Alcoholism and Its Treatment

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Exerpted from Breaking Your Prescribed Addiction

Alcohol intoxication and dependence is one of the most pervasive mental disorders in the United States. There are approximately 15.4 million adults with serious alcohol-related problems. Teens and adolescents rate a close second with 4.6 million having serious alcohol-related problems. Alcoholism ranks as the number two killer in this country behind cancer, and many believe alcoholism actually outranks cancer. Alcohol affects 65 million people in the US.

With alcohol the number one drug of abuse in the US, the cost to the economy approaches $115 billion every year. Alcoholics constitute a large group of potential suicidal risks, particularly older males living alone with no family and suffering from chronic health problems. Alcohol induces depression. Alcohol depletes neurotransmitters needed by the brain. Alcoholics present a number of neurological syndromes attributed to vitamin and amino acid deficiencies. Alcohol also increases urinary excretion of magnesium and zinc.

Although no specific type of personality appears to predispose a person to develop drug or alcohol addiction, stress, anxiety, depression, and especially unresolved feelings seem to increase the potential of addiction. Specific personality traits in the alcoholic may become more prominent in certain situations. The introvert may become extroverted, the gentle one violent, the sensitive one insensitive, and so on. In the early stages, those with alcohol problems become more irritable, moody, and depressed when not drinking. They deny that they drink too much, blaming the drinking on stress, jobs, or even their families.

Those with alcohol problems see the world as close, threatening, and depression producing. The alcoholic uses alcohol to solve problems because the problems seem to diminish after a drink -- the blood alcohol increases and the self-degenerating circuits of the brain are anesthetized. Alcoholism is not a reaction to a situation, but rather a basic primary drive as powerful as hunger -- established by and associated with chemical alcohol. The relief from the alcohol provides only a temporary lift, and relief from the depression is short-lived. Alcohol depresses the central nervous system. After the high wears off, the depression can intensify. Addiction is a vicious cycle, and once the behavior is established, the problems continue and intensify. Alcohol shares similar properties with many hypnotic and antianxiety drugs. Alcohol disguises itself as courage for the alcoholics since it works primarily on anticipatory anxiety. Most alcoholics live in a constant state of anxiety, and experi ence sleep disturbances, sexual dysfunction, as well as multiple nonspecific medical problems.

GRAPH): Progression of Drinking Symptoms

Chronic drinking causes major nutritional deficiencies that, in turn, cause many major health problems. Alcohol has a direct toxic effect on the pancreas producing acute pancreatitis, and hypoglycemia which is activated by chronic drinking. Chronic pancreatitis is common in alcoholics. A number of neurological syndromes occurring in chronic drinkers can be attributed to vitamin deficiencies. The nutritional problems of alcoholics are more complex than those found in any other single group with addiction problems.

Anxiety, depression, muscle spasms, tremors, and chronic pain show up in alcoholics due to magnesium deficiencies, common among chronic drinkers. Deficiencies, as well as chronic stress syndrome, occur in anyone using addictive substances.

GRAPH): Symptoms of Alcohol Withdrawal

All mammals, including humans, make a small amount of alcohol in the body as part of normal metabolism. In this process the average person makes about one ounce of alcohol per day, which is broken down in the liver by an enzyme called alcohol dehydrogenase. This enzyme also handles the alcohol ingested from alcoholic beverages.

In the next step, alcohol is converted by alcohol dehydrogenase to acetaldehyde, and this substance can damage the body in several ways:

It can cause abnormal chemical bonds in large molecules, like proteins (causing hardening of the arteries, loss of elasticity, skin wrinkling).
It can damage DNA molecules (resulting in abnormal cell function).
Damage can also result when acetaldehyde is oxidized in the body, yielding dangerous and reactive chemical fragments called free radicals which can cause damage to many cell structures; cancer; birth defects; atherosclerosis; and are implicated as major factors in aging.
Acetaldehyde is a very toxic chemical, and the body breaks it down with the enzyme called aldehyde dehydrogenase. The breakdown of acetaldehyde is crucial. If the liver does not produce enough aldehyde dehydrogenase, many toxic side effects can occur, especially to the liver cells. "Normal" people who do not ingest excess alcohol have no difficulty breaking down the alcohol to acetate in their bodies. The enzyme system can be overloaded when alcohol is ingested too quickly. Acetaldehyde and its free radical by-products from the alcohol breakdown cause most of the damage to the body and the brain, including cardiovascular disease, premature aging, liver damage, brain damage, lowered resistance to disease, alcohol addiction, etc.

An overload of acetaldehyde in the brain can lead to bizarre and complicated chemical reactions. It competes with other chemical substances, known as brain amines or neurotransmitters, for the attention of certain enzymes. Acetaldehyde blocks the enzymes from achieving their primary duty of inhibiting the neurotransmitter activity. Addiction to alcohol might never occur if acetaldehyde stopped interfering at this point with the brain's chemical activities. The brain neurotransmitters interact with acetaldehyde to form compounds called isoquinolines. These compounds also release the stored neurotransmitters. The isoquinolines are very similar to opiates, and research has suggested that they may act on the opiate receptors in the brain. The opiate receptors may contribute to the alcohol addiction. These mischievous substances may trigger the alcoholic to drink more and more to counter the painful effects of the increasing buildup of acetaldehyde.

Recently, scientists have discovered that many alcoholics have a metabolic defect which causes them to have twice as much of the toxic acetaldehyde in their bloodstream after a drink as normal people. This is enough to set the vicious cycle into motion. Acetaldehyde made by the liver makes the drinker feel bad. He drinks more alcohol; this makes him feel better, and helps protect him from the acetaldehyde poison--until the liver produces more acetaldehyde out of the additional alcohol, so he continues to drink.

Researchers continue to look for the one cause of alcoholism. But all research has concluded that there is no one factor; studies have shown that a number of physiological differences exist between the nonalcoholic and the alcoholic. Physiology determines whether one person becomes alcoholic and another does not. The alcoholic's body- his hormones, enzymes, genes, and brain chemistry -- all work jointly to cause his abnormal reaction to alcohol. Of course, psychological, family history, and social factors certainly influence the alcoholic's drinking habits and behavior.

Alcoholism and nutrition interrelate and intertwine on many levels.

Ethyl alcohol or ethanol, itself, contains nutrients; however, it also changes the balance of other nutrients in the diet and may disperse them as well.
Ingestion of ethanol affects the absorption and digestion of many nutrients; it may alter dietary requirements.
In addiction, nutritional alterations may affect the metabolism of alcohol in the body.
GRAPH): Metabolism of Alcohol

4. Chronic alcohol consumption may cause temporary or permanent damage to many organs -- the liver, brain, heart, and bone marrow. The effects may be modified by nutritional factors such as dietary intake of protein, fat, and vitamins.
5. Organ damage may yield changes in nutrient metabolism. The organ most affected is the liver. The liver plays an important role in metabolism and alcohol ingestion frequently alters that role.
Identifying the cause of malnutrition from alcoholism is not a simple matter. Certain groups of alcoholics may have an inadequate nutrient intake, but a major factor is the primary toxic effect of ethanol on the gastrointestinal tract, pancreas, liver, bone marrow, and other tissues such as the heart. Research data by Rubin and Lieber in 1974 suggested that a nutritious diet could not and will not prevent the development of alcoholic liver disease.

GRAPH): Factors Leading to Malnutrition in Alcoholism

Alcoholic beverages provide calories derived mainly from their ethanol content. A pint of 86-proof liquor supplies about half the normal daily calories required by an adult, but these alcoholic calories are utterly empty of other nutrients. Ethanol does not even provide caloric food value equal to carbohydrates. If alcohol consumption is heavy and the drinker limits his food intake, he worsens his already severe vitamin and nutrient deficiencies. Conversely, if he does not reduce his food intake, many of the extra ethanol calories are converted to fat, causing high serum triglyceride levels and obesity.

GRAPH): Alcohol/Drug-Induced Nutritional Deficiencies

Acute and chronic consumption of alcohol may markedly alter digestion and gastrointestinal absorption. Alcohol-induced changes in digestion and absorption may yield marginal deficiencies or augment deficiencies arising from other causes.

A number of neurological syndromes occurring with chronic usage of alcohol are attributed to vitamin deficiencies. Just to name a few, these include: Wernicke's disease, Korsakoff's syndrome, peripheral neuropathy, Morel's carotid sclerosis, and cellular degeneration. Alterations in the metabolism of the B vitamins in the alcoholic person affect the levels in his body. Commonly, chronic drinking decreases the level of B1 (thiamine), B3 (niacin), B6 (pyridoxine), B12, B15, and folic acid. Anemias occur with deficiencies of folic acid or B6, while deficiencies of niacin or thiamine may cause neurological symptoms.

The metabolism of the fat-soluble vitamins may be altered by the alcohol ingestion. In alcoholics with cirrhosis, Vitamin A deficiencies may occur due to malabsorption, impaired liver storage of vitamin A, or simply too much alcohol in the body competing in the liver. Vitamin D may be depleted through dietary insufficiency. Vitamin K deficiency in the alcoholic may manifest itself as a bleeding disorder related to the liver's failure to make clotting factors.

Mineral deficiencies, especially magnesium and zinc can be caused by drinking alcohol; alcohol increases the excretion of magnesium and zinc via the kidneys. Magnesium depletion can be responsible for the symptoms of the "horror" or delirium tremors. Low levels of calcium have been found due to increased excretion of calcium in the urine over a period of years; this can lead to osteoporosis.

The excessive intake of alcohol is one factor which precipitates clinical vitamin deficiencies. This depletion usually includes many of the vitamins, but the most common include: folic acid, thiamine, riboflavin, niacin, vitamins B6, B12, and C. Mineral depletion usually includes magnesium and zinc. A protein deficiency usually exists due to malnutrition. The alcoholic has a wide range of deficiencies and needs nutritional supplementation.

Treatment

Treatment for and control of the ingestion of alcohol require a team effort. Good nutrition can help the control by maintaining an adequate blood sugar level. Dr. Robert Meiers has found a low blood sugar level (hypoglycemia) in 95% of alcoholics; this results from decreasing food intake and substituting alcohol for essential calories and nutrients. Hypoglycemia has been implicated as one of the contributing factors in the cause of alcoholism. If the blood sugar drops, the alcoholic needs a drink. Blood sugar can be controlled and normalized by taking chromium picolinate, 400 mcg. Chromium picolinate is known as the glucose-tolerance mineral.

GRAPH): Nutrition and Amino Acid Program for the Therapeutic

GRAPH): Supplement Regimen

Abstinence is the ultimate goal. The greatest majority of alcoholics cannot become social drinkers again because they tend to relapse into heavy drinking. In Feed Yourself Right, Lendon Smith, MD states, "All people who drink must remember that alcohol is a biochemical stress, and each swallow must be accompanied with B vitamins, some nourishing food, and at least sometime that day or week, the minerals known to be lost must be replaced."

Here we would like to mention, and strongly recommend that if you have an alcohol or substance-abuse problem, seek out a psychotherapist or behavior therapist that you can work with and get counseling for your family as well. If you are the child of an alcoholic, you are predisposed to an addictive personality and should seek counseling.

Children of alcoholics have the same neurotransmitter imbalances as their parents or even grandparents. The deficiencies can show up in many ways, such as ADD. This means the child has a glutamine deficiency that must be corrected. Use Brain Link daily and Super Glutamine powder, 1,000 to 3,000 mgs daily as needed. If anxiety is a problem, use Anxiety Control; if under 75 pounds, take 1 capsule or if over 75 pounds, take 2 capsules, 2 times daily. Many teachers will suggest Ritalin; do not think this is the answer, it is not. Address deficiencies in the brain with Brain Link and glutamine. Ritalin is addictive and is not the answer for children of alcoholics. Memory and concentration problems are commonly associated not only with alcoholics but children of alcoholics.

Once you have reached your goal and no longer crave alcohol or other recreational substances, you may alter the amounts of nutrients to what you need. The following may be used to maintain sobriety, and remember you can restart any supplements you used after withdrawing from the alcohol (such as those listed previously).

GRAPH): Supplements

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By Billie Jay Sahley and Katherine M. Birkner

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