2. ALCOHOL Where does it come from?

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5. 4 History of Use? beer dates back to at least the Egyptians 5000-6000 BC, probably further wines date back a few thousand years distilled spirits “younger”; in China about 1000 BC but in Arabia/Europe around 800 AD

6. 5 Prevalence of Use Almost everyone will have at least sipped alcohol in the course of their lifetime; 1 in 4 lifetime abstainers Consumption per person actually highest in the mid-1800s Since 1935 consumption has generally increased, peaking in the early 80s In 2001, per capita alcohol ingestion was about 2.2 gallons http://www.health.gov/dietaryguidelines/dga2005/report/H TML/D8_Ethanol.htm#top

7. 6 Standard Drink Chart SPIRITS Standard Drinks 1oz. (86-100 proof) 1 8 oz. (1/2 pint) 8 16 oz. (pint) 16 “Fifth” (4/5 quart) 26 32 oz. (quart) 32 1/2 gallon (2 quarts) 64 1 liter (1 quart) 32 750 ml (3/4 liter) 24 BEER Standard Drinks 12 oz (5% alc by vol.) 1 16 oz. (pint) 1.33 32 oz. (quart) 2.67 WINE 4 oz. (12% alc by vol.) 1 12 oz. (bottle) 3 REINFORCED WINE OR CORDIAL 2.5 oz. 1

8. 7 Prevalence of Use From my first visit to a major brewery, I learned a lot: –250, 000 cases of beer are shipped out of Anheiser Busch in St. Louis daily, to just the midwestern states

9. 8 NHSDA Data 2004 Lifetime82.4% Past Year65.1 Past Month (current)50.3 Past Month Binge22.8% Heavy Usage6.6

10. 9 Prevalence of Use by Age Rates of current use were at least 60% for most age groups in the 21-44 age range curvilinear effect Find the usage rate for your specific age bracket at: (Fig. 3.1) http://www.oas.samhsa.gov/nhsda.htm

11. 10 Prevalence of Use by Race/Ethnicity Whites continue to have highest rate of use Heavy use among groups about the same?? –Si o no? See figure 3.3 from NSDUH

12. 11 Prevalence of Use by Gender As you might guess, current (past month) alcohol use is more prevalent among males : (56.9% vs. 44% - 2004 data) Men were much more likely to be binge and be “heavy” drinkers

13. 12 Prevalence of Use by Education In contrast to drug abuse patterns, the more education a person has, the more likely they reported current drinking 66% of college grads vs. 39% of those having less than high school education Heavy drinking more common among those without high school education (6.8 vs 3.7)

14. 13 Figure 3.4 Heavy Alcohol Use among Adults Aged 18 to 22, by College Enrollment: 2002-2006

15. 14 College binge drinking Harvard Study: 43% binged in prior 2 weeks (48% men; 39% women) about 65% of the members of frats/sor. Binged Reasons for drinking19931997 “get drunk”39%52%

16. 15 Alcohol’s Pharmacology It is a CNS depressant Peak concentrations are reached between 30-90 minutes after drinking is stopped Alcohol is distributed to all tissues in the body and passes to the brain easily LD 50 is 25 drinks in 1 hour; BAC of.45 -.55 (BAC is expressed as a ratio of milligrams or weight of alcohol per 100 milliliters - about 3 ounces of blood)

17. 16 Relationship Between Blood Alcohol and Alcohol Intake Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

18. 17 most of the consumed alcohol metabolized in liver broken down to acetaldehyde (by ADH - alcohol dehydrogenase and then to acetic acid by aldehyde dehy.) carbon dioxide and water excreted by lungsexcreted in urine

19. 18 Addiction and Withdrawal Indicators Is it Addictive? How do we know? –Tolerance (cellular & metabolic) develops –Withdrawal symptoms occur BAC can still be above.00 for withdrawal sx to begin

20. 19 Withdrawal Indicators Stoppage (or reduction in) etoh use that has been heavy and prolonged Symptoms developing within hours to a few days may include: (need at least 2 for DSM criteria) –autonomic hyperactivity (sweating or pulse rate > than 100) –increased hand tremor –insomnia –nausea or vomiting –transient visual, tactile, or auditory hallucinations or illusions –psychomotor agitation –anxiety –grand mal seizures

21. 20 CONSEQUENCES What are some positive and negative effects?

22. 21 Short-term Effects Physiological –urination, increased gastric secretion stimulating appetite at low or moderate doses –disruption of sleep; suppresses REM throughout night at high doses –hangover (although no alcohol in body, driving ability may still be impaired) –body sway –may experience a decrease in pain sensitivity, and in vision-taste senses

23. 22 Short-term Effects cont. Psychological – mood enhancer at lower doses – mood state prior to drinking critical – emotional lability and aggression by some at higher doses Social/familial Interference –but may facilitate emotional expression and be the only time that this happens; drinking subcultures

24. 23 Short-term Effects cont. Cognitive – memory impairment – reaction time slows Other –Drunk driving –Suicide –Sexual assualt, esp. acquaintance rape –High risk sex

25. 24 Drinking and Driving The many skills involved in driving are not all impaired at the same BAC –Ability to divide attention between 2 or more sources of visual stimuli impaired at.02 –Impairments occur consistently at.05 or more: eye movements glare resistance depth perception reaction time information processing some steering tasks

26. 25 Drinking and Driving Drivers with BACs of.15 or greater have about 380 times the risk of being in a single-vehicle fatal crash versus those not drinking at all MV crashes leading cause of death among youth 15- 20 E.g. In 1994 about 7,800 16-20 year-olds were drivers in fatal crashes; 23% of these had positive BACs –Inexperience in driving, in drinking, and in combining the two activities is often fatal

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28. 27 Long-term Consequences: 60% of males & 30% of females have had at least one negative alcohol-related incident

29. 28 Long-term Consequences cont. Physical: –fatty liver, alcohol hepatitis, and cirrhosis –increased risk of CAD and various types of cancers –increased susceptibility to illness; lower immune system functioning –GI problems such as pancreatitis –FAS: small eyes, droopy eyelids, small head, low intellectual functioning; associated with low SES

30. 29 (a) Normal Liver (b) Cirrhotic Liver Figure 11-4 11-6 a. b. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

31. 30 Long-term Consequences cont. Cognitive: –impairs memory, problem-solving, learning and reaction time –neuropsychological damage can be reversed with prolonged abstinence –Wernicke-Korsakoff Syndrome unable to learn new material due to failure to transfer confabulation

32. 31 Long-term Consequences cont. Social and family consequences: –Sometimes its helpful to look not only at what has directly happened due to long-term alcohol abuse, but what the drinker and family missed out on Psychological consequences:

33. 32 College binge drinking Harvard Study: 43% binged in prior 2 weeks (48% men; 39% women) about 65% of the members of frats/sor. Binged Reasons for drinking19931997 “get drunk”39%52% Now

34. 33 Alcohol’s effects on aggressive behavior Associated with: –domestic violence –child abuse –murder –common assaults –suicide (in one study of 3,400, 35% had been drinking)

35. 34 THEORIES: Alcohol as a Direct Cause of Aggression –alcohol as a disinhibitor of those brain functions that normally prevent aggression –alcohol “paralyzes the brakes, does not step on the gas” Indirect Cause –alcohol causes physical, emotional and cognitive changes that make aggression more likely e.g. Cognitive: perceive risk where there is none e.g. Physical:increases arousal levels

36. 35 THEORIES cont. Motives for Drinking –people drink for some main reason, maybe to reduce anxiety or increase their feeling of power EX. men drink to feel stronger Predispositional - Situational Factors –certain types of people are predisposed to act aggressively…and drinking situations give them an outlet to do so –those who expect alcohol to increase aggression act aggressively…“blame the bottle” –drinking situations may be seen as culturally agreed on time-outs

37. 36 Alcohol and Aggression –** while these models overlap a bit, they give us hypotheses to do further research Chermack & Taylor (1995) Study: –one of the studies that tried to tease out the relationship between alcohol and aggression used 40 male college students being paid 5 bucks per hour to help study “the effects of alcohol on cognitive and psychomotor tasks.”

38. 37 Alcohol and Aggression Most likely, aggression results from a complex interplay between alcohol expectancy, alcohol dose, personal factors and situational factors