Alcohol Flashcards
3 most common psychoactive drugs
- Alcohol- has the longest history by far
- Nicotine
- Caffeine
Impact of alcohol on society and culture
There have been times in history where the water was toxic, so it was necessary to drink alcohol. Alcohol was a major part of religions, births, marriages, funerals. In some cultures, it was part of the truce process after war- truce wasn’t official until everyone got drunk afterwards
3 forms of alcohol
Wine, beer, hard liquor- depends on the process of fermentation
Fermentation
A chemical reaction where sugar (glucose) is dissolved in water and exposed to air. This creates an environment for living microorganisms (yeasts). Yeast produces byproducts, like alcohol and carbon dioxide (released into the air). As yeasts grow, so does the percentage of alcohol
Distillation
Most fermented beverages do not exceed 15% alcohol content, so distillation is used to increase the alcohol content in a beverage. Hard liquor also requires distillation. Alcohol has a lower boiling point than water, so it is heated in a distillation apparatus until it evaporates from the solution. It is cooled back to liquid in a condenser, so the receiving flask of the apparatus will contain pure alcohol
Alcohol contents of a beverage
In the US, contents of a beverage are denoted by volume. For example, a 16 oz beverage containing 50% alcohol contains 8 oz of alcohol
Proof
A term typically used for distilled spirits. It equals 2x the percentage of alcohol/volume. For example, 90 proof vodka/2= 45% alcohol
Origin of the term “proof”
The term originated in England. When 57% alcohol/volume is poured over gunpowder, it ignites an open flame. The English refer to alcohol as “over proof” (greater than 57%) or “under proof” (less than 57%).
How long have humans been using alcohol?
Humans have used alcohol for thousands of years. The first wines were probably made from fruit juice, and the first beers are thought to have been produced in Egypt 5000-6000 years ago. The earliest reference to distilled spirits was in China, one thousand years ago
Devastating impacts of alcohol
Alcohol is consumed in excess by many. It makes domestic violence more likely and can cause death
Alcohol in colonial America
Puritans viewed drunkenness as sin, yet they had no problems with the consumption of alcohol as long as the person didn’t get drunk. The tavern was the center of town, in addition to the church. It was the location for discussing- politics, business, trade, gossip and pleasure, and male comradery. The drinker’s dictionary (1737) by Ben Franklin
included more than 235 terms for a drunk person
History of alcohol consumption in the US
By 1790, the average adult citizen in the US drank 6 gallons of alcohol per capita, per year. By 1830, it increased to 7 gallons, which is 5 drinks per day per adult. People started to become aware of problems associated with drinking, especially as society started to become more urban and industrial. The Temperance movement started to gain strength- at this point, they were looking at reduction or reasonable consumption rather than total abstinence
The impact of saloons on culture
As we moved west due to manifest destiny, men began gathering in saloons to drink. Saloons were generally associated with aggressive men with no home or no family connections, like trappers, settlers, or cowboys. Consumption of large quantities of whiskey was associated with manliness at the time, but it was also associated with thievery, gambling, prostitution, and political corruption. Men generally vastly outnumbered women in these towns, and saloons became centers for toxic masculine behavior. The saloon was where a lot of old western ideas came from. For these reasons, saloons led to the emergence of the temperance movement with more fervor- now they advocated for full abstinence from all alcohol
Prohibition
Occurred from 1920-1933. Prohibition was directly responsible for the rise of organized crime in the US- people were secretly importing and consuming alcohol, and most people drank illegally. Once repealed, many different state laws emerged to restrict alcohol. In Indiana, blue laws sales are illegal on Sundays. In Alabama, beer must be sold at room temperature. In Hawaii, you can’t order more than 1 drink at a time. In Illinois, happy hours are illegal
Which decades saw drastic increases in drinking?
There was a small increase in drinking 1933-1940, and a considerable increase in drinking from 1960-70. Gen X (born 1965-80) and older millennials who were adolescents/young adults in the 80s and 90s tended to be heavy drinkers. This age group were more likely to be allowed to drink small sips of alcohol when they were young, and they watched their parents drink a lot. There was a college culture (culture of alcohol) during this time period. Currently- 9% of adults aged 35-44 (includes elder millennials) continue to drink even though it has negatively impacted their life
Alcohol sites of action
Alcohol is a CNS depressant. It alters the cell membranes’ anatomy by entering their internal structure, resulting in reduced efficiency of the conduction of neural impulses along the axons. Neurotransmitter release is also inhibited, so impulses are not transferred across the synapse.
Which neurotransmitters does alcohol act on?
Alcohol appears to work on GABA by acting on benzodiazepine receptors. It is a GABA agonist and binds to GABA receptors by acting like GABA, dampening the activity of the CNS. There is also evidence that alcohol enhances serotonergic and dopaminergic activity
Absorption of alcohol
Usually absorbed from the stomach and small intestine, and can also be absorbed as vapor. Alcohol may be absorbed through the skin (but you need a lot of it) and mucous membranes. This can be dangerous because it bypasses the liver and other protective mechanisms
Absorption of alcohol can be influenced by (4)
- Food- did the person eat beforehand
- Rate of drinking
- Concentration of alcohol- like on the rocks vs “neat”.
- Carbonated beverages are absorbed faster than noncarbonated
What does a breathalyzer analyze?
Analyzes the concentration of alcohol in the blood
Pylorospasm
The shutting of the pylorus (valve between stomach and intestines) which occurs when large quantities of alcohol have been consumed. Only about 10-20% of alcohol is absorbed in the stomach, so pylorospam slows absorption by preventing alcohol from reaching the small intestine (main site of absorption)
Distribution of alcohol in the body
After absorption, the blood distributes alcohol to all of the body’s tissues. A variety of factors influence distribution. Someone with a higher fat content will absorb more alcohol than a thinner person. Also, tissues with lots of blood have higher concentrations of alcohol. Because alcohol passes through the blood brain barrier, the concentration of alcohol in the brain is approximately the same as the blood
Blood alcohol concentration (BAC)
BAC is the percentage of weight of alcohol/100 units of blood volume, or Mg of alcohol/ 100 ml of blood. The legal BAC in the US is .08 (8% of the blood). If a healthy 160 lbs. man consumes 1 standard drink, BAC rises .02% within 45-60 minutes. Behavioral tolerance does not impact BAC, just the perception of how drunk a person is.
What is the lethal/toxic BAC?
The lethal/toxic dose for most people: BAC is .45-.5 (very high)
Which body composition factors impact BAC?
- Amount of muscle mass influences BAC (along with other factors)
- Alcohol is water soluble and fat contains a lot of water. Therefore, more fat= higher BAC (1 drink results in lower BAC for a leaner person)
Alcohol shows cross tolerance with
Alcohol shows cross tolerance and sometimes cross dependence with benzodiazepines because the act on the same receptors (GABA receptors). Alcohol and benzodiazepines like Valium show cross tolerance and cross dependence. You can stave off the effects of withdrawal from one drug by taking the other (like taking valium to stave off the effects of alcohol withdrawal)
How quickly does tolerance for alcohol develop?
Tolerance increases relatively quickly with regular drinking, and decreases relatively quickly after periods of abstinence. Functional tolerance is better as alcohol is working its way out of your system- you can better compensate for the behavioral changes caused by alcohol
Does tolerance impact BAC?
BAC is the same regardless of tolerance- this can put you at risk of an overdose. Therefore, chronic drinkers may not feel drunk, but will blow well over .08%. A drink generally won’t be subjectively felt for around 45 minutes, and people will often have consumed multiple drinks by then, increasing their BAC before they feel any effects at all
Alcohol withdrawal
Physical dependence occurs with chronic drinking. There are 3 main stages of withdrawal, and the end of withdrawal occurs 5-7 after stopping consuming alcohol. At this time, people can experience exhaustion and severe dehydration. Withdrawal can sometimes be dangerous and should be done under medical supervision
Stage 1 of alcohol withdrawal (3)
This begins begins as soon as a few hours after drinking.
1. Shakes, sweating, weakness, agitation, headache, nausea and vomiting
2. High heart rate
3. Intense visual, auditory, or tactile hallucinations
Stage 2 of alcohol withdrawal
Occurs within 24 hours of cessation. People can experience grand mal seizures, which range from 1 severe seizure to several in a row
Stage 3 of alcohol withdrawal (4)
Occurs after 30 hours (may last 3-4 days)
1. Agitation and confusion
2. High body temperature, rapid heart rate, terrifying hallucinations (visual, auditory, tactile)
3. Delusions- with potential for violence, people can be paranoid and may be physically aggressive.
4. Deaths during this stage occur due to cardiovascular collapse
Delusions definition
A belief the person won’t let go of despite being presented with contradictory evidence
Physiological effects of alcohol at low doses (6)
- Inhibits secretion of antidiuretic hormone
- Reduces the amount of body fat that is oxidized- this can cause weight gain over time (“beer gut”)
- Peripheral dilator- can cause red appearance and rapid loss of body heat
- Disrupted sleep- can suppress REM
- Impairs memory- blackouts
- Hangovers
Inhibition of ADH secretion
ADH is needed to produce urine and makes your body conserve water by reducing the amount of water excreted in urine. Inhibition of ADH results in the need to urinate more frequently. This is more likely in the acquisition stage where people are still building up their BAC
Hangovers
Occurs 4-12 hours after peak alcohol. Symptoms include nausea, headache, dizziness, and thirst. Hair of the dog- having a drink during a hangover can often alleviate the symptoms
Korsakoff syndrome
A type of dementia resulting from vitamin B1 deficiency and is associated with chronic drinking. This disorder is generally only due to a lifetime of alcoholism. Patients exhibit damage to brain structures- abnormalities in diencephalon
Symptoms of Korsakoff syndrome (4)
- Confusion
- Loss of memory
- Staggering gait
- Confabulation (fabrication of events)
