Brain
Expert Pharmacologist
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Medical alcohol in a siphon, tobacco enemas, and vodka from newborn mice. How to minimize the harms of alcohol and other addictions with the help of science.
- Why did our ancestors infuse vodka with women's menstrual blood and black dog feces?
- How do dolphins get addicted?
- How long will it take you to recover if you quit smoking today?
The BB team interviewed the Director of the Munich Institute for Molecular Toxicology and Pharmacology, Prof. Dr. Martin Göttlicher, who was happy to explain to us in simple language about pressing issues.
— What are the benefits of alcohol, if you look at it scientifically?
— Ethanol acts as a depressant. Not in the sense that it spoils our mood, but from the pharmacological point of view it depresses the activity of the brain's neurons. If we work very long hours, get overexcited, get nervous a lot, the first (small!) doses of alcohol dampen all these feelings - and we feel good and easy. Problems don't go away, but we begin to treat them differently. There may be a positive side to alcohol, if the problems are really such that it makes no sense to worry too much about them. But this is also the trap: if the problems are real, alcohol can become a way to avoid them.
— How much should you drink or how much should you drink to stay cheerful longer?
— There is no unequivocal answer here. Neurophysiologists conducted a study and found that drinking a «small dose» (about 20 grams of pure ethanol) is sufficient, that is, about 25 milliliters. If converted to wine and beer, that's 200 ml of wine or 450 ml of beer.
But there are a lot of nuances. Alcohol affects different people differently. Even the same person gets drunk in different states in different ways. If he's tired, hasn't slept well, has just had an infection, finished taking a course of medication, he may from the very beginning of the fun instead of turning into a gloomy zombie, who at best will quickly get drunk and fall asleep, and at worst, after another drink he will find enemies around him and begin to destroy them and get into a fight, aggression will appear.
— Ethanol acts as a depressant. Not in the sense that it spoils our mood, but from the pharmacological point of view it depresses the activity of the brain's neurons. If we work very long hours, get overexcited, get nervous a lot, the first (small!) doses of alcohol dampen all these feelings - and we feel good and easy. Problems don't go away, but we begin to treat them differently. There may be a positive side to alcohol, if the problems are really such that it makes no sense to worry too much about them. But this is also the trap: if the problems are real, alcohol can become a way to avoid them.
— How much should you drink or how much should you drink to stay cheerful longer?
— There is no unequivocal answer here. Neurophysiologists conducted a study and found that drinking a «small dose» (about 20 grams of pure ethanol) is sufficient, that is, about 25 milliliters. If converted to wine and beer, that's 200 ml of wine or 450 ml of beer.
But there are a lot of nuances. Alcohol affects different people differently. Even the same person gets drunk in different states in different ways. If he's tired, hasn't slept well, has just had an infection, finished taking a course of medication, he may from the very beginning of the fun instead of turning into a gloomy zombie, who at best will quickly get drunk and fall asleep, and at worst, after another drink he will find enemies around him and begin to destroy them and get into a fight, aggression will appear.
— Are there any tips to make your body react more slowly to alcohol? Like taking sorbents or eating something fatty before going to the bar?
— Oh, yeah, the famous useless tiphook. Think about it, if you eat something very fatty but potentially digestible, it will immediately, while still in the stomach, begin to digest.
— To create some kind of protective barrier on the mucous membrane of the stomach, you need to, first, use some inedible oil, say, Vaseline oil, and second, after that, dance the bottom break, so that everything evenly smeared on the walls of the intestine. Do you need it?
— It's the same with sorbents. They are mostly sharpened for bacterial toxins, rather large protein molecules, while ethanol is a tiny molecule of universal solubility. Ethanol is already absorbed in the oral cavity. You can check this out on a famous student pastime. In my youth, when I was a student and lived in the dormitory, we had a game called «Thimbles»: they poured gin into thimbles and suggested that competitors drink first one thimble, then two, and then in arithmetic progression. In my memory, no one ever got to 10 thimbles. About 35% of ethanol is absorbed before it reaches the duodenum.
— Oh, yeah, the famous useless tiphook. Think about it, if you eat something very fatty but potentially digestible, it will immediately, while still in the stomach, begin to digest.
— To create some kind of protective barrier on the mucous membrane of the stomach, you need to, first, use some inedible oil, say, Vaseline oil, and second, after that, dance the bottom break, so that everything evenly smeared on the walls of the intestine. Do you need it?
— It's the same with sorbents. They are mostly sharpened for bacterial toxins, rather large protein molecules, while ethanol is a tiny molecule of universal solubility. Ethanol is already absorbed in the oral cavity. You can check this out on a famous student pastime. In my youth, when I was a student and lived in the dormitory, we had a game called «Thimbles»: they poured gin into thimbles and suggested that competitors drink first one thimble, then two, and then in arithmetic progression. In my memory, no one ever got to 10 thimbles. About 35% of ethanol is absorbed before it reaches the duodenum.
Alcohol containing 40% ethanol is absorbed worse than 20% tincture or 5% beer. The more we dilute the alcohol, the faster it is absorbed. It turns out that if you just drink 50 ml of 40% alcohol, the maximum concentration of ethanol in the blood will accumulate slower than if this portion of alcohol is drunk with water or some carbonated drink.
In general, if you want to get drunk quicker, it doesn't matter if you drink alcohol or not. In case you want to avoid a hangover - drink any alcohol at all, and it is better to drink non-carbonated mineral water. Whole molecule of ethanol has a good diuretic effect, so the more water will be in your body, the better. Again, everything in moderation.
— If we add carbonated cola to whiskey, do we reduce the concentration or disperse the alcohol with bubbles?
— The scariest drink I've ever seen in my life was pure medical alcohol loaded into a soda siphon.
— Just 50 ml of this miracle drug incapacitated my American colleague, Lieutenant Walter Reed of the hospital, for almost a day. He came to our institute in 1990 as part of a committee for training. It took a lot of work to bring him to his senses. I still carry the medical emblems my colleague gave me after this whole story as a trophy.
— But if we answer the question from the point of view of science, it turns out an interesting physics: we significantly increase the area of contact of the drink with the intestinal mucosa, which greatly increases the rate of absorption, and it is proved that the rate of absorption in the rectum is much faster than in the mucosa of other organs.
— Can I mix energy drinks with alcohol?
— This is dangerous. Energy drinks usually contain tangible doses of caffeine. And because of the caffeine, the myocardium needs large doses of oxygen.
— There was a story: a 19-year-old guy drank a new drink, which was a mixture of hard alcohol and a large dose of caffeine, and he had a myocardial infarction. And this was on the assumption that he had never had any heart problems, he had played sports at all.
— The attending physician reported that the symptoms were very unusual for his age and more like an overdose of cocaine or amphetamines. In addition, caffeine masks intoxication. The person feels as if they can drink more.
— This happens because the inhibitory neurotransmitter adenosine is temporarily blocked. But the effect of caffeine stops at some point. Adenosine, with all its accumulated mass, pushes on the brake pedal in the brain. And what will be the result of this process shows us the statistics of traffic accidents in the world.
— This is dangerous. Energy drinks usually contain tangible doses of caffeine. And because of the caffeine, the myocardium needs large doses of oxygen.
— There was a story: a 19-year-old guy drank a new drink, which was a mixture of hard alcohol and a large dose of caffeine, and he had a myocardial infarction. And this was on the assumption that he had never had any heart problems, he had played sports at all.
— The attending physician reported that the symptoms were very unusual for his age and more like an overdose of cocaine or amphetamines. In addition, caffeine masks intoxication. The person feels as if they can drink more.
— This happens because the inhibitory neurotransmitter adenosine is temporarily blocked. But the effect of caffeine stops at some point. Adenosine, with all its accumulated mass, pushes on the brake pedal in the brain. And what will be the result of this process shows us the statistics of traffic accidents in the world.
— What, besides blocking adenosine, happens in our brains when we get drunk? Why do we start looking for answers to questions like «why didn't Frodo fly the eagles right away»?
— There is a widespread belief that a glass of wine a day is useful, is this true?
— Do I understand correctly that a healthy person's hangover is ethanol poisoning and an alcoholic's hangover is a lack of ethanol in the blood?
— Yes, for some reason these two fundamentally different states are often confused.
— Alcohol hangover = ethanol withdrawal. Ethanol is a drug, and you can become addicted to it fairly quickly. There are two known ways to get rid of withdrawal: either by enduring withdrawal until it disappears, or by taking another dose of alcohol. A healthy person's hangover (Veisalgia) = poisoning by ethanol metabolites, primarily acetic aldehyde. There is a lot of it in the blood, hence the whole clinical picture. If you take another dose of alcohol on this background, you can only aggravate your condition.
— What to do in case of a hangover?
— Sleep, replenish the loss of electrolytes and water, and the body will do the rest. It needs time to distill all the acetic aldehyde into acetic acid, remove these metabolites from the cell into the general bloodstream, then turn them into acetyl coenzyme A, «spin» it in the Krebs cycle and finally get water and carbon dioxide as the output. But you definitely don't need to drink coffee, work or have sex in the morning after a party.
— Yes, for some reason these two fundamentally different states are often confused.
— Alcohol hangover = ethanol withdrawal. Ethanol is a drug, and you can become addicted to it fairly quickly. There are two known ways to get rid of withdrawal: either by enduring withdrawal until it disappears, or by taking another dose of alcohol. A healthy person's hangover (Veisalgia) = poisoning by ethanol metabolites, primarily acetic aldehyde. There is a lot of it in the blood, hence the whole clinical picture. If you take another dose of alcohol on this background, you can only aggravate your condition.
— What to do in case of a hangover?
— Sleep, replenish the loss of electrolytes and water, and the body will do the rest. It needs time to distill all the acetic aldehyde into acetic acid, remove these metabolites from the cell into the general bloodstream, then turn them into acetyl coenzyme A, «spin» it in the Krebs cycle and finally get water and carbon dioxide as the output. But you definitely don't need to drink coffee, work or have sex in the morning after a party.
— Are there any specific folk treatments for hangovers?
— There are many folk remedies. Just use Google and you will be swept up in a wave of ancestral wisdom. I'm sure that almost any reader can share his or her own, precisely working recipe for hangovers, passed down in his or her family from generation to generation.
— There were recipes with dubious rationality, and I have read many historical publications on the subject. For example, vodka should have been infused with the worms that breed in pubs from dampness before consumption. Or on newborn mice and the hub of the cart wheel under which they were found. Or on the feces of a black dog. Or on straw from the barn. Or on his wife's menstrual blood. My ancestors were a bit of a trickster.
— Why is it that when you drink, you instantly feel the urge to smoke?
— According to the researchers, bad habits reinforce each other's effects, but not in the way we would like them to. It is known that both alcohol and nicotine are perceived by the brain as a kind of reward. The main mediator is dopamine.
— According to the researchers, bad habits reinforce each other's effects, but not in the way we would like them to. It is known that both alcohol and nicotine are perceived by the brain as a kind of reward. The main mediator is dopamine.
— What is our next action in response to smoking a cigarette? That's right, drink alcohol again. It's a vicious circle.
— There is a silver lining here: medicines that help extinguish nicotine addiction also reduce the patient's craving for alcohol. This is the medical dialectic.
— There are many folk remedies. Just use Google and you will be swept up in a wave of ancestral wisdom. I'm sure that almost any reader can share his or her own, precisely working recipe for hangovers, passed down in his or her family from generation to generation.
— There were recipes with dubious rationality, and I have read many historical publications on the subject. For example, vodka should have been infused with the worms that breed in pubs from dampness before consumption. Or on newborn mice and the hub of the cart wheel under which they were found. Or on the feces of a black dog. Or on straw from the barn. Or on his wife's menstrual blood. My ancestors were a bit of a trickster.
— Why is it that when you drink, you instantly feel the urge to smoke?
— According to the researchers, bad habits reinforce each other's effects, but not in the way we would like them to. It is known that both alcohol and nicotine are perceived by the brain as a kind of reward. The main mediator is dopamine.
— According to the researchers, bad habits reinforce each other's effects, but not in the way we would like them to. It is known that both alcohol and nicotine are perceived by the brain as a kind of reward. The main mediator is dopamine.
— What is our next action in response to smoking a cigarette? That's right, drink alcohol again. It's a vicious circle.
— There is a silver lining here: medicines that help extinguish nicotine addiction also reduce the patient's craving for alcohol. This is the medical dialectic.
— Does nicotine cause cancer?
— It is nicotine that does not lead to cancer, but very much goes along with it: nicotine can «hide» the tumor from the immune system, or provide it with «new» blood vessels, as well as increase the rate at which cancer cells multiply.
— What causes cancer then? What does nicotine do to our body in general?
— Nicotine is the safest substance in tobacco smoke. It is not for nothing that electronic cigarettes are considered a safer alternative to conventional «oxygen sticks». I mean that if you already smoke, then at least switch to electronic cigarettes in order to spoil your life and the life of those around you.
— In tobacco products, in addition to nicotine contains another 7500 very different substances, 70% of which is very strong «toxicological background». These compounds cause direct harm not only to the smoker himself, but also to people around him, including through the second and even third hands. That is you have smoked or stood next to those who have smoked, come home, your clothes are saturated with tobacco smoke. And this smoke begins to breathe your family members. This influence is especially detrimental to children.
— The true epidemic of bronchial asthma in the 20th century is directly related to the extremely widespread use of cigarettes. So if we are talking about the complex effect of all components of tobacco smoke, diseases occur significantly more often in smokers than in non-smokers. There are a lot of negative effects.
— It is nicotine that does not lead to cancer, but very much goes along with it: nicotine can «hide» the tumor from the immune system, or provide it with «new» blood vessels, as well as increase the rate at which cancer cells multiply.
— What causes cancer then? What does nicotine do to our body in general?
— Nicotine is the safest substance in tobacco smoke. It is not for nothing that electronic cigarettes are considered a safer alternative to conventional «oxygen sticks». I mean that if you already smoke, then at least switch to electronic cigarettes in order to spoil your life and the life of those around you.
— In tobacco products, in addition to nicotine contains another 7500 very different substances, 70% of which is very strong «toxicological background». These compounds cause direct harm not only to the smoker himself, but also to people around him, including through the second and even third hands. That is you have smoked or stood next to those who have smoked, come home, your clothes are saturated with tobacco smoke. And this smoke begins to breathe your family members. This influence is especially detrimental to children.
— The true epidemic of bronchial asthma in the 20th century is directly related to the extremely widespread use of cigarettes. So if we are talking about the complex effect of all components of tobacco smoke, diseases occur significantly more often in smokers than in non-smokers. There are a lot of negative effects.
— Why do plants produce nicotine?
— For protection against insect pests. Nicotine, like caffeine, is an insecticide. Nicotine is essential on the Colorado potato beetle, it naturally rips it to shreds. But hamsters, horses, and humans, being more highly organized, can eat nicotine. In certain doses, of course.
— I've heard that nicotine was once used to treat some diseases? For example, a tobacco enema - what is that?
— Relatives of nicotine are still treated today, e.g. nicotinic acid (it's vitamin B3, helps in dilation of peripheral blood vessels). And the tobacco enema is analogous to the modern automatic defibrillators that are hung up in public places.
— In England and the Netherlands in the 19th century, tobacco enema kits were placed on canal embankments where suicides often visited. It was believed that an enema could bring a drowned man back to life.
— For protection against insect pests. Nicotine, like caffeine, is an insecticide. Nicotine is essential on the Colorado potato beetle, it naturally rips it to shreds. But hamsters, horses, and humans, being more highly organized, can eat nicotine. In certain doses, of course.
— I've heard that nicotine was once used to treat some diseases? For example, a tobacco enema - what is that?
— Relatives of nicotine are still treated today, e.g. nicotinic acid (it's vitamin B3, helps in dilation of peripheral blood vessels). And the tobacco enema is analogous to the modern automatic defibrillators that are hung up in public places.
— In England and the Netherlands in the 19th century, tobacco enema kits were placed on canal embankments where suicides often visited. It was believed that an enema could bring a drowned man back to life.
— If a person wants to quit alcohol and cigarettes, what alternative would you offer? What kind of healthy addiction would he choose?
— Addictions in general are never healthy, even the excessive enthusiasm for the «healthy lifestyle» has its own diagnosis - orthorexia. So it would be more correct to live without addictions. But it doesn't work that way, because our highly evolved brain is a lazy substance that likes to get the most by putting in the least.
— Some people smoke/drink alcohol/eat a lot, while others dive into caves/ride down mountains on mountain bikes/jump from unfinished skyscrapers, etc.-these are all phenomena of the same system.
— Dolphins, for example, drug echinoderms by sticking their faces into their poisonous needles and then getting high by hanging out in the water column. Do you think dolphins push drowning people to the surface out of humanity? No. They just take them for their stoned brethren, who sometimes forget how to breathe in a narcotic haze.
— What works and what doesn't work in aspects of quitting smoking depends on the specifics and individual characteristics of the body. Someone just made up his mind and quit. Someone read Carr and quit. Someone went to acupuncture - and quit. Someone gradually reduced the number of cigarettes a day - and quit. Some of us used special patches and chewing gum to quench our nicotine cravings - and stopped.
— Addictions in general are never healthy, even the excessive enthusiasm for the «healthy lifestyle» has its own diagnosis - orthorexia. So it would be more correct to live without addictions. But it doesn't work that way, because our highly evolved brain is a lazy substance that likes to get the most by putting in the least.
— Some people smoke/drink alcohol/eat a lot, while others dive into caves/ride down mountains on mountain bikes/jump from unfinished skyscrapers, etc.-these are all phenomena of the same system.
— Dolphins, for example, drug echinoderms by sticking their faces into their poisonous needles and then getting high by hanging out in the water column. Do you think dolphins push drowning people to the surface out of humanity? No. They just take them for their stoned brethren, who sometimes forget how to breathe in a narcotic haze.
— What works and what doesn't work in aspects of quitting smoking depends on the specifics and individual characteristics of the body. Someone just made up his mind and quit. Someone read Carr and quit. Someone went to acupuncture - and quit. Someone gradually reduced the number of cigarettes a day - and quit. Some of us used special patches and chewing gum to quench our nicotine cravings - and stopped.
— And someone tried all of the above, but could not quit smoking, like Mark Twain. Or, like me, they have accepted the fact that they will live 10-15 years less than the main population, but in exchange for this they have received a remote control of the brain, considering such an exchange more than equivalent. If you can't quit on your own, see a doctor.
— What can you get high from in that case, if you don't consider psychoactive substances?
— Getting high in life. There is definitely a place in life for getting high. Look at this: you went to a live concert of your favorite band. A buzz? Yes! Kissing your loved one in the back rows of a movie theater, or sliding down an alpine snowy slope, that's a buzz too.
— So carpe diem, as the ancient Romans would say.
— What can you get high from in that case, if you don't consider psychoactive substances?
— Getting high in life. There is definitely a place in life for getting high. Look at this: you went to a live concert of your favorite band. A buzz? Yes! Kissing your loved one in the back rows of a movie theater, or sliding down an alpine snowy slope, that's a buzz too.
— So carpe diem, as the ancient Romans would say.
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