Numerous research studies have provided evidence that heavy alcohol use and alcohol abuse are risk factors that contribute to the burden of disease. Alcohol use, especially heavy alcohol use, affects a person’s susceptibility to infectious disease via both indirect direct and direct routes.
For example, according to information provided by the Centers for Disease control and Prevention (CDC), immediate effects of heavy alcohol use can indirectly result in an increased risk to develop numerous infectious conditions because heavy alcohol use increases the risk of:
- Injuries due to accidents, burns, falls, fights
- Being a victim of crime, physical or sexual abuse, and/or intimate partner violence
- Suffering extremely elevated levels of alcohol in one’s blood that can lead to alcohol poisoning
- Engaging in risky behaviors, such as having unprotected sex or the use of illicit drugs that may involve sharing needles
- A decrease in maintaining attention to self-care or hygiene
All of these factors can indirectly increase the risk to develop some sort of infectious condition. In addition, the CDC reports that the long-term effects of chronic alcohol abuse or heavy drinking include:
- An increased potential for the development of cardiovascular issues, including high blood pressure, heart disease, and stroke
- An increased potential to develop gastrointestinal, liver, and kidney problems
- An increased potential to develop nearly every form of cancer
- An increased potential to develop neurological problems, including issues with dementia
- An increased risk to develop numerous psychiatric/psychological disorders\
All of these chronic conditions can indirectly lead to an increased risk for the development of infectious diseases. Alcohol also directly affects numerous bodily systems that results in an increased risk to develop infectious diseases.
Alcohol’s Effects on the Immune System
Everyone is constantly exposed to numerous bacteria, viruses, fungi, and other potentially dangerous microorganisms. Many of the microorganisms that people are exposed to can actually be beneficial for them, whereas others can have toxic effects and exposure to them can lead to numerous infectious illnesses or diseases. According to the book The Immune System, the immune system consists of numerous systems in the body that detect and remove these potentially dangerous organisms and that can also assist in repairing tissue and, in some cases, even in the regeneration of organs and other bodily systems. The immune system is an elaborate network of very highly specialized cells that interact in an organized fashion to perform these functions.
Some of these defense and control networks are present at birth, and referred to as a person’s innate immunity, whereas aspects of the immune system that continue to develop and adapt throughout an individual’s lifetime as a result of experience are often referred to as adaptive immunity. The innate immune system includes barriers, such as the skin and blood-brain barrier that protect organs of the body, the stomach and gastrointestinal system, and specialized immune cells function throughout the body. The adaptive immune system involves several types of cells and other molecules that protect the body from pathogens, that develop and strengthen as a function of being exposed to disease-bearing organisms, and that then actually remember these organisms so if they are ever encountered again, the response can be swift and efficient. There are numerous highly specialized cells in the body that include white blood cells, natural killer cells, T cells, B cells, macrophages, etc.
Alcohol consumption affects the number of immune cells in an individual’s system, alters their functioning, and can often kill existing cells. The specific effects on the immune system that occur with alcohol use are directly related to the amount of alcohol an individual typically uses and how often the individual uses alcohol, but even singular episodes of binge drinking may have measurable effects on the immune system.
Over the long-term, the abuse of alcohol results in weakening of the immune system and increases the risk of contracting bacterial and viral infections, including HIV,respiratory infections, hepatitis (hepatitis B and C), and numerous other disease. It can also reduce the effects of vaccinations for numerous diseases, including influenza, pneumonia, etc. Chronic alcohol use results in inflammation of various organs, including the pancreas, gastrointestinal tract, and the brain, which can result in an increased risk to develop infectious diseases in these organs as well.
Pregnant women who consume alcohol can disrupt the development of the fetal immune system, and this can increase the risk for infection in infants born to mothers with alcohol use disorders. This increased risk may continue throughout the person’s life. Research now indicates that any alcohol use during any stage in pregnancy can result in many problems for the fetus, but it appears that alcohol use during the second trimester of pregnancy, when the immune system is developing, can have long-lasting effects on the child’s immune system.
How Alcohol’s Effects on the Liver Can Increase the Potential for Infectious Disease
The liver’s primary functions include metabolizing nutrients and detoxifying the system after substances have passed on from the gastrointestinal system. The liver is the primary organ that metabolizes and eliminates alcohol from an individual’s system. Individuals who chronically abuse alcohol and drink it in large amounts over time can have significant liver damage that activates immune cells within the liver, resulting in inflammation.
The liver also functions to produce numerous antibacterial proteins. If the damage to the liver as a result of alcohol becomes chronic, it can result in an increase in an individual’s susceptibility to infectious disease. Severe chronic damage to the liver can result in cirrhosis, which can lead to severe alcoholic hepatitis.
Alcohol’s Effect on the Gastrointestinal System
The gastrointestinal tract, the stomach and intestines, is one of the first organ systems in the body that is exposed alcohol. It also is often seriously damaged in chronic alcohol abusers.
Chronic consumption of alcohol alters the composition of the bacteria in the GI tract that is typically useful, such that chronic drinking reduces the number of beneficial bacteria and allows for an increase in the number of potential harmful bacteria. In addition, alcohol directly affects the functioning of the gastrointestinal tract by resulting in ulcers and other lesions that can increase the risk for disease.
Chronic Alcohol Use and Increased Risk for Respiratory Disease
According to sources, such as a 2015 article in Alcohol Research: Current Reviews, chronic abuse of alcohol can lead to damage in numerous areas of the defense system of the lungs, resulting in an increased susceptibility to respiratory infections, including tuberculosis and pneumonia. Long-term heavy alcohol abuse significantly damages the cells lining the airways that are covered with cilia (tiny hairs) that trap potential infectious particles before they get into the lungs.
Heavy alcohol use interferes with the ability of immune cells to identify and destroy bacteria that is in the lungs and can lead to an increased risk for infection. Heavy alcohol use also impairs the function of the immune cells that recognize and destroy pathogens that cause tuberculosis, and individuals who have dormant tuberculosis infections can develop tuberculosis rather quickly. Severe lung diseases, such as acute respiratory distress syndrome, are 2-4 times more common in individuals who have a history of alcohol abuse than in individuals who do not have such a history.
Alcohol Use and Increased Risk for infections in the Brain
Research studies examining the brains of individuals who have been diagnosed with alcohol use disorders following their death have found that these individuals have higher levels of inflammation in the brain and alterations in immune factors in the central nervous system that can result in an increased risk for infections in the brain. It is posited that some conditions, such as certain forms of dementia, may be related to neural inflammation and even brain infections, and chronic use of alcohol may increase the risk for these infections; however, further research is needed.
How History of Alcohol Abuse Affects Treatment
The research strongly suggests that the effects that alcohol abuse has on the immune system can lead to important implications regarding the treatment of individuals who are critically ill and also have a history of alcohol abuse or an alcohol use disorder. These individuals are much more likely to:
- Require intensive medical interventions
- Have longer inpatient stays in clinics or hospitals
- Have significantly more complications associated with the withdrawal process from alcohol
- Require intensive treatments for all of their issues
- Have an increased risk to develop complications with their illness and with their alcohol use disorder
- Need higher doses of medications to deal with their issues
- Have significantly higher rates of mortality that will be related to alcohol abuse or some other issue
According to the World Health Organization’s Global Status Report on Alcohol and Health 2014, the cost of infectious disease and other chronic medical conditions related to alcohol abuse amounts to billions of dollars worldwide for direct care. The figure is even higher when estimates are compiled for issues related to lost productivity and other secondary factors. Treatment for these individuals can be quite challenging, and those who have serious issues with alcohol abuse, a chronic infectious disease, and other medical conditions that are exacerbated by their previous use of alcohol will require significantly more resources than other individuals who do not have a history of alcohol abuse.
Physicians should be made aware of potential issues with alcohol abuse or the presence of an alcohol use disorder in any patient being treated for a disease in order to develop a formal treatment plan that addresses all their needs. This means that the assessment process for individuals with medical conditions should include a thorough review of the person’s history that includes at least a preliminary screening for alcohol and drug abuse.
Because these individuals often have numerous medical issues, one of the most important considerations is to immediately have them abstain from alcohol use. This often requires significant medical management of potential withdrawal symptoms, behavioral and medical management to reduce cravings for alcohol, and medical interventions for an exacerbation of their medical problems, including any disease-related symptoms.
Even individuals who have serious infectious conditions can get started on a program of recovery from alcohol use disorder via the use of therapy and participation in groups like Alcoholics Anonymous. Because of the direct and indirect effects that alcohol produces on an individual’s system, resulting in increased susceptibility to infectious disease, the surest way to ensure that an individual who has a history of an alcohol use disorder will not suffer further complications related to their alcohol abuse is to get them involved in a formal alcohol use disorder treatment program.