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Uppers, Downers and All Arounders Downers: Alcohol.

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Presentation on theme: "Uppers, Downers and All Arounders Downers: Alcohol."— Presentation transcript:

1 Uppers, Downers and All Arounders Downers: Alcohol

2 Alcohol Overview Most people drink alcohol except in Islamic countries In U.S. 48% had at least one drink last month 25-30% of hospital admissions was due to direct and indirect medical complications from alcohol ½ of American adults had a family member who is an alcoholic Worldwide 2 million people died as a result of alcohol –10% of diseases and injuries were a direct result of alcohol

3 Alcohol Overview Alcohol is the oldest known and most widely used psychoactive drug in the world Historians believe that alcohol was found accidentally Historians believe that first civilized settlements were created to ensure regular supply wine, grain & opium First evidence of use is recipe for beer dated to 8000 B.C.

4 Alcohol Overview Historically alcohol has been used for: –Food (beer) for peasants –Solvent for opium –Sacrament for religious ceremonies –Water substitute –Social –Tranquilizer –Source of taxes

5 Alcohol Overview All countries have had periods of restriction for alcohol consumption –England: 1700’s unrestricted sale of gin led to abuse and addiction –America: 1920-1933 Prohibition period Repealed because of major source or revenue and tax –1930 American Alcoholics Anonymous founded in

6 Alcohol Beverages Hundreds of different alcohols –Ethyl (beverage) –Methyl (wood alcohol) –Isopropyl –Butyl –Any alcohol with 2% grain is considered a beverage alcohol Alcohol occurs naturally as a result of airborne yeast feeding on sugars in honey, fruits, berries, vegetables and grains called “fermentation” that produces alcohol and carbon dioxide

7 Alcohol Beverages Beer: Drink of common people in early times –Ale –Stout –Porter –Malt liquor –Larger –Bock beer –Beer is brewed or fermented by roasting barley and cereal grains then combining the result with water, grain, hops and yeast –Alcohol content: Larger beers: 4-5% Ales: 5-6% Malt liquor: 6-9%

8 Alcohol Beverages Wine was the drink of priest and nobles in early times –Fermented from berries and other fruit and starchy grains like rice –8-14% alcohol –More than 14% alcohol content are fortified with pure alcohol or brandy added after fermentation

9 Alcohol Beverages Distilled Spirits discovered by Arabs in A.D. 800 Result of boiling wine or other alcoholic beverages and collecting the condensation Brandy is distilled from wine Rum distilled from sugar cane or molasses Vodka from potatoes Whisky and gin from grains Distilled beverages have high alcohol content than wine or beer Alcoholism exploded as a result of distilled spirits


11 Absorption & Distribution Absorption into bloodstream: –Takes place along various sites along the gastrointestinal tract: Stomach, small intestines and colon Men and women process alcohol differently even with the same body weight –In men 10-20% of alcohol absorbed by stomach –In women most alcohol is absorb in the walls of the small intestine at a rate of 30% –Women feel the effects of alcohol faster and more intensely.

12 Absorption & Distribution Absorption: Women –Women have higher blood alcohol content than men due to –Lower % of body water than men –Less alcohol dehydrogenase enzyme in stomach to break down alcohol so less alcohol is metabolized before entering bloodstream –Changes in gonadal hormones levels during menstruation affect the rate of alcohol metabolism –Death rates are 50-100% higher than men

13 Absorption Factors that speed-up absorption: –Increasing the amount drunk or drinking rate –Drinking on a empty stomach –Using high alcohol concentrations up to a maximum of 95% with Everclear –Drinking carbonated drinks like champagne, sparkling wines, soft drinks, and tonic mixers –Warming the alcohol Factors that slow Absorption –Eating before or while drinking (meat, cheese & fatty foods) –Diluting drinks with ice, water or fruit juice

14 Metabolism & Alcohol Concentration Alcohol treated as toxin or poison so elimination begins as soon as it is ingested 2-10% eliminated without being metabolized 90-98% neutralized through metabolism by liver Excreted by kidneys and lungs Alcohol high in calories, but no real food value causing high malnutrition Alcoholics get have their energy from empty calories

15 Metabolism & Alcohol Concentration Blood Alcohol concentration (BAC) –1 oz. of pure alcohol eliminated every 3 hours –Person’s biochemical makeup due to heredity can have strong effect on metabolism and elimination –Actual reaction and level of impairment depends on: Drinking history Tolerance Mood And other factors –Most states consider.08 or 1.0 of BAC Drunk


17 Levels of Use Low-to-moderate: 1 drink for women & 2 drinks for women daily –Generally does not have negative consequences –Generally not safe for pregnant women, people who have physical or mental impairments –Use includes: –Relaxation –Relax muscles –Stimulate appetite –Reduce incidents of heart attack & stroke –Alcohol interferes with REM sleep & dreaming essential to feeling fully rested

18 Levels of Use High-doses (heavy drinking) –5 or more drinks at one sitting for males and 4 or more for females at least 5xs per month Depresses nervous system Possibly leading to cardiac failure or death.40 is threshold for alcohol poisoning that can fatally..20 can result in severe depressed respiration and vomiting while semiconscious –Vomit can be aspirated or swallowed blocking air passages to lungs resulting in asphyxiation and death

19 Levels of Use Blackouts: Person appears to be acting normally and is awake and conscious but afterwards cannot recall anything. –Early signs of alcoholism –Different from passing out (drinker has partial recollection) Hangovers –May be severe many hours after –Effects include: –Headache –Nausea –Vomiting –Thirst –Dizziness –Dry mouth –Inability to concentrate –General depressed feeling

20 Levels of Use Mental and emotional effects –Depresses and slows functions to Cental and peripheral NS –Moves from initial relaxation to lowered inhibitions –Mental confusion –Mood swings –Loss of judgment –Emotional turbulance –BAC of.10 slurred speech –Chronic alcoholism results in daily fatigue –Nightmares, bed wetting and heavy snoring

21 Levels of Use Liver Disease –10-35% of chronic alcoholics develop alcoholic hepatitis Causes inflammation of the liver Areas of fibrosis Necrosis (cell death) Damaged membranes –10-20% cirrhosis of the liver Occurs when alcohol causes scarring Most advanced form of liver disease Leading cause of death among alcoholics 10,000-24,000 die each year France and Germany have a rate of 2-3 times more than U.S.

22 High Use of Alcohol

23 Liver Disease –Fatty Liver: accumulation of fatty acids in the liver Occurs after a few days of heavy drinking Abstention eliminates much of accumulated fat Liver diseases decrease the ability of the liver to metabolize alcohol thus allowing alcohol to travel to other organs in original toxic form


25 High Use of Alcohol Digestive system –Moderate to high use stimulate production of stomach acid and delay emptying time of the stomach causing acid stomach and diarrhea –Gastritis (stomach inflammation) common –Inflammation and irritation of esophagus, small intestine and pancreas –Linked to ulcers, stomach hemorrage and gastrointestinal bleeding –Can cause hypoglycemia in drinkers that get little nutrition (too little sugar) –Hyperglycemia in people who have sufficient nutrition (too much sugar)

26 High Use of Alcohol Cardiovascular disease –Related to heart disease, including Hypertension, cardiac arrhythmias Damages striated heart muscles Cardiomyopathy, (enlarged, flabby and insufficient heart) Increases risk of stroke


28 High Use of Alcohol Central Nervous System (CNS) –Causes direct damage to nerve cells –Alcohol-induced malnutrition can injure brain & disrupt brain chemistry –Brain atrophy (loss of brain tissue) documented in50-100% of alcoholics in autopsy –Dementia –Wernicke’s encephalopathy and Kosakoff’s psychosis (serious brain damage caused by chronic alcoholism and thiamin deficiency) –m–m

29 High Use of Alcohol Reproductive System In females –Decreases sexual desire and intensity of orgasm –Raises chances of infertility and spontaneous abortion In men –Impairs gonadal function causing decrease in testosterone levels –8% are impotent –Only half recover sexual function after abstinence

30 High Use of Alcohol Cancer: –Association between breast cancer and heavy drinking –Risk of mouth, throat, larynx & esphageal cancer are 6 times greater and 38% for those who smoke and drink Systemic Problems –Leeches minerals from body cause greater risk of fracture –Unbalances electrolytes by chronic use –Reddish skin completion –Respiratory infections –Turberculosis –Pnenomonia –Weaken immune system

31 Addiction to Alcohol 10-12% of 140 million Americans develop addiction to alcohol 2-3 times greater for men 20% consume 80% of alcohol E.M. Jellineck classification of alcoholics: –Primary: immediate liking of alcohol, progressing to alcoholism –Steady endogenous: alcohol is secondary to psychiatric disease –Intermittent: periodic binge drinking –Stammtisch: alcoholism precipitated by outside and social causes

32 Addiction to Alcohol Modern classifications –Type I Later onset Effects men and women Requires genetic and environment predisposition Can be moderate to severe Takes years of drinking to trigger it –Type II “Male Limited” Affects sons of alcoholics Moderately severe Primarily genetic Mildly influenced by environmental factors

33 Addiction to Alcohol Modern classifications –Type A Later-onset of alcoholism Less family history Less severe dependence –Type B More severe alcoholism with earlier onset More impulsive behavior and conduct disorders More co-occurring disorders More severe dependence

34 Addiction to Alcohol Disease Concept –Primary disease with genetic, psychosocial and environment factors influencing development and manisfestation –Progressive –Fatal –Impaired control –Preoccupation –Use of alcohol despite negative consequences –Distortions in thinking –Most notably denial of problem drinking –Can be periodic or continuous

35 Addiction to Alcohol Heredity: –Strong genetic influences shown in family, twin, and adoption studies –Several genes have an influence on one’s susceptibility to alcoholism –Strong genetic susceptibility to blackouts –Hereditary link to physical consequences to cirrhosis and alcoholic psychosis Environmental factors –Child abuse –Poor nutrition –Alcohol/drug abusing friends and relations –Extreme stress

36 Addiction to Alcohol Exposure to brain initiates process of adaptation or change in brain function Tolerance –Body changes as alcohol is metabolizes –Heavy drinking causes liver to be less able to metabolize alcohol (reverse tolerance) –Brain cells and neurons become more resistant to effects by increasing receptor sites –Drinkers learn how to “handle their liquor” and modify their behavior

37 Addiction to Alcohol Withdrawal –Minor symptoms 85% will have minor symptoms Rapid pulse Sweating Increased body temperature Hand tremors Anxiety Depression

38 Addiction to Alcohol Withdrawal –Major Symptoms Tachycardia Transient visual, tactile or audio hallucinations & delusions Psychomotor agitation Grand-mal seizures Delirium tremens (DTs) requiring hospitalization Kindling: repeated bouts of drinking causing severe withdrawal that causes seizures

39 Alcohol and Pregnancy Leading cause of mental retardation in children 12.4% drank alcohol during several months of pregnancy 3.9% had binge pattern 0.7% heavy drinkers 5.5% Study of infants with FAS found that 89% were using alcohol and at least two other drugs 49% were using just two drugs, usually cocaine and alcohol

40 Alcohol and Pregnancy Fetal Alcohol Syndrome –Retarded growth before and after birth –Facial abnormalities, including shortened eye openings, thin upper lip, flattened midface, missing groove in upper lip. –Occasional problems with heart and limbs –Delayed intellectual development –Neurological problems –Behavioral problems –Visual problems –Hearing loss –Balance or gait problems

41 Alcohol and Pregnancy Critical period during pregnancy for alcohol effects on brain development is weeks 3 – 8 at onset of embryogenesis 7 standard drinks per week was threshold for pregnant women

42 Aggression & Violence ¼ 11.1 million victims of violent crime report that the offender had been drinking alcohol 34-37% of sexual assaults predators 30-79% of victims drinking Encourages release of pent-up anger, hatred and desires forbidden by society Any type of violence can cause permanent biochemical changes in victim that makes them susceptible to drug abuse and other emotional problems

43 Driving Under the Influence 40% of fatalities in 2001 1 in 4 drinker gets behind wheel after 2 hours of drinking Of those convicted of DUI –61% drank beer –2% drank wine –18% drank liquor –20% drank combination 15-25% emergency room patients 16 x’s likely to die in falls 10 x’s likely like to become burn victims 31% boating accidents

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