One doesn't need a crystal ball, or a degree in medicine, to know that alcohol affects the brain profoundly.
From the irrational behavior and talkativeness of the tipsy, through the slurred speech and the characteristic "drunken gait" of the acutely intoxicated, to the blackouts and memory lapses of the binge drinker, the evidence of deleterious effects of alcohol on brain function is glaring.

Apart from the acute manifestations of alcoholism on the brain, chronic alcoholism -- long-term indulgence in alcohol abuse, equally has its own baggage.

The argument usually posed by alcoholics is that alcohol, in small quantities, has some health benefits, notable among which is its cardio-protective [heart-friendly] function. While this is true, the bummer is the age-long question: how much is "small" ? Every alcoholic was once a "taster" who takes "just few sips", and then later "few gulps", "few bottles", until alcohol dragged him through the valleys of addiction to the gallows of dependence.

Addiction and dependence are also a testament of what grip alcohol can have on the brain. And once the brain is taken captive by alcohol, it becomes a roller-coaster ride to perdition, one that is self-perpetuated: the brain becomes so used to alcohol's "calming" effect on it, so used that slight withdrawal from alcohol sends brain cells into an overdrive as they agitate in protest for alcohol, triggering the so called withdrawal syndromes.

To prevent this from happening, the alcoholic finds himself compelled to be "topping his alcohol levels" continuously, setting the stage perfectly for chronic alcoholism and its attendant complications, which in the brain includes;

• Psychiatric disorders like major depression, and dementia.

and named syndromes like:

• Wernicke's Encephalopathy

• Korsakoff's Psychosis

And

•Marchiafava-Bignami disease.

These disorders are either due to the direct effect of alcohol on brain cells, or effect of alcohol on the liver [hepatic encephalopathy], or due to alcohol-induced nutritional deficiencies [example Wernicke-Korsakoff's syndrome due to thiamine deficiency]

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I'm already out of words but my post wouldn't be complete without a 'relatable' story. So please permit me to share this story.

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A BINGE TO COMA

About 10 days ago, or so, I was called for an emergency at about midday.

It was a middle-aged man, in his fifties, who was unresponsive and in deep coma.

The relatives who brought him knew next to nothing concerning his past medical history; they were called about 3 days earlier to come pick him up after he passed out at a bar following an alcoholic binge.

They had taken him home thinking he just needed to "sleep it off" and would be fine by the following day.

A day passed. Two. Three. And he was yet to regain consciousness, so they had to bring him to the hospital.

By the time I saw him, he was unresponsive, and the consciousness level was 8 on a scale of 15: coma! His blood pressure was not recordable, the pulse was barely palpable, the breathing pattern was erratic, and pupils reacted sluggishly to light.

I could not get any meaningful history as to whether there was any preceding illness; he was unmarried, with no child, and thus lives alone.

The only thing he was known for was drinking. He uses alcohol to rinse his mouth in the morning, swims in it during the day, and bathes with it at night before going to bed. No farm to work on, no paying job, and no food.

The risk factors for Wernicke's encephalopathy were glaring. In attempt to rule out other possibilities, the blood sugar was okay, the liver seemed okay, and the HIV test came out negative. All the other tests we did [could do rather] checked out fine.

While examining him, I noticed a punctured vein. In alarm I asked what it was used for, and they said they had called a CHEW who was giving him a dextrose infusion [sugar-containing drip] at home! And my heart sank. Giving a chronic alcoholic a glucose infusion, without first correcting the apparent thiamine deficiency, could worsen the situation and lead to severe brain damage. But he had to be alive first, so his brain function was not my major concern then.

So, I made an assessment [diagnosis] of "Hemodynamic shock [querry cause] on a background of chronic alcoholism; keep in view Wernicke's Encephalopathy", and started aggressive resuscitation with normal saline drip, and B'complex infusion [ as we didn't have Vitamin B1 (thiamine).

Within 2 hours the blood pressure was up, the pulses were palpable, and he had started making urine; and over 3 days, he slowly regained full consciousness.

With the regain of full consciousness, it was obvious that his brain functions were severely affected, and that the diagnosis of Wernicke's Encephalopathy was right as he had a broad-based staggering gait while walking, and had lost some of his executive functions and was mostly confused.

The major problem became how to get him the much needed thiamine, and in time, before he progressed to the end of the spectrum and develops the more permanent Korsakoff's psychosis.

It took up to a week before we could get him thiamine [ did that just yesterday; had to travel out of the state], but while we waited, we were giving him B'complex and multivitamins, which was probably what kept him this long, and what caused the little improvement in brain function noticed so far.

We can only hope he regains HIS FULL BRAIN FUNCTION, but with the initial dextrose infusion, and the delay, the prognosis looks bleak.

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CONCLUSION

It's already a LONG read, so I will make the conclusion simple:

1. Alcoholism and drug abuse ruins your mind and your body.
2. If you must drink, drink responsibly and eat well.

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Thanks to @AIR-CLINIC for this platform.

JOIN AIR-CLINIC AND LIVE RIGHT.

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Thanks for reading.
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Doc. Joe