A Small Dose of Alcohol – 04/03/10 An Introduction To The Health Effects of Alcohol A Small Dose of Alcohol

A Small Dose of Alcohol – 04/03/10

An Introduction To The Health Effects of Alcohol

A Small Dose of Alcohol

A Small Dose of Toxicology A Small Dose of Alcohol – 04/03/10

What Is This?

CH

H

H

OHC

H

H

(CH3-CH2-OH)


Ethanol

CH

H

H

OH

Ethyl Alcohol

C

H

H


Methanol

CH

H

H

OH

Methyl Alcohol


"You will conceive and bear a son…now then be careful to take no wine or strong drink and to eat nothing unclean".

Bible - Judges 13:3-4

Ancient Awareness


’T is not the drinking that is to be blamed, but the excess.

John Selden (1584–1654)

In “Table Talk” 1689

Historical Perspective


“Alcohol is the number one drug of choice among our Nation’s youth. Yet the seriousness of this issue does not register with the general public or policymakers.”

Enoch Gordis, M.D. Director, National Institute on Alcohol Abuse and Alcoholism.

Current Views


7.4% of adult population in U.S. alcoholic $185 Billion – cost of alcohol abuse in U.S. 100,000 deaths annual in U.S. related to $1.2 Billion spent on wine, beer and liquor

advertisements in U.S.

Some Current Facts


Production of Alcohol

Fermentation – Sugar to Alcohol and Carbon dioxide

C6H12O6→ 2(CH3-CH2-OH) + 2CO2


Health Effects

What are the pleasant effects of alcohol?

The adverse effects (toxicity)?


• CNS Depressant• Depression of inhibitory control• Vasodilation, warm, flushed, reddish skin• Emotional outbursts• Decreased memory & concentration• Poor judgment• Decreased reflexes

Acute Effects


Obvious• Alcoholism, death, cancer (oral cavity,

esophagus, liver), fetal effects (FAS)

Alcoholism• Cirrhosis of liver, appetite loss, poor

judgment Subtle

• Lost productivity, impaired performance, motor impairment, cost to society

Long Term Adverse Effects


Alcohol & Cancer

Ethanol consumption increases risk of cancer

Oral CavityPharynx and Larynx

EsophagusLiver


Fetal Alcohol Syndrome (FAS)

Most common preventable cause of adverse CNS development

4,000-12,000 infants per year in US

CharacteristicsGrowth retardation

Facial malformationsSmall head

Greatly reduce intelligence


Fetal Alcohol Syndrome (FAS)

1 to 3 births per 1,000 world wide??

1968 first association by French researchers at the University of Nantes

Early 1970’s FAS as condition – University of Washington, Seattle WA, USA



Fetal Alcohol Effect (FAE)

Milder form of FAS


CharacteristicsGrowth deficiency

Learning dysfunctionNervous systems disabilities


Effects of Prenatal Alcohol


Effects of Prenatal Alcohol

A Small Dose of Toxicology A Small Dose of Alcohol – 04/03/10FAS Child (National Geographic, George Steinmetz, Feb 1992)


Mouse – Scanning EM

(National Geographic, George Steinmetz, Feb 1992)


Rapidly absorbed from stomach, small intestine, and colon

Maximal blood concentration within 30 to 90 minutes

Can be absorbed through the lungs

Absorption


Uniformly distributed throughout tissues and body fluids

Readily crosses placenta, to exposure fetus

Distribution


Urinary ExcretionExhalationMetabolism

Elimination


Metabolism I

CH OH

Ethanol

H

H

C

H

H

CH

H

H

C O

H

=

Acetaldehyde

(ADH – Alcohol Dehydrogenase)

ADH


Metabolism II

CH

H

H

C O

H

=

Acetaldehyde(ALDH – Acetaldehyde Dehydrogenase)

ALDH

Acetate

CH

H

H

C O

OH

=


Metabolism III

80-90% Metabolized Rate is constant (not increased

by concentrations in the blood) About 30 ml (1 oz) in 3 hours


Gender Differences

Females higher blood alcohol levels than males

Males have higher stomach metabolism of alcohol than females


Genetic Variation in ALDH

Acetaldehyde Dehydrogenase (ALDH) varies in Caucasians, Blacks and Asians.

50% of Asians have inactive ALDH

Elevated acetaldehyde cause increased flushing, tachycardia (elevated heart rate), nausea, vomiting & hyperventilation.

Disulfiram – inhibits ALDH


Alcoholism - Disulfiram

Alcoholism Treatment with Disulfiram

Inhibits acetaldehyde dehydrogenase (ALDH)

Elevated acetaldehyde cause increased flushing, tachycardia (elevated heart rate),

nausea, vomiting & hyperventilation.


Alcoholism – Alcohol Dependence

Characterized by the following:

• Craving: A strong need, or compulsion, to drink. • Loss of control: The inability to limit one’s drinking

on any given occasion. • Physical dependence: Withdrawal symptoms, such

as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.

• Tolerance: The need to drink greater amounts of alcohol in order to “get high.”

(from: U.S. Alcohol & Drug Information - http://ncadi.samhsa.gov/)


Alcoholism – Alcohol Dependence

Approximately 14 million Americans—7.4 percent of the population —meet the diagnostic criteria for alcohol

abuse or alcoholism

(from: U.S. Alcohol & Drug Information - http://ncadi.samhsa.gov/)


• Tremor• Nausea• Irritability• Agitation• Tachycardia• Hypertension• Seizers• Hallucinations

Alcohol Withdrawal Effects


Ethanol as Antidote

Antidote for Poisoning by:

Methanol

Ethylene glycol

Diethylene glycol

Inhibits metabolic activation by alcohol dehydrogenase (ADH)


U.S. Government Warning

The Alcoholic Beverage Labeling Act of 1988 requires that the following health warning statement appear on the labels of all containers of alcohol beverages offered for sale or distribution in the United States:

U.S. GOVERNMENT WARNING: (1) According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects. (2) Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery, and may cause health problems.


• 1981 - U.S. Surgeon General first advised that women should not drink alcoholic beverages during pregnancy.

• 1988 - U.S. requires warning labels on all alcoholic beverages sold in the United States.

• 1990 - U.S. Dietary Guidelines state that women who are pregnant or planning to become pregnant should not drink alcohol.

• 1998 - 19 states require the posting of alcohol health warning signs where alcoholic beverages are sold

Regulatory Status


A Small Dose of ™ Alcohol


Additional Information

Web Sites• England – Department of Health (DOH) Alcohol

Misuse Information. Online: <http://www.dh.gov.uk/en/publichealth/healthimprovement/alcoholmisuse/index.htm> (accessed: 3 April 2010).

• Health Canada – Fetal Alcohol Spectrum Disorder. Online: <http://www.phac-aspc.gc.ca/fasd-etcaf/index-eng.php> (accessed: 3 April 2010).


Authorship Information

For Additional Information ContactSteven G. Gilbert, PhD, DABT

E-mail: [email protected]: www.asmalldoseof.org

This presentation is supplement to “A Small Dose of Toxicology”

Documents

A Small Dose of Alcohol – 04/03/10 An Introduction To The Health Effects of Alcohol A Small Dose of Alcohol