Alcohol Use_ Misuse_ and Abuse

					  Alcohol Use, Misuse, and Abuse
• Alcohol and your
• Drinking in America
• Impacts of alcohol
• Individual differences
  and alcohol
• Alcoholism
• Ethyl alcohol (ethanol) is found in alcoholic
• One drink:
  – 12 ounces of beer (5% alcohol)
  – 4 ounces of wine (12% alcohol)
  – 2.5 ounces of fortified wine (20% alcohol)
  – 1 ounce of liquor (50% alcohol)
• Proof: 2 x % alcohol
  Blood Alcohol Concentration
• Amount of alcohol in your blood
• Max for driving: 0.08%
• Typically, up to 0.05% feel the good
  effects of alcohol (relaxation,euphoria)
• Above 0.05%, feel bad effects
  – Slurred speech, bad balance, odd emotions
  – At 0.2%, pass out
  – 0.3%, coma is possible
  – 0.4% can be fatal
             Effects on BAC
• How much and how       • Your race
  quickly you drink      • Other drugs
• What you’re drinking   • Family history of
• Your size                alcoholism
• Your gender            • If you’re eating
• Your age               • Expectations
                         • Physical tolerance
• Mild inebriation to loss of consciousness:
  – Slurred speech, poor coordination, unsteady
    gait, abnormal eye movements, impaired
    attention or memory, stupor, coma
• Liver processes up to 0.5 ounce per hour
• Alcohol poisoning:
  – Alcohol depresses nerves that cause
    involuntary reflexes; if they vomit, a person
    can asphyxiate
How to Tell if Someone has Alcohol
• If the person is:
  – Breathing ≤ 12 times per minute or stops
    breathing for 10+ seconds
  – Asleep and you are unable to wake them
• If the person’s skin is cold, clammy, pale,
  and/or bluish in color
• Stay with a person who is vomiting. Keep
  them sitting up or on their side. Watch for
      Lasting Effects of Alcohol
• Black coffee, a cold shower, and ‘sleeping
  it off’ do not work
• Breathing can slow or stop, resulting in
  permanent brain damage
• Seizures, vomiting are possible
• Binge drinking can lead to ingesting a fatal
  dose before unconsciousness
         Drinking in America
• 60% of American adults use alcohol
• White are more likely to be daily users
  than nonwhites
• Median age of onset for use disorders: 20
• Abstinence:
  – 1 in 5 students reports never using alcohol
  – Pregnant women, those taking medications,
    drivers/boaters, etc. shouldn’t drink
            Why people drink
• To relax                   •   Relationship issues
• To heighten their          •   Psychological factors
  sense of masculinity       •   Self-medication
  or femininity              •   Social ease
• Inherited susceptibility   •   Role models
• Childhood traumas          •   Advertising
• Depression
          Moderate Drinking
• No more than 1 drink a day for women, no
  more than 2 for men
• Max of 1.75 ounces of alcohol a day
  (fewer than 15% of daily calories)
  – 3 beers, 2 mixed drinks, 3.5 glasses of wine
• Moderation drinking can lower risk of heart
                      WHAT IS MODERATION?


12 oz. regular beer         5 oz. of wine   1.5 oz. of 80 proof
  (150 calories)           (100 calories)     (100 calories)

                                                     Fig. 12-4b, p. 343
             Binge Drinking
• 5 or more drinks in a single sitting for men,
  4 for women
• Half of alcohol-related deaths and a wide
  range of serious health/social problems
  – Car accidents, injuries from falls, drowning,
    hypothermia, burns, heart attacks, suicide,
    violence to others, unplanned pregnancy, STI
        Drinking and Driving
• Drunk driving is the most frequently
  committed crime in US
• More than 42,000 die each year in alcohol
  related crashes
• Changes in laws means different
        Drinking on Campus
• About 8 in 10 undergraduates drink
• 2 in 5 binge drink
• 18% never use alcohol
• Peer-pressure the top rated reason for
• Binge drinking is the leading cause of
  preventable death among undergrads
  The Toll of College Age Drinking
• Alcohol involved in:
  – 95% of violent crimes on campus
  – 2/3 of student suicides
  – 9 of 10 rapes
Strategies for Preventing Problems
• Designated drivers, eating before/during
  drinking, keeping track of # drinks
  consumed, consuming no more than 1
• Secondhand problems: loss of sleep,
  interruption of studies, assaults,
  vandalism, unwanted sexual advances
• Sexual consent laws often require you be
  sober to be capable of consent
        How to Stay in Control
• Keep a diary              • Drink slowly
• Pace yourself             • Avoid salty snacks
• Stay busy                 • Have 1 drink at a time
• Try low-alcohol           • Be assertive
  alternatives              • Pay attention
• Have alcohol-free         • Don’t leave with a
  days                        stranger
• Start with a soft drink   • Abstain for 48 hours
• Use standard drinks       • Be a responsible host
           Impact of Alcohol
• Quickly and easily absorbed through wall
  of stomach and small intestine
• Most of the alcohol consumed must be
  processed by the liver
  – 95% converted to CO2 and H2O
  – 5% excreted unchanged in urine, breath,
• Alcohol is a diuretic
                                            • Damages and eventually
                                               destroys brain cells
                                            • Impairs memory
                                            • Dulls senses
Immune system                               • Impairs physical
• Lowers resistance to                      coordination

                                            • Weakens heart muscle
                                            • May raise blood
• Damages and eventually
                                            • Causes irregular
  destroys liver cells
• Displaces important
nutrients,resulting in malnutrition
                                            Stomach and
Reproductive system                         intestines
• In women, menstrual cycles                • Causes bleeding
   become irregular; pregnant               and inflammation
   women have an increased risk             • May trigger cancer
   of bearing children with birth defects
• In men, hormone levels may be altered;
   impotence may occur
                                                        Fig. 12-7, p. 351
Impact of Alcohol-Digestive System
• Alcohol reaches stomach fast
  – Partially digested
  – Remainder absorbed through stomach wall
• Alcohol  acids released into stomach
• Alcohol in bloodstream eventually reaches
  – Converts excess alcohol to fat
     Impact of Alcohol-Weight
• 7 calories/gram
• Each drink is typically at least 100 calories
• Must walk one mile to burn off calories
  from 1 glass of wine
• Alcohol stimulates appetite
 Impact of Alcohol-Cardiovascular
• Moderate drinkers have lower mortality
  rates after heart attack (also lower risk of a
  heart attack) than abstainers and heavy
• Moderate drinking:
  – 12 ounces beer, three 4-oz glasses of wine, 2
    shots liquor
  – 3 or more days a week
• Thought to improve cholesterol ratio, anti-
  inflammatory effect
  Impact of Alcohol-Breast Cancer
• Women who have 2 or more drinks/day:
  40% more likely to develop breast cancer
  than nondrinkers
• Even 1 drink/day increases the risk (very
  little, but the risk increases as the alcohol
  consumption increases)
• Alcohol raises estrogen
Impact of Alcohol-Immune System
• Chronic alcohol use can inhibit the
  production of white and red blood cells
• Results: not efficient oxygen delivery to
  tissues, not efficient disese prevention
      Impact of Alcohol-Brain
• Alcohol effects parts of brain that control
  behavior, so little bit makes you feel looser
• Loss of concentration, memory, judgment,
  and fine motor skills
• Moderate amount of alcohol:
  – Impaired perception, dulled smell and taste,
    diminished sensation, altered sense of space,
    impaired motor skills, impaired sexual
Impact of Alcohol-Risk of Death
• 3rd leading cause of death (after tobacco,
  improper diet and lack of exercise)
• Leading alcohol related death: injury
• Alcohol plays a role in ½ of all traffic
  fatalities, ½ of all homicides, ¼ of all
• Moderate drinkers have lower risk of death
  than abstainers for all causes of death
     Fetal Alcohol Syndrome
• 15% of women drink while pregnant
• Fetal alcohol effects: low birth weight,
  irritability as newborns, permanent mental
• One of 7 babies born has FAS:
  – Small head, abnormal facial features, jitters,
    poor muscle tone, sleep disorders, sluggish
    motor development, failure to thrive, short
    stature, delayed speech, mental retardation,
 Impact of Alcohol-Interaction with
           Other Drugs
• Of the 100 most commonly prescribed
  drugs, half have at least one ingredient
  that interacts with alcohol
• Alcohol can drastically increase the effect
  of medications (prescription and OTC)
• Particularly bad to combine alcohol with
  other depressants or anxiety medications
        Alcohol and Gender
• Women absorb 30% more in bloodstream
  (less enzyme to break it down in stomach)
• Men drink more frequently, consume
  larger quantities, and report more alcohol
  related problems
• Alcohol interferes with male sexual
  function and fertility
• In women, alcohol can block the uptake of
           Alcohol Problems
• Use of alcohol in any way that creates
  difficulties, potential difficulties, or health
  risks for an individual
• Alcoholic: cannot stop drinking
• Abuse: continued use despite problems
  – Failure to fulfill major role obligations, use of
    alcohol in physically hazardous situations,
    legal problems, continued use despite social
    or interpersonal problems
           Alcohol Problems
• Dependence: strong cravings that lead to
  tolerance, withdrawal if they stop drinking
  – Tolerance, withdrawal, drinking to avoid
    withdrawal, consuming larger amounts of
    alcohol, persistent desire, spending lots of
    time getting/using alcohol, avoiding normal
         Causes of Alcoholism,
• Genetics
  – Not just one gene
• Stress and traumatic experiences
  – Start drinking as coping mechanism
• Parental alcoholism
  – 4-5 times more likely in children of alcoholics
• Drug abuse
        Medical Complications
•   Liver disease
•   Cardiovascular disease
•   Cancer
•   Brain damage
•   Vitamin deficiency
•   Digestive problems
•   Accidents and injuries
•   Higher mortality
• Detoxification: gradual withdrawal of
  alcohol from body
• Symptoms of withdrawal:
  – Sweating; rapid pulse; elevated BP; hand
    tremor; insomnia; nausea/vomiting; malaise or
    weakness; anxiety; depressed mood or
    irritability; headache; temporary hallucinations
• Heavier drinkers experience worse
• Medications
  – 3 medications reduce cravings
  – Antabuse- makes you sick if you drink
• Inpatient
  – Less than 28 days is the norm
• Outpatient
  – AA is the most successful program
  – Options for less spiritual folks
• Lifelong process
• First 2 years the most difficult
• Treatment programs focus on relapse