Why Do Men Have Nipples? Hundreds of Questions You'd Only Ask a Doctor After Your Third Martini

CHAPTER 5. DRUGS AND ALCOHOL

Eloise,with her wounds cleaned and dressed, is back in business and is refreshing glasses and making small talk. Leyner appears wounded from his laboratory mishap and is quietly sitting cross-legged in the corner, sullenly nursing the dregs of his bottle of tequila. I’ve never condoned casual drug use, but I almost feel compelled to spike the punch bowl with a strong sedative and sneak out to find my way home. I resist this evil urge and feel better until I am confronted again by the indefatigable but once fat guy Jeremy Burns.

Jeremy, aside from his Atkins obsession, has never grown out of his penchant for fraternity hijinks. Eloise offers him one of her signature frozen daquiris, but Jeremy only wants a Jell-O shot, a beer bong, or some Ecstasy. Eloise turns her nose up at his boorish request, and he turns to me to plead for a prescription for some medical-grade marijuana. I explain to him that prescription pot is not available in New York, and that I wouldn’t give it to him anyway.

Jeremy is not ready to give up and asks, “Then can you get me any of that shit that Rush Limbaugh takes?”

“OxyContin,” I reply.

“Yeah, yeah,” he says. “Oh and also some of that stuff that Matthew Perry and Brett Favre do.”

“Vicodin,” I reply again.

Jeremy says that he already has plenty of Vicodin and asks if maybe I can just get him a little ketamine.

I am becoming exasperated and I realize that I have an opening. “Jeremy, you know that ketamine is a potent horse tranquilizer… and that guy over there is a veterinarian,” I say, pointing to a portly, balding gentleman in the next room.

Jeremy rushes off, as I breathe a sigh of relief.

With a culture dedicated to the use and abuse of caffeine, nicotine, alcohol, and an endless array of illegal substances, questions abound about the safest and quickest ways in which we can intoxicate ourselves and how to avoid the dreaded hangover.

This one isn’t all that clear. Or maybe it’s because of those drinks we just had.

The biggest problem with this rhyme is that nobody seems to remember how it goes. As for the science, there is no research to prove or disprove it.

One theory about this little ditty attempts to explain that the carbonation in beer causes increased alcohol absorption. There is no proof that this is true. Nor should you believe that coffee will help you with a hangover or that bread will absorb the alcohol in your system. Only time will cure your pain as you wait for the alcohol to leave your bloodstream.

Intoxication is defined as a blood alcohol level of 100 mg/dL (.10 %). In adults, the level usually falls about 15 to 20 mg/dL per hour. Everyone metabolizes differently, but on average it would take about six to eight hours for you to return to normal from a mild drunken state.

Blood Alcohol Concentration

Symptoms

.02%

light-headed

.05%

mild euphoria

.08%

loss of critical judgment

.10%

lack of coordination and balance

.15%

disorientation

.20%

vomiting

.30%

drunken stupor

.40%

coma

.45 %+

death

Simply put, alcohol causes intoxication, so the more you drink, the sicker you get. It doesn’t have anything to do with the order in which you tend to chug your beer or wine.

As for the dreaded hangover that follows, it is caused mainly by dehydration and interrupted sleep. The sleep and water that will ultimately cure you are not as interesting as some of these famous hangover cures:

1. The Prairie Oyster (olive oil, tablespoon of tomato ketchup, one egg yolk, salt and pepper, Tabasco, Worcestershire sauce, vinegar or lemon juice)

2. Cold pizza

3. IV fluids (helps to date an M.D. or paramedic)

4. The hair of the dog that bit you (i.e., the blessed Bloody Mary)

5. Vitamins B and C

6. And the most effective, and most expensive, kidney dialysis

If it’s the Jewish holiday Purim and you plan on competing in the Olympics, you may want to think twice before gorging on poppy seed hamantaschen. Eating enough poppy seeds can cause your urine to test positive for opiates. It is difficult to say how many poppy seeds you need to eat to fail your drug test, but some reports have stated that three poppy seed bagels, for example, could generate a positive test result. Pastries and cookies that contain heavy amounts of poppy seeds, like hamantaschen, could also lead to a positive test. There is an additional test that looks for certain chemicals present in heroin that are not present in poppy seeds. So, your athletic future really will depend on the exact test you are taking.

What is the poppy seed — heroin connection? Cultivated poppies are the source of opium, from which morphine and heroin are produced.

Answer: To keep Domino’s and Frito-Lay in business.

Marijuana is the most commonly used illicit drug in the United States. The main active chemical in marijuana is THC (delta-9-tetrahydrocannabinol), or The High Causer. THC falls in the category of chemicals called cannabinoids.

A study in the April 2001 issue ofNature helps us to better understand how marijuana causes users to have an increased appetite, the famous “munchies.” Molecules called endocannabinoids, marijuanalike chemicals present in our own brain, bind with receptors in the brain and activate hunger. These endocannabinoids in the hypothalamus of the brain then activate cannabinoid receptors that are responsible for maintaining food intake. The chemicals from marijuana bind to these cannabinoid receptors and cause the munchies. Sound complicated? Maybe you’re too stoned to understand. Go eat some cookie dough.

Hold the Rogaine. If you are bald, there may be another advantage besides the cost savings on hair products. You won’t have any hair to offer for your drug test.

As drugs are ingested into the body, they circulate in a person’s bloodstream. Trace amounts of these drugs or the drug metabolites are deposited in the hair follicle. As the hair grows, they remain stored in the core of the hair shaft.

When a person is tested, samples are taken at various levels in the hair shaft so that a reasonably accurate approximation can be made of how long ago a particular drug was used. Drugs or drug metabolites cannot be washed, bleached, or flushed out of the hair follicle.

The major practical advantage of hair testing compared with urine testing for drugs is that it can show that drug use occurred in the past weeks to months, depending on the length of the hair shaft, versus within only the past two to four days for other tests. Hair analysis is the least invasive of the testing methods but might not reveal recent use. Blood analysis is the most accurate but definitely invasive. Urine analysis is typically the least expensive and can detect infrequent or a recent single use. Urine analysis is the most commonly used form of drug testing.

So, if you constantly hit the bong, you might want to consider shaving your head.

There has been much discussion and research over the years on the health benefits of alcohol. In the 1920s the “Guinness Is Good for You” campaign in the United Kingdom made people believe that this famous Irish stout had health properties. The slogan stemmed from intense scientific market research: people told the company that they felt good after a pint, and the slogan was born.

Echinacea, vitamin C, zinc, and chicken soup, as well as a stiff belt, have all been postulated to prevent or cure the common cold. Unfortunately, there is no strong evidence for any of these choices. There are many other home remedies, several of which include brandy or whiskey. A friend has her own recipe, combining vodka and orange juice into a screwdriver, as her own special cold cure. Most likely the buzz just helps you forget how bad you feel.

Alcohol is the most common drug that leads people to throw their friends in the shower or force-feed them coffee. Time is the only thing that will sober up a drunk person. Coffee, showers, exercise, sweating it out, fresh air, or any other method will not increase the rate at which alcohol is eliminated from the body. The liver just needs the time to metabolize the alcohol.

As for other, more hardcore drugs, the coffee won’t help, but keeping someone awake until help arrives could be a lifesaver. Heroin and other opiates cause you to stop breathing, and this leads to cardiac arrest. Remember, coffee is only a temporary measure and medical help should be sought for any drug overdose. If someone stops breathing, you should begin CPR. The shower is probably unnecessary, and a big waste of precious time.

Vomiting from excessive drinking is simply your body’s way of getting rid of the toxins in alcohol quickly. Vomiting is not a bad thing in this case, but repeated hurling can lead to potentially life-threatening dehydration and electrolyte imbalances. There is also the danger of choking on vomit, like the guy from Led Zeppelin.

The urge to vomit comes from two anatomically and functionally separate units — a vomiting center and a chemoreceptor trigger zone. The vomiting center, which has overall control of vomiting, is located in the part of the brain called the medulla. The chemoreceptor trigger zone, which sends signals to the vomiting center, is found in the fourth ventricle of the brain. The ventricles are a system of four communicating cavities in the brain that are filled with cerebrospinal fluid. Alcohol probably acts on the chemoreceptor trigger zone.

In the hospital vomiting is referred to as emesis, but many doctors prefer these more colorful terms:

puke

barf

uneat

blow chow

ride the porcelain bus

pray to the porcelain god

technicolor yawn

toss your cookies

lose your lunch

feed the fish

spill the groceries

This is a question that gets asked a lot, both because of the increasing popularity of Ecstasy and the fact that people keep forgetting that they asked in the first place. So, yes, Ecstasy probably does cause memory loss.

Ecstasy, or MDMA (3–4 methylenedioxymethamphetamine), is a synthetic psychoactive drug chemically similar

to the stimulant methamphetamine and the hallucinogen mescaline. Some refer to it as a “designer amphetamine.”

One of the major results from the use of Ecstasy is that both in short-term and long-term use it could have serious effects on brain cells. Specifically, Ecstasy harms neurons that release serotonin, a brain chemical thought to play an important role in regulating memory and other important functions. Case reports and interviews with Ecstasy users report memory loss, depression, alterations in sleep, and anxiety. Memory deficits seem to persist even after stopping the use of Ecstasy.

In the process of researching this book, the authors had a working dinner, and in the course of our hard work, we consumed large quantities of beer, wine, and tequila. As we stumbled down the street, Mark insisted that he was fine to take the train home. Better judgment prevailed, and I wrestled him into a cab. The cab drove away and I started to walk home. A block later, I came upon the cab and found Mark fumbling with his empty wallet in the backseat. I opened the door. Mark, with no memory of our evening, said, “What are you doing here?” Alcohol surely kills brain cells.

To properly answer this question we must separate light to moderate drinking from heavy drinking. We also need to separate temporary from permanent damage.

In general, alcohol doesn’t specifically kill brain cells but alcohol damages the dendrites, the small branches that extend from the cells and receive information. The mechanism of action for intoxication is multifactorial but the end result is the slurred speech, clumsiness, slow reflexes, and loss of inhibition that we associate with being drunk. This damage isn’t permanent in light to moderate usage. This means you can have one to seven drinks a week and be just fine.

Heavy alcohol use does clearly cause neurological damage. CT scans of chronic alcoholics can show brain atrophy and studies have shown that heavy use damages retrospective memory. Alcoholism can produce Wernicke-Korsakoff syndrome, which is caused by deficiency of the B-vitamin thiamine; alcohol decreases the absorption of this vitamin, and alcoholics also don’t have the healthiest diets. Patients with this condition have symptoms such as confusion, delirium, disorientation, inattention, memory loss, and drowsiness. If thiamine is not given promptly, the syndrome may progress to stupor, coma, and death.

Nothing is worse than the moment when you hit the sheets and the room starts to spin. Trying to explain why this happens causes almost as much dizziness.

The vestibular system is a complicated network of passageways and chambers within the inner ear, all of which work together to control equilibrium and balance. Inside there are tubes and sacs that contain different fluids, each of which has a different composition. When you are healthy, and both sides of your vestibular system are functioning properly, both sides send symmetrical impulses to the brain. When someone gets very intoxicated, the alcohol changes the density of the blood and this affects the intricate system of balance. That is when the spinning starts. This is very similar to the condition called vertigo.

There is a common serenade in any emergency room. The coarse snore of the regular alcoholic fills the air. Normally, we just ignore it. But sometimes, too much alcohol actually impedes the breathing process. We fix this easily with a short small rubber tube in the nose, an aptly named nasal trumpet. Alcohol increases snoring by relaxing the muscles that hold the throat open, allowing the soft palate tissue and uvula to flutter more as air passes.

Finally, some good news.

Historically there has been a belief that wine has medicinal properties. Hippocrates and Thomas Jefferson both considered wine an important part of their health regimens. Louis Pasteur, the famous French biologist, said, “Wine is the most healthful and hygienic of beverages.”

There now is an enormous amount of research about what has been called “the French Paradox,” that despite a diet rich in fats there is a lower-than-expected prevalence of cardiovascular disease among the Gauls.

Scientific studies have linked this surprising fact to the moderate consumption of alcohol, specifically red wine. Red wine has also been linked to a reduced risk of some cancers, atherosclerosis, heart disease, and even the common cold.

So drink a whole bottle tonight. Your bed will spin but you probably won’t have a heart attack.

There are some important medical uses for marijuana, and some of these lead to solid arguments for legalization. However, the use of marijuana for glaucoma does not appear to have any benefit over available medications.

Marijuana does reduce pressure in the eye, but in order to sustain this reduction you would have to smoke about ten to twelve joints a day. Your eye pressure might be lower but you will be too stoned to get anything else accomplished except naked guitar playing, gluttonous pork rind consumption, or deriving profound meaning from Rob Schneider films.

The arrival of the Saint Bernard with the little cask around its neck is a heartwarming image but drinking alcohol to warm yourself or prevent frostbite doesn’t make any medical sense, we’re sorry to report. Alcohol consumption actually can be dangerous in these conditions as it decreases blood circulation and thus can enhance heat loss and impair shivering.

Poor, sad toads. They always seem to take a backseat to the frogs. Frogs get kissed and turn into princes, and toads just get to cause warts. Well, here is some good news for toads. Toads do not cause warts. Toads do, however, produce a protective substance in the parotid gland behind the eyes. This toxin can make animals, such as dogs, very sick and can be irritating to the human eye. But some people go way beyond touching toads and actually lick them in an attempt to get high from a “psychedelic” substance supposedly found on its skin.

The species known as the Bufo toad does have a psychedelic substance on its skin. This substance is similar to serotonin and LSD and can cause hallucinations. Be careful when trying this method because some people have been arrested for toad licking.

Straight from the Department of Psychology at the University of Glasgow, a paper entitled “Alcohol Consumption Increases Attractiveness Ratings of Opposite-Sex Faces: A Possible Third Route to Risky Sex,” thus proving that beer goggles do exist. Feel free to use this paper to excuse your bad behavior.