alcohol where does it come from? 2 3 4 history of use? beer dates back to at least the egyptians...
TRANSCRIPT
ALCOHOL
Where does it come from?
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History of Use?
• beer dates back to at least the Egyptians 5000-6000 BC, probably further
• wines date back a few thousand years
• distilled spirits “younger”; in China about 1000 BC but in Arabia/Europe around 800 AD
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Prevalence of Use
• Almost everyone will have at least sipped alcohol in the course of their lifetime; 1 in 4 lifetime abstainers
• Consumption per person actually highest in the mid-1800s• Since 1935 consumption has generally increased, peaking
in the early 80s• In 2001, per capita alcohol ingestion was about 2.2 gallons
• http://www.health.gov/dietaryguidelines/dga2005/report/HTML/D8_Ethanol.htm#top
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Standard Drink Chart
SPIRITS Standard Drinks• 1oz. (86-100 proof) 1• 8 oz. (1/2 pint) 8• 16 oz. (pint) 16• “Fifth” (4/5 quart) 26• 32 oz. (quart) 32• 1/2 gallon (2 quarts) 64• 1 liter (1 quart ) 32• 750 ml (3/4 liter) 24
BEER Standard Drinks• 12 oz (5% alc by vol.) 1• 16 oz. (pint) 1.33• 32 oz. (quart) 2.67
WINE• 4 oz. (12% alc by vol.) 1• 12 oz. (bottle) 3
REINFORCED WINE OR CORDIAL• 2.5 oz. 1
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Prevalence of Use
• From my first visit to a major brewery, I learned a lot: – 250, 000 cases of beer are shipped out of
Anheiser Busch in St. Louis daily, to just the midwestern states
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NHSDA Data
2004
• Lifetime 82.4%
• Past Year 65.1
• Past Month (current) 50.3
• Past Month Binge 22.8%
• Heavy Usage 6.6
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Prevalence of Use by Age
• Rates of current use were at least 60% for most age groups in the 21-44 age range
• curvilinear effect
• Find the usage rate for your specific age bracket at: (Fig. 3.1)
http://www.oas.samhsa.gov/nhsda.htm
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Prevalence of Use by Race/Ethnicity
• Whites continue to have highest rate of use
• Heavy use among groups about the same??– Si o no?
• See figure 3.3 from NSDUH
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Prevalence of Use by Gender
• As you might guess, current (past month) alcohol use is more prevalent among males :
(56.9% vs. 44% - 2004 data)
• Men were much more likely to be binge and be “heavy” drinkers
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Prevalence of Use by Education
• In contrast to drug abuse patterns, the more education a person has, the more likely they reported current drinking
• 66% of college grads vs. 39% of those having less than high school education
• Heavy drinking more common among those without high school education (6.8 vs 3.7)
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Figure 3.4 Heavy Alcohol Use among Adults Aged 18 to 22, by College Enrollment: 2002-2006
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College binge drinking
Harvard Study:
• 43% binged in prior 2 weeks (48% men; 39% women)
• about 65% of the members of frats/sor. Binged
• Reasons for drinking1993 1997
• “get drunk” 39% 52%
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Alcohol’s Pharmacology
• It is a CNS depressant
• Peak concentrations are reached between 30-90 minutes after drinking is stopped
• Alcohol is distributed to all tissues in the body and passes to the brain easily
• LD 50 is 25 drinks in 1 hour; BAC of .45 - .55 (BAC is expressed as a ratio of milligrams or weight of alcohol per 100 milliliters - about 3 ounces of blood)
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Relationship Between Blood Alcohol and Alcohol Intake
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most of the consumed alcohol metabolized in liver
broken down to acetaldehyde (by ADH - alcohol dehydrogenase and then to acetic acid by aldehyde dehy.)
carbon dioxide and water
excreted by lungs excreted in urine
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Addiction and Withdrawal Indicators
• Is it Addictive? How do we know?
– Tolerance (cellular & metabolic) develops
– Withdrawal symptoms occur• BAC can still be above .00 for withdrawal sx to begin
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Withdrawal Indicators• Stoppage (or reduction in) etoh use that has been
heavy and prolonged• Symptoms developing within hours to a few days
may include: (need at least 2 for DSM criteria)
– autonomic hyperactivity (sweating or pulse rate > than 100)
– increased hand tremor
– insomnia
– nausea or vomiting
– transient visual, tactile, or auditory hallucinations or illusions
– psychomotor agitation
– anxiety
– grand mal seizures
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CONSEQUENCES
What are some positive and negative effects?
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Short-term Effects
• Physiological– urination, increased gastric secretion stimulating
appetite at low or moderate doses– disruption of sleep; suppresses REM throughout
night at high doses– hangover (although no alcohol in body, driving
ability may still be impaired)– body sway– may experience a decrease in pain sensitivity, and
in vision-taste senses
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Short-term Effects cont.
• Psychological– mood enhancer at lower doses– mood state prior to drinking critical– emotional lability and aggression by some at higher
doses
• Social/familial Interference– but may facilitate emotional expression and be the
only time that this happens; drinking subcultures
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Short-term Effects cont.
• Cognitive– memory impairment– reaction time slows
• Other– Drunk driving– Suicide– Sexual assualt , esp. acquaintance rape– High risk sex
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Drinking and Driving
• The many skills involved in driving are not all impaired at the same BAC– Ability to divide attention between 2 or more
sources of visual stimuli impaired at .02– Impairments occur consistently at .05 or more:
• eye movements• glare resistance• depth perception
• reaction time• information processing• some steering tasks
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Drinking and Driving
• Drivers with BACs of .15 or greater have about 380 times the risk of being in a single-vehicle fatal crash versus those not drinking at all
• MV crashes leading cause of death among youth 15-20
• E.g. In 1994 about 7,800 16-20 year-olds were drivers in fatal crashes; 23% of these had positive BACs
– Inexperience in driving, in drinking, and in combining the two activities is often fatal
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Long-term Consequences:
• 60% of males & 30% of females have had at least one negative alcohol-related incident
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Long-term Consequences cont.
• Physical:– fatty liver, alcohol hepatitis, and cirrhosis– increased risk of CAD and various types of
cancers– increased susceptibility to illness; lower immune
system functioning– GI problems such as pancreatitis– FAS: small eyes, droopy eyelids, small head, low
intellectual functioning; associated with low SES
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(a) Normal Liver (b) Cirrhotic LiverFigure 11-4
11-6
a.
b.
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Long-term Consequences cont.
• Cognitive:– impairs memory, problem-solving, learning and
reaction time– neuropsychological damage can be reversed with
prolonged abstinence– Wernicke-Korsakoff Syndrome
• unable to learn new material due to failure to transfer
• confabulation
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Long-term Consequences cont.
• Social and family consequences:– Sometimes its helpful to look not only at what has
directly happened due to long-term alcohol abuse, but what the drinker and family missed out on
• Psychological consequences:
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College binge drinking
Harvard Study:
• 43% binged in prior 2 weeks (48% men; 39% women)
• about 65% of the members of frats/sor. Binged
• Reasons for drinking1993 1997
• “get drunk” 39% 52%
• Now
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Alcohol’s effects onaggressive behavior
• Associated with:– domestic violence– child abuse– murder– common assaults– suicide (in one study of 3,400, 35% had been
drinking)
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THEORIES:
• Alcohol as a Direct Cause of Aggression– alcohol as a disinhibitor of those brain functions
that normally prevent aggression– alcohol “paralyzes the brakes, does not step on the
gas”
• Indirect Cause– alcohol causes physical, emotional and cognitive
changes that make aggression more likely• e.g. Cognitive: perceive risk where there is none
• e.g. Physical: increases arousal levels
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THEORIES cont.• Motives for Drinking
– people drink for some main reason, maybe to reduce anxiety or increase their feeling of power
• EX. men drink to feel stronger
• Predispositional - Situational Factors– certain types of people are predisposed to act
aggressively…and drinking situations give them an outlet to do so
– those who expect alcohol to increase aggression act aggressively…“blame the bottle”
– drinking situations may be seen as culturally agreed on time-outs
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Alcohol and Aggression
Most likely, aggression results from a complex interplay between
alcohol expectancy,
alcohol dose,
personal factors
and
situational factors