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Alcohol.pdf

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Department
Psychology
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Psychology 2020A/B
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Riley Hinson

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Term  Alcohol  =  refer  to  ethanol  or  ethyl  alcohol       Formed  as  result  of  conversion  of  sugars  into  cellular  energy       C 6 O 12  à6(heat)  à  2C H O2 5+  2CO   2   Fermentation:  one  molecule  of  glucose  (sugar)  acted  upon  by  yeast  in  the  presence   of  heat  in  the  absence  of  oxygen,  produces  2  molecules  of  ethanol  and  carbon   dioxide  as  waste  products   • Naturally  occurs  in  any  item  that  has  sugars     • Fermentation  process  tightly  controlled  by  use  of  special  yeasts  and   controlled  temperatures         HISTORY  OF  ALCOHOL  USE   • Archeologists  have  identified  beer  jugs  providing  evidence  that  there  were   purposely  fermented  beverages  produced  10  000  BC     o Fermented  honey  know  as  mead  as  first  intentionally  produced   alcoholic  drink     • Alcoholic  beverages  were  part  of  normal  Egyptian,  Chinese,  Babylonian,  and   Indian  societies  around  2000  –  5000  BC     • EGYPTIANS  produced  “beers”     o Thick,  dough-­‐like  products     o Source  of  nutrition,  pleasure,  medicine,  and  rituals     o Osiris  (God  of  afterlife)  was  attributed  to  beer  invention     • Laws  concerning  alcoholic  beverages  were  directed  towards  production  and   sale  rather  than  consumption     o Example:  Code  of  Hammurabi  enacted  in  1790  BC     § Sixth  Babylonian  King   § Specified  quality  of  alcohol  beverages,  hours  of  opening  wine   shops,  standards  for  those  employed  by  wine  sellers,  nothing   to  say  about  consumption       • Wine  was  part  of  ANCIENT  GREECE  society  by  2000  BC  (growing  excessive   drinking)     • The  Cult  of  Dionysus  à  devoted  to  heavy  drinking  since  it  was  believed   intoxication  brought  closer  to  the  gods   • Plato  &  Aristotle  commented  on  dangers  and  undesirable  effects     o State  had  right  to  control  alcohol  consumption,   o Laws  forbidding  women  and  children  were  enacted  (none  for  men)     • ANCIENT  ROME  may  have  been  worlds  first  wine  connoisseurs   o Importing  based  on  quality,  discussing  merits  of  different  vintage   years,  specialty  glasses   • Moderation  was  advocated  but  excessive  was  quite  common     o Example:  soldiers  were  promoted  based  on  ability  to  consume  large   amounts  of  alcohol     • Laws  tried  to  be  put  in  place  to  control  consumption  (did  not  work)     • Writers  provided  detailed  accounts  of  chronic  consumption  of  alcohol  like   todays  alcoholism     • Seneca  (4BC  –  65AD)  difference  between  moderate  and  excessive  use  (loss   of  control)     • Ulpian  (170  –  228)  Roman  senator  and  jurist  à  noted  addictive  nature  of   alcohol  and  that  disease  may  be  involved  and  advocated  chronic  users  be   treated  as  physically  ill       Developing  alcohol  through  fermentation  yields  about  14%  by  volume       -­‐  Alcohol  will  kill  yeast  and  stop  development  of  more  alcohol       -­‐  Highest  alcohol  content       Distillation:  possibility  to  create  higher  alcohol  content     • Distillation  of  fermented  beverages  occurred  in  China  1000  BC     • Systematic  development  of  distillation  dated  around  700  –  800  AD     • Arabic  alchemist  Jabir  ibn  Hayyan  (Gerber)  OR  Arabic  physician  Persian   al-­‐Razi  (Rhazes)  was  credited  with  development       • The  fermented  alcohol  (14%)  is  boiled   • Alcohol  boils  at  lower  temperature  than  water  =  produces  steam     • Boiling  process  has  higher  alcohol  content  than  water     • Steam  is  condensed  by  cooling     • RESULT  –  greater  alcohol  content  than  original  fermented  beverage   • Process  may  be  repeated  several  times  –  each  time  increasing  alcohol   content       Arabic  word  al-­‐kuhl  or  al-­‐gawl  =  origin  for  English  word  “alcohol”       Distilled  beverages  were  called  aqua  vitae  meaning  water  of  life       • Prior  to  1500’s  alcohol  consumption  in  EUROPE  was  mostly  in  the  form  of   beer,  wine  (moderation  was  the  rule)     • In  1500’s  alcohol  consumption  increased  dramatically  (40x  by  mid  1500’s),   declined  Catholic  Church,  enactment  of  laws  against  drunkenness   o Ironically,  they  were  also  encouraging  distillation  to  get  rid  of  excess   grain  products       • In  ENGLAND  alcohol  consumption  was  mostly  in  form  of  Gin     o Made  from  potatoes  and  flavoured  juniper  berries     o Developed  by  DUTCH  (“jenever”)   o Called  in  English  “Madam  Geneva”   • Adopted  Gin  as  national  drink     • Result  of  French  national  drink  was  wine     • 1720  –  1750  à”Gin  Epidemic”  lower  prices  for  Gin  then  other  alcohol     • 1750  à  estimated  that  7%  of  all  homes  in  London  were  used  for  the  sale   of  Gin   • Deaths  due  to  Gin  consumption  were  so  high  that  British  population  was   declining     o Legislative  attempts  to  control,  but  broke  out  in  “gin  riots”       • NORTH  AMERICAN  consumption  was  very  heavy     • 1790  à  per  capita  consumption  was  6  gallons  of  ethanol     • 1830  à  per  capita  consumption  was  7  gallons  of  ethanol     o Equivalent  to  5  alcoholic  beverages  per  day  for  every  adult     o Roughly  3x  the  level  of  current  consumption       • Anthony  Benezet’s  1774  Publication  of  The  Mighty  Destroyer  Displayed     o First  anti-­‐drinking  tract   • Dr.  Benjamin  Rush  (signer  of  declaration  of  independence)     o Most  notable  opponent  to  alcohol     o Alcoholism  was  a  disease  and  abstinence  was  only  cure   o “inebriometer”  =  showing  effects  o  different  types  of  drinking       American  Society  for  the  Promotion  of  Temperance  1826  (first  movement)     -­‐ In  1836  changed  name  to  American  Temperance  Union     -­‐ Goal:  total  abstinence   -­‐ Membership  in  the  union  decreased       End  of  American  Civil  War  1865  à  opposition  to  alcohol  became  more  vocal       Women’s  Christian  Temperance  Union  (WCTU)  formed  in  1873     -­‐ Lead  figure  in  US  against  alcohol  was  Carrie  Nation   -­‐ Alcohol  was  prima  facie  evidence  for  moral  failing       Alcohol  Prohibition  in  Canada  (March,  1918  –  repelled  2  yrs  later  December  1919)   Volstead  Act  in  U.S.  (October  1919  –  repelled  in  1933)   -­‐ “the  noble  experiment”       • Al  Capone  was  the  leader  of  one  of  the  biggest  illegal  crime  groups  during   prohibition  period     • “Speakeasies”  (places  where  illegal  alcohol  was  sold)     o Often  quite  fancy  establishments,  dress  codes,  entertainment     • Other  illegal  alcohol  trade  was  “blind  pigs”     o Would  be  charged  to  see  a  blind  pig  and  given  complementary  drink   (drinking  was  not  prohibited  –  just  production  and  sale)         CONSUMPTION  IN  MODERN  TIMES     • Alcohol  is  the  second  most  widely  used  psychoactive  substance  in  the  world     • Estimated  90%  of  people  in  Western  society  have  consumed  alcohol  at  some   point  in  their  life     • European  &  Eastern  European  à  top  of  list  for  estimated  per  capita   consumption  among  persons  15  or  older   o 20  Liters  of  95%  pure  alcohol  (equivalent  to  1070  drinks/year)   o Portugal  or  Luxembourg  at  top       th • Canada  ranks  about  45  per  capita  at  8.25  Liters  of  95%  pure  alcohol  (442   standard  drinks/year)     • Canada  and  U.S  average  age  for  first  drink  is  12  (little  below  for  boys  and  a   little  above  for  girls)     • Average  age  for  regular  use  around  16     • Estimated  80%  of  Canadians  are  current  drinkers     o Low  of  75%  in  PEI  and  high  of  82%  in  Quebec     • 20%  of  them  have  engaged  in  some  sort  of  problematic  drinking  g     2004  Survey  of  Canadian  Undergraduate  Students     Past  year  use:  86%   30  days:  77%       2007  Ontario  Student  Drug  Use  and  Health  Survey     Lifetime:  65%     Past  year:  61%  (representing  about  620  000  grade  7-­‐12)         Binge  Drinking  (5+  drinks  on  one  occasion)   26%  of  Students     Grade  7  à  Past  year:  28%       Binge:  4%           Grade  12  à  Past  year:  83%       Binge:  48%     • Estimated  Canadians  spend  about  $18  billion  of  alcohol  in  2007     o $667  per  Canadian  (number  actually  a  little  lower)     • Loss  Productivity  (crime,  health  care,  car  accidents  etc.)  =  $12  Billion/year   o $463  per  Canadian       • U.S  total  costs  of  alcohol  estimated  $116  Billion/year  in  2005     o $600  per  American     • 15%  of  all  health  care  expenses  are  alcohol  related     • 10%  of  deaths  are  alcohol  related     • 40%  of  traffic  fatalities  are  alcohol  related  (BAC  .10  or  greater)     • 60%  fatal  teenage  drivers  had  been  drinking  prior  to  accident     • 50%  of  all  accidental  falls  and  fire  are  alcohol  related     • Alcoholics  die  10  –  15  years  earlier  than  general  population     • Risk  of  Suicide  =  30x  greater  in  alcoholics  than  general  population     o US  –  11.9/100  000     Canada  –  15.1/100  000     • Alcoholism  is  cause  of  nutritional  deficiency  in  Western  countries     • Consumption  of  alcohol  can  be  related  to  acute  problems     o 40%  of  men  have  experienced  at  least  one  occasion  of  drinking   resulting  in  arrest  for  DWI,  fighting,  or  damage  to  property     • Does  produce  chronic  problems  at  high  levels  on  a  regular  basis   • 80%  of  alcohol  consumed  is  consumed  by  30%  of  the  people  who  drink     • 50%  of  alcohol  consumed  is  consumed  by  10%  of  the  people  who  drink     • Estimated  10%  males  and  5%  females  in  North  America  meet  some   definition  of  alcoholism     • Estimated  that  approximately  4  other  people  are  detrimentally  affected   by  each  problem  drinker     o Most  often  in  drinkers  family       • More  men  then  women  drink  daily  (heavily)   • Problem  drinking  starts  later  in  women  than  men     • Women  tend  to  seek  treatment  after  shorter  drinking  history  than  men     o Women  drinking  is  said  to  be  telescoped  (analogy  meaning  end  point   brought  closer)       • Aboriginal  peoples  appear  in  treatment  higher  than  proportion  in  general   population     • Estimated  that  less  than  5%  of  alcoholics  conform  to  stereotypic  image     o Bum  lying  in  street  with  bottle  and  paper  bag       CHARACTERISTICS  OF  ALCOHOLIC  BEVERAGES  &  ABSORPTION     • Beer,  wine  (table  wines,  dessert  wine,  ports,  sherries,  liqueurs,  vermouths,   wine  coolers),  distilled  spirits  (rum,  rye,  whisky,  vodka,  gin,  absinthe,  spirit   coolers)   • North  America  à  alcohol  content  expressed  by  %  by  volume     o Example:  50%  by  volume  =  16oz  beverage  =  8oz  of  alcohol     • In  past  à  expressed  as  “proof”     o Term  from  military  usage  related  to  content  of  alcohol  needed  for   liquid  to  ignite     o 2x  %  by  volume     o Example:  80  proof  =  40%  by  volume       • Most  regular  Canadian  beer  typically  =  5%     o Light  beer  =  4%     o Strong  beer  =  7%     • Most  table  wine  =  9%  (white  wine  with  residual  sugar)  –  14%  (red  wine  hot   climates  no  residual  sugar)     • Most  fortified  wines  –  Port,  Sherry  =  20%     • Most  distilled  spirits  =  40%  (may  be  higher)     o Example:  absinthe  =  80%     some  rums  =  75%     • Neutral  Grain  spirits  =  95%  by  volume     Method  Of  Administration:   • Main  method  is  by  drinking     • Possible  to  inhale  vapors  (used  in  animal  models)     • Machine  called  AWOL  –  Alcohol  Without  Liquid  –  produces  fine  alcohol   mist  which  is  inhaled     • Inhalation  is  faster  to  reach  brain  than  oral     o Not  subjected  to  metabolism  in  stomach  or  first  pass  liver     • Very  Dangerous!   o Protective  factor  against  ingesting  lethal  dose  of  alcohol  is  that  person   is  very  likely  to  pass  out  before  enough  alcohol  is  consumed  to   produce  lethal  effect     Absorption:   • Fairly  rapidly  absorbed  through  stomach  (particularly  small  intestine  and   colon)   o Taken  orally  à20%  of  alcohol  is  absorbed  from  stomach  and  80%   from  small  intestine     • Stomach  alcohol  is  subjected  to  metabolism  by  dehydrogenase   • Gastrointestinal  tract  absorption     o Greater  concentration  (25%)  of  alcohol  more  rapid  absorption     § Higher  alcohol  content  moves  faster  from  stomach  to  intestines   where  it  is  absorbed  better   o Other  chemicals  in  alcohol  slow  down  absorption     § Vodka/gin  better  absorbed  than  coloured  spirits   whisky/rye/rum   o Food  in  stomach  slows  absorption  and  can  reduce  peak  blood  alcohol   concentration  as  much  as  50%   § Longer  time  to  metabolize  the  alcohol  (dehydrogenase)   § Less  alcohol  enters  blood  per  unit  of  time   o Alcohol  in  carbonated  beverages  (champagne)  more  rapidly  absorbed   § Carbonation  speeds  gastric  emptying  into  intestine   o More  rapid  ingestion  =  more  rapid  absorption  (higher  blood  alcohol   concentration)   § Liver  metabolizes  alcohol  at  steady  rate  à  if  consumption  is   more  than  liver  cannot  keep  up     § Liver  à  Brain     o Lean  body  mass  about  70%  water;  body  fat  only  10-­‐40%  water   § Alcohol  more  widely  distributed  by  higher  water  content     § Example:  analogy  –  put  constant  amount  of  food  colouring  in  a   beaker  with  a  given  weight  of  water  (lean  person)  –  compared   to  beaker  filled  with  water  and  rocks  (fat  person)  –  more  water   in  1  beaker  so  food  colouring  more  diluted     o 15%  of  ingested  alcohol  metabolized  in  stomach  by  alcohol   dehydrogenase     o Women  have  50%  less  alcohol  dehydrogenase  then  men  (higher  BAC)   • Metabolized  in  liver  from  alcohol  dehydrogenase  to  acetaldehyde     o Broken  down  by  acetaldehyde  dehydrogenase  to  acetic  acid  and   ultimately  carbon  dioxide  and  water     • 5%  of  alcohol  normally  escapes  through  the  lungs     o Produces  a  “sour”  breath  of  chronic  drinker       Standard  Drink:  can  of  beer  –  5oz/355ml  of  12%  wine  –  1.5oz/45ml  distilled   spirits,  contains  about  13.5g  of  alcohol       • Typical  measure:  Blood  Alcohol  Curve  (BAC)  or  Blood  Alcohol  Level   (BAL)   o Shows  amount  of  alcohol  in  blood  as  function  of  time  since  ingestion     o Bell  shaped  curve  rising  to  a  peak  and  then  declining     • In  Ontario  à  0.05  or  higher  (50mg  alcohol  per  100mg  blood)  legally  defines   impairment     • Alcohol  is  metabolized  at  rate  of  about  0.015/hour   • BAC  effected  by  individual  absorption  and  metabolization       Example:  Estimated  BAC  for  120lb  woman  and  180lb  man  à  drinking  one  beer     • Take  body  weight  (kg)  x  0.75  (men)  or  0.66  (women)  PAGE  181   • 120lb  =  could  drink  a  little  more  than  one  beer  before  legal   impairment     • 180lb  =  just  a  little  over  2  standard  drinks       ALCOHOL  EFFECTS   • Alcohol  diffuses  readily  across  capillary  walls  including  blood  brain  barrier     • About  90%  of  blood  alcohol  crosses  BBB  immediately       Characteristics  of  BAC:   0.03  or  less  à  little  noticeable  effect,  no  loss  of  coordination,  increased  sociability   0.03  –  0.06  à  relaxation,  warmth,  euphoria,  beginning  of  behavioral  and  cognitive   impairments   0.06  –  0.09  à  reduced  reaction  time,  increased  irritability  and  aggression     0.09  –  0.12  à  substantial  motor  coordination,  attention,  slurred  speech     0.12  –  0.19  à  gross  motor  impairment,  blurred  vision,  dysphoria,  nausea     0.20  à  confused,  disoriented,  difficulty  standing/walking,  nausea  and  vomiting     0.25  à  blackouts   0.30  à  probably  passed  out     0.35  à  coma  –  level  of  surgical  anesthetic     0.45  and  up  à  possible  death       Behavioral  Ataxia  and  Loss  of  Motor  Coordination:     • Due  to  effect  on  balance  control  of  inner  ear     • May  be  reason  room  seems  to  ‘spin’  when  one  lies  down  after  drinking     • Stumbling  and  falling  over   • Simplest  test  is  finger-­‐finger  test   o Cardboard  attached  to  persons  finger  on  one  hand  and  a  marking  on   other  hand     o Told  to  bring  fingers  together  at  the  point  (harder  as  increase  BAC)   • Stabiliometer  –  devise  that  quantifies  body  sway     o Effects  was  more  when  imitated  bar/club  (disco  lights)     • Behavioral  Ataxia  measured  by:     o Flat  surface  that  is  slowly  raised  on  an  angle  (degree  of  tilt  animal   slides  down  is  measured)     o Intoxicated  animals  slide  down  at  more  shallow  angle  than  sober     • Rotarod  task  –  horizontal  bar  that  rotates  about  long  axis     o Drugged  rats  fall  off  bar  in  dose  dependent  manner     • Similar  to  “walk  in  straight  line”  –  animals  must  walk  forward  and  backwards   on  moving  belt  and  avoid  falling  on  electric  grid       Effect  on  Body  Temperature  and  Vasodilation:   • Alcohol  lowers  core  temperature  because  increases  peripheral  vasodilation   leading  to  heat  loss     o Causes  skin  to  feel  warm  and  turn  red     • Alcoholics  experience  chronic  vasodilation  that  breaks  blood  vessels  in  upper   cheeks  and  nose     o “jolly  red  nose”  à  associated  with  Silenus  (god  of  wine/merriment)     Impaired  Judgment  (related  to  driving):   • Probability  of  an  accident  is  4x  greater  when  BAC  is  between  0.04  –  0.08   • 7x  greater  when  BAC  reaches  0.10  –  0.14     • 25x  greater  if  BAC  is  0.15  or  higher     • Increase  risk  due  to:     o Reduced  attention  to  stimuli  in  peripheral  visual  field,  slow  reaction   times   o Impairs  judgment  about  driving  ability  (how  far  things  appear)       Alcohol  Impairment  on  Cognitive  Tasks:   • Attributed  to  interfering  with  inspection  time,  capacity  to  divide  attention   among  demands,  sustain  attention,  ignore  irrelevant  stimuli,  info  processing     • More  complex  the  task  the  lower  dose  of  alcohol  necessary  to  produce   impairment       Alcohol  and  Cardioprotective  Effects:   • Early  1990’s  epidemiologists  noted  French  diet  was  high  in  saturated  fats   they  had  relatively  low  incident  of  heart  disease  (French  Paradox)   •  French  regularly  consumed  moderate  amount  of  alcohol  (2  drinks  –  men,  1   drink  –  women)  lower  risk  of  cardiovascular  disease     • Due  to  increase  in  (HDL),  eliminating  cholesterol,  decrease  in  (LDL)     • This  is  lost  in  anyone  who  smokes  cigarettes       Alcohol  and  Sexual  Behaviour:   • Shakespeare  summarizes  effects:  “It  provokes  the  desire,  but  takes  away  the   performance”   • Penile  tumescence  –  measurement  of  sexual  arousal  (men)   o Shows  BAC  <0.025  sexual  responsiveness  may  be  increased   o BAC  >0.05  sexual  responsiveness  decreases     o BAC  >0.10  temporary  impotency     • Women  sexual  responsiveness  –  vaginal  photoplethysmograph  or  by  time   to  reach  orgasm  –  decreased  by  alcohol   o Increased  subjective  arousal  and  pleasure     • Most  people  under  belief  that  alcohol  increase  sexual  responsiveness     o Expectancies  effect  outcome  of  drug  (influence  how  they  will  behave   when  take  drug)     o Classic  example  Placebo  Effect     § Given  sugar  tablets  –  told  powerful  analgesics  –  to  be  able  to   endure  more  pain   • Placebo  Balance  Design  –  2x2  factor  analysis     o Men  who  thought  they  were  given  alcohol  (whether  or  not  real)  had   greater  penile  responses,  more  time  watching  erotic  pictures,  greater   subjective  arousal     • Expectancy  effects  have  been  less  consistently  demonstrated  in  women     o One  explanation:  women  expect  to  receive  alcohol  experience  more   anxiety  and  less  likely  for  self  disclosure  –  less  likely  to  report  sexual   arousal       Alcohol  and  Violence:     2  Strong  Relationships  between  A  &  V     • People  who  commit  violent  acts  often  are  under  influence     • People  who  have  suffered  from  violence  of  alcohol     • Roizen  estimated  over  80%  homicides,  60%  sexual  assaults,  60%  male   domestic  assaults,  30%  female  domestic  assaults,  15%  sexual  abuse  cases   were  committed  by  someone  who  was  intoxicated   • People  who  start  drinking  by  age  17  are  4x  as  likely  to  have  been  involved   in  violence  during  the  last  year  than  person  who  started  drinking  at  21  +   • Alcohol  increases  aggression:   o Old  Theory:  disinhibition  theory  à  alcohol  lowers  normal   inhibitions  that  keep  aggression  in  check     § Difficult  to  test  (circular  argument)     o Neurochemical  Account:  effect  of  alcohol  on  neurotransmitter   serotonin     § Low  levels  of  serotonergic  activity  are  associated  with  increase   levels  of  impulse  and  violent  acts     o Expectancies:  Given  situation  (believed  to  drink  alcohol)  then  later   allowed  to  give  electric  shock  to  person  from  before     § Those  who  thought  drinking  delivered  intense,  longer  shocks   Blackouts:   • Period  of  amnesia  without  loss  of  consciousness   • Person  is  awake  and  behaving  but  have  no  memory  of  what  they  did  during   that  time   • Quite  often  person  will  engage  in  high  risk  activities  (driving,  unprotected   sex,  aggression,  vandalism)     • Divided  into  2  categories     o “En  bloc”  blackouts  –  inability  to  later  recall  any  memories  from   intoxicated  period,  even  when  prompted     o “Fragmentary”  blackouts  –  events  from  intoxicated  period  may  be   recalled,  while  others  are  not  recalled  unless  cued     § more  common     • Blackouts  are  likely  at  BAC  around  0.25  (VERY  HIGH  BAC)     • Research  showing  that  capacity  to  transcribe  memory  proteins  from  genetic   material  is  impaired  around  BAC  0.25       Hangovers:   • Symptoms  experienced  4  –  12  hours  after  stop  period  of  heavy  drinking   o Pounding  headache,  dizziness,  nausea,  general  body  aches,  vertigo,   sensitivity  to  light  and  sound,  shakes,  extreme  thirst  (cotton  mouth)     • Considered  form  of  acute  withdrawal  –  even  if  no  long  history  of  drinking    
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