Fermented alcoholic beverages have been available to the human species for an estimated 10,000 years. They have always been used as a symbol of celebration, and they have always been abused by some, more so now than at many other times in history. Of the many countries whose cultures center around alcohol consumption, many are Western, such as France, Italy, and the Scandinavian countries. Most Third World or native populations are less abusive unless alcohol is introduced to them by others—for example, among native Americans and Mexican-Americans, alcohol problems are now commonplace.

Alcohol abuse is commonly associated with denial of the problem, which, I believe, is inherent in this emotional disease. It is especially important for alcoholics to avoid other addictions, such as cigarette smoking and caffeine drinking, as these add even more risks to the health problems of alcohol. But since most alcohol abusers have a generally destructive lifestyle and poor attitude toward life and self, nicotine and caffeine are common companions. Red-meat diets with many fatty and refined foods often go along with drinking, and may also contribute to problems of excess and deficiency. Often, our whole life needs to be corrected to deal with alcohol abuse. Alcoholism is a disease that needs treatment.

The risks of alcohol are directly related to the amount of alcohol consumed and the time period over which it is used. Individual sensitivity and associated nutritional balance, supplements, allergy, and lifestyle factors also contribute to the specific problems that may result from alcohol. Empirically, high risk may be assumed to be posed by more than five drinks daily; moderate risk by three to five drinks daily; and low risk by one or two drinks daily. Social drinking of one or two drinks a week is considered light use.

Given the general liberal viewpoint regarding low-level alcohol consumption that prevails in common medical literature, I should clarify who should not drink. Clearly, people with diabetes, hypertension, or heart disease and pregnant or nursing mothers (and those planning pregnancy) should avoid alcohol completely. People with hypoglycemic problems, liver disorders, especially hepatitis, viral diseases, candidiasis, mental confusion, fatigue, or hypersensitive reactions to alcoholic beverages should also avoid it.

Major Risks of Alcohol

1. Symptoms from drinking itself. These include dizziness, talkativeness, slowed reflexes, slowed mental functions, loss of memory, poor judgment, emotional outbursts, incoordination, inability to walk, and loss of consciousness.

2. Symptoms of hangover. These include dryness of mouth, thirst, headache (throbbing temples are common), nausea, vomiting, stomach upset, fatigue, and dizziness. Alcohol dehydrates the cells, removes fluid from the blood, swells the cranial arteries, and irritates the gastrointestinal tract. Hangovers are more common with distilled, stronger alcohol drinks and less so with red wine, champagne, white wine, and beer. One theory is that the hangover is primarily an effect of the chemical congeners produced through the formation of fermentation by-products and the many chemicals used in growing the foods and manufacturing the beverages, although no chemicals (even food dyes) need be listed on a label.

3. Symptoms of withdrawal. These include alcohol craving, nausea, vomiting, gastrointestinal upset, abdominal cramps, anorexia, fatigue, headache, anxiety, irritability, dizziness, dry mouth, fevers, chills, depression, hyperactivity, insomnia, tremors, weakness, hallucinations, seizures, and delirium tremens (DTs). These symptoms, of course, vary according to the degree of alcohol abuse and individual sensitivities.

4. Injuries, auto accidents, violent crimes, and jail. It has become clear that alcohol abuse affects others through the actions of the abuser, causing innocent people to be injured and killed. Alcohol is responsible for more than 25,000 deaths a year from auto accidents, about half of all driver deaths and about one-third of pedestrian mortalities. About 20 percent of home accidental deaths are also attributed to alcohol, as are many falls and drownings. Other drugs may also be involved in these accidents and injuries, but alcohol is by far the most common culprit. The suppressant action of alcohol also reduces self-control, judgment, and usual moral sense. Drunk people act out their aggressions, often on their loved ones or strangers as well as themselves. Alcoholics have higher than average suicide rates. The weakened adrenal response from alcohol makes us less able to handle stress. With the growing awareness of the menacing qualities of alcohol, more stringent laws are being enacted to prosecute drunk drivers, and jail is usually good negative feedback for changing alcohol abuse. However, this alone may not correct or cure this common disease.

5. Liver disease. Alcohol irritates the liver, raising the liver enzyme levels and leading to hepatitis (liver inflammation). Remember, 95 percent of alcohol consumed must be metabolized in the liver; this process requires a lot of work and takes precedence over many other necessary functions. Fat metabolism is decreased, and fatty buildup can occur in the liver. Alcohol converts to fat, not to glucose or glycogen. Obesity also occurs with high alcohol use. With chronic use, fat continues to be stored in and irritate the liver, which eventually swells, scars, and shrinks (the process of cirrhosis) until only a small percentage is functional. Usually more than half the liver must be destroyed before its work is significantly impaired. Advanced liver disease leads to all kinds of complications, including ascites, a fluid buildup in the abdomen. Still, since the liver is our most regenerative organ, stopping drinking will usually allow for recovery. Hemorrhoids and varicose veins are commonly a result of liver disease in alcoholics. Thiamine (B1), and niacinamide (B3) help the liver detoxify alcohol, so if body levels of these are low, the liver may be more sensitive to inflammation.

6. Stomach disorders—gastritis and ulcers. Alcohol irritates and injures the mucosal lining of the upper gastrointestinal tract, including the esophagus, stomach, and upper small intestine. It also increases hydrochloric acid production. This combination, along with poor nutritional protection, often leads to stomach inflammation —that is, gastritis—associated with abdominal pain and difficulty in eating. Both gastric and duodenal ulcers are found with increased frequency in alcoholics. A reduction in digestive enzymes needed to break down foods and alkalize the gastrointestinal tract causes irritating acid fluids to go further down the tube and affect the intestinal mucosa. This can lead to the "leaky gut syndrome," which allows larger, incompletely digested molecules to be absorbed and generates more food allergic reaction. The irritation of the esophagus can cause a painful esophagitis. Dilated (varicose) veins also can occur there because of liver circulation back up, and these can rupture, creating a medical emergency.

7. Pancreatitis and gallstones. Inflammation of the pancreas is a painful problem that is thought to be caused by alcohol irritation in certain individuals. There are likely other factors contributing to this problem. Gallbladder disease and gallstones are also probably caused by a number of factors, including alcohol irritation, poor fat utilization, and improper nutrient metabolism.

8. Nervous system disorders. Alcohol crosses the blood-brain barrier and directly affects the brain. It can actually destroy brain cells, leading to brain damage as well as behavior and psychological problems. Chronic use of alcohol, probably with associated B vitamin deficiencies, may lead to painful nerve inflammations called polyneuritis. Premature senility occurs with alcohol abuse, as does a chronic degenerative brain syndrome, termed encephalopathy.

9. Cardiovascular disease. Although it appears that a small amount of alcohol may raise HDL cholesterol and protect against atherosclerosis, the overall effect of alcohol abuse is deadly to the heart and blood vessels. The blood pressure is elevated, which increases cardiovascular risk. Lipid metabolism is affected, which increases triglyceride levels, which in turn raises blood cholesterol. With the familial hyperlipidemia disorders, this alcohol influence can be worse. Alcohol also reduces the essential fatty acid and protective prostaglandin levels; this further sensitizes the cardiovascular system. Heart function, heart muscle action, and electrical conductivity in the heart are all decreased with alcohol. This can lead to heart disease, congestive heart failure, and cardiac arrhythmias. Cardiomyopathy, or enlarged heart, with poor function has been associated with alcohol and some ingredients in the beverages, such as cobalt.

10. Carbohydrate metabolism—hypoglycemia and diabetes. Since alcohol is a simple sugar that is rapidly absorbed and utilized, and affects the digestion as well as liver and pancreatic functions, it has a tendency to weaken glucose tolerance with chronic use. The incidence of both hypoglycemia and diabetes is higher with alcohol abuse. Blood sugar problems are generally more frequent with regular use of alcohol. The poor blood sugar utilization can affect the nerve and liver health as well.

11. Nutritional excesses—obesity. An increase in alcohol calories that specifically turn into fat will lead to weight gain and more body fat unless it is balanced by exercise and a good diet. Many athletes drink excessively and can handle alcohol better than the less active person; when exercise is reduced, however, there is more concern. Also, with regular alcohol use, there is much more danger of nutrient deficiencies.

12. Nutritional deficiencies. Alcohol can interfere with a number of functions related to the metabolism of nutrients. In addition to the poor intake of food nutrients common with alcohol abuse, alcohol impairs digestion and absorption of many nutrients from the small intestine. These include most B vitamins, such as B1, B6, B12, choline and folic acid, as well as some minerals; and with liver impairment absorption of the fat-soluble vitamins A, D, E, and K is also reduced. Alcohol’s diuretic effect can lead to the loss of nutrients and create dehydration as well. Alcohol also uses nutrients that it does not provide for its own metabolism, impairs the metabolism of many others, and reduces liver stores of even more. For example, vitamins B1 and B3 are needed by the liver to metabolize alcohol, and these are often in short supply. Folic acid’s function in the bone marrow, where it helps make red blood cells, is diminished by alcohol. Thus, anemia may develop more easily with alcohol abuse, especially with low levels of vitamin B12 and reduced absorption and storage of iron. The low vitamin D availability and poor calcium absorption can lead to an increased risk of osteoporosis. The loss of many minerals, such as zinc and magnesium, increases even more with caffeine use. The lack of appetite caused by alcohol abuse also makes it harder to get needed nutrients. In the elderly, where nutritional status is often unstable and alcohol consumption a problem, nutritional deficits can be exacerbated. Alcoholism in all ages is commonly associated with malnutrition. Other nutrients commonly deficient with alcohol abuse include vitamins B2, B6, A, and C, essential fatty acids, and methionine.

13. Low sexuality and impotence. Alcohol increases levels of the liver enzyme that breaks down testosterone, a hormone that stimulates sexuality. Alcohol’s depressant effect on the nervous system can also reduce a man’s ability to perform, although it may reduce inhibitions and increase his desires. In teenage boys, the reduction of testosterone may delay sexual maturity. In later life, alcohol abuse is more commonly associated with impotence.

14. Cancer factor. Alcohol is probably a cofactor in cancer development and is implicated in malignancy of the mouth, esophagus, pancreas, and breast. All of these cancers are even more likely to occur when alcohol abuse is combined with cigarette smoking. One theory is that cigarette smoke and alcohol together chemically create ethyl nitrite, which is a mutagen. Cancer rates are higher in heavy drinkers than in more moderate ones. Nutritional deficiencies likely play a role as well.

15. Birth defects. Alcohol can be a definite problem for the fetus, a fact that seemed to be acknowledged thousands of years ago, but had been forgotten for awhile. Alcohol crosses the placenta and gets into the fetal circulation, where it cannot be handled metabolically because of undeveloped liver function, so it is more toxic. The fetal alcohol syndrome recently described is associated with undersized babies with small facial features and mental deficits due to brain damage. To some authorities, limiting consumption to less than two drinks daily is enough to prevent this problem; to most others, there is no safe level—women simply should not drink while pregnant! Even one to two drinks a day in the first trimester can lead to retarded growth and mental development. Since alcohol has this influence on the fetus even during the first couple of months, a woman who is planning to become pregnant or even open to the possibility should avoid or at least limit (one drink only) alcohol intake. For the mother-to-be, who needs to be very well nourished to handle pregnancy, alcohol is an added stress, irritant, and nutritional drain. Alcohol also gets into the breast milk, and this may adversely affect nursing babies, although not as seriously as when in utero. Nursing mothers are also better off without the depleting effects of alcohol.

16. Immune suppression.Alcohol clearly sedates the immune system by decreasing phagocytic activity, lymphocyte action, and mucous lining protection. Drinkers tend to have more infections and more severe problems than nondrinkers, especially with heavy use. Pneumonia is not at all uncommon in alcoholics.

17. Other health problems.Alcohol use may precipitate gout attacks in those prone to this disease of uric acid metabolism, as alcohol reduces its elimination. Alcohol also worsens PMS (premenstrual syndrome) symptoms in many women with this problem. Vaginitis from Candida albicans and other infections are more common with alcohol abuse, as are headaches. Anemia may arise from nutritional deficiencies or bleeding disorders; swelling and redness of the nose and dilated blood vessels in the face are also signs of alcohol abuse.

18. Social problems.Alcohol use lessens both our inhibitions and our self-control. With increased drinking, we may make other bad choices that are detrimental to the interest of our health and the welfare of others. Alcohol abuse can be very devastating to the family unit, to a marriage, and to the health of children. The social life of the alcoholic can influence the rest of his or her life because of forming unwise associations, spending time in bars, or getting lost for days at a time.

19. Economic disaster. Alcohol abuse in the work force costs an estimated 20 billion a year in absenteeism and lost labor. The personal and medical costs are extreme because of the cost of alcoholic beverages and the medical care needed to treat the problems that alcohol causes.

Alcoholism
The alcoholic is someone who has lost control over the drug. Clearly, alcoholism is a major problem in the United States and the rest of the world. A genetic deficiency may make it a disease rather than just a lifestyle problem. This deficiency may cause an intense biological craving for alcohol or the products from which it is made. A problem with blood sugar metabolism may be at the root, and allergy-addictions may also be a factor. More research is needed to clarify the causal associations of this important problem.

There are many warning signs to suggest a problem with alcohol. I believe that anybody who drinks daily has a problem, though he or she may not be an alcoholic. If we can easily stop drinking for a week or two at a time (we begin with one day, of course), that is a good sign. This is also important to our personal perspective on alcohol. Remember, most alcoholics deny that there is any problem.

Other warning signs of alcoholism include drinking alone, skipping meals and drinking instead, drinking before social or business functions, drinking in the morning or late at night, missing work because of drinking, and periods of amnesia or blackouts. People who have any of these drinking problems or who believe that they might have an alcohol problem should definitely seek treatment. Even in the absence of these drinking characteristics, there are many reasons to stop drinking, especially for those with regular or moderate to heavy alcohol intake. Our wallet, automobile, our liver, brain, muscles, gastrointestinal tract, and our mind and memory are a few important reasons; our family, job, and self-image are others.

To deal with an alcohol problem, we first need to admit that we have a problem and get the support of our spouse or a friend. Clear the alcohol from home, work, car, or wherever, and then see a physician or therapist. A medical checkup and blood test may be in order. We may need pharmaceutical support to get off drink; tranquilizers such as Valium or Ativan are commonly used to get through the first few days of withdrawal.

There is a fairly good chance that we can get off alcohol if we are willing to try. With a multileveled approach and the current community and professional support, our chances are better than 50 percent. Our doctor may help us find out whether allergy is a factor in our alcohol abuse. If corn, wheat, barley, rye, or yeast generates positive tests, avoiding these foods may help relieve alcohol cravings.

Psychological counseling, family therapy, Alcoholics Anonymous (AA), or some religious/spiritual practice may also improve our motivation, self-image, and ability to create a new life. Regular AA meetings continue the positive support for many recovering alcoholics. Avoiding negative influences, such as our old drinking buddies, parties, and exposure to alcohol, for a while will be helpful. Regular exercise, especially at the usual drinking time, and learning and practicing relaxation exercises are also very useful. Massage therapy can be wonderful, helping to clear body toxins and promoting relaxation and self-love. Acupuncture has also been shown to be beneficial for many recovering alcoholics, during withdrawal and afterward.

Alcohol detoxification may be very difficult, depending on the level of abuse, and it may take months or even years to completely clear its effects. Alcoholics can get fairly sick during withdrawal. Even with mild elimination, there may be increased tension, headaches, and irritability for a few days. For more severe withdrawal, tranquilizers may be needed. Medical care in a hospital setting is not uncommon for acute alcohol withdrawal, although this is usually necessary only for heavy drinkers, those who consume more than eight to ten drinks daily.

If the willpower is poor, a drug, such as Antabuse (disulfiram) can be used. This produces terrible nausea and vomiting when alcohol is drunk. Antabuse is usually tolerated fairly well for a while, but it can have side effects, such as affects on the cardiovascular system or psyche. Lithium therapy has recently been shown to reduce the urge to drink. For recovering alcoholics, many authorities believe that it is imperative to avoid all alcohol, for life, because the addictive potential never disappears. Nonalcoholic beverages may be all right, but even some dealcoholized drinks still contain small amounts of the drug.

Alcohol Detoxification
Diet and megavitamin therapy may be helpful during withdrawal, detoxification, and recovery from alcoholism. Alcoholics while drinking generally need more supplements than most other people. And during the detox time, they may need even more. This extra support will give a greater chance of recovery than just having psychotherapy. As I just mentioned, attending AA meetings may aid alcoholics greatly.

During the actual withdrawal period, which may last from a few days to a week, the diet can be focused on fluids and the alkaline foods. The appetite is usually not great, and liquids will help in clearing alcohol from the body. Water, diluted fruit and vegetable juices, warm broths and soups, and teas using herbs, such as chamomile, skullcap (a nervine), or valerian root all will serve the needs. Some other herbs that may be helpful during withdrawal are white willow bark to reduce pain and inflammation, ginseng, cayenne, and peppermint. Small amounts of light proteins, such as nonfatty poultry, fish, or even chicken soup, will provide more nourishment. Amino acid powder can also be supportive. Up to 2-3 grams of L-tryptophan can be taken for sleep. L-glutamine, another amino acid, has been shown to reduce cravings for alcohol and sugar, and is used in many detox clinics.

I have seen intravenous vitamins be very helpful during withdrawal. Extra vitamin C, B vitamins, and a few minerals, such as calcium, magnesium, and potassium, are the usual ones used, especially if supplements taken by mouth are not well tolerated. A vitamin C powder buffered with those same minerals, taken orally mixed in a liquid, such as water or juice, may be helpful. This particular formula is also useful during the detox period.

Alcohol detoxification continues for at least several weeks after the withdrawal period. During this recovery time, the body will eliminate alcohol, its by-products, and other toxins and begin breaking down some of the fat that may have been stored during alcohol abuse. General supportive and balanced nourishment with a low-fat, moderate protein, basic complex carbohydrate diet is recommended. Since alcoholics often have blood sugar problems, basic hypoglycemic principles should be followed. These include avoiding sugars and refined foods, soft drinks, candy, and so on; small amounts of fruits and fruit juices may be tolerated. Regular eating every few hours is recommended. Small meals and snacks of protein or complex carbohydrate, including whole grains, pasta, potatoes, squashes, legumes, and other vegetables, can be the basic diet. Proteins such as soy products, eggs, fish, or poultry can also be added, but the basic aim is to maintain an alkaline diet, so the primary focus initially during withdrawal should be on vegetables and fruit.

Water should be drunk throughout the day as well; chamomile or peppermint teas can also be used. All alcoholic beverages should, of course, be eliminated. Foods containing potentially damaging fats, including fried foods, chips, burgers, hot dogs, fast foods, and ice cream should also be avoided. These foods are all congesting and more acid-forming as well. Caffeine and cigarette smoking are best minimized. Many recovering alcoholics take in large amounts of coffee and smoke intensely, as can be clearly seen at AA meetings. This is not recommended at all. These habits suggest a need for stronger psychological support to become generally less addictive. Luckily though, in recent years there is a strong faction for nonsmoking AA meetings, and this is a big plus.

During detoxification from alcohol (usually from other substances, too), many other important nutrients besides diet can be added. Amino acids can be used, including L-tryptophan for sleep. Calcium and magnesium supplements taken at night may also aid sleep, as may valerian root capsules. L-glutamine is an amino acid that generates glutamic acid, and this can get directly into the brain and be used for fuel. Glutamine is naturally found in liver, meats, dairy foods, and cabbage. It can diminish the craving for alcohol and sugar (chromium may also help with sugar cravings). A dosage of 500-1,000 mg. three times daily between or before meals is suggested, as capsules or as L-glutamine powder, taken before or after meals and before bed.

A basic "multiple" along with antioxidant nutrients can be employed during detoxification from alcohol. Extra minerals, such as zinc, iron, calcium, and magnesium, can be taken to replace those lost during alcohol abuse. Higher levels of niacin, even up to several grams, along with 5-10 grams of vitamin C daily, have been used with some success in alcohol withdrawal and detox. A more modest level of C would be 500-1,000 mg. taken four to six times daily.

Other detoxifying nutrients include additional fiber, which helps to bind toxins in the bowel and improve elimination. Choline and inositol, about 500 mg. each three times daily, will improve fat digestion and utilization. Lemon water with a couple of teaspoons of olive oil and a quarter teaspoon or capsule of cayenne pepper will help detoxify the liver. Taking fiber along with oil decreases the oil absorption, but olive oil alone is thought to be nourishing to the liver and helpful in clearing chemical toxins. Cold-pressed olive oil is part of many natural liver therapies. Goldenseal root powder, one or two capsules twice daily, is also helpful for toning and clearing the liver. Parsley tea improves kidney elimination and cleansing of the blood. The amino acid L-cysteine is another helpful detoxicant for the liver, blood, and colon.

Other nutrients and herbs that are helpful during detoxification of alcohol include pancreatic digestive enzymes after meals and brewer’s yeast, which, if tolerated, supplies many B vitamins and minerals. The essential fatty acids help to decrease the inflammatory prostaglandins. Gamma-linolenic acid from evening primrose or borage seed oil helps to reduce alcohol toxicity. White willow bark tablets can be used for pain, and valerian root, a natural and milder form of Valium, can be taken to decrease anxiety. Chamomile will help to calm the digestive tract, as will licorice root.

Nutritional Support for Drinkers
The basic support plan for an active drinker varies only a bit from that used during alcohol detox. A generally balanced, nutritious diet will help minimize some of the potential problems from alcohol. Regular nourishment is important, although even the best diet and supplement program will not fully protect us and our liver from the toxic effects of ethanol. When our liver has to deal with alcohol metabolism, it is helpful to avoid fried foods, rancid or hydrogenated fats, and other drugs, such as cocaine, all of which are hard on the liver. Thioctic acid as a supplement of 100-200 mg. daily may help protect the liver against some of the drug toxicity.

Alcohol abusers need more nutrients than most other people to protect them from malnutrition. Obviously, basic multiple and antioxidant formulas are important. Part or possibly most of the toxic effects of alcohol may be caused by production of free radicals, so higher than RDA levels of vitamins A, C, and E, beta-carotene, and the minerals selenium, zinc, manganese, and magnesium are suggested (see supplement table). The nutrients that are commonly deficient with alcohol use also need extra support. Thiamine and riboflavin, in dosages of 50 mg. twice daily, and niacin, in dosages of 50 mg. three times daily, help circulation and blood cleansing and can reduce the effects of hangovers. Folic acid is needed in amounts of 800-1,000 mcg. per day, more than twice the RDA; leafy greens and whole grains, both rich in this vitamin, should be added to the diet

. Water and other nonalcoholic liquids are needed to counteract the dehydrating effects of alcohol. Calcium is also supportive, as is extra zinc, 45-75 mg. daily, as its absorption is diminished and its elimination is increased with alcohol use. Zinc is commonly deficient in drinkers. This supplemental intake should be balanced out with 3 mg. of copper. The essential fatty acids and gamma-linolenic acid from evening primrose oil or borage seed oil support normal fat metabolism and protect against inflammation caused by free radicals and prostaglandins (PGEs). Alcohol decreases the levels of the anti-inflammatory PGE1, and these oils will increase them. Glutathione helps prevent fat buildup in the liver by its enzyme activities, so the tripeptide glutathione (or L-cysteine, which forms glutathione) may be supplemented along with basic L-amino acids. Many alcohol users are not able to get enough glutamic acid to their brain; additional L-glutamine will help get it across the blood brain barrier.

Social drinkers can use a lighter program, but still, I believe, need protection. A good diet is, of course, recommended. B vitamins, including 50 mg. each of B1, B2, and B3, 400 mcg. of folic acid, and 100 mcg. of B12, 15-30 mg. of zinc, and 300-500 mg. of magnesium should all be taken before drinking, along with some food. Drinking should be limited to two drinks per day.

A number of things can be done to prevent getting too drunk or developing a hangover. Our blood level of alcohol is affected by how much and how fast we drink. If we drink fast on an empty stomach, absorption is immediate. Ideally, it is best to have some food in the stomach unless we limit consumption to one drink and want a quick "buzz" before dinner. Food definitely helps prevent us from getting sick. Drinking slowly is suggested. Women seem to be more quickly affected by alcohol than men and so get drunk more easily with less alcohol, even taking body weight into consideration. Foods to eat before drinking should be low-salt complex carbohydrates, such as bread, some crackers, or even vegetable sticks. Carbohydrates delay alcohol absorption. Fat-protein snacks, such as milk or cheese, will decrease alcohol absorption and thus help reduce drunkenness and hangovers. Some people drink a little olive oil before parties to coat their stomachs so that they can handle their drinking better. A few capsules of evening primrose oil will also help.

It does take a while for alcohol to clear from the blood after it gets in there. With heavy drinking, extra coffee and exercise, such as walking, do not really help, other than by making more active drunks; however, with mild intoxication they can increase alertness. Definitely avoid other psychoactive drugs with alcohol; these include tranquilizers, narcotics, sedatives, antihistamines, and marijuana, all of which may increase the alcohol effect.

Blood levels of alcohol have been studied to see varying effects of this drug. Legally this level can be determined through testing and used to clarify degrees of safety or drunkenness. Usually one or two drinks will keep most people in a safe range, but over that can create problems.

Hangovers are caused by the dehydrating effect of alcohol and some toxic effects of the chemical congeners that are created during fermentation or are added to the beverages before, during, or after processing. Allergies to some of the ingredients, such as corn, wheat, barley, or yeast, may intensify hangovers and withdrawal.