Alcohol is the most popular psychoactive drug in Western societies. It is categorized as a depressant that is absorbed through the stomach and small intestine and distributed via bloodstream. Alcohol is metabolized in the liver, though a small percentage is not broken down. Blood alcohol concentration depends on factors like weight, drinking rate, and genetics. Acute effects include impaired judgment and motor skills, while long-term heavy use can damage major organs and increase cancer risks. Treatment programs aim to address alcohol abuse and dependence.

1. Chapter 10
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2. Alcoholic Beverages
 Alcohol is the most popular psychoactive drug in the Western world
 Categorized as a depressant
 Ethyl alcohol – only alcohol that can be consumed
 Beer 3-6% alcohol by volume
 Ales and malt liquors 6-8% alcohol by volume
 Table wines 9-14% alcohol by volume
 Fermenting
 Fortified wines 20% alcohol by volume
 Sugar added
 Extra alcohol is added
 Hard liquors 35-50% alcohol by volume (or stronger)
 Distilling brewed or fermented grains or other plant products
 Proof value
 Two times the alcohol percentage concentration
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3. Standard Drinks and Calories
 One drink = standard drink
 One drink typically contains 0.6 ounces of alcohol
 Caloric content
 7 calories per gram
 One drink (14-17 grams) has about 100-120 calories
 Also contains carbohydrates
 One beer about 150 calories
 “Light” in light beer refers to calories (about 100)
 5-ounce glass of red wine has 100 calories
 5-ounce glass of white wine has 96 calories
 3-ounce margarita has 157 calories
 6-ounce Cosmopolitan has 143 calories
 6-ounce rum and Coke has 180 calories
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4. Table 10.1 Serving Sizes Versus Standard Drinks
of Common Alcoholic Beverages
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5. Absorption
 20% is rapidly absorbed from the stomach
 75% is absorbed in the upper small intestines
 Any remaining is absorbed along the GI track
 Absorption is affected by what is in the drink
 Carbonation increases the rate of absorption
 Artificial sweeteners (in drink mixers) increase the
absorption
 Food in the stomach slows the absorption
 Drink of high concentration slows absorption
 Eventually all the alcohol ingested will be absorbed
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6. Metabolism and Excretion
 Transported throughout the body via the
bloodstream
 Easily moves through most biological membranes
 Main site for metabolism is the liver
 About 2-10% of ingested alcohol is not metabolized
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7. Alcohol Intake and
Blood Alcohol Concentration (BAC)
 Blood alcohol concentration (BAC)
 The amount of alcohol in a person’s blood; a measure of intoxication
 Body weight
 Percentage of body fat
 Sex
 Balance of alcohol absorbed and rate of metabolism
 Genetic factors
 Drinking behavior
 Can not be influenced by:
 Exercise
 Breathing deeply
 Eating
 Drinking coffee
 Taking other drugs
 Metabolism is the same if the person is awake or asleep
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8. Figure 10.2 Approximate Blood Alcohol
Concentration and Body Weight
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9. The Immediate Effects
of Alcohol on Health
 Depends on the individual
 Low concentrations 0.03%-0.05%
 Higher Concentrations 0.1%-0.2%
 Concentration of .35% and higher can be fatal
 Alcohol hangover
 Alcohol poisoning
 Using alcohol with other drugs
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10. Alcohol and Impaired Judgment
 Alcohol-related injuries and violence
• Homicide
• Suicide
• Automobile crashes
• Hostility
 Alcohol and aggression
 Antisocial personality disorder
 Leads to arrest
 Impairs home life
 Alcohol and sexual decision making
 More likely to engage in unsafe sex
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11. Drinking and Driving
 In 2008,
 275,000 people were injured in alcohol
related automobile crashes
 11,773 people were killed in alcohol related
accidents
 Dose-response function
• Driving with a BAC of 0.14% is over 40
times more likely to be involved in a crash
• Greater than 0.14%, the risk of fatal crash
is estimated to be 380 times higher
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12. Figure 10.3 The Dose-Response Relationship
Between BAC and Automobile Crashes
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13. 
The Effects of Chronic Use
Diseases of the digestive, cardiovascular systems, and some cancers
 Digestive system
 Liver function
 Liver cell damage and destruction (cirrhosis)
 Cirrhosis causes drinker to lose tolerance
 Pancreas inflammation
 Cardiovascular system
 Moderate doses may reduce the risk of heart disease
 Higher doses elevates blood pressure, may weaken heart muscle or cardiac myopathy
 Cancer
 Mouth, throat, larynx, and esophagus
 5-6 total drinks daily
 Responsible for the most common form of liver cancer
 Hepatitis speeds the growth of this cancer
 Breast cancer
 Increase risk with 2-3 drinks per day
 Brain damage
 Cognitive impairments and brain shrinkage
 Memory loss, dementia, and compromised problem-solving
 Mortality
 Alcoholics’ average life expectancy is about 15 years less than non-alcoholics
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14. Figure 10.4 The Immediate and Long-Term Effects of Alcohol Abuse
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15. The Effects of Alcohol
Use During Pregnancy
 Effects are dose-related
 Fetal alcohol syndrome (FAS)
 Full-blown FAS occurs in up to 15 out of every 10,000 live
births in the U.S.
 Alcohol-related neurodevelopment disorder (ARND)
 Negative effects on the baby’s brain development
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16. Possible Health Benefits of Alcohol
 Abstainers and light to moderate drinkers live longer
than do heavy drinkers
 35 years old and younger, your odds of dying
increase in proportion to the amount consumed
 Moderate drinking = one drink per day for women
and two drinks per day for men
 May lower coronary heart disease
 Raises blood levels of HDL, reduces blood clots
 May lower risks of diabetes, arterial blockages, Alzheimer’s
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17. Alcohol Abuse and Dependence
 Statistics on American alcohol usage
• 60% ages 18 or older routinely drink alcohol
• 15% are former drinkers
• 25% are lifetime abstainers
• 7% are classified as heavy alcohol users
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18. Abuse Versus Dependence
 Alcohol abuse is recurrent use that has negative
consequences
 Alcohol dependence (alcoholism) involves more extensive
problems, tolerance, and withdrawal
 Warning signs of alcohol abuse
 Drinking alone or secretively
 Using deliberately and repeatedly
 Self-medicating
 Feeling uncomfortable on certain occasions when no alcohol
 Escalating consumption
 Consuming alcohol heavily in risky situations (before driving)
 Getting drunk regularly
 Drinking in the morning or at unusual times
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19. Binge Drinking
 The National Institute on Alcohol Abuse and Alcoholism
defines:
 Pattern of alcohol use that brings a person’s BAC up to 0.08 or
above (typically four drinks for a male or three for a woman)
within two hours
 National Survey on Drug Use and Health defines:
 Having five drinks in a row for a man or four in a row for a
woman within two hours
 About 75% of the alcohol consumed by adults in the U.S.
meets the definition of binge drinking
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20. Table 10.2 The Effects of Binge
Drinking on College Students
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21. Alcoholism
 Patterns and prevalence
1. Regular daily intake of large amounts
2. Regular heavy drinking limited to weekends
3. Long periods of sobriety interspersed with binges or daily
heavy drinking lasting for weeks or months
4. Heavy drinking limited to periods of stress
 Health Effects
 Delirium tremens (the DTs)
 Blackouts and other memory problems
 Social and psychological effects
 Causes of alcoholism
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22. Treatment Programs
 Different programs work for different people
 Alcoholics Anonymous (AA)
 12-step program
 Al-Anon, Rationale Recovery, Women for Sobriety
 Employee assistance and school-based programs
 Inpatient hospital rehabilitation
 Pharmacological treatments.
 Disulfiram (Antabuse)
 Inhibits the metabolic breakdown; feel ill
 Naltrexone (ReVia, Depade)
 Reduces the craving for alcohol and
decreases its pleasant effects
 Injectable naltrexone (Vivtrol) – single monthly shot
 Acamprosate (Campral)
 Acts on brain pathways related to alcohol abuse
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23. Gender and Ethnic Differences
 Men
 White American men
 Non-white men
 Women
 African Americans
 Latinos
 Asian Americans
 American Indians and Alaska Natives
 Helping someone with an alcohol problem
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24. Table 10.3 Users and Abusers of
Alcohol in the U.S.: 2008
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25. Drinking Behavior and
Responsibility
 Examine your drinking behavior
 CAGE screening test
 Drink moderately and responsibly
 Drink slowly
 Space your drinks
 Eat before and while drinking
 Know your limits and your drinks
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26. Promote Responsible Drinking
in Others
 Encourage responsible attitudes
 Be a responsible host
 Hold the drinker responsible
 Take community action
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27. Develop Responsible
Drinking Habits
 Keep a record of your behavior in a health journal
 Analyze your record
 Set goals
 Devise a plan
 Monitor your progress
 Reward yourself
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28. Chapter 10
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