The biochemistry of alcohol and alcohol abuse

The vast majority of the adult population of most societies consume alcohol to some degree. In the U.K., although average alcohol consumption is moderate, it is not generally appreciated that the per capita consumption varies markedly within the population: approximately one-twentieth of the adult population accounts for half of the total alcohol consumed. Alcohol abuse is consequently a major health problem affecting 1-1.5 million people in this country. The most obvious effects of excessive alcohol consumption are on the central nervous system and on social behaviour. However, alcohol is metabolized predominantly in the liver and it can impair and impede the liver's capacity to metabolize other substances including nutrients, steroids, vitamins, and certain organic compounds foreign to the body (referred to as xenobiotics). It is possible therefore, from the biochemical perspective, to explain many of the effects of alcohol on the body on the basis of its interaction with essential liver metabolism. What remains obscure is the mechanism whereby chronic alcohol abuse leads to permanent damage to the liver and other organs. Recent research suggests that acetaldehyde (a metabolite of alcohol) may play a key role in this process.