Ch 11: Alcohol- The Most Popular Drug

1. headache 2. shakiness 3. nausea 4. diarrhea 5. fatigue 6. impaired mental function

*6 Symptoms of an alcohol hangover:

0.3%+, 0.4%+

*A coma is most likely to occur when a person's BAC reaches __% Death can occur with a BAC of ___%

1. combination of toxic products of alcohol breakdown 2. dehydration 3. hormonal effects

*A hangover is caused by 3 things:

higher

A person with a higher percentage of body fat will usually develop a ___ BAC than a more muscular person of the same weight.

cocaine and alcohol

When ___ and ___ are used together, they form a toxic substance in the liver called cocaethylene, which can produce effects that neither drug alone does.

Alcoholism

a pathological use of alcohol or impairment in functioning due to alcohol; characterized by tolerance of alcohol and withdrawal symptoms

alcohol-related neurodevelopmental disorder (ARND)

cognitive and behavioral problems seen in people whose mothers drank alcohol during pregnancy

highly concentrated

drinking ___ ___ alcoholic beverages such as hard liquor slows absorption.

ethyl, ethanol

In this book, the term alcohol refers only to ___ alcohol (or ___)

Alcohol-drug

___-___ combinations are a leading cause of drug-related deaths.

50-60%

___-___% of a person's risk for alcoholism is determined by genetic factors.

cirrhosis

a disease in which the liver is severely damaged by alcohol, other toxins, or infection

Hallucinations

a false perception that does not correspond to external reality, such as seeing visions or hearing voices that are not there

alcohol poisoning, coma, and death

-at very high doses, ___ ___, ___, and ___ can occur. Effects may be increased if alcohol is combined with other drugs.

drunk

*If you see any signs of a ___ driver, avoid that vehicle by pulling off the road or turning at the nearest intersection. Report the driver to the police.

one drink or less, one to two drinks

*Moderate doses of alcohol: Women- ___ drink/drinks or less a day Men- ___ to ___ drink/drinks a day may reduce the risk of heart disease and heart attack in some people.

five to six, three to four

*Nearly all men can expect a hangover if they drink more than ___ to ___standard drinks; for women, the number is ___ to ___ drinks.

less, more

*Women metabolize ___ alcohol in the stomach than men do because the stomach enzyme that breaks down alcohol before it enters the bloodstream is four times ___ active in men than in women.

Men

*are more likely to drink alcohol, to misuse alcohol, and to develop an alcohol use disorder.

There are also several medical treatments for alcoholism.

-Disulfiram (Antabuse) -Naltrexone (ReVia, Depade) -Injectable naltrexone (Vivitrol) -Acamprosate (Campral)

To determine a person's place on the disorder spectrum, ask these questions:

-Do you often consume alcohol in large amounts over a long period? -Do you find that your efforts to control your alcohol use are unsuccessful? -Do you spend excessive time using alcohol or recovering from its effects? -Do you have a strong desire or craving to use alcohol? -Does your persistent alcohol use cause a failure to fulfill obligations at work, school, or home? -Do you continue using alcohol despite recurrent social or interpersonal problems caused by its effects? -Have you reduced important social or recreational activities because of your alcohol use? -Do you persist in using alcohol in situations that are physically risky? -Do you continue using alcohol despite knowing that it can cause or worsen a recurrent physical or psychological problem? -Do you have a need for increased amounts of alcohol to achieve a desired effect (increased tolerance)? -Do you experience symptoms of withdrawal, such as sweating, increased pulse rate, hand tremor, insomnia, nausea, and anxiety?

Warning signs of serious problems with alcohol:

-Drinking alone or secretively -Using alcohol deliberately and repeatedly to perform or get through difficult situations -Using alcohol as a way to "self-medicate" in order to dull strong emotions or negative feelings -Feeling uncomfortable on certain occasions when alcohol is not available -Escalating alcohol consumption beyond an already established drinking pattern -Consuming alcohol heavily in risky situations, such as before driving -Getting drunk regularly or more frequently than in the past -Drinking in the morning

strategies for keeping your drinking and your behavior under control

1. Drink slowly. 2. Space your drinks. 3. Eat before and while drinking. 4. Know your limits and your drinks.

4 different common patterns of excessive alcohol use, including:

1. Regular daily intake of large amounts 2. Regular heavy drinking limited to weekends 3. Long periods of sobriety interspersed with binges of daily heavy drinking lasting for weeks or months 4. Heavy drinking limited to periods of stress

Strategies for promoting responsible drinking in others include:

1. encouraging responsible attitudes 2. being a responsible host 3. holding the drinker responsible for his or her actions 4. learning about prevention programs 5. taking community action.

When you are the host:

1. serve nonalcoholic beverages as well as alcohol. 2. Have only enough alcohol on hand for each guest to have a moderate amount. Don't put out large kegs of beer because these invite people to overindulge. 3. For parties hosted by a dorm, fraternity, or other campus group, don't allow guests to have unlimited drinks for a single admission fee because this also encourages binge drinking. 4.Always serve food along with alcohol 5. stop serving alcohol an hour or more before people will leave. 6. If possible, arrange carpools with designated nondrinking drivers in advance. 7. Remind your guests who are under 21 about the zero-tolerance laws in many states 8. Insist that guests who drink too much take a rideshare or taxi, ride with someone else, or stay overnight rather than drive.

1. how fast you drink 2. how fast your stomach empties its contents 3. how much and what type of food 4. other drugs are in your system 5. Kind of alcohol (volume, concentration, and nature)

4 factors determine the rate of absorption:

1. examining attitudes about drinking and drinking behavior 2. drinking slowly 3. spacing drinks 4. eating before and while drinking 5. knowing one's limits

5 Strategies for keeping drinking under control include:

1. encouraging responsible attitudes 2. being a responsible host 3. holding the drinker responsible for his or her actions 4. learning about prevention programs 5. taking community action.

5 Strategies for promoting responsible drinking in others include:

bloodstream, liver

After being absorbed into the ___ in the stomach and small intestine, alcohol is transported throughout the body. The ___ metabolizes alcohol as blood circulates through it.

misuse

Alcohol ___ involves drinking in dangerous situations or drinking to a degree that causes academic, professional, interpersonal, or legal difficulties.

misuse, abuser

Alcohol ___ is recurrent alcohol use that has negative consequences, such as drinking in dangerous situations (before driving, for instance) or drinking patterns that result in academic, professional, interpersonal, or legal difficulties. The person who drinks only once a month, but then drives while intoxicated, is an alcohol ___.

fatty tissue

Alcohol does not concentrate as much in ___ ___ as in muscle and most other tissues, in part because fat has fewer blood vessels.

1. oral mucosa 2. stomach 3. small intestine. 4. gastrointestinal (GI) tract

Alcohol gets into the bloodstream by being absorbed by (4):

CNS depressant.

Alcohol is a CNS ___ At low doses, it tends to make people feel relaxed.

higher

Alcohol is a CNS depressant. at ___ doses interferes with motor and mental functioning

7

Alcohol provides ___ calories per gram, and the alcohol in one drink (14-17 grams) supplies about 100-120 calories.

neurotransmitters

Alcohol readily enters the human brain. There it affects

social and psychological

Alcohol use causes more serious ___ and ___ problems than all other forms of drug abuse combined.

40%

Alcohol use contributes to ___% of all murders, assaults, and rapes.

injury and violence

Alcohol use increases the risk of ___ and ___; drinking before driving is particularly dangerous, even at low doses.

AA, job- and school, inpatient hospital, pharmacological

Alcoholism treatment approaches include: 1. mutual support groups like ___ ___ 2. ___- and ___-based programs 3. ___ ___ programs 4. ___ treatments

6-8%

Ales and malt liquors, which also have grain bases and are similar to beer in their processing, typically contain ___-___% alcohol by volume.

liver

Although a small amount of alcohol is metabolized in the stomach, most is metabolized in the ___.

metabolic

Although the rate of alcohol absorption can be slowed by factors like food, the ___ rate CANNOT be influenced by exercise, breathing deeply, eating, drinking coffee, or taking other drugs. Whether a person is asleep or awake, the rate of alcohol metabolism is the same.

90%

Among Americans under age 21, most drinking occurs in the form of bingeing, and over ___% of the alcohol they drink is consumed while binge drinking.

15

Average life expectancy among people with alcohol use disorder is about ___ years less than among people who do not have the disorder.

Eat before and while drinking. strategies for keeping your drinking and your behavior under control

Avoid drinking on an empty stomach. Food in your stomach will not prevent the alcohol from eventually being absorbed, but it will slow down the rate somewhat and lower the peak BAC. In restaurants, order your food before you order a drink. Try to have something to eat before you go out to a party where alcohol will be served.

absorption, metabolism

BAC also depends on the balance between the rate of alcohol ___ and the rate of alcohol ___.

Body weight Percentage of body fat Sex

BAC is affected by the amount of alcohol consumed in a given amount of time and by 3 individual factors:

3-6%

Beer is a mild intoxicant brewed from a mixture of grains. By volume, beer usually contains ___-___% alcohol.

digestive, cardiovascular

Chronic alcohol use has negative effects on the ___ and ___ systems and increases cancer risk and overall mortality

denial, rationalization

Common psychological features of individuals who misuse alcohol are ___ and ___.

amount, stage

Damage to the fetus depends on the ___ of alcohol consumed and the ___ of the pregnancy.

Space your drinks. strategies for keeping your drinking and your behavior under control

Drink nonalcoholic drinks at parties, or alternate them with alcoholic drinks. Learn to refuse a round: "I've had enough for right now." Parties are easier for some people if they hold a glass of something nonalcoholic that has ice and a twist of lime floating in it so that it looks like an alcoholic drink.

Hispanic

Drunk driving and cirrhosis are the most common causes of alcohol-related death and injury among ___ men.

absorption

Food in the stomach slows the rate of alcohol ___.

alcohol

Exposure to ___ is "the leading preventable cause of birth defects and intellectual and neurodisabilities in children."

35-50%

Hard liquor—such as gin, whiskey, rum, tequila, vodka, and liqueur—is made by distilling brewed or fermented grains or other plant products. Hard liquors usually contain ___-___% alcohol but can be much stronger.

The CAGE screening test can help you determine whether you, or someone close to you, may have a drinking problem. Answer yes or no to the following questions:

Have you ever felt you should . . . Cut down on your drinking? Have people . . . Annoyed you by criticizing your drinking? Have you ever felt bad or . . . Guilty about your drinking? Have you ever had an . . . Eye-opener (a drink first thing in the morning to steady your nerves or get rid of a hangover)?

enabler, resources

Helping someone who abuses alcohol means avoiding being an ___ and obtaining information about available ___ and persistently encouraging their use.

small amount, 20%, 75%, remaining

How alcohol gets into the bloodstream: 1. a ___ ___ is absorbed by the oral mucosa 2. About ___% is absorbed in the stomach 3. about ___% is absorbed through the upper part of the small intestine. 4. Any ___ alcohol enters the bloodstream farther along the gastrointestinal (GI) tract.

metabolize, metabolism

If people drink more alcohol each hour than the body can ___, blood alcohol concentration (BAC) increases. The rate of alcohol ___ depends on a variety of individual factors.

9-14%

In table wines, the concentration of alcohol is about ___-___%.

men

Most alcohol-related deaths and injuries among ___ result from motor vehicle crashes, falls, drowning, suicide, and homicide

treatment program

Most alcoholics require a ___ ___ of some kind in order to stop drinking.

two

Meeting ___ of the criteria indicates an alcohol use disorder

Alcoholics Anonymous (AA)

One of the oldest and best-known recovery programs is ___ ___.

binge drinking

Over half the alcohol consumed by all adults in the United States is downed during ___ ___.

mental

People suffering from an alcohol use disorder frequently have ___ disorders.

tolerance and withdrawal, chronic

Physical consequences of alcoholism include: The direct effects of ___ and ___as well as all the problems associated with ___drinking.

memory, mental

Physical consequences of alcoholism include: Psychological problems associated with alcoholism include ___ loss and additional ___ disorders such as depression.

Psychological

Physical consequences of alcoholism include: ___ problems associated with alcoholism include memory loss and additional mental disorders such as depression.

HDL, thinning, inflammation, blood clots

Previous studies showed that light to moderate drinking may improve heart health by: 1. raising blood levels of ___ 2. ___ the blood 3. reducing ___ and the risk of dangerous ___ ___ all of which can contribute to the risk of a heart attack.

use disorder

Rather than using the terms alcoholic or nonalcoholic, the DSM-5 prefers alcohol ___ ___.

counseling, nonpharmacological

Several medical treatments for alcoholism work best in combination with ___ or other ___ programs.

Drink slowly. strategies for keeping your drinking and your behavior under control

Sip your drinks instead of gulping them. Do not drink alcoholic beverages to quench your thirst. Avoid drinks made with carbonated mixers, especially if you're thirsty; you'll be more likely to gulp them down.

breast, menstrual

Some alcohol-related health issues are unique to women, including increased risk of ___ cancer and ___ disorders, and exposing children to alcohol during pregnancy.

Eighty percent

___% of arrests happen for drug- and alcohol-related offenses (domestic violence, driving under the influence of alcohol, public drunkenness, and property and drug offenses).

rate

The ___ at which your body absorbs alcohol will affect how quickly you feel drunk or how quickly your behavior is impaired.

CAGE, One

The ___ screening test can help you determine whether you, or someone close to you, may have a drinking problem. ___ yes response suggests a possible alcohol problem; if you answered yes to more than ___ question, it is highly likely that a problem exists.

circulatory

The ___ system quickly transports alcohol throughout the body.

dose-response

The ___-___ function is the relationship between the amount of alcohol or drug consumed and the type and intensity of the resulting effect. Higher doses of alcohol are associated with a much greater probability of automobile crashes

alcohol, blood

The amount of ___ in the ___ is a primary factor determining the effects of alcohol.

one drink (also called a standard drink)

The amount of a beverage that typically contains about 0.6 ounce of alcohol

prevention

The best treatment for hangover is ___.

0.03-0.05%

The effects of alcohol can first be felt at a BAC of ___-___%. These effects may include lightheadedness, relaxation, and a release of inhibitions.

0.08%

The legal limit for BAC is ___% in the United States.

genetic factors, drinking behavior

The rate of alcohol metabolism varies among individuals and is determined largely by ___ ___ and ___ ___.

Asian

___ Americans have a higher prevalence of this hepatitis infection.

Excessive alcohol use, third

___ ___ ___ is responsible for 90,000 deaths per year among Americans and is the ___ leading lifestyle-related cause of death.

Al-Anon, Alateen

___ ___ and ___ are companion programs to AA for families and friends of alcoholics. spouses and others explore how they enable the alcoholic to drink by denying, rationalizing, or covering up his or her drinking and how they can change this codependent behavior.

Binge drinking

___ ___ is a common form of alcohol abuse that has negative effects on both drinkers and nondrinkers. For numerous reasons, college students may be especially prone to ___ ___.

AA

___ ___ remains the mainstay of treatment for most people and is often a component of even the most expensive treatment programs.

Moderate

___ doses of alcohol may reduce the risk of heart disease and heart attack in some people.

Hormonal

___ fluctuations may also affect the rate of alcohol metabolism, making a woman more susceptible to high BACs at certain times during her menstrual cycle.

alcohol

___ has remained the most popular psychoactive drug in the Western world.

Alcohol

___ is responsible for more toxic overdose deaths than any other drug. (alone or in combination with other drugs).

alcoholism

___ is usually characterized by tolerance to alcohol and withdrawal symptoms.

six

___ or more symptoms is a severe alcohol use disorder

Two

___ ounces of 100-proof whiskey contain 1 ounce of pure alcohol.

four to five

___ to ___ symptoms is a moderate alcohol use disorder

two to three

___ to___ symptoms indicates a mild alcohol use disorder

delerium tremens (DTs)

a state of confusion brought on by the reduction of alcohol intake in an alcoholic-dependent person; other symptoms are sweating, trembling, anxiety, hallucinations, and seizures

alcoholic use disorder

abuse of alcohol that leads to clinically significant impairment

Men

account for the majority of alcohol-related deaths and injuries in the United States, the greatest proportion occurring in ___ age 35 and under.

Native

alcohol use disorder is significantly more prevalent among ___ Americans compared to other groups, as is the death rate from alcohol-related causes such as motor vehicle crashes.

antisocial personality disorder

an underlying psychiatric condition: Their destructive behavior—repeated criminal acts, deceitfulness, impulsiveness, repeated fights or assaults, and disregard for the safety of others—worsens under the influence of alcohol.

20%

fortified wine: A more potent type of wine because extra alcohol is added during its production. Fortified wines—such as sherry, port, and Madeira—contain about ___% alcohol.

five

heavy drinking involves bingeing on ___ or more days in the past month.

accountable

holding the individual fully ___ is a more effective policy.

50%

if a beverage is 100 proof, it contains ___% alcohol by volume

Injectable naltrexone (Vivitrol)

medical treatments for alcoholism: - acts the same as oral naltrexone, but it is a single monthly shot administered by a health professional. Compliance with a monthly regimen may be better for some alcoholics.

Disulfiram (Antabuse)

medical treatments for alcoholism: - inhibits the metabolic breakdown of acetaldehyde and causes patients to flush and feel ill when they drink, theoretically inhibiting impulse drinking. However, disulfiram is potentially dangerous if the user continues to drink.

Acamprosate (Campral)

medical treatments for alcoholism: -helps people maintain abstinence after they have stopped drinking.

Naltrexone (ReVia, Depade)

medical treatments for alcoholism: - binds to a brain pleasure center that reduces the craving for alcohol and decreases its pleasant, reinforcing effects. When taken correctly, naltrexone usually does not make the user feel ill.

binge drinking

periodically drinking alcohol to the point of severe intoxication: about 4 drinks (for women) and 5 drinks (for men) consumed within a period of about two hours

speed, concentration

the ___ at which your blood alcohol concentration rises has been linked to the degree of impairment, more than the ___ itself

carbonation

the ___ in a beverage like champagne increases the rate of alcohol absorption, as do artificial sweeteners (commonly used in drink mixers)

Blood Alcohol Concentration (BAC)

the amount of alcohol in a person's blood, expressed as a percentage of alcohol in a deciliter of blood, used as a measure of intoxication

Metabolism

the chemical transformation of food and other substances in the body into energy and wastes, first through breaking apart the components and then using them in other forms.

neurotransmitters

the chemicals that carry messages between brain cells.

alcohol

the intoxicating ingredient in fermented or distilled beverages; a colorless, pungent liquid

Know your limits and your drinks. strategies for keeping your drinking and your behavior under control

try one of the many apps or websites that provide estimates of BAC. You can learn how different BACs affect you by seeing how you respond to a set amount—say one or two drinks in an hour. (Try this experiment only in a safe setting and only if drinking is legal for you.) A good test is walking heel to toe in a straight line with your eyes closed or standing with your feet crossed and trying to touch your finger to your nose with your eyes closed.

proof value

two times the percentage of alcohol in a beverage, measured by volume; a 100-proof beverage contains 50% alcohol

cardiac myopathy

weakening of the heart muscle through disease