
False. Moderate drinking is not more
than one drink per day for women and
no more than two drinks per day for
men.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
2

C. Most other adults drink lightly and
occasionally; a small number of heavy drinkers,
about 7% of adults, consume more than half of
all the alcohol in the United States. Overall,
college students drink more alcohol and are
more likely to binge drink than young adults
who are not in college, but nonstudents are
more likely to be dependent on alcohol.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
3

True. Women usually have a higher
percentage of body fat than men and a
less active form of a stomach enzyme
that breaks down alcohol. Both factors
cause them to become intoxicated
more quickly and to a greater degree.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
4

True. Consuming a number of drinks
over a period of several hours is likely to
cause intoxication, followed by a
hangover; chugging the same amount
in an hour or less can be lethal.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
5

False. Once alcohol has been absorbed
by the body, nothing speeds its
metabolism.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
6

False. The figure is more than 97,000
students each year, a half million
students report having unsafe sex while
drunk or having sex when they are too
intoxicated to know whether they have
consented.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
7










55% adult Americans (age 18 and older) currently drink
14% are former drinkers
31% are lifetime abstainers
Of those who drink:
› 79% are light drinkers
› 14% are moderate drinkers
› 7% are heavy drinkers
› 3.5% are dependent on alcohol
› 4.3% classified as alcohol abusers
Social, economic and medical costs of alcohol abuse are
estimated at over $180 billion per year
Between 20 and 40 percent of all hospital beds are occupied by
people being treated for medical, psychiatric, and traumatic
complications of alcohol use.
Alcohol is responsible for about 85,000 deaths per year
Alcohol is the third leading actual cause of death among
Americans
Alcohol is the leading cause of death among people aged 1524.
Alcohol is the number one drug of abuse.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
8
How does alcohol affect people?
 Does it affect some people differently
than others?
 Can some people handle alcohol?

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
9





Within minutes after alcohol is consumed it enters the
bloodstream and nerve cells are numbed.
Nerve messages are slowed to all parts of the body.
Alcohol acts as a relaxant when one or two drinks are
taken.
When larger amounts of alcohol are consumed, the
nerve centers in the brain that govern judgment,
memory, speech, reaction time, coordination,
muscular control, and brain activity are impaired.
The depressive effects of alcohol intensify as the
concentration of alcohol in the blood increases.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
10




20% is rapidly absorbed from the stomach into the
bloodstream
75% is absorbed in the upper small intestines
Remaining is absorbed along the gastro-intestinal
track into the bloodstream
Rate of Absorption
› Carbonation increases rate of absorption
› Artificial sweeteners in drink mixers increase rate of
absorption
› Food in the stomach slows the absorption
› Drink of high concentration slows absorption
› Eventually all the alcohol ingested will be absorbed
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
11



Easily moves through most biological membranes
Main site for metabolism is the liver though small
amount is metabolized in the stomach.
2-20% of ingested alcohol is not metabolized but is
excreted unchanged by the lungs, kidneys, and
sweat glands.
› Excreted alcohol causes the breath to smell
› The basis for breath and urine analysis

The body can metabolize about ½ ounce
of alcohol per hour for an average-sized
person.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
12
Blood Alcohol Concentration (BAC) is the
ratio of alcohol in a person’s blood to the
person’s total amount of blood. BAC is
expressed as a percent.
 BAC is a measure of intoxication and can
be measured through:
› Urine
› Breath
› Blood samples

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
13

BAC is determined by:
 Amount of time of metabolism
 Body weight
 Percentage of body fat
 higher body fat = higher BAC than more muscular
person of the same weight because fat has fewer blood
vessels
 Gender
 because of less active stomach enzyme in women,
women are generally smaller and contain more body fat
and hormonal fluctuations during certain times of
menstrual cycle
 Race
 Age
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
14

Less alcohol consumed than can metabolize in
an hour = BAC remains low
› This is how people can consume large amounts over
a long period of time without becoming noticeably
drunk however consider long-term hazards

More alcohol consumed than can metabolize
in an hour = BAC steadily increases
› Person will get more and more drunk

Time is essential to BAC
› Several drinks over several hours results in intoxication
and hangover
› Several drinks in an hour could be lethal
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
15
 Exercise
 Breathing
 Eating
deeply
 Drinking
coffee
 Taking other drugs
 Sleep
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
16




Dependant on the individual.
Alcohol is a Central Nervous System
depressant
At any given BAC, the effects are more pronounced
when the BAC is rapidly increasing than slowly
increasing, steady or decreasing
Low Concentrations .03% -.05%.
› Relaxed, jovial, light-headedness, mild euphoria

Higher Concentrations 0.1% -0.2%.
› Angry, sedated, sleepy, interference with motor
coordination, verbal performance and intellectual
functions
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
17
BAC %
Common Behavioral Effects
Hours Required
to Metabolize
Alcohol
0.00 – 0.05
Slight change in feelings, usually relaxation and euphoria.
Decreased alertness.
2-3
0.05 – 0.10
Emotional instability, with exaggerated feelings and behavior.
Reduced social inhibitions. Impairment of reaction time and fine
motor coordination. Increasingly impaired during driving. Legally
drunk at 0.08%.
3-6
0.10 – 0.15
Unsteadiness in standing and walking. Loss of peripheral vision.
Driving is extremely dangerous.
6-10
0.15 – 0.30
Staggering gait. Slurred speech. Pain and other sensory
perceptions greatly impaired.
More than 0.30
ChapterTen
Stupor or unconsciousness. Anesthesia. Death possible at
0.35% and above. Can result from rapid or binge drinking with
few earlier effects.
©2008 McGraw-Hill Companies. All Rights Reserved.
10-24
More than 24
18

Proof Value = The concentration of alcohol in a
beverage
› Two times the percentage concentration
› 100 proof beverage = 50% alcohol
› 2 ounces of 100 proof whiskey contains 1 oz. of pure
alcohol

1 drink is equal to:
›
›
›
›
1 12 oz. beer
5 oz. table wine
Cocktail containing 1.5 oz. 80 proof liquor
Each contains the same amount of alcohol = 0.5 – 0.6
ounces
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
19

Ingestion
› 7 calories per gram
› 1 drink = 14-17 grams or 100-120 calories
› Most alcoholic beverages also contain some carbohydrate
 1 beer = 150 calories
 1 light beer = 100 calories
 “Light” refers to calories and not amount of alcohol





5
5
6
6
6
oz.
oz.
oz.
oz.
oz.
red table wine = 100 calories
white table wine = 96 calories
margarita = 314 calories
cosmopolitan = 143 calories
rum and coke = 180 calories
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
20

In 2004
› 250,000 were injured in alcohol related
automobile crashes – average of 1 person
injured every 2 minutes
› 42,000 people are killed in alcohol related
accidents - =40% which is down from 50% in
1990
 Increased public education and stiffer drunk
driving laws are largely responsible
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
21

Dose-response function
› Relationship between the amount of alcohol
or drug consumed and the type and
intensity of the resulting effect
 Higher doses are associated with a much
greater probability of auto crashes
 Driving 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
 Younger drivers result in significant
impairment with BACs as low as 0.02%
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
22




Driving Under the Influence (DUI)
› In Maryland = BAC 0.04% to 0.07%
Driving While Intoxicated (DWI)
› All states and Washington DC = BAC 0.08%
and above
Zero-Tolerance Laws
› In some states – drivers under age 21 who
have consumed any alcohol may have their
licenses suspended
Penalties include fines, loss of license,
confiscation of vehicle, jail time, public scrutiny
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
23
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
24
BAC and Body weight
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
25

Alcohol-related injuries and violence
› 1.6 million emergency room visits in 2004
› Linked to more than 75,000 American deaths in 2001
› A 2006 study showed that more than 3000 minors die
›
›
›
›
each year as a result of alcohol abuse
Alcohol use contributes to over 50% of all murders,
assaults, and rapes. Alcohol is frequently found in the
bloodstream of perpetrators and victims.
The majority of people who attempt suicide have
been drinking, about half of all successful suicides
are alcoholics.
Alcohol use triples the chances of fatal injuries during
leisure activities such as swimming and boating.
More than half of all fatal falls and serious burns
happen to people who have been drinking.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
26



Alcohol poisoning can result from Binge Drinking
Binge Drinking is drinking 5 or more drinks in a
row
› Drinking large amounts of alcohol over a short
period of time can rapidly increase BAC into the
lethal range
Alcohol Poisoning happens as a result of drinking
more alcohol than the body can process.
› Alcohol poisoning can be caused in situations
with inexperienced drinkers, drinking games,
competitions, young drinkers
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
27

Binge drinkers can be…
› College students, high school students,
middle school students
4.4 million teens under 21 are classified
as binge drinkers
 Students who binge drink are twice as
likely to die from accidental injuries as
non-bingers

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
28
Alcohol alone or in combination with other
drugs is responsible for more toxic Overdose
deaths than any other drug
 Death is caused by Central Nervous System
and respiratory depression or by inhaling
fluid or vomit into the lungs
 The amount of alcohol it takes to make a
person unconscious is dangerously close to a
fatal dose.

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
29
Heavy drinking can result in severe Central
Nervous System depression resulting in
sleep, general anesthesia, coma and
death.
 Death from alcohol overdose occurs due to
respiratory failure because of effects on the
breathing center in the brain.

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
30
Don’t leave your friend alone!
 Call 911 for medical assistance
immediately.
 Place your friend on his/her side to
reduce risk of choking on vomit.
 Wait with your friend until help arrives.
Explain what you know to EMS about
how much alcohol your friend has
ingested.

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
31

Alcohol and Sexual Decision Making
› Frequent binge drinkers are 5 times more likely to engage in
unplanned sexual activity and 5.5 times more likely to have
unprotected sex than non-binge drinkers
› Heavy drinkers are more likely to have multiple sex partners
and to engage in other forms of high-risk sexual behavior
› Rates of STDs and unwanted pregnancies are higher
among people who drink moderately or excessively
› Women who binge drink are at increased risk for rape and
other forms of nonconsensual sex.
› Laws state a person who is very drunk or passed out cannot
consent to sex. If you have sex with a person who is drunk
or unconscious, you are committing sexual assault.
› Ohio high school football players
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
32

Alcohol abuse is recurrent use that has

Alcohol dependence or Alcoholism has
negative consequences.
more extensive problems, tolerance and
withdrawal
 Alcoholism is a progressive disease
 The consequences get increasingly worse in the
absence of treatment.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
33









Drinking alone
Using deliberately and repeatedly
Feeling uncomfortable on certain occasions
Escalating consumption
Getting drunk regularly
Drinking in the morning or unusual times
Preoccupation with getting a supply
Changes in behavior
Changes in peer groups
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
34

Not one program works for everyone.
› AA – Alcoholics Anonymous
 12-step program
› Al-Anon – program for friends and family
members
› Al-Ateen – program for young people
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
35

Using Alcohol with other drugs
› Increases effects with both drugs potentially leading to
coma, respiratory depression, and death
 Barbiturates, valium-like drugs, narcotics (codeine) and
OTC antihistamines (Benadryl)
› 3 or more drinks per day cause OTC pain relievers like
aspirin, ibuprofen, or acetaminophen to increase risk of
stomach bleeding or liver damage
› Antibiotics and diabetes medications can also interact
dangerously
› When cocaine and alcohol are used together, a toxic
substance called cocaethylene is formed; responsible for
more than half of cocaine-related deaths
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
36






Diseases of the digestive, cardiovascular systems and some cancers
Digestive system
› Liver function
 “Fatty liver” – fat deposits in the liver
 Alcoholic Hepatitis – inflammation of the liver
 Cirrhosis - liver cell damage and destruction
 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 – Alcoholics 10 times higher cancer rate
Brain Damage – men 100 or women 80 or more drinks per month
experience impairment of memory, processing speed, attention, balance
Mortality – Alcoholics life expectancy 15 years less
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
37
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
38

Effects are dose-related.
› FAS Fetal Alcohol Syndrome




Occurs in 1 or 2 out of every 1000 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 slow.Remain mentally
impaired. Fine motor skill problems, coordination, learning
and behavioral problems (ADS).
› ARND Alcohol-related neurodevelopment disorder.
› Heavier drinking early in pregnancy.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
39



Abstainers 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
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
41

Binge Drinking
› Having five drinks in a row for a man or four in a
row for a women.
› 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
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
42
Alcohol consumption by college students
Only one in five college students is a frequent binge drinker but binge
drinkers account for nearly three-fourths of all the alcohol consumed
by college students each year.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
43

Patterns and Prevalence
› Regular daily intake of large amounts
› Regular heavy drinking limited to weekends
› Long periods of sobriety interspersed with binges or
daily heavy drinking
› Heavy drinking limited to periods of stress

Health Effects
› DTs (delirium tremens)
› paranoia


Social and Psychological effects
Causes of Alcoholism
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
44

Men
› White American men
› “Other men”
Women
 African Americans
 Latinos
 Asian Americans
 American Indians and Alaska Natives

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
45
Past Year Prevalence (Percentage)
Alcohol Abuse
Alcohol
Dependence
Men
6.1
4.6
Women
2.6
2.4
White
4.6
3.5
African American
2.9
3.4
American Indians and Alaska Natives
4.4
10.4
Native Hawaiians and Pacific Islanders
1.9
n/a
Asian Americans
2.7
1.0
Latinos
4.5
3.6
4.3
3.5
Gender
Ethnicity
Total Population
ChapterTen
©2008 McGraw-Hill Companies. All Rights Reserved.
46
Examine your attitudes about alcohol use.
 Examine your drinking behavior.
 Drink Moderately and responsibly
 Drink slowly
 Space your drinks
 Eat before and while drinking
 Know your limits and your drinks

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
47
Encourage responsible attitudes
 Be a responsible host
 Hold the drinker responsible
 Learn about prevention programs
 Take community action

©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
48



Depressant
Psychoactive ingredient
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 juices of grapes and other fruits
 Fortified wines 20% alcohol by volume
 Sugar and alcohol added such as sherry, port, Madiera
 Hard liquors 35-50% alcohol by volume
 Distilling or fermented grains such as gin, whiskey, brandy, rum,
tequila, vodka, and liqueurs
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
49
Disturbs sleep patterns making sleep more
light, punctuated with awakenings, and
unrefreshing
 Alcohol hangover

› Headache, shakiness, nausea, diarrhea, fatigue,
impaired mental functioning
› Result of alcohol breakdown, dehydration and
hormonal effects
› Absenteeism and poor job performance
 EEG studies show slowing of brain waves for up to
16 hours after BAC drops to zero.
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
50
©2008 McGraw-Hill Companies. All Rights Reserved.
ChapterTen
51