Use and Abuse
• 51.9% of Americans older than 12 years of age
• Alcohol abuse occurs when the drinker’s
harmful use of alcohol affects social
interactions such as with one’s job, family,
Factors of Abuse
• Alcoholism has been shown to have a variety of
origins, many of them biological.
• People with a first-degree relative
– Behavior and temperament
• More likely if impulsive, aggressive, and
have short attention spans, slow ability to
calm oneself, a thrill-seeking nature, and an
inability to delay gratification.
– What Else contributes? (think Ch 1)
– Brain Effects: Intoxication is impaired
functioning of the central nervous system.
• Alcohol affects parts of the brain that control
drives, emotions, and skeletal muscle
• At high doses, causes nausea and vomiting.
• Over time, the drinker develops tolerance to
• Chronic drinkers do not experience aversive
effects as quickly as occasional drinkers.
Factors Related to Alcohol Use and Dependence
– Psychological, Social and Developmental
• People expect positive effects from drinking
• Parent who abuses alcohol
Alcohol and College Students
– Alcohol abuse often appears or accelerates
during college years.
– Alcohol is the most abused drug among
– Moderate drinkers who do not abuse alcohol
cite a variety of reasons for drinking, such as
social ease or stress relief. They are not goaloriented drinkers (ex. getting drunk).
– Heavy drinkers who abuse alcohol usually
drink for escapist and goal-oriented reasons.
Alcohol and College (2)
– Freshmen or sophomore status and low GPA
also are associated with alcohol abuse.
– Binge Drinking and Drinking Games
• Binge drinking often is accompanied by
drinking games. The danger of
unconsciousness, coma, and death
increases as alcohol consumption
Alcohol and College (3)
Alcohol and College Students
– Alcohol-related deaths in college students
• 5,000 alcohol-related deaths occur each
year among those aged 18 to 24.
• 1,600 are killed each year due to alcoholrelated injuries.
• ¾ of these deaths are due to alcohol-related
car crashes and 1/4 to other alcohol-related
causes, such as drownings, falls, gunshots,
and alcohol/drug poisonings.
– Alcohol absorbed into the bloodstream from
the stomach and intestinal tract
– The blood transports alcohol to the
“detoxification center” of the body—the liver.
– Alcohol is absorbed into the bloodstream more
quickly than it can be broken down by the liver,
and the excess alcohol stays in the blood.
– Thus, eating food, which keeps alcohol in the
stomach longer allows more to be broken down
before entering the bloodstream.
• Blood Alcohol Content (BAC)
–Related to Body weight, sex and amount of
food in the stomach, amount of alcohol
consumed and how much time in between
–2 hours to process 1oz (FAA)
Diseases of the Liver
• Fatty Liver: Most liver cells die as a result of
fat being stored in them.
• Cirrhosis: due to alcohol killing liver cells.
–Usually after 10-20 years of heavy
• Alcoholic Hepatitis:- inflammation of the
liver that can result in death.
• Acute or Chronic
– Roughly 3.2 million cases in U.S.
– 16,000 acute cases in 2009
– immediate transmission (acute)
– roughly 6 months for virus to do damage
Cardiovascular Disease and
• Heavier drinking is associated with
increased risks of cardiomyopathy,
hypertension, arrhythmias, and stroke.
• Alcohol use is associated with increased
risks of cancers of the esophagus and liver.
– Immune System Suppression
• Chronic drinking suppresses the immune
system, predisposing the drinker to
Impacts on Men
• Lower than normal testosterone levels
• Shrinking testicles
• Loss of sex drive (libido).
Impact on Women
• Women - irregular menstrual periods or
no periods, higher rate of premature
• During pregnancy alcohol consumption
can have a devastating effect on the
Detrimental Effects on the Brain
• Brain Disorders
• Intoxication – the impairment of the central
• Withdrawal symptoms- mild agitation, shaking,
anxiety, loss of appetite, restless, insomnia.
• Severe withdrawal symptoms –hyperactivity,
hallucinations, disorientation, and confusion.
The Brain (2)
–Hangover also may be the result of drinking
certain toxic acidic compounds or
formaldehyde, which is produced when the
body cannot keep up with the breakdown of
alcohol as it is being consumed.
–Only time cures a hangover.
Alcohol and Safety
• Serious and Fatal Injuries
»8 hrs bottle to throttle (minimum)
»30-70% of drownings are associated with
–Automobile Accidents (roughly a third)
»Roughly 10,000 in 2011 (drop from
18,000 in 2006)
»1.5M DUI arrests and climbing
– Plan how much you will drink ahead of time
– Drink slowly
– Eat before and while drinking
– Set a limit for yourself, how many drinks, how
long you will drink
– Don’t drink to avoid problems
– Know how to refuse a drink
– Don’t drink daily
Reasons for Use
– Most start in adolescence
– Psychological Reasons for Using Tobacco
• Peer influence is the most important factor.
• Low self esteem, little knowledge, poor
academic achievement are most susceptible.
• Those who think their parents don’t care about
Addiction to Nicotine
• Nicotine becomes addicting during the first few
years of use
• Withdrawal from nicotine causes unpleasant
• A smoker builds tolerance to the effects of
nicotine during the day.
• The smoker smokes more cigarettes as the
day wears on.
Health Effects of Tobacco Use
– 1964:Tobacco use linked with lung cancer &
– Cigarette smoking is the leading cause of
preventable death in the United States.
Nicotine and Carbon Monoxide:
• Increased the heart rate and blood pressure
• Increases the metabolic rate.
• The carbon monoxide in cigarette smoke
interferes with the red blood cells’ ability to
• Cilia damage (lining of respiratory tract)
• Inability to expel foreign particles – smokers
• Acute Bronchitis: an inflammation of the
mucous membranes of the bronchi.
• Chronic bronchitis: a persistent inflammation
and thickening of the lining of the bronchi
caused by the constant irritation of smoke. Can
result in death.
Respiratory Illness Cont’d
• Pneumonia: inflammation of the lungs
• Emphysema: a condition in which the air sacs
of the lungs lose their normal elasticity.
–Lungs normal capacity to allow air to enter
is decreased, making breathing a continual
• Chronic Obstructive Pulmonary Disease
(COPD): chronic bronchitis and emphysema,
• Coronary Artery Disease, Hypertension,
• Women + Oral Contraceptives = higher risk
• Light Cigarettes = same risk
• 3-9 years after quitting smoking the risk of
death returns to that of a non-smoker.
• Cancer is the second biggest killer of
Americans, and tobacco use is responsible for
about 30% of cancer deaths and 87% of lung
cancer deaths annually in the United States.
• Use of tobacco products affects the oral cavity,
creating problems such as bad breath, stained
teeth, and even oral cancer
• Disease of the supporting tissues around the
teeth including the gums, bone, and ligaments.
• Leukoplakia (lesions around the mouth that
can turn into caner) is common in young
people who use smokeless tobacco products.
• Smoking cigarettes can cause osteoporosis, or
loss of bone density.
• This is a particular concern for women in their
postmenopausal women because it increases
the risk of bone fractures, back pain and other
Environmental Tobacco Smoke:
– ETS can cause lung cancer in nonsmokers, have
an increased risk of cardiovascular disease and
– Children - increased respiratory symptoms such
as coughing and wheezing and lower respiratory
tract infections such as bronchitis, influenza, and
pneumonia, and asthma
– Nonsmoking areas adjacent to smoking areas
contain unacceptable levels of airborne pollutants
unless the areas have separate ventilation
– Most smokers want to quit
– Benefits of Quitting
• Lower risk of various diseases and conditions
including certain cancers, heart attack, stroke,
and chronic lung disease.
• In pregnant women, to reduce the risk of
having a low--birth--weight baby.
• Stop exposing family and other people around
to second-hand smoke.
• Nicotine patches and other nicotine-containing
products can reduce these symptoms.
• Electronic cigarettes are highly questioned by
• Nicotine vaccine is in clinical trial.
• 1st 6 months – quitting period
• 6 month- 1 yr – maintenance
• Relapse – can occur and can be overcome