© 2012 McGraw-Hill Companies. All Rights Reserved. Chapter One: Alcohol McGraw-Hill/Irwin

© 2012 McGraw-Hill Companies. All Rights Reserved.1-2 Points for consideration  History of alcohol use  Theories to explain use  Views of alcohol problems  Response to alcohol problems in US  Public policy issues

© 2012 McGraw-Hill Companies. All Rights Reserved.1-3 Alcohol  Alcohol a product of fermentation  Sugar in plants + yeast  alcohol  15% alcohol highest strength naturally  Distillation produces higher concentration

© 2012 McGraw-Hill Companies. All Rights Reserved.1-4 History of alcohol History of alcohol Evidence of alcohol in  Neolithic times  linked to early agriculture Alcohol in the classical period  beverage  medication  libation  foster spiritual life Introduction of distillation, 10th century allows strength up to 93%

© 2012 McGraw-Hill Companies. All Rights Reserved.1-5 Early history of alcohol in US  arrived on Mayflower  Spanish missioners brought grape vines  1640, first distillery on Staten Island  drinking accepted in early colonies

© 2012 McGraw-Hill Companies. All Rights Reserved.1-6 Theories to explain drinking Central question: “Why is alcohol used” Answers: “Because alcohol...  reduces anxiety for individuals and societies  promotes feelings of power  alters consciousness  expectations and myths

© 2012 McGraw-Hill Companies. All Rights Reserved.1-7 Views of alcohol problems  alcohol use accompanied by problems  recurrent themes  alcohol problems as a sin or moral failing  alcohol problems as a legal issue  confusion between drunkenness and alcoholism

© 2012 McGraw-Hill Companies. All Rights Reserved.1-8 U.S. response to alcohol problems  In early days of U.S. drinking primarily family centered  Settling of western — drinking moved outside the home  Changes in drinking patterns  led to political action  the “wets” versus “drys”

© 2012 McGraw-Hill Companies. All Rights Reserved.1-9 U.S. response to alcohol problems (cont.)  Temperance movement  initially not anti-alcohol  initially anti-liquor  broad social movement  included social programs  Prohibition swallowed up temperance 0 %

© 2012 McGraw-Hill Companies. All Rights Reserved U.S. response to alcohol problems (cont.)  Prohibition movements  political parties  fraternal orders  WCTU  18th Amendment (prohibition)   far-reaching impact

© 2012 McGraw-Hill Companies. All Rights Reserved Early treatment responses  Drunkenness versus inebriety  how to distinguish between these ?  Historically some points where seen as different  Alcoholism a modern concept

© 2012 McGraw-Hill Companies. All Rights Reserved U.S. landmarks in alcohol treatment  Benjamin Rush-1st Surgeon general  Hospitalization- 1830s  Washingtonian- self-help initiative, Societyfounded in 1841  AA-formed in 1935  Yale efforts- late 1930s  NIAAA-founded in 1971

© 2012 McGraw-Hill Companies. All Rights Reserved U.S. public policy on alcohol  NIAAA formed  Emergence of treatment professionals  Prevention efforts initiated  Insurance coverage  Lobby groups around — underage drinking, DWI, advertising