Chapter 1 INTRODUCTION Alcohol drinking has been practiced in the majority of human society since early times. Alcohol (ethyl alcohol) is a drug which acts principally as a depressant on central nervous system. Its effects on behavior are well known and regular use gives rise to an increased tolerance, so that the drinker needs to take gradually increasing amounts to obtain the same effect. Chronic excessive alcohol consumption leads to life threatening hazards (Best, 1999). Alcohol related diseases are rising rapidly in Western countries as well as in Asia. According to the World Health Organization (2008), there are about 2 billion people worldwide who consume alcoholic beverages and 76.3 million with diagnosable alcohol related disorders. Alcohol consumption is the leading risk factor for disease burden in developed countries and the third largest risk factor in developing countries (WHO, 2008). Excessive alcohol intake has detrimental effects on the cardiovascular system leading to cardiomyopathy, coronary heart diseases, hypertension and hemorrhagic stroke (Klatsky, Armstrong and Friedman, 1990). As Schuckit (2008) described, alcohol can also damage the liver, pancreas, stomach, intestine and central nervous system. The effects of alcohol on central nervous system are generally proportional to blood ethanol concentration. However, individuals who are habituated to alcohol may have few symptoms, despite massive blood ethanol concentration. Young people who are not accustomed to alcohol may become comatose at more modest blood ethanol concentration (Johnson and Robinson, 1988). Peripheral neuropathy is a common finding in chronic alcoholics. There also is a population having autonomic neuropathy in chronic alcoholics (Duncan et al., 1980). Johnson and Robinson (1988) reported that vagal neuropathy in chronic alcoholics is associated with significantly higher mortality than in general population. They also suggested that the major cause of death in chronic
Cited: in Tan et al., 1984). Autonomic neuropathy has been found to be associated with alcoholic peripheral neuropathy (Mourot, Bouhaddi and Regnard, 2009). Barter and Tanner (1987) assessed autonomic nervous system integrity in 30 alcoholic subjects and 30 age-sex matched controls using five standard tests of cardiovascular responses. There was evidence of definite parasympathetic neuropathy 15 14 + 14 Nicolosi et al., 2005 chronic alcoholics = 32 non alcoholics = 32 total = 64