Chapter 10

Chemistry of Alcohol
Psychoactive ingredient Depressant Ethyl Alcohol only alcohol that can be consumed

Beer 3-6% alcohol by volume Malt Liquors 6-8% alcohol by volume Table wines 9-14% alcohol by volume

Fermenting

Fortified wines 20% alcohol by volume

Hard liquors 35-50% alcohol by volume

Sugar added Extra alcohol is added

Proof Value Ingestion

Distilling or fermented

Two times the percentage concentration 7calories per gram 1 drink 14-17 grams or 100-120 calories
2

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Absorption

20% is rapidly absorbed from the stomach 75% is absorbed in the upper small intestines Remain is absorbed along the GI track Absorption
Carbonation
Food in the stomach slows the absorption Drink of high concentration slows absorption Eventually all the alcohol ingested will be absorbed

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Metabolism and Excretion

Transported throughout the body via the

bloodstream. Easily moves through most biological membranes Main site for metabolism is the Liver. 2-20% of ingested alcohol is not metabolized.

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Alcohol Intake and Blood Alcohol Concentration

Blood Alcohol Concentration(BAC) A measure of intoxication Body weight Percentage of body fat Sex Balance of alcohol absorbed and rate of metabolism Genetic factors Drinking Behavior Can not be effected by Exercise Breathing deeply Eating Drinking coffee Taking other drugs Metabolism is the same if the person is awake or asleep
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The Immediate Effects of Alcohol on Health

Dependant on the individual.
Low Concentrations .03% -.05%. Higher Concentrations 0.1% -0.2%. Concentration of .35% and higher. Alcohol hangover Alcohol poisoning Using Alcohol with other drugs

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Drinking and Driving

In 2004 250,000 were injured in alcohol related automobile crashes 42,000 people are killed in alcohol related accidents Dose-response function Driving with a BAC of 0.14% is more than 40 times more likely to be involved in a crash. Greater than 0.14% the risk of fatal crash is estimated to be 380 times higher.
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Figure 10.2 Approximate blood concentration and body weight

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The Effects of Chronic Use

Diseases of the digestive, cardiovascular systems and some cancers Digestive system Liver function liver cell damage and destruction (cirrhosis) Cirrhosis causes drinker to lose Tolerance Pancreas inflammation Cardiovascular system moderate doses may reduce the risk of HD Higher doses elevates BP, may weaken heart muscle or cardiac myopathy. Cancer

Mouth, throat, larynx, and esophagus

Responsible for the most common form of liver cancer

5-6 total drinks

Breast cancer

Hepatitis speeds the growth of this cancer Increase risk when 2-3 drinks per day

Brain Damage

Mortality

Cognitive impairments Memory loss, dementia, and compromised problem-solving Wernicke-Korsakoff syndrome Alcoholics average life expectancy is about 15 years less than non-alcoholics

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The Effects of Alcohol use During Pregnancy

Effects are dose-related. Fetal Alcohol Syndrome (FAS)

Full-blown FAS occurs in up to 15 out of every 10,000 live births in the U.S. Under weight, flat nasal bridge, and long upper lip. Small and have heart defects. Physical and mental growth is slowed. Remain mentally impaired. Fine motor skill problems, coordination, learning and behavioral problems (ADS).

ARND Alcohol-related neurodevelopment disorder. Heavier drinking early in pregnancy.

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Possible Health Benefits of Alcohol

Abstainers and light to moderate drinkers live longer

than heavy users. 35 years old and younger, your odds of dying increase in proportion to the amount consumed Moderate drinking = one drink per day for women and two drinks per day for men.
May lower coronary heart disease. Raising blood levels of HDL.

May lower risks of; diabetes, arterial blockages,

Alzheimers

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Alcohol Abuse and Dependence

Alcohol abuse is recurrent use that has negative

consequences.

Alcohol dependence or Alcoholism more extensive

problems, tolerance and withdrawal Warning signs of alcohol abuse

Drinking alone Using deliberately and repeatedly

Feeling uncomfortable on certain occasions

Escalating consumption
Getting drunk regularly Drinking in the morning or unusual times
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Alcohol Abuse and Dependence

Binge Drinking The National Institute on Alcohol Abuse and Alcoholism defines:

National Survey on Drug Use and Health defines: Having five drinks in row for a man or four in a row for a women within two hours. Frequent binge drinking in college were three to seven

Pattern of alcohol use that brings a persons BAC up to 0.08 or above (typically four drinks for a male or three for a women)within two hours.

times more likely than non-binge drinkers to engage in unplanned or unprotected sex Healthy People 2010

Reduce the rate of binge drinking to 20% among college students

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Table 10-2 The Effects of Binge Drinking on College Students

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Alcoholism
Patterns and Prevalence
Regular daily intake of large amounts 2. Regular heavy drinking limited to weekends 3. Long periods of sobriety interspersed with binges or daily heavy drinking 4. Heavy drinking limited to periods of stress
1.

Health Effects
DTs (delirium tremens)

paranoia

Social and Psychological effects Causes of Alcoholism

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Treatment Programs
Not one program works for everyone. AA.

Al-Anon. Employee Assistance. Inpatient hospital rehabilitation Pharmacological treatments.

12-step program

Disulfiram (Antabuse) Inhibits the metabolic breakdown Naltrexone (ReVia, Depade) Reduces the craving for alcohol and decreases its pleasant effects. Injectable Naltrexone (Vivtrol) single monthly shot Acamprosate (Campral) Acts on brain pathways related to alcohol abuse.
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Gender and Ethnic Differences

Men White American men Other men Women
African Americans Latinos Asian Americans American Indians and Alaska Natives Helping Someone with an Alcohol Problem
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Table 10.4 Users and Abusers of Alcohol in the U.S.: 2007

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Drinking Behavior and Responsibility

Thinking about the environment.
Examine your drinking behavior. CAGE screening test Drink Moderately and responsibly Drink slowly Space your drinks Eat before and while drinking Know your limits and your drinks

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Promote Responsible Drinking In Others

Encourage responsible attitudes
Be a responsible host Hold the drinker responsible Learn about prevention programs Take community action

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Chapter 10