1. PHP 1540: Alcohol Use and Misuse Dr. Kate Carey Department of Behavioral & Social Sciences Center for Alcohol & Addiction Studies 121 South Main Street Room 531

2. Road map for today Introductions Why I find alcohol studies fascinating... Alcohol studies: some basics Intoxication Standard drinks BAC Absorption Metabolism

3. Pleasant stimulation Unpleasant sedation Alleviation of tension and negative mood  No correlation with consumption or problems  Negatively correlated with quantity consumed  Positively correlated with drinking frequency and alcohol-related problems

5. A standard drink = 14.0 grams (0.6 ounces) of pure alcohol Generally, this amount of pure alcohol is found in 12-ounces of beer 8-ounces of malt liquor 5-ounces of wine 1.5-ounces or a “shot” of 80-proof distilled spirits (e.g., rum, vodka)

6. Blood alcohol concentration BAC represents the % of alcohol in your bloodstream BAC of.10 =.1 of 1% of your blood is alcohol Units of measurement in US: % weight by volume.10% =.10g/dL = grams percent 100mg% = 100 mg/dL = milligrams percent

7. .02  Nontolerant drinkers begin to feel some effect  Measurable impairment in divided attention tasks.04  Most people begin to feel relaxed  Greater talkativeness  Less self-consciousness.06  Standing steadiness impaired  Lowered inhibitions  Social judgment is affected For the average social drinker, the effect of alcohol is a function of BAC: Most of the sought-after effects of alcohol occur at BACs <.06

8. .08  Impairment of fine muscle coordination (e.g., driving)  People do things they would not do when sober.10  Slurred speech  Deterioration of reaction times.15  Balance and motor control are impaired  More intense or changeable mood.20  Memory blackouts likely  Vomiting may occur as a protective reaction.25  Severe motor disturbances  Sensory perceptions greatly impaired.30  Many people lose consciousness (HR, breathing)  Risk of death For the average social drinker, the effect of alcohol is a function of BAC: continued

10. Alcohol poisoning and what to do about it? Person is unconscious or semiconscious Slow respiration (< 8 breaths/minute or more than eight sec. between breaths) Cold, clammy, pale or bluish skin odor of alcohol (usually) Treat as a medical emergency -- call 911 Turn the intoxicated person on his/her side to prevent choking should the person vomit Stay with the person until medical help arrives

11. What determines your BAC? Number of drinks consumed Time spent drinking Gender Body weight Individual differences in absorption & metabolism Recent food consumption Medications Physical health

12. Blood alcohol concentration (BAC) after the rapid consumption of different amounts of alcohol by eight adult fasting male subjects.* (Adapted from Wilkinson et al., Journal of Pharmacokinetics and Biopharmaceutics5(3):207-224, 1977.)

13. 2 drinks in 1 hour =.041 BAC 2 drinks in 1 hour =.048 BAC 140 lbs Given similar weights, if a woman matches a man drink for drink, she will reach higher BACs

14. 2 drinks in 1 hour =.034 BAC 2 drinks in 1 hour =.059 BAC 160 lbs BUT... given the typical weight differential, she may reach significantly higher BACs 120 lbs

15. Gender differences... Women are smaller, in general, than men Women have more body fat, and less body water: alcohol distributes itself in water Women have less ADH, an enzyme that starts breaking down alcohol in the stomach Therefore, women will become more intoxicated on a given “dose” of alcohol

16. Alcohol Metabolism Acetaldehyde Beverage alcohol Acetic acid Carbon dioxide, water & energy Alcohol dehydrogenase (ADH) + coenzymes Acetaldehyde dehydrogenase (ALDH) + coenzymes

17. Alcohol Metabolism First-pass metabolism occurs in stomach Any alcohol broken down before absorption into the small intestine is not available to enter the bloodstream 70-85% alcohol is broken down in the liver Metabolism occurs at a constant rate given a healthy liver ~.015 BAC per hour