One too many: Why alcohol hits some people hard

There is a moment many drinkers recognise but rarely speak about. The moment when what used to feel manageable no longer is.

Amon Kipkoech laughs a little when he says it now.

"I’m going to 40. I almost did not make it here."

There is an ease in his voice today, but his story began in a very different place. In 2013, while working at a cement maker in Nairobi, he was overwhelmed by stress and went to hospital seeking help.

“All I got were painkillers. Nobody asked how I felt.”

The pain turned into depression, and when alcohol came along, it felt like the relief he had been looking for all too desperately. For a while, it worked.

"It made me relieved. I had no fatigue," he says.

But relief slowly gave way to dependence. Within three months, he was drinking in the morning. His body demanded more, and he responded, moving from local brews to whisky when he could find it.

Between 2013 and 2017, his life was a train wreck. His weight dropped from 74 to 48 kilogrammes. When he tried to stop, his body resisted violently.

"I had some form of psychosis. I used to see things, hear, and feel them. I had rapid heartbeats and nauseas. My headaches were more of a pain; it was too much. It’s like my body was fighting but I was still harming it."

He could not eat, was constantly vomiting, and felt cold deep in his bones. He lost jobs, one after another, never lasting more than six months. His family sensed something was wrong but did not know what.

"They had no idea that I was struggling with alcoholism," he says.

By 2017, he was living on the streets of Nairobi, sleeping at bus stages, earning just enough for the next drink. This went on until 2019. Then came a turning point.

“Towards the end of that year, I was doing badly. But it was the death of my friend in 2020 that woke me up and I decided to get help. I got great support and by 2021, I had quit drinking.”

Today, Amon works as an addiction counsellor.

However, not every story begins in visible crisis. For Nkatha Mwenda, the slippery slope of addiction began with deep sadness and a need to cope with the many disappointments of life.

Nkatha grew up in a home where alcohol was forbidden. At 18, in aviation school, she stayed away from drinking, choosing soda when her classmates ordered alcohol. Then one day, she tried a “small” drink. .

For a time, she managed her drink functionally and it never interfered with her daily life. Then her dream to pursue a commercial pilot’s licence in the United States was cut short due to financial constraints. Outwardly, Nkatha seemed to have taken everything in good stride even enrolled at Kenyatta University to study food, nutrition and dietetics. But inside, she was crushed.

Read: Dealing with alcoholism in the family

"For me, it was the beginning of the spiral. I started drinking a lot because I was not happy," she says.

She completed her studies, got a job, rose to regional manager, then oversaw operations across five East African countries for an American institution. But alcohol followed her into every space, growing with her career. She called in sick to party, falsified letters, attended meetings intoxicated. Eventually, she was forced to resign.

Even when she started her own consultancy, the drinking continued and affected her work. Sometimes she would see clients while intoxicated, or fail to show up all together.

“I dropped from a size 10 to a size eight. I was a bit of a skeleton. I replaced my meals with alcohol. I would have blackouts where I have no memory of what happened the previous night," Nkatha narrates.

In March 2016, she was found unconscious over her steering wheel on Riara Road. “I had a blackout and later learnt that a stranger moved me to the passenger seat and drove me to safety.”

After repeated incidents, her body could no longer tolerate alcohol. A vivid dream of her own death became the final warning. She quit on December 24, 2016, went through withdrawal, and has remained sober since.

Amon and Nkatha’s stories speak to addiction, but also to something else: the body’s shifting relationship with alcohol.

Dr Stephen Onyango, a gastroenterologist at the Digestive Health Clinic in Nairobi, explains that alcohol tolerance is not fixed. It changes with age, biology and habit.

“As you age, your liver also ages,” he says. “Because alcohol is mostly processed in the liver, once the liver becomes aged, its capacity to process alcohol also decreases. So, you can tolerate less alcohol.”

But the liver is only part of the story. The body itself changes over time. Muscle mass declines, fat increases, and with it comes less body water.

“If you have less water in your body, you can have a higher alcohol concentration in your blood because the distribution is less,” he explains.

This is also why alcohol affects men and women differently. Women generally have higher body fat and lower body water, meaning alcohol becomes more concentrated in their system. The impact is stronger, and damage can occur at lower quantities.

Tolerance itself is temporary. It builds with repeated drinking, then fades when a person stops. “A person who is starting to drink now will just drink a little and get drunk because their body cannot tolerate it,” Dr Onyango says.

This is where many people get hooked. After a break from alcohol, they return to drinking at the same level as before, not realising the body has reset. Often, the warning signs come early: stronger hangovers, quicker intoxication, slower recovery. But alcohol’s effects go beyond the physical.

“Alcohol interferes with your sleep. You are more irritable. It interferes with your judgment, even in things like driving,” he says. “People cheat more when they are drunk. People catch HIV more when they are drunk.”

For those on medication, the risks increase. “Ideally, you are advised not to take any alcohol when you are on medications.”

In his clinic, he is seeing more severe outcomes. “Right now, I am seeing more people with cirrhosis, which can lead to cancer of the liver, and it is because of alcohol more than before, there is also chronic pancreatitis,” he says.

By the time these conditions manifest, it is often late. “By the time you are getting there, it is already too much,” he says. “Many times, when the signs come, it is too late.”

For those trying to cut back, Dr Onyango advises getting accountability and if need be, professional help. “It is good to associate with somebody who can support you and who does not drink a lot and who can be like your gatekeeper. When needed, professional help remains essential.”

There are also common myths he is quick to dismiss. The morning drink to cure a hangover does not work. “It does not work because it is just adding more alcohol to alcohol.” Switching to wine does not make drinking safer either. “What is damaging in the drink is called ethanol. And ethanol is in all the alcoholic drinks.”

In practical terms, the limits are clear. Two beers, one glass of wine, or two measures of whisky all count the same. Two units per sitting, per day, is the upper limit, not something to accumulate and consume at once.

“Two per sitting per day does not mean if you miss the whole week, then on Sunday you can count the 14 units for the whole week. If you binge drink, that is even worse.”

Although alcohol consumption is not prohibited among adults in Kenya, Dr Onyango cautions that its risks far outweigh the benefits.

“Alcohol is a drug and it has many risks. The benefits are very few. If you are not drinking, do not drink. If you are drinking, please limit your consumption to just two units per sitting. More than that is inviting medical hazards.”

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