drugs & society chapters 7 & 8
TRANSCRIPT
AlcoholHanson Chapters 7 & 8
SOC 204 Drugs & Society
Is someone close to you an alcoholic?
A. Yes, more than one person
B. Yes, one person
C. No
Yes, m
ore th
an one p
erson
Yes, o
ne per
son No
56%
24%20%
Alcohol
• Fermentation
• Distillation
• Proof
Pharmacology• Absorption• Distribution• Metabolism• Mechanism of Action• BLOOD ALCOHOL
CONTENT
Alcohol is metabolized in your liver
A. True
B. False
True
False
0%
100%
Figure 7.1 How alcohol is absorbed in the body.
Data from Masters, S., and A. Trevor “The Alcohols.” In Basic and Clinical Pharmacology, 13th ed., edited by B. Katzung, 384–395. New York: McGraw-Hill, 2015.
You can increase your rate of metabolizing
alcohol by exercise or by taking caffeine
A. True
B. False
True
False
88%
12%
Alcohol’s Effects
• Alcohol acts on the cerebrum affecting
▫ Judgment
▫ Reasoning
▫ Inhibitions
▫ Motor activity
▫ Impairs the senses
• Mouse Party
BAC (%)
Behavioral Effects
•0.05 Lowered alertness, release of inhibitions, impaired
judgment
•0.10 Slower reaction times, impaired motor function, less
caution
•0.15 Large, consistent increases in reaction time
•0.20 Marked depression in sensory and motor capability,
intoxication
•0.25 Severe motor disturbance, staggering, great impairment
•0.30 Stuporous but conscious—no comprehension of what’s
going on
•0.35 Surgical anesthesia; about LD1, minimal level causing
death
•0.40 About LD50
Figure 7.2 The principal control centers of the brain affected by alcohol
consumption.
Alcohol primarily impacts this part of
the brain:
A. Limbic system
B. Cerebellum
C. Cerebral cortex
D. Basal ganglia
Limbic
syst
em
Cerebellu
m
Cerebra
l cort
ex
Basal g
anglia
0% 0%
56%
44%
Alcohol sedates by increasing
glutamate’s action – an agonist
response.
A. True
B. False
True
False
63%
38%
Alcoholism
• Alcoholism ▫ Condition in which an individual loses control over
intake of alcohol
• Substance Use Disorder▫ Physical, social, intellectual, emotional, or financial
problems resulting from the use of alcohol▫ Withdrawal symptoms▫ Tolerance▫ Blackouts
Alcoholism
• Some consider alcoholism to be a disease
▫ Compared to heart disease or diabetes
▫ 1956 American Medical Association declared it a disease
▫ Disease can be used as a legal defense
▫ Receive treatment rather than punishment
Early Characterizations of Alcoholic
Types by Jellinek (1960)• Alpha alcoholics: Mostly a psychological dependence
• Beta alcoholics: Mostly socially dependent on alcohol
• Gamma alcoholics: Most severe; suffers from emotional and psychological impairment
• Delta alcoholics: Constantly losing control over the amount of alcohol consumed
• Epsilon alcoholics: Constantly binge drinking and at times days at a time
• Zeta alcoholics: Moderate drinker who becomes abusive and violent
Types of Alcoholics by Moss and
Colleagues in 2007
• Young Adult (31.5% of U.S. alcoholics): Young adult drinkers without major problems regarding their drinking
• Young Antisocial (21% of U.S. alcoholics): Mid-20s, had earlier onset of regular drinking and alcohol problems, and come from heavy alcohol use families
• Functional (19.5% of U.S. alcoholics): Middle-aged, well-educated, with stable jobs and families
• Intermediate Familial (19% of U.S. alcoholics): Middle-aged, with 50% from families with multigenerational alcoholism
• Chronic Severe (9% of U.S. alcoholics): Mostly middle-aged, high rates of antisocial personality disorder and criminality
Do you agree alcoholism is a disease?
A. Yes
B. No
C. I’m not sure
YesNo
I’m n
ot sure
0% 0%0%
I know that for the discussion
Thursday, I have to interview two
people
A. Yep. On it.
B. Noooo
C. What discussion?
Yep.
On it.
Noooo
What
disc
ussio
n?
100%
0%0%
Alcoholism
• Genetics
▫ 50-60% of alcoholism vulnerability has a genetic basis
▫ Environmental factors affect the impact of genetics
Alcohol and Genetics
• Alcoholism is among the most inherited
mental illnesses
• Specific genes contribute to: (i) excessive
consumption, (ii) diminished negative
feedback, (iii) enhanced sense of pleasure, and
(iv) diminished hangovers
• However, environment is as important as
genetics
Alcoholism
• Psychosocial factors
▫ 20% of alcoholics have a mood or anxiety disorder
▫ Individuals are more likely to drink heavily when in a group
▫ Expectations about alcohol are predictors of dependence
▫ Associated with a greater number of sexual partners
Happy Tuesday toyou!
This is theMonday-est
Tuesday ever.
57%
43%
Happy Tuesday
A. Happy Tuesday to you!
B. This is the Monday-estTuesday ever.
Alcoholism
• Culture
▫ Attitudes toward alcohol affect rates of alcohol abuse
Culture and Alcohol (continued)
• Some psychologists contend that both set and setting can often overshadow the pharmacological effects of most drugs, including alcohol.
▫ Set: An individual’s expectation of what a drug will do to his/her personality
▫ Setting: The physical and social environment where most drugs, including alcohol, are consumed
Culture and Alcohol
• Culture provides how alcohol use is perceived (e.g., violation of norms, “normal” to drink, sexy, sophisticated, mature).
• Cultural rules state how much one can drink and where one can drink.
• Cultures provide ceremonial meaning to alcohol use.
• Culture provides a model of
alcoholism.
• Culture provides attitudes and stereo-
types regarding drinking behavior.
Distinctions Between “Wet” and “Dry
Cultures
“Wet” Cultures - In these cultures alcohol is integrated into daily life and activities (e.g., alcohol consumed with meals). In these cultures, abstinence rates are low and wine is largely the beverage of preference. European countries bordering the Mediterranean have traditionally exemplified wet cultures.
“Dry” Cultures – Alcohol consumption is not as common during everyday activities. Abstinence is more common, however, when drinking occurs, it is more likely to result in intoxication. Scandinavian countries, the U.S., and Canada are examples of counties that are dry.
Alcohol Withdrawal
• Characteristics of alcohol withdrawal:
▫ Craving for alcohol
▫ Delirium tremens (DTs)
▫ Extreme arousal
▫ Auditory and visual hallucinations
▫ Physiological symptoms
▫ Cognitive symptoms
Impacts of AlcoholIndividual
Family Society
Family Effects
• Children of alcoholics▫ Often experience sleep difficulties, depression,
loneliness, and stomach problems▫ Alienated from parents, have poor communication
skills, less trust, and more emotional longing▫ Attention deficit hyperactivity disorder (ADHD)
• Adult children of alcoholics (ACOAs)▫ Feelings of failure and self-deprecation▫ Feel a great need to be in control
Addict
• Behaviors▫ Use of
chemicals▫ Abusive▫ Controlling▫ Withdrawal of
love, attention, affection
▫ Blaming▫ Anger▫ Self-
righteousness
Underlying feeling:
SHAME
Co-Dependent
• Behaviors
▫ Rescuing
▫ Excusing
▫ Denial
▫ Helplessness
▫ Martyr
Underlying feeling:
ANGER
Hero
• Behaviors▫ The “Good Kid”
▫ High achiever
▫ Successful
▫ Overly responsible
▫ Intellectual
Underlying feeling:
INADEQUACY
Scapegoat
• Behaviors▫ Acting out
▫ Defiant
▫ Peer-oriented
▫ Sullen, angry
▫ Irresponsible
▫ Chemical use
▫ Law breaking, truancy
Underlying feeling:
HURT
Lost Child
• Behaviors
▫ Withdrawn
▫ Loner
▫ Day dreamer
▫ Unnoticed
Underlying Feeling:
LONELINESS
Mascot
• Behaviors
▫ Attention-getting
▫ Humor
▫ Clowning
▫ Super cute
▫ Overly active
▫ Silly
Underlying Feeling: FEAR
Which do you most identify with?
A. Addict
B. Co-dependent
C. Hero
D. Scapegoat
E. Lost Child
F. Mascot
Addict
Co-dependent
Hero
Scapego
at
Lost
Child
Masc
ot
7%4%
22%
15%
11%
41%
COSTS• Hero
▫ Compulsive drive, pressure, suicide
• Scapegoat
▫ Addiction, criminal behavior, drop out
• Lost Child
▫ Isolation, abuse victim, eating disorders
• Mascot
▫ Immaturity, distant relationships, manipulation
Alcohol and the Family (1 of 3)
• Important Key Terms:▫ Codependency (or co-alcoholism):
Behavior displayed by either addicted or nonaddicted family members (codependents) who identify with the alcohol addict and cover up the excessive drinking behavior, allowing it to continue and letting it affect the codependent’s life
▫ Enablers: Those close to the alcohol addict who deny or make excuses for enabling his or her excessive drinking
Alcohol and the Family (2 of 3)
• Children of alcoholics (COAs) are 2–4 times more likely to become alcoholics themselves.
• Adult children of alcoholics (ACOAs) are 2–4 times more likely to develop alcoholism.
• Approximately 9.7 million children age 17 or younger are living in households with one or more adults classified as having an alcohol abuse or dependence problem.
▫ Seventy percent of these children were biological, foster, adopted, or stepchildren.
▫ As a result, 6.8 million children, or about 15% of children aged 17 or younger, meet the formal definition of children of alcoholics.
Alcohol and the Family (3 of 3)
• COAs and ACOAs are more likely to marry into families where alcoholism is prevalent.
• Twenty-five percent of American children are exposed to an alcoholic before the age of 18.
How’s your group doing?
A. We rock.
B. Working on it.
C. We need help.
D. Group? What group?
We ro
ck.
Work
ing o
n it.
We n
eed help
.
Group?
What g
roup?
20%
0%
10%
70%
Correlations with
ViolenceAs alcohol use escalates, so does violence
▫ Domestic partner violence 66%
▫ Sexual Assault 37%
▫ Homicides 40%
▫ Child abuse 70%
http://www.ph.ucla.edu/sciprc/pdf/ALCOHOL_AND_VIOLENCE.pdf
Suicide
▫ About 7% of alcoholics commit suicide
▫ 16% of men and 10% of women entering alcohol treatment have contemplated suicide
▫ 38% of people who hanged themselves had alcohol in their system
▫ 32% of veterans who attempted suicide were diagnosed with alcohol abuse or disorder
Accidents and Alcohol
▫ Drinking while driving Emergency room admissions
▫ Fire-related fatalities
▫ Alcohol-related boating accidents
▫ Drowning fatalities
YouTube
Helping the Family Recover
(1 of 2)
Important Key Terms:•Psychodrama: A family therapy system developed by Jacques Moreno in which significant interpersonal and intrapersonal issues are enacted in a focused setting using dramatic techniques.
•Role-playing: A therapeutic technique in which group members play assigned parts to elicit emotional reactions.
•Genogram: A family therapy technique that records
information about behavior and relationships on a type of family tree to elucidate persistent patterns of dysfunctional behavior.
Helping the Family Recover
(2 of 2)
• Post-traumatic stress disorder (PTSD):A psychiatric syndrome in which an individual who has been exposed to a traumatic event or situation experiences psychological stress that may manifest itself in a wide range of symptoms, including re-experiencing the trauma, numbing of general responsiveness, and hyper-arousal.
Recovery from Alcoholism
Treatment of alcoholism:
▫ Denial as a psychological defense
▫ Easy to relapse (relapsing syndrome) without radical shift in lifestyle
▫ Alcohol rehabilitation and medical ramifications
▫ More emotionally fragile than other addicts
Withdrawal
Important Key Terms:
• Relapsing syndrome: Returning to the use of
alcohol after quitting
• Acute alcohol withdrawal syndrome: Symptoms that occur when an individual who is addicted to alcohol does not maintain his or her usual blood alcohol level
• Delirium tremens (DTs): The most severe, even life-threatening, form of alcohol withdrawal, involving hallucinations, delirium, and fever.
Prohibition
• Temperance Movement – view of alcohol
• Prohibition • States 1851
• Federal 1919
• Repealed in 1933• Since 1933, states
regulate alcohol • Federal taxation
Who drinks and why
• Cultural Differences
• Trends in US
• Regional Differences
• Gender Differences
• Drinking Among College Students
Total estimated U.S. per capita ethanol consumption in gallons per year by state, 2007
Source: Data from NIAAA
© 2011 McGraw-Hill Higher Education. All rights reserved.
Alcohol Abuse Among College
and University Students
CORE Institute (2008) research results:• Approximately 72% of college students consumed
alcohol and 42% to 55% engaged in binge drinking within 30 days when survey was given.
• College students consume an average of 5.4 alcoholic drinks per week.
• Of all the drugs reported, alcohol was the most heavily
abused on college campuses, followed by tobacco (44%) and marijuana (31%).
Alcohol Abuse Among College and
University Students (continued)
Other studies found that …• The main reason given for binge drinking was “to get
drunk.”• Males binge drink more than females.• For binge drinkers, the impact on impaired academic
performance is just as great for women drinkers.• Being white, involved in athletics, or a resident of a
fraternity or sorority made it more likely that a student would be a binge drinker.
Alcohol Abuse Among College and
University Students
• On U.S. campuses, alcohol is a factor in 40% of all academic problems and 28% of all dropouts.
• Seventy-five percent of male students and 55% of female students involved in acquaintance rape had been drinking or using drugs.
• The transition into college is associated with a doubling of the percentages of those who drink for both males and females.• For heavier drinkers, grades
suffered for both male and female students.
Women and Alcohol
• Women possess greater sensitivity to alcohol, have a greater likelihood of addiction, and develop alcohol-related health problems sooner than men (e.g., stomach cancer, cirrhosis of the liver).
• More women in alcohol treatment come from sexually abusive homes (70%) in comparison to men (12%).
Women and Alcohol (continued)
• Three major reasons why women are more sensitive to the effects of alcohol:
1. Body size (men generally larger than women)
2. Women absorb alcohol sooner—women possess more body fat and body fat does not dilute alcohol
3. Women possess less of a metabolizing enzyme that gets rid of (processes out) alcohol
Women and Alcohol (continued)• Alcohol consumption patterns of women:
▫ Women 21 to 34 years of age were least likely to report alcohol-related problems if they had stable marriages and were working full time.
▫ Women tend to marry men whose drinking habits match their own.
▫ Between 35 to 49 years of age, the heaviest drinkers were divorced or separated women without children.
▫ Between 50 to 64 years of age, the heaviest drinkers were women whose husbands/partners drank heavily.
▫ Women 65 and older comprised less than 10% of drinkers with drinking problems.
Alcohol Consumption in the
United States• Alcohol consumption has dropped sharply
since 1981.• What explains the steady decline in alcohol
consumption during the past twenty years?▫ Demographics▫ Conservatism▫ Decrease in social acceptability▫ Increased awareness of risks▫ Increased concerns for health
Figure 8.1 Current, binge, and heavy alcohol use among persons
aged 12 or older, by age: 2014
Data from: Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the
2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Rockville, MD, 2015.
Additional Facts Regarding
Alcohol Use/Abuse• Drinking and driving: On most weekend nights
throughout the United States, 70% of all fatal single-vehicle crashes involve a driver who is legally intoxicated.
• Income/wealth: Less affluent people drink less than more affluent individuals.
• The average “alcoholic”: The largest percentage of alcoholics are secret or disguised drinkers who look very much like common working people.
• On average: Most people who consume alcohol do not become problem drinkers.
Most college students reduce their
binge drinking after graduating
from college.
A.True
B.False
True
False
24%
76%
The younger one is when drinking
alcohol for the first time, the more
likely one will become a problem
drinker.
A.True
B.False
True
False
29%
71%
Underage Drinking
• Underage drinking is associated with premature death, disease, injury, property damage, motor vehicle crashes, alcohol-related crime and loss of productivity
• There is a significant relationship between drinking before age 13 and suicide attempts
Underage Drinking
• High school students who engaged in binge drinking were six times more likely to drink and drive
▫ 7.2% of 8th-grade students binge drink
▫ 16.3% of 9th-grade students binge drink
▫ 23.2% of 12th-grade students binge drink
Moderate alcohol drinkers have
lower rates of cardiovascular
disease than abstainers.
A.True
B.False
True
False
0%0%
Physiological Toxicity
• Overdose
• Hangover
When someone passes out from
alcohol use:
A. Put them on their back
B. Put them to bed and let them sleep it off
C. Put them on their side
Put them
on th
eir back
Put them
to b
ed and le
t...
Put them
on th
eir sid
e
0% 0%0%
Fetal Alcohol Syndrome
There is a safe level of alcohol to
consume while pregnant
A. True
B. False
True
False
86%
14%
Physiological
Toxicity - Brain• Wernicke-Korsakoff
syndrome develops because alcohol impedes the body’s ability to utilize thiamine (a B vitamin)
• Alcohol use is associated with psychological symptoms: depression, anxiety
Physiological Toxicity - Liver
• Three main conditions associated with alcohol:
▫ Fatty liver
▫ Alcohol hepatitis
▫ Cirrhosis
• Cirrhosis is irreversible, even if alcohol use stops
Physiological Toxicity – Digestive System
• In moderate amounts, alcohol aids digestion by increasing gastric juice in the stomach
• Too much alcohol can irritate the stomach, leading to internal bleeding
• Heavy alcohol use is implicated in acute pancreatitis
• Alcoholics often have malnutrition because alcohol interferes with the body’s ability to utilize nutrients
Physiological Toxicity – Circulatory System
• Moderate alcohol use reduces risk of heart disease, boosts good (HDL) cholesterol and helps prevent type 2 diabetes
• Effects of heavy alcohol use:▫ Degeneration of the heart muscle▫ High blood pressure▫ Cardiac arrhythmias▫ Ischemic heart disease ▫ Strokes
Physiological Toxicity – Immune System
• Studies show that moderate alcohol use reduces immunity
• Alcohol interferes with white blood cells, particularly T lymphocytes, which help to resist infections