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This condition is reversible, but if the heavy drinking continues a different
kind of damage occurs. Liver cells begin to die off, and are replaced by scar
tissue. The beginnings of this irreversible process can be seen long before it
reaches the disease stage known as cirrhosis. As living liver tissue is replaced
by scars, the liver is less and less able to produce energy and lter impurities
(including alcohol) from the bloodstream.
The Immune System
Alcohol decreases the body’s ability to ght off diseases and infections. The
immune system — the body’s defense — works less efciently whenever a
person drinks, and over a period of heavy drinking the body’s defenses can
be greatly weakened. As a result, the person becomes more vulnerable to
infections, cancers, and other illnesses. The risk of cancers in general among
heavy drinkers is twice that of other people. Sores and injuries tend to heal
more slowly, and it becomes harder to shake off sickness.
The Reproductive System
Alcohol has clear negative effects on the reproductive system. In men, drink-
ing decreases the body level of testosterone, the primary male hormone, If a
man drinks heavily for a period of time, this loss of testosterone can result in a
“feminization” of his body — the loss of body hair, enlargement of fatty tissue
in the breasts, and a shrinking of the testicles. Heavy drinking can also contrib-
ute to sexual problems such as impotence.
In women, heavy drinking has been linked to increased rates of sexual,
menstrual and other gynecological problems. Alcohol also changes sex hor-
mone balances in women, and can promote a loss of feminine body character-
istics. Heavy drinking during pregnancy has been clearly linked to increased
rates of miscarriage and stillbirth, and to birth defects, behavior problems, and
mental retardation of children exposed to alcohol in the womb. Alcohol con-
sumed by a pregnant woman directly affects the fetus, and there is no known
safe level of drinking during pregnancy.
Summary
In short, once alcohol is consumed, it is rapidly distributed throughout the
body, where it affects virtually every organ system. There are no proven
benecial health effects of drinking, but there are many proven harmful effects
of heavy drinking. Many of these damaging effects can be reversed, at least
partly, when a heavy drinker stops drinking. In general, the longer the period of
heavy drinking, the less reversible the damage, but quitting usually results in
improved health and tness, even after many years of excess.
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Social and Psychological Problems
The damaging physical effects of heavy drinking are only part of the picture.
Heavy drinkers are also at risk for many other kinds of problems.
Risk-Taking and Accidents
Alcohol-related accidents and violence are the leading cause of death
among Americans under the age of 35. How can this be?
There are several reasons. First, as many people know, drinking makes a
person less in control. Alcohol, even at levels well under the “legal limit” can
cause dangerous changes in a person’s ability to react, to control muscles,
and to perceive the world accurately.
These changes are made all the more dangerous by something else that
happens when a person drinks. Among the rst things to be changed by al-
cohol is a person’s judgment. Experienced race drivers, for example, become
much poorer drivers after even a few drinks, but may actually perceive them-
selves to be better drivers under the inuence of alcohol. In short, a person
cannot tell how much he or she is being affected. You can’t judge when your
judgment is affected!
These judgment changes, in turn, often make a person overcondent, and
more likely to take foolish risks. After a few drinks, people are less able to
make good decisions, and are more likely to do things they would never do
while sober. Sometimes the result is only embarrassment, but other times it
is much more serious. A majority of people in prison, for example, commit-
ted their crimes while under the inuence of alcohol. When drinking, people
are more likely to misjudge others as threatening or challenging them, and
to react impulsively, aggressively, even violently. Other misjudgments can be
disastrous as well. Tens of thousands of deaths and hundreds of thousands
of injuries happen each year because people drink before driving vehicles,
using power tools or rearms, or engaging in fun but hazardous sports such as
swimming, boating, or skiing — activities where even a small misjudgment can
be very dangerous.
Mood
Drinking also affects mood. After one or two drinks, some people feel hap-
pier, more relaxed, less tense and anxious. Interestingly, these same changes
happen when people believe they are drinking alcohol, even if they are not.
Alcohol itself is a depressant drug, and its effects, in heavier doses at least,
are to turn good feelings bad, and to make bad feelings worse. After several
drinks, mood tends to take a turn for the worse. It is around this same
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