2. ALCOHOL Where does it come from?

3. 2 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

4. 3 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 _________________________________________________ _________________________________________________

5. 4 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

6. 5 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

7. 6 NSDUH Data 2004 Current Lifetime82.4% Past Year65.1 Past Month (current)50.3 Past Month Binge22.8% Heavy Usage6.6

8. 7 Prevalence of Use by Age Rates of current use were at least ____% for most age groups in the 21-44 age range curvilinear effect Find the usage rate for your specific age bracket at the latest National Survey for Drug Use and Health: http://www.oas.samhsa.gov/nhsda.htm

9. 8 Prevalence of Use by Race/Ethnicity Whites continue to have highest rate of use Heavy use among groups about the same?? –Si o no?

10. 9 Prevalence of Use by Gender As you might guess, current (past month) alcohol use is typically more prevalent among males : 56.9% vs. 44% - 2004 data; 2010? ______________ Men were much more likely to be binge and be “heavy” drinkers

11. 10 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

12. 11 Figure 3.4 Heavy Alcohol Use among Adults Aged 18 to 22, by College Enrollment: 2002-2006

13. 12 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)

14. 13 Relationship Between Blood Alcohol and Alcohol Intake Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

15. 14 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

16. 15 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

17. 16 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

18. 17 CONSEQUENCES What are some positive and negative effects?

19. 18 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)

20. 19 Short-term Effects cont. Psychological – Social/familial Interference

21. 20 Short-term Effects cont. Cognitive – memory impairment – reaction time slows Other –Drunk driving –Suicide –Sexual assualt, esp. acquaintance rape –High risk sex

22. 21 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

23. 22 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

24. 23

25. 24 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 –

26. 25 Long-term Consequences cont. Cognitive: –impairs memory, problem-solving, learning and reaction time –neuropsychological damage can be reversed with prolonged abstinence –Wernicke-Korsakoff Syndrome

27. 26 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:

28. 27 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)

29. 28 THEORIES: Alcohol as a Direct Cause of Aggression Indirect Cause

30. 29 THEORIES cont. Motives for Drinking Predispositional - Situational Factors –certain types of people are predisposed to act aggressively…and drinking situations give them an outlet to do so

31. 30 Alcohol and Aggression Most likely, aggression results from a complex interplay between alcohol______________, alcohol _______, ___________ factors and ____________ factors