Heavy drinkers

The microsomal ethanol oxidizing system is another mechanism of ethanol metabolism. CYP2E1 may be an important enzyme in the metabolism of ethanol in heavy drinkers, who may have a 10-fold increase in activity. Two aUehc variants in the gene cl and c2) are associated with differing enzymatic activity. Approximately 40% of Japanese have the more active c2 allele, which is rare in individuals of European heritage (Sun et al. 2002). It is not believed to be a risk or protective factor in the development of alcohohsm, although current studies are examining its relationship to a variety of ethanol-related diseases. 

Balldin J, Berggren U, Engel J, et al Effect of citalopram on alcohol intake in heavy drinkers. Alcohol Clin Exp Res 18 1133-1136, 1994... 

Naranjo CA, Sellers EM, Chater K, et al Non-pharmacological interventions in acute alcohol withdrawal. Clin Pharmacol Ther 34 214—219, 1983 Naranjo CA, Sellers EM, Roach CA, et al Zimelidine-induced variations in alcohol intake hy nondeptessed heavy drinkers. Clin Pharmacol Ther 35 374-381, 1984 Naranjo CA, Sellers EM, Sullivan ]T, et al The serotonin uptake inhibitor citalopram attenuates ethanol intake. Clin Pharmacol Ther 41 266-274, 1987 Naranjo CA, Sullivan ]T, Kadlec KE, et al Differential effects of viqualine on alcohol intake and other consummatory behaviors. Clin Pharmacol Ther 46 301 -309,1989 Naranjo CA, Kadlec KE, Sanhueza P, et al Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers. Clin Pharmacol Ther 47 490 98, 1990... 

After I d been painting for about seven years, I started reacting to some of the finishes I used. I started getting dizzy, things like that. I also found out I had liver damage. The doctor wanted to know if I was a heavy drinker. I wasn t a heavy drinker, but I had liver damage. I ve learned that that is common among painters. 

An estimated 50% of oriental people have the ALDH-2/2 variant and thus the inactive isoenzyme, which probably accounts for the far lower incidence of heavy drinkers found amongst Chinese and Japanese than, say, Caucasians. Disulfiram is a drug used to treat alcoholics its action is to inhibit ALDH thus creating in heavy or compulsive drinkers an unpleasant and hopefully deterrent reaction. 

Durazzo et al. (2007) 17 36 NR NA Among heavy drinkers, smokers had smaller temporal lobe and total gray matter volume than nonsmokers. Heavy drinkers who were smokers also exhibited smaller volumes of temporal, parietal, and total neocortical gray matter. 

Durazzo TC, Cardenas VA, Studholme C, Weiner MW, Meyerhoff DJ (2007) Non-treatment-seeking heavy drinkers effects of chronic cigarette smoking on brain structure. Drug Alcohol Depend 87(l) 76-82... 

Alcohol has a range of effects for some, desirable acute effects unwanted effects on the developing fetus and with long-term consumption, effects on the liver and other organs. In the US, over 2 million people experience alcohol related liver disease. Effects on the liver are dose related the more you consume the greater the effects. Early on there is an accumulation of fat in the liver as a result of the metabolism of alcohol. Some heavy drinkers develop an inflammation (alcoholic hepatitis) of the liver. Metabolites of alcohol, produced by the liver, are toxic to the liver cells. 

Ethanol. Alcohol (ethanol) ingestion has repeatedly been associated with potentiation of carbon tetrachloride-induced hepatic and renal injury in humans. In two cases in which men cleaned furniture and draperies with carbon tetrachloride, one man, a heavy drinker, became ill and died (Smetana 1939). His coworker, a nondrinker, suffered a headache and nausea but recovered quickly after breathing fresh air. Both men were subjected to the same carbon tetrachloride exposure, as they had been working in the same room for the same amount of time. In 19 cases of acute renal failure due to carbon tetrachloride inhalation or ingestion, 17 of 19 patients had been drinking alcoholic beverages at about the time of their carbon tetrachloride exposure (New et al. 

As noted above, persons who are moderate to heavy drinkers are at greatly increased risk of liver and/or kidney injury following ingestion or inhalation of carbon tetrachloride. Occupational exposure to isopropanol has also been reported to markedly potentiate the hepatorenal toxicity of carbon tetrachloride in men and women (Folland et al. 1976). This report and numerous animal studies indicate that primary, secondary, and tertiary alcohols, as well as their ketone analogues, can substantially enhance the toxic potency of carbon tetrachloride. Substantial exposures to alcohols and ketones may occur in occupational settings or in certain instances in the use of household products containing these chemicals. 

A light drinker generally is defined as one who consumes an average of one drink or less per day, usually with the evening meal a moderate drinker is one who has approximately three drinks per day and a heavy drinker is one who has five or more drinks per day (or in the case of binge drinkers, at least once per week with five or more drinks on each occasion). 

In adults, ethanol is metabolized at about 10 to 15 mL/hour. Since metabolism of ethanol is slow, ingestion must be controlled to prevent accumulation and intoxication. There is little evidence that chronic ingestion of ethanol leads to a significant induction of alcohol dehydrogenase, even in heavy drinkers. 

Naranjo CA, Sellers EM, Roach CA, et al. Zimelidine-induced variations in alcohol intake by non-depressed heavy drinkers. Clin Pharmacol Ther 1984 35 374-381. 

Liver disease is the most common medical complication of alcohol abuse an estimated 15-30% of chronic heavy drinkers eventually develop severe liver disease. Alcoholic fatty liver, a reversible condition, may progress to alcoholic hepatitis and finally to cirrhosis and liver failure. In the United States, chronic alcohol abuse is the leading cause of liver cirrhosis and of the need for liver transplantation. The risk of developing liver disease is related both to the average amount of daily consumption and to the duration of alcohol abuse. Women appear to be more susceptible to alcohol hepatotoxicity than men. Concurrent infection with hepatitis or C virus increases the risk of severe liver disease. 

A link between heavier alcohol consumption (more than three drinks per day) and hypertension has been firmly established in epidemiologic studies. Alcohol is estimated to be responsible for approximately 5% of cases of hypertension, making it one of the most common causes of reversible hypertension. This association is independent of obesity, salt intake, coffee drinking, and cigarette smoking. A reduction in alcohol intake appears to be effective in lowering blood pressure in hypertensives who are also heavy drinkers the hypertension seen in this population is also responsive to standard blood pressure medications. 

For a heavy drinker to make a major change in his drinking patterns requires a reconstruction of his way of life. The drinker must learn over time to see the world in different terms, to cultivate new values and interests, to find or create new physical or social settings, to develop new relationships, to devise new ways of behaving in those new relationships and settings. (110)... 

Consider the remarks of a former heavy drinker "It seems to me that a person needs to have it within himself, be strong enough to handle his own problems— You have got to have some inner strength, some of your own strength in resources that you can call up in yourself" (Peelc 1985,194). 

Alcohol is an inducer of CYP2E1, which can lead to situations of enhanced drug toxicity in alcoholics or heavy drinkers (e.g., from paracetamol overdose). 

Why do heavy drinkers have a greater tolerance for alcohol ... 

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