before and after alcohol use and eat healthy. You can also take some extra vitamin B supplements
  • Drink in moderation: up to 1 -2 glasses a day (women) and up to 2-3 drinks a day (men) with two alcohol-free days a week
  • Drink for fun or to relax. Do not drink to forget about stress or problems
  • Only drink when you feel well, both mentally and physically
  • Do not combine alcohol with drugs, sleeping pills, sedatives or other medications
  • Do not drink before you participate in traffic
  • Do not drink during pregnancy or when you are breastfeeding
  • Please note that alcohol can work as an aphrodisiac. Protect yourself against STDs and AIDS during sex by using a condom

Do you want more information about alcohol, do you have any questions or do you want to talk to someone about alcohol? Or do you have any questions about other drugs? Click here for our contact details in your area or e-mail us via info@unity.nl

Would you like more information, do you have a question or would you like to chat about this or another drug? Look for contact details in your area or send an email to info@unity.nl.

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