1. Chapter 10 © 2012 McGraw-Hill Companies. All Rights Reserved.

2. Alcoholic Beverages Alcohol is the most popular psychoactive drug in the Western world Categorized as a depressant Ethyl alcohol – only alcohol that can be consumed Beer 3-6% alcohol by volume Ales and 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 (or stronger) Distilling brewed or fermented grains or other plant products Proof value Two times the alcohol percentage concentration 2

3. © 2012 McGraw-Hill Companies. All Rights Reserved. Standard Drinks and Calories One drink = standard drink One drink typically contains 0.6 ounces of alcohol Caloric content 7 calories per gram One drink (14-17 grams) has about 100-120 calories Also contains carbohydrates One beer about 150 calories “Light” in light beer refers to calories (about 100) 5-ounce glass of red wine has 100 calories 5-ounce glass of white wine has 96 calories 3-ounce margarita has 157 calories 6-ounce Cosmopolitan has 143 calories 6-ounce rum and Coke has 180 calories 3

4. © 2012 McGraw-Hill Companies. All Rights Reserved. 4 Table 10.1 Serving Sizes Versus Standard Drinks of Common Alcoholic Beverages

5. © 2012 McGraw-Hill Companies. All Rights Reserved. Absorption 20% is rapidly absorbed from the stomach 75% is absorbed in the upper small intestines Any remaining is absorbed along the GI track Absorption is affected by what is in the drink Carbonation increases the rate of absorption Artificial sweeteners (in drink mixers) increase the absorption Food in the stomach slows the absorption Drink of high concentration slows absorption Eventually all the alcohol ingested will be absorbed 5

6. © 2012 McGraw-Hill Companies. All Rights Reserved. Metabolism and Excretion Transported throughout the body via the bloodstream Easily moves through most biological membranes Main site for metabolism is the liver About 2-10% of ingested alcohol is not metabolized 6

7. © 2012 McGraw-Hill Companies. All Rights Reserved. Alcohol Intake and Blood Alcohol Concentration (BAC) Blood alcohol concentration (BAC) The amount of alcohol in a person’s blood; 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 influenced by: Exercise Breathing deeply Eating Drinking coffee Taking other drugs Metabolism is the same if the person is awake or asleep 7

8. © 2012 McGraw-Hill Companies. All Rights Reserved. Figure 10.2 Approximate Blood Alcohol Concentration and Body Weight 8

9. © 2012 McGraw-Hill Companies. All Rights Reserved. The Immediate Effects of Alcohol on Health Depends on the individual Low concentrations 0.03%-0.05% Higher Concentrations 0.1%-0.2% Concentration of.35% and higher can be fatal Alcohol hangover Alcohol poisoning Using alcohol with other drugs 9

10. © 2012 McGraw-Hill Companies. All Rights Reserved. Alcohol and Impaired Judgment Alcohol-related injuries and violence Homicide Suicide Automobile crashes Hostility Alcohol and aggression Antisocial personality disorder Leads to arrest Impairs home life Alcohol and sexual decision making More likely to engage in unsafe sex 10

11. © 2012 McGraw-Hill Companies. All Rights Reserved. Drinking and Driving In 2008, 275,000 people were injured in alcohol related automobile crashes 11,773 people were killed in alcohol related accidents Dose-response function Driving with a BAC of 0.14% is over 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 11

12. © 2012 McGraw-Hill Companies. All Rights Reserved. 12 Figure 10.3 The Dose-Response Relationship Between BAC and Automobile Crashes

13. © 2012 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 heart disease Higher doses elevates blood pressure, may weaken heart muscle or cardiac myopathy Cancer Mouth, throat, larynx, and esophagus 5-6 total drinks daily Responsible for the most common form of liver cancer Hepatitis speeds the growth of this cancer Breast cancer Increase risk with 2-3 drinks per day Brain damage Cognitive impairments and brain shrinkage Memory loss, dementia, and compromised problem-solving Mortality Alcoholics’ average life expectancy is about 15 years less than non-alcoholics 13

14. © 2012 McGraw-Hill Companies. All Rights Reserved. 14 Figure 10.4 The Immediate and Long-Term Effects of Alcohol Abuse

15. © 2012 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. Alcohol-related neurodevelopment disorder (ARND) Negative effects on the baby’s brain development 15

16. © 2012 McGraw-Hill Companies. All Rights Reserved. Possible Health Benefits of Alcohol Abstainers and light to moderate drinkers live longer than do heavy drinkers 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 Raises blood levels of HDL, reduces blood clots May lower risks of diabetes, arterial blockages, Alzheimer’s 16

17. © 2012 McGraw-Hill Companies. All Rights Reserved. Alcohol Abuse and Dependence Statistics on American alcohol usage 60% ages 18 or older routinely drink alcohol 15% are former drinkers 25% are lifetime abstainers 7% are classified as heavy alcohol users 17

18. © 2012 McGraw-Hill Companies. All Rights Reserved. Abuse Versus Dependence Alcohol abuse is recurrent use that has negative consequences Alcohol dependence (alcoholism) involves more extensive problems, tolerance, and withdrawal Warning signs of alcohol abuse Drinking alone or secretively Using deliberately and repeatedly Self-medicating Feeling uncomfortable on certain occasions when no alcohol Escalating consumption Consuming alcohol heavily in risky situations (before driving) Getting drunk regularly Drinking in the morning or at unusual times 18

19. © 2012 McGraw-Hill Companies. All Rights Reserved. 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 woman) within two hours National Survey on Drug Use and Health defines: Having five drinks in a row for a man or four in a row for a woman within two hours About 75% of the alcohol consumed by adults in the U.S. meets the definition of binge drinking 19

20. © 2012 McGraw-Hill Companies. All Rights Reserved. Table 10.2 The Effects of Binge Drinking on College Students 20

21. © 2012 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 lasting for weeks or months 4. Heavy drinking limited to periods of stress Health Effects Delirium tremens (the DTs) Blackouts and other memory problems Social and psychological effects Causes of alcoholism 21

22. © 2012 McGraw-Hill Companies. All Rights Reserved. Treatment Programs Different programs work for different people Alcoholics Anonymous (AA) 12-step program Al-Anon, Rationale Recovery, Women for Sobriety Employee assistance and school-based programs Inpatient hospital rehabilitation Pharmacological treatments. Disulfiram (Antabuse) Inhibits the metabolic breakdown; feel ill 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 22

23. © 2012 McGraw-Hill Companies. All Rights Reserved. Gender and Ethnic Differences Men White American men Non-white men Women African Americans Latinos Asian Americans American Indians and Alaska Natives Helping someone with an alcohol problem 23

24. © 2012 McGraw-Hill Companies. All Rights Reserved. Table 10.3 Users and Abusers of Alcohol in the U.S.: 2008 24

25. © 2012 McGraw-Hill Companies. All Rights Reserved. Drinking Behavior and Responsibility 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 25

26. © 2012 McGraw-Hill Companies. All Rights Reserved. Promote Responsible Drinking in Others Encourage responsible attitudes Be a responsible host Hold the drinker responsible Take community action 26

27. © 2012 McGraw-Hill Companies. All Rights Reserved. Develop Responsible Drinking Habits Keep a record of your behavior in a health journal Analyze your record Set goals Devise a plan Monitor your progress Reward yourself 27

28. Chapter 10 © 2012 McGraw-Hill Companies. All Rights Reserved.