Wet Brain
Here are 10 Facts to Understand About “Wet Brain”
What Is Wet
Brain? Alcohol Abuse and Its Connection to Wet Brain The National Institute on Alcohol Abuse and Alcoholism (NIAAA) published in 2013 that 86.8 percent of American adults aged 18 or older had consumed alcohol at some time in their lifetime. Drinking alcohol in moderation is not generally a bad thing, and alcohol is even touted as having certain health benefits. The Dietary Guidelines for Americans establishes that drinking in moderation is one drink per day for a woman and two per day for a man, and this is generally considered safe. Anything beyond these levels may constitute binge or heavy drinking, and repeated episodes of heavy or binge drinking may lead to problem drinking or an alcohol use disorder (AUD). The NIAAA reports that 16.6 million American adults aged 18 and older and 697,000 adolescents between the ages of 12 and 17 battled an AUD in 2013. Long-term alcohol abuse, or alcoholism, has a multitude of negative health risks and side effects. The NIAAA publishes that up to 80 percent of alcoholics may have a thiamine (B1) deficiency, for example. Thiamine is an essential vitamin responsible for helping the body to successfully break down and utilize sugars in order to produce energy. Thiamine levels are depleted through a poor diet, which is often caused by regular alcohol abuse as alcoholics may make poor nutritional and lifestyle choices. In addition, alcohol withdrawal symptoms may include nausea and vomiting, further depleting essential vitamins and minerals. Thiamine deficiency can cause brain damage and result in Wernicke-Korsakoff syndrome (WKS), “wet brain.” It is most commonly the result of alcohol abuse. It is difficult to quantify how many people may suffer from Wernicke-Korsakoff syndrome, as the symptoms may be similar to those of alcohol withdrawal or intoxication at times. In addition, many alcoholics may be homeless or have a diminished social circle or support system due to their alcoholism, resulting in fewer formal diagnoses of WKS. This brain disorder comes on suddenly and is often considered to be “alcohol-related dementia,” as brain damage can cause difficulties with learning and memory functions that may be permanent and irreversible. Oxford University Press estimated that between 10 and 24 percent of brain damage and dementia cases may be related to alcohol abuse. The Alzheimer’s Society reports that “wet brain” may affect around two percent of the general population. Symptoms of Wet Brain WKS is actually two different conditions that are commonly considered different stages of one disorder: Wernicke encephalopathy and Korsakoff psychosis. Wernicke Encephalopathy Wernicke encephalopathy usually manifests first and is characterized by bleeding in the brain that may cause the following symptoms:
The main three symptoms of Wernicke encephalopathy, mental confusion, abnormal eye movements, and ataxia (staggering gait), are only all present in about 10 percent of patients, making diagnosis extremely difficult, according to an article published in the Swiss Medical Review. Wernicke encephalopathy is generally short-lived, and the NIAAA estimates that around 80-90 percent of alcoholics will go on to develop Korsakoff psychosis. Korsakoff Psychosis This second stage of WKS can be debilitating and permanent if not treated properly and early. Korsakoff psychosis symptoms include:
Memory Loss In addition to these symptoms, someone who has developed WKS from chronic alcohol abuse may also suffer from alcohol withdrawal symptoms that can include tremors, sweating, and other unpleasant side effects. Wernicke-Korsakoff syndrome may have a genetic component, making some people more susceptible than others. While the most common cause of WKS may be chronic and regular alcohol abuse, anorexia or other disorders that can deplete thiamine may also be involved in its onset. The rapid introduction of glucose to a thiamine-deficient brain may cause wet brain as well. For instance, if you are a chronic and heavy drinker who makes poor nutritional choices and eats foods high in sugar, this can speed up the potential onset of Wernicke-Korsakoff syndrome. Prognosis and Treatment Chronic alcohol abuse damages the cerebellum, which is the region in the brain responsible for coordination, movement, and even potentially some functions related to memory and learning. Depriving the brain of thiamine for a long period of time damages this region, and left untreated and unchecked, the brain damage can be permanent. Wernicke encephalopathy doesn’t have to continue on to Korsakoff psychosis. It can be arrested and reversed if diagnosed and treated early on with thiamine supplements, healthy diet changes, and a reduction in alcohol consumption. Often, healthy lifestyle changes may include detoxification services and therapy in order to be effective long-term in reducing problem drinking. The best way to manage wet brain is through preventative measures. Regulating alcohol abuse and avoiding malnutrition through healthy eating habits are key. FRN treatment centers specialize in
treating both mental health disorders and substance abuse.
Highly trained and compassionate professionals use
evidence-based treatment methods to promote a long and
sustained recovery. Contact an
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Why Does the Government Want You to Get Wet
Brain? It is often a consequence of drinking extremely large quantities of alcohol over a long period of time, as some people who drink to great excess live on a “liquid diet” and stop eating. Alcohol also interferes with absorption of thiamine and the liver’s capacity to store it. Wernicke-Korsakoff Syndrome rarely occurs outside of conditions of extreme alcohol consumption, starvation, or HIV. What is Wet Brain? “Wet brain” is actually a combination of two conditions: Wernicke’s encephalitis, and Korsakoff Syndrome. Wernicke’s encephalitis is rapid onset and is irreversible unless large doses of thiamine, usually via IV, are administered with in a very short period of time, such as three days. Symptoms include opthalmoparesis (weakness or paralysis of the eye muscles), ataxia (lack of coordination and muscle control, leading to irregular gait, or plainly put, stumbling around) and confusion and memory loss. Korsakoff’s Psychosis often develops as the symptoms of Wernicke’s encephalitis resolve, and is a permanent condition resulting in inability to form new memories, severe loss of memory, and hallucinations. People with Korsakoff’s Psychosis often make up stories to try to make up for gaps in their memories, a phenomenon called “confabulation.” They may believe these stories are true, as they are unable to remember what has actually occurred. People with Wernicke-Korsakoff Syndrome are usually unable to function normally, and most require permanent institutionalization, causing tremendous costs to the healthcare system and irrevocable damage to quality of life. Wernicke-Korsakoff Syndrome is not caused by alcohol itself, rather it is caused by thiamine deficiency as a result of malnutrition and lack of thiamine absorption. There is a simple solution to this problem that could be easily implemented, saving countless dollars in healthcare spending and thousands of years of quality life for those who have severe alcohol problems. What’s this simple solution? Fortification With Thiamine The idea of fortifying alcoholic beverages with thiamine has been around for a long time. Synthetic thiamine was first developed in 1936 (ironically right around the time Alcoholics Anonymous was getting its start) and the alcoholic beverage industry began to fortify their products with thiamine. According to a 1979 New York Times article calling for the fortification of liquor with thiamine, Seagrams and Sons, the California Wine Institute, and Anheuser Busch all found thiamine supplements to be stable in their products, without affecting taste. Drug companies also started to develop thiamine fortified wines. According to a 1979 New York Times article calling for the fortification of liquor with thiamine, Seagrams and Sons, the California Wine Institute, and Anheuser Busch all found thiamine supplements to be stable in their products, without affecting taste. Drug companies also started to develop thiamine fortified wines.-KENNETH ANDERSON Then the federal government stopped the fortification of alcoholic beverages by issuing a ruling that vitamin content could not be listed on their labels. Since by law food additives have to be listed on labels, this effectively outlawed putting thiamine into alcoholic drinks. The American Medical Association jumped on board, saying that thiamine wines were “unacceptable.” This is a classic fight between those who believe in abstinence-only, and would prefer that “alcoholics” suffer and die rather than implement public health measures to minimize harm, and harm reduction, which attempts to protect the health of those who use substances and minimize the negative consequences of problematic substance use. Opponents of fortification argue that putting vitamins into alcoholic beverages would encourage their consumption, and that manufacturers would advertise beer and liquor as health foods. Proponents of harm reduction point out that some people are going to drink to great excess no matter what (they did, even during prohibition!) and that the cost in healthcare spending and human life is so great that to deprive people of a simple and cheap intervention that could save quality of life years is nothing short of being an accomplice to murder. By 1979 estimates, each dollar invested in thiamine fortification of alcoholic beverages would save $7 in nursing home care for those with Wernicke-Korsakoff’s. Imagine what this savings could equal with today’s healthcare costs. Letting Politics Trump Science The United States is not the only nation to engage in debate around thiamine in liquor. In Australia, which has very high rates of Wernicke-Korsakoff Syndrome and high rates of alcohol consumption overall, health authorities have had similar arguments about the effects on public perception of alcohol use to those in the US. After much debate, Australia finally began to fortify bread with thiamine. Even this change did not come about without controversy: in the 1970’s, a graduate student working in a tiny town of 3,500 people, 25% of whom were Aboriginal (meaning they were native to Australia before the British colonized the continent), found that more than 30% of the Aboriginal population of the town had classic signs of severe vitamin deficiency. As their diet consisted mostly of white bread with honey and sweetened tea, a result of years of government rationing where the only foods given to Aboriginal people were flour, sugar and tea, the graduate student theorized that if he could fortify the bread with vitamins, he could reduce or eliminate vitamin-deficiency related diseases. He collaborated with the local baker to do so, in compliance with legal regulations on food fortification and with the approval of the local residents. However, as soon as the national press got wind of this, an article came out in the National Times called “The Guinea-Pigs of Bourke: The Secret Bread Experiment.” While many doctors agreed with the graduate student’s intervention, he was vilified in the national press and the baker, unable to handle the stress, refused to continue fortifying the bread. Sure enough, while blood levels of essential vitamins in Aboriginal people had become safe and normal during the fortification era, they returned to clinically low levels once fortification ended, and diseases returned. Eventually Australia, as well as the US, began to fortify bread with thiamine and other vitamins. The controversy shows us how politics often trumps science and true concern for the public’s health. Especially for those who are the most vulnerable and stigmatized, such as those who use alcohol and other drugs in dangerous amounts, measures that would help preserve health and prevent needless deaths are too often rejected by later day Puritans who seem to view these diseases as punishment for the “sin” of consuming substances. Ending Wernicke-Korsakoff Syndrome in Alcohol Users While the US now fortifies bread, this does little to help those who drink but do not eat, a common pattern for people who drink extreme amounts of liquor daily over a long period of time. Fortification of all alcoholic beverages with thiamine could put an end to Wernicke-Korsakoff Syndrome in alcohol users, yet our government continues to keep fortification illegal. Apparently, they would prefer that severe alcohol users suffer and die rather than live long enough to get a chance at changing their drinking. “I went to visit Pete and it was so depressing,” said Al, a member of HAMS whose personal choice has been abstinence for alcohol for the last fifteen years, but who supports harm reduction wholeheartedly. “He couldn’t hold a conversation. He didn’t remember the nurse checking on him ten minutes before. It was like he barely knew who I was.” Al’s friend for over thirty years
is now in a nursing home, at the age of 55, showing signs of
dementia that would be more normal in a 90-year-old
Alzheimer’s patient. Al supported Pete through numerous
attempts to change his drinking, but nothing worked.
Thiamine in the whiskey and beer Pete consumed on a daily
basis could have saved his brain…and his life. Here
are 10 Facts to Understand About “Wet
Brain” 2. A severe lack of thiamine can cause wet brain even in the absence of chronic alcoholism. For instance, periods of vomiting from “morning sickness” or bulimia can cause a thiamine deficiency. Even a diet solely consisting of polished white rice can cause wet brain. 3. Korsakoff Syndrome has a sudden onset, and does not occur gradually. It can be brought on by a large dose of glucose in someone with a Vitamin B1 deficiency. It’s hazardous for malnourished drinkers to consume a lot of sweets and foods with no vitamins. 4. This condition has been unwittingly caused by physicians administering a glucose drip to under-nourished alcoholics in their care. 5. The syndrome is generally believed to happen in two stages. First, Wernicke’s Encephalopathy presents itself as mental confusion, staggering, and the paralysis of eye movements. This is followed by Korsakoff’s Psychosis, which is the loss of memory function in the brain. 6. Failure to diagnose this syndrome leads to death in 20 percent of cases, while brain damage occurs in 75 percent of cases. 7. If caught early, during the Wernicke’s Encephalopathy phase, thiamine injections can sometimes reverse the damage and allow patients a full recovery. After the second stage of this condition, the injury to the brain is not reversible. 8. Wernicke-Korsakoff Syndrome is generally treated with thiamine and abstinence from alcohol. Over time there can be some improvements, but total recovery is very unlikely. 9. The National Institute of Health’s Office of Rare Diseases lists Wernicke-Korsakoff syndrome as a rare disease due to the fact it affects less than 200,000 in the United States. 10. Preventing wet brain is a matter of limiting alcohol intake or abstaining from it all together, while maintaining a nutritional diet that includes a regular intake of Vitamin B1. Alcohol is the oldest and most widely abused drug in the world. It’s estimated that 15 million people in U.S. alone are currently struggling with alcohol abuse and dependence. Proper treatment can help those struggling with addiction lead happy, healthy and sober lives. No one should ever have to endure the debilitating effects of a severe brain condition caused by prolonged use of alcohol. If you suspect that someone you know
may be experiencing Wernicke-Korsakoff Syndrome symptoms,
it’s imperative that you get treatment for them
immediately.
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