The Big Picture

The effects we have discussed here are the short-term effects of alcohol, how a drink or several drinks travel through your body, affecting its ability to function normally. But there are even more serious effects that are caused when you drink steadily for longer periods of time.

One obvious effect is tolerance. Your body becomes accustomed to the alcohol. You require more and more alcohol to get the effect that a single drink used to give. Your liver has adapted

Urobilinogen Cirrhosis

This comparison of a normal liver to a fibrotic liver demonstrates the mechanism through which cirrhosis develops. During fibrosis, stellate cells in the liver lose vitamin A and secrete scar tissue. This scar tissue interferes with the normal exchange of nutrients into and out of the sinusoid which is essential to maintaining a healthy liver. Activation of the Kupffer cells (specialized cells in the liver that destroy bacteria and worn-out blood cells) by alcohol may be responsible for starting this chain of events, which ultimately inhibits the normal functioning of the liver.

to the alcohol and now is able to metabolize it more quickly.

Alcohol can be addictive. If you drink steadily for long periods of time, your body does more than become accustomed to alcohol—it becomes dependent on it. Your body will experience symptoms of withdrawal when you stop drinking, such as shaking, sweating, vomiting, difficulty sleeping, and irritability.

Frequent drinking often damages the liver. Cirrhosis is one of the most common diseases of the liver caused by too much alcohol. Excessive alcohol causes the liver to become inflamed and diseased, and scar tissue develops. This condition cannot be corrected, and once cirrhosis develops, your body struggles to get rid of toxic substances. There is a much greater risk of early death. Inflammation of the liver may also lead to hepatitis.

Alcohol abuse damages more than just the liver. It damages brain cells and reduces the supply of blood to the brain. It robs the brain of vitamins that are necessary for proper brain functioning. It damages the central nervous system by affecting coordination, movement, and perception, as well as leading to loss of memory functioning. It can create confused and disorganized thinking.

Excessive alcohol consumption leads to premature aging. It can damage the digestive system, making it more difficult for the body to process nonalcoholic foods.

And research has shown that alcohol, even in small amounts (as little as one or two drinks), can greatly increase a pregnant woman's risk for having a baby with birth defects, for miscarriages, or for premature delivery. Why? In the same way that alcohol quickly travels through the body's fluids, it passes into the placenta (the organ within a pregnant woman that joins to the fetus). The developing unborn child has no tolerance for alcohol, and, worse, the impact of alcohol is much greater on a fetus's growth and development. When a developing fetus is exposed to alcohol, fetal alcohol syndrome may result. Its impact can be devastating and include symptoms and abnormalities like mental retardation, undersized head and brain, lack of proper height and weight growth, facial abnormalities, poorly formed organs, and overactive behavior.

Teenage Trends and Attitudes

It can be extremely difficult to be at a party or with a group of friends and be the only one who says "no" to something. We all want to fit in, to be accepted. Alcohol can seem like an easy way to be accepted. If everyone is drinking, you may feel uncomfortable being the only one choosing not to drink.

But is it true that "everybody" is drinking? Exactly who chooses to drink beer, wine, or other alcoholic beverages? And why?


According to a 2000 Gallup Poll, approximately 64 percent of all Americans are drinking alcoholic beverages—drinks like wine, beer, and other spirits. Approximately 36 percent of all Americans do not drink any alcohol (a group sometimes described as "teetotalers"). This may seem like a high number (more than half of all Americans are consuming some kind of alcoholic beverage), but it actually marks a decline from the late 1970s, when Gallup recorded that more than 70 percent of all Americans drank alcohol. More Americans drink beer than any other form of alcohol, according to the same poll. Wine came in second, followed by other forms of spirits.

But what about teens? Is it true that "everybody" is drinking? A study by MADD shows that approximately 50 percent of all 10th graders have had too much to drink at some time, whereas 41 percent of 9th graders have reported having tried alcohol at least once. But these experiments with alcohol come with a price tag: there

■ Heavy Use* ■ Binge Use" (Not Heavy) ■ Alcohol Use (Not Binge)

■ Heavy Use* ■ Binge Use" (Not Heavy) ■ Alcohol Use (Not Binge)

13 15 17 20 25 29 34 39 44 49 54 59 64 Age Group

This graph from the 2000 National Household Survey on Drug Abuse (NHSDA) shows the pattern of alcohol use in different age groups. Binge drinking was defined as five or more drinks on a single occasion in the past month, and heavy drinking was defined as five or more drinks on a single occasion on five days in the past month.

is a relationship between students who drink and poor grades. In more than 40 percent students who have academic problems, alcohol is a factor. And alcohol is also a factor in 28 percent of all high-school dropouts.

Problems with alcohol aren't just limited to high-school students. A study by the Core Institute, 2000 Statistics on Alcohol and Other Drug Use on American Campuses, notes that 23 percent of all college students who drank alcohol reported doing poorly on a test or project afterward, and more than 33 percent admit to missing classes because of alcohol use.

There are many other risks posed by alcohol. Alcohol is a leading cause of driving accidents for teens, as well as a factor in suicide, depression, and violent crimes involving teens. The earlier you start drinking, the more likely you are to become dependent on or abuse alcohol. Given all of these risks and dangers, why are teens drinking? Why are they choosing to use—and often abuse—alcohol?

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