Chapter 10

© 2010 McGraw-Hill Companies. All Rights Reserved. Chemistry of Alcohol Psychoactive ingredient Depressant Ethyl Alcohol – only alcohol that can be consumed Beer 3-6% alcohol by volume Malt Liquors 6-8% alcohol by volume Table wines 9-14% alcohol by volume Fermenting Fortified wines 20% alcohol by volume Sugar added Extra alcohol is added Hard liquors 35-50% alcohol by volume Distilling or fermented Proof Value Two times the percentage concentration Ingestion 7calories per gram 1 drink grams or calories 2

© 2010 McGraw-Hill Companies. All Rights Reserved. Absorption 20% is rapidly absorbed from the stomach 75% is absorbed in the upper small intestines Remain is absorbed along the GI track Absorption Carbonation Food in the stomach slows the absorption Drink of high concentration slows absorption Eventually all the alcohol ingested will be absorbed 3

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Metabolism and Excretion Transported throughout the body via the bloodstream. Easily moves through most biological membranes Main site for metabolism is the Liver. 2-20% of ingested alcohol is not metabolized. 5

© 2010 McGraw-Hill Companies. All Rights Reserved. Alcohol Intake and Blood Alcohol Concentration Blood Alcohol Concentration(BAC) A measure of intoxication Body weight Percentage of body fat Sex Balance of alcohol absorbed and rate of metabolism Genetic factors Drinking Behavior Can not be effected by Exercise Breathing deeply Eating Drinking coffee Taking other drugs Metabolism is the same if the person is awake or asleep 6

© 2010 McGraw-Hill Companies. All Rights Reserved. The Immediate Effects of Alcohol on Health Dependant on the individual. Low Concentrations.03% -.05%. Higher Concentrations 0.1% -0.2%. Concentration of.35% and higher. Alcohol hangover Alcohol poisoning Using Alcohol with other drugs 7

© 2010 McGraw-Hill Companies. All Rights Reserved. Drinking and Driving In ,000 were injured in alcohol related automobile crashes 42,000 people are killed in alcohol related accidents Dose-response function Driving with a BAC of 0.14% is more than 40 times more likely to be involved in a crash. Greater than 0.14% the risk of fatal crash is estimated to be 380 times higher. 8

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Figure 10.2 Approximate blood concentration and body weight 10

© 2010 McGraw-Hill Companies. All Rights Reserved. The Effects of Chronic Use Diseases of the digestive, cardiovascular systems and some cancers Digestive system Liver function liver cell damage and destruction (cirrhosis) Cirrhosis causes drinker to lose Tolerance Pancreas inflammation Cardiovascular system moderate doses may reduce the risk of HD Higher doses elevates BP, may weaken heart muscle or cardiac myopathy. Cancer Mouth, throat, larynx, and esophagus 5-6 total drinks Responsible for the most common form of liver cancer Hepatitis speeds the growth of this cancer Breast cancer Increase risk when 2-3 drinks per day Brain Damage Cognitive impairments Memory loss, dementia, and compromised problem-solving Wernicke-Korsakoff syndrome Mortality Alcoholics average life expectancy is about 15 years less than non-alcoholics 11

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© 2010 McGraw-Hill Companies. All Rights Reserved. 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. Under weight, flat nasal bridge, and long upper lip. Small and have heart defects. Physical and mental growth is slowed. Remain mentally impaired. Fine motor skill problems, coordination, learning and behavioral problems (ADS). ARND Alcohol-related neurodevelopment disorder. Heavier drinking early in pregnancy. 13

© 2010 McGraw-Hill Companies. All Rights Reserved. Possible Health Benefits of Alcohol Abstainers and light to moderate drinkers live longer than heavy users. 35 years old and younger, your odds of dying increase in proportion to the amount consumed Moderate drinking = one drink per day for women and two drinks per day for men. May lower coronary heart disease. Raising blood levels of HDL. May lower risks of; diabetes, arterial blockages, Alzheimer’s 14

© 2010 McGraw-Hill Companies. All Rights Reserved. Alcohol Abuse and Dependence Alcohol abuse is recurrent use that has negative consequences. Alcohol dependence or Alcoholism more extensive problems, tolerance and withdrawal Warning signs of alcohol abuse Drinking alone Using deliberately and repeatedly Feeling uncomfortable on certain occasions Escalating consumption Getting drunk regularly Drinking in the morning or unusual times 15

© 2010 McGraw-Hill Companies. All Rights Reserved. Alcohol Abuse and Dependence Binge Drinking The National Institute on Alcohol Abuse and Alcoholism defines: 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: Having five drinks in row for a man or four in a row for a women within two hours. Frequent binge drinking in college were three to seven times more likely than non-binge drinkers to engage in unplanned or unprotected sex Healthy People 2010 Reduce the rate of binge drinking to 20% among college students 16

© 2010 McGraw-Hill Companies. All Rights Reserved. Table 10-2 The Effects of Binge Drinking on College Students 17

© 2010 McGraw-Hill Companies. All Rights Reserved. Alcoholism Patterns and Prevalence 1. Regular daily intake of large amounts 2. Regular heavy drinking limited to weekends 3. Long periods of sobriety interspersed with binges or daily heavy drinking 4. Heavy drinking limited to periods of stress Health Effects DTs (delirium tremens) paranoia Social and Psychological effects Causes of Alcoholism 18

© 2010 McGraw-Hill Companies. All Rights Reserved. Treatment Programs Not one program works for everyone. AA. 12-step program Al-Anon. Employee Assistance. Inpatient hospital rehabilitation Pharmacological treatments. Disulfiram (Antabuse) Inhibits the metabolic breakdown Naltrexone (ReVia, Depade) Reduces the craving for alcohol and decreases its pleasant effects. Injectable Naltrexone (Vivtrol) – single monthly shot Acamprosate (Campral) Acts on brain pathways related to alcohol abuse. 19

© 2010 McGraw-Hill Companies. All Rights Reserved. Gender and Ethnic Differences Men White American men “Other men” Women African Americans Latinos Asian Americans American Indians and Alaska Natives Helping Someone with an Alcohol Problem 20

© 2010 McGraw-Hill Companies. All Rights Reserved. Table 10.4 Users and Abusers of Alcohol in the U.S.:

© 2010 McGraw-Hill Companies. All Rights Reserved. Drinking Behavior and Responsibility Thinking about the environment. Examine your drinking behavior. CAGE screening test Drink Moderately and responsibly Drink slowly Space your drinks Eat before and while drinking Know your limits and your drinks 22

© 2010 McGraw-Hill Companies. All Rights Reserved. Promote Responsible Drinking In Others Encourage responsible attitudes Be a responsible host Hold the drinker responsible Learn about prevention programs Take community action 23

Chapter 10