Friday, June 4, 2010

Alcohol: Risky Business For The Brain

By Lisa A M Bauman

Imagine sitting by the sea sipping a margarita without a care in the world. Now imagine each sip traveling through your body making signals to your brain that cause a chain reaction. Our bodies are working everyday in ways far beyond our imagination. Alcohol can harm many parts of the body, but its effects on the brain are frightening. Because of societal pressures and lack of awareness about the effects of alcohol consumption in the brain, many people do not know that alcohol can quickly and permanently kill brain cells even if the person is not an alcoholic. This lack of self-awareness can be life-altering when combined with alcohol abuse. It is important that when you drink you fully understand the risks and responsibilities involved with alcohol consumption and use this information despite the influences of peers and cultural pressures. The affects of alcohol in the brain, the scope of the problem, and the long term consequences involved in drinking alcohol are worthy of examination.

A person becomes intoxicated when they ingest ethanol, which is a generic term for alcohol. This ethanol is produced through fermentation from many types of foods ("Alcohol Intoxication"). Fermentation is possibly the oldest chemical technology in world and is believed to be first discovered a millennia ago by Middle Eastern and Far Eastern cultures. Since after the first century A.D, distillation has been used to provide an even purer form of ethanol ("Alcohol History"). It is a simple reaction that occurs when yeast metabolizes sugars in fruits, vegetables, honey, molasses, or grains and produces ethanol as a byproduct ("Alcohol History"). The most common recipes today include barley, hops, and grapes ("Alcohol Intoxication").

Alcohol abuse affects American society greatly. Americans commonly drink alcoholic beverages at social gatherings and overlook signs of alcoholism in themselves and their friends. Nearly fourteen million Americans abuse alcohol or are alcoholic. According to several national surveys, about ninety-two percent of US adults report binge drinking “within the last month” ("Alcohol and Public Health"). From the 100,000 US deaths in 2001, 19,817 were alcohol-induced and 27,035 were from alcohol related chronic liver disease and cirrhosis. This means that up to forty-seven percent of American deaths each year can be related directly to alcohol consumption ("Statistics about Alcoholism").

In addition to the direct effects alcohol abuse can cause to the brain, there are significant indirect effects. Brain damage can occur as an effect of alcohol consumption even if the victim has not ingested alcohol. For example, an unborn child can suffer brain damage if the mother consumes alcohol, injury can occur during drunk driving accidents and other acts of poor judgment, or harm can be done by violence caused by an intoxicated person. Damage can also occur when alcohol consumption alters the immune system and hormones and create substances that travel through the bloodstream to the brain. Alcohol can indirectly damage the brain due to alcohol-induced deficiencies in nutrition and liver disease. (Boggan).

It is important to understand the types of use that are considered abuse when discussing the negative effects of alcohol in the brain. Many people believe that because they are not alcoholic that they are not abusing alcohol. Moderate drinking in America is usually defined as men who drink no more than two drinks per day and women and people over sixty-five years of age who drink no more than one drink per day. One drink is considered to be twelve ounces of beer, five ounces of wine, or 1.5 ounces of eighty-proof distilled spirits ("What Is Alcohol Abuse?").

There are several types of alcohol abuse: at-risk use, alcohol abuse, and alcohol dependence. At-risk use means that the person is consuming alcohol in a way that has the risk of leading to another form of more serious alcohol abuse. When a man has four or more drinks a day or a woman or person over sixty-five years of age has more than three drinks a day, all are considered to be at risk ("What Is Alcohol Abuse?").

Although physical dependence is not an aspect of alcohol abuse, if it is not treated it can lead to alcohol dependence. Alcohol abuse can be identified by several symptoms. Alcohol abusers may have difficulty carrying out major responsibilities at work, school, or home, they may drink in physically dangerous situations and while driving, or they may have legal problems related to using alcohol. Another sign alcohol abuse is that the abuser continues drinking despite ongoing problems that are caused by drinking ("What Is Alcohol Abuse?").

One very dangerous form of alcohol abuse is binge drinking. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Advisory Council defines binge drinking as a "pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 gram percent or above." In general men who consume five or more drinks, or women and people over sixty-five years of age who consume four or more drinks in two hours are considered to be binge drinking ("What Is Alcohol Abuse?").

The most damaging long-term form of alcohol abuse is alcohol dependence, or alcoholism. There are many symptoms of alcoholism. The first sign is an alcohol tolerance. This causes the drinker to require increasing amounts of alcohol to produce the same effect. After an absence of alcohol in the body, the alcoholic may suffer withdrawal symptoms, such as shakiness, sweating, nausea, anxiety, and depression. Alcoholics may use alcohol to relieve or avoid withdrawal symptoms or may find themselves drinking larger amounts and for longer than they intended. The alcoholic may become obsessed with the consumption of alcohol by dedicating an excessive amount of time obtaining alcohol, drinking it, and recovering from it. They may even reduce leisurely and work related activities to enable more time for drinking. Finally, despite the negative effects that alcohol is creating, alcoholics are unable or unwilling to quit. If a person has three or more of these symptoms within a year he or she is considered to be an alcoholic ("What Is Alcohol Abuse?").

The brain controls all the systems in the body. To understand how alcohol interferes with brain processes one needs to know how a normal brain functions. Each area of the brain is used for different processes. The cerebellum is involved with coordination, the frontal cortex is used for cognitive processes, the occipital lobe is for vision, and the temporal lobe is used for hearing. Each part of the brain is connected together with nerve cells called neurons which enable the brain to communicate between each brain area. This complex system is estimated to contain 100 billion nerve cells (Boggan).

Between nerve cells there is a small gap called a synapse (see Fig. 2) and chemical signals called neurotransmitters (NTs) are used for transmission of information between neurons. Neurotransmitters travel across this synapse and bind to a receiving neuron's receptor site. This site is specifically designed for the unique neurotransmitter. The action causes some change in the receiving cell, which will excite it or inhibit it from performing an action. "Though there is usually only one or two NTs released from a particular neuron, numerous NTs bind to each neuron and their collective action determines the overall response of the neuron (Boggan)."

As a person increases their intake of alcohol their symptoms of impairment from intoxification increase. The first sign of intoxification is disinhibition which is often demonstrated by loud talking, laughing or lack of social awareness ("Alcohol Intoxication"). Because of this symptom, many people associate alcohol with amphetamines (Boggan; Dekker). Although disinhibition may appear to be an excitatory effect, it is not (Boggan).

The next symptoms are loss of memory, confusion, and disorientation. A person's movements will become uncoordinated and the symptoms will start to become progressively lethargic. If the person continues to ingest alcohol, he or she may go into a coma and even die because the respiratory centers completely shut down ("Alcohol Intoxication"). The succession of symptoms illustrate that increasing ingestion causes a progressively more severe depressant state in the brain and body.

Every system in the body is affected when alcohol is consumed and the effect starts at the brain. Let's look at several specific areas of the brain that are affected to understand the impact. The limbic system controls memory and emotions. Alcohol affects this part of the brain by causing memory loss and exaggerated states of emotion. The cerebellum coordinates muscle movement. When alcohol affects the cerebellum, muscle movements become uncoordinated. The medulla, or brain stem controls body functions that occur automatically, such as the heart rate, temperature, and breathing. When alcohol affects the medulla, a person will start to feel sleepy (Boggan).

This intoxified state impairs mental and physical abilities. When alcohol is introduced to a neuron's synapse, the normal neurotransmission is affected and impairment occurs. Alcohol interferes with the communication between nerve cells by interacting with their receptors in the brain ("Alcohol Intoxication"). Alcohol’s molecules fit neatly into receptor sites and appear similar enough to corresponding inhibitory neurotransmitters that the body responds by increasing inhibitory nerve pathway activity. In other receptor sites, the molecules fit just enough to block the intended excitatory neurotransmitters and deny natural excitatory body functions from taking place (Boggan; Dekker).

Alcohol affects four major neurotransmitters in the brain: glutamate, gamma aminobutyric acid (GABA), dopamine (DA), and serotonin. Glutamate is the major excitatory neurotransmitter in the brain. When ethanol is introduced to this system, it inhibits glutamate receptors and reduces their excitatory actions. GABA is the brain's major inhibitory neurotransmitter. Ethanol acts on GABA's receptors as well, but enhances its natural inhibitory effect (Boggan). In addition to the dramatic inhibitory affects caused by these changes in both types of receptors which make the natural neurotransmitters unable to bind to neurons, this combination appears to be the cause of a person's development tolerance to and dependence of alcohol. Additionally, dopamine and serotonin are involved in reward processes in the brain and are believed to give the drinker a feeling of reward when ingesting the drug (Boggan).

When a person incurs brain damage caused by alcohol consumption, it is called alcohol related brain injury (ARBI). People with this type of brain damage may experience memory problems, poor cognitive abilities, physical incoordination, and “a range of medical and neurological disorders.” The cycle of brain injury begins when alcohol takes its toxic effect on the central nervous system. It leads to a change in metabolism, heart functioning and blood supply, and drastically interferes with the absorption of vitamin B1 (thiamine). Thiamine is an important brain nutrient. The inability to absorb it can lead to poor nutrition, dehydration, and the loss of brain cells (“Alcohol and Brain Damage”).

Most research about alcohol's affect on the brain has been done on chronic alcoholic patients. Only recently have studies been popping up that find insight into the damage that can occur in light drinkers, binge-drinkers, and non-alcoholic, heavy drinkers. In a recent study commissioned by Alcoholism: Clinical and Experimental Research (ACER), the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism, frontal white brain matter, which is associated with lower executive and working memory functions in the brain, was found to be lower in heavy drinkers than light drinkers (see Fig. 3). Dr. Dieter J. Meyerhoff explains that "Although the men and women who drank heavily for many years demonstrated fewer changes in brain metabolites than do alcoholics in treatment, the abnormalities that we found are nonetheless associated with lower brain function." Lower cognitive functioning can affect daily living routines in ways that may be too gradual for the person to notice, but will considerably interfere with basic "cognitive processes such as decision making, planning, regulation of emotion and motivation, memory, and motor control (Blumenfeld et al)."

It is very possible for someone to suffer brain damage over a short period of time from aggressive binge drinking, especially if the binge drinking results in alcohol poisoning. Rapid intake of alcohol can cause a more concentrated ethanol distribution in the brain to increase because the body in unable to metabolize it at the rate that it is ingested. This causes BAC level to rise. Alcohol begins to work its depressant or inhibitory effect immediately in the system. It mostly affects the frontal lobe and cerebral cortex. When a person suffers alcohol poising alcohol's affect begins to move into the brain stem. This is the most insensitive part of the brain, but the most crucial for survival since it is responsible for maintaining heart rate, respiration, and digestion. As alcohol concentration increases in the body, the brain stem begins to shut down and die ("Alcohol and Brain Damage;" Sullivan).

There are several types of brain damage that can occur through any form of alcohol use and abuse. Cerebellar atrophy can occur when damage takes place in the cerebellum. This is often called ataxia or cerebellar degeneration ("Alcohol and Brain Damage"). This happens because neurons in the cerebellum deteriorate and die. The most characteristic symptom of cerebellar degeneration is a "wide-based, unsteady, lurching walk, often accompanied by a back and forth tremor in the trunk of the body.” Other symptoms may include slow, unsteady and jerky movement of the arms or legs, slowed and slurred speech, and rapid, small movements of the eyes ("Cerebellar Degeneration Information Page").

Other types of brain damage cause memory and cognition problems and physiatric issues. As during acute intoxication with many recreational drugs, alcohol consumption and blood alcohol level can cause frontal lobe dysfunction (Espay). This damage results in cognitive difficulties with abstract thinking and planning. Hepatic encephalopathy, another form of brain damage, causes psychiatric symptoms, mood changes, confusion, and hallucinations. Hepatic encephalopathy has been known to occur especially in patients with alcohol related liver disease.

In addition to alcohol's affect on cognition, the brain can send painful signals to the body if it has been damaged due to alcohol's affects on the nerves. Peripheral neuropathy, often referred to as alcoholic neuropathy, is a form of brain dysfunction that causes the body to be affected by numbness, pain, and a feeling of pins and needles. It is caused by the affect of alcohol's widespread damage to nerve tissue by disabling the body's ability to absorb nutrients, especially thiamine, which is essential to healthy nerve function ("Alcohol and Brain Damage;" "Peripheral Neuropathy Fact Sheet").

Wernicke-Korsakoff syndrome is a two-stage brain disorder caused by an alcohol induced thiamine deficiency. Thiamine is needed for cells to generate energy from sugar. If thiamine levels drop too low, this ability ceases. Wernicke encephalopathy is the first phase and Korsakoff psychosis is the second chronic stage of the disorder. Symptoms of the Wernicke-Korsakoff syndrome include confusion, permanent gaps in memory, problems with learning new information, vision impairment, stupor, coma, hypothermia, hypotension, ataxia, and confabulation ("Alcohol and Brain Damage;" "Wernicke-Korsakoff Syndrome Information Page"). Confabulation is a symptom where patients make up stories to fill the missing gaps in their memories. They may not be lying, but actually believe the newly created memories (HealthCentral.com).

Early detection and treatment can reverse some of the damage, but the majority of alcohol related brain injuries are permanent. Recovery from this form of brain damage in alcoholic patients is limited because the problem is compounded by deficiencies in nutrition and the inability of the body to retain necessary nutrition for the repair due to the damage caused by alcoholism. Alcohol abuse can lead to nerve damage, liver function damage, and the inability to absorb several B vitamins that are essential in neuron health (Alz.org).

Since the 1960's researchers discovered that contrary to common belief adults can grow new brain cells. This was facilitated by the discovery of stem cells which can divide infinitely. This new information is leading to research for new treatments that can be made for children born with down-syndrome and people who suffer from alcohol related brain damage. Still, more research and testing needs to be done before treatments become available ("Alcoholic Brain Damage").

Our culture promotes drinking and leaves the impression that it is a harmless and fun activity. Drinking alcohol is more than a leisurely activity, it is a serious health risk. Alcohol immediately affects the brain when ingested and can cause brain damage even when the user is not an alcoholic. In addition, alcohol can be responsible for brain damage from deadly circumstances created by others who are drinking. It is important that when you drink you understand how to advocate for your own health through a real understanding of the risks involved with consuming alcohol despite the influences of peers and cultural pressures.

Works Cited
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*** Research Essay for WR123: Research Writing Class, Instructor Linda Spain, Linn-Benton Community College, Spring 2010

Thursday, June 3, 2010

LBCC Houses The Gladiators of Writing Support

LBCC Houses The Gladiators of Writing Support
Written by Lisa AM Bauman
Contributing Writer & Assistant Sales Director for The Commuter
Ever get that kind of help in your studies that makes you feel like Spiderman just swung in from a building, rescued you, and set you down onto solid ground? OK, that may sound a bit dramatic, but if you have ever been really struggling and someone knew just what to say, then you know how empowering that can feel. This is exactly what the Writing Center aims to do and they have been backing it up with gladiator-like training.

Victoria Fridley, the Writing Center Facilitator has devised a training program for student assistants with the help of other faculty and advice from OSU's Assistant Director and Writing Center Coordinator, Dennis Bennett. The intensive training requires 4 hours of reading, and about 12 hours of training, prior to the start of the quarter. The trained assistants then partake in 6 to 10 hours of observation. Even more training is required for individuals who will respond to student writing that is submitted through OWL, a service that allows students to submit writing via the internet.

“It’s a complex position involving … different subjects … different people … and different types of writing.” says Fridley. The process requires an assistant to rapidly change topics and adjust to different student personalities.

The first element in the training is for the assistant to read "The Bedford Guide for Writing Tutors" by Leigh Ryan and Lisa Zimmerelli. Then, several class sessions discus, present, and walk the assistant through the ideals presented in the material.

The training often incorporates guest speakers who are authoritative and specialize in subjects such as scholarship essays and learning disabilities. “I sometimes bring a guest speaker in from ESOL … to tell about skills we need to be more effective in working with students whose main language is not English." said Fridley.

The Writing Center's policy is to advocate the writer's idea and "argue for that position, to help them make as strong as a case for it as possible” regardless of the assistant's feelings on the piece. “We talk about that a lot in the training. That is one of the core values.” said Fridley. “It is extremely important that students feel welcome.”

The training focuses on listening with respect and responding in a very supportive way. The goal is to help students "strengthen writing skills and become a more confident writer.” says Fridley.

In addition to the annual training, the Writing Center cultivates an on-going team mentality. “We try to get together at least 3-4 times a quarter as a team.” Fridley said. “We continue learning. Every time we work with a student we learn. All of us are responsible for the success of the Writing Center.”



*** An article for The Commuter: Linn-Benton Community College, Spring 2010