The Responsible Use of Alcohol

Chapter 10

The Nature of Alcohol • CNS Depressant; effects vary b/c different body systems are affected to different degrees at different BACs– Low concentrations (0.03%-0.05% ) : light-

headedness, relaxation, release of inhibitions– High concentrations (0.1% -0.2%): motor coordination,

verbal performance and intellectual functions impaired

• Ethyl Alcohol – only alcohol that can be consumed

• Beer: 3-6% alcohol by volume• Malt Liquors (not lower than 5%): 6-8% alcohol by

volume• Table wines: 9-14% alcohol by volume• Fortified wines: 20% alcohol by volume

– Sugar and extra alcohol is added• Hard liquors: 35-50% (or more) alcohol by volume

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•Proof Value– Two times the percentage concentration

•Ingestion– 7 calories per gram– 1 drink contains 14-17 grams, or 100-

120 calories

The Nature of Alcohol

Alcohol Absorption• 20% is rapidly absorbed from the

stomach• 75% is absorbed in the small

intestines• Remaining is absorbed along the GI

tract• Affected by many factors – Carbonation: increases absorption rate– Food in the stomach: slows rate– Increased alcohol concentration: slows

rate (irritates mucous membranes)4

Alcohol Intake and Blood Alcohol Concentration

•Blood Alcohol Concentration (BAC)– A measure of intoxication, determined by amount of

alcohol consumed in a given amount of time and by:• Body Weight: smaller people develop higher BAC• Percentage of body fat: higher % body fat, higher BAC

(alcohol stays in bloodstream, less in fat)• Sex: women metabolize less alcohol in stomach, more

released into bloodstream and women tend to have higher % body fat

• Balance of alcohol absorbed and rate of metabolism• Genetic factors: chronic drinkers metabolize alcohol faster• Drinking behavior: the faster you drink, the faster BAC rises

– Can NOT be influenced by• Exercise, breathing deeply, eating, drinking coffee, taking

other drugs

•Metabolism is the same if the person is sleep or awake or asleep

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Metabolism and Excretion

• Transported throughout the body via the bloodstream

• Easily moves through most biological membranes

• Main site for metabolism is the liver (digests about 1 drink/hour)

• 2-10% of ingested alcohol is not metabolized but excreted through skin, etc.

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The Immediate Effects of Alcohol on Health

• Dependant on the individual• Alcohol hangover• Alcohol poisoning• Higher Concentrations– Coma usually occurs at 0.35% and

higher concentrations can be fatal

• Dangerous if using alcohol with other drugs

• Alcohol-related injuries and violence7

Drinking and Driving• In 2010– 32,885people were killed in alcohol

related accidents• Dose-response function– Describes the change in effect on an

organism caused by differing levels of doses to a chemical

– Driving with a BAC of 0.14% makes you more than 40 times more likely to be involved in a crash than with a BAC =0.0%

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Figure 10.3 The dose-response relationship between BAC and automobile crashes

The Effects of Chronic Use• Digestive system– Alters liver function• Liver cell damage and destruction (cirrhosis)• Cirrhosis causes drinker to lose capacity to

tolerate alcohol– Acute Pancreatitis- inflammation of pancreas

that can be caused by heavy alcohol use

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•Cardiovascular system•Higher doses elevates BP, and may weaken heart muscle (cardiac myopathy)

•Cancer– Mouth, throat, larynx, liver, breast,

& esophagus•Brain Damage

– Cognitive impairments– Memory loss, dementia, and

compromised problem-solving•Mortality

– Alcoholics average life expectancy is about 15 years less than non-alcoholics

The Effects of Chronic Use

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.

• Small head, abnormal facial structures, heart defects, and other physical abnormalities

• Slowed physical and mental growth, with many mentally impaired

– Alcohol-related neurodevelopment disorder (ARND)• Appear physically normal but often have learning and

behavioral disorders; more likely to develop substance abuse as adults

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Possible Health Benefits of Alcohol

• Moderate doses may reduce the risk of HD

• Moderate drinking = one drink per day for women and two drinks per day for men– Raises blood levels of HDL–May lower risk of diabetes, arterial

blockages, and Alzheimer’s• On average, light to moderate drinkers

live longer than both abstainers and heavy users

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Alcohol Abuse and Dependence

• Alcohol abuse is recurrent use that has negative consequences

• Alcohol dependence or alcoholism includes more extensive problems like tolerance and withdrawal

• Warning signs of alcohol abuse– Drinking alone– Using deliberately and repeatedly– Feeling uncomfortable on occasions when not

drinking– Escalating consumption– Getting drunk regularly– Drinking in the morning or unusual times14

Alcohol Abuse and Dependence• Binge Drinking– The National Institute on Alcohol Abuse and

Alcoholism defines as:• 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 as:• Having five drinks in a row for a man or four in a

row for a women within two hours.– Frequent binge drinkers in college were three

to seven times more likely than non-binge drinkers to engage in unplanned or unprotected sex

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• Health Effects– DTs (delirium tremens)– Paranoia

• Social and Psychological Effects– Can withdraw from society– Increased anxiety and depression

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Alcohol Abuse and Dependence

Treatment Programs• No one program works for everyone– AA• 12-step program

– Employee assistance programs– Inpatient hospital rehabilitation– Pharmacological treatments• Antabuse–Inhibits the metabolic breakdown

• Naltrexone–Reduces the craving for alcohol and

decreases its pleasant effects

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Drinking Behavior and Responsibility

• Examine your drinking behavior– CAGE screening test: Feel the need to CUT

down, ANNOYED by criticism, feel GUILTY about drinking, use alcohol as an EYE-OPENER

• Drink moderately and responsibly– Drink slowly– Space your drinks– Eat before and while drinking– Know your limits and your drinks

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