335 flashcards 2

• Source of alcohol


  Fermentation

  -Sugar is dissolved in water and left exposed to the air

  -Yeasts

  -Ethanol and Carbon Dioxide

  -10-15%

  
  

  Distillation

  -40-50%

  -Alcohol lower boiling point vs water
• Measurement of Alcohol Content

  In the United States, a proof spirit (100 proof) is one containing 50 percent alcohol by volume

  -80 proof vodka would be 40% Alcohol

  
  

  Thus, the U.S. proof number is twice the percentage of alcohol by volume.

  
  

  Typically, the proof is printed on the label.
• Origin and history of alcohol


  Use from before recorded history

  
  

  Most cultures drink alcohol regularly

  
  

  The first alcohol that humans consumed was probably in the form of fermented honey or fruit.

  
  

  Deliberate fermentation probably began with the development of agriculture.

  
  

  Grapevine (around 6000 B.C.).
• History


  Egyptian Book of the Dead (about 3000 B.C.) - beer

  
  

  Distillation - China 3000B.C.

  
  

  Greeks and Romans (lead poisoning)

  
  

  Distillation revealed 1200s
• Early British and American Experience

  Usquebaugh = whiskey (1500s)

  
  

  An Inquiry into the Effects of Ardent Spirits (1785)
• American Prohibition


  Temperance Movement

  
  

  Eighteenth Amendment (1917) — Prohibition Enacted

  
  

  Twenty-First Amendment (1933) — Prohibition Repealed

  
  

  Prohibition in 1917

  -consumption dropped

  
  

  After prohibition ended in 1933 rates went back up
• Yearly Alcohol Consumption


  Current U.S. Levels Peaked in 1979
• Blood Alcohol Level (BAL)


  Concentration of alcohol in whole blood
• Metric Measurements and Percent

  BAL = milligrams (mg) of alcohol per 100 milliliters (ml) of blood

  
  

  Conversion = moving the decimal point three places

  
  

  BAL of 80 mg per 100 ml (or 80 mg/dl) is the same as 0.08 percent
• Absorption of alcohol


  Orally - absorption in digestive tract

  
  

  First pass metabolism in stomach (get in blood stream this way)

  
  

  Faster on empty stomach - direct to small intestine
• Gender difference in first pass metabolism

  Females - less alcohol dehydrogenase (takes longer to break down alcohol)

  
  

  Distinct sex differences

  
  

  Binge drinking is 4 or 5 for female and 5 or 6 for male
• Concentration contributes to speed of absorption

  40% most rapid

  
  

  Higher slows stomach and interferes with absorption

  
  

  Only lower or higher its slower
• Inhalation of alcohol


  AWOL (Alcohol Without Liquid)

  -Vaporizes liquor

  -Absorbed in lungs

  
  

  Likely to cause higher BALs

  -Hits you right away

  -Don't have to wait for it to metabolize

  
  

  Banned?
• Distribution of alcohol


  Depending upon proportional body fat

  - More fat = Less water/ dilution and greater BAL

  
  

  Gender

  -Because women have less water in body, alcohol is less diluted so higher alcohol %

  
  

  Age

  -Older metabolize it less effectively (get drunker on less)

  
  

  Distributed throughout body

  -Crosses blood-brain & placental barrier

  -Excreted from lungs at known rate (why we can use breathalyzer)
• Excretion of alcohol


  Small percentage eliminated

  
  

  Breath, Sweat, Tears, Urine, and Feces

  
  

  90% metabolized by the liver
• Metabolism of Alcohol


  Rate-limiting step (1st step) - dependent on alcohol dehydrogenase

  
  

  Acetaldehyde: intermediate byproduct that occurs early in the breakdown

  
  

  Converted into acetyl-coenzyme (2nd step)

  
  

  Turned into energy, water & carbon dioxide
• Individual differences with alcohol


  Drinking experience and food can affect metabolism

  -Drinking experience: get more alcohol dehydrogenase to break down your alcohol the more frequently you drink

  
  

  Microsomal ethanol-oxidizing system (MEOS):

  - Alternate pathway of ethanol metabolism that occurs in the smooth endoplasmic reticulum in the oxidation of ethanol to acetaldehyde.

  - While playing only a minor role in ethanol metabolism in average individuals, MEOS activity increases after chronic alcohol consumption

  
  

  Alternate metabolizing system - Hyperactive among heavy drinkers

  
  

  Barbiturates and benzodiazepines are also affected
• Neuropharmacology of alcohol


  Nonspecific Receptor Sites

  
  

  May interact with an alcohol-sensitive "pocket" area on the receptor

  
  

  Enter and block the ion channels

  
  

  Inhibits Glutamate - NMDA Receptor inhibition

  -Upregulation - hypersensitization - seizures/withdrawal

  
  

  Excites GABA-Receptor excitation

  -keeps GABA channels open for longer

  -enhanced inhibition

  -Ultimately downregulation of GABA when you stop drinking (anxious)

  
  

  Production and release of endorphins
• Alcohol Antagonists (don't have good alcohol antagonists)


  RO 15-4513 (possible but hasn't been taken further)

  
  

  Naltrexone (opioid antagonists; only effective antagonists of alcohol)

  -Proves alcohol is dependent on opioid system

  
  

  Caffeine? (Doesn't reverse impairments, just stimulates you)
• Effects of alcohol on the body

  Dilation of blood vessels in the skin (warm, flush)

  
  

  Makes skin feel warm

  
  

  Loss of body water (frequent urination)
• Effects of alcohol on sleep

  Induces sleep

  
  

  Decreases time it takes to go to sleep

  
  

  Depresses REM sleep

  
  

  Rebound- when you stop drinking you get REM rebound (nightmares; bad dreams)

  
  

  Cessation leads to disturbances in sleep patterns - long term
• Effects on Human Behavior

  Low dose = stimulation of GABA

  -Increased talking & higher pitch

  -Excitement & elation

  
  

  High dose = sedation

  -Anger & depression
• Effects of perception and performance

  Perception

  -Greater visual thresholds (harder to notice changes) and decreased flicker fusion

  -Decreased sensitivity of smell, taste & pain

  
  

  Performance

  -Reaction time - 10% at low doses

  -Romberg sway test - inner ear - the spins

  -Expectancy & incentives and motivation
• Memory and Blackouts


  Affect both storage and retrieval of information

  
  

  Fragmentary blackout (grayout)

  -Difficult to retrieval information

  -Have memory but can retrieve it

  
  

  En bloc blackouts

  -Encoding

  -Hippocampus

  -Have no memory (indicator of problematic alcohol use)
• Effects on Driving


  Higher speeds

  
  

  Increase in collisions

  
  

  At 0.8 BAL increased risk of accident (why we choose 0.8 for legal limit)

  
  

  Age 35-54 have least risk (more experienced driver)
• Effects on the Behavior of Nonhumans

  Conditioned Behavior

  
  

  Biphasic - Greater @ low dose Lower @ high dose

  
  

  Punishment - reemergence of punishment suppressed

  
  

  E.g. if you stopped being rude sober, will be rude drunk
• Discriminative Stimulus Properties


  Alcohol v. Saline

  Easily

  
  

  Barbiturates/ benzo

  Yes & no
• Acute Tolerance


  Across the BAL curve

  
  

  Feel most tolerant at first drink and less as you drink more drinks
• Chronic Tolerance


  Dose increase 30-50% within weeks (can drink 6-8 drinks instead of 4 and have same effects)
• Metabolic Tolerance


  Dehydrogenase & MEOS effect
• Behavioral Tolerance


  Practice (used to being drunk, doesn't feel different than normal)

  
  

  "Functional alcoholic"
• Withdrawal early symptoms


  8-12 hours start - last 48 hrs

  
  

  Agitation, tremors, muscle cramps, vomiting, nausea, sweating, vivid dreaming, and irregular heartbeats
• Withdrawal late symptoms


  2 after days onset - lasts 7-10 days

  
  

  Delirium tremens (DTs)

  
  

  Hallucinations & seizures

  
  

  Morbidity
• Self-Administration in Nonhumans


  Oral Self-Administration

  -Taste problems

  -With options moderate consumptions

  
  

  Intravenous Self-Administration

  -Erratic

  -Binge & abstinence
• Self-Administration in Humans


  Binge followed by abstinence

  -2-3 days

  
  

  Factors that Affect Consumption

  -Culture - warriors vs priests

  
  

  National differences in consumption patterns

  -Gender & age
• Behavioral Economics


  Elastic > work = < consumption (if you have to work more to get alcohol you will drink less)

  
  

  Varies across cultures

  
  

  Studies on Laboratory Animals

  -Elastic but depends on exposure

  
  

  More availability = more consumption
• Harmful Effects of an Acute Administration

  Alcohol Poisoning

  -Respiratory failure

  -TI 3.5

  -Vomit for safety!

  
  

  Hangover

  
  

  Alcohol-Induced Behavior

  
  

  Reproduction
• Harmful effects of chronic consumption

  Liver

  -Cirrhosis

  
  

  Nervous System

  -Korsakoff's

  -Wernicke's

  
  

  Cancer

  -Mouth, throat and liver (acetaldehyde is a carcinogen)

  
  

  Reproduction

  -Males: shrinking of the testicles, impotence, and loss of sexual interest

  -Females: menstrual dysfunctions

  -Fetal Alcohol Syndrome (FAS) and low birth weight

  
  

  Heart Disease

  -Alcoholic cardiomyopathy
• Substance abuse treatment


  Alcohol is 40% of what gets treated

  
  

  Use a comprehensive treatment program
• Finding the best treatment program

  Inpatient versus outpatient treatment

  
  

  Pharmacological versus psychotherapy or counseling

  -Natlrexone & Acamprosate

  
  

  Self-help groups versus individualized treatment

  
  

  Length of treatment program

  
  

  Aftercare