Lecture 4: Alcohol Flashcards
(29 cards)
Alcohol use: Early views
Before American Revolution
- People drank more alcohol than water
- Drunkenness was view as misuse of positive product
After American Revolution
- Alcohol itself viewed as the cause of serious problems, an active agent of evil
- Alcohol was first psychoactive substance to become demonized in American culture
Prohibition
States began passing prohibition laws in 1851
- By 1917, 64% of Americans lived in a “dry” territory
- Laws reflected issues of class, ethnicity, religion, immigration, and politics
- People still drank illegally in speakeasies and private clubs and legally through purchase of patent medicines
Federal Prohibition
18th Amendment to the US Constitution, banning the sale of alcohol, was ratified in January 1919
National prohibition went into effect in January 1920
People continued to buy and sell alcohol illegally, and enforcement was challenging and expensive
Organized crime became more organized and profitable
Alcohol dependence and alcohol-related deaths declined
Prohibition Repealed
Concerns that widespread disrespect for Prohibition laws encouraged a general sense of lawlessness
Taxation: Alcohol taxes had been a major source of revenue
Repealed by the 21st Amendement
- Ratified in 1933
Alcohol per capita sales and consumption increased slowly until after WWII, when they returned to pre-Prohibition levels
Regulation and Taxation
Regulation after 1933
- Some states remained dry after national prohibition ended, but most allowed at least beer sales
- Laws were slowly relaxed until the last dry state, Mississippi, became wet in 1966
- Drinking ages were lowered in some states but raised again to 21 following concerns over increased drinking rates and alcohol-related traffic accidents
Taxation
- Federal and state taxes and licensing fees= about half the price of an alcoholic beverage
- When taxes go up, consumption goes down, but not dramatically
Who drinks and why?
Cultural influences on drinking- varying factors
Trends in US alcohol consumption
- Use peaked in 1981, followed by a decline, mirroring patterns of illicit drug use
- Decline particularly significant for distilled spirits
- About one-third of Americans abstain
- Average consumption among drinkers= about 3 drinks per day- but most drink far less
- Half of all alcohol consumed in the US is consumed by about 10% of the drinkers
US Alcohol Consumption
Regional differences in the US
- Stress index: Drinking rates higher in states where people experience a great deal of social stress and tension
- Drinking norms: Drinking rates higher in states where people tend to approve of the use of alcohol to relieve stress
Gender differences
- Men more likely to drink than women, and more likely to drink more
Drinking among college students
- College students drink more than their nonstudent peers
- Many campuses have banned sale and advertising of alcohol, and many fraternities have banned keg parties; Alcohol use and drinking behavior hasn’t changed significantly in response
- Today’s college students are less likely to drink and drive compared to students in the early 1980s
Adults in WI
The prevalence of binge drinking among adults in WI is one of the highest in the US
Alcohol Pharmacology: Absorption
Some absorbed in the stomach, most in the small intestine
Absorption is slower if there is food or water in the stomach
Absorption is faster in the presence of carbonated beverages
Alcohol Pharmacology: Distribution
Blood alcohol concentration (BAC) is a measure of the concentration of alcohol in blood, expressed as a percentage in terms of grams per 100 ml
Alcohol is distributed throughout body fluids
Alcohol is less distributed in fatty tissues, so a lean person will have a lower BAC than a fatter person of the same weight
Alcohol Pharmacology: Metabolism
Liver metabolizes about 0.25 ounces of alcohol per hour
- If rate of intake= rate of metabolism, BAC is stable
- If rate of intake exceeds rate of metabolism, BAC climbs
Blood Alcohol Concentration
The relationship between blood alcohol concentration and alcohol intake
Alcohol metabolism
About 2% of alcohol is excreted unchanged
About 90% is metabolized in the liver
Exercise, coffee, and other strategies do not speed up the rate of metabolism
- Caffeine and alcohol are a dangerous mix
Liver responds to chronic intake of alcohol by increasing enzyme activity
- Contributes to tolerance among heavy users
- Can result in cross-tolerance to other depressants
Behavioral Effects
Blood alcohol concentration determines effects
- At low effective blood levels: Complex and abstract behaviors disrupted
- At higher blood levels: simpler behaviors also affected
BAC% and Behavioral effects
- 05
- Lowered alertness, release of inhibitions, impaired judgment
0.10
Slower reaction times, impaired motor function, less caution
0.15
Large, consistent increases in reaction time
0.20
Marked depression in sensory and motor capability, intoxication
0.25
Severe motor disturbance, staggering, great impairment
0.30
Stuporous but conscious- no comprehension of what’s going on
0.35
Surgical anesthesia; about lethal dose, minimal level causing death
0.40
About lethal dose
Blackouts
Tend to happen when BAC is high, and particularly when BAC rises quickly
Ways to notice
- Less clarity in things that happened earlier
- Someone starts telling the same story again and again
Behavioral effects
Alcohol use serves as a social signal for a time-out from responsibilities, work, and seriousness
Intoxicated individuals focus on the here and now, with little care for future consequences (alcohol myopia)
Behavioral Effects: Sexual behavior
Alcohol use enhances interest in sex but impairs physiological arousal
Linked to unsafe sex
Behavioral Effects: Blackouts
A danger sign of excessive alcohol use
Behavioral Effects: Crime and violence
Alcohol use is statistically related to violence
- Homicide
- Assault, including family violence, sexual assault, and date rape
- Suicide
Acute physiological toxicity
Alcohol overdose (poisoning) is common and dangerous
If someone drinks enough to pass out
- Place them on side and monitor breathing or take to ER immediately
- Do not leave the person alone
If someone drinks enough to vomit
- He or she should stop drinking
- Vomiting reflex indicates a rapidly rising BAC but is suppressed at BACs above 0.20 percent
Hangovers
Symptoms
- Upset stomach
- Fatigue
- Thirst
- Depression
- Anxiety
- General malaise
Possible causes
- Alcohol withdrawal
- Exposure to congeners
- Cellular dehydration
- Gastric irritation
- Reduced blood sugar
- Accumulation of acetaldehyde
Moderate drinking or abstinence are the only ways to avoid a hangover
Differences between the biological sexes
Daily drinking limits
- 1 in a day for women, 2 for men
Weekly Drinking Limits
- 7 for women, 14 for men (?)
- Women need less alcohol to get drunk
- Women experience more harm from alcohol
Women tend to be more susceptible than men to the effects of alcohol after consuming the same amount
- Alcohol dehydrogenase (a stomach enzyme) is more active in men; women absorb a greater proportion of the alcohol they drink
- Women tend to weigh less and have a higher proportion of body fat; “tank” into which alcohol is added is smaller
Alcohol is ~30% more powerful in women than men
Relative to men, women:
- Have a lower % of body water, higher body fat %
- Experience more fluctuation in hormone levels (more absorption during premenstrual period)
- Tend to be lighter than men
Alcohol dependence: Withdrawal syndrome
Abstinence syndrome is medically more severe and more deadly than opioid withdrawal
Abstinence syndrome occurs in stages
- Stage 1: Tremors, rapid heartbeat, hypertension, heavy sweating, loss of appetite, insomnia
- Stage 2: Hallucinations (auditory, visual, and/or tactile)
- Stage 3: Delusions, disorientation, delirium
- Stage 4: Seizures
Initial detoxification should be carried out in an inpatient setting
Sedatives given in stage 1 or 2 prevent stages 3 and 4
Some symptoms can last for up to several weeks
