Alcohols are a group of compounds, many of which are ingredients in perfumes, extracts, tinctures, paints, and other products. Alcohols are also essential to many manufacturing processes.

The form of alcohol in the beverages we drink is ethyl alcohol (ethanol), a colorless liquid that in its pure, undiluted form has a biting or burning taste. It is produced by the fermentation of sugars, which occurs naturally in grains and fruits such as barley and grapes.

When you drink alcohol, it depresses your central nervous system by acting as a sedative or tranquilizer. In some people, the initial reaction may be stimulation, but as drinking continues, sedative effects occur. By depressing the controlling centers of your brain, it relaxes you and reduces your inhibitions. The more you drink, the more you are sedated. Initially, alcohol affects areas of thought, emotion, and judgment. In sufficient amounts, alcohol can impair your speech and muscle coordination, and produce sleep. Taken in large enough quantities, alcohol is a lethal poison-it can cause life-threatening coma by severely depressing the vital centers of your brain.

The principal site for alcohol absorption is your small intestine, although very small amounts are absorbed in your mouth and esophagus and only slightly more is absorbed in your stomach. The rate at which the alcohol is absorbed depends on several factors.

If your stomach is empty, most of the alcohol is usually quickly absorbed. Food in your stomach or small intestine, especially solid and fatty foods, slows the emptying of your stomach and absorption of the alcohol into your bloodstream. Once the alcohol has been absorbed, it is quickly transported throughout your body to wherever there is water, including inside individual cells. This distribution accounts for the intoxicating effects of alcohol. Taking a drink on a full stomach spreads the metabolism of that drink over a longer period, so the concentration of alcohol attained in your blood is lower.

Nearly all of the alcohol is burned as fuel for your body, although small amounts are lost in your urine and from the lungs. It is the alcohol in the air you exhale that is measured in breath tests to determine the amount of alcohol in your body. The level of alcohol in your exhalations closely parallels the concentration of alcohol in your blood.

Alcohol also dilates your peripheral blood vessels (those nearest your skin) to produce an initial feeling of warmth, although this is only temporary. Your pulse rate rises and you produce more urine because of the increased fluid intake and the diuretic action of the alcohol on your kidneys. Alcohol also stimulates your stomach to secrete acid.

Your body uses alcohol just as it uses other food-by metabolizing it in the liver to gain heat and energy. The food value of alcohol is limited because its calories provide no vitamins, minerals, or proteins. Alcoholics often have deficiencies in nutrients. Common deficiencies include thiamine (vitamin B1), riboflavin (vitamin B2), niacin, folic acid, pyridoxine (vitamin B6), magnesium, potassium, and zinc.

Physicians once thought that the effect of alcohol on nutritional status was the only cause of the long-term liver damage alcoholics commonly experience (conditions called fatty liver and cirrhosis; see Enlarged Liver, and Cirrhosis. Today it is known that the toxic effect of alcohol can harm the liver directly.

Many people who choose to drink alcohol do not have a problem limiting their consumption to amounts that cause no harmful health or social consequences. Millions of other people (about 10%), however, use alcohol excessively and suffer adverse consequences. As a result, alcoholism and alcohol abuse are major social, economic, and public health problems.

Treating people who have drinking problems - or their agreeing to get treatment themselves - is particularly complex given the very nature of the problem. Most people with a drinking problem deny there is a problem. It is important to keep in mind, however, that alcoholism is a disease. In fact, alcoholism is the third-largest killer in the United States, ranking only behind heart disease and cancer. If traffic fatalities and death certificate diagnoses were included in statistics, alcoholism would be recognized as our nation's number one killer.

Controversy persists over what levels of drinking might be problematic or unhealthy. The importance of distinguishing between alcoholism and alcohol abuse is chiefly that the treatment approaches and goals may differ considerably.

Drinking problems in people who do not have all the characteristics of alcoholism are often referred to as "alcohol abuse," "the harmful use of alcohol," or "problem drinking." These individuals also engage in repeated excessive drinking that results in health or social problems, or both. And they may continue to consume alcohol despite knowing that continued intake poses social problems for them. However, they are neither dependent on alcohol, nor have they lost control over the use of alcohol.

Although it takes years for an adult to develop alcohol dependence, teenagers can become addicted in just months. While alcohol consumption among high school students overall is decreasing as it is among adults, use is still high and often increases dramatically during the 10th and 11th grades. Also, more and more adolescent girls are taking up drinking even though drinking continues to be predominantly a male problem. Each year in the United States, more than 7,000 young people between the ages of 16 and 20 die in alcohol-related automobile accidents, according to the National Institute of Drug Abuse. Alcohol is also often implicated in other teenage deaths, including drownings, suicides, and fires.

Generally, alcoholism is considered a chronic disease, often progressive and fatal, with genetic, psychosocial, and environmental factors influencing its development. It is characterized by periods of preoccupation with alcohol, distortion in thinking most notably denial impaired control over alcohol intake, and repetitive use of alcohol despite adverse consequences. Each of these symptoms may be continuous or periodic. It is the physical dependence (addiction) on alcohol, demonstrated by tolerance and withdrawal symptoms, as well as compulsive behavior related to alcohol use, that usually distinguishes alcoholics from other problem drinkers.

Alcoholism is a chronic and often-progressive disease characterized by periods of preoccupation with alcohol, impaired control over alcohol intake, and repetitive use of alcohol, despite the known risk of adverse consequences related to drinking. In this context, alcoholism is alcohol dependence.

Often, dependency on alcohol begins after the individual discovers that having a few drinks helps to relieve stress from family problems, difficulties at work, or social isolation. Despite occasional hangovers and the fact that this relief is only temporary, the person gradually falls into the pattern of drinking whenever they feel tense. Unfortunately, the more an alcohol-dependent person drinks, the less tension he or she can tolerate without alcohol.

The actual number of drinks is not the critical issue, because some people can easily become intoxicated after very little. The diagnosis of alcohol dependency is made when you have difficulty getting through the day without regular alcohol consumption. We are not yet certain of the cause of alcoholism, although it does seem to run in families and there is some evidence pointing to a genetic predisposition. Alcoholism tends to be under diagnosed because one classic trait of alcoholics is that they deny their dependency.

Approximately 7 million Americans abuse alcohol and 11 million are alcoholics. Alcoholism is more common among men than women (although the prevalence among women is increasing) and among the urban poor and minority groups.

In treating alcoholism, a fundamental principle is "Once an alcoholic, always an alcoholic." Most research indicates that an alcoholic is unable to become a normal social drinker. Consequently, treatment aims to eliminate alcohol totally from the routine. An person suffering from alcoholism should never take another drink.

Alcoholics Anonymous (AA) is the most effective treatment known. It provides group support, a 12-step abstinence program with a spiritual base, and gentle confrontation of the various ways in which alcoholics deny their illness. In addition, psychotherapy also can help establish new patterns of healthy behavior.