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Transcript of Alcohol. Alcohol Support Services Washington Recovery Line: 1-866-789-1511Washington Recovery Line...
Alcohol
Alcohol Support Services
• Washington Recovery Line: 1-866-789-1511
• Teen Link: 866-TEENLINK (866-833-6546)
• Crisis Clinic: 206-461-3222/1-866-427-4747
• Alcoholics Anonymous: 206-587-2838
• Alanon & Alateen: 206-625-0000
• Adult Children of Alcoholics: 425-213-3919/ 1-800-562-1240
• Substance Abuse & Mental Health Services Administration Facility Locator
Alcohol Consumption Statistics, U.S.
• % of adult Americans consuming alcohol regularly (1 per month)
• 51% (CDC, 2012)
• Percent of adult infrequent drinkers
• 13% (CDC, 2012)
• Binge drinking, 4/month, 8 drinks (CDC, 2012)
• 1 in 6 adults• 2.28 gallons/person (NIAAA, 2011)
Alcohol Consumption Statistics, World
• Percent of population, 15+ years who consumes alcohol
• 38% (WHO, 2014)
• (found conflicting information on amount consumed/person)
• 3.3 million deaths (WHO, 2014)
• Across globe, consumption varies dramatically (WHO, 2011, via fasdprevention)
– Greenfacts.org: chart (via 2004 WHO statistics)
Alcohol Consumption
• Type of alcohol also impacts consumption variation across world
• Top 20 countries with highest beverage-specific adult per capita consumption (Green Facts.org, via WHO 2004 statistics)
• Global Status Report on Alcohol and Health (WHO, 2014)
Burden of Disease Attributable to Alcohol
• Mild: intoxication• More severe:
alcoholism, liver cancer, esophageal cancer, cirrhosis, homicide, motor vehicle accidents
• WHO: 5.1% of global burden
• Incidence across the world (WHO via reuters.com)
Direct Alcohol Impact on Kids
• Alcohol Cost Calculator for Kids
• Population estimates for individuals aged 12-20 years
Source: Ensuring Solutions to Alcohol Problems, with data from National Survey on Drug Use and Health
Alcohol Formation
• Alcohol available for thousands of years• Created from natural fermentation process
– Yeast consumes a form of sugar/grain/fruit
– Products are alcohol and carbon dioxide
– Different sugars yield different alcohol forms
– Yeast is killed when fermenting solution accumulates enough alcohol to kill yeast
– Alcohol percentage depends on the yeast (& on manufacturer), 5-20%
– Video: Short animation of concept (Vimeo)
– Video: How Stuff Works: Fermentation
Alcohol Forms
• Beer and Ale: fermented cereal grains and malt– 3-8% alcohol content
• Wine: fermented grapes and other fruits– 9-15% alcohol content– Marula fruit – impact on animals in Africa
(YouTube)
• Hard Liquor: distillation– 40-50% alcohol solution
Distillation
• Used to separate alcohol from water
• Alcohol has lower boiling point than water– Alcohol evaporates into tube
– Cold water cools alcohol
– Alcohol collects in flask
• Animation (TutorVista, via YouTube)
• Animation #2 (no narration, 20to9.com via YouTube)
• Cognac distillation (cognac.fr)
Distilled Spirits
• Whiskey– Corn, rye, barley
• Rum– Molasses, sugar cane
• Brandy– Fruit juice/wine
• Gin– Rye/other grains– Addition of berries
• Tequila– Agave plant
• Vodka– Potatoes, rye, corn
Alcohol “Proof”
• Story of “proof”– Alcohol and water solution– Added to gun powder– If gun powder could ignite/pop, it was “proof”
solution contained ~50% alcohol
• Today, “proof” refers to alcohol content– The proof equals double the alcohol percentage– 40% alcohol = 80 proof
Alcohol Absorption
• Alcohol absorbed throughout GI tract– Some from stomach– Most from small intestine
• When food or other liquid present, absorption takes longer
• Carbonation speeds up absorption
• The path of alcohol in the body (SCRAM-x)
• Alcohol and the Brain (YouTube via TuneInNotOut; 2:52-5:42)
Alcohol Metabolism
• Metabolism = breakdown• Liver breaks down most of
alcohol• Alcohol broken down into
acetaldehyde– Acetic acid
• Carbon dioxide & water
• Metabolism = ~one drink/hour
• Caffeine, exercise, water do not change process
• Men metabolize faster
Alcohol Metabolism
• Gender differences– Females metabolize
alcohol slower than males
– Males have more muscle, so more water
– Alcohol dissolves in water
• Alcohol metabolism news feature (YouTube, 0:41-4:47)
Blood Alcohol Concentration (BAC)
• The amount of alcohol present in 100 ml of blood– .05 = .05 grams of alcohol per 100 ml of blood– .05 does not equal 5%, but .05%
• Intoximeters Drinking Wheel
• Stages of Alcohol Intoxication
Alcohol: Acute Effects
• Alcohol effects on brain (Vimeo, Sam Scopelliti)
• Results: similar to those in stages of intoxication, previous slide
Alcohol: Chronic EffectsImage below created by Mikael Haggstrom and is in the public domain
Alcoholism
• Among the most common psychiatric disorders
• Symptoms: recurrent intoxication, mood swings, anxiety, hallucinations, GI distress, unsteady gait, erectile dysfunction, blackouts
World Alcohol Dependence
• Difficult to accurately determine– Different ways of collecting data– Interpretation of dependence– Age cut-off for assessment varies across
countries– Data collected at different times– Alcohol dependence over lifetime vs last year
Source: WHO Global Status Report 2004
World Alcohol DependencePercent of Adult Population
• USA: 7.7% (male = 10.8%; female = 4.8%)• Poland: 12.2% (23.3%/4.1%)• Ethiopia: 1.0% (1.9%/0.1%)• Belgium: 7.0% (9.5%/3.6%)• Peru: 10.6% (17.8%/4.3%)• Singapore: 0.6% (1.1%/0.2%)• Japan: 4.1% (8.4%/0.7%)
Source: WHO Global Status Report 2004
Pharmacology for Alcoholism
• Variety of pharmacotherapies
• Antabuse has been used for decades– Blocks conversion of
acetaldehyde– When Antabuse taker
consumes alcohol, he/she becomes very ill
– No action on craving– Can be used as
supplemental treatment to other medications
Pharmacology for Alcoholism
• Naltrexone (ReVia)– Prevents relapse of drinking– Reduces craving– Thought to block opioid
system, involved with alcohol craving
– Side effects include nausea, anxiety, liver problems
– Video: YouTube
• Vivitrol-injectable version– Video: YouTube
• FDA approved
Pharmacology for Alcoholism
• Acamprosate– Used extensively in
Europe
– FDA approved in 2004
– Improves abstinence rates
Pharmacology for Alcoholism
• Acamprosate– Mechanism is not fully understood
• May target specific neurotransmitter systems (GABA & glutamate)
• Reduces PAWS (post acute withdrawal syndrome)– Anxiety– Mood swings– Fatigue– Sleep problems
Source: Substance Abuse and Mental Health Services Administration
Pharmacology for Alcoholism
• Ondansetron (Zofran)– Has been used to treat
nausea in chemotherapy patients
– Reduces alcohol consumption
– Improves abstinence among early-onset alcoholism
– Works with serotonin in brain to reduce craving
– YouTube video– Not yet FDA approved
Pharmacology for Alcoholism
• Nalmefene– Has been used for epilepsy– Blocks pleasure associated
with drinking– Can prevent relapse– Blocks more opioid
receptors than naltrexone– Used to reduce drinking
behavior (Naltrexone - maintain abstinence)
– Injectable, not yet FDA approved
Pharmacology for Alcoholism
• Topimirate (Topamax)– Has been used for epilepsy,
mood disorders– Reduces cravings– Works on dopamine
receptors– Reduces heavy drinking;
2008 study showed reduction in blood pressure, BMI, blood cholesterol
– Increased risk for cleft lip/palate among pregnant women using Topamax