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About Alcohol in Islam

The first alcohol (today known as ethyl alcohol) was discovered by the tenth-century Persian alchemist al-Razi. The current Arabic name for alcohol (ethanol) is الغول al-ġawl – properly meaning "spirit" or "demon" – with the sense "the thing that gives the wine its headiness" (in the Qur'an sura 37 verse 47). It ist often stated that Alcohol come from the word Al-Kohl which is a black substance (Lead Sulfite) that can be ground to a fine powder and is used to blacken the eyelids12

It is, however more logical that the word was from the ghawl (a Qur'aanic word) than from another term which had not such a clear association with the "spirit" which is alcohol.3

It is hard for people to stop drinking, it was even hard for the people in the time of the Prophet Muhammed peace and blessings be with him, who was the most charismatic leader in history4
So ALLAH sent different verses that came down in the Qur'aan. These verses were revealed in an order to the first Muslims.

First ALLAH stated that there is Alcohol and good provision and that it is a sign for us (it is in the Qur'aan Khamr / Wine) 5
Second ALLAH stated that it has good and bad in it and the bad is greater than the benefit6
Third We should not go near our prayer when we have drunk alcohol or are otherwise intoxicated7
Fourth ALLAH tells us to avoid8
Fifth Keep away from it altogether (desist) 9

One Companion of the prophet stated that "if he had commanded us to stop drinking alcohol we could not have done it" but in this stepwise manner, people could understand.10

It has the story that in islamic history after the coming down of one of those verses, people were pouring wine on the street until the whole street was red from it.10

There is similar Data in the medical literature today. First it was published that alcohol seems to have some positive effect. Interestingly this so called "french paradox" is researched for (red) wine. However more recent research has shown that this positive effect is only there for

  1. people who already have a certain condition of their heart that is sick (Hypertension) and for nobody else
  2. people it is of no benefit to start drinking, it is only of benefit to not stop drinking
  3. men over the age of 40 Years, and Women over the age of 50 Years11
  4. However the scientific studies are usually wrongly interpreted by the public.
    And most importantly it has not even be proven if the effect is due to the alcohol or to other ingredients in the red wine12, or even to the cheese that people in France eat13

    So it should be stated that the hazard of alcohol is far less propagated by the Companies that earn their money with it and the users that are addicted to Alcohol without noticing.
    It must be stated that the risks, hazard and ill-effect of alcohol heavily outweighs the benefit (except for this small group of people mentioned above)

    Risks are: Traffic accidents due to drunk-driving, acute Liver failure, liver cancers, and other diseases of the liver. Throat and esophagus cancers. Domestic violence, other violence related to alcohole. etc. etc. The data ist actually so overwhelming against alcohole that it is really difficult to understand why people in Europe are not turning against it as they have against smoking tobacco.

    For example, even small amounts of alcohol during pregnancy can seriously harm the unborn child, smoking is also harmful but in this case not as much as alcohol intake. Medical science states repeatedly that there is no minimum toxic dose, every sip, every drop of alcohol during pregnancy puts the health of the baby at risk and many women do not know about their pregnancy the first period when they are pregnant.

    However, many sources like the WHO state that they aim to reduce the "harmful use of alcohol" 14
    this is simply difficult, if there is no minimal amount that is without risk. Every amount is at risk to be harmful. However as ALLAH has taught us via his prophet, we have to go our way step by step, first it must be clear to everybody that Alcohol
    exists and that it has harmful effects. Second it must be made clear to everybody that the harmful by far outreach the beneficial effects and
    third that people must be put in clear situations that require them to not drink.
    In Germany it was common for workers on building sites that they would drink one or two bottles of beer during lunch, this is now forbidden. Nobody is allowed to drink on a building site during working hours.

    It used to be allowed to have a certain amount of alcohol in the blood while driving a car, this amount has been lowered and now arrived at a level that appropriates one glass of beer or wine. For young people there is no such limit, they must not drink at all when driving a car.
    But there are still many things that have to change in Germany to reach the same situation as in the USA where no Alcohol is allowed during driving. And even still more work before alcohol is banned from use completely, except for external disinfection and cleaning.

    Further references:

    Many epidemiological studies have shown that moderate alcohol intake, from 10 to 30 g of ethanol a day, decreases cardiovascular mortality from atherosclerotic ischaemic heart disease and ischaemic stroke as compared to non-drinkers. This beneficial effect outweighs the risks of alcohol consumption in subgroups of people with a higher risk of atherosclerosis: the elderly, people with coronary risk factors and patients with previous coronary events. It has not been demonstrated that alcohol intake, even in moderate amounts, is beneficial for the general population, in particular, men under the age of 40 and women under 50, because it raises mortality due to other causes, especially injury, cirrhosis of the liver and some types of cancer, thereby outweighing the benefits for coronary artery disease. Thus, alcohol consumption should not be recommended as a prophylaxis for the general population. Guidelines on alcohol drinking habits--whether to continue, to start, to modify or to stop--must be given on an individual basis, taking into account the relative risks and benefits for each patient. The benefits of moderate alcohol consumption on the cardiovascular system seem to be exerted fundamentally through its effects on plasma lipoproteins, principally by raising high density lipoprotein (HDL) cholesterol and to a lesser degree, by decreasing low density lipoprotein (LDL) cholesterol. It appears to exert additional beneficial effects on the heart by decreasing platelet aggregability and by bringing about changes in the clotting-fibrinolysis system. Although there has been some debate about the relative superiority of different types of alcoholic beverages (wine, beer or hard liquor), and to a greater extent, about different types of wine, there is no current evidence of any kind of beneficial effect from other components of the beverage besides ethanol. Thus, it does not seem appropriate to recommend any particular type of alcoholic drink, except for sociocultural reasons. The added benefits from some components of different types of wine with a high antioxidant activity on plasma lipoproteins remain only an interesting hypothesis. Meanwhile, encouraging a healthy diet, flavonoid rich and with a predominance of natural ingredients (fruit, legumes, cereals and seeds), in the general population should stop the current tendency of Southern European countries from abandoning the Mediterranean diet. Because of the multifactorial nature of coronary heart disease, it is necessary to remember that atherosclerotic risk reduction is achieved by behavior modification of multiple risk factors present in individual patients and in the general population. Therefore, guidelines regarding alcohol intake should always be linked to pertinent recommendations about other atherosclerotic risk factors.11

    Moderate ethanol consumption (1-3 drinks/day on 5-6 days/week) has a favourable effect on vascular disease-related mortality and morbidity [especially ischaemic heart disease (IHD)]. This cardioprotective effect may be due to significant effects on cardiovascular risk factors such as high density cholesterol (HDL) concentration (HDL protects from IHD) and an inhibition of platelet aggregation (increased platelet aggregability predicts coronary events). In contrast, alcoholics and problem drinkers have an excess of IHD-related, and possibly stroke-related, mortality. Excessive alcohol intake may raise the blood pressure. Prolonged alcohol abuse can also result in alcoholic heart muscle disease. Alcohol is the major cause of non-ischaemic cardiomyopathy in Western society. Although there is a widespread belief that red wine protects more than other alcoholic beverages, several studies do not support this interpretation.15

    The protective effect of moderate alcohol consumption on the risk of cardiovascular disease has been consistently shown in many epidemiological studies. Antiatherogenic alterations in plasma lipoproteins, particularly increase in high-density lipoprotein (HDL) cholesterol,are considered as the most plausible mechanism of the protective effect of alcohol consumption on coronary artery disease (CHD). Other potential mechanisms contributing to the cardio-protective effects of moderate alcohol consumption include anti-thrombotic down regulation of blood platelet function, as well as of the coagulation and fibrinolysis balance. Since the proposal of a "French paradox" in the early Nineties, the possibility that consuming alcohol in the form of wine might confer a protection against CHD above that expected from its alcohol content, has made the topic"wine and health" increasingly popular. Many epidemiological studies have explored such a possibility, by comparing specific alcoholic beverage types (wine,beer, liqueur) in respect to their relative capacity to reduce the risk of CHD. In parallel, experimental studies have been done, in which wine and wine-derived products have been tested for their capacity to interfere with molecular and cellular mechanisms relevant to the pathogenesis of CHD. Wine might indeed conceivably have other ethanol unrelated beneficial effects. The biological rationale for such a hypothesis has been linked to the enrichment in grape-derived, non-alcoholic components, that possibly make it peculiar in respect to other alcoholic beverages. In fact, while the mechanisms underlying the effects of alcohol on cardiovascular disease have been limited to lipid metabolism and the haemostatic system, those related to wine consumption have also been extended to specific anti-inflammatory, antioxidant and nitric oxide related vaso-relaxant properties of its polyphenolic constituents. The effect of wine consumption has been carefully investigated to account for potential confounding of several conditions (inappropriate use of abstainers as control population, correlation between wine or total alcohol consumption and markers of healthy lifestyle and socioeconomic factors, diet, etc.). Strong evidence indicates that moderate wine consumption rather than confounders reduces both fatal and non fatal CHD events. In spite of the fact that the healthy effect of moderate intake of wine is by now well accepted, important issues remain to be resolved about the relationship between wine, alcohol and alcoholic beverages, the (possibly different) optimal amount of alcohol intake in men and women, the individual or environmental modulation of the alcohol related effect and the pattern of drinking. Some of these issues have been recently addressed in a large meta-analysis, in which the relationship between wine or beer consumption and CHD risk was quantitatively evaluated. We shall summarize here the experimental and epidemiological studies with wine or wine-derived products aimed at finding biological explanations for the supposed superior cardio-protective effects of wine consumption and to discuss some open questions about wine and vascular disease as approached in epidemiological studies.16

    The term FRENCH PARADOX was coined in 1992 to describe the relatively low incidence of cardiovascular disease in the French population, despite a relatively high dietary intake of saturated fats, and potentially attributable to the consumption of red wine. After nearly 20 years, several studies have investigated the fascinating, overwhelmingly positive biological and clinical associations of red wine consumption with cardiovascular disease and mortality. Light to moderate intake of red wine produces a kaleidoscope of potentially beneficial effects that target all phases of the atherosclerotic process, from atherogenesis (early plaque development and growth) to vessel occlusion (flow-mediated dilatation, thrombosis). Such beneficial effects involve cellular signaling mechanisms, interactions at the genomic level, and biochemical modifications of cellular and plasma components. Red wine components, especially alcohol, resveratrol, and other polyphenolic compounds, may decrease oxidative stress, enhance cholesterol efflux from vessel walls (mainly by increasing levels of high-density lipoprotein cholesterol), and inhibit lipoproteins oxidation, macrophage cholesterol accumulation, and foam-cell formation. These components may also increase nitric oxide bioavailability, thereby antagonizing the development of endothelial dysfunction, decrease blood viscosity, improve insulin sensitivity, counteract platelet hyperactivity, inhibit platelet adhesion to fibrinogen-coated surfaces, and decrease plasma levels of von Willebrand factor, fibrinogen, and coagulation factor VII. Light to moderate red wine consumption is also associated with a favorable genetic modulation of fibrinolytic proteins, ultimately increasing the surface-localized endothelial cell fibrinolysis. Overall, therefore, the "French paradox" may have its basis within a milieu containing several key molecules, so that favorable cardiovascular benefits might be primarily attributable to combined, additive, or perhaps synergistic effects of alcohol and other wine components on atherogenesis, coagulation, and fibrinolysis. Conversely, chronic heavy alcohol consumption and binge drinking are associated with increased risk of cardiovascular events. In conclusion, although mounting evidence strongly supports beneficial cardiovascular effects of moderate red wine consumption (one to two drinks per day; 10-30 g alcohol) in most populations, clinical advice to abstainers to initiate daily alcohol consumption has not yet been substantiated in the literature and must be considered with caution on an individual basis.17

    Popular belief has it that alcohol, particularly red wine, protects against atherosclerosis and associated cardio- and cerebrovascular conditions. That presumption motivates this paper, which describes the mechanisms underlying the J-shaped risk curve for alcohol use, with benefits for vascular disease risk at low consumption levels and harmful effects-both directly on the user and indirectly on the bystander-at higher levels. The importance of further exploring alcohol use in patients with cardiovascular risk factors and of intervening to modify non-social use of alcohol to prevent serious adverse health consequences is also addressed.18

    With more than 8000 polyphenols found in food (mainly, wine, tea, coffee, cocoa, vegetables and cereals), many epidemiological studies suggest that the intake of polyphenol-rich foods has a beneficial effect on a large number of cardiovascular risk factors, such as high blood pressure, high blood cholesterol, obesity, diabetes and smoking. The mechanisms involved in the cardioprotective effects of polyphenols are numerous and include antioxidant, vasodilator, anti-inflammatory, anti-fibrotic, antiapoptotic and metabolic. Most importantly, recent experimental data demonstrate that polyphenols can exert its cardioprotective effect via the activation of several powerful prosurvival cellular pathways that involve metabolic intermediates, microRNAs, sirtuins and mediators of the recently described reperfusion injury salvage kinases (RISK) and survivor activating factor enhancement (SAFE) pathways.19

    The cardiovascular effects of alcohol are well known. However, most research has focused on the beneficial effects (the "French paradox") of moderate consumption or the harmful consequences, such as dilated cardiomyopathy, associated with heavy consumption over an extended period. An association between the ingestion of acute alcohol and onset of cardiac arrhythmias was first reported in the early 70's. In 1978, Philip Ettinger described "Holiday heart syndrome" (HHS) for the first time, as the occurrence, in healthy people without heart disease known to cause arrhythmia, of an acute cardiac rhythm disturbance, most frequently atrial fibrillation, after binge drinking. The name is derived from the fact that episodes were initially observed more frequently after weekends or public holidays. Since the original description of HHS, 34 years have passed and new research in this field has increased the volume of knowledge related to this syndrome. Throughout this paper the authors will comprehensively review most of the available data concerning HHS and highlight the questions that remain unresolved.20

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