If someone abstains from alcohol for a few days, then has a few drinks, and then is suddenly very drunk indeed, is this more likely to be a sign of decreased alcohol tolerance, or of organ damage?
This is not about a specific example so I don’t think it has to necessarily go to IMHO but it may be that the variables here matter so much it has to. Just making this clear.
Speaking as a medical professional who is quite familiar with alcohol dependence and the complications thereof, and given the data you’ve provided, I can definitively say it could very well be a sign of signficant organ damage, particularly liver, kidney or even brain. Or it could be something else completely.
Not enough info to say much more than that.
I think a worse sign is that the person considers “a few days” abstaining.
No doctor here, but drinking… now you’re speaking my language.
What you mentioned sounds like a simple tolerance issue to me, nothing more.
My doctor once told me that my liver enzymes were high, and that this was an indication that I was damaging my liver. I stopped the whiskey, but kept on with the beer as usual, as an experiment. My next test showed not just a decrease in my liver enzymes, but a return to normal. And this was with drinking beers plural on a daily basis. So, at least in my case, it’s the hard stuff that makes all the difference.
Check with a doctor if you’re concerned; have your liver enzymes measured.
Again, I’m no freaking doctor.
As bobot mentioned, frequent drinkers can have elevated levels of liver enzymes. Dramatically decreasing the amount you drink causes those enzymes to start to drop back to normal levels, which in turn decreases your tolerance. I’m not sure if a couple of days is long enough for this to happen, though.
It’s not normalization of liver enzymes that decreases tolerance. It’s generally de-activation of the microsomal enzyme oxidation system that decreases tolerance, although the issue is more complex than that. And it takes more than just a few days of abstinence for the microsomal enzyme system to downregulate in response to less alcohol in the system.