Nutrition, alcohol and drug abuse.

Alcohol (ethanol) is the commonest addictive substance known to man and is accepted as a legal psychotropic drug by most customs and religions. It is, however, well known that heavy consumption of alcohol will lead to physical, mental, social and economic damage, just as it will with the chronic consumption of any other pharmacologically active substance. It is because of this and the increased use of all forms of drugs that the whole matter of drug use, abuse and addiction has become one of the major preoccupations of the World Health Organization. Its Expert Committee on Drugs Liable to Produce Addiction has now been working for 25 years to co-ordinate international action to control the spread of drug abuse. I t is, however, essential to start with a clear definition of addiction, and that of the World Health Organization (1957) is more than adequate for this purpose: ‘Drug addiction is a state of periodic or chronic intoxication detrimental to the individual and society, produced by the repeated consumption of a drug (natural or synthetic). Its characteristics include: ( I ) an overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means; ( 2 ) a tendency to increase the dose; (3) a psychological and sometimes a physical dependence on the effects of the drug’. This definition does not seek to differentiate between the various types of drugs, but it should be clearly understood that alcohol differs considerably from virtually every other drug, although its withdrawal symptoms are said to be similar to those for barbiturates. The very fact that it is socially acceptable makes alcohol a very insidious drug and it frequently becomes the starting point for other forms of drug dependency. Alcohol is the most widely misused and abused drug of all, but three-quarters of all alcoholics are able to hold down jobs and there is a strong tendency for alcohol-dependent people to be protected and tolerated by society. As a result, the full magnitude of the alcohol problem is usually obscured while problems of other forms of drug abuse are frequently more obvious. Contrary to popular belief, alcohol is a depressant, not a stimulant. After being absorbed by the walls of the duodenum and upper intestine it rapidly affects the central nervous system, numbing the high reasoning centres of the brain. Whilst this creates a sense of relaxation which may show itself in a display of conviviality and a lessening of inhibitions, the progressive increase of the blood alcohol level results in a disruption of the motor skills such that reaction times and co-ordination deteriorate.