AlcoholHanson Chapters 7 & 8

SOC 204 Drugs & Society

Is someone close to you an alcoholic?

A. Yes, more than one person

B. Yes, one person

C. No

Yes, m

ore th

an one p

erson

Yes, o

ne per

son No

56%

24%20%

Alcohol

• Fermentation

• Distillation

• Proof

Pharmacology• Absorption• Distribution• Metabolism• Mechanism of Action• BLOOD ALCOHOL

CONTENT

Alcohol is metabolized in your liver

A. True

B. False

True

False

0%

100%

Figure 7.1 How alcohol is absorbed in the body.

Data from Masters, S., and A. Trevor “The Alcohols.” In Basic and Clinical Pharmacology, 13th ed., edited by B. Katzung, 384–395. New York: McGraw-Hill, 2015.

You can increase your rate of metabolizing

alcohol by exercise or by taking caffeine

A. True

B. False

True

False

88%

12%

Alcohol’s Effects

• Alcohol acts on the cerebrum affecting

▫ Judgment

▫ Reasoning

▫ Inhibitions

▫ Motor activity

▫ Impairs the senses

• Mouse Party

BAC (%)

Behavioral Effects

•0.05 Lowered alertness, release of inhibitions, impaired

judgment

•0.10 Slower reaction times, impaired motor function, less

caution

•0.15 Large, consistent increases in reaction time

•0.20 Marked depression in sensory and motor capability,

intoxication

•0.25 Severe motor disturbance, staggering, great impairment

•0.30 Stuporous but conscious—no comprehension of what’s

going on

•0.35 Surgical anesthesia; about LD1, minimal level causing

death

•0.40 About LD50

Figure 7.2 The principal control centers of the brain affected by alcohol

consumption.

Alcohol primarily impacts this part of

the brain:

A. Limbic system

B. Cerebellum

C. Cerebral cortex

D. Basal ganglia

Limbic

syst

em

Cerebellu

m

Cerebra

l cort

ex

Basal g

anglia

0% 0%

56%

44%

Alcohol sedates by increasing

glutamate’s action – an agonist

response.

A. True

B. False

True

False

63%

38%

Alcoholism

• Alcoholism ▫ Condition in which an individual loses control over

intake of alcohol

• Substance Use Disorder▫ Physical, social, intellectual, emotional, or financial

problems resulting from the use of alcohol▫ Withdrawal symptoms▫ Tolerance▫ Blackouts

Alcoholism

• Some consider alcoholism to be a disease

▫ Compared to heart disease or diabetes

▫ 1956 American Medical Association declared it a disease

▫ Disease can be used as a legal defense

▫ Receive treatment rather than punishment

Early Characterizations of Alcoholic

Types by Jellinek (1960)• Alpha alcoholics: Mostly a psychological dependence

• Beta alcoholics: Mostly socially dependent on alcohol

• Gamma alcoholics: Most severe; suffers from emotional and psychological impairment

• Delta alcoholics: Constantly losing control over the amount of alcohol consumed

• Epsilon alcoholics: Constantly binge drinking and at times days at a time

• Zeta alcoholics: Moderate drinker who becomes abusive and violent

Types of Alcoholics by Moss and

Colleagues in 2007

• Young Adult (31.5% of U.S. alcoholics): Young adult drinkers without major problems regarding their drinking

• Young Antisocial (21% of U.S. alcoholics): Mid-20s, had earlier onset of regular drinking and alcohol problems, and come from heavy alcohol use families

• Functional (19.5% of U.S. alcoholics): Middle-aged, well-educated, with stable jobs and families

• Intermediate Familial (19% of U.S. alcoholics): Middle-aged, with 50% from families with multigenerational alcoholism

• Chronic Severe (9% of U.S. alcoholics): Mostly middle-aged, high rates of antisocial personality disorder and criminality

Do you agree alcoholism is a disease?

A. Yes

B. No

C. I’m not sure

YesNo

I’m n

ot sure

0% 0%0%

I know that for the discussion

Thursday, I have to interview two

people

A. Yep. On it.

B. Noooo

C. What discussion?

Yep.

On it.

Noooo

What

disc

ussio

n?

100%

0%0%

Alcoholism

• Genetics

▫ 50-60% of alcoholism vulnerability has a genetic basis

▫ Environmental factors affect the impact of genetics

Alcohol and Genetics

• Alcoholism is among the most inherited

mental illnesses

• Specific genes contribute to: (i) excessive

consumption, (ii) diminished negative

feedback, (iii) enhanced sense of pleasure, and

(iv) diminished hangovers

• However, environment is as important as

genetics

Alcoholism

• Psychosocial factors

▫ 20% of alcoholics have a mood or anxiety disorder

▫ Individuals are more likely to drink heavily when in a group

▫ Expectations about alcohol are predictors of dependence

▫ Associated with a greater number of sexual partners

Happy Tuesday toyou!

This is theMonday-est

Tuesday ever.

57%

43%

Happy Tuesday

A. Happy Tuesday to you!

B. This is the Monday-estTuesday ever.

Alcoholism

• Culture

▫ Attitudes toward alcohol affect rates of alcohol abuse

Culture and Alcohol (continued)

• Some psychologists contend that both set and setting can often overshadow the pharmacological effects of most drugs, including alcohol.

▫ Set: An individual’s expectation of what a drug will do to his/her personality

▫ Setting: The physical and social environment where most drugs, including alcohol, are consumed

Culture and Alcohol

• Culture provides how alcohol use is perceived (e.g., violation of norms, “normal” to drink, sexy, sophisticated, mature).

• Cultural rules state how much one can drink and where one can drink.

• Cultures provide ceremonial meaning to alcohol use.

• Culture provides a model of

alcoholism.

• Culture provides attitudes and stereo-

types regarding drinking behavior.

Distinctions Between “Wet” and “Dry

Cultures

“Wet” Cultures - In these cultures alcohol is integrated into daily life and activities (e.g., alcohol consumed with meals). In these cultures, abstinence rates are low and wine is largely the beverage of preference. European countries bordering the Mediterranean have traditionally exemplified wet cultures.

“Dry” Cultures – Alcohol consumption is not as common during everyday activities. Abstinence is more common, however, when drinking occurs, it is more likely to result in intoxication. Scandinavian countries, the U.S., and Canada are examples of counties that are dry.

Alcohol Withdrawal

• Characteristics of alcohol withdrawal:

▫ Craving for alcohol

▫ Delirium tremens (DTs)

▫ Extreme arousal

▫ Auditory and visual hallucinations

▫ Physiological symptoms

▫ Cognitive symptoms

Impacts of AlcoholIndividual

Family Society

Family Effects

• Children of alcoholics▫ Often experience sleep difficulties, depression,

loneliness, and stomach problems▫ Alienated from parents, have poor communication

skills, less trust, and more emotional longing▫ Attention deficit hyperactivity disorder (ADHD)

• Adult children of alcoholics (ACOAs)▫ Feelings of failure and self-deprecation▫ Feel a great need to be in control

Addict

• Behaviors▫ Use of

chemicals▫ Abusive▫ Controlling▫ Withdrawal of

love, attention, affection

▫ Blaming▫ Anger▫ Self-

righteousness

Underlying feeling:

SHAME

Co-Dependent

• Behaviors

▫ Rescuing

▫ Excusing

▫ Denial

▫ Helplessness

▫ Martyr

Underlying feeling:

ANGER

Hero

• Behaviors▫ The “Good Kid”

▫ High achiever

▫ Successful

▫ Overly responsible

▫ Intellectual

Underlying feeling:

INADEQUACY

Scapegoat

• Behaviors▫ Acting out

▫ Defiant

▫ Peer-oriented

▫ Sullen, angry

▫ Irresponsible

▫ Chemical use

▫ Law breaking, truancy

Underlying feeling:

HURT

Lost Child

• Behaviors

▫ Withdrawn

▫ Loner

▫ Day dreamer

▫ Unnoticed

Underlying Feeling:

LONELINESS

Mascot

• Behaviors

▫ Attention-getting

▫ Humor

▫ Clowning

▫ Super cute

▫ Overly active

▫ Silly

Underlying Feeling: FEAR

Which do you most identify with?

A. Addict

B. Co-dependent

C. Hero

D. Scapegoat

E. Lost Child

F. Mascot

Addict

Co-dependent

Hero

Scapego

at

Lost

Child

Masc

ot

7%4%

22%

15%

11%

41%

COSTS• Hero

▫ Compulsive drive, pressure, suicide

• Scapegoat

▫ Addiction, criminal behavior, drop out

• Lost Child

▫ Isolation, abuse victim, eating disorders

• Mascot

▫ Immaturity, distant relationships, manipulation

Alcohol and the Family (1 of 3)

• Important Key Terms:▫ Codependency (or co-alcoholism):

Behavior displayed by either addicted or nonaddicted family members (codependents) who identify with the alcohol addict and cover up the excessive drinking behavior, allowing it to continue and letting it affect the codependent’s life

▫ Enablers: Those close to the alcohol addict who deny or make excuses for enabling his or her excessive drinking

Alcohol and the Family (2 of 3)

• Children of alcoholics (COAs) are 2–4 times more likely to become alcoholics themselves.

• Adult children of alcoholics (ACOAs) are 2–4 times more likely to develop alcoholism.

• Approximately 9.7 million children age 17 or younger are living in households with one or more adults classified as having an alcohol abuse or dependence problem.

▫ Seventy percent of these children were biological, foster, adopted, or stepchildren.

▫ As a result, 6.8 million children, or about 15% of children aged 17 or younger, meet the formal definition of children of alcoholics.

Alcohol and the Family (3 of 3)

• COAs and ACOAs are more likely to marry into families where alcoholism is prevalent.

• Twenty-five percent of American children are exposed to an alcoholic before the age of 18.

How’s your group doing?

A. We rock.

B. Working on it.

C. We need help.

D. Group? What group?

We ro

ck.

Work

ing o

n it.

We n

eed help

.

Group?

What g

roup?

20%

0%

10%

70%

Correlations with

ViolenceAs alcohol use escalates, so does violence

▫ Domestic partner violence 66%

▫ Sexual Assault 37%

▫ Homicides 40%

▫ Child abuse 70%

http://www.ph.ucla.edu/sciprc/pdf/ALCOHOL_AND_VIOLENCE.pdf

Suicide

▫ About 7% of alcoholics commit suicide

▫ 16% of men and 10% of women entering alcohol treatment have contemplated suicide

▫ 38% of people who hanged themselves had alcohol in their system

▫ 32% of veterans who attempted suicide were diagnosed with alcohol abuse or disorder

Accidents and Alcohol

▫ Drinking while driving Emergency room admissions

▫ Fire-related fatalities

▫ Alcohol-related boating accidents

▫ Drowning fatalities

YouTube

Helping the Family Recover

(1 of 2)

Important Key Terms:•Psychodrama: A family therapy system developed by Jacques Moreno in which significant interpersonal and intrapersonal issues are enacted in a focused setting using dramatic techniques.

•Role-playing: A therapeutic technique in which group members play assigned parts to elicit emotional reactions.

•Genogram: A family therapy technique that records

information about behavior and relationships on a type of family tree to elucidate persistent patterns of dysfunctional behavior.

Helping the Family Recover

(2 of 2)

• Post-traumatic stress disorder (PTSD):A psychiatric syndrome in which an individual who has been exposed to a traumatic event or situation experiences psychological stress that may manifest itself in a wide range of symptoms, including re-experiencing the trauma, numbing of general responsiveness, and hyper-arousal.

Recovery from Alcoholism

Treatment of alcoholism:

▫ Denial as a psychological defense

▫ Easy to relapse (relapsing syndrome) without radical shift in lifestyle

▫ Alcohol rehabilitation and medical ramifications

▫ More emotionally fragile than other addicts

Withdrawal

Important Key Terms:

• Relapsing syndrome: Returning to the use of

alcohol after quitting

• Acute alcohol withdrawal syndrome: Symptoms that occur when an individual who is addicted to alcohol does not maintain his or her usual blood alcohol level

• Delirium tremens (DTs): The most severe, even life-threatening, form of alcohol withdrawal, involving hallucinations, delirium, and fever.

Prohibition

• Temperance Movement – view of alcohol

• Prohibition • States 1851

• Federal 1919

• Repealed in 1933• Since 1933, states

regulate alcohol • Federal taxation

Who drinks and why

• Cultural Differences

• Trends in US

• Regional Differences

• Gender Differences

• Drinking Among College Students

Total estimated U.S. per capita ethanol consumption in gallons per year by state, 2007

Source: Data from NIAAA

© 2011 McGraw-Hill Higher Education. All rights reserved.

Alcohol Abuse Among College

and University Students

CORE Institute (2008) research results:• Approximately 72% of college students consumed

alcohol and 42% to 55% engaged in binge drinking within 30 days when survey was given.

• College students consume an average of 5.4 alcoholic drinks per week.

• Of all the drugs reported, alcohol was the most heavily

abused on college campuses, followed by tobacco (44%) and marijuana (31%).

Alcohol Abuse Among College and

University Students (continued)

Other studies found that …• The main reason given for binge drinking was “to get

drunk.”• Males binge drink more than females.• For binge drinkers, the impact on impaired academic

performance is just as great for women drinkers.• Being white, involved in athletics, or a resident of a

fraternity or sorority made it more likely that a student would be a binge drinker.

Alcohol Abuse Among College and

University Students

• On U.S. campuses, alcohol is a factor in 40% of all academic problems and 28% of all dropouts.

• Seventy-five percent of male students and 55% of female students involved in acquaintance rape had been drinking or using drugs.

• The transition into college is associated with a doubling of the percentages of those who drink for both males and females.• For heavier drinkers, grades

suffered for both male and female students.

Women and Alcohol

• Women possess greater sensitivity to alcohol, have a greater likelihood of addiction, and develop alcohol-related health problems sooner than men (e.g., stomach cancer, cirrhosis of the liver).

• More women in alcohol treatment come from sexually abusive homes (70%) in comparison to men (12%).

Women and Alcohol (continued)

• Three major reasons why women are more sensitive to the effects of alcohol:

1. Body size (men generally larger than women)

2. Women absorb alcohol sooner—women possess more body fat and body fat does not dilute alcohol

3. Women possess less of a metabolizing enzyme that gets rid of (processes out) alcohol

Women and Alcohol (continued)• Alcohol consumption patterns of women:

▫ Women 21 to 34 years of age were least likely to report alcohol-related problems if they had stable marriages and were working full time.

▫ Women tend to marry men whose drinking habits match their own.

▫ Between 35 to 49 years of age, the heaviest drinkers were divorced or separated women without children.

▫ Between 50 to 64 years of age, the heaviest drinkers were women whose husbands/partners drank heavily.

▫ Women 65 and older comprised less than 10% of drinkers with drinking problems.

Alcohol Consumption in the

United States• Alcohol consumption has dropped sharply

since 1981.• What explains the steady decline in alcohol

consumption during the past twenty years?▫ Demographics▫ Conservatism▫ Decrease in social acceptability▫ Increased awareness of risks▫ Increased concerns for health

Figure 8.1 Current, binge, and heavy alcohol use among persons

aged 12 or older, by age: 2014

Data from: Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the

2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Rockville, MD, 2015.

Additional Facts Regarding

Alcohol Use/Abuse• Drinking and driving: On most weekend nights

throughout the United States, 70% of all fatal single-vehicle crashes involve a driver who is legally intoxicated.

• Income/wealth: Less affluent people drink less than more affluent individuals.

• The average “alcoholic”: The largest percentage of alcoholics are secret or disguised drinkers who look very much like common working people.

• On average: Most people who consume alcohol do not become problem drinkers.

Most college students reduce their

binge drinking after graduating

from college.

A.True

B.False

True

False

24%

76%

The younger one is when drinking

alcohol for the first time, the more

likely one will become a problem

drinker.

A.True

B.False

True

False

29%

71%

Underage Drinking

• Underage drinking is associated with premature death, disease, injury, property damage, motor vehicle crashes, alcohol-related crime and loss of productivity

• There is a significant relationship between drinking before age 13 and suicide attempts

Underage Drinking

• High school students who engaged in binge drinking were six times more likely to drink and drive

▫ 7.2% of 8th-grade students binge drink

▫ 16.3% of 9th-grade students binge drink

▫ 23.2% of 12th-grade students binge drink

Moderate alcohol drinkers have

lower rates of cardiovascular

disease than abstainers.

A.True

B.False

True

False

0%0%

Physiological Toxicity

• Overdose

• Hangover

When someone passes out from

alcohol use:

A. Put them on their back

B. Put them to bed and let them sleep it off

C. Put them on their side

Put them

on th

eir back

Put them

to b

ed and le

t...

Put them

on th

eir sid

e

0% 0%0%

Fetal Alcohol Syndrome

There is a safe level of alcohol to

consume while pregnant

A. True

B. False

True

False

86%

14%

Physiological

Toxicity - Brain• Wernicke-Korsakoff

syndrome develops because alcohol impedes the body’s ability to utilize thiamine (a B vitamin)

• Alcohol use is associated with psychological symptoms: depression, anxiety

Physiological Toxicity - Liver

• Three main conditions associated with alcohol:

▫ Fatty liver

▫ Alcohol hepatitis

▫ Cirrhosis

• Cirrhosis is irreversible, even if alcohol use stops

Physiological Toxicity – Digestive System

• In moderate amounts, alcohol aids digestion by increasing gastric juice in the stomach

• Too much alcohol can irritate the stomach, leading to internal bleeding

• Heavy alcohol use is implicated in acute pancreatitis

• Alcoholics often have malnutrition because alcohol interferes with the body’s ability to utilize nutrients

Physiological Toxicity – Circulatory System

• Moderate alcohol use reduces risk of heart disease, boosts good (HDL) cholesterol and helps prevent type 2 diabetes

• Effects of heavy alcohol use:▫ Degeneration of the heart muscle▫ High blood pressure▫ Cardiac arrhythmias▫ Ischemic heart disease ▫ Strokes

Physiological Toxicity – Immune System

• Studies show that moderate alcohol use reduces immunity

• Alcohol interferes with white blood cells, particularly T lymphocytes, which help to resist infections