Does alcohol affect men and women differently? What about whether they're short or tall, heavy or slender?

The answer to that is yes. Alcohol does affect men and women differently. Part of it is because of their height and weight. Alcohol is water soluble so it is diluted in your body. With women being generally smaller and shorter, they will have a higher concentration of alcohol given the same amount to drink. There are a couple of other factors: women tend to have a little less water weight than men per pound, so the concentrations are even higher in women than just given their size. To even complicate it further, our stomachs are different and the absorption rates are different so women end up getting more alcohol and it's in a higher concentration. So they tend to get drunk faster and have a higher toxicity. The same is true but to a lesser extent for a smaller man.

What are the signs someone may have had too much alcohol to drink?

At higher concentrations, people's reaction times get slowed down, their voices can become slurred, they can raise their voices, there are emotional swings that can happen--either aggression, anger, or sadness--after that things begin to get a little physiological. The breathing starts slowing down, balance is affected, they can't track with their eyes as well, and, in extreme cases, one of the reactions is vomiting and if they've passed out and vomit, they can actually choke on their own vomit, which is a kind of disgusting thing to think about, but it can happen.

When someone drinks alcohol, what are the stages the body goes through to process the alcohol?

The alcohol first goes to the stomach where it's absorbed directly into the blood stream, so the effects are fairly fast and at that point it's transmitted all through the body, crosses the blood brain barrier, and washes the brain with the alcohol that's in the system. The higher the concentration of alcohol in the blood, the more alcohol gets into the brain and that starts shutting down sections of the brain, usually judgment first. Eventually it can, in alcohol poisoning, shut down the breathing centers, but that takes quite a bit. In the meantime, your body's liver is trying to get rid of the toxins from your system and so it's working overtime trying to get the poison out.

Alcohol affects the entire body. Can you briefly tell us the effects alcohol has on:

The brain?
As I said, it is a depressant and it tends to shut down areas of the brain, beginning in the more frontal areas where judgment is located. As the concentration increases for a prolonged period to time, other areas shut down and things like balance, reaction time, and vision get affected.

The way people look--their appearance?
When a person's drunk, they're usually lax, their faces are more lax, they're acting more relaxed to the point of being to too relaxed, almost rag dollish. Other than that, the effects on people's appearance come from not paying attention to your appearance.

The gastrointestinal tract?
Alcohol is extremely toxic, we pickle things with alcohol, and it's pretty hard on the gastrointestinal tract. It can cause cancer after long periods of time, and in shorter periods of time, can cause ulcerations or just holes to form because of the killing cells. It's mostly in the esophagus and stomach.

The reproductive system?
There are interesting effects--interesting though negative effects--on the male reproductive system. It seems to cause some cell death. It reduces potency, and causes changes in the male's testosterone and other reproductive hormones. It's not totally understood why that's the case, but it seems to have a fairly direct effect on men.

An unborn baby?
Alcohol can cross over to the baby. There's a relationship between alcohol and what's called fetal alcohol syndrome. That's sort of rare, but it is profound and we're not quite sure how much alcohol or when the alcohol is consumed (and it seems to vary by mother and child). There's one way to make sure it doesn't happen and that's not to drink when you're pregnant.

Many young people may believe the worst that can happen when drinking too much alcohol is a hangover. Is that true?

Certainly not! The hangover is probably the least of the things. Arrest is a big probability because people aren't behaving like their normal selves and the people around them aren't behaving like their normal selves.

Beyond arrest, there are the various physical problems that occur later on, like cancer in the gastrointestinal system. Then there's vehicular homicide, which no one plans on. There is the increased chance of assault and rape, both as the perpetrator or as the victim.

Then there's just the old fashioned addiction that can occur with long periods of use and there's no way of telling how quickly that works for one person or another. In other words, one person can drink for just a few years and become alcohol-dependent and another person can drink their entire lives without ever reaching that dependency. There's really no way of telling.

If your friend has had too much to drink, as a friend, what steps should we take to assure they will be okay?

For small amounts, probably making sure that the person makes it home and gets to bed is sufficient. Now, there's the problem that you don't always know how much your friend's had to drink or what their reaction is or how much tolerance they have; in which case it can be lethal. So paying attention to the person for several hours after their last drink probably is a good idea. Be sure they're on their side, not on their back, so if they get sick, there's a place for the vomit to go. Monitor their breathing. If there are any signs of problems that seem out of the ordinary, it is probably very wise to call paramedics--alcohol poisoning can be fatal .  

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