Alcohol Use & Abuse
Following Prohibition alcohol consumption rapidly increased by more than what percent?
50%
What percent of sales go to people with alcohol problems?
80%
What percent of problem drinkers are employed or employable?
95%
What percent of Americans consume 50% of the alcohol?
<7%
Drunkenness is considered?
A sin or a moral failing and the drunk as a moral weakling
Highest strength of alcohol that can be produced naturally is what percent?
15%
What percent of people have a problem with alcohol?
15%
Studies of deaths from falls showed alcohol involved
15% to 63% of them
When did they start hospitalizing people?
1830
Word alcoholism was introduced in?
1849
When was the first modern treatment?
1930
When was alcohol use seen as a disease?
1970
Punishment laws were the only thing up until when?
1971
When did alcohol consumption peak?
1980's
What's the drinking age in the United States?
21
How long does it take to remove all alcohol completely from 5 drinks (.10)?
24 hours
Women overuse
3 drinks
Both overuse
3-4x a week
What percent of Americans do not use alcohol at all?
30%
Men overuse
4 drinks
Temperance movement
Coincided with the rise of social consciousness To reduce risk of drinking, moderate
Overdose causes?
Coma, death, decreased levels of serotonin (increases dopamine)
First pass metabolism
Describe breakdown of alcohol that occurs in the stomach
Norepinephrine
Enhances communication
What is the first thing to go when drinking alcohol?
Judgment
When does the body start absorbing the alcohol?
The second you start tasting it.
Vasodilator
What makes the blood vessels bigger
Risks of fall?
increase with BAC
Two-steppers:
lives become unmanageable from alcohol
Higher the concentration
more quickly is alcohol absorbed
A heavy drinker is someone who?
Has had 5 or more drinks on at least 5 occasions in the past month.
NSDUH defines a drinker as someone who?
Has had a drink in the past month.
A binge drinker is someone who?
Has had at least 5 drinks on any one occasion (24 hour period) in the past month.
What was one of the first groups to work with people with alcohol problems?
Washington Temperance Society
Cytochrome P450 system
(part of the liver) Secondary system for metabolizing alcohol Contribues significantly only after long-term heavy drinking
Temperance movement goal:
-Initially aimed to be rehabilitative -By 1869, National Prohibition Party advocated the complete suppression liquor by law
Alcohol's acute effects: Production & activity of neurotransmitters are affected
-Decreases the levels of inhibitory transmitters, GABA -Hastens the breakdown & removal of noradrenergic neurotransmitter, norepinephrine -Depresses the activity of serotonin in some regions of brain Increases level of endogenous opiate-like substances (aka- endorphins)
Alcohol's acute effects: Central Nervous System (CNS)
-Depressant effect -Acute intoxication induces mild delirium -Higher mental functions are affected -Physical structure of nerve cell membranes are affected
NAD+
-Present in the liver & stomach -Required for ADH -Determines the rate of metabolism -Converted to NADH when alcohol is oxidized to acetaldehyde
Alcohol's acute effects: Digestive system
-Promotes the flow of gastric juices -Intoxicating amounts impede or stop digestion & irritates the lining of stomach & small intestine
Alcohol's acute effects: Liver
-Rapid accumulation of fat in liver cells -Normal liver functions are interfered -Process of gluconeogenesis blocked , leading to hypoglycemia -Interference in metabolism of other meds
Prohibition
-Real problems created by alcohol were obscured by the false wet-dry controversy -Major legacy of Prohibition was the development of underground crime syndicates
Male per serving is?
.02
Female per serving is?
.03
What is legally drunk?
0.08
Determinants of Blood Alcohol Concentration (BAC)
1. Amount consumed 2. Size of individual 3. Gender 4. Rate of absorption depends on: -amount and concentration of alcohol in the stomach -rate of ingestion
Alcohol related deaths may run as high as what percent of all annual deaths in the U.S.
10%
Who was first to study effects of alcohol
1.) Dr. Benjamin Rush 2.) Dr. Thomas Trotter
Groups promoting treatment of alcoholism?
1.) Washington Temperance Society 2.) Alcoholics Anonymous (AA)
About what fraction of family members are touched by alcohol?
1/4
Small intestine
Absorbs in to the blood stream and distributes through out the body
Second step in metabolism of alcohol:
Acetaldehyde is metabolized to carbon dioxide and water by body cells and tissues
Alcohol's acute effects: circulatory system
Alcohol acts as vasodilator of the surface blood vessels
ADH
Alcohol dehydrogenase
AWOL
Alcohol without liquid
Gate way/entry drugs
Alcohol, tobacco, pot
Serotonin
Associated with anxiety, depression, impulsivity, aggression, and suicidal behavior
First step in metabolism of alcohol:
Associated with conversion of alcohol to acetaldehyde: makes a person have a hangover
Dopamine
Associated with feelings of pleasure and attentional processes
Endorphins
Associated with pleasure, feelings of well-being
What's the last thing to go when drinking alcohol?
Brain stem
Emergence of Modern Treatment
Brought in by efforts of Yale University and AA in late 1930s when prohibition failed
Mellanby effect:
CNS & behavioral effects of BAC are greater when the blood alcohol level is rising
Drunkenness
Considered a medical matter rather than legal one
Pyloric valve
Controls the passage of the stomach's contents into the small intestine Serves as a self protective mechanism
What's "quality of life costs"
Costs of caring for these individuals (paralysis cases)
Overdose
Decreased levels of serotonin & increases dopamine
Common denominator in the views of drunkenness
Drunk chooses to be drunk
Prohibition Amendment
Effect from 1920-1933
What centuries did the medical considerations of inebriety happen?
Eighteenth and nineteenth centuries
Alcohol is the product of?
Fermentation
Alcohol's acute effects: kidneys
Increased urination due to decreased secretion of ant-diuretic hormone by pituitary gland
What employment status is most likely to use alcohol?
Individuals working full-time (consume, not overuse)
GABA
Inhibitory, slows communication, reduces anxiety
Whats the first organ to metabolize alcohol in the body?
Liver
What are the key organs in metabolism?
Liver and stomach
Bigger people have
Lower BAC
Glutamate
Major excitatory neurotransmitter
What group is the lowest risk of drinking problem?
Middle class, ages 30-60, working
What is produced by alcohol's depressant effects?
Mild delirium
National Council of Alcoholism (NCA)
Provided public info and education about alcohol Now renamed National Council on Alcohol and Other Drug Dependence (NCADD)
What drugs are most widely used?
Nicotine and caffeine
Does exercise speed up metabolization of alcohol?
No
Drinking patterns in the United States are closest to what country?
Norway
How much does the liver process per hour?
One standard drink (1/2 oz. pure alcohol) per hour
If one has not eaten, low glycogen can cause what?
One to feel very ill-tremor, headache
Alcopops
Single servings in test tube shaped vials
Part of the decline in per capita consumption is due to changes in the age distribution in the general population
Starting in 1997
What in plants when exposed to yeast is converted to alcohol?
Sugar
Who opened the first distillery on Staten Island in 1640?
The Dutch
Digestion does not have to occur to feel the effects of alcohol
The absorption is what increases the BAC
Alcohol's acute effects on the body
The brain is very sensitive to the acute effects of alcohol
Ethanol
The chemical name for alcohol safe for human consumption
Lowest rate of drinking is found among?
Those not in the labor market
What is part of the economic costs of alcoholism?
Treatment costs
Heavy drinking is more common among?
Unemployed
Binge drinking is slightly higher among?
Unemployed than those with a job
What country is that with alcohol disorder rises with higher education?
United States
What percent of alcohol does the stomach absorb?
Up to 20% and metabolizes a small portion.
What group has the highest number of current drinkers?
Whites
In 2011 the smallest proportion of alcohol consumed came from what?
Wine
Does alcohol have calories?
Yes
Following alcohol treatment, there is a rapid decline in the total family's health care costs
prior to this, it is up to 100% higher than a family with no alcohol issues.