Alcohol and Its Abuse
Drugs and Our Society
Part 13
Effects of Alcohol
1.
Impact on the United States
- and the world
a. Alcohol effects everyone
- by own use
- someone else’s use
b. Attitudes: run the gamut
- from reverence
- to dismay
Effects, cont.
2.
Oldest known drug
- primitive societies: ritually / socially
- anxiety / unstable environment
a. Not always acknowledged as a drug
- it is legal
- harmful / government would control
- commercials: beautiful people drinking
b. Parents / role models consume
Effects, cont
3.
People drink for many reasons
- relax
- reduce inhibitions
- pleasure
- to forget
- intoxication
a. Part of social fabric / American life
- family dinners / festive occasions / super
bowl / weddings / celebrate holidays
Effects, cont.
b. Difficult to think of drug:
- served many cultural purposes
- cause so much havoc
4.
History of alcohol use in US
- beginning of colonial times
- temperance movement / Prohibition /
contemporary use
a. Colonial times
History of Alcohol
-
1620: Plymouth Rock
positive attitude towards alcohol
drinking in moderation: acceptable
drunkenness was punished
b. Importance of alcohol
- sanitation / nutrients
(1) Sanitary practices lacking
- wells contaminated
History, cont.
- was a preservative
(2) Important nutrients
- vitamins / minerals / yeast
- made from grains / vegetables
(3) 1640: first distillery (Staten Island)
- Dutch rum trade
- New England’s largest business
- most profitable
History, cont.
c. Consumption peaked: 1801 – 1809
- Jefferson’s presidency
- farmer’s took alcohol into fields
- employers gave to employees on job
- politicians gave to voters at polls
d. Continental Army
- troops received daily rations
- either rum or whiskey
History, cont.
e. 1850: first national census
- aged 15 or older
- over 6 gallons per person
- twice the levels of today
5.
Temperance movement (early 1800s)
- stop escalating use / abuse
- few made connection between alcohol /
social problems
History, cont.
a. Did realize problem of uncontrolled use
- began in 1826
- declined during Civil War (1861 – 1865)
- reasserted late 1860s
b. Before Civil War: 6 gallons per adult
- before Prohibition: 2 gallons
c. Three most influential in alcohol reform
- Women’s Christian Temperance Union
History, cont.
- Anti-Saloon League
- National Prohibition Party
d. Grew into powerful political force
- 1880 to 1889: 7 states prohibition law
- 1907/1919: 34 states passed
- 2 states repealed laws banning alcohol
6.
Prohibition
- movement gathered strength in early 1900s
History, cont.
- movement to ban gathered strength
a. Amendment to ban
- ‘Volstead Act’ (Andrew Volstead)
- adopted by US Senate (1917)
- House (1918)
- 35 states must ratify
- all but 2 (Rhode Isl / Connecticut)
- 18th Amendment (January 16, 1920)
History, cont.
b. Negative effects
- illegal trade in alcohol
- using adulterants
- lack of enforcing the law
- home brewing (not illegal)
c. Law repealed (1933): 21st Amendment
- disregard for law
- loss of jobs
- loss of revenue
Current Alcohol Use
1.
Most people = social drinkers
- drinking patterns: no health/social problems
- experience immediate risks (accidents)
- able to abstain at will
a. Cannot abstain (medical/social difficulties)
- problem drinkers / alcoholics
b. Label: depends on criteria used
- can abuse / not be alcoholic
Current Use, cont.
- problem drinkers: not drink daily
b. Not easily categorized
- do they: drink alone or with friends
- do they: drink and drive / or take taxi
c. One factor observed:
- costs rise / consumption drops
- among social drinkers
- not heavy drinkers
Current Use, cont.
d. State cracking down (alcohol level)
- DUI: .08%
- 26 states: drive-thru alcohol sales
- Washington state: Sunday sales
2.
Drinking patterns
- vary among different groups
a. College students
- fraternity/sorority: higher consumption
than students not affiliated
Current Use, cont.
b. Gay / lesbian / bisexual college students
- more than heterosexual
c. Heavy drinking
- highly correlated with bar patronage
- singles / males
d. Alcohol-related problems
- greater: more access to places to drink
or buy
Current Use, cont.
e. Per capita consumption
- higher in New England states
- lowest in Mid-Atlantic states
f. Men vs. Women
- men more likely to drink
- consumption levels: greater
- heavy drinking by younger women
increasing
- single older women
Current Use, cont.
3.
Drinking patterns of women
- more seeking treatment
a. Demographic subgroups
- unemployed
- looking for work
- employed part-time
b. Patterns more prevalent among:
- divorced / separated
- unmarried / living with a partner
Current Use, cont.
c. Age 20 to early 30s
- husband / partner drinks heavily
- greater risk for problem drinker
d. 21 – 34 with children
- less likely to report drinking problems
4.
College campus arrests (alcohol / drugs)
- increased dramatically
- may reflect stricter enforcement
Campus Arrests, cont.
a. Alcohol
- Michigan State University 856
- University of Maine 673
- Western Michigan University - 563
- University of CA, Berkeley 546
b. Drugs
- University of CA, Berkeley - University of Maine - Michigan State University - University of Washington -
265
143
133
127
Binge Drinking
1.
Among young people:
- 5 or more drinks (men)
- 4 drinks (women)
- in short period of time
a. Starts around age 13
- increases during adolescence
b. 14% (13 – 17) met criteria / heavy drinking
- only 16%: admitted drinking problem
Binge Drinking, cont.
2.
Parties very / somewhat important
- more likely to binge
a. High school athletes
- more likely than non-athletes
b. More than 2/3s high school students
- obtain alcohol from 21 or older
c. 14%: 18 to 20 years – commercial outlet
Older Americans
1.
60 years and older
- lower levels of use / abuse
- alcoholism: increasing
a. Vulnerability
- loneliness / isolation
- 10% of all elderly
b. Older men
- twice as likely as older women
Older Americans, cont.
- alcohol related problems
- late-life onset of alcoholism
c. Primary reason problem drinking so low
- heavy drinkers dying
2.
Race and alcohol use
- 29% African-American men: abstain
- 23% Caucasian men: abstain
- 46%: black women / 34%: white women
Race, cont.
a. Heavy drinking
- more prevalent in 18 – 29 age group
- both white men and women
b. This age group for black men/women
- more likely to abstain
1.
Alcoholic beverages
- central nervous system depressant
- “ethyl alcohol” / not “methyl alcohol”
Beverages, cont.
a. Fermentation
- certain yeasts with carbon / hydrogen /
oxygen of sugar and water
- transform: ethyl alcohol/carbon dioxide
- yields beverage 14% alcohol
b. Distillation: percentage increased
- lower boiling point than other liquids
- steam rises / cooled / back to liquid
- distilled liquid: higher alcohol content
Process, cont.
2.
Beer
- sprouted barley added to cereal grains
- changes carbohydrates to sugar
- yeast: changes sugar into 5% alcohol
Pharmacology of Alcohol
1.
Transformed in the liver: acetaldehyde
- then into: acetate / water / carbon dioxide
(acetate acid = vinegar)
Process, cont.
a. Most toxic poison created
- alcohol metabolism
b. Found in: cigarette smoke / car exhaust
/ embalming fluid (“getting bombed”)
c. Causes: hangovers / liver disease /
cancer / alcoholism
- interferes with neurotransmitter activity
- you drink = you ingest poison
Pharmacology, cont.
2.
Rate of elimination
- excreted in urine / breath / sweat
a. Leaves body: 3/4th ounce per hour
- shot spirits / bottle beer / glass wine
- about the same amount of alcohol
- produce same intoxicating effect
b. Primary site of absorption
- small intestine
Pharmacology, cont.
2.
Factors effecting absorption rate
a. Food in stomach
- absorbed more slowly
- wine/beer less quickly = distilled spirits
- champagne: exception (carbon dioxide)
- liquor + carbonated beverage (quickly)
b. Males / females: absorb at different rates
- male: larger / more water
- less likely to feel effects same amount
Pharmacology, cont.
c. Premenstrual phase
- absorb more quickly
- birth control pills: more quickly
3.
Concentration in blood
- blood alcohol concentration (BAC)
- blood alcohol level (BAL)
a. Effect of alcohol on individual
- correlates to % of alcohol in bloodstream
Pharmacology, cont.
b. Consumed at rate exceeding metabolism
- leaving the body
- BAC rises
c. As BAC rises
- behavioral / subjective efforts
- become more pronounced
- speech / movement / thinking / vision
d. Drinking too much / short time / fatal
Health Effects
1.
Accounts for 10% of all deaths in US
- alcoholic life expectancy: reduced 15 years
a. Effects every bodily organ
- depend on frequency / quantity
- type of alcohol does not matter
b. Study of adolescents
- beer / wine / distilled spirits
- equally damaging physical impairment
Effects on Brain
2.
Alcohol and the brain
- highly sensitive
a. 5 to 6 drinks daily
- adversely affect: cognitive functioning
- increase impairment: higher consumption
- 15 to 30% nursing home patients
b. Acts on cerebrum
- affects judgment / reasoning / inhibitions
Effects on Brain, cont.
- stimulates release of serotonin
- accounts for disinhibiting effects
c. Acts on cerebral cortex
- effects motor activity
- moods change quickly
- stimulates release of dopamine
- feelings of pleasure / euphoria
d. Acts on cerebellum
Effects on Brain, cont.
- senses are impaired
- experience memory loss
e. Acts on medulla (increased amounts)
- sedated to point respiration could stop
3.
Autopsy studies: alcohol shrinks the brain
- especially in women
a. Drinking small amounts daily
Effects on Brain, cont.
- does not affect memory adversely
- large amounts: harm the memory
- alcohol-induced amnesia last short time
b. Conditioned alcoholic
- appear conscious
- even function when drinking
- have no memory of what transpired
- condition referred to as:
alcohol-induced blackout
1.
Alcohol and the Liver
Liver: main site of metabolism
- heavy use: devastating on liver
a. Three main conditions:
- fatty liver
- alcohol hepatitis
- cirrhosis
b. Fatty liver
- not a serious problem
- may progress into cirrhosis
Liver, cont.
c. Alcohol hepatitis
- inflammation of liver
d. Cirrhosis
- injury and scarring
- destruction of normal liver tissue
- results: 25,000 deaths annually
2.
Alcohol liver disease
- more common in women
Liver, cont.
a. Women
- drink over a period of years
- 6 oz. wine / 13 oz. beer / 2 oz. whiskey
b. Men
- drink over a period of years
- 20 oz. wine / 40 oz. beer / 6 oz.
whiskey
3.
Alcohol / Intestinal Tract
Intestinal Tract
- small amounts help digestion
- can irritate stomach
- large amounts can cause bleeding
4.
Alcohol / cardiovascular system
- small amount: help reduce coronary disease
- reduce risk by 40%
- but only in older adults
- for wine / not hard liquor
Cardiovascular, cont.
a. Heavy use:
- degeneration of heart muscle
- Alcoholic Heart Muscle Disease (AHMD)
- cardiomyopathy: becomes inflamed
b. High blood pressure
- deficient circulation of blood
- abnormal cardiac rhythm
5.
Other problems:
Other Problems, cont.
- impacts immune system / white blood
cells
a. Research: links alcohol use and cancer
- esophageal cancer
- 10 times greater: consume 21 drinks or
more per week
b. Fetal Alcohol Syndrome
- 3rd most common cause of birth defects
Problems, cont.
6.
Underage drinking
- 10% of all alcohol consumed
- 1/3rd consume at least once per month
- underage males: more than adult males
- underage females: slightly less
a. Problems generated:
- automobile accidents: death / injuries
- alcohol induced violence
- unplanned / unprotected sex
Problems, cont.
- poor academic performance
- school dropout rate
- delinquent (illegal) behavior
b. Early 1970s: states lowered drinking age
- if you can go to war / you can drink
- accidents / injuries / deaths increased
- 1984: feds set drinking age at 21
- highway funds to control states
Alcoholism
1.
Alcoholism has many definitions
- none universally accepted
a. Many consider it a disease
- identified as having a personal defect
- used term alcoholic for decades
b. Today: alcohol abuse / dependence used
- US Dept. Health and Human Services
definition:
Alcoholism, cont.
“A disease that is characterized by
abnormal alcohol-seeking behavior that
leads to impaired control over drinking.”
b. Withdrawal
- alcohol can create dependency
- drinking stops: withdrawal symptoms
c. First 5 days: most severe
- symptoms can last for weeks
Alcoholism, cont.
- craving for alcohol obvious symptom
2.
Physical symptoms:
- headaches / sweating / nausea / insomnia
- loss of appetite / paleness / rapid heart rate
- clammy skin / abnormal movements
- hand tremors / stomach cramps
a. Severe symptoms:
- confusion/hallucination (delirium tremor)
Alcoholism, cont.
3.
Causes for:
- 1800s: common view = personal choice
- heredity / socio-cultural / biochemistry /
personality / interpersonal factors
a. Genetics
- research on twins
- 31% for identical / 24% fraternal
b. Psychosocial factors
Alcoholism, cont.
- look at why we start drinking
- why we continue
- factors that influence
c. Culture
- attitude of culture / subculture / group
- used in religion / families / neighbors
- less likely abused
4.
Alcohol and society
Alcohol and Society
- can devastate friends / family / others
a. Statistics
- 6 to 11% of elderly admitted to hospitals
- 20% in psychiatric wards
- 14% in emergency rooms (alcoholism)
- 25% all emergency room admissions
b. Automobile accidents
- leading cause of death (5 to 34 years old)
- 2/3s involve alcohol
Alcohol and Society, cont.
c. How alcohol affects the driver
- process information more slowly
- look at center of visual field / do not
use peripheral vision
- unable to deal with multiple sources of
information
- even moderate drinkers (.05 BAC)
underestimate hazards when driving
d. Accidents
Alcohol and Society, cont.
- more likely injury accidents / fatal falls
- .10 BAC = 10% more likely to fall
e. Suicide
- 20 to 36% after consuming alcohol
- related primarily to distilled spirits
f. Family violence
- 57% men under influence
- 27% women
- alcohol use escalates / so does violence