Alcohol metabolism and health hazards associated with alcohol abuse in a South African context: a narrative review

Abstract

The World Health Organization recently stated that alcohol consumption is the fifth leading cause of death worldwide and that intakes are increasing, especially in developing countries. Alcohol-related effects are major threats to global public health. There is growing recognition of an association between alcohol abuse and a host of health and social problems in many parts of the world. In South Africa, a developing country with a rapidly growing economy, available evidence shows that alcohol is a leading risk factor for mortality and morbidity, and hence a significant contributor to the burden of disease. The observed pattern of binge drinking of about a third of South African drinkers is of concern. In addition to physical dependence on alcohol, other psychological, genetic and social factors may contribute to the development of alcohol-related diseases. To develop a relevant, integrated and coherent strategy to address alcohol use, misuse and abuse in South Africa, we need a much better understanding of the metabolism of alcohol, and how the metabolic products and changes associated with alcohol abuse ultimately lead to biological health hazards. This review offers a broad understanding of the metabolism of alcohol and the biological health hazards associated with its abuse. Levels of foetal alcohol syndrome in South Africa are the highest ever recorded, and hence this review will separately address teratogenic effects associated with abuse.