Lecture 4: alcohol, cocaine and tobacco

Question 1

How long have people been consuming and producing alcohol for?

Answer 1

Since BC ppl have been consuming ethanol and alcohol. People have also been producing alcohol for a long time (fermenting grass)

Question 2

What age group is alcohol consumption relatively common among?

Answer 2

Young people (49% in ages 15-17/18) (83% in ages 17/18-24) (85% from age 25-34)

Question 3

Where does alcohol rank for all age groups In the top 5 substances used in Canada?

Answer 3

Number 1

Question 4

underage drinking in Canada

Answer 4

Youth from grade 7-12, 45% of youths in Canada have consumed alcohol in the past year, they drink less than adults. There is a small decline in this

Question 5

Post-secondary drinking In Canada Based on a convenience sample collected in 2016 from 43,780 students in post secondary institutions

Answer 5

69.3 of students reported any use of alcohol within the last 30 days preceding the survey (70.2 of females and 68.1 of males)
Risky drinking: 35% reported 5 or more drinks in a sitting (38.8 of males and 33.5% of females)
Not representative of all post-secondary students in Canada

Question 6

What is The cost of substance abuse in Canada?

Answer 6

Substance use can impact our healthcare and justice system both directly and indirectly. It indirectly affects productivity, It directly sucks resources from our healthcare system, It directly effects the criminal justice system. (total cost 39.8 billion)
Alcohol (463$ per capita) and tobacco (541$ per capita) are more common because they are legal

Question 7

What was the aim of the study about drug use linked to individual and other harms

Answer 7

Provide better guidance to policy makers in health, policing and social care on the harms that drugs cause

Question 8

What was the method of the study about drug use linked to individual and other harms

Answer 8

People attending ACMD identified 16 harm criteria
9 relate to the harms that a drug produces in the individual and 7 relate to the harms to other locally and internationally. Rated 20 representative drugs on a 0-100 point scale. Participants as a group scored each drug on each harm criterion in an open discussion. Also assessed the relative importance of the criteria within each cluster and across clusters. Alcohol causes more harm to others in comparison to others, it also causes a lot of harm to individuals

Question 9

What is the category “physical harm to the individual” made up of?

Answer 9

Drug specific mortality: How lethal is the drug?
Drug related mortality: engaging in a behaviour that is related to the consumption (drinking and driving)
Drug specific damage: a direct consequence of consuming the drug
Drug related damage

Question 10

What is the category “Psychological harm to the individual Category” made up of?

Answer 10

Dependence, Drug specific impairment of mental functioning: psychosis, Drug related impairment of mental functioning: losing a job

Question 11

What is the category “social harm to the individual” made up of?

Answer 11

Loss of tangibles, Loss of relationships

Question 12

What is the category “Physical and psychological harm to others” made up of

Answer 12

Injury

Question 13

What is the category “social” made up of?

Answer 13

Crime
Environmental damage
Family adversities
International damage (drugs are an international enterprise- smuggling, trafficking)
Economic cost (substance use has a large financial cost on society)
Community

Question 14

What substance use ranks the highest in Canada?

Answer 14

Alcohol use or dependence ranks the highest amongst substance use disorders in canada (18.1% or a third of our population)

Question 15

Why do people consume alcohol?

Answer 15

Positive reinforcement (I.e., to get a high), Negative reinforcement (i.e., depression - to forget painful memories or anxiety) Social (i.e., celebrate), Conformity

Question 16

How do people measure an alcohol problem?

Answer 16

Three subscales in the audit : Hazardous alcohol consumptions (items 1-3), Dependence symptoms (items 4-6), Harmful alcohol use (items 7-10)

Question 17

What is the relationship between Personality factors, alcohol consumption and drinking motives ?

Answer 17

Personality traits —> alcohol consumption (this happens via drinking motives)

Question 18

Study about personality factors, drinking motives and alcohol use severity: Method

Answer 18

Study involving university and high school students (N=550). Big 5 personality traits (Neuroticism, extraversion, agreeableness, conscientiousness and openness to new experiences) Five drinking motives, AUDIT

Question 19

Study about personality factors, drinking motives and alcohol use severity: Results

Answer 19

• Greater conscientiousness was associated with less severe alcohol use via lower enhancement and lower coping-depression motives
• Greater agreeableness was associated with less severe alcohol use via lower enhancement, social, and coping-depression motives
• Greater extraversion was associated with more severe alcohol use via greater social conformity motives
• Greater neuroticism was associated with less (via conformity motive) and more (via coping depression motives) severe alcohol use
• Openness to new experiences was not related to severity of alcohol use via drinking motives

Question 20

Study about personality factors, drinking motives and alcohol use severity: Limitations

Answer 20

• Cross sectional research design
• Did not statistically control for shared variance between the personality traits
• Did not examine interactive effects of personality on drinking motives and severity of alcohol use
• Did not examine interactive effects of drinking motives on severity of alcohol use

Question 21

Alcohol and the brain

Answer 21

Inhibitory neurotransmitters (GABA), are active throughout the brain. They control neural activity (i.e., cell firing). When GABA binds to its receptor on a cell, the cell is less likely to fire. In another area of the brain, another neurotransmitter (glutamate) acts as the brain’s general purpose excitatory neurotransmitter

Question 22

What are the 4 things that happen when alcohol enters the brain?

Answer 22

1) Binds to GABA receptors thus making the inhibitory signal of GABA even stronger
2) Activates opioid receptors that induces release of endorphins 3) The endorphins then bind to receptors on dopaminergic neurons in the reward centers (e.g., NAcc and amygdala) triggering release of DA
4) Alcohol also binds to glutamate receptors thus blocking glutamate from exciting the cell

Question 23

What is tolerance?

Answer 23

With repeated use, there is a decreased response to alcohol and an increased dose is needed to achieve the original response. GABA, glutamate and DA receptors may become less sensitive to alcohol
It is also possible that neurons remove these receptors from the cell wall leaving fewer receptors for binding

Question 24

What happens in the transition to alcohol addiction?

Answer 24

alcohol consumption is now driven largely but not exclusively, by negative reinforcement rather than positive. Neural changes resulting from exposure to high alcohol doses. Once neuroadaptation has occurred, abstaining from alcohol produces symptoms of withdrawal

Question 25

What is neurodegeneration?

Answer 25

Reduction in production of new neurons. Volume of brain areas associated with executive functioning and decision making (PFC). Deficits in PFC impair ability to inhibit impulsive behaviour thereby further contributing to pathological drug seeking behaviour

Question 26

What is withdrawal?

Answer 26

Physiological changes and Delirium tremens

Question 27

What people are at risk of acute alcohol intoxication

Answer 27

Younger and older people are at greater risk

Question 28

What is alcoholic korsakoff syndrome

Answer 28

``` Chronic memory disorder Severe thiamine deficiency in brain due to alcohol consumption Problems learning new information Inability to remember recent events Long term memory gaps ```

Question 29

What are the low risk recommendations for drinking?

Answer 29

Limit setting. Reduce your long-term health risks by drinking no more than: 10 drinks a week for women, with no more than 2 drinks a day most days, 15 drinks a week for men, with no more than 3 drinks a day most days Plan non-drinking days every week to avoid developing a habit

Question 30

When should you abstain from drinking?

Answer 30

-Driving a vehicle or using machinery and tools -Taking medicine or other drugs that interact with alcohol Doing any kind of dangerous physical activity -Living with mental or physical health problems -Living with alcohol dependence -Pregnant or planning to be pregnant -Responsible for the safety of others -Making important decisions Pregnant or breastfeeding

Question 31

Safer drinking tips:

Answer 31

Set limits and stick to them Drink slowly. Have no more than 2 drinks in any 3 hours For every drink of alcohol, have one non-alcoholic drink Eat before and while you are drinking Always consider your age, body weight and that might suggest lower limits