Alcoholism reduces life expectancy by about 10 - 12 years. The earlier people begin drinking heavily, the greater their chance of developing serious illnesses later on.
Alcoholism and Early Death
Alcohol can affect the body in so many ways that researchers have a hard time determining exactly what the consequences are from drinking. Heavy drinking is associated with earlier death. However, it is not just from a higher risk of the more common serious health problems, such as heart attack, heart failure, diabetes, lung disease, or stroke. Chronic alcohol consumption leads to many problems that can increase the risk for death:
- People who drink regularly have a higher rate of death from injury or violence.
- Alcohol overdose can lead to death. This is a particular danger for adolescents who binge drink.
- Delirium tremens is a very serious form of alcohol withdrawal with symptoms that involve mental and nervous system changes. In some cases, it can be fatal.
- Alcohol abusers who need surgery have an increased risk of postoperative complications, including infections, bleeding, reduced heart and lung functions, and problems with wound healing. Alcohol withdrawal symptoms after surgery may further stress the patient and delay recuperation.
Alcohol-induced liver disease (also called alcoholic liver disease) is a spectrum of liver disorders caused by excessive alcohol consumption. Alcohol-induced liver disease includes:
- Fatty liver
- Alcoholic hepatitis
- Alcoholic cirrhosis
Fatty liver is an accumulation of fat inside liver cells. It is the most common type of alcohol-induced liver disease and can occur even with moderate drinking. Symptoms include an enlarged liver with pain in the upper right quarter of the abdomen. Fatty liver can be reversed once the patient stops drinking. Fatty liver can also develop without drinking, especially in people who are obese or have type 2 diabetes.
Alcoholic hepatitis is inflammation of the liver that develops from heavy drinking. Symptoms include fever, jaundice (yellowing of the skin), right-side abdominal pain, fatigue, and nausea and vomiting. Mild cases may not produce symptoms. Patients who are diagnosed with alcoholic hepatitis must stop drinking. Patients who continue to drink may go on to develop cirrhosis and liver failure.
Alcoholism also increases the risks for hepatitis B and C, which are associated with increased risks for cirrhosis and liver cancer. Chronic forms of viral hepatitis pose risks for cirrhosis and liver cancer, and alcoholism significantly increases these risks. People with alcoholism should be immunized against hepatitis B. There is no vaccine for hepatitis C.
Cirrhosis is a progressive and irreversible scarring of the liver that can eventually be fatal. Excessive alcohol use is the leading cause of cirrhosis. Consequences of a failing liver include excessive fluid in the abdomen (ascites), bleeding disorders that increase pressure in certain blood vessels (portal hypertension), and brain function disorders (hepatic encephalopathy).
Between 10 - 20% of people who drink heavily develop cirrhosis. Alcoholic cirrhosis (also sometimes referred to as portal, Laennec’s, nutritional, or micronodular cirrhosis) is the primary cause of cirrhosis in the U.S.
Not eating when drinking and consuming a variety of alcoholic beverages increase the risk for liver damage. Obesity also increases the risk for all stages of liver disease.
Alcoholism can cause many problems in the gastrointestinal tract. Violent vomiting can produce tears in the junction between the stomach and esophagus. It increases the risk for ulcers, particularly in people taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. It can also lead to swollen veins in the esophagus, (varices), and to inflammation of the esophagus (esophagitis) and bleeding.
Alcohol can contribute to serious acute and chronic inflammation of the pancreas (pancreatitis) in people who are susceptible to this condition. There is some evidence of a higher risk for pancreatic cancer in people with alcoholism, although this higher risk may occur mainly in people who are also smokers.
Effect on Heart Disease and Stroke
Moderate amounts (one to two drinks a day) of alcohol can improve some heart disease risk factors, such as increasing HDL (“good cholesterol”) levels. However, there is no definitive proof that moderate drinking improves overall health, and the American Heart Association does not recommend drinking alcoholic beverages solely to reduce cardiovascular risk.
Excessive drinking clearly has negative effects on heart health. Alcohol is a toxin that damages the heart muscle. In fact, heart disease is one of the leading causes of death for alcoholics. Alcohol abuse increases levels of triglycerides (unhealthy fats) and increases the risks for high blood pressure, heart failure, and stroke. In addition, the extra calories in alcohol can contribute to obesity, a major risk factor for many heart problems.
Heavy alcohol use increases the risks for mouth, throat, esophageal, gastrointestinal, liver, and colorectal cancers. Even light drinking can increase the risk of breast cancer. Women who are at high risk for breast cancer should consider not drinking at all.
Effects on the Lungs
Pneumonia. Over time, chronic alcoholism can cause severe reductions in white blood cells, which increases the risk for pneumonia. Patients who are alcohol dependent should get an annual pneumococcal pneumonia vaccination. The initial signs of pneumococcal pneumonia are high fever and cough, sometimes with stabbing chest pains. Contact your doctor immediately if you experience these symptoms.
Skin, Muscle, and Bone Disorders
Severe alcoholism is associated with osteoporosis (loss of bone density), muscular deterioration, skin sores, and itching. Alcohol-dependent women seem to face a higher risk than men for damage to muscles, including the muscles of the heart.
Effects on Reproduction and Fetal Development
Sexual Function and Fertility. Alcoholism increases levels of the female hormone estrogen and reduces levels of the male hormone testosterone, factors that possibly contribute to erectile dysfunction and enlarged breasts in men, and infertility in women. Other increased risks for women include menstruation problems such as absent menstrual periods and abnormal uterine bleeding.
Drinking During Pregnancy and Effects on the Infant. Even moderate amounts of alcohol can have damaging effects on the developing fetus, including low birth weight and an increased risk for miscarriage. High amounts can cause fetal alcohol syndrome, a condition associated with poor growth and developmental delay. The risk for fetal alcohol syndrome is increased depending on when alcohol exposure occurs during pregnancy, the pattern of drinking (4 or more drinks per occasion), and how often alcohol consumption occurs.
Effect on Weight and Diabetes
Light-to-moderate alcohol consumption may help protect the hearts of adults with type 2 diabetes. Heavy drinking, however, is associated with obesity, which is a risk factor for this form of diabetes. In addition, alcohol can cause hypoglycemia, a drop in blood sugar, which is especially dangerous for people with diabetes who take insulin.
Effects on Sleep
Alcohol is associated with insomnia and other sleep disorders. Although alcohol may hasten falling asleep, it causes frequent awakenings throughout the night. Alcohol disrupts sleep patterns—it reduces sleep quality and the amount of time spent in deep sleep. Alcoholics who stop drinking often continue to experience sleep problems for some time.
Effects on Mental Functioning
Both short- and long-term alcohol use adversely affects the brain and causes cognitive impairment, including lapses in memory, attention, and learning abilities. Short-term heavy drinking can cause blackouts. Long-term alcohol use can physically shrink the brain. Depending on length and severity of alcohol abuse, neurologic damage may or may not be permanent. .
Recent high alcohol use (within the last 3 months) is associated with some loss of verbal memory and slower reaction times. Over time, chronic alcohol abuse can impair so-called "executive functions," which include problem solving, mental flexibility, short-term memory, and attention. These problems are usually mild to moderate and can last for weeks or even years after a person quits drinking. In fact, such persistent problems in judgment are possibly one reason for the difficulty in quitting. Alcoholic patients who have co-existing psychiatric or neurologic problems are at particular risk for mental confusion and depression.
Vitamin and Mineral Deficiencies
People who are alcohol dependent should be sure to take vitamin and mineral supplements. Deficiencies in vitamin B pose particular health risks. Other vitamin and mineral deficiencies, however, can also cause widespread health problems.
Folate Deficiencies. Alcohol interferes with the metabolism of folate, a very important B vitamin. (In supplement form, folate is called folic acid.) Folate deficiencies can cause severe anemia. Deficiencies during pregnancy can lead to birth defects in the infant.
Wernicke-Korsakoff Syndrome. Wernicke-Korsakoff syndrome, also called alcohol-related dementia, is a serious consequence of severe thiamin (vitamin B1) deficiency. Symptoms of this syndrome include severe loss of balance, confusion, and memory loss. Eventually, it can result in permanent brain damage and death. Once the syndrome develops, oral supplements have no effect, and only a rapid infusion of intravenous vitamin B1 can treat this serious condition.
Peripheral Neuropathy. Vitamin B12 deficiencies can also lead to peripheral neuropathy, a condition that causes pain, tingling, and other abnormal sensations in the arms and legs.
Alcohol interacts with nearly all medications. The effects of many medications are strengthened by alcohol, while others are inhibited. Of particular importance is alcohol's reinforcing effect on anti-anxiety drugs, sedatives, sleep medications, antidepressants, and antipsychotic medications.
Alcohol also interacts with many drugs used by people with diabetes. It interferes with drugs that prevent seizures or blood clotting. It increases the risk for gastrointestinal bleeding in people taking aspirin or other nonsteroidal inflammatory drugs (NSAIDs), including ibuprofen and naproxen.
In general, people who require medication should use alcohol with great care, if at all.
Increased Risk for Other Addictions
Alcohol and nicotine addiction share common genetic factors, which may partially explain why alcoholics are often smokers. Alcoholics who smoke compound their health problems. In fact, some studies indicate that people who are alcohol-dependent and smoke are more likely to die of smoking-related illnesses than alcohol-related conditions. Abuse of other drugs is also common among alcoholics.
Accidents, Suicide, and Murder
Alcohol plays a large role in accidents, suicide, and crime:
- Alcohol plays a major role in more than half of all automobile fatalities.
- Alcohol-related automobile accidents are one of the leading causes of death in young people.
- Fewer than two drinks can impair the ability to drive. Even one drink may double the risk of injury, and more than four drinks increase the risk by 11 times.
- Alcoholism is the primary diagnosis in a quarter of all people who commit suicide.
- Alcohol is implicated in over half of all murders.
Domestic Violence and Child Abuse
Alcoholic households are less cohesive and have more conflicts, and their members are less independent and expressive than households with nonalcoholic parents. Domestic violence is a common consequence of alcohol abuse.
Alcoholism in parents also increases the risk for child abuse. Children of alcoholics tend to do worse academically and have a higher incidence of depression, anxiety, stress, and lower self-esteem than their peers. In addition to their own inherited risk for later alcoholism, many children of alcoholics have serious coping problems that may last their entire life.
Adult children of alcoholic parents are at higher risk for divorce and for psychiatric symptoms. One study concluded that the only events with greater psychological impact on children are sexual and physical abuse.
Special Concerns for the Elderly
Doctors may overlook alcoholism when evaluating elderly patients, mistakenly attributing the signs of alcohol abuse to the normal effects of the aging process. But alcohol abuse is a serious concern for older people. Some older people have struggled with alcohol abuse or dependence throughout their lives. Others may turn to alcohol later in life to cope with loss (death of a spouse), loneliness, and depression.
Alcohol affects the older body differently. It takes fewer drinks to become intoxicated, and older organs can be damaged by smaller amounts of alcohol than those of younger people. Alcohol can worsen many conditions common in older populations (diabetes, memory loss, osteoporosis, high blood pressure). It can increase the risk for falls. Also, many of the medications prescribed for older people interact adversely with alcohol.
The Effects of Hangover
Although not traditionally thought of as a medical problem, hangovers have significant consequences. Hangovers can impair job performance, increasing the risk for mistakes and accidents. Hangovers are generally more common in light-to-moderate drinkers than heavy and chronic drinkers, suggesting that binge drinking can be as threatening as chronic drinking. Any man who drinks more than five drinks or any woman who has more than three drinks at one time is at risk for a hangover.