Understanding Alcohol – Q & A with Dr Clara Vasquez

Understanding alcohol. I know that alcohol is bad for us, a hangover is a sure sign that our bodies don’t like what we’ve put into it and loss of control, double vision, slurred speech, the spins and vomiting are just a few other things that happen to us when we drink so yeah, alcohol is a poison.

I know this and it has become clearer to me since quitting drinking – feeling good, feeling healthy, being clear headed and energized made me realize just how much I was harming myself before.  I know this, but I don’t necessarily know why. I am fascinated by the affects that alcohol has on our bodies, our emotions and mental state so naturally over this past year I have been reading a lot doing research and talking to people.

Understanding alcohol and getting into the science and the medical information behind alcohol use, abuse, physical and psychological effects is something that interests me, yet I know it can be confusing and overwhelming when trying to process and understand all the information. I also know that by understanding alcohol and what it actually does is key to unlocking the reasons we drink and therefore seeing alcohol for what it really is and not something to be glorified, revered or romanticized.

I have a good friend who also happens to be a doctor and she was delighted to answer some of my questions about understanding alcohol which I want to share with you in this blog post.  Clara graduated from the school of medicine at the University of Barcelona, she specialized in psychiatry and currently works as a specialist in the mental health section of our local hospital. She sees first hand the effects of alcohol on the wellbeing of her patients. She also tells me that alcohol is the main player in causing many of the problems that her  patients face. #

Below is the result of our chat. The answers are from a medical point of view which I found absolutely fascinating and it really helped me to put things into perspective. It also made me realize that I had absolutuley no clue what I was really doing to my mind and body when drinking. I hope you find this information as interesting and helpful as I did.

How does alcohol affect the brain?

Alcohol is a drug that depresses the central nervous system, that is, slows down the functions of the brain. Alcohol affects the ability of self-control, so it can be confused with a stimulant.

Alcohol ingested in a drink is absorbed into the digestive system, from where it passes to the blood circulation where it can remain for up to 18 hours.

A few minutes after having a drink, a series of effects may appear whose manifestation varies according to the amount drunk and the characteristics of the person.

In order of appearance in time, and in relation to the concentration of alcohol in the blood, these effects are the following:

• Disinhibition
• Euphoria
• Relaxation
• Increase in sociability
• Difficulty speaking
• Difficulty in associating ideas
• Loss of motor coordination
• and, finally, acute poisoning

In cases where the concentration of alcohol in the blood reaches or exceeds 3 grams of alcohol per liter apathy and drowsiness may appear, coma or even death.

The effects of alcohol depend on the amount consumed, but there are other circumstances that can accelerate or aggravate it.

• Age. Young people are more sensitive to the effects of alcohol in activities that have to do with planning, memory and learning, and are more “resistant” than adults to the sedative effects and to the motor incoordination.
• Weight and sex. Alcohol affects smaller people more severely. In general, women weigh less than men and the size of her internal organs is proportionately smaller. Therefore, lower amounts of alcohol can cause damage to the female body more quickly.
• The quantity and speed of the intake. The more alcohol drunk over the shorter the time, the greater the possibility of intoxication.
• The combination with carbonated beverages such as tonic, cola, etc. accelerates intoxication.
• Food. If you eat at the same time you drink, especially fatty foods, the intoxication is slowed down, but the damage to the body is not avoided or reduced.
• The combination with other substances. If tranquilizers or relaxants are taken, the sedative effects of alcohol are enhanced. When combined with cannabis the sedative effects of both substances are increased.

Why do we find we need more than just one drink?

This phenomenon is called dependency.

There are various factors that contribute to the development of dependence on alcohol:

a.) Effects of alcohol on the reward system, which promotes consumption by its ability to act as positive reinforcement (psychological dependence)

b.) consumption as a negative reinforcement to avoid the discomfort associated with abstinence (physical dependence)

There is also a third factor which is the social pressure put on us to drink and this is equally important in making us continue to drink and is one of the most challenging aspects that people face when trying to abstain from drinking alcohol.

Alcohol is a depressant so why does it make us feel better?

This is because the first thing that alcohol inhibits or “sleeps” are the areas of the brain related to social and motor inhibition, so that initially we feel more uninhibited, with greater gift of speech and ability to socialize, more energetic etc but, as we continue to drink more, alcohol ends up  inhibiting more functions of the brain making us lethargic, clumsy, leading to slurred speech, loss of control and in extreme cases causes us to pass out or even go into a coma.

Is drinking just a habit?

No, it is not just a habit, or at least not in all cases, it can become a disease with important physical, social, family, economic consequences … due to the power to create dependence on alcohol and the susceptibility of some people to it. Not everyone who tries alcohol however ends up becoming dependant or has the problem of alcoholism.

I would highlight in this section the existence of the vulnerability to the abusive consumption of alcohol and the relationship of this consumption with stress, using alcohol as a sedative or reducing the suffering.

Regarding the former, this vulnerability is defined by personality traits, heritability (studies confirm a higher risk of consumption in children of genetically defined alcoholic parents) and by modeling (imitation of behaviors of parents, peers or closest friends).

Consumption is usually initiated by curiosity, social pressure, the search for some of its immediate effects and as a habit included in culturally accepted celebrations, but that is only the beginning.

Why is it so difficult for us to break the cycle of drinking regularly?

Precisely because of the changes in the brain generated by the consumption of alcohol which are maintained, as well as psychosocial factors (social pressure, alcohol as a sedative in situations of emotional suffering, excessive availability …). Alcoholism is a social disease, not a problem of the alcoholic and I would add that no alcoholic drinks because he wants to once this is a problem, but because he cannot do otherwise with the tools available.

The properties of alcohol, which destabilize the systems of excitation and inhibition of the body because the brain tries to adapt to return to balance after consumption, generate discomforts that lead to continued drinking but we need more quantity of alcohol to generate the same effect or avoid abstinence (is the so-called tolerance). In this way it can be very difficult to stop drinking.

Why is it that when we consciously don’t want to drink, our subconscious is so strong that we end up drinking anyway?

It is not just a matter of cognitive dissonance. In the consumption maintained by alcohol and within the factors that influence when breaking their abstinence, of course the self-deception type of self talk comes into play such as “this is going to be the last”, or, “I can stop whenever I want “, or ” just one won’t hurt “… but we must not forget the main thing: the physiological adaptations that determine dependence, which differentiates the drinking of a habit to an addictive disease or disorder.

What are cravings?

Cravings are an impulse to consume alcohol with the subjective desire to re-experience its beneficial effects.

It is a learned reaction, because of the gratifying experience of consumption and the need to avoid withdrawal symptoms.

Cravings can be triggered in response to:

• symptoms of withdrawal
• the lack of pleasure
• occasions or situations associated with drinking
• desires of satisfaction

All these triggers are very important when it comes to avoiding relapses.

How can we rewire our brains to not crave alcohol or want to drink?

We can address the problem of alcohol abuse from a bio-psycho-social approach. And how is this done? Applying pharmacological aids to reduce desire, social aids aimed at increasing and maintaining motivation throughout abstinence and psychological aids.

The latter, in professional treatment could be divided into

1. a) cognitive techniques (analyzing the thoughts and behaviours in relation to the consumption of alcohol to modify beliefs and behaviours), including the prevention of relapses, self-control techniques , training in social skills, motivational interventions and systematic desensitization;
2. b) Behavioural therapy (substituting inappropriate behaviours for more healthy ones): aversive therapy, contingency contract and prevention of exposure responses;
3. c) Psychodynamics, which analyze the unconscious motivations of behaviour and propose changes in the defence mechanisms of the individual that are less self-destructive than alcohol
4. d) Others: family and group therapies.

All of these treatments and therapies are usually combined in an effort to help someone to stop drinking alcohol. Group therapies are often the key in the recovery and maintaining this positive lifestyle change.

Of course all this work can be done by the individual without professional help and we must congratulate these cases because the task can be extremely difficult without support.

Why do we associate alcohol with certain situations such as celebrating, stress, commiserating?

We associate alcohol so much with celebration, as a method to drown our sorrows, for ancestral cultural issues that perpetuate its consumption. Let’s say that there is an unconscious collective alcoholism where both the identified alcoholics and the rest of the population collaborate to maintain this ritual.

The theory says that the origin of alcohol dates from 9,000 years ago associated with methods of food conservation after the emergence of agriculture and the need for storage.

It is true that alcohol initially helped the social interaction between the first human settlements, and was part of magic-religious rituals and celebrations. Since then it was used as medicine for many ailments or even as a protective drink to avoid disease, as its fermentation protected from infections that water and other drinks contained.

So it is part of what some call collective subconscious, which would be ideas that would initially help us to survive and that are passed down through generations and generations even if they cease to be helpful and generate harm.

Also, behaviours around alcohol use which are associated with intense emotions, whether positive or negative, are prevailing behaviours and are very difficult to cope with if you are used to dealing with these behaviours by using alcohol.

How can we deal with difficult emotions without alcohol?

The only way to exclude alcohol from our lives, is by not having it available and therefore developing alternative strategies to deal with emotional suffering.

But it is not easy to resist using alcohol, abstain completely or develop strategies which we are not used to when dealing with stress when previously, alcohol was our ‘go to’ solution.

For starters I would dare say that the most important thing is to recognize that we used alcohol in a negative capacity, admit it, verbalize it (the more people who know what we are trying to do, the more people will help us) and ask for help from others (it does not have to be professional, our partner can suffice, a good friend, or people in the same situation …)

Find out why it is difficult for us to face and accept negative emotions; learn alternative strategies and behaviours which are not compatible with using alcohol  but which make us feel good (walking, reading, talking to someone, going for a run or crushing it in the gym.  Above all, trust in ourselves and love ourselves a lot, a lot, a lot.

I really hope you find this information as inspiring as I do in understanding alcohol. Please let me know your thoughts in the comments below.

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