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© 2010 McGraw-Hill Companies. All Rights Reserved.
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 14-17 grams or 100-120 calories
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Absorption20% is rapidly absorbed from the stomach75% is absorbed in the upper small intestinesRemain is absorbed along the GI trackAbsorption
CarbonationFood in the stomach slows the absorptionDrink of high concentration slows absorptionEventually all the alcohol ingested will be
absorbed
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© 2010 McGraw-Hill Companies. All Rights Reserved.
Metabolism and ExcretionTransported throughout the body via the
bloodstream.Easily moves through most biological
membranesMain site for metabolism is the Liver.2-20% of ingested alcohol is not metabolized.
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Alcohol Intake and Blood Alcohol ConcentrationBlood Alcohol Concentration(BAC)
A measure of intoxication Body weightPercentage of body fatSex
Balance of alcohol absorbed and rate of metabolismGenetic factorsDrinking BehaviorCan not be effected by
ExerciseBreathing deeplyEatingDrinking coffeeTaking other drugs
Metabolism is the same if the person is awake or asleep
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The Immediate Effects of Alcohol on HealthDependant on the individual.Low Concentrations .03% -.05%.Higher Concentrations 0.1% -0.2%.
Concentration of .35% and higher.Alcohol hangoverAlcohol poisoningUsing Alcohol with other drugs
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Drinking and DrivingIn 2004
250,000 were injured in alcohol related automobile crashes
42,000 people are killed in alcohol related accidents
Dose-response functionDriving 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.
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Figure 10.2 Approximate blood concentration and body weight
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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
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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
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Possible Health Benefits of AlcoholAbstainers 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
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Alcohol Abuse and DependenceAlcohol abuse is recurrent use that has
negative consequences.Alcohol dependence or Alcoholism more
extensive problems, tolerance and withdrawalWarning signs of alcohol abuse
Drinking aloneUsing deliberately and repeatedlyFeeling uncomfortable on certain occasionsEscalating consumptionGetting drunk regularlyDrinking in the morning or unusual times
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Alcohol Abuse and DependenceBinge 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
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Table 10-2 The Effects of Binge Drinking on College Students
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AlcoholismPatterns and Prevalence
1. Regular daily intake of large amounts2. Regular heavy drinking limited to weekends3. Long periods of sobriety interspersed with binges
or daily heavy drinking4. Heavy drinking limited to periods of stress
Health Effects DTs (delirium tremens) paranoia
Social and Psychological effectsCauses of Alcoholism
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Treatment ProgramsNot one program works for everyone.
AA. 12-step program
Al-Anon.Employee Assistance.Inpatient hospital rehabilitationPharmacological 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.
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Gender and Ethnic DifferencesMen
White American men“Other men”
WomenAfrican AmericansLatinosAsian AmericansAmerican Indians and Alaska NativesHelping Someone with an Alcohol Problem
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Table 10.4 Users and Abusers of Alcohol in the U.S.: 2007
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Drinking Behavior and ResponsibilityThinking about the environment.Examine your drinking behavior.
CAGE screening testDrink Moderately and responsiblyDrink slowlySpace your drinksEat before and while drinkingKnow your limits and your drinks
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Promote Responsible Drinking In Others
Encourage responsible attitudesBe a responsible hostHold the drinker responsibleLearn about prevention programsTake community action
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Chapter 10