Chapter 10

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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

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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

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Absorption20% is rapidly absorbed from the stomach75% is absorbed in the upper small intestinesAny remaining is absorbed along the GI trackAbsorption is affected by what is in the drink

Carbonation increases the rate of absorptionArtificial sweeteners (in drink mixers) increase

the absorptionFood in the stomach slows the absorptionDrink of high concentration slows absorptionEventually all the alcohol ingested will be

absorbed5

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Metabolism and ExcretionTransported throughout the body via the

bloodstreamEasily moves through most biological

membranesMain site for metabolism is the liverAbout 2-10% of ingested alcohol is not

metabolized

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Alcohol Intake andBlood 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 asleep7

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Figure 10.2 Approximate Blood Alcohol Concentration and Body Weight

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The Immediate Effectsof Alcohol on Health

Depends on the individualLow concentrations 0.03%-0.05%Higher Concentrations 0.1%-0.2%

Concentration of .35% and higher can be fatalAlcohol hangoverAlcohol poisoningUsing alcohol with other drugs

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Alcohol and Impaired JudgmentAlcohol-related injuries and violence• Homicide• Suicide• Automobile crashes• Hostility

Alcohol and aggressionAntisocial personality disorderLeads to arrest Impairs home life

Alcohol and sexual decision makingMore likely to engage in unsafe sex

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Drinking and DrivingIn 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

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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 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

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Figure 10.4 The Immediate and Long-Term Effects of Alcohol Abuse

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The Effects of AlcoholUse During Pregnancy

Effects are dose-relatedFetal 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

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Possible Health Benefits of AlcoholAbstainers and light to moderate drinkers live

longer than do heavy drinkers35 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 menMay lower coronary heart diseaseRaises blood levels of HDL, reduces blood clotsMay lower risks of diabetes, arterial blockages,

Alzheimer’s

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Alcohol Abuse and DependenceStatistics 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

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Abuse Versus DependenceAlcohol abuse is recurrent use that has negative

consequencesAlcohol dependence (alcoholism) involves more

extensive problems, tolerance, and withdrawalWarning signs of alcohol abuse

Drinking alone or secretivelyUsing deliberately and repeatedlySelf-medicatingFeeling uncomfortable on certain occasions when no alcoholEscalating consumptionConsuming alcohol heavily in risky situations (before driving)Getting drunk regularlyDrinking in the morning or at unusual times

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Binge DrinkingThe 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 hoursAbout 75% of the alcohol consumed by adults in

the U.S. meets the definition of binge drinking

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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 drinking lasting for weeks or months4. Heavy drinking limited to periods of stress

Health Effects Delirium tremens (the DTs) Blackouts and other memory problems

Social and psychological effectsCauses of alcoholism

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Treatment ProgramsDifferent programs work for different people

Alcoholics Anonymous (AA) 12-step program

Al-Anon, Rationale Recovery, Women for SobrietyEmployee assistance and school-based programsInpatient hospital rehabilitationPharmacological 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

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Gender and Ethnic DifferencesMen

White American menNon-white men

WomenAfrican AmericansLatinosAsian AmericansAmerican Indians and Alaska NativesHelping someone with an alcohol problem

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Table 10.3 Users and Abusers of Alcohol in the U.S.: 2008

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Drinking Behavior and ResponsibilityExamine 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 responsibleTake community action

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Develop ResponsibleDrinking Habits

Keep a record of your behavior in a health journal

Analyze your recordSet goalsDevise a planMonitor your progressReward yourself

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Chapter 10

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