Chapter 11: Drinking Alcohol Responsibly

Costs to Society

$249 billion when health insurance, criminal costs, treatment cost, and lost productivity are summed together - 72% loss of work productivity - 22% health care expenses - 10% criminal - 5% losses from vehicle crashes - binge drinking accounts for 77% of economic costs, excessive drinking $807 per person and $2.05 per drink

standard drink

(according to the NIAAA) is any drink that contains 14 grams of pure alcohol (.6 fluid oz or 1.2 tablespoon)

cardiovascular effects

- 2 drinks of red wine (light to moderate) can reduce the risk of coronary artery diseases because possibly there is in increase in high density proteins (HDL) - it also has some good effects on our blood clotting, insulin sensitivity, and inflammation - persistent drinking can lead to CARDIOMYOPATHY (degenerative disease of the heart muscle) and HEART ARRHYTHMIAS (irregular heartbeats) - high BP, risk of stroke and heart attack, damage to the heart

Alcohol and Rape, Sexual Assault, and Dating Violence

- 20% of women and 5% men were sexually assaulted - alcohol is the most common drug to conduct rape - 61% of people had been drinking and 88% used alcohol; they were sexually assaulted - double standard in our society = "oh yeah she was raped because she was intoxicated"

What is the impact of Student Drinking

- 3% men and 1% women reported that they injured someone because of their drinking - alcohol = more sleep disruptions and academic problems

Lo 3. Alcohol Use in College

- 60% of college students claimed that they drank alcohol in the past 30 days - in 1992 36 percent of men and 20% of women engaged in binge drinking - 2015 about 37% men and 27%

Alcohol and Weight Gain

- 7 calories per gram - fewer nutrients - standard drink = 12-15 grams of alcohol (means that its 100 empty calories) - drinking an extra 150 calories a day - 1 lb gained a month - and stimulates your hunger

men are responsible for college students driving drunk

- 81% of drinking and driving episodes and 85% are binge drinkers - 23% and 2% had driven after drinking

recent studies that shown that college students try to prevent getting bad effects of alcohol

- 81% reported eating - 88% stayed with the same group when drinking - 87% said they used a designated driver - 69% keep track of how many drinks they consume

High Risk Drinking and College Students

- about 1,825 college students die each year because of alcohol-related unintentional injuries (car accidents included) - NUMBER ONE PREVENTABLE DEATH among college students

Alcohol Poisoning

- acute alcohol intoxication - potentially lethal BAC that inhibits the brain's ability to control consciousness, respiration, and heart rate; because of drinking a large amount of alcohol in a short period of time - responsible fore more toxic overdose - kills 2,200 Americans each year - 3 in 4 are men between ages 35-64

alcohol use disorder (AUD)

- alcohol abuse and dependence refers to problems drinking so severe that at least two or more alcohol related issues are present, such as having problems at work or school, or issues with relationships

short term effects of alcohol

- alcohol depresses CNS functions -- decreases respiratory rate, pulse rate, and blood pressure - cause urination (diuretic effect) -- dehydration (could be retained in the cerebral tissues or the water can be taken out of the CSF causing a headache) - indigestion and heartburn - increase irregular heartbeats, stroke, BP, damage to the heart muscle

A Dangerous Alternative: Alcohol Inhalation

- alcohol is turned into vapor by using nebulizers, CO2 pills, or pouring alcohol over dry ice - allows for quick intoxication with. no calories - when inhaled it goes directly to the lungs to the brain and blood stream which means you get drunker faster; it is not metabolized (does not lose potency/force); can't gag - liver and brain damage

Alcohol and Sexual Decision Making

- alcohol lowers inhibition, has a control on the ability to carry out decisions about sex - less safer sex - 1 in 5 students in college report unsafe sex - increase chance of STIs and pregnancy

Absorption and Metabolism

- alcohol molecules: are small and fat soluble; 20% is diffuses in the stomach and 80% passing through the upper third small intestine

Cancer

- alcoholic beverages as known carcinogens - cancer risk for women is lower than men as well as daily and binge drinking - linked to cancer in the esophagus, livers, colon, rectum, breast, stomach, oral cavity - alcohol related cancer for women is breast cancer and for men it is colorectal cancer - .5 - 1.5 drinks per day can lead to a 6% increase risk of breast cancer

Effects on Family And Friends

- becomes apart of the dynamics of addiction - 1 in 4 children live in households with people who are addicted

effects on the nervous system

- can experience shrink brain and weight, and intellectual ability - alcohol damages the front areas of a teens brain (which controls impulses and thinking) - our system is very sensitive

alcohol

- contains 7 calories (kcal) per gram - a beer then contains about 150 calories - the calories in alcohol is then used for immediate energy or for storage as fat

Identifying an Alcoholic

- craving, loss of control, tolerance, psychological dependence, and withdrawal symptoms = addict - 15% people in the US are problem drinkers; 5-10% are male drinkers and 3-5% are females - denial - 1 in 5 college meet the guidelines to be considered as an alcoholic -the progression to alcohol dependency is based on the college student drinking pattern when they entered in college

Long Term Effects of Alcohol

- effects on the nervous system - CV effects - liver disease - cancer - sleep - immune system - other effects

E-interventions and social norms

- electronically based alcohol education interventions - sending consistent messages to students about actual drinking behavior on campus (first time comers think that their peers drink a lot but in reality they do not)

mood

- emotions affect how long it takes the stomach content to empty into the intestine (like when people are stressed alcohol is absorbed much faster then people who are relaxed)

Lo 1. Alcohol: An Overview statistics

- half of Americans drink - 21% abstain from drinking - whites drink more - abstainers likely to be women, Asians, AA, or employed, poor families (twice to be abstainers)

liver disease

- heavy drinking can make the liver begin to store fat (FATTY LIVER); if given no time the fat cannot be transported and then the fat filled liver cells stop functioning - lead to FIBROSIS (the damaged area of the liver makes a fibrous scar tissue); at this point it can help if you stop - if the person continues cirrhosis could happen

biological and family factors

- higher rates of alcoholism among children of alcoholics ( 4 to 8 times more common) - alcohol use disorders 60% heritable - alcohol stimulates dopamine which activates the pleasure center; in alcoholics the dopamine response to alcohol is diminished leading to drink more to feel the effects

immune system

- lowers the WBC which makes it harder to fight of diseases - inhibits the body to make RBC which transport oxygen to the body tissue and organs

Women for Sobriety and Secular Organizations for Sobriety (SOS)

- needs for female alcoholics focuses on behavioral changes through positive reinforcement , relaxing, cognitive, reinforcement, meditating, diet, exercise, amen group involvement

BAC of .02, .05, .08, .10

- relaxed, in a good mood - relaxation, some motor impairment, talk - euphoric, motor impairment - bad, drowsy, drowsy

short term health effects form picture

- slow reaction time, speech, impaired judgment and motor, high BP - dulled senses, less acute vision and hearing - broken capillaries/ flushing, sweating - decrease respitratory rate, low BP - nausea, inflammaiton - peeing - less lubrication/ erectile problems

among Asians

- strong social and cultural influences - genetic predisposition that might influence their low risk for alcohol abuse - posses a variant of the gene that codes the enzyme aldehyde dehydrogenase (which plays a role in metabolism of alcohol) which makes them feel unpleasant form the side effects of alcohol

Alcohol and Pregnancy

- teratogenic substances causes birth defects (alcohol is the most dangerous) (goes to the placenta); more than 1 in 5 women report alcohol use

weight and percentage of body fat

- the heavier the person the larger the body surface for alcohol to diffuse (thus lower concentration of alcohol) - alcohol does not diffuse as fast in fat thus those people with high body fat has a higher concentration of alcohol

social and cultural factors

- to deal with emotional and social problem - families influence and how you are raised - drinking habits of that individual's social group

Efforts to Reduce Student Drinking

- university banning alcohol on campus and during events and banning advertising, dry houses, and groups to help

Alcohol and injuries

-70% of fatal injuries involves alcohol - effects psychomotor skill and cognitive skills (on creation time and judgement) - involves in 20% of suicides

long term health effects from picture

-memory impaired, damaged brain cells - lower resistance - weak heart muscles and high BP - liver cancer and fatty liver/cirrhosis - inflammation of tummy and pancreas, cancers of esophagus, tummy, pancreas, and colon - osteoporosis - weird periods/birth defects/ breast cancer/ impotence

what is the average BAC for college students

.06

legal limit for driving

.08 percent BAC

what is the amount of alcohol that causes the person to lose consciousness

.35 percent BAC

breakdown of alcohol

0.5 ounce per hour - 12 oz in 5% beer - 5 oz in 12% - 1.5 ox of 40% liquor

why do college students drink so much?

1. alcohol heightens the risk of suicide, automobile crashes and fails 2. university celebrations encourages dangerous practices and patterns of alcohol 3. alcoholic beverage industry target colleges 4. drinks specials 5. peer influence 6. administrators deny that there are alcohol problems on campus

signs of alcohol poisoning

1. inability to be roused 2. irregular pulse 3. irregular breathing 4. skin color change

Relapse

1/3 who are quit drinking will s=continue not to drink - guard tendency to relapse - relapse prevention - increase self esteem and resume personal growth

HS and drinking

17% of HS report binge drinking and 20% report having been drink and 35% drank within the past month

binge drinking

2/3of college students engage in drinking games that involves binge drinking; can lead to memory loss and losing money because you cannot remember - alcohol related injuries and alcohol poisoning and with the easy access to alcohol it makes it easier to binge

the cost of underage drinking

24.6 billion of excessive alcohol consumption was related to underage drinking - 58% loss of work productivity - 19% law enforcement - 15% health care - 6% automobile crashes

alcoholism is directly or indirectly responsible for more than

25% of the nation's medical expenses and lost earnings

% of college students cite that alcohol as their primary lifetime problem

42%

Brief Alcohol Screening and Intervention for College Students (BASICS)

NIAAA - program to help students who drink and have experienced or at risk for alcohol related problems

Lo 5. Ethnic Differences in Alcohol Use and Abuse heavy alcohol use

WHITE: 7.3% AA: 4.5 LATINOS: 5.8 NATIVE: 8.9 ASIAN: 2.0 BIRACIAL: 7.5

motivational interviewing

a cognitive behavioral skills training with motivational interviewing, a nonjudgemental approach to working with students to change behavior

drunkorexia

a colloquial term to describe the combo of disordered eating, excessive PA, and heavy alcohol consumption -motivation: weight gain, getting drunk faster, and saving money on foods to buy drinks -risks: blackouts, forced and unintended sexual activity and alcohol poisoning

binge drinking

a pattern of drinking alcohol that brings BAC to .08 gram-percent or above; corresponds to consuming 5 drinks or more (M) and 4 drinks or more (W) in 2 hours - 38 million (1 in 6) binge drink about four times a month - common to 18-34 - household with 75,000 have they highest drinking

Family's and Friend's Roles in Recovery intervention

a planned confrontation with an alcoholic by a professional counselor in which family members or friends try to get the alcoholic to face realty go their problem and to seek help

acetaldehyde

a toxic chemical that can cause nausea and vomiting and liver damage

binge drinking rates in college

about 35% that means that women consume about 4 drinks in 2 hours and men 5 drinks - if you drink one time a week with these amounts within one week = binge drinker

The Chemistry and Potency of Alcohol ethyl alcohol (ethanol)

addictive drug produced by fermentation that is the intoxicating substance in alcoholic beverages

Pre-gaming, binge drinking, and calorie "saving" pre-gaming

aka pre-loading or front-loading - drinking heavily at home before going to an event or other location - 44%; men are more likely

alcohol absorbed in the blood stream

alcohol circulates through the body and goes to liver to be converted to acetaldehyde by the enzyme alcohol dehydrogenase which then oxidized to acetate then converted. to CO2 and H20 and excreted

among the native Americans

alcohol is the widely used drug; alcohol related death rates are eight times higher than the national average; two to three times higher than the rate of national average; highest rates of car crashes, people killed, suicide, and falls

why pregaming?

avoid paying for high cost drinks, to socialize with friends, reduce social anxiety, and to enhance male bonding - higher alcohol consumption during the evening and negative consequences like blackouts out @ night

The Causes of Alcohol Use Disorders alcohol use disorders is a disease with

biological and social/environmental components

fetal alcohol syndrome (FAS)

birth defect involving physical and mental impairment that results from the mother's alcohol consumption during pregnancy - 3rd most common birth defect and 2nd leading cause of retardation (.2 to 1.5 cases in every 1,000 live births) - MOST PREVENTABLE

how to determine if a person is intoxicated?

breath analysis and urinalysis and blood tests

death for alcohol poisoning

can be caused by the CNS and respiratory depression or by inhaling vomit or fluid into the lungs; alcohol depresses the nerves that control involuntary actions

restricting your calories

can make you more prone to getting drunk heavily - 28% women and 8% men - 29% do it for every occasion highly PA college students are likely to binge drink

alcoholism (alcohol dependence)

condition in which personal and health problems related to alcohol use are severe, and stopping alcohol use results in withdrawal symptoms

Alcoholic Hepatitis

condition resulting from prolonged use of alcohol in which the liver is inflamed, and can be fatal

saving calories

control their eating and exercise so that they can save their calories to consume more alcohol - drunkorexia

drinking more and a higher BAC can result in

danger of asphyxiation through chocking to death on vomit

having sun with alcohol can be a way to

deal with stress, boredom, anxiety, or pressure by the social and academic demands - can lead to intoxication, unconsciousness, alcohol poisoning and even death ,

alcohol consumption among college students have shown the consequences of

disrupting sleep, (second half of sleep) which increase daytime sleepiness and decreases alertness

children in dysfunctional families; they assumed the roles as

don't talk, don't trust, don't feel 1. Family Hero: tries to divert the attention by being too good to be true 2. Scapegoat: draws the attention aways from the fam problem through misbehavior 3. Lost Child: becomes passive and quietly withdraws 4. Mascot: Disrupts tense situation through comic relief

results and laboratories have concluded that

drivers are even impaired at .08 BAC - drivers are likely to be involved in a crash with a BAC of .05 to .08

Pharmacological Treatment disulfiram (Antabuse)

drug used for treating alcoholism; deter drinking ad it cause the person to become ill when drinking; it inhibits the breakdown of acetaldehyde from the liver

Therapy

family therapy, individual, and group family: members and person look at the psychological reasons for the addiction and the environmental factors individual and group: learn form positive coping skills for situation that caused them to turn alcoholic

drinking during the

first trimester poses the highest risk in organ development and the last trimester is likely to affect the CNS development

congeners

forms of alcohol that are metabolized more slowly than ethanol and produce toxic byproduct (which can be the reason why for a hangover)

Alateen

helps teens living with alcoholic parents by teaching them they are not at fault for their parents problem

hormones

hormonal differences, periods, and oral contraceptives may make the women feel more intoxicated

withdrawal symptoms include

hyperexcitablity, confusion, agitation, sleep disorders, convulsions, tremors, depression, headaches, and seizures

Lo 7. Treatment and Recovery why no treatment

inability to admit to the problem, social stigma, require abstinence, desire to deal with it by self

alcohol also causes

increased production of hydrochloric acid -- irritates the stomach lining and causes nausea; recovery takes about 12 hours for hangover

other effects

inflammation of the pancreas (organ that makes digestive enzymes and insulin); less enzymes would mean less absorption of nutrients and it can block the absorption of calcium which decrease bone density

Sleep

insomnia = alcohol problems and drinking alcohol dependence and drinking = insomnia - increase snoring and sleep apnea - teens it increases the severity of sleeping

Al-Anon

is a group dedicated in helping adult relatives and friends of alcoholics understand the disease and how can they help

the decrease in percentage of intoxicated drivers involved in fatal crashes

it could be due to the laws that increased drinking age to 21, laws that prohibit people under 21 to drive with a detectable BAC, are automobile safety, educational programs

it is better to slow absorb the alcohol because

it will delay the time that it effects the organs and it will give you a little BAC but we want our body to breakdown the alcohol fast (break it down fast enough so it nothing to absorb) - unmetabolized alcohol circulates in the bloodstream until enough time has pass that the body can break it down

dehydration

loss of water from body tissues

proof

measure of the percentage of alcohol in a beverage; the proof is double the percentage of alcohol in the drink ex. 80 proof vodka is 40% alcohol by volume - wine is 12-15% alcohol and bars is 2 and 8%

among Mexicans

men have a higher rate of alcohol abuse and alcohol related problems - could be due to the individual's acculturation = drinking increase with the acculturation into American culture

alcohol related fatal crashes

occur at night; between 9 pm to 6 am - 25% of all fatal crashes were during the week compared to 44% on the weekends

Lo 2. Alcohol and your Health what does consequences of alcohol depend on?

on individual, amount of alcohol, and your circumstances

Support groups Alcoholics Anonymous (AA)

organization whose goal is to help alcoholics stop drinking; includes auxililalry branches such as Al-Anon and Alateen

Private Treatment Facilities

physical exam, after detoxification they being their treatment for psychological addiction (3 to 6 weeks) $,$$$

hangover

physiological reaction to excessive drinking; including headache, upset tummy, anxiety, depression, poopy, and thirst

what accounts for the high account of alcoholism rates?

poor comic conditions and cultural belief that alcoholism is a spiritual problem

fermentation

process in which yeast organisms break down plant sugars to yield ethanol (and CO2) - beers, ales, and wine

distillation

processing which alcohol vapors are condensed and mixed with water to make hard liquor

Treatment Programs

psychologists, psychiatrists, private centers, hospitals, community centers, and support groups

pylorospasm

pyloric valve becomes stick in the closed position - the alcohol becomes trapped in the stomach causing irrational and vomiting

Naltrexone

reduce the craving for alcohol and decrease the effects of alcohol without making the user feel ill

potential benefits of alcohol

reduced risk of CVD and osteoporosis (social economic status)

symptoms of FAS

small head, tremors, abnormalities of the face, limes, heart, and brain - kids may experience difficulty learning, reduced attention span, impulsive, poor abilities among others

alcohol use disorder criteria

spectrum from mild (2-3), moderate (4-5), to severe (6 or more)

acamprosate (cameral)

stabilizes the chemical imbalance in the brain to reduce the physical and emotional distress in attempts to stay alcohol free

delirium tremens (DTs)

state of confusions, delusions, and agitation brought on by withdrawal from alcohol

who drinks??

students who enter college; people who believe that their parents approve of them drinking, people who drank heavy in HS,

Alcohol and Prescription Drug Abuse

take together can lead to alcohol position, unconsciousness, respiratory depression, and death

among the AA

tend to be more heavier drinkers; twice as many AA die from cirrhosis of the liver, hypertension rates, esophagus cancer, and homicide

learned behavioral tolerance

the ability of heavy drinks to modify behavior so they appear sober even when they have a high BAC level

what are the factors that influence how quickly your body absorbs alcohol?

the alcohol concentration amount of alcohol consumed amount of food in stomach metabolism weight body mass index mood

blood alcohol concentration can continue to be higher because

the alcohol in the stomach and intestine continues to empty into the blood

alcohol dehydrogenase

the enzyme that breaks down alcohol in the tummy before it reaches the bloodstream and the brain

cirrhosis

the last stage of liver disease associated with chronic heavy alcohol use; during which liver cells die and damage becomes permanent - top 10 causes of death

the more alcohol you consume

the longer absorption takes - it takes longer if it has food because the surface area exposed to alcohol is smaller

the higher the concentration of alcohol

the more rapidly it is absorbed' like fizzy alcoholic drinks

detoxification

the process by which addicts end their dependence on a drug

Blood Alcohol Concentration

the ratio of alcohol to total blood volume; the factor used to measure the physiological and behavioral effects of alcohol

the greatest rate of absorption happens in

the small intestine and carbonated drinks increase the rate of absorption

carbonated drinks and pyloric valve

the valve controls the passage of stomach contents into the S.intestine; it causes the valve to relax and thus emptying the stomach more vastly

Functional Alcoholics

they are typical educates, have a good job, have a family, and are middle aged, seem to have their life in order - suffer from denial

AUD in Women

they turn to alcoholics at later ages after a fewer years if heavy drinking; get addicted faster; greater risks of cirrhosis, excessive memory loss, shrinkage of the brain and heart disease and cancers - occur with women who are living with a partner but not married (20-30) or has a husband that drinks

Lo 4. Drinking and Driving

traffic accidents are the leading cause of death for all age groups form 1 to 25 years old - 121 million times adults who are drunk get behind the wheel - 1 in 3 crashes deaths which results n 10,000 deaths a year (every 53 minutes)

children tend to be codependents for the alcoholic

try to cover up for the addict; they try t make excuses for the behavior

fetal alcohol spectrum disorder (FASD)

umbrella that includes partial fetal alcohol syndrome (PFAS) alcohol related neurodevelopment disorder (ARND) and FAS - 40,000 infants

Lo 6. Abuse and Dependence alcohol abuse

use of alcohol in a way that interferes with work, school, or personal relationship or that entails violations of the law

what does BAC depend on

weight and percentage of body fat, water content, concentration alcohol, rate of consumption, and the volume of alcohol consumed

studies have found that students who play intramural sports

were in abusive relationships, had high stress levels, belonged to a frat or sorority or were depressed

amount of alcohol dehyrdrogenase

women have less alcohol dehyrdrogenase; BAC would be 30% higher than man