The Responsible Use of Alcohol Chapter 10

The Nature of Alcohol CNS Depressant; effects vary b/c different body systems are affected to different degrees at different BACs – Low concentrations (0.03%-0.05% ) : light-headedness, relaxation, release of inhibitions – High concentrations (0.1% -0.2%): motor coordination, verbal performance and intellectual functions impaired Ethyl Alcohol – only alcohol that can be consumed Beer: 3-6% alcohol by volume Malt Liquors (not lower than 5%): 6-8% alcohol by volume Table wines: 9-14% alcohol by volume Fortified wines: 20% alcohol by volume – Sugar and extra alcohol is added Hard liquors: 35-50% (or more) alcohol by volume 2

Proof Value – Two times the percentage concentration Ingestion – 7 calories per gram – 1 drink contains grams, or calories The Nature of Alcohol

Alcohol Absorption 20% is rapidly absorbed from the stomach 75% is absorbed in the small intestines Remaining is absorbed along the GI tract Affected by many factors – Carbonation: increases absorption rate – Food in the stomach: slows rate – Increased alcohol concentration: slows rate (irritates mucous membranes) 4

Alcohol Intake and Blood Alcohol Concentration Blood Alcohol Concentration (BAC) – A measure of intoxication, determined by amount of alcohol consumed in a given amount of time and by: Body Weight: smaller people develop higher BAC Percentage of body fat: higher % body fat, higher BAC (alcohol stays in bloodstream, less in fat) Sex: women metabolize less alcohol in stomach, more released into bloodstream and women tend to have higher % body fat Balance of alcohol absorbed and rate of metabolism Genetic factors: chronic drinkers metabolize alcohol faster Drinking behavior: the faster you drink, the faster BAC rises – Can NOT be influenced by Exercise, breathing deeply, eating, drinking coffee, taking other drugs Metabolism is the same if the person is sleep or awake or asleep 5

Metabolism and Excretion Transported throughout the body via the bloodstream Easily moves through most biological membranes Main site for metabolism is the liver (digests about 1 drink/hour) 2-10% of ingested alcohol is not metabolized but excreted through skin, etc. 6

The Immediate Effects of Alcohol on Health Dependant on the individual Alcohol hangover Alcohol poisoning Higher Concentrations – Coma usually occurs at 0.35% and higher concentrations can be fatal Dangerous if using alcohol with other drugs Alcohol-related injuries and violence 7

Drinking and Driving In 2010 – 32,885people were killed in alcohol related accidents Dose-response function – Describes the change in effect on an organism caused by differing levels of doses to a chemical – Driving with a BAC of 0.14% makes you more than 40 times more likely to be involved in a crash than with a BAC =0.0% 8

9 Figure 10.3 The dose-response relationship between BAC and automobile crashes

The Effects of Chronic Use Digestive system – Alters liver function Liver cell damage and destruction (cirrhosis) Cirrhosis causes drinker to lose capacity to tolerate alcohol – Acute Pancreatitis- inflammation of pancreas that can be caused by heavy alcohol use 10

Cardiovascular system Higher doses elevates BP, and may weaken heart muscle (cardiac myopathy) Cancer – Mouth, throat, larynx, liver, breast, & esophagus Brain Damage – Cognitive impairments – Memory loss, dementia, and compromised problem-solving Mortality – Alcoholics average life expectancy is about 15 years less than non-alcoholics The Effects of Chronic Use

The Effects of Alcohol Use During Pregnancy Effects are dose-related – Fetal Alcohol Syndrome (FAS) Full-blown FAS occurs in up to 15 out of every 10,000 live births in the U.S. Small head, abnormal facial structures, heart defects, and other physical abnormalities Slowed physical and mental growth, with many mentally impaired – Alcohol-related neurodevelopment disorder (ARND) Appear physically normal but often have learning and behavioral disorders; more likely to develop substance abuse as adults 12

Possible Health Benefits of Alcohol Moderate doses may reduce the risk of HD Moderate drinking = one drink per day for women and two drinks per day for men – Raises blood levels of HDL – May lower risk of diabetes, arterial blockages, and Alzheimer’s On average, light to moderate drinkers live longer than both abstainers and heavy users 13

Alcohol Abuse and Dependence Alcohol abuse is recurrent use that has negative consequences Alcohol dependence or alcoholism includes more extensive problems like tolerance and withdrawal Warning signs of alcohol abuse – Drinking alone – Using deliberately and repeatedly – Feeling uncomfortable on occasions when not drinking – Escalating consumption – Getting drunk regularly – Drinking in the morning or unusual times 14

Alcohol Abuse and Dependence Binge Drinking – The National Institute on Alcohol Abuse and Alcoholism defines as: 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 women) within two hours. – National Survey on Drug Use and Health defines as: Having five drinks in a row for a man or four in a row for a women within two hours. – Frequent binge drinkers in college were three to seven times more likely than non-binge drinkers to engage in unplanned or unprotected sex 15

Health Effects – DTs (delirium tremens) – Paranoia Social and Psychological Effects – Can withdraw from society – Increased anxiety and depression 16 Alcohol Abuse and Dependence

Treatment Programs No one program works for everyone – AA 12-step program – Employee assistance programs – Inpatient hospital rehabilitation – Pharmacological treatments Antabuse – Inhibits the metabolic breakdown Naltrexone – Reduces the craving for alcohol and decreases its pleasant effects 17

Drinking Behavior and Responsibility Examine your drinking behavior – CAGE screening test: Feel the need to CUT down, ANNOYED by criticism, feel GUILTY about drinking, use alcohol as an EYE-OPENER Drink moderately and responsibly – Drink slowly – Space your drinks – Eat before and while drinking – Know your limits and your drinks 18