November 1, 2022

The Social Perception of Alcohol Use ?Discussion Topic Why is alcohol perceived as acceptable for social use as well as for relieving stress and anxiety? Why do many people often forg

Discussion- The Social Perception of Alcohol Use

Discussion Topic

Why is alcohol perceived as acceptable for social use as well as for relieving stress and anxiety? Why do many people often forget alcohol’s harmful consequences?

Discussion Requirements:

At least 275 words.

**LO4, LO5**

External Resource: Alcohol and Substance Use

Required Text or E-Book: Drug Use and AbuseISBN-13:978-0-357-37595-2Authors : Stephen Maisto • Mark Galizio • Gerard Connors

Maisto_DrugUse_9e_PPT_CH09-Tagged.pdf

Chapter 9

Alcohol

Icebreaker

• How many of you have ever had anything to drink that contained any alcohol? Please raise your hand.

• Let’s all look at how many hands are raised.

• Okay, thank you. You may put your hands down.

• Now, those of you who have never had anything alcoholic to drink, please raise your hands.

• Now let’s look at how many hands are raised.

• Thank you. You may put your hands down.

• Whether or not you have ever had alcohol, we can all learn some things from this chapter, which will discuss the production, history, use, action, tolerance, dependence, effects, consequences, and disordered use of alcohol. [5 minutes]

Chapter Objectives After studying this chapter, you will be able to…

9-1 Describe the historical and contemporary patterns of alcohol use, including current patterns of alcohol consumption among college students 9-2 Explain the mechanism of action for alcohol 9-3 Describe how alcohol is absorbed, distributed, metabolized, and excreted from the body 9-4 Describe patterns of dispositional and protracted tolerance and physical dependence to alcohol 9-5 Distinguish between the physiological, sensorimotor, and psychological effects of acute alcohol use 9-6 Examine the effects that chronic heavy drinking has on the body and brain functioning 9-7 Differentiate between the traditional and biopsychosocial approaches to the development of alcohol use disorder

Alcoholic Beverages

9.1

Fermentation and Distillation

Three major classes of alcoholic beverages: Beer, wine, and hard liquor or distilled spirits; all depend on processes of fermentation and distillation

• Fermentation: sugar dissolved in water and exposed to air creates perfect environment for living yeast microorganisms • Yeasts eat sugar, multiply rapidly; convert sugar to ethanol and carbon dioxide • CO2 rises to top, leaving ethanol; accumulated ethanol kills yeast cells once it

exceeds c. 1015% alcohol • Grape juice ferments into wine; grains ferment into beer

• Distillation: increases ethanol content of fermented beverages • Alcohol has lower boiling point than water: steam from boiling alcoholic liquid has a

higher alcohol content than the original liquid; cooling condenses the vapor, creating a liquid with higher alcohol content; repetition of this process raises alcohol content progressively

Expressing the Alcohol Content of a Beverage

•In the United States, alcohol content = percentage by volume (16 oz. with 50% alcohol = 8

oz. of alcohol); in England, alcohol content = by weight

•Proof: Used mainly for distilled spirits; = twice the percentage of alcohol by volume: A

beverage that is 43% alcohol by volume = 86 proof

•History: 17th-century England: a mixture 57% alcohol by volume would ignite in an open

flame if poured over gunpowder •The English still refer to beverages as “over proof” or “under proof”

•Brandy, bourbon, whiskeys, tequila, rum, gin, and vodka are all distilled or fermented from

various fruits, vegetables, grains, other plants, or sugars; some are aged or flavored

Knowledge Check 1: Alcoholic Beverages

Question: What is the purpose of distillation in producing alcoholic beverages?

a. Creating a perfect environment for yeast microorganisms

b. Converting sugar to ethanol and CO2, leaving the ethanol

c. Increasing ethanol content in liquids that were fermented

Knowledge Check 1: Answer

Question: What is the purpose of distillation in producing alcoholic beverages?

a. Creating a perfect environment for yeast microorganisms

b. Converting sugar to ethanol and CO2, leaving the ethanol

c. Increasing ethanol content in liquids that were fermented

Answer: c. Increasing ethanol content in liquids that were fermented. Creating a perfect environment for yeast microorganisms and converting sugar to ethanol and CO2, leaving the ethanol, are both purposes of fermentation, which is done before distillation.

History of Alcohol Use

9.2

A Brief History of Alcohol Use (1 of 2)

First nondistilled alcoholic beverages made inadvertently by natural fermentation

• Rice wine c. 7000 B.CE>.in Jiahu region of China—fermented rice, honey, fruit

• First beers thought to be in Egypt, 60005000 B.C.E.

• Some sources suggest humans intentionally made alcoholic drinks as long as 10,000 years ago

• Evidence from Egypt 2000 B.C.E. of blending water and malt

• Distilled spirits last to be produced; earliest reference circa 1000 B.C.E. China • Records of distilled spirits in Western Europe not found until circa 800 A.D.

Positive and negative roles of alcohol in society

• Important in births, religious ceremonies, marriages, and funerals

• Some people have always consumed alcohol in excess, causing problems

Colonial America adopted many drinking customs from Western Europe; drinking was pervasive—led to America’s reputation as a country with excessive alcohol consumption: By 1830, average was almost five drinks a day per adult

Alcohol Blamed for Social Problems, 18th-Century Europe

Eighteenth-century Europeans tended to attribute many of their social problems to alcoholic beverages,

particularly distilled spirits, as depicted in Hogarth’s print Gin Lane.

A Brief History of Alcohol Use (2 of 2)

Dr. Benjamin Rush: An Inquiry into the Effects of Ardent Spirits upon the Human Body and Mind (1785)—supported the 19th-century temperance movement and was the basis for the long controversial idea that alcoholism is a disease

• Nineteenth-century westward expansion: Saloons developed • Saloon behavior revived the temperance movement after the Civil War

• Temperance movement stance changed from moderation to abstinence; industrialists like Rockefeller, Carnegie, and Ford supported this

• World War I: Prohibition, then the Volstead Act • Prohibition repealed in 1933

▶ States still had much discretion in regulating sale and use of alcohol

• General trend since the 1980s: limiting alcohol use through changes in social attitudes, tighter governmental controls • Negative consequences are more apparent than ever, yet alcohol use continues

Knowledge Check 2: History of Alcohol Use

Question: Alcohol consumption in the United States was pervasive during Colonial times, and by 1830, the average amount of pure alcohol consumed had reached almost _____ drinks a day per adult.

a. Three

b. Five

c. Seven

Knowledge Check 2: Answer

Question: Alcohol consumption in the United States was pervasive during Colonial times, and by 1830, the average amount of pure alcohol consumed had reached almost _____ drinks a day per adult.

a. Three

b. Five

c. Seven

Answer: b. Five. By 1830, American per capita alcohol consumption had reached 7 gallons a year. This amount is the equivalent of almost five drinks a day per adult.

Consumption of Alcohol and Heavy Drinking in the United States

9.3

Per Capita Consumption

After Prohibition ended, from 1935 into the 1940s, American alcohol consumption increased; after many years of stable use, it increased from 1965 to 1980; declined in the early 1980s, then slightly increased in the late 1990s

• 1980s1990s decline = Largely due to reduction in use of hard liquor

• 19952006: Wine and hard liquor consumption increased slightly; beer drinking decreased slightly; similar trends with smaller increases for wine and hard liquor were found for 20072009; since 2001= steady increase in per capita consumption of wine, slight increase in distilled beverages

• Averaging masks large variations in American drinking quantities and patterns • Drinking varies according to factors like age, gender, and ethnicity • “Heavy” drinking = associated with negative consequences

• National Survey on Drug Use and Health (2015) defines “heavy” drinking as 5 (men)/4 (women) drinks at least 5 days in past 30 days

Per Capita Consumption of Alcohol in Gallons in the United States, 19352016

Percentages of Individuals in Different Age, Gender, and Racial/Ethnic Groups Who Reported Heavy Alcohol Use in the Past Month, 2015

Gender Age: 1217 1825 >26 Total

Male 1.1 13.6 9.1 8.9

Female 0.7 8.2 3.9 4.2

Race/Ethnicity

White 1.2 14.2 7.3 7.6

Black 0.3 5.7 5.2 4.8

Hispanic 0.7 8.0 4.8 4.8

Total 0.9 10.9 6.4 6.5

Note: “Heavy” alcohol use is five or more drinks per occasion on 5 or more days in the past 30 days. Data are based on the 2015 National Survey on Drug Use and Health conducted by the National Institute on Drug Abuse.

Source: Center for Behavioral Health Statistics and Quality (2016).

Consumption of Alcohol Among College Students (1 of 2)

Many believe there is a campus “culture of alcohol” (NIAAA, 2002, 2008)

• A series of major surveys finds more than half of college students aged 1822 drank

alcohol in the last month; more than a third reported binge drinking

• Binge drinking = BAC 0.08% or higher; 5 (men)/4 (women) drinks in c. 2 hours

• Widespread availability of alcohol and inconsistent enforcement of laws prohibiting

drinking are factors on many college campuses

• Drinking by undergraduate students contributes to over 1,500 student deaths, an

estimated 696,000 assaults, and 97,000 sexual assaults/date rapes each year

Consumption of Alcohol Among College Students (2 of 2)

Students who drink least: Attend religious schools, commuter schools, historically Black

colleges and universities, have discussed risks of alcohol use with parents/guardians

Students who drink most: Freshmen, Whites, fraternity and sorority members, athletes

• Colleges and local governments have increased alcohol prevention efforts in past

several decades: Campus programs; environmental change (decrease availability, raise

prices and taxes, limit sales venues, change sale days and service hours)

• Heavy college drinking does not predict alcohol problems later in life

Drinking in College

Drinking games, such as beer pong, are popular among college students and promote heavy drinking.

Knowledge Check 3: Consumption of Alcohol and Heavy Drinking in the United States

Question: According to data from the National Institutes of Health, when was per capita consumption of alcohol in the United States the highest?

a. Around 1960

b. Around 1970

c. Around 1980

d. Around 1990

e. Around 2000

Knowledge Check 3: Answer

Question: According to data from the National Institutes of Health, when was per capita consumption of alcohol in the United States the highest?

a. Around 1960

b. Around 1970

c. Around 1980

d. Around 1990

e. Around 2000

Answer: c. Around 1980. As shown in Figure 9.1, the highest point in the curve, just below 2.8 gallons, appears circa 1980.

Pharmacology of Alcohol

9.4

Mechanism of Action

Alcohol affects cell membranes, all neurochemical systems, and all endocrine systems

• Alcohol depresses the central nervous system (CNS)

• Alcohol alters cell membrane anatomy, reducing efficiency of conduction of neural impulses, which reduces action potential amplitude reaching the synapse • Neurotransmitter release and transmission of impulses are inhibited

• There is good evidence that alcohol acts on GABA-benzodiazepine receptors

• There is increasing evidence that alcohol enhances serotoninergic and dopaminergic activity

Pharmacokinetics of Alcohol: Absorption

Absorption rates vary widely by individual differences in physiology and situation

• Eating while drinking, and especially drinking milk, slows alcohol absorption

• Faster/slower drinking means faster/slower absorption

• Higher alcohol concentrations are absorbed faster

• Food substances in beer slow its absorption

• Carbonated drinks are absorbed faster than noncarbonated ones

• Time between stopping drinking and peak BAC may range from 30 to 90 minutes

• Pylorospasm: the pylorus, a muscular valve between stomach and intestines, reflexively shuts in some people after they ingest a large amount of alcohol • Causes vomiting—important safeguard: only 1020% of alcohol in the stomach is

absorbed • Natural defense against becoming a very heavy drinker

Pharmacokinetics of Alcohol: Distribution (1 of 2)

Blood is c. 70% water, so gets a higher concentration of alcohol than muscle, bone

• Alcohol freely passes through blood-brain barrier: concentration of alcohol in brain approximates that in the blood

• Standard drink = 0.6 oz. alcohol = 1.5 oz. 80-proof distilled spirits, 12 oz. 5% alcohol beer, or 5 oz. 12% alcohol table wine • The average adult would reach alcohol’s LD 50 after about 25 standard drinks in an hour or

so, though many would die from considerably fewer drinks than this

• One drop (c. 10 mg) alcohol in 1,000 drops (c. 100 ml) blood = BAC of 0.01%

• Legal level for intoxication in District of Columbia, Puerto Rico, Canada, and England = 0.08% • Levels are 0.05% in Finland, 0.02% in Norway and Sweden

• Total body mass is a major factor, as are proportions of muscle and fat; so are individual differences in rates of metabolism

• Approximation formula: Estimated BAC = NSD x (0.025%) – NHD x (0.015%)

Pharmacokinetics of Alcohol: Distribution (2 of 2)

Based on the approximation formula (see previous slide), a 160-lb. man who drinks three 12- oz. regular beers in an hour will have a BAC of c. 0.06%

• BAC rises quickly and then more gradually returns to zero after drinking stops • Time = an important factor in determining BAC, independent of the number of standard

drinks (NSD) because the liver generally metabolizes alcohol at a constant rate over a given time period

• For medical or legal purposes, BAC is estimated as precisely as possible by standardized procedures

• Blood and urine samples • Breath analysis • Gas chromatography • Improved electronic technology has enabled breath-testing devices that yield more

accurate, less expensive estimates of BAC

Conversion Chart for Approximating BAC

Acute Tolerance to Alcohol’s Effects

Pharmacokinetics of Alcohol: Metabolism and Excretion

More than 90% of alcohol absorbed is metabolized by the body, mainly in the liver

• In the liver, the enzyme alcohol dehydrogenase breaks alcohol down to acetaldehyde; acetaldehyde is eventually broken down to CO2 and water • Energy (in calories) released; CO2 excreted through lungs, water in urine • Rate of alcohol metabolism is independent of body’s need for calories • Rate of alcohol oxidation is constant, averages c. 0.35 ounce per hour

• Vigorous exercise and caffeine from drinking black coffee do not hasten removal of alcohol from the body • If you go to bed Saturday at 2 a.m. with a BAC of 0.15%, you will still be legally drunk

3 hours later at 4 a.m. (with a BAC of c. 0.105%), and you will not be alcohol-free until 12 noon

Breath Analysis

Blood alcohol concentration can be measured

by breath analysis, as shown here.

Knowledge Check 4: Pharmacology of Alcohol

Question: If you get legally drunk—i.e., your BAC is 0.08% or higher—what will determine most how long it takes for you to become sober?

a. Exercising vigorously for 15 minutes after you stop drinking

b. Having large amounts of strong black coffee after drinking

c. Eating a good meal with plenty of food after your final drink

d. Waiting for your liver to metabolize all the alcohol you drank

Knowledge Check 4: Answer

Question: If you get legally drunk—i.e., your BAC is 0.08% or higher—what will determine most how long it takes for you to become sober?

a. Exercising vigorously for 15 minutes after you stop drinking

b. Drinking large amounts of strong black coffee after drinking

c. Eating a good meal with plenty of food after your final drink

d. Waiting for your liver to metabolize all the alcohol you drank

Answer: d. Waiting for your liver to metabolize all the alcohol you drank. Vigorous exercise will not increase the metabolism rate. Caffeine may make you feel more awake but will not decrease alcohol intoxication. Though eating while drinking will slow alcohol absorption, eating after drinking will not speed up alcohol metabolism or excretion. However long your liver takes to metabolize the alcohol is the only sure determinant of how long it takes to get sober.

Tolerance and Dependence

9.5

Tolerance

Dispositional tolerance: acquired via regular alcohol use; can be reversed with a period of abstinence from alcohol

Functional tolerance: has a greater practical influence than dispositional tolerance in changing how alcohol affects someone with repeated use

Tolerance to alcohol may be both acute and protracted

• Acute tolerance: Some effects at a given BAC are greater when rising than when descending; but doesn’t matter legally if BAC is >0.08%

• Protracted tolerance: Requires drinking more to achieve same effect as before • Protracted functional tolerance far outpaces dispositional tolerance: a person will drink more

and more just to get the same perceived mood change, but BACs will be higher and higher  vulnerability to toxic effects

• People who regularly drink a lot may not feel drunk or even impaired when legally drunk • Cross-tolerance with other CNS depressant drugs—causes problems with anesthesia

• Cross-dependence with other CNS depressant drugs—valuable in managing withdrawal symptoms (one drug can suppress withdrawal symptoms of another drug)

Physical Dependence (1 of 2)

Chronic heavy drinking can cause individuals to develop physical dependence

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The Social Perception of Alcohol Use ?Discussion Topic Why is alcohol perceived as acceptable for social use as well as for relieving stress and anxiety? Why do many people often forg

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