Drugs and Health Ch.8 Alcohol: Behavioral Effects

Alcohol is the most widely used drug in the United States, and alcohol problems cost the nation nearly

$249 billion each year

The hidden costs of excessive alcohol consumption in 2010 were as follows

$82 billion—lost productivity $75 billion—early mortality $28 billion—healthcare costs $25 billion—crime $13 billion—car crashes $28 billion—other costs

In estimating the costs of alcohol abuse as it relates to illnesses, three major categories that have to be included are:

(1) expenditures on medical treatment (a large proportion of which is for the many medical consequences of alcohol consumption; the remainder is for treatment of alcohol abuse and dependence themselves), (2) the lost productivity that results from workers' abuse of alcohol, and (3) the losses to society from premature deaths that are due to alcohol problems"

Why do women respond differently than men to alcohol?

(1) women have smaller body sizes (men are generally larger than women); (2) women absorb alcohol sooner than men because on average they possess more body fat, and body fat does not dilute alcohol as well as water (male bodies contain more water); (3) women possess less of a metabolizing enzyme that functions to get rid of (process out) alcohol.

Statistics on College Drinking (continued)

-150K develop an alcohol-related health problem -3.36 million drive under the influence -11% have damaged property -25%/50% of administrators report campus property damage -5% involved w/ police/campus security b/c drinking -31% meet the criteria for abuse; 6% dependence -Drinking behaviors becoming more similar between genders

AGE DIFFERENCES (Ages 12 to 17):

-Any alcohol use—An estimated 9.0% of adolescents 12 to 17 in 2018 were current alcohol users; this corresponds to 2.2 million adolescents who drank alcohol in the preceding month. -Binge alcohol use—About 1.2 million adolescents aged 12 to 17 in 2018 were past-month binge drinkers, which corresponds to 4.7% of adolescents. -Heavy alcohol use—In 2018, an estimated 131,000 adolescents 12 to 17 were current heavy drinkers. Stated another way, about one out of 200 adolescents (0.5%) engaged in binge drinking on five or more days in the preceding 30 days.

AGE DIFFERENCES (Aged 18 to 25):

-Any alcohol use—In 2018, an estimated 55.1% of young adults ages 18 to 25 were current alcohol users, which corresponds to about 18.8 million young adults. -Binge drinking—An estimated 34.9% of young adults 18 to 25 in 2018 were binge drinkers in the preceding month, which corresponds to about 11.9 million young adults. -Heavy alcohol use—About one out of every 11 young adults 18 to 25 (9.0%) in 2018 was a current heavy alcohol drinker. This percentage corresponds to 3.1 million young adults who engaged in heavy drinking in the preceding month

AGE DIFFERENCES (Aged 26 or Older):

-Any alcohol use—More than half of adults 26 or older in 2018 (55.3%) were current alcohol users. This percentage corresponds to about 118.8 million adults in this age group who drank alcohol in the preceding month. -Binge alcohol use—In 2018, about a quarter (25.1%) of adults ages 26 or older were current binge drinkers. This percentage corresponds to about 54.0 million adults in this age group who were binge drinkers. -Heavy alcohol use—An estimated 6.2% of adults 26 or older in 2018 were current heavy drinkers. This percentage corresponds to about 13.4 million adults in this age group who engaged in heavy drinking in the past month

In summary, the preceding definitions either list or hint at the following major components of alcoholism

-Craving: An overwhelming compulsion to drink even when not feasible, such as at work, while driving a car, while mowing a lawn, and so on. -Loss of control and highly impaired: An inability to limit one's drinking once drinking has begun; for example, one drink only before going to bed is impossible to control. -Physical dependence: The presence of withdrawal symptoms when attempting to abstain from usage. Such symptoms as nausea, sweating, shakiness, and anxiety about the availability of alcohol are common. -Tolerance: A need to continually increase the amount of alcohol consumed to maintain its effects (or to maintain the "buzz").

frequent binge drinkers: In summary, the finding was:

-One-third (33%) of schools surveyed qualified as high-binge drinking campuses. To be qualified for a high-binge drinking campus, more than half of the students responding to the survey had to indicate they were binge drinkers. -The strongest predictor for binge drinking was living in a sorority or fraternity house. Eighty percent of sorority women and 86% of fraternity men living in Greek housing qualified as binge drinkers.

EMPLOYMENT STATUS AND ALCOHOL USE

-The rate of current alcohol use in 2018 was 64.8% for full-time employed adults 18 or older, which was higher than the rate for unemployed adults (53.8%). Rates of binge drinking were similar for adults who were employed full-time and those who were unemployed (31.5% and 31.3%, respectively). -Among adults in 2013, most binge and heavy alcohol users were employed. Among the 58.5 million adults who were binge drinkers, 44.5 million (76.1%) were employed either full- or part-time. Among the 16.2 million adults who were heavy drinkers, 12.4 million (76.0%) were employed

Defining Alcoholics

-When can a person be defined as an alcoholic? -The stereotypical image represents only a very small percentage of Americans that qualify as alcoholics -Most functioning alcoholics are secret or closeted drinkers who look very much like everyday working people

Prohibition Era (1920-1933)

-alcohol consumption did not completely stop -Prohibition created a black market for the production and selling of alcohol -organized crime increased -Gangsters grew rich buying and selling illegal alcohol -Law officials did not give up easily the meaning of temperance was gradually altered from moderation to total abstinence. All alcoholic beverages were attacked as being unnecessary, harmful to health, and inherently poisonous. Over the course of the 19th century, the demand gradually arose for total prohibition

ALCOHOL USE: AGE 12 OR OLDER BY ETHNICITY AND RACE

-among persons age 12 or older in 2018, whites were more likely than other racial or ethnic groups to report current use of alcohol (56.7%). The rates were 46.0% for persons reporting two or more races, 41.0% for Hispanics or Latinos, 35.9% for American Indians and Alaska Natives, 43.0% for blacks, and 39.3% for Asians -In 2019, Asians had the lowest overall rates of binge drinking or heavy use of alcohol rates across all age groups whereas whites had the highest current, binge, and heavy alcohol use.

Current Statistics & Trends

64% of adult population drinks 26% report excessive drinking patterns 29% report drinking has caused family problems Higher level of education attained, the higher the likelihood of current use People most likely to drink have higher income <65yrs, do not attend church, don't live in the South, liberals

Myth 5 Beer doesn't have as much alcohol as hard liquor.

A 12-ounce bottle of regular beer (about 5 percent alcohol by volume) has the same amount of alcohol as a 5-ounce glass of wine (about 12 percent alcohol by volume), or 1.5 ounce shot of liquor or distilled spirits (about 40 percent alcohol by volume).

genogram

A family therapy technique that records information about behavior and relationships on a type of family tree to elucidate persistent patterns of dysfunctional behavior.

posttraumatic stress disorder (PTSD)

A psychiatric syndrome is when an individual who has been exposed to a traumatic event or situation experiences persistent psychological stress that may manifest itself in a wide range of symptoms, including re-experiencing the trauma, numbing of general responsiveness, and hyperarousal.

disinhibitor

A psychoactive chemical that depresses thought and judgment functions in the cerebral cortex, which has the effect of allowing relatively unrestrained behavior (as in alcohol inebriation).

Alcohol Consumption in the U.S.

Alcohol has always been present in our society People can drink excessively w/o many noticing Often is not perceived as a drug by Americans Findings on alcohol use More than half ≥12yrs are current drinkers 23% ≥12yrs report past month binge drinking 6.9% ≥12yrs are heavy drinkers

Alcohol & Sex

Alcohol is linked to an overwhelming proportion of unwanted sexual behaviors -Date rape, unplanned pregnancies, STIs Contributing factors include: disinhibition of sexual constraints; poor judgment; unconsciousness or helplessness

Children of Alcoholics (COA)

Alcoholism is a disease of the family; problems affect all members COAs at high risk for developing drug problems

EDUCATION AND ALCOHOL USE

Among adults age 18 or older, the rate of past-month alcohol use increased with increasing levels of education. Among adults in 2013 with less than a high school education, 36.5% were current drinkers. In comparison, 69.2% of college graduates were current drinkers Among adults age 18 or older, rates of binge and heavy alcohol use varied by level of education. Among adults in 2013, those who had graduated from college were less likely than those with some college education but no degree to be binge drinkers (23.1% vs. 26.4%) or heavy drinkers (6.0% vs. 7.6%)

The World Health Organization (WHO) reported that throughout the world, the following ten countries has the highest average alcohol consumption of pure alcohol per capita (per person):

Belarus (ranked first with 14.4 liters); Lithuania, (ranked second with 12.9 liters); Grenada (ranked third with11.9 liters); the Czech Republic and France (ranked fourth with 11.8 liters each); Russia (ranked fifth with 11.4 liters); Ireland, Luxembourg, and Slovakia (ranked sixth with 11.4 liters each); Germany and Hungry (ranked seventh with 11.3 liters); Portugal (ranked eighth with 11.0 liters), Poland (ranked ninth with 10.9 liters); Slovenia (ranked 10th with 1.6 liters) and the United States (ranked 25th with (8.7 liters)

wet cultures

Cultures in which alcohol is integrated into daily life and activities (e.g., is consumed with meals) and is widely available and accessible (e.g., European countries bordering the Mediterranean have traditionally exemplified wet cultures).

Role of Alcohol in Domestic Violence

Domestic violence: is a behavior used in order to control a spouse or partner by using fear & intimidation There is a significant relationship b/wn battering & alcohol abuse 87% of female alcoholics were abused as children

Myth 1 I can drink and still be in control

Drinking impairs your judgment, which increases the likelihood that you will do something you'll later regret. It increases the chance that you will cause harm to others and/or not be aware of potential dangers around you. Critical decision-making abilities are already diminished long before a person shows physical signs of intoxication.

Statistics on College Drinking

Drinking rates have remained fairly stable -1,825 alcohol-related deaths each yr -599K unintentional injuries while drinking -696K assaulted by someone under the influence -97K victims of alcohol-related sexual assault or date rape -400K unprotected sex; 100K too drunk to know if consented -25% report academic consequences of drinking

Problems with reduced productivity of alcohol-abusing employees include the following:

Employees who drink heavily off the job are more likely to experience hangovers that cause them to be absent from work, show up late or leave early, feel sick at work, perform poorly, or argue with coworkers. People with drug or alcohol problems were more likely than others to report having worked for three or more employers in the previous year

psychodrama

Family therapy system developed by Jacques Moreno in which significant interpersonal and intrapersonal issues are enacted in a focused setting using dramatic techniques

Myth 6 I'll be better off if I learn to "hold my liquor."

For some people who drink, it takes quite a few drinks to "get a buzz" or feel relaxed, and they may be less likely to show signs of intoxication compared to others. This is sometimes called being able to "hold your liquor" or "drink someone under the table." Often they are unaware that their body's lower response to the intoxicating effects of alcohol isn't protection from alcohol problems but instead is a reason for caution. These individuals tend to drink more, socialize with people who drink a lot, and develop a tolerance to alcohol, i.e., it takes more and more alcohol to feel or act intoxicated. As a result, they have an increased risk for developing AUD. Someone who misuses alcohol, especially over the long-term, can experience permanent liver, heart, or brain damage. And all people who drink regardless of the amount need to be aware that critical decision-making abilities and driving-related skills are already diminished long before a person shows physical signs of intoxication.

Alcohol Consumption Patterns of Women: Issues among Women

Greater sensitivity & likelihood of addiction, and develop health problems sooner Long-term risks are more dangerous -Higher rate among 12-17yr old (delayed puberty, affecting adolescent maturation) -More likely to combine w/ Rx drugs -Risk for early menopause

teetotaler

Individuals who drink no alcoholic beverages whatsoever; a term in common usage in decades past; today, teetotalers are referred to as abstainers

Myth 3 I can sober up quickly if I have to.

It takes about 2 hours for the adult body to eliminate the alcohol content of a single drink, depending on your weight. Nothing can speed up this process—not even coffee or cold showers.

bootlegging

Making, distributing, and selling alcoholic beverages during the Prohibition era.

Culture Provides Rules for Drinking Behavior

Many cultures such as traditional Italian and Jewish cultures permit moderate drinking within the family, especially at meals, but disapprove of drunken behaviors. Note that many differences separate these groups.

Myth 2 Drinking isn't all that dangerous.

Many risks are associated with drinking, including impaired driving, unintentional injuries, violence, unsafe sexual behavior, suicide attempts, overdoses, and death. Even college students who don't drink may experience secondhand effects, such as disrupted study and sleep or being involved in an alcohol-related assault.

Economic Costs of Alcohol Abuse

Most of the costs of alcohol abuse result from adverse effects on health -Cost of abuse fall into 3 categories: 1. Expenditures on medical treatment 2. Lost productivity from workers' abuse 3. Losses to society from premature deaths -The third leading cause of preventable death in the U.S. -Illness, accidents & crimes connected to alcohol

Codependency and enabling

Often codependence & enabled by the same person Codependency & enabling perpetuate the disease

Underage Alcohol Use

Rates of current (2.4%), binge (1.9%) & heavy (0.7%) use declined from 2002-2008 Whites are more likely than other groups to report current drinking (12-17yr olds)

set and setting

Set refers to the individual's expectation of what a drug will do to his or her personality; setting is the physical and social environments where the drug is consumed

speakeasies

Small, often backroom bars where alcoholic beverages were illegally consumed and sold during the Prohibition era from 1920 to 1933 (in some states, Prohibition was longer than this period of time).

acute alcohol withdrawal syndrome

Symptoms that occur when an individual who is addicted to alcohol does not maintain his or her usual blood alcohol level.

Codependency

The behavior displayed by either addicted or nonaddicted family members (codependents) who identify with the alcohol addict and cover up the excessive drinking behavior, allowing it to continue and letting it affect the codependent's life.

drunken comportment

The behavior exhibited while under the direct influence of alcohol; is determined by the norms and expectations of a particular culture.

Alcohol Abuse vs. Alcoholism

The difference is a matter of degree Abuse: craving, loss of control & physical dependence is less prominent -Outcomes of abuse affect alcoholics, but not all outcomes of alcoholism are experienced by abusers -The distinction is helpful in providing a more precise understanding of abuse vs. dependence

Myth 7 I can manage to drive well enough after a few drinks

The effects of alcohol start sooner than people realize, with mild impairment (up to 0.05 blood alcohol concentration [BAC]) starting to affect speech, memory, attention, coordination, and balance. And if you are under 21, driving after drinking any amount of alcohol is illegal and you could lose your license. The risks of a fatal crash for drivers with positive BAC compared with other drivers increase as the BAC increases, and the risks increase more steeply for drivers younger than age 21 than for older drivers. Critical decision-making abilities and driving-related skills are already diminished long before a person shows physical signs of intoxication.

What is Binge drinking?

The heavy consumption of alcohol over a short period of time Today the generally accepted definition of binge drinking in the United States is: Heavy binge drinking includes three or more such episodes in 2 weeks

patent medicines

The ingredients in these uncontrolled "medicines" were secret, often consisting of large amounts of colored water, alcohol, cocaine, or opiates

delirium tremens (DTs)

The most severe, even life-threatening, form of alcohol withdrawal, involves hallucinations, delirium, and fever.

Enablers

Those close to the alcohol addict who deny or make excuses for enabling his or her excessive drinking

Helping the Alcoholic Family Recover

Two of the techniques used in understanding roles and relationships are: psychodrama (or role-playing) genogram

Alcoholic abuse

Uncontrollable drinking that leads to alcohol craving, loss of control, and physical dependence but with less prominent characteristics than found in alcoholism

Definitions of Alcoholism

Various definitions have been offered -Most definitions either list or hint at the following major components: Craving: overwhelming compulsion to drink, even when not feasible Very impaired or loss of control: inability to limit drinking once begun Physical dependence: presence of withdrawals when abstinent Tolerance: need to continually increase to maintain its effects

Overall Demographic Patterns

Whites have the highest current use; binge drinking is highest among Latinos Full-time college students are more likely to report past- months, binge & heavy drinking Current use is higher for full-time employed adults than for unemployed

Myth 4 (for women) It's ok for me to drink to keep up with the guys

Women process alcohol differently. No matter how much a guy drinks, if you drink the same amount as your male friends your blood alcohol concentration will tend to be higher, putting you at greater risk for harm.

Amnesiac

a person affected by amnesia causing loss of memory

pseudointoxicated

acting drunk even before alcohol has had a chance to cause its effects The frequency of use or the amount consumed has less effect on how drinkers comport themselves; instead, the cultural values, beliefs, mental maps, and norms cause a particular behavioral outcome.

dry cultures

cultures in which alcohol consumption is not as common during everyday activities (e.g., it is less frequently a part of meals) and access to alcohol is more restricted; abstinence is more common (e.g., Scandinavian countries, the United States, and Canada)

Alcoholism

medical condition consisting of physical and psychological addiction to ethanol (alcohol), a psychoactive substance.

relapsing syndrome

returning to the use of alcohol after quitting, people will almost always relapse

Prohabition/Temperence movement

seen as a social issue wasn't just drinking- seen as a greater saloon problem- people would use their whole paycheck, saloons had prostitution and gambling led to moral issues- because men wouldn't have the money to provide for their families

Although for decades many people believed that college students "majored in drinking,"

students during the 1930s grew to consider heavy use as romantic and adult, resonating with the romantic, heavy-drinking expatriate community of writers in Paris such as Ernest Hemingway.

Percentages of the Drinking Population: A Pyramid Model

the base of 35% of people who are teetotalers, then a layer of about 13% who occasionally drink, and a top 52% who drink regularly. In 2018, 24.7% (67.1 million) of those age 12 or older reported that they engaged in binge drinking in the past month; 16.6 million people age 12 or older (6.1% of the population) reported that they engaged in heavy alcohol use2 in the preceding month

An estimated 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol...

the third leading preventable cause of death in the United States. The first is tobacco, and the second is poor diet and physical inactivity