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.