Overview

Beer is the oldest and perhaps most common alcoholic drink on earth. Beer has been widely available since as far back as the earliest civilizations thousands of years ago, and has since become available widely in nearly every country on every continent. Beer makes up a significant portion of the United States’ economy, with over $252.6 billion being attributable to beer alone.¹ Despite beer’s legality and commonality, alcohol is still a drug, and one that is responsible for more deaths than many of the most dangerous drugs, with over 88,000 people dying from alcohol every year, and up to 15.1 million having a physical dependency on alcohol.² Alcohol functions on the essential multipurpose neurotransmitters GABA and glutamate, inhibiting and suppressing their ordinary functioning to produce a sedating inebriating effect on the brain. While alcohol produces little to no effects when drunk in small quantities, becoming inebriated produces effects such as uncoordinated movements, loss of motor control, slurred speech, increased sociability, rapid mood shifts, nausea, and dizziness. Long-term alcohol abuse can lead to severe liver damage and failure, cardiovascular damage resulting in heart attacks and heart disease, and intestinal ulcers. Alcoholism is treatable with various medications including Antabuse, Naltraxone, and Campral, as well as various therapeutic options including Cognitive Behavioral Therapy and the 12Step Program, and rehabilitation facilities offer extensive resources for recovering from alcohol abuse in a safe, stable, and comfortable manner.

What is Beer?

Beer is one of the most iconic, recognizable, and widely available alcoholic drinks on earth. Because of the commonality of beer, as well as its reputation for its lower alcohol content and more subtle flavor than other alcoholic beverages, many fail to see the danger hidden behind beer’s marketing and social acceptance. Beer was perhaps the earliest alcoholic drink ever produced in human history, and dates back over 7,000 years. Beer was present in most of the greatest civilizations throughout human history, including the Mesopotamians, Egyptians, and ancient Greeks. Evidence suggests this early use of beer was a way of harnessing the natural process of cereal grains fermenting in long-term storage as a way to not waste it. In modern times, beer has dominated the alcoholic beverage industry, and accounts for over double the economic impact of wine and other alcohol in the United States, totaling over $252.6 billion generated purely by the manufacturing and distribution of beer. But don’t let the commonplace acceptance of beer distract from the fact that beer, like all alcohol, is still a drug. The National Institute on Alcohol Abuse and Alcoholism reports that up to 15.1 million adults have Alcohol Use Disorder, a chronic disease characterized by uncontrolled consumption of and dependency on alcohol. Alcohol is also responsible for such a significant death toll that it is considered the fourth leading cause of preventable death in the U.S., with over 88,000 people dying from alcohol, including beer, every year. Beer, along with nearly all other alcohol, is unscheduled by the Controlled Substances Act (CSA).

How Does Alcohol Addiction Work?

Beer’s hidden danger and addictiveness can be attributed primarily to its effect on GABA, a common inhibitory neurotransmitter that is responsible for a large amount of various neurological functioning, as well as the excitatory neurotransmitter, glutamate. Once beer is consumed, it works to enhance the inhibitory power of GABA in the brain, allowing GABA’s inhibitory functions to have a stronger effect. In addition, alcohol inhibits the excitatory effect of glutamate in the brain, preventing it from binding in the synapse. These effects give alcohol a powerful sedative effect, particularly in the areas of the brain that control inhibition, decision making, and impulse control. These numerous issues compound to create a dangerous effect that functions both to inhibit and sedate essential neurological functioning, while also impairing essential areas of the brain that can prevent reckless, irrational, and dangerous behavior. This deadly self-feeding cycle of addiction is at the root of beer’s effectiveness at becoming addictive. This sedating effect and the perceived confidence boost from becoming drunk is the root of alcohol’s mental addictiveness, and the painful withdrawals and hangovers experienced when trying to stop drinking only work to increase alcohol’s physical addictiveness.

Short and Long Term Effects

Beer is a beverage that, when consumed in low quantities, will have little to no effect on the brain. However, beer is commonly drunk in excess to become drunk, which can produce feelings such as:

The short term effects of beer are similar to the effects of dopamine in general – only amplified. Users report short-term mental effects such as feelings of:

• Increased sociability
• Tiredness
• Mood shifts
• Loss of inhibitions

And physical effects such as:

• Heaviness of limbs
• Slurred speech
• Lowered body temperature
• Nausea and vomiting
• Dizziness

Repeated long-term use of beer leads to physical side effects such as:

• Liver damage – One of the most common physical effects of alcohol is damage to the liver. The liver is responsible for filtering and cleansing toxic substances from circulating blood, which is a vital functioning for maintaining the body’s health. Alcohol, which gets filtered through the liver, causes irreparable damage which frequently leads to a variety of liver diseases such as cirrhosis and in the case of long-term drinking, liver failure. This can lead to a host of other physiological conditions due to its diminished capabilities, as well as death.
• Ulcers – Because of alcohol’s damage to mucus membranes in the body, as well as its damage to the liver, frequent alcohol consumption can lead to a variety of intestinal ulcers in which the mucus membrane is irreparably damaged, allowing stomach acid to further eat through the sensitive stomach and intestinal tissue.
• Decay in health of skin, teeth, and hair – Alcohol abuse leads to a variety of vitamin and mineral deficiencies. These vitamins and minerals, such as iron and vitamin B, are essential for maintaining the health of proteins in the body response for skin, teeth, hair, and nails, as well as circulatory and immune health.
• Cardiovascular damage – Alcohol has been linked to strong increases in blood pressure as well as damage to the heart. Long-term alcohol usage can damage these vital organs leading to heart disease, stroke, and even heart attacks.
• Insomnia – Due to a general decay in personal health as well as frequent interruptions in ordinary circadian activity, chronic drinkers often experience worsening sleeping problems that can develop into insomnia.

Long-term use of beer also carries several mental side effects including:

• Depression – Due to alcohols sedating effect and damage to neurological functioning, alcoholics often experience depression due to the brain’s inability to utilize dopamine effectively.
• Anxiety – Anxiety is a frequent symptom of drug abuse in general, and is common in alcoholics due to external factors such as family or friends finding out, and internal factors from the alcohol itself.

Other risks posed by beer abuse include:

• Risk of alcohol poisoning – Because of beers’ damage to the liver, alcohol can build up without being safely metabolized when drunk in excess, which can lead to a fatal condition called alcohol poisoning. Symptoms of alcohol poisoning include passing out, severe dehydration, confusion, aggressive behavior, loss of motor control, flushed skin, slurred speech, and severe alcohol poisoning may result in coma.
• Pregnancy – Alcohol abuse can lead to a wide variety of difficulties with pregnancy. This includes both fatal and nonfatal birth defects, Fetal Alcohol Syndrome (FAS) which leads to physical deformities as well as neurological damage. Babies born with FAS or in

mothers who drank heavily while pregnant have shown significant delay in learning, neurodevelopment, and cognitive functioning.

• Alcohol withdrawal is a notoriously difficult process to go through, and includes withdrawal symptoms such as:
• Cold sweats
• Uncontrollable shaking and shivering
• Diarrhea
• Nausea and vomiting
• Elevated heart rate
• Headache
• Irritability
• Muscle aches and cramps
• Insomnia

Methods of Treatment

Pharmacological:

Treatment for beer addiction via medication is a common and effective form of treatment for alcohol addiction. Due to the physical and neurological damage of chronic drinking and the severity of withdrawal symptoms, treatment through medication aims at minimizing as many adverse reactions to withdrawal as possible. Treatment through medication begins with a detoxification process in which the body is given time to expel alcohol from the body, which is often accompanied by common withdrawal symptoms such as diarrhea and vomiting. Once the user has gone through detox, they begin treatment with certain medications. These drugs allow a gradual transition from addiction to sobriety while minimalizing unpleasant side effects of withdrawal that are likely to lead to relapse. The oldest medication developed for alcohol addiction is Antabuse, which has been used for over 50 years. Antabuse works by inhibiting enzyme production that is used in alcohol breakdown, which allows acetaldehyde to build in the body without the ability to be metabolized, resulting in severely unpleasant effects when only a small amount of alcohol is consumed. Campral is another common medication used in treating alcohol abuse, which functions quite differently from Antabuse. Antabuse focuses on the symptoms of alcohol withdrawal rather than on preventing the ingestion of alcohol in the first place, allowing detoxification to occur more easily. Naltraxone works similarly to both Antabuse and Campral in that it works as an opioid antagonist, which effectively minimizes the pleasure obtained from consuming alcohol, while also minimizing the unpleasant effects of withdrawal. Each of these medications functions differently and is prescribed on a case-to-case basis to best fit the needs of the individual undergoing treatment.

Therapeutic:

Other forms of treatment for beer addiction come in the form of psychological and behavioral therapies. These treatments focus on the behaviors and habits that led to addiction in the first place in an attempt to remove the root of addiction. Amongst these forms of treatment, Cognitive Behavioral Therapy (CBT) is one of the most common, and is growing in support from the scientific and clinical communities all the time. Cognitive Behavioral Therapy sees substance abuse such as beer addict as a symptom of a greater psychological issue, and not a cause in and of itself. By utilizing reflective and analytic techniques, an addict is better able to understand what led them to addiction in the first place, change bad habits, and avoid behaviors that may trigger cravings. The twelve-step program, which is utilized by Alcoholic Anonymous, is a long-established method of treating drug and alcohol addiction. The twelve-step program works as a gradual method of guiding principles and pragmatic steps that can be taken to go from the depths of addiction and unhealthy habits to sobriety. These twelve steps are aimed at effectively recovering from compulsive and addictive behaviors, and addressing mental and behavioral problems that led to addiction in the first place. These twelve steps include both internal and external actions aimed at making amends for past mistakes, accepting responsibility for the actions that led to addiction, and moving forward to establish healthy habits and a positive mindset.

Rehabilitation

There are two main types of rehabilitation: inpatient and outpatient. Inpatient rehabilitation refers to programs that require patients to check themselves into a facility where they will undergo all rehabilitation treatment. Although inpatient rehabilitation requires a greater level of commitment, the facilities, environment, and support offered by these facilities are conducive to a stable and effective recovery. Inpatient facilities generally offer services such as psychiatrists, counselors, group therapy, and all of the living facilities necessary for a comfortable stay. The extensive support offered by these facilities, combined with an environment that is focused on self-improvement and wellness is a great combination for providing the motivation to push through the difficulties of withdrawal and to establish good healthy habits to prevent relapsing once you leave. This form of rehabilitation is effective for those who would benefit from a stricter more scheduled recovery in which the outside distractions and temptations of life won’t get in the way of focusing on recovery.

Outpatient rehabilitation is based on the principle of spending only part of your time in recovery programs while offering you the freedom to continue daily living on your own. Generally these programs will require ten to twelve hours of commitment per week spent in a treatment facility participating in similar activities to those done in an inpatient facility such as group therapy, counseling, and even detox. While this does offer easier access to drugs, some may find being able to maintain their normal daily schedule more beneficial. This form of rehabilitation is effective for those who require more freedom and contact with friends and family.

Both forms of rehabilitation are effective solutions at combatting beer addiction, and there is a variety of different types of both inpatient and outpatient rehabilitation to suit the personal needs of each individual.

References

1. Morris, Chris. “Here’s How Massive the American Beer Industry Has Become.” Fortune.com, Fortune, 5 Aug. 2015, fortune.com/2015/08/05/beer-industry-craft-beer/.
2. “Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, Feb. 2017, www.niaaa.nih.gov/alcohol-facts-andstatistics.