Chapter 15 - Summary Connect Core Concepts in Health PDF

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KIN170 Chapter 15 Alcohol Use and Alcoholism -

The Nature of Alcohol  Alcoholic Beverages o Alcohol: the intoxicating ingredient in fermented/distilled beverages; a colourless, pungent liquid o Common Alcoholic Beverages  Beer – mild intoxicant brewed from mixture of grains; contains 36% alcohol  Wines – made from fermented juices of grapes/other fruits o During fermentation, sugars from the fruit react with yeast to create ethanol and other by-products o Concentration = 9-14% o Fortified = extra alcohol added during production (20%)  Hard liquor – made by distilling brewed/fermented grains/other plant products; 35-50% alcohol o Standard Drinks vs Actual Servings  One Drink: the amount of a beverage that typically contains 13.6 grams of alcohol; AKA a standard drink o Typical serving of most alcoholic beverages is larger than a single standard drink o Caloric Content  7 calories per gram  Alcohol in one standard drink = 100-120 calories  One beer = 140 calories o Light beer = 99 calories  145-mm glass of wine = 100 calories  85-mm margarita = 157 calories  175-mm cosmo = 143 calories  175-mm rum and cola = 180 calories  Strategies for cutting back: o Space drinks an hour apart o Not drinking daily o Replacing alcoholic beverages with “virgin” or half alcohol subs  Absorption o 20% absorbed from stomach into bloodstream o 75% absorbed through upper part of small intestine o Remaining alcohol enters bloodstream from gastrointestinal tract o Carbonation and artificial sweeteners increases rate of alcohol absorption o Food and highly concentrated alcoholic beverages slows rate of absorption

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Metabolism and Excretion o Metabolism: the chemical transformation of food and other substances in the body into energy and wastes o Main site of alcohol metabolism = liver o 2-10% of alcohol not metabolized in liver/other tissues but excreted unchanged by lungs/kidneys/sweat glands o Affects neurotransmitters o Effects become permanent with chronic heavy usage o Interferes with production of new brain cells in unborn children/young children/adults/young adults in whom the brain continues to develop until about age 21  Alcohol Intake and Blood Alcohol Concentration o Blood Alcohol Concentration (BAC): amount of alcohol in the blood expressed as the percentage of alcohol in a decilitre of blood; used as a measure of intoxication  Affected by amount of alcohol consumed in a given amount of time and by individual factors: o Body weight o Percentage of body fat o Sex (women metabolize less alcohol in the stomach than men; therefore, women may have a higher BAC than men after consuming same amount of alcohol)  Depends on balance between rate of alcohol absorption and rate of alcohol metabolism  Remains low if one absorbs slightly less alcohol each hour than he/she can metabolize in an hour o Rate of alcohol metabolism varies among individuals and is largely determined by genetic factors and drinking behaviour o People who drink frequently metabolize alcohol more rapidly than nondrinkers Alcohol and Health  Immediate Effects of Alcohol o BAC = primary factor o Low concentration = relaxed and jovial o High concentrations = angry, sedated or sleepy o Effects more pronounced if drinking on an empty stomach because alcohol absorbed more quickly, and BAC rises more quickly, and if BAC is rapidly increasing rather than slowly increasing/steady/decreasing o Low Concentrations of Alcohol  Effects first felt at BAC of .03-.05  Light headedness, relaxation, release of inhibitions  Mild euphoria and more sociable

KIN170 Chapter 15 Alcohol Use and Alcoholism

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 Stimulation occurs because alcohol depresses inhibitory centres in the brain Higher Concentrations of Alcohol  Pleasant effects replaced by negative ones  Interference with motor coordination, verbal performance, intellectual functions  BAC = .1%, sensory and motor functioning reduced, sleepy, vision/taste/smell/hearing become less acute  BAC = .2%, unable to function because of pronounced depression of central nervous system/muscles/other body systems  Coma usually occurs at BAC of .35%; higher levels = fatal  Small doses often improve sexual functioning; higher doses have negative effects like reduced erectile response; heavy drinking = reduction of testosterone levels and impairment of sperm production  Causes blood vessels near skin to dilate, leading to warm feelings  Induces sleepiness; large amounts disturb normal sleep patterns  Can worsen/cause sleep apnea Alcohol Hangover  Headaches, shakiness, nausea, diarrhea, fatigue and impaired mental functioning  Caused by combo of toxic effects of alcohol breakdown, dehydration and hormonal effects  Heart rate and blood pressure increase, making some vulnerable to heart attacks  Best treatment = prevention; drinking less, drinking slowly, eating food and drinking non-alcoholic liquids Alcohol Poisoning  Death from alcohol poisoning may be caused by central nervous system and respiratory depression/inhaling fluid/vomit into the lungs  BAC can keep rising during unconsciousness Using Alcohol with Other Drugs  Alcohol-drug combos leading cause of drug-related deaths  Caffeinated Alcoholic Beverages (CABs) = growing cause of concern because combined effects of alcohol and caffeine can be dangerous Alcohol-related Injuries and Violence  Homicide/suicide/car crashes etc. linked to estimated 6700 deaths in CAD each year  More than triples chances of fatal injuries during leisure activities (swimming and boating)

KIN170 Chapter 15 Alcohol Use and Alcoholism

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o Alcohol and Aggression  Contributes to more than 50% of all murders/assaults/rapes  Only some become violent under alcohol’s influence; those predisposed to aggressive behaviour and are highly impulsive o More likely to become addicted to alcohol o Alcohol and Sexual Decision Making  Impairs decisions about sex  Frequent binge drinkers 5x more likely to engage in unplanned sexual activity, unprotected, and have multiple sex partners  Someone who is drunk/passed out cannot consent to sex Drinking and Driving o More than 42% of the 2541 crash fatalities in 2010 were impairment related o Unable to drive safely because judgment is impaired, reaction time is slower, and coordination is reduced o Dose-response function = relationship between amount of alcohol/drug consumed and the type and intensity of the resulting effect o Signs someone is driving drunk:  Wide, abrupt and illegal turns  Straddling centre line/lane marker  Driving against traffic/on the shoulder  Weaving, swerving or nearly striking an object/another vehicle  Following too closely  Erratic speed  Driving with headlights off at night  Driving with window down in very cold weather Effects of Chronic Abuse o Digestive System  Alters functioning of the liver; fat accumulates in liver cells (“fatty liver”); reversible if person stops drinking  Cirrhosis: a disease in which the liver is severely damaged by alcohol, other toxins, or infection o Risk depends on susceptibility (largely geneticallydetermined) o Signs = jaundice, accumulation of fluid in abdomen and lower extremities o Treatments = correcting nutrient deficiencies and abstinence from alcohol  Inflames pancreas causing nausea, vomiting, abnormal digestion and severe pain o Acute pancreatitis can occur after just one/two severe binge-drinking episodes and is often fatal

KIN170 Chapter 15 Alcohol Use and Alcoholism

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 Bleeding in gastrointestinal tract o Cardiovascular System  Elevates blood pressure  Weakening of heart muscle (cardio myopathy)  Abnormal heart rhythms (“holiday heart”) o Cancer  Risk factor for cancer in breast, colon, rectum, esophagus, liver, mouth, larynx and pharynx  Largely responsible for most common form of liver cancer o Continued heavy drinking in people with hepatitis accelerates progression to this cancer o Brain Damage  Tempered by individual’s physiology and genetics  Brain shrinkage with loss of grey and white matter  Reduced blood flow  Slowed metabolic rates in some brain regions  Can be reversed to some extent over time with abstinence  Memory loss, dementia, compromised problem-solving and reasoned abilities o Mortality  About half of deaths caused by alcohol due to chronic conditions such as cirrhosis and cancer, other half due to acute conditions/events like car crashes/falls/suicide Alcohol Use During Pregnancy o Early in pregnancy = spontaneous abortion/miscarriage, or cause range of disabilities such as FASD o Children with FAS = small head, abnormal facial structure, heart defects, and other physical abnormalities, as well as physical and mental growth slower than normal; most have mental disabilities o Alcohol-related Neurodevelopmental Disorder (ARND): cognitive and behavioural problems seen in people whose mothers drank alcohol during pregnancy  As adults = more likely to have substance abuse problems and criminal records o Drinking during breastfeeding not recommended Possible Health Benefits of Alcohol o 35 or younger = odds of dying increase in proportion to amount of alcohol you drink o Moderate alcohol use:  Lowest rates of CHD deaths

KIN170 Chapter 15 Alcohol Use and Alcoholism  Improves heart health by raising HDL in the blood, thinning the blood and reducing inflammation and risk of dangerous blood clots  Less likely to develop/better able to manage diabetes, high blood pressure, strokes, arterial blockages in legs, cognitive decline and benign prostate enlargement -

Alcohol Use  Canada’s Low-risk Alcohol Drinking Guidelines o Aims to reduce long-term (chronic) risk of diseases and conditions caused by several years of alcohol consumption; women = no more than 10 drinks/week, men = no more than 15 drinks/week o Reduce short-term (acute) risk of injury, harm and/or acute illness from drinking alcohol; women = no more than 3 drinks and men = no more than 4 drinks on any single occasion o Identifies populations/situations where alcohol should be avoided altogether o Age-specific recommendations:  Youth should delay drinking until late teens  Late teens  age 24 = women never exceed 2 drinks/day or 10 drinks/week; men never exceed 3 drinks/day or 15 drinks/week  Older adults (over age 65) should never exceed previous recommendations  Alcohol Use Disorder: a disorder that first appeared in the DSM-5, combining the previously distinct categories of alcohol abuse and alcohol dependence; diagnosed as mild, moderate or severe depending on number of criteria and individual meets over a 12-month period o Mild = 2-3 symptoms from list of possible 11 o Moderate = 4-5 symptoms o Severe = 6+ symptoms o List of criteria:  Consuming alcohol in larger amounts over longer period than was intended  Having persistent desire/making unsuccessful efforts to control use  Cravings  Spending a great deal of time in activities necessary to obtain alcohol  Recurrent alcohol use resulting in failure to fulfill obligations at work/school/home  Continued use despite having persistent/recurrent social/interpersonal problems caused by alcohol  Giving up/reducing important activities because of use

KIN170 Chapter 15 Alcohol Use and Alcoholism

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 Recurrent use in hazardous situations  Continued use despite knowledge of problems likely to be caused/worsened by alcohol  Developing tolerance  Experiencing alcohol withdrawal resulting in unpleasant physical/cognitive symptoms Patterns and Prevalence  Once established = often exhibit pattern of exacerbations/remissions  After period of abstinence, people addicted often attempt controlled drinking, leading to escalation and more problems Health Effects  Withdrawal = trembling hands, rapid pulse, nightmares, insomnia, anxiety and gastrointestinal upset  More severe symptoms of withdrawal = seizures, confusion, hallucinations, delirium tremens (state of confusion)  Specific health effects vary Social and Psychological Effects  Frequently have mental disorders in addition to substance addiction o Usually experience clinical depression, panic disorder, borderline personality disorder, antisocial personality disorders or schizophrenia  Major source of trouble in many families Causes  Genetics  Personality disorders  Growing up in violent/troubled home  Imitating alcohol abuse in peers/other role models  Social factors = urbanization, disappearance of extended family, loosening of kinship ties, increased mobility and changing values Treatment  Most require program of some kind  AA  12-step program  Al-Anon = companion program to AA for families and friends of people with alcohol addictions  In-patient rehab  Medical treatments o Antidepressants/antianxiety medications for those who use alcohol to treat their anxiety/depression...