Alcohol Alcohol Chapter 10Chapter 10

Alcohol Use PatternsAlcohol Use Patterns• 49% of Americans abstain from 49% of Americans abstain from

alcohol usealcohol use• 22% are considered “light” 22% are considered “light”

drinkersdrinkers• 29% are considered “risky” 29% are considered “risky”

drinkersdrinkers• Alcohol is responsible for more Alcohol is responsible for more

than 70,000 deaths per year than 70,000 deaths per year among Americansamong Americans

Chemistry of AlcoholChemistry of Alcohol• Psychoactive ingredientPsychoactive ingredient• DepressantDepressant• Ethyl Alcohol – only alcohol that can be consumedEthyl Alcohol – only alcohol that can be consumed

• Beer 3-6% alcohol by volumeBeer 3-6% alcohol by volume• Malt Liquors 6-8% alcohol by volumeMalt Liquors 6-8% alcohol by volume• Table wines 9-14% alcohol by volumeTable wines 9-14% alcohol by volume

– FermentingFermenting• Fortified wines 20% alcohol by volumeFortified wines 20% alcohol by volume

– Sugar addedSugar added– Extra alcohol is addedExtra alcohol is added

• Hard liquors 35-50% alcohol by volumeHard liquors 35-50% alcohol by volume– Distilling or fermentedDistilling or fermented

• Proof ValueProof Value– Two times the percentage concentrationTwo times the percentage concentration

• IngestionIngestion– 7calories per gram7calories per gram– 1 drink 14-17 grams or 100-120 calories1 drink 14-17 grams or 100-120 calories

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AbsorptionAbsorption•20% is rapidly absorbed from the stomach20% is rapidly absorbed from the stomach•75% is absorbed in the upper small 75% is absorbed in the upper small

intestinesintestines•Remain is absorbed along the GI trackRemain is absorbed along the GI track•AbsorptionAbsorption

– CarbonationCarbonation– Food in the stomach slows the absorptionFood in the stomach slows the absorption– Drink of high concentration slows absorptionDrink of high concentration slows absorption– Eventually all the alcohol ingested will be Eventually all the alcohol ingested will be

absorbedabsorbed

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Metabolism and ExcretionMetabolism and Excretion•Transported throughout the body via Transported throughout the body via

the bloodstream.the bloodstream.•Easily moves through most biological Easily moves through most biological

membranesmembranes•Main site for metabolism is the Liver.Main site for metabolism is the Liver.•2-20% of ingested alcohol is not 2-20% of ingested alcohol is not

metabolized.metabolized.

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Alcohol Intake and Blood Alcohol Alcohol Intake and Blood Alcohol ConcentrationConcentration

• Blood Alcohol Concentration(BAC)Blood Alcohol Concentration(BAC)– A measure of intoxication A measure of intoxication – Body weightBody weight– Percentage of body fatPercentage of body fat– SexSex

• Balance of alcohol absorbed and rate of Balance of alcohol absorbed and rate of metabolismmetabolism

• Genetic factorsGenetic factors• Drinking BehaviorDrinking Behavior• Can not be effected byCan not be effected by

– ExerciseExercise– Breathing deeplyBreathing deeply– EatingEating– Drinking coffeeDrinking coffee– Taking other drugsTaking other drugs

• Metabolism is the same if the person is awake Metabolism is the same if the person is awake or asleepor asleep

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The Immediate Effects of The Immediate Effects of AlcoholAlcohol• At .03 - .05% = relaxation and jovialAt .03 - .05% = relaxation and jovial

• At .08 = DUIAt .08 = DUI • At .10% = physical impairmentAt .10% = physical impairment• At .20% = uncontrollable movementAt .20% = uncontrollable movement• At .35% = coma and possible deathAt .35% = coma and possible death

Drinking and DrivingDrinking and Driving• In 2004In 2004

– 250,000 were injured in alcohol related 250,000 were injured in alcohol related automobile crashesautomobile crashes

– 42,000 people are killed in alcohol related 42,000 people are killed in alcohol related accidentsaccidents

•Dose-response functionDose-response function– Driving with a BAC of 0.14% is more Driving with a BAC of 0.14% is more than 40 times more likely to be than 40 times more likely to be involved in a crash.involved in a crash.– Greater than 0.14% the risk of fatal Greater than 0.14% the risk of fatal crash is estimated to be 380 times higher.crash is estimated to be 380 times higher.

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Figure 10.2 Approximate blood Figure 10.2 Approximate blood concentration and body weightconcentration and body weight

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The Effects of Chronic The Effects of Chronic UseUse

• Diseases of the digestive, cardiovascular systems and some Diseases of the digestive, cardiovascular systems and some cancerscancers

• Digestive systemDigestive system– Liver functionLiver function

• liver cell damage and destruction (cirrhosis)liver cell damage and destruction (cirrhosis)• Cirrhosis causes drinker to lose ToleranceCirrhosis causes drinker to lose Tolerance

– Pancreas inflammationPancreas inflammation• Cardiovascular systemCardiovascular system

• moderate doses may reduce the risk of HDmoderate doses may reduce the risk of HD• Higher doses elevates BP, may weaken heart muscle or cardiac myopathy.Higher doses elevates BP, may weaken heart muscle or cardiac myopathy.

• CancerCancer– Mouth, throat, larynx, and esophagusMouth, throat, larynx, and esophagus

• 5-6 total drinks5-6 total drinks– Responsible for the most common form of liver cancerResponsible for the most common form of liver cancer

• Hepatitis speeds the growth of this cancerHepatitis speeds the growth of this cancer– Breast cancerBreast cancer

• Increase risk when 2-3 drinks per dayIncrease risk when 2-3 drinks per day• Brain DamageBrain Damage

– Cognitive impairmentsCognitive impairments– Memory loss, dementia, and compromised problem-solvingMemory loss, dementia, and compromised problem-solving– Wernicke-Korsakoff syndromeWernicke-Korsakoff syndrome

• MortalityMortality– Alcoholics average life expectancy is about 15 years less than non-alcoholicsAlcoholics average life expectancy is about 15 years less than non-alcoholics

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The Effects of Alcohol use During The Effects of Alcohol use During PregnancyPregnancy

•Effects are dose-related.Effects are dose-related.– Fetal Alcohol Syndrome (FAS)Fetal Alcohol Syndrome (FAS)

• Full-blown FAS occurs in up to 15 out of every Full-blown FAS occurs in up to 15 out of every 10,000 live births in the U.S.10,000 live births in the U.S.

• Under weight, flat nasal bridge, and long upper lip.Under weight, flat nasal bridge, and long upper lip.• Small and have heart defects.Small and have heart defects.• Physical and mental growth is slowed. Remain Physical and mental growth is slowed. Remain

mentally impaired. Fine motor skill problems, mentally impaired. Fine motor skill problems, coordination, learning and behavioral problems coordination, learning and behavioral problems (ADS).(ADS).

– ARND Alcohol-related neurodevelopment ARND Alcohol-related neurodevelopment disorder.disorder.

– Heavier drinking early in pregnancyHeavier drinking early in pregnancy..15

Possible Health Benefits of AlcoholPossible Health Benefits of Alcohol

•Abstainers and light to moderate Abstainers and light to moderate drinkers live longer than heavy users.drinkers live longer than heavy users.

•35 years old and younger, your odds of 35 years old and younger, your odds of dying dying increaseincrease in proportion to the in proportion to the amount consumedamount consumed

•Moderate drinking = one drink per day Moderate drinking = one drink per day for women and two drinks per day for for women and two drinks per day for men.men.– May lower coronary heart disease.May lower coronary heart disease.– Raising blood levels of HDL.Raising blood levels of HDL.– May lower risks of; diabetes, arterial May lower risks of; diabetes, arterial

blockages, Alzheimer’sblockages, Alzheimer’s

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Alcohol Abuse and Alcohol Abuse and DependenceDependence

•Alcohol abuseAlcohol abuse is recurrent use that has is recurrent use that has negative consequences.negative consequences.

•Alcohol dependence or AlcoholismAlcohol dependence or Alcoholism more more extensive problems, tolerance and extensive problems, tolerance and withdrawalwithdrawal

•Warning signs of alcohol abuseWarning signs of alcohol abuse– Drinking aloneDrinking alone– Using deliberately and repeatedlyUsing deliberately and repeatedly– Feeling uncomfortable on certain occasionsFeeling uncomfortable on certain occasions– Escalating consumptionEscalating consumption– Getting drunk regularlyGetting drunk regularly– Drinking in the morning or unusual timesDrinking in the morning or unusual times

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Alcohol Abuse and Alcohol Abuse and DependenceDependence

• Binge DrinkingBinge Drinking– The National Institute on Alcohol Abuse and The National Institute on Alcohol Abuse and

Alcoholism defines:Alcoholism defines:• Pattern of alcohol use that brings a person’s BAC up to 0.08 Pattern of alcohol use that brings a person’s BAC up to 0.08

or above (typically four drinks for a male or three for a or above (typically four drinks for a male or three for a women)within two hours.women)within two hours.

– National Survey on Drug Use and Health defines:National Survey on Drug Use and Health defines:• Having five drinks in row for a man or four in a row for a Having five drinks in row for a man or four in a row for a

women within two hours.women within two hours.– Frequent binge drinking in college were three to Frequent binge drinking in college were three to

seven times more likely than non-binge drinkers seven times more likely than non-binge drinkers to engage in unplanned or unprotected sexto engage in unplanned or unprotected sex

– Healthy People 2010Healthy People 2010• Reduce the rate of binge drinking to 20% among college Reduce the rate of binge drinking to 20% among college

studentsstudents

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Table 10-2 The Effects of Table 10-2 The Effects of Binge Drinking on College Binge Drinking on College

StudentsStudents

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AlcoholismAlcoholism•Patterns and PrevalencePatterns and Prevalence

1.1. Regular daily intake of large amountsRegular daily intake of large amounts2.2. Regular heavy drinking limited to weekendsRegular heavy drinking limited to weekends3.3. Long periods of sobriety interspersed with Long periods of sobriety interspersed with

binges or daily heavy drinkingbinges or daily heavy drinking4.4. Heavy drinking limited to periods of stressHeavy drinking limited to periods of stress

•Health EffectsHealth Effects– DTs (delirium tremens)DTs (delirium tremens)– paranoiaparanoia

•Social and Psychological effectsSocial and Psychological effects•Causes of AlcoholismCauses of Alcoholism

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Treatment ProgramsTreatment Programs• Not one program works for everyone.Not one program works for everyone.

– AA.AA.• 12-step program12-step program

– Al-Anon.Al-Anon.– Employee Assistance.Employee Assistance.– Inpatient hospital rehabilitationInpatient hospital rehabilitation– Pharmacological treatments.Pharmacological treatments.

• Disulfiram (Antabuse)Disulfiram (Antabuse)– Inhibits the metabolic breakdownInhibits the metabolic breakdown

• Naltrexone (ReVia, Depade)Naltrexone (ReVia, Depade)– Reduces the craving for alcohol and decreases its Reduces the craving for alcohol and decreases its

pleasant effects.pleasant effects.• Injectable Naltrexone (Vivtrol) – single monthly shotInjectable Naltrexone (Vivtrol) – single monthly shot• Acamprosate (Campral)Acamprosate (Campral)

– Acts on brain pathways related to alcohol abuse.Acts on brain pathways related to alcohol abuse.

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Gender and Ethnic Gender and Ethnic Differences on AlcoholismDifferences on Alcoholism

• Among White American men, drinking Among White American men, drinking starts in the teenage years and progresses starts in the teenage years and progresses into late adulthoodinto late adulthood

• Women tend to become alcoholics much Women tend to become alcoholics much later (40’s or 50’s)later (40’s or 50’s)

• African-Americans tend to have more African-Americans tend to have more health related problems with alcohol usehealth related problems with alcohol use

• Drunk driving and cirrhosis tend to be Drunk driving and cirrhosis tend to be common elements with Latino mencommon elements with Latino men

• American Indians and Alaskans tend to American Indians and Alaskans tend to abuse alcohol early in lifeabuse alcohol early in life

Table 10.4 Users and Abusers of Table 10.4 Users and Abusers of Alcohol in the U.S.: 2007Alcohol in the U.S.: 2007

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Tips to Drink Tips to Drink ResponsiblyResponsibly

• Drink SlowlyDrink Slowly• Space your drinksSpace your drinks• Eat before and Eat before and

while drinkingwhile drinking• Know your limits Know your limits

and your drinksand your drinks

Promote Responsible Drinking In OthersPromote Responsible Drinking In Others

•Encourage responsible attitudesEncourage responsible attitudes•Be a responsible hostBe a responsible host•Hold the drinker responsibleHold the drinker responsible•Learn about prevention programsLearn about prevention programs•Take community actionTake community action

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