Alcohol is a drug that produces a dual effect on the body: a primary depressant effect that lasts a relatively short time, and a weaker agitation of the central nervous system that persists about six times as long as the depressant effect. Awareness of these two effects may depend upon the degree of excitability of the central nervous system at the time of drug administration. This, in turn, depends on the environmental setting of drug use and on the personality of the user.

In a quiet, nonsocial environment, the excitatory influence may be impaired, and the sedation and drowsiness produced by the drugs are then readily perceived as depression of the central nervous system.

In a social setting, where there is a great deal of sensory input, the effects of low doses of alcohol may be perceived as stimulation. However, these effects are the result of the release from inhibition of specific areas of the brain cortex. The drinker may demonstrate excitement-- such as talkativeness, heightened vivacity, increased self-confidence, and general loss of self restraint. As the dose is increased, and during chronic intoxication, the alcohol produces more of the same effects. There may be slurred speech, staggering, loss of emotional control, stupor from which arousal is difficult, severe respiratory depression, coma, and death.

With prolonged or chronic drinking, the presence of the dual effects depends on the time that elapses between drinking episodes. Since the depressant effects are greater, they will be significant for the first two hours after the last drink. As the time since the last drink increases, the longer-lasting agitation effect becomes dominant. This effect eventually leads to morning drinking to calm the drinker. The "morning after" hangover and shakiness is due to the residual central nervous system agitation. This agitation can be temporarily counter-balanced by more drinking because of its dominant depressant effect. Thus, a vicious circle is in motion.Withdrawal symptoms eventually include restlessness, shakiness, confusion, hyperventilation, hallucination, and convulsions. The chronic loss of calcium and magnesium, general malnutrition, and dehydration contribute to these symptoms. Symptoms are usually far more dangerous than those after withdrawal from the opiates or other drugs to which physical dependence may be developed. Severity of the symptoms depends on the length of alcohol abuse and the degree of intoxication. In the typical course of withdrawal, symptoms begin within the first 24 hours after the last drink, reach their peak intensity within two or three days, and disappear within one or two weeks. During the first day of withdrawal, there may be headaches, anxiety, involuntary twitching of muscles, tremor of hands, weakness, insomnia, and nausea.

During the next 48 hours, the symptoms become progressively more intense. There may be a fall in blood pressure; fever; delirium characterized by disorientation, delusions, and visual hallucinations; and convulsions similar to those exhibited in grand mal epileptic seizures. The fever, delirium, and convulsions are the most serious symptoms and have proved fatal in a number of instances.Aside from withdrawal itself, alcohol has a pervasive effect on the body's gastrointestinal tract, liver, bloodstream, brain and nervous system, heart, muscles, and endocrine system. Alcohol, unlike other drugs, can be utilized by the body as a source of energy. This supply of calories often suppresses appetite, leading to dietary deficiencies that may be responsible in part for the pathologic conditions seen in chronic alcoholism. Early alcoholic drinking may produce the following specific medical conditions:

• Loss of control of eye muscles
• Hypoglycemia
• Gastritis
• Increased susceptibility to infections
• Cardiac arrhythmia
• Anemia
• Constant flushing of facial edema
• Peripheral
• neuritis
• Pancreatitis
• Increase in blood alcohol level
• Withdrawal signs
• Fatty liver
• Increase in blood pressure

Chronic alcohol drinking produces even more severe conditions, some of which may be irreversible, such as:

• Liver damage
• Korsokoff Syndrome (vitamin B deficiency)
• Brain damage
• Cardiomyopathy
• Cancer of the tongue, mouth, or pharynx, hypopharynx, esophagus, and liver

These specific medical conditions show how extensive and pervasive the effects of heavy drinking are to health. The extent of damage is shown by the finding that the brains of some alcoholics after death are so soft, pulpy, and deteriorated that they are not suitable for dissection by medical students who need to study brain structure

.Main Source: National Drug Abuse Center for Training and Resource Development -- Drugs in Perspective

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