1. PHP 1540: Alcohol Use and Misuse October 16, 2012 Assessing Health Effects of Drinking: Moderate drinking Global burden Relative burden Alcohol’s effects on the brain

2. WINNER: Taking on the Establishment and Insisting on Data-Driven Policy Award Observation 1: Drug scheduling, policy, resource allocation, and public attention has been driven by tradition and factors other than modern analysis of actual harms Observation 2: A comprehensive analysis of drug-related harms must consider harms to the individual and also harms to others

3. Nutt et al (2010): “To provide better guidance to policy makers in health, policing, and social care, the harms that drugs cause need to be properly assessed.” When the two part-scores were combined, alcohol was the most harmful drug followed by heroin and crack cocaine.

4. Fun Facts about the Liver largest solid organ of the body (~ 3 lbs) Filters a liter of blood/min The primary organ for removing toxins from the body, including alcohol Can regenerate itself!

5. Alcohol-related liver disease fatty liver -> hepatitis-> cirrhosis Cirrhosis causes scar tissue, blocks blood flow, affects structure and function Toxins and drugs build up in body and brain Cirrhosis related to chronic alcohol consumption – Drinking pattern: average 2-3 drinks daily over 10 years – Beverage type makes a difference: spirits > beer 10-15% of alcoholics develop cirrhosis

6. Alcoholic Cirrhosis Marker for alcohol consumption in a community: strong relationship between cirrhosis mortality and per capita alcohol consumption – Mortality down during Prohibition! – Italy, France, Spain > New Zealand, Iceland, Norway Factors enhancing risk of cirrhosis: – Hepatitis C infection – Female gender (higher BACs) – Ethnicity (??)