The Responsible Use of Alcohol

1. The Responsible Use of Alcohol Chapter 10

2. The Nature of Alcohol • Ethyl Alcohol (Ethanol, EtOH) • Is the only alcohol that can be consumed • Is the psychoactive ingredient in alcoholic beverages • There are varying amounts of alcohol in various alcoholic beverages: • 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

3. The Nature of Alcohol The concentration of alcohol in a beverage is indicated by its proof value • Proof Value • Two times the percentage concentration • So if the alcohol percentage is 40% then it is 80 proof • Caloric Content of alcohol • 7 calories per gram • 1 drink contains ~100-120 calories

4. Alcohol Absorption • 20% of alcohol is rapidly absorbed in the stomach;75% is absorbed in the small intestines • Once alcohol is in the bloodstream it produces sensations of intoxication • The rate at which alcohol is absorbed is affected by many factors: • Carbonation: increases absorption rate • Food in the stomach: slows rate • Increased alcohol concentration: slows rate (irritates mucous membranes)

5. alcoholMetabolism • Alcohol is transported through the body in the bloodstream • Main site for metabolism is the liver (digests about 1 drink/hour) • 2-10% of ingested alcohol is not metabolized by the liver but is excreted unchanged through skin, lungs, etc.

6. Alcohol Intake and Blood Alcohol Concentration (BAC) • Blood Alcohol Concentration (BAC) is the amount of alcohol in a persons blood • BAC is affected by the amount of alcohol consumed in a given amount of time and by individual factors which are: • Body Weight: smaller people develop higher BAC; smaller people have less body tissue into which alcohol can be distributed. • Percentage of body fat: higher % body fat = higher BAC (alcohol stays in bloodstream, and not in fat) • Gender: women metabolize less alcohol in stomach, more unmetabolized alcohol is released into bloodstream and women tend to have higher % body fat • Drinking behavior : chronic drinkers metabolize alcohol faster, so lower BAC • Drinking behavior: the faster you drink, the faster BAC rises

7. Metabolism and Excretion of alcohol • Alcohol is eliminated from the body by excretion and metabolism (most is metabolized). • You cannot change the rate at which alcohol is metabolized. • The rate of alcohol metabolism is constant, while the rate of absorption can vary. • Once BAC reaches a certain level, the only way to lower it is to wait for liver enzymes to do their job. • Heavy drinkers metabolize alcohol faster than light or non-drinkers.

8. The Immediate Effects of Alcohol • Alcohol depresses the CNS and its effects vary with BAC • The effects vary b/c different body systems are affected to different degrees at different BACs • At low concentrations (0.03%-0.05% ): effects of alcohol are light-headedness, relaxation, release of inhibitions • At higher concentrations (0.1% -0.2%): motor coordination, verbal performance and intellectual functions impaired • At 0.2% most drinkers are completely unable to function (physically or psychologically • A BAC of 0.35% or higher can be fatal

9. The Immediate Effects of Alcohol • Other effects include: • Alcohol hangover- caused by a combination of toxic products of alcohol breakdown, dehydration and hormonal effects. • Alcohol poisoning –rapid rise in BAC; loss of consciousness and possible death from CNS and respiratory depression or by inhaling fluid or vomit into the lungs. • Using alcohol with other Drugs- Alcohol-drug combinations are a leading cause of drug-related deaths. • Alcohol-related injuries and violence -the combination of impaired judgement, weakened sensory perception, reduced inhibitions, impaired motor coordination and increased aggressiveness and hostility can be dangerous.

10. The Effects of Chronic Use of alcohol • Digestive system • Chronic alcohol use alters liver function • Cirrhosis -Liver cell damage and death • Cirrhosis causes drinker to lose their capacity to tolerate alcohol • Acute Pancreatitis- inflammation of pancreas that can be caused by heavy alcohol use

11. The Effects of Chronic Use of alcohol • Cardiovascular system • Higher doses elevates BP, and may weaken heart muscle (cardiac myopathy) • Cancer • Mouth, throat, larynx, liver, breast, and esophagus • Brain Damage • Death of brain cells leading to brain disorders like memory loss, dementia, delirium tremens and compromised problem-solving • Mortality • Average life expectancy for alcoholics is about 10 years less than non-alcoholics

12. Alcohol Abuse and Dependence • Alcohol abuseis recurrent use that has negative consequences • Alcohol dependence or alcoholismincludes 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 times

13. Drinking and Driving • In 2015, 10,265 people were killed in alcohol impaired crashes • Dose-response function • Is the relationship between the amount of alcohol or drug consumed and the type and intensity of the resulting effect. • 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%

14. The dose-response relationship between BAC and automobile crashes

15. The Effects of Alcohol Use During Pregnancy • Effects are dose-related • Fetalalcohol spectrum disorders (FASD)are a group of birth defects that can happen when a pregnant woman drinks alcohol. Fetalalcoholsyndrome (FAS) is the most severe type of the disorder. • Symptoms can range from mild to severe. • Full-blown FAS occurs in up to 10-15 out of every 10,000 live births in the U.S. • Characteristics include small head, abnormal facial structures, heart defects, and other physical abnormalities • Slowed physical and mental growth, with many mentally impaired

16. Possible Health Benefits of Alcohol • Moderate drinking = one drink per day for women and two drinks per day for men • Moderate drinking raises blood levels of HDLs, so may reduce the risk of developing and dying from heart disease • Moderate use may reduce risk of ischemic stroke • Moderate doses may lower risk of diabetes, arterial blockages, and Alzheimer’s • On average, light to moderate drinkers live longer than both abstainers and heavy users

17. 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

18. Treatment Programs • No one program works for everyone • Alcoholics Anonymous (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