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ALCOHOL AND THE BODY: CUMULATIVE EFFECTS

The immediate effects of the drug alcohol have been described. With continued drinking, changes take place. There are cumulative effects. Any drinker, not only the alcoholic, can testify to this. The first few times someone tries alcohol, with one drink they feel tipsy. With drinking experience, one drink no longer has that effect. In part this may reflect greater wisdom. The veteran drinker has learned "how to drink" to avoid feeling intoxicated, that is, by not chugging a drink or not drinking on an empty stomach. The other reason is that with repeated exposure, the CNS has adapted to the presence of alcohol. It can tolerate more alcohol and still maintain normal function. This is one of the properties that defines alcohol as an addictive drug. Over the long haul the body requires a larger dose to induce the effects earlier produced at smaller levels. Not only does this adaptation occur over long spans of time, there are also rapid adaptive changes in the CNS every time someone drinks. A drinker is more out of commission when the blood alcohol level is climbing than when it is falling. If someone is given alcohol to drink and then performs certain tasks, there are predictable results. Impairment is greater on the ascending limb, or absorption phase. As the blood alcohol level drops in the elimination phase, the individual will be able to function better with the same blood alcohol content. It is as if one learns to function better after "practice" with the presence of alcohol. In fact what probably has happened is that the brain has made some subtle adjustments in the way it functions. Here, too, there are differences between men and women. Both have more impairment as alcohol levels rise, but there are differences in the kinds of impairment. With intoxication, women appear to have greater impairment than men for tasks that require motor coordination. Yet, they are superior to men on tasks that require attention. Since driving requires both skills, neither appears the better bet on the highway.

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