Transcript ALCOHOL

ALCOHOL
Where does it come from?
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
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Standard Drink Chart
SPIRITS
Standard Drinks
• 1oz. (86-100 proof)
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• 8 oz. (1/2 pint)
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• 16 oz. (pint)
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• “Fifth” (4/5 quart)
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• 32 oz. (quart)
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• 1/2 gallon (2 quarts)
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• 1 liter (1 quart )
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• 750 ml (3/4 liter)
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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.)
• 12 oz. (bottle)
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REINFORCED WINE OR CORDIAL
• 2.5 oz.
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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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NSDUH Data
2004
• Lifetime
• Past Year
• Past Month (current)
82.4%
65.1
50.3
• Past Month Binge
• Heavy Usage
22.8%
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Current
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Prevalence of Use
by Age
• Rates of current use were at least ____% for
most age groups in the 21-44 age range
• curvilinear effect
• Find the usage rate for your specific age
bracket at the latest National Survey for Drug
Use and Health:
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?
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Prevalence of Use
by Gender
• As you might guess, current (past month)
alcohol use is typically more prevalent among
males :
56.9% vs. 44% - 2004 data; 2010? ______________
• 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
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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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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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Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
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)
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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)
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Short-term Effects cont.
• Psychological
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• Social/familial Interference
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Short-term Effects cont.
• Cognitive
– memory impairment
– reaction time slows
• Other
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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 singlevehicle fatal crash versus those not drinking
at all
• MV crashes leading cause of death among
youth 15-20
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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
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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
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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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Alcohol’s effects on
aggressive behavior
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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
• Indirect Cause
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THEORIES cont.
• Motives for Drinking
• Predispositional - Situational Factors
– certain types of people are predisposed to act
aggressively…and drinking situations give them an
outlet to do so
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Alcohol and Aggression
Most likely, aggression results from a complex
interplay between
alcohol______________,
alcohol _______,
___________ factors
and
____________ factors
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