Alcohol

Alcohol, also known as ethanol (ethyl Alcohol) is a psychoactive substance that is commonly found in alcoholic beverages. It is a clear, colorless liquid that has a distinctive odor and a slightly sweet taste. Alcohol has been used by humans for thousands of years for its mind-altering effects, and it is now one of the most widely used psychoactive substances in the world.

Physical properties of Alcohol : Ethyl alcohol is a clear, colorless liquid that has a boiling point of 78.5°C and a density of 0.789 g/cm³. Ethyl Alcohol should not be confused with Methyl Alcohol which is toxic and is often used as a solvent and as an antifreeze agent. It is also used in the production of formaldehyde and other chemicals.
The chemical formula for ethanol is C2H5OH, and it is produced through the fermentation of sugars by yeast. The process of fermentation occurs when yeast consumes the sugars in a substance such as grapes, grains, or potatoes and converts them into alcohol and carbon dioxide. This is the process that is used to make beer, wine, and spirits such as whiskey, vodka, and rum.

When consumed, alcohol acts as a central nervous system depressant, slowing down the activity of the brain and nervous system. This is what causes the characteristic effects of alcohol consumption, such as relaxation, reduced inhibitions, impaired judgment, and slowed reaction times. These effects can vary depending on the amount of alcohol consumed, the individual's body weight and metabolism, and other factors such as whether the person has eaten recently.

Despite its widespread use and cultural significance, alcohol can also have a number of negative health effects. In the short term, excessive alcohol consumption can lead to alcohol poisoning, which can cause symptoms such as confusion, vomiting, seizures, and even coma or death. Over time, regular alcohol consumption can also lead to a range of long-term health problems, including liver disease, heart disease, and certain types of cancer.
Additionally, alcohol can be highly addictive, and some individuals may develop alcohol use disorders that require treatment. These disorders can range from mild to severe and may include symptoms such as cravings, withdrawal symptoms, and difficulty controlling alcohol use.

The actual alcohol content in typical drinks can vary depending on a number of factors, including the specific brand and type of drink, the serving size, and the production method. Here are some general guidelines for the alcohol content of common alcoholic beverages:

1. Whisky: The alcohol content of whisky typically ranges from 40% to 50% ABV, with most brands falling in the 40% to 45% range.
   
2. Rum: The alcohol content of rum can vary widely, depending on the type of rum and its country of origin. Generally speaking, most rums range from 40% to 50% ABV, with some premium rums exceeding 60% ABV.
   
3. Brandy: The alcohol content of brandy typically ranges from 35% to 60% ABV, with most brands falling in the 40% to 45% range.
   
4. Vodka: The alcohol content of vodka typically ranges from 35% to 50% ABV, with most brands falling in the 40% to 45% range.
   
5. Beer: The alcohol content of beer can vary widely, but most beers fall in the range of 4% to 8% ABV. Light beers tend to have a lower ABV, while craft beers and stronger beers can have a higher ABV.
   
6. Gin: The alcohol content of gin typically ranges from 35% to 50% ABV, with most brands falling in the 40% to 45% range.
   

Alcohol Withdrawal

Alcohol Withdrawal symptoms appear when a person accustomed to frequent high consumption of alcohol suddenly stops consuming alcohol. Such alcohol withdrawal symptoms do not occur in occasional drinkers. Since alcohol has a sedating effect on the brain, the brain of a heavy drinker adjusts itself to high levels of alcohol by producing larger amounts of serotonin. When there is sudden withdrawal of alcohol, the brain has to cope with a dramatic change in chemistry.

The body experiences alcohol withdrawal symptoms such as anxiety and irritability. Alcohol withdrawal symptoms include depression, difficulty in concentration and clear thinking. There are emotional changes that also occur. A person experiencing alcohol withdrawal may suffer headache, nausea and vomiting. There is loss of appetite and clammy skin. Often there is involuntary tremors in the hands and other abnormal movements. Alcohol withdrawal can result in a delirious state of hallucinations.

The patient may suffer damage to other organs due to excessive consumption of alcohol. There may be nutritional deficiencies. Treatment for alcohol withdrawal includes screening and providing extensive social support. Medicines such as benzodiazepines are prescribed to control anxiety and confusion associated with alcohol withdrawal. Adequate nutrition and sufficient rest are advised. Dietary changes such as reduced sugar intake and avoidance of caffeine are part of the treatment for alcohol withdrawal.

Delirium Tremens

Delirium Tremens or DT is a serious condition of alcohol withdrawal syndrome. DT leads to sudden and severe mental and nervous system changes.

Causes of Delirium Tremens

When a person suddenly stops drinking alcohol after a period of heavy consumption, and does not eat enough food, delirium tremens occurs. This means, a person consuming 4-5 pints (about 1880 ml ) of wine or 7-8 pints (about 3290 ml) of beer or a pint (about 470 ml ) of hard alcohol every day for several months. This could happen to people with more than a decade of drinking alcohol.

One important reason is that in long term drinkers, alcohol interferes with body's ability to regulate a neurotransmitter called GABA. In chronic alcohol abuse, the body mistakes alcohol for GABA and reacts to this by reducing its production of the neurotransmitter. As alcohol levels falls too low, it means there is not enough GABA for proper functioning. This can also occur due to infection, injury and illness in people with a history of heavy alcohol use and abuse.

Signs and symptoms of Delirium Tremens

Symptoms normally occur within 72 hours of the last drink, but they can also occur up to 10 days after the last drink. Common symptoms include:

• Body tremors
  
• Functional changes
  
• Agitation
  
• Anger and irritability
  
• Confusion and loss of focus
  
• Reduced attention span
  
• Deep sleep that lasts for a day or longer
  
• Excitement and fear
  
• Hallucination
  
• Hyperactivity
  
• Quick mood reversals
  
• Restlessness
  
• Sensitivity to light, sound and touch
  
• Sleeplessness and fatigue.
  

There could be seizures, most commonly in the first 12-48 hours after the last drink. As DT can temporarily reduce the amount of blood flow to the brain, symptoms as confusion, disorientation, stupor and loss of consciousness and hallucinations occur. There are other medical complications that can arise due to alcohol abuse. These include:

• Alcoholic liver disease
  
• Cardiomyopathy
  
• Neuropathy
  
• Blood clotting disorders
  
• Wernicke Korsakoff's syndrome, a brain disorder due to thiamine deficiency
  
• Injury from fall during seizures
  
• Irregular heartbeat which can be life threatening
  
• Delirium and injury to self/others in a state of confusion
  

The body goes through change due to withdrawal of alcohol when a person suddenly stops drinking after prolonged use. Alcohol has a slowing and sedating effect on the brain and the brain of a long term drinker is conditionally exposed to the depressant effect of alcohol. The brain starts producing naturally stimulating chemicals to compensate for the effect of alcohol. Hence, if the alcohol is withdrawn suddenly, the brain is lost. This dangerous condition of delirium tremens occurs in almost 1 out of every 20 persons. In this condition the brain is unable to read the chemistry after alcohol is stopped and therefore creates a temporary confusion leading to dangerous changes in the way the brain regulates body circulation and breathing. This creates risk of heart attack, stroke and death.

Diagnosis of DT

Blood tests can be done to assess blood magnesium and blood phosphate levels. Comprehensive metabolic panel and toxicology tests are also conducted. A stay in hospital in required for treatment. Regular checks of blood chemistry levels, such as electrolytes, body fluids level and vital signs such as temperature, pulse, breathing rate and blood pressure are monitored. Medications such as anticonvulsants, central nervous system depressants and sedatives are administered for symptoms such as seizures and irregular heartbeat. Sometimes the patient is put in a state of sedation for a week until withdrawal is complete. Benzodiazepine medications are given to treat seizures, anxiety and tremors. Only after the patient recovers from immediate symptoms is long term preventive treatment given. The doctor allows a ‘drying out' period in which no alcohol is consumed.