While drinking alcohol in moderation may not be that dangerous, there are some serious side effects of drinking heavily over a long period of time. According to the World Health Organization (WHO), globally, 3.3 million deaths every year result from the harmful use of alcohol. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes alcohol use disorder as a drinking problem that becomes severe. Usually, people with this condition don’t know when or how to stop drinking. They spend a lot of time thinking about alcohol, and they cannot control how much they consume, even when it causes serious problems at home, work, and financially. Dr Joseph Ryarasa Nkurunziza, Chairperson of Health Development Initiative Rwanda-HDI, says that alcohol consumption is quite common among most societies of different age groups. Those who consume alcohol can be classified in different categories; heavy drinkers, alcoholics and social drinkers, he says. Nkurunziza explains that while these different categories consume alcohol differently, alcohol consumption can severely impact brain and hormonal functionality which could lead to development of some anxiety related mental disorders. “Some of the most common physical and mental illnesses associated with alcoholism include, but are not limited to, bipolar disorder; this disorder is associated with increased levels of energy and hyper activeness which can be channelled into a feeling of extreme power,” he says. Nkurunziza says that schizophrenia is another illness. This is classified as a chronic brain disorder characterised by delusions, hallucinations and difficulties, and making sense of one’s surroundings as a result of excessive consumption of alcohol. Nkurunziza further notes that regular drinking can affect the quality of one’s sleep, making them feel tired throughout the day. He adds that alcohol aggravates the stomach and digestive system. A small amount of alcohol causes the stomach to produce more acid than usual as well, which leads to inflammation of the stomach lining. This can lead to stomach pain, vomiting, and diarrhoea. Furthermore, Nkurunziza says, alcohol addicts over time tend to portray psychiatric symptoms as a result of dependence which often leads to depression, panic attacks, personality disorders and short-term memory loss. In most cases, these psychiatric disorders linked to alcohol disorders are usually caused by a variety of issues that are considered to be extremely difficult to handle, hence, excessive consumption of alcohol, he notes. Nkurunziza points out that the process of supporting alcohol addicts, depression, anxiety and mood disorders tend to be more prevalent, however, if alcohol addiction is dealt with, physical and mental illnesses tend to improve with time, support and the right treatment. According to Dr Michel Baingi, a general practitioner in Kigali, alcoholism is the inability to control drinking due to a physical and emotional dependence on alcohol. He says that the type of alcohol commonly consumed is ethanol with different alcoholic beverages containing different percentages for it. Ethanol acts to depress brain functioning very much in the style of an anaesthetic. Baingi explains that alcohol abuse can cause signs and symptoms of depression, anxiety, psychosis and anti-social behaviour, during intoxication and withdrawal. He says that over drinking also imposes long term health risks such as chronic diseases and other serious problems, including; arterial hypertension, heart disease, stroke, liver disease, and cancer of the breast, mouth, oesophagus, liver and colon. Baingi adds that in most cases, Korsakoff syndrome is as a result of over drinking or use of alcohol. Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Scientists don’t yet know why heavy drinking causes severe thiamine deficiency in some alcoholics and leads to Wernicke encephalopathy. This is a life-threatening illness caused by thiamine deficiency, which primarily affects the peripheral and central nervous systems. He adds that alcohol consumption is another factor that has been linked to the onset of Parkinson’s disease—a disorder of the central nervous system that affects movement, often including tremors. Baingi says that various neurotransmitters have been implicated in alcohol addiction due to their imbalance in the brain, which could be either due to excess activity or inhibition. Neurotransmitters are chemical messengers that transmit a message from a nerve cell across the synapse to a target cell.