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a word about B O O Z E

By | August 11, 2010

one thing you might not know about dr. leigh is she is very sympathetic to the lives of teenagers. (“teenagers,” of course, referring to those of any age who are regarded by grownups as having “no real responsibilities”.)

teenagers live in a liminal space where, it turns out, love is the most important thing. art, in some form, is likely to be the next most important. everything they do may ultimately be in the service of art or love. what they wear, how they pray, their music, their rages, their terrible mistakes.

unfortunately, without the ballast of “real responsibilities”, some teenagers act a fool.

dr. leigh has a number of teenaged friends [of any age] who booze it up a lot. as a physician, she naturally feels that this is very bad behavior. however, as a mother, her primary concern is risk reduction. (you see how readily the physician and the mother exchange priorities!)

some of these teenagers will become hardcore drunks. i hope not! but it happens. dr. leigh spends a suprising amount of time coaching people to not be afraid of alcoholics anonymous. after all, it’s anonymous! and it can totally help you stop ruining your life.

but anyway, here are some of dr. leigh’s tips on how to manage your booze consumption, you silly teenagers.

number one:
do not get in a car with a drunk driver.

number two, three, four, five:
do not get in a car with a drunk driver.

corollary: do not ride in the trunk of a car with a drunk driver, alone or with company, even in the summertime.

do not BE a drunk driver, goes without saying, and the bartender and your friends will probably remind you that, for example, you will never get malpractice insurance ever in your life if you have a DUI on your record. hopefully, they’ll take your keys. laugh nicely. tomorrow is another day.

a little science lesson about booze:

alcohol blocks the effects of catecholamines (“catta-COLE-a-means”) in the brain.
catecholamines are like adrenaline, made by the adrenal glands. they maintain your heart rate and blood pressure and muscle activity and so on – all that “fight or flight” ability. they function as neurotransmitters in the brain, too, helping with attention and interest and alertness, etc.

when you drink every day, your levels of catecholamines are unusually low, so your body compensates by making extra.

then when alcohol is not in your system, your body is exposed to unusually high levels!
example: a drunk gets the shakes in the morning (like with too much adrenaline), and makes them go away by drinking. we have all seen this.

example: a drunk gets in a car crash and is unconscious in the ICU, and nobody knows they are a drunk. they go into alcohol withdrawal and have seizures. this is caused by too much catecholamines. i have personally seen this several times – it’s very dangerous.

this is why i tell hardcore drunks not to quit cold turkey unless they are in the hospital, where they can get medicine.
what medicine? we give them valium. it works the same way alcohol does! (and that is why it is also very dangerous to withdraw cold turkey from valium: seizures.)

booze is also pure carbohydrate – similar to just eating spoonfuls of white sugar. your body makes extra insulin to cope with it. then when you are undernourished during the day (skipping meals, etc), your blood sugar drops too low because of higher insulin + no nutrition. makes you feel shaky and weak. this is also why people get “beer bellies” – stored fat because of too many empty calories, including fat building up in the liver.

booze is also dehydrating. you know how it makes you pee a lot? it’s a diuretic. if you are not well hydrated, your blood volume is low, and you are more sensitive to drops in your blood pressure, which can make you feel faint and dizzy, and give you flashes and sweats.
other things that are dehydrating: caffeine, nicotine.

last problem: booze in the bloodstream impairs absorption of thiamine, vitamin b1 (from food).
thiamine is needed to make energy from blood sugar.
deficiency causes nerve damage, including brain damage. this is why long-term, hardcore drunks appear to be brain damaged, walk funny, can’t talk right, swimmy eyes, etc.
(this is a completely separate issue from brain damage caused by liver failure, which can also occur.)

DO NOT PANIC
the take-home message is, if you are drinking a lot, you really need to compensate for all these issues with good hydration and nutrition.
– small frequent healthy high-protein (low-carb) snacks, instead of infrequent jumbo starch-and-fat-based meals
– 2 liters of water per day, instead of 2 liters of coffee and booze per day
– daily multivitamin with minerals, including magnesium (all multis have thiamine in them)
– cut down gradually on booze, by alternating a pint of water in between each drink.

(i find that when one becomes intoxicated, one keeps habitually picking up the glass and tipping it. this can cause you to drink more than you intended. protect yourself from this automatic drinking-rhythm by always always asking for a large glass of water with your drink, and don’t go back to the bar or fridge until both drink and water are gone.)

also, don’t go to bed drunk! watch the clock and stop boozing 2 hours before bed! switch to water from that point onward. you will be very glad, next day, that you did so.

also, teenagers, please: review your safe sex guidelines, and always carry your safety pack: condoms + a cell phone with taxicab number on speed-dial + a $20 bill you will never use for anything other than rescue.

if you wake up wondering how you got home (or how you got… wherever) – well, you know what it means. i’m not judging you. but let’s talk.

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