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A firsthand look at what happens when you drink too much
By: Bob Drury
What havoc did New Years Eve and all those office parties wreak?
Men's Health sent an intrepid reporter, as a public service mind you, to simulate a round of end-of-the-year partying. Indulge the way we all do during those dizzying two weeks between December 15 and New Year's Eve, and see what really happens inside your body. It's not a wives' tale...
This is silly. No, this is stupid. I mean, I enjoy a cocktail as much as the next guy. But I never drink like this. Seven straight nights. A conflated period of excessive imbibing.
The premise: Simulate a round of end-of-the-year partying. Indulge the way we all do during those dizzying 2 weeks between December 15 and New Year's Eve. It's not a wives' tale. According to surveys conducted by the Centers for Disease Control and Prevention, Americans in general—all races, all creeds, both sexes—drink more in December than any other month. We're a nation of Christmas sots.
There are the obvious ways alcohol kills—40 percent of traffic fatalities involve alcohol—but that isn't my focus. (I don't drive all week.) My aim is to quantify the cumulative physiological effects of a weeklong binge. Take the lessons I've learned to heart this holiday season. Remember them on St. Patty's Day or at your next tailgate. Gentlemen, make no mistake: We're killing ourselves here. Slowly, yes, but as surely as by drinking and driving.
The Morning After
I'm sitting in the office of Anthony Verga, M.D., who's none too pleased. "Alcohol is a toxic substance," he says. "Physiological functioning cannot occur when it's present. This experiment you've performed during this compressed period of binge drinking [defined as having five or more drinks in one sitting] will have long-lasting effects on your organs. Shall we count the ways?"
Dr. Verga is the soft-spoken medical director of the Seafield Center for Alcohol and Substance Abuse in New York, and supervising psychiatrist at the New York Diagnostic Centers. My bender ended 2 days ago, and I've come here for the postgame show. Initially, he's bemused at the premise. But as I recite the lengths (depths?) to which I have gone in the name of research, I'm convinced he thinks me insane. The first clue is his inflection on the word "experiment."
"Okay," he says, "I see you limping in here. You tell me you've been diagnosed with gout. So let's start with your kidneys."
Dr. Verga tells me that excessive alcohol consumption is a common precursor to gout, a form of arthritis to which American males are particularly susceptible. What basically occurred, he explains, is that a hiccup in my metabolism—i.e., the ingestion of 16 ounces of tequila in 1 night—resulted in an overproduction of uric acid in my blood.
My pickled kidneys were stymied, so the surplus hardened into microscopic crystals—like tiny spears of jagged, broken glass—which lodged in the joint of my right big toe.
Next, I ask him if it's true that you lose brain cells every time you take a drink. "Nobody can say, 'For every 2 ounces of alcohol you drink, you lose 10,000 brain cells,' " he says. "But acute alcohol ingestion can kill brain cells. It's just a question of how many. And they won't regenerate."
He asks about my stomach. "Does it hurt?" Well, now that you mention it. . . . "Alcoholic gastritis is definitely an acute effect of alcohol intoxication," he says. "The blood vessels become irritated, and they bleed in your stomach. It will knock you on your rear end."
My hemorrhoids are acting up again
Speaking of which, he mentions hemorrhoids. They occur when, through chronic overindulgence, the pressure backs up in your liver. "Cirrhosis is the hardening of this very pliable organ," Dr. Verga says. "In the process, the overall diameter of the liver's blood vessels diminishes, making it more difficult to push blood, to cleanse it, through the organ. Think of water forced through a 5-inch hose. Suddenly you're pushing the same amount of water through a 3-inch hose. That pressure backs up. Other veins, to help dissipate the pressure on the liver, begin to bulge. You get hemorrhoids. You also get esophageal varices."
Esophageal, huh?
"Esophageal varices. Varicose veins at the bottom of the esophagus. Sometimes they burst. The blood just gushes. From the mouth. The nose. Bloodshot eyes. It's chaos. Within 30 seconds, it looks as if blood is pouring out of every orifice. If I could have everybody who binge drinks in attendance with me as I deal with a case of burst esophageal varices, I could cure alcoholism overnight." (Binge drinking and chronic alcoholism are different animals, but the former is a symptom of the latter.)
Then Dr. Verga's tone turns serious. "Ever hear of alcoholic congestive cardiomyopathy?"
"Sure, comes up in conversation every day." He ignores this.
"Here's the deal: The heart is a muscle, and we know that acute alcohol ingestion can weaken muscle. The more alcohol, the weaker the heart becomes. It cannot pump blood as effectively. When it can't pump blood effectively, there's a backup of fluid into the lungs. You are in a situation, initiated by alcohol, that resembles congestive heart failure."
Wait a second here. I mention the countless studies that suggest alcohol is good for the heart. I bring up a French study that concluded that one or two drinks a day—especially red wine—reduces the risk of heart attack.
Aha! I swivel (hemorrhoid-free) in my chair, confident in my small victory.
Dr. Verga is unimpressed. If you read the fine print, he explains, you'll see a key phrase: Alcohol can reduce heart-attack risk in those with heart disease. As in, already sick. Alcohol is a poison, but it's less bad for you than the fatty plaque building up in your arteries. An analogy would be radiation treatment. It's not healthy. But when the alternative is cancer, well, it's proportionately less bad.
It's in Your Genes
Hobbling to my Jeep, I realize I'm a bit confused. After all I have just learned, after everything I now know I've subjected my body to, why do I feel like picking up my tattered copy of Borstal Boy and heading to a dark bar? I hope Gene-Jack Wang, M.D., will have the answer. Dr. Wang is the clinical head of the Positron Emission Tomography Group at the Brookhaven National Laboratory's Center for Translational Neuroimaging. Known for its work with the U.S. Department of Energy, Brookhaven is also at the forefront of biomedical research.
"Alcohol tolerance? Alcohol addiction? Alcohol cravings?" Dr. Wang is warming to the subject as he escorts me into his office. "It's all genetic. It's all evolution."
To illustrate, he tells a story. Did I know, he asks, that a disproportionate number of Asians do not possess the enzymes in their livers to metabolize alcohol? "It's a very toxic effect. Me, I cannot drink. A small half glass of beer is okay. A full glass, I fall asleep. My grandfather only had to smell alcohol to fall asleep."
I ask Dr. Wang why, even understanding alcohol's damaging effects, we insist on returning to the well, liver enzymes or not.
It's here that we get to the crux of the matter. Using positron emission tomography (PET), in which a camera records images of brain function, Dr. Wang and his associates have conducted studies probing our cravings for psychostimulants like cocaine, methamphetamines, opiates, and alcohol. His studies are far from complete, but all results point to dopamine receptors in the midbrain. Dopamine is one of the brain's neurotransmitters, facilitating communication between cells. Dr. Wang and his colleagues studied one strain of dopamine receptors, the D2 family, which are found in the part of the brain that controls "wellness, reward, and good feelings," he says.
In one study, they found that individuals with low levels of D2 receptors had a pleasant response to a psychostimulant, while those with high levels had an unpleasant reaction. Further, in experiments with rats, they found that when they injected into the alcohol-addicted animals a virus that increased their D2 receptors by 50 percent, the rats subsequently spurned any alcohol. "By the time their receptors decreased back to baseline," says Dr. Wang, "they were craving alcohol again." Dr. Wang stresses that we're only beginning to understand the role of dopamine in the brain. So no, we won't soon be able to buy a pill to raise our levels of D2 receptors. But that's the promise of this research: a vaccine for alcoholism.
Until then, I am simply left to curse, or toast, the inherited genes of my Irish forebears.
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Old's cool.
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