Chapter 9 Alcohol

Question 1

What is needed to make alcohol?

Answer 1

Water, sugar, and yeast.

Question 2

How is alcohol made?

Answer 2

• yeast converts the sugar to alcohol through fermentation
• the liquid can be heated and distilled to concentrate the alcohol
• liquid is the filtered, often multiple times, then is stored

Question 3

What are the many forms of alcohol?

Answer 3

• beer and ale (grain and malt based)
• wine and champagne (fruit based)
• distilled wine (wine which is then concentrated)
• fortified wine (wine which has had hard liquor added to it to preserve it)
• hard liquor (seriously distilled)

Question 4

Where does the flavor of alcohol come from?

Answer 4

the flavor of an alcoholic beverage comes from the fruit or grain, the storage containers, any additives, and congeners
- a congener is the by-product of the manufacture process; some are desirable, others are not

Question 5

What leads to alcohol having no flavor?

Answer 5

some distilleries produce “grain-neutral spirits” by fermenting potatoes, corn or other starchy vegetable, distilling it and filtering to the point where there is only alcohol, no flavor. This can then be bottled or flavored.

Question 6

What are the drinking trends?

Answer 6

• more men than women
• younger people more than older
• Caucasians more than other ethnic group (Asians may not be able to metabolize alcohol well)
• educated more than uneducated
• northerners more than southerners
• while it is often assumed that very religious persons don’t use alcohol, that depends on the religion and the time; even Puritans were OK with the use of alcohol

Question 7

Why did alcohol use used to be greater?

Answer 7

Without refrigeration, any sweet liquid would ferment, wand water wasn’t always safe

Question 8

What was the initial focus of the temperance movement?

Answer 8

Limiting alcohol consumption. Beer and wine were okay in moderation, until Eastern European immigrants came along

Saloons gave free lunches and some services’ to drinkers. They came home without money but with plenty of aggression. Women suffragist groups were among early temperance supporters

Question 9

Did prohibition work?

Answer 9

The 18th amendment came into effect in 1920, but enforcement was spotty; there wasn’t universal “buy-in” and commitment of resources.

There were still many ways to acquire alcohol. “Speakeasies” were also places were prostitution and gambling took place. Women were more likely to go to a speakeasy than to a bar.

Organized crime gained traction; Al Capone gained a great deal of power through bootlegging

Question 10

Why was the 18th amendment repealed, and when?

Answer 10

The 18th amendment was repealed in 1933 due to a need for tax income. Alcohol use was reduced but it did not go away; neither did the criminal network for providing alcohol.

Alcohol use has waxed and waned over the years and is at relatively low levels currently.

Question 11

How is alcohol absorbed?

Answer 11

Alcohol is absorbed from the stomach and small intestine. It is much more rapidly absorbed on an empty stomach. Carbonated forms are absorbed more quickly than non-carbonated.

Question 12

What affects the distribution of alcohol?

Answer 12

Alcohol is not distributed well into fatty tissue. Therefore, a 200-lb fat person will have a higher BAL than a 200-lb muscular person.

Alcohol crosses the BBB freely, as well as the placental barrier.

Question 13

How is alcohol metabolized?

Answer 13

Alcohol is metabolized by alcohol dehydrogenase (present in the stomach and liver) into acetaldehyde. Normally, the acetaldehyde is rapidly converted by aldehyde dehydrogenase into acetic acid, which is then converted into CO2 and water, and eliminated.

Question 14

How does acetaldehyde buildup happen and what are the results?

Answer 14

If a person, due to medication or biology, does not manufacture sufficient aldehyde dehydrogenase, they will experience acetaldehyde buildup, which results in nausea, flushing, and headache.

Disulfiram (Antabuse) is designed to produce this reaction in combination with so as to discourage alcohol consumption.

Acetaldehyde is toxic and tissue damage associated with alcoholism is probably related to acetaldehyde exposure as much as to exposure to the alcohol itself.

Question 15

What is the mechanism of action via GABA?

Answer 15

Alcohol at low to moderate doses affects a receptor on the GABA receptor complex. This in turn slightly alters the GABA receptor itself, so that it has higher affinity for GABA.

This means the GABA molecules bind to it for a longer period, and this the CL- channel associated with it allows a greater Cl- influx; more Cl- causes more hyperpolarization. This has the resulting effect of inhibiting the affected neurons.

Question 16

What are other mechanisms of alcohol?

Answer 16

• alcohol inhibits certain glutamate receptors, which can result in cellular tolerance in heavy drinkers. This is thought to explain why alcohol withdrawal can produce seizures
• alcohol can interact indirectly with other drugs that suppress any neuronal actibity
• at higher doses, alcohol affects neuron membranes and slows neuronal impulses
• people with biological predispositions to alcohol may have an opiate system that is less sensitive and this could make alcohol more appealing to them; one treatment for alcoholism is an opiate antagonist, naltrexone

Question 17

What are the doses of alcohol?

Answer 17

• the dose of alcohol is often described in “drinks”
• a drink is 1 ounce of 80-proof alcohol, a 4-ounce glass of 12% alcohol wine, or a 6-ounce glass of 8% beer (or 12-ounce of 4% beer)
• the human body metabolizes alcohol at a constant level of about 0.5 drink/hour, so even if you haven’t drunk for a couple of hours after a binge, your BAC could still be high
• a constant proportion of alcohol is excreted via the breath, so a breathalyzer is really a blood test

Question 18

What is the legal limit in the US for a DUI?

Answer 18

A BAC of.08 (8/10 of 1%). Driving can be impaired below .08, and various industries will set their own limit much lower (for instance, for pilots the FAA sets the limit at .04%)

Question 19

What is the LD50 for alcohol?

Answer 19

Roughly a BAC of .40, but this is extremely variable. A person using certain medication may be in trouble well below this level while a heavy drinker may be walking around at .45. A cases have found people to survive BACs of 1% and above.

People usually pass out before they drink enough to die; otherwise we’d see a lot more deaths.

Question 20

What are the effect of alcohol, from low to increasing doses?

Answer 20

• relaxation, mild euphoria, feeling confident and talkative, reduced anti-diuretic hormone
• volatile mood, lessening of judgement and inhibition, risky behavior, slowing of reflexes, aggression, blackouts
• loss of coordination, gross motor impairment
• loss of consciousness
• death

Question 21

What are the risky behaviors of alcohol use?

Answer 21

When people have been drinking, they are more likely to be aggressive.
- inhibition of aggressive impulses is impaired
- others’ behaviors more likely to be interpreted as aggressively motivated
Drinking is associated with sexual behavior, including risky sexual behavior
- men are more likely to think women are interested in sex if they think the woman has been drinking
- sex is more likely on a date if both people have been drinking
- after drinking, prospective partners are more likely to justify forgoing a condom
- people tend to attribute more blame to a rape victim if they believe they have been drinking

Question 22

What are the long-term effects of alcohol use?

Answer 22

Dependence: presents with shaking or trembling, insomnia, sweating, seizures, hallucinations and delusions (“delirium tremens”); can last several weeks. In serious alcoholics, stopping alcohol completely can cause death.

Liver problems: fatty liver (can recover up to a point) and cirrhosis of the liver (no recovery)

There is an increased cancer risk, especially is alcohol use is paired with smoking. There is the possibility of neurotoxicity and fetal alcohol syndrome.