Nutrition & Diets

INTRODUCTION

The two-carbon alcohol ethanol, CH3CH2OH, is a CNS depressant that is widely available to adults; its use is legal and accepted in many societies, and its abuse is a societal problem. The relevant pharmacological properties of ethanol include effects on the gastrointestinal, cardiovascular, and central nervous systems, effects on disease processes, and effects on prenatal development. Ethanol disturbs the fine balance between excitatory and inhibitory influences in the brain, producing disinhibition, ataxia, and sedation. Tolerance to ethanol develops after chronic use, and physical dependence is demonstrated on alcohol withdrawal. Understanding the cellular and molecular mechanisms of these myriad effects of ethanol in vivo requires an integration of knowledge from multiple biomedical sciences.
HISTORY AND OVERVIEW

Alcoholic beverages are so strongly associated with human society that fermentation is said to have developed in parallel with civilization. Indeed, there is speculation that human alcohol use is linked evolutionarily to a preference for fermenting fruit, where the presence of ethanol signals that the fruit is ripe but not yet rotten (Dudley, 2000) (the terms ethanol and alcohol are used interchangeably).

The Arabs developed distillation about 800 C.E., and the word alcohol is derived from the Arabic for “something subtle.” Alchemists of the Middle Ages were captivated by the invisible “spirit” that was distilled from wine and thought it to be a remedy for practically all diseases. The term whiskey is derived from usquebaugh, Gaelic for “water of life,” and alcohol became the major ingredient of widely marketed “tonics” and “elixirs.”

Although alcohol abuse and alcoholism are major health problems in many countries, the medical and social impacts of alcohol abuse have not always been appreciated. The economic burden to the U.S. economy is about $185 billion each year, and alcohol is responsible for more than 100,000 deaths annually. At least 14 million Americans meet the criteria for alcohol abuse or alcoholism, but medical diagnosis and treatment often are delayed until the disease is advanced and complicated by multiple social and health problems, making treatment difficult. Biological and genetic studies clearly place alcoholism among diseases with both genetic and environmental influences, but persistent stigmas and attribution to moral failure have impeded recognition and treatment of alcohol problems. A major challenge for physicians and researchers is to devise diagnostic and therapeutic approaches aimed at this major health problem.