Chapter 9- Alcohol
Alcoholic Beverages
● Uses fermentation and distillation
○ Fermentation is when sugar is dissolved in water and exposed to air
○ Yeast multiplies by eating the sugar and converts it to ethanol and carbon dioxide
○ Fermented beverages cannot have an alcohol content higher than 15%
○ Distillation was developed to increase ethanol content
■ Involves heating a fermented mixture
● Alcohol Content
○ Percentage is denoted by volume, weight, or proof
○ Proof = % doubled
○ Serving size is usually 14g
History of Alcohol Use
● First made inadvertently by natural fermentation
○ Between 6000 BC and 5000 BC
● Attitude towards drinking
○ 4-5 drinks per day 1800’s
○ 3-4 drinks per week today
Consumption of Alcohol and Heavy Drinking in US
● Consumption was on an upward trend after the prohibition up until the 1980’s where
there was a decline which reversed in 1990
● Consumption rose again 1995-2012
● Declines were largely due to reduction in use of hard liquor
● Highest consumption in college aged americans
○ 52.5% (18-22 years of age) drank in the past month
○ 33.0% binge drink (5 or more drinks on an occasion) in the past month
○ 8.2% engaged in heavy drinking (5 or more drinks on an occasion on 5 or more
occasions per month) in the past month
● Men report heavier drinking than women
● White people report heavier drinking than black or hispanic people
Pharmacology of Alcohol
● Sites of action:
○ Depresses the CNS
○ Dissolves lipid membranes which disturb normal chemical actions
○ Reduced efficiency of conduction of neural impulses along axons (reduces action
potential amplitude that reaches synapse)
○ Neurotransmitter release and transmission impulses are inhibited
○ Acts on GABA benzodiazepine receptors and enhances serotonergic and
dopaminergic activity
● Pharmacokinetics of Alcohol
○ Absorption
■ Must pass through the stomach to the small intestine for absorption
■ Absorption can be slowed by eating or drinking milk while drinking
■ Pylorospasm- when the pylorus shuts after a large amount of alcohol has
, been ingested and prevents stomach contents from reaching intestines
● Only 10-20% of the alcohol in stomach is absorbed
○ Distribution
■ Alcohol is water soluble and blood is 70% water so it gets a high
concentration compared to muscle and bone
■ A standard drink is .6 ounces of alcohol
○ Metabolism & Excretion
■ >90% of absorbed alcohol is metabolized by the liver
● Small % not metabolized is excreted in pure form through the
kidneys and lungs
■ Broken down to acetaldehyde by the enzyme alcohol dehydrogenase
■ Acetaldehyde is broken down to CO2 and water
● Release of energy and calories
● .35 ounces oxidized per hour
● 75 calories liberated per half ounce
Tolerance & Dependence
● Tolerance
○ Functional tolerance has a greater influence than dispositional tolerance in
altering how alcohol affects a person with repeated use
○ Tolerance can be both acute and protracted
○ Due to acute tolerance, some effects at a given BAC tend to be greater when the
BAC curve is rising than when its descending
● Physical Dependence
○ Three phases of physical dependence
○ Chronic heavy use of alcohol can lead to physical dependence on it. The alcohol
withdrawal syndrome is a serious medical problem that can result in death if not
treated properly
Therapeutic Uses
● Ingredient in medical products
○ Excellent solvent
● Alcoholic beverages may be recommended in moderate amounts to elderly patients to
stimulate appetite and digestion
● Used in compounds to treat skin problems
● Ethanol sponges treat fevers bc it cools as it evaporates
● Dehydrated alcohol can be injected close to nerves or sympathetic ganglia to relieve
chronic pain
Acute Effects of Alcohol
● Physiological effects
○ Inhibits the secretion of antidiuretic hormone, increases urination
■ Occurs when BAC is rising but not falling
○ Reduces the amount of body fat that is oxidized
■ Results in long-term increased body fat and weight gain
○ Peripheral dilation, causes skin to feel warm and turn red
○ Increases gastric secretion, stimulates appetite
, ■ High doses harms stomach mucosa and causes gastric distress
○ Release of corticosteroids, reaction to stress
○ Suppression of REM sleep
■ Low dose only suppresses for the first half of the night and rebounds and
increases for the second half
■ Large dose suppresses for the entire night
○ Impairs memory
■ Blackout- loss of memory without loss of consciousness
■ Failure in the transfer of information to long term memory
■ Alcohol interferes with receptors in the brain that enhance connections
among neurons
○ Hangovers
■ Being 4-12 hours after reaching peak BAC
○ Interacts synergistically with other CNS depressants
○ Slight respiratory depression at lower doses
○ Higher doses associated with sleep, stupor, coma, cardiovascular depression,
and dysfunction of the more primitive areas of the brain (medulla controls
breathing and heartbeat)
● Sensorimotor Effects
○ Vision decreases in acuity
○ Taste and smell are less sensitive
○ Pain sensitivity decrease in 0.08-0.1 BAC range
○ Reaction time slows at 0.1 BAC
○ Body sway and staggering leading to inability to walk independently
■ Affects balance control in the inner ear
○ Negatively affects fine motor dexterity and gross motor functions like standing
and walking
■ Neural messages are not being sent to the muscles
● Alcohol and Driving
○ 1980’s marked more conservative views on alcohol
○ Alcohol is a possible causal factor in traffic fatality rates
○ Alcohol impairs performance on divided attention tasks at BAC of 0.05 or lower
■ Basis for argument that legal driving limit be lowered to 0.05 instead of
0.08
○ Young drivers are more likely to be involved in alcohol related accidents
■ Consistent across range of BAC
■ Risk of fatal crash is highest when the BAC is in the lower range
■ Inexperienced in both driving and drinking
■ Younger people show less protracted tolerance in general
○ Young men are most likely to be intoxicated while driving
■ Young men most likely to drink heavily
■ Young men take more risks in a group and intoxicated
○ Strict drunk driving laws and driver’s perception of arrest and conviction being
likely reduce drunk driving problems
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