First the statistics:

Drinking-
None- teetotling away yer life
<1/d- Mild drinker. This is pretty broad encompasing 1/month to 6/week, but the understanding is pretty clear.
1-3/d- Moderate drinker. Probably most of us. We are walking a fine line.
4+/day- Heavy drinker. You know who you are. Denial is not a river in Egypt.
Alcoholic: Heavy drinker w psychological and/or physical addiction (dependence).

Use-normal moderate intake-what we all think we do
Abuse-excessive intake often bingelike- been to an offline lately?
Addiction-compulsive use- whqat web site is this again?
Dependence - biologic adaptation; continued use despite signs and symptoms
Tolerance- reduced response to continued use of usual doses(vs sensitivity- heightened response etc)


JUST THE FACTS MAM

Experimentation w alcohol- ~99% e g teetotlers 1%
Mild drinkers- 70 %
Alcoholism- 5-10% for men ;3-5% for women =15 Million (vs 5 Million Hard core druggies)

Alcohol is classified as a DEPRESSANT because it produces sedation and sleep. The initial effects reduce latency time to fall asleep, but also decreases REM , increases non REM, and risk for apniec (halting of breathing) sleep. Primary or initial insomnia is inhibited so we fell drowsy, but secondary insomnia (waking up too early eg 3 AM) is common. Over time fragmented sleep occurs.
Alcohol impairs primarily the functions of the brain that depend on training: memory, concentration, indsight. Inhibitory centers (GABA) are affected first so especially at lower doses this is often perceived as stimulation.
In low doses, first effects are on recent memory -"who brought the Harlan?" and in high doses produces palimpsets or black outs after which amnesia occurs "-did we go to the offline?" Reports from drinkers during a binge are not reliable. People say they drink to relieve anxiety or depression, but with more na more alcohol the mood becomes exasctly that (dysphoric). Alcoholics have the highest rate of suicide amongst drug takers. Alcoholism does increase risk of other drug abuse and produces cross tolerance to trnaquilizers and is additive or worse (synergistic) with many other drugs like antidepressnats, MAO inhibitors etc.

Cardiovascualr effects are minor, except in chronic alcoholics who get cardiomyopathy and heart failure. Dilation of blood vessels can produce warm flushed skin but this is mostly an indirect consequence of brain changes.

Alcohol decreases LDL/HDL,reducing risk for atherosclerosis. In my 1 year experience as a deaner, alcoholics had the cleanest aortas of any group of people except teenagers.

Alcohol increases stomach secetions at concentrations >10% (most red wine), irritates it over 40% (put that mixed drink down) and is worse when aspirin or NSAIDS anti inflammatory drugs are taken. Gastritis, reflux esophagitis, pancreatitis, hepatitis, are all caused in some cases by alcohol.
At low doses say a glass of wine, alcohol causes fat accumulation in the liver (fatty liver) even in normal people, by inhibiting metabolism of fat. Alcohol is a reducing agent, preventing normal oxidation. Some alcohol is oxidized to acetaldehyde which is toxic to cells andcauses haepatitis and eventually faulty repair of cirrhosis. Reduction of vitamin and glutathione processing follows.

Alcohol has marked damaging effects on the developing fetus. The number one cause in the world of mental retardation is fetal alcohol syndrome in an estimated 1/500 pregnancies. Reorts of women drinking 5 glasses of wine a day produced such babies. There is no evidence of any safe limit. Stillborns and abortions occur with 2-3 drinks a day in some cases.
Alcohol is antisexual, producing aggressive sexual behavior with decreased performance. Chronically, the effects are steriltiy, and overt evidence of bad behavior- testicle atrophy, male breasts, and obesity.

Once imbibed, alcohol is initially rapidly absorbed then plateaus. Food delays overall absorption from the stomach but not the intestine. Voiting is nature's response to getting rid of toomuch of this toxic stuff. Once absorbed, alcohol goes everywhere. 95% Alcohol is metabolized proportionately toliver weight and function, thus roughly to overall body size roughly on average 120 mg/kg-hr or 1 oz over 3 hours, roughly 1 glass of wine per hour. There is genetic variance at work here.

An increase in reaction time, diminished fine motor control, and impaired decision making occur at Blood alcohol content (BAC) OVER 20 MG/DL. The legal drinking limit by the NAtional Safety Council and supported by the AMA is 80mg/dl (.8%) though in my opinion this is a poor compromise and should be half that. Many tolerant alcoholics can have levels up to 3% without appearing grossly sedated. The lethal limit >4% remains the same so these people may seem OK before they kick it. Determining for legal puposes BAC can be done directly--give me your arm buddy-- by breathalyser in expired air (~0.05% of blood) or in the urine --you're gonna visit the Piss Man (150% of blood).

Once over the allowed limit, getting in a car puts you at 10x the sober person's risk of a fatal motor vehicle adccident( MVA). The "rule"wait an hour to drinve since your last drink applies to non binge drinking of course. One glass of wine increases your BAC to 0.4% but this can be halved on a full stomach. Alcohol and or drug account for 85% arrests, 70% MVA's(alcohol alone in 50%). The reorted(we all know that means underreported) number of drunk drivers at any one time is 1 million

People have been drinking since the first rotten grape fell off the vine. Arabs introduced the method of distilling alcohol into Europe in the Middle Ages, where it was promoted as the elixir of life. In fact, the Gaelic term for whiskey usquebaugh means water of life. The true therapeutic value of alcohol is quite limited to rubbing (liniment) systems. It is useful to denature the proteins in posion ivy and sumac on exposed limbs, for use as a skin disinfectant as rubbing 50-70% alcohol, for cooling and rubefacient benefits and preventative to bedridden pts at risk for decubitus ulcers, and as an injectant over nerves to relieve pain, or vessels to stop bleeding. The old "head cold" remedy is really to get someone drowsy enought to stay in bed "hang the hat on the bedpost; if you see two, you stay in bed."