{Page 54 & Others}
... Researchers conclude that large and continuous doses of alcohol stimulate the cells to adjust the structure and thus the functioning of their membranes. The cells now welcome alcohol and adjust to its toxic aftereffects. As a result, the cells are able to cope with increasingly large doses of alcohol; they become, in other words, tolerant to alcohol.
If the alcoholic continues to drink in large quantities, however, the toughened membranes are continually battered and gradually damaged by alcohol's poisonous aftereffects ... The results are catastrohpic ... The destruction of cell membranes is linked with many of the conditions which afflict alcoholics in the late stage of their disease, including severe withdrawal symptoms, such as convulsions, hallucinations, and delerium tremens, and damage to the heart muscle (alcoholic cardiomyopathy).
The ability to tolerate large amounts of alcohol can develop over a period of weeks or years, depending on the individual. Some alcoholics experience a subtle gradual shift from normal drinking to a drinking pattern of increased frequency and stepped-up amounts over a period of many years. Most alcoholics, however, experience a more immediate change in their tolerance level and are able to drink more than their friends and show less impairment soon after they first start drinking.
Tolerance is actually responsible for the alcoholic's continued and increasingly large intake of alcohol. In fact, an increase in the amount and frequency of drinking is the typical symptom of a developing tolerance to alcohol and one of the first warning signs of alcoholism.
When the alcoholic become tolerant to alcohol's effects, he is responding to changes which are occurring inside him. He is not responsible for initiating theses changes. He is not even conscious that these changes are taking place.
{Page 58 & Others}
Something completely different happens when the early-stage alcoholic drinks. Alcoholics in the early, adaptive stage of their disease also show improvement of functioning as the blood alcohol level begins to rise. But unlike the nonalcoholic, this improvement continues with additional drinking.
Even when blood alcohol remains at fairly high levels -- levels which would overwhelm the nonalcoholic, causing him to stumble, stutter, and sway -- the early alcoholic is often able to talk coherently, walk a straight line, or skillfully maneuver a car. Only when the alcoholic stops drinking and his BAL descends, does his performance deteriorate -- and it does so very rapidly.
Most alcoholics discover "maintenance drinking" early on in their drinking careers, and they learn ways to protect themselves against the disasterous drop in blood alcohol level ... "... keep a bottle in the car to maintain him until he gets home ... pick a tavern closer to home and gulp a last drink just before leaving ..."
Maintenance drinking is not gluttony or irresponsible drinking, but a protective device whereby the alcoholic delays the drop in BAL until he is safely off the road and back in bed. By drinking continuously but never overdrinking, he attempts to hold on to the benefits of drinking while forestalling the penalties.
Tragically, the alcoholic can only temporarily control his drinking behavior. Over a period of years, the cells' dependence on alcohol becomes more firmly entrenched until, at some point, the alcoholic no longer has a choice. He needs alcohol to function, and he suffers terribly when he stops drinking. The benefits of adaptation are gradually overshadowed by the penalties of deterioration.