Alcohol and Tobacco: Health Effects and Management Strategies
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Understanding Alcohol and Tobacco Health Impacts
Hangover Treatment
The excitement stage of a hangover usually does not require specific treatment, only observation until the clinical picture disappears. In the comatose stage, urgent intervention is required, ensuring intravenous fluids and electrolyte balance.
Chronic Alcohol Intoxication
This condition results from regular, excessive alcohol consumption over an extended period. The consequences stem from the affectation of various systems and organs involved in the biotransformation, distribution, and elimination of ethanol at a physiological level:
Digestive Tract
- Chronic gastritis
- Changes in intestinal absorption, villous atrophy
- Altered gastrointestinal contractions in the middle third of the esophagus
- Increased intestinal permeability to macromolecules
- Mallory-Weiss syndrome and Boerhaave syndrome
Pancreas
- Acute and chronic pancreatitis
- Alcoholic pancreatopathy, which affects the synthesis and excretion of triglycerides
Circulatory System
- Alcoholic cardiomyopathy
- Alcohol-induced arrhythmias
- Ischemic heart disease
- Cerebral hemorrhagic stroke
- Hypertension
Social and Occupational Issues
- Family disorganization
- Marital conflicts
- Separation
- Family hostility
- Deterioration of interpersonal relationships with peers
- Work maladjustment
- Absenteeism and sick leave
- Job instability and job loss
- Job degradation
- Inability to work
Alcohol Withdrawal Syndrome
A rapid decrease in the body's alcohol content typically produces various physical manifestations in individuals who consume alcohol intensely and/or prolonged. Symptoms include:
- Intensification of hand tremor
- Insomnia and early motor restlessness
- Nausea and vomiting
- Anxiety
- Increase in blood pressure, heart rate, and body temperature
Symptoms typically begin 48-72 hours after the last drink and can last up to a week.
Potential Complications
Alcohol withdrawal may be complicated with:
- Delirium tremens
- Alcoholic hallucinosis
- Alcoholic paranoia
Alcohol Addiction Treatment
Following withdrawal management, psychotherapeutic treatment is established, based on individual, family, and group therapy. Alcohol-aversive drugs (interdictors) work by blocking alcohol metabolism through the inhibition of the enzyme aldehyde dehydrogenase. This produces an acetaldehyde reaction, accompanied by warmth, facial flushing, throbbing headache, increased heart rate, nausea, vomiting, hypotension, anxiety, and dyspnea.
Tobacco and Nicotine Effects
Tobacco Elimination Routes
There are four routes for the elimination of tobacco components from the body:
- Urine
- Sweat
- Breast milk
- Saliva
Nicotine
Nicotine is metabolized in the liver and lungs and excreted in the urine. It is a vasoconstrictor, elevating blood pressure and heart rate. It is the substance responsible for causing withdrawal symptoms and is what makes tobacco addictive.
Carbon Monoxide
Carbon monoxide is produced from tobacco combustion and is highly toxic, causing neurological and circulatory disorders.
Irritants in Tobacco
These molecules disrupt the defense and purification mechanisms of the bronchial mucosa and alveolar wall.
Tar
Tar accumulation is linked to cancer, being responsible for cellular tumor development.
Physiological Effects of Tobacco
While central nervous system (CNS) effects are primarily perceived by consumers, tobacco actually impacts various body systems and organs:
Central Nervous System
- Central nervous system stimulant
- Inhibits spinal reflexes, decreasing knee jerk
- Creates tolerance
- Stimulates the release of antidiuretic hormone
Cardiovascular System
- Bradycardia
- Increased blood pressure
- Peripheral vasoconstriction
Other Systemic Effects
- It increases the concentration of free fatty acids in plasma and may aggravate diabetes
- Inhibits prostacyclin synthesis
- High doses can cause nausea, vomiting, tremors, and convulsions