Learning About Alcohol Video Part 9 – The Disease of Alcoholism
By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
If you have ever had a really good time, drank a lot of alcohol to celebrate and then experienced a hangover afterward you can in large measure thank Acetaldehyde.
Acetaldehyde is the first breakdown product as your liver starts to go to work on that alcohol. You and your liver are not in agreement on the consumption of alcoholic beverages by the way. For the liver, not much is worse than alcohol. So no matter what noxious, poisonous or even used and expendable chemicals you liver detects it generally goes to work on the really bad stuff, meaning alcohol, first.
The first time your liver experiences alcohol it may be mystified by how this poisonous substance got into the bloodstream. But it will quickly gear up and produce ever-increasing amounts of alcohol dehydrogenase (ADH) the enzyme that breaks down the alcohol.
This first step in the processing and elimination is why disulfiram, trade name Antabuse, by interfering with that first step in the breakdown, makes people who take disulfiram become very sick when they drink. The theory was that this would be an adverse experience that stopped the person with the alcohol use disorder from drinking. In practice, those with an alcohol use disorder will avoid taking the med or they will endure the adverse effects so that they can still drink. Disulfiram has helped some people but it does not seem to be the magic cure we had hoped for.
Men’s stomachs produce some ADH, you ladies should know that your stomachs produce little or no ADH. The result of this gender difference is women get higher doses of alcohol entering the intestine than men do even if you drink the same amount.
Once the alcohol is broken down to produce acetaldehyde the liver kind of kicks back and takes its time working on that acetaldehyde. Turns out that the acetaldehyde is more poisonous to the body than the alcohol was, but it takes more time for your liver to gear up and get that stuff broken down.
So despite all those hangover remedies, you will need to wait while your liver prioritizes the processing of the alcohol before it gets going full steam on the Acetaldehyde.
Eventually, your body will produce other enzymes related to ADH to break down the acetaldehyde into acetic acid and then ultimately that will be processed into water and carbon dioxide. The liver has only one speed when it comes to using ADH to break down Alcohol. No matter how much alcohol you put in the bloodstream your liver just works at its one speed. This whole chemical manufacturing process going on inside your body just takes time.
Putting up with the hangover is just a small price to pay for having a liver that works so hard getting all those toxins out of your body.
Please treat that liver well because if it ever gets damaged and goes on strike your whole interior neighborhood will become polluted and eventually your body may become uninhabitable.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
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