ALCOHOL ABUSE

Alcohol Abuse

• Approx 14 million Americans are alcoholics• Approx 100,000 death/yr associated with alcohol

abuse• 18.8% have lived with an alcoholic some time during

their childhood• 9.2% have been married or cohabitated with an

alcoholic• 37.9% have a blood relative who is an alcoholic• Approximately 1/3 of high school students report

binge drinking once a month• 1,400 college students a year die from accidents,

violence or poisoning related to alcohol

Alcohol Abuse

• Alcohol is a central nervous system depressant, not a stimulant

• Feel release of personal inhibitions• Broken down by the liver at a rate of 2/3 to

3/4 of an ounce per hour• If you drink more then this the alcohol level

in your blood will rise

Factors that influence absorption

• Strength of the drink• Number of drinks consumed• Speed of consumption• Presence of food in your stomach• Body chemistry– Amount of time it takes for the stomach to empty

depends on stress, anger, fear, nausea

Factors that influence absorption

• Gender– Women produce less of enzyme needed to

breakdown alcohol– Women have greater fat content and alcohol is

not fat soluble so it enters the blood stream faster– Women have less water so alcohol does not

become diluted– Women absorb more alcohol during the

premenstrual phase

Blood Alcohol Levels

• Legal blood alcohol is less the 0.08 if you are over 21

• 0.04 for 18-21• 0.01 below 18

Blood Alcohol Levels

• 0.02 – no effect• 0.03-0.05 – relaxed, slightly lightheaded,

decreased inhibitions– Level reached by 160 pound man taking 2 drinks

per hour

• 0.1 – loss of motor coordination and impaired judgment

• 0.15 – significant impairment of motor coordination and reaction time, slurred speech

Blood Alcohol Levels

• 0.2 – severely intoxicated, loud obnoxious drunk

• 0.3 – limited control of functions, may be unconscious

• 0.4 – comatose• 0.6-0.7 –suffocation and death, usually pass

out before this point

Sobering Up

• Acute alcohol poisoning– Drank too much, too fast

• Call 911 if– Unable to awaken person– Shallow breathing– Fast heart rate– Cool skin– Bluish color to skin

Sobering Up

• Regurgitation and aspiration• Lay person on their side and do not leave

them alone

Alcohol Related Health Problems

• Hangover– Mild withdrawal from alcohol– Nerve cells become dehydrated by alcohol– No cure except time– “hair of the dog that bit you” means drinking

again to avoid withdrawal symptoms

Alcohol Related Health Problems

• Alcohol and pregnancy do not mix• Increased number of miscarriages• Fetal alcohol syndrome (FAS)– Mental retardation– Slow growth– Facial abnormalities

• Small heads• Widely spaced eyes• Flattened noses

• 10 or more drinks/day 74% will have FAS

Alcohol Related Health Problems

• Cardiovascular system– High blood pressure– Scar tissue formation on the heart– Fatty deposit increase the size of the heart– Death from heart failure

Alcohol Related Health Problems

• Liver metabolizes the alcohol• Liver is the most vulnerable organ to alcohol• Heavy drinking damages the liver causing

cirrhosis and eventual death

Alcohol Related Health Problems

• Gastrointestinal system – GI bleeding– Esophageal varacies– Malnutrition– Esophageal cancer

Alcohol Related Health Problems

• Endocrine disorders– Decreased testosterone production– Second leading cause of impotence– May lead to early menopause in women– Alters the menstrual cycle

Alcohol Related Health Problems

• Central nervous system– Brain cell loss– Impaired nerve function

• Depression– Alcoholics 30 times more likely to commit suicide

then the general population

Tolerance to Alcohol

• Develop a physical and psychological addiction to alcohol

• Develop a tolerance to alcohol– Takes more alcohol to get the relaxed feeling– As damage to liver increases unable to

breakdown alcohol and it takes less alcohol to get drunk

Effect on Society

• Motor vehicle crashes– Every two minutes an alcohol related car

crash injury happens– 28% if all 18-29 yr olds say they have

driven while drunk– Do not drink and drive– If caught you will lose you license for one

year

Effect on Society

• Drownings– Alcohol is involved in 34%

• Fires and burns– Half of burn victims above legal BAL

• Crime and violence– Homicides have alcohol involved 67% of the time– 50% of rapists are intoxicated and 30% of victims

• Suicide– Half of all suicides are committed by alcoholics– Alcohol is related to impulsive suicides vs

premeditated ones

Hosting a Party Responsibly

• You are responsible for the health and safety of you guests and may be held liable if they drink and drive

• Don’t push drinks• Don’t serve doubles• Don’t keep the glasses full• Have non-alcoholic beverages• Serve non-salty snacks

Hosting a Party Responsibly

• Don’t make drinking the main activity at the party

• Do not let someone drive if they are intoxicated, take their keys or call 911

Keeping Yourself Sober

• Drink slowly• Space your drinks• Know your limits• Designated driver• Don’t drink before the party• Don’t drink if you are mad or depressed• Avoid drinking games• Consume only a pre-planned number of drinks and

stop drinking at a pre-planned hour

Stages of Alcohol Dependence

• Early– Escape drinking– Binge drinking– Guilt feelings– Sneaking drinks– Difficulty stopping after beginning to drink– Increased tolerance– Preoccupation with drinking– Occasional blackouts

Stages of Alcohol Dependence

• Middle– Loss of control– Self hate– Impaired social relationships– Changes in drinking patterns (more frequent

binge drinking)– Dietary neglect– Increased blackouts

Stages of Alcohol Dependence

• Late– Prolonged binges– Alcohol used to control withdrawal symptoms– Alcohol psychosis– Nutritional disease– Frequent blackouts

Causes of Alcoholism

• Genetics– Strong family link– 50% of fathers, sons, brothers of alcoholics are

likely to become alcoholics– Children of alcoholics are more then 3-4 times

more likely to become alcoholics

• Personality types– Low self esteem– Chronic anxiety– Antisocial personalities

Treatment

• Biggest barrier to treatment and recovery is denial

• Families delay treatment by enabling the alcoholic– Families deny the problem, delay treatment– Cover up for the alcoholic

• Codependence with a significant other– Dual addiction– Alcoholic is addicted to alcohol and the family

member is addicted to them– Delays treatment

Treatment

• Detoxification is first– Go through physical withdrawal from alcohol– Inpatient medical treatment– Avoid DTs and seizures

• Psychological addiction is next– Changing long term behavior– Problem solving skills– Stress management

• 2/3 can recover with good emotional support

Treatment

• Alcohol Anonymous (AA)– Based on the belief that people have to admit they

have lost control over alcohol and they are powerless to control their drinking

– One of the most successful programs

• Alcoholics can not be social drinkers