Chapter 13: Alcohol Use

Relapse Prevention Programs

-Controlled Drinking -Drink refusal training -Stress management training -Coping and social skills training

Alcohol Use Among U.S. Adults

2/3 of adults in U.S. currently drink alcohol. 10% are binge drinkers. 5% are heavy drinkers

Fetal Alcohol Syndrome

A cluster of birth defects (facial abnormalities, low intelligence, and retarded body growth) caused by the mother's use of alcohol during pregnancy

Delirium Tremens (DTs)

A symptom of alcohol withdrawal that can occur if you stop drinking after excessive and prolonged use. sweating, trembling, anxiety, and hallucinations

Psychosocial Consequences

Abbey, Zawacki, & McAuslan (2000): 176 college students (88 M/F pairs). 2 alcoholic or nonalcoholic drinks/10-minute absorption period. 15-minute conversation. Trained observers code for attentive cues and sexual interest cues. Results: drinkers exaggerated sexual interest cues and ignored ambiguous, attentive cues. Alcohol allows people to concentrate on salient cues that fit their current beliefs. These factors may contribute to risky sexual behaviors, Increased # sexual partners, Decreased use of condoms, Increased STDs and unwanted pregnancies.

Who drinks alcohol?

Adults age 25-44 have highest rates of drinking. Men are more likely to drink than women. People with more education are more likely to drink. However, HS dropouts are more likely to develop drinking problems. College drinking: 60.3% college students drank alcohol in past month. 51.9% non-college peers.40.1% college students binge drink. 35% non-college peers. European Americans higher alcohol consumption than other race/ethnic groups. Native Americans highest rates of heavy and binge drinking. Asian Americans lowest rates of drinking.

Alcohol Use Disorders

Alcohol Abuse Alcohol Dependence

The Effects of Alcohol

Alcohol is metabolized by two enzymes Alcohol dehydrogenase (ADH) Aldehyde dehydrogenase (ALDH)

Social Learning Model

Alcohol use is a learned behavior that can be unlearned. Often start drinking for social reasons. Observing others' drinking (e.g., social modeling; parents, friends, movies). Beliefs about social norms. Drinking becomes reinforcing and habitual-Negative reinforcement = escape from unpleasant situations Tension Reduction Drinking may reduce stress and tension. Self-Awareness-Drinking may make you less self-critical. Role of expectations-Beliefs about alcohol predict its effects on you.

Korsakoff's Syndrome

Alcohol-induced neurological disorder where cannot lay down new memories. Related to thiamin deficiency.

Self-Help Groups

Alcoholics Anonymous. Abstinence based program. Goal is to never drink again. Once an alcoholic, always an alcoholic

Aversion Therapy

Behavioral therapy that pairs an unpleasant stimulus (emetic drug) with an undesirable behavior (drinking). Antabuse

Alcohol and the Brain

Breaks down into chemicals that affect neurotransmitters in the brain. Emotional and behavioral control. Memory

Treatment and Prevention of Alcohol Dependence

Change without therapy. Many people can change on their own. Drug Treatment. Aversion Therapy Self-Help Groups Relapse Prevention Programs

Direct Physical Effects of Excessive Alcohol Consumption

Cirrhosis of the liver. Cardiovascular disease. Acetaldehyde is a carcinogen. Fetal Alcohol Syndrome. Korsakoff's Syndrome.

Genes and Alcohol Dependence

Clear evidence of genetic factors. Among males, alcoholism in a first-degree relative is the single best predictor of alcoholism. Adopted children are more susceptible to dependency if one or both biological parents was alcohol-dependent. Identical twins have twice the concordance rate of fraternal twins.

Alcohol Poisoning

Consuming toxic amounts of alcohol in short time (toxic blood alcohol levels). Liver can only process about one unit of alcohol/hr Symptoms: Confusion, low body temperature, pale (bluish) skin, stupor (unresponsive but conscious), passes out, slow or weird breathing, vomiting. Rates: 50,000 cases annually in US (1 death / week). What to do? CALL 911

Drug Treatment

Detoxification agents, opiate antagonists to reduce alcohol's reinforcing properties.

Genes and Alcohol Use

Genetic factors may affect alcohol metabolism.Fast ADH and slow ALDH = high levels of Acetaldahyde when drink. Unpleasant (facial flushing; nausea; increased HR).May explain ethnic differences in alcohol use

Are there benefits of alcohol use?

Light or moderate drinking has been associated with: Reduce mortality. Lower heart disease deaths. Lower risk of developing Type 2 diabetes. Decrease risk for ulcers and digestive tract cancers. Decrease risk for Alzheimer's disease.

Alcohol Abuse

Maladaptive drinking pattern that results in harm to health, relationships, and role obligations. Cannot fulfill responsibilities. School or work affected; relationships affected. Drink in dangerous situations. Experience legal problems because of drinking-E.g. DUI or DWI. Health-Losing time or blacking out. Continue to drink despite problems in living.

Alcohol Consumption

Moderate Drinking: < 1 drink/day females; < 2 drinks/day males Binge Drinking: Having 4+ drinks at once for females; 5+ drinks at once for males. At least 1 day in past month. Heavy Drinking: >5 drinks at once for 5 or more days in past month. Low risk for developing an alcohol use disorder. Women: < 3 drinks in a single day AND < 7 drinks per week. Men: < 4 drinks in a single day AND < 14 drinks per week. BUT it depends on how quickly you drink and other health issues you may have and age (Elderly should drink less)

Why people use and abuse alcohol

Social Learning Model.

Alcohol Myopia

Tendency of alcohol to increase concentration on immediate events, reducing awareness of distant events.

Behavioral Disinhibition

The false sense of confidence and freedom from social restraints that results from alcohol consumption.

Indirect Effects of Excessive Alcohol Consumption

Unintentional injuries. Motor vehicle accidents. 40% linked to alcohol use.most frequent in 21-25 year olds. Suicidal ideation. Aggression. Crime. Risky decision-making

Alcohol Dependence

Use of alcohol is required to function normally. Tolerance. Withdrawal. Delirium Tremens (DTs)