Livia Borsoi MD, MPH Center for Public Health Institute of Social Medicine Email:  [email_address] Alcohol Problems and so...
History  <ul><li>The use of alcohol has been traced as far back as 8000 BC </li></ul><ul><li>The names origines from the A...
What place had wine in the  Christianity? Giotto(1303-1305) Padova – Scrovegni‘s  chapel . Wedding Feast at Caanan
What place had alchohl  in the  Christianity?
How is it today? Simpsons. The last supper
<ul><li>High cultural acceptance </li></ul><ul><li>Low cost of alcohol </li></ul><ul><li>Alcoholics are everywhere </li></...
Why do you drink?
Why Drink? <ul><li>People often drink as a way to:  </li></ul><ul><li>Get a break from their daily routine. </li></ul><ul>...
ALCOHOL'S TRIP THROUGH THE BODY 1 MOUTH 2 STOMACH   3 SMALL INTESTINE   4 BLOODSTREAM   5 LIVER   6 BRAIN   About  20%  of...
Acute effects of alcohol  <ul><li>after 30 -60 minutes reaches the highest blood concentration </li></ul><ul><li>relaxatio...
Alcohol Metabolism <ul><li>  </li></ul>Alcohol Dehydrogenase ACETALDEHYDE ETHANOL NAD+ NADH/ H+ When the  liver  processes...
How Does Gender Influence the Effects of Drinking? <ul><li>Different Enzyme Level </li></ul><ul><li>Women and Men Differ i...
Effects of Age on Drinking? <ul><li>Young people are more affected by alcohol than adults  because: </li></ul><ul><li>They...
<ul><li>Most teens start drinking alcohol between 13 and 15 years. </li></ul>Austrian law prohibits  to smoke and drink ti...
Half of  Austrians boys and 30 % of girls  already got drunk repeatedly at age 15 http://www.api.or.at/akis/kurzinfo/gajug...
What kind of alcoholic drinks Austrian teen agers ( 16-19 y.) choose to drink Source: „Repräsentativerhebung 1993/94“, Uhl...
<ul><li>Intoxications </li></ul><ul><li>Disco accidents </li></ul><ul><li>Risk of violence and aggressions </li></ul><ul><...
 
10 golden rules to enjoy drinking…. <ul><li>Eat before or while drinking.  </li></ul><ul><li>Drink slowly and maybe switch...
BAC -  Blood alcohol content   (Eng.  per mille   ‰ ) <ul><li>Volume percent = how much alcohol there is in the drink </li...
<ul><li>Car drivers : 0,1 ‰ for the first 2 years after getting a car licence </li></ul><ul><li>0,5 ‰ after the first two ...
Effects at different permille levels Loss  of consciousness, reduction in heart beat and respiration, coma, possible death...
The golden rule of 0,5 Per mille <ul><li>Girls (55 kg) have 0,5 ‰ 30 min. after </li></ul><ul><li>1 big beer ( 0,5l) </li>...
What affects my BAC? <ul><li>How fast a person’s BAC rises varies with a number of factors: </li></ul><ul><li>The number o...
<ul><li>900.000 drink quantities of Alcohol that can be dangerous </li></ul>Who uses alcohol? Source : Handbuch Alkohol 20...
5% of Austrians are alcoholics: 330.000!  Females 1/3 Males 2/3 Source : Handbuch Alkohol 2001 -Österreich
A PROBLEM DRINKER typically:  <ul><li>Drinks to get drunk.  </li></ul><ul><li>Tries to solve problems by drinking.  </li><...
An ALCOHOLIC typically:  <ul><li>Spends a lot of time thinking about drinking and planning where and when to get the next ...
Daily recommended maximum number of drinks  <ul><li>24g  </li></ul>http://www.api.or.at/akis/kurzinfo/hrmgef.htm ½l beer o...
Drinking Alcohol in Moderation: Better Health & Longer Life <ul><li>Moderate consumption of alcohol appears to be benefici...
Coffee? Sleep? Cold bath? Take a Walk? The only thing that reverses the effects of alcohol  is time! I feel so bad….
Critical Signs for Alcohol Poisoning <ul><li>Mental confusion, stupor, coma, or person cannot be roused.  </li></ul><ul><l...
What to do if someone needs help <ul><li>Don‘t leave him alone </li></ul><ul><li>Talk to him, calm him down if necessary <...
Think before you drink! <ul><li>In Austria who‘s brought to the hospital and get diagnosed with „ acute alcohol intoxicati...
Where do I get informations and help? <ul><li>wienXtra-jugendinfo . Babenbergerstraße 1, 1010 Wien Tel.: 01 1799 E-Mail:  ...
<ul><li>Prevention campaign  &quot;Nachdenken statt Nachschenken&quot;  2007 </li></ul><ul><li>Increased controls in sales...
Alcohol self test        True    7. I never drink alcohol when I am alone  8. I never ride a bicycle or moped  a...
I am done…
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Alcohol

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  • Alcohol

    1. 1. Livia Borsoi MD, MPH Center for Public Health Institute of Social Medicine Email: [email_address] Alcohol Problems and solutions
    2. 2. History <ul><li>The use of alcohol has been traced as far back as 8000 BC </li></ul><ul><li>The names origines from the Arabic : الغول ‎ , &quot;al-ġuḥl„, fine powder </li></ul><ul><li>Alcoholic beverages were used for pleasure, nutrition, medicine, ritual, remuneration and funerary purposes </li></ul>
    3. 3. What place had wine in the Christianity? Giotto(1303-1305) Padova – Scrovegni‘s chapel . Wedding Feast at Caanan
    4. 4. What place had alchohl in the Christianity?
    5. 5. How is it today? Simpsons. The last supper
    6. 6. <ul><li>High cultural acceptance </li></ul><ul><li>Low cost of alcohol </li></ul><ul><li>Alcoholics are everywhere </li></ul><ul><li>Lots of economical interests </li></ul>Most people don‘t think about the possible effects of drinking because…
    7. 7. Why do you drink?
    8. 8. Why Drink? <ul><li>People often drink as a way to: </li></ul><ul><li>Get a break from their daily routine. </li></ul><ul><li>De-stress from school or work. </li></ul><ul><li>Reward themselves. </li></ul><ul><li>Feel less inhibited in social situations. </li></ul><ul><li>Fit in with others that are drinking. </li></ul><ul><li>Express feelings that are difficult to express when they are sober. </li></ul><ul><li>Suppress painful feelings such as shame, anger, sadness or loneliness. </li></ul>
    9. 9. ALCOHOL'S TRIP THROUGH THE BODY 1 MOUTH 2 STOMACH 3 SMALL INTESTINE 4 BLOODSTREAM 5 LIVER 6 BRAIN About 20% of the alcohol is absorbed in the stomach and about 80% is absorbed in the small intestine.
    10. 10. Acute effects of alcohol <ul><li>after 30 -60 minutes reaches the highest blood concentration </li></ul><ul><li>relaxation </li></ul><ul><li>slight body warmth </li></ul><ul><li>muscle coordination becomes poor </li></ul><ul><li>short-term memory loss </li></ul><ul><li>loss of balance </li></ul><ul><li>lethargy </li></ul>
    11. 11. Alcohol Metabolism <ul><li> </li></ul>Alcohol Dehydrogenase ACETALDEHYDE ETHANOL NAD+ NADH/ H+ When the liver processes alcohol, the poison acetaldehyde is produced. Fatty liver Cirrhosis of the Liver The liver breaks down most alcohol we ingest at a speed of about 0,1 – 0,2 Permille of alcohol an hour.
    12. 12. How Does Gender Influence the Effects of Drinking? <ul><li>Different Enzyme Level </li></ul><ul><li>Women and Men Differ in Body Size and Composition </li></ul><ul><li>Health effects </li></ul>
    13. 13. Effects of Age on Drinking? <ul><li>Young people are more affected by alcohol than adults because: </li></ul><ul><li>They weight normaly less than adults. </li></ul><ul><li>their body has less water than adults, so that BAC is higher. </li></ul><ul><li>They have less liver enzymes to break down alcohol than adults </li></ul>
    14. 14. <ul><li>Most teens start drinking alcohol between 13 and 15 years. </li></ul>Austrian law prohibits to smoke and drink till age 16!
    15. 15. Half of Austrians boys and 30 % of girls already got drunk repeatedly at age 15 http://www.api.or.at/akis/kurzinfo/gajug.htm
    16. 16. What kind of alcoholic drinks Austrian teen agers ( 16-19 y.) choose to drink Source: „Repräsentativerhebung 1993/94“, Uhl & Springer, 1996 66% 21% 7% 4% 3%
    17. 17. <ul><li>Intoxications </li></ul><ul><li>Disco accidents </li></ul><ul><li>Risk of violence and aggressions </li></ul><ul><li>Unsafe sex (unwanted pregnancy, Sex.Trans.Disease) </li></ul>What consequences of drinking face young people?
    18. 19. 10 golden rules to enjoy drinking…. <ul><li>Eat before or while drinking. </li></ul><ul><li>Drink slowly and maybe switch to non alcoholic drinks in between. </li></ul><ul><li>Do not drink to get drunk! </li></ul><ul><li>Don‘t drink to cope with stress, anger, sadness or because you can‘t sleep… </li></ul><ul><li>Never drive after drinking! </li></ul><ul><li>Don‘t mix alcohol with drugs or medications! </li></ul><ul><li>Respect non-drinkers. </li></ul><ul><li>Don‘t allow anybody to tell you have to drink if you don‘t feel like it. </li></ul><ul><li>Check that who‘s driving stays sober </li></ul><ul><li>Always use a condom to have sex! </li></ul>
    19. 20. BAC - Blood alcohol content (Eng. per mille ‰ ) <ul><li>Volume percent = how much alcohol there is in the drink </li></ul><ul><li>Per mille is the concentration of alcohol in a person's blood. ( ‰) </li></ul><ul><li>BAC Calculators: </li></ul><ul><li>English: http://www.ladrunkdrivinglawyer.com/bac_calculator.html </li></ul><ul><li>German: www.1-2-free.at </li></ul>What is Permille ?? X*#X*Z/ @XXY‘‘##
    20. 21. <ul><li>Car drivers : 0,1 ‰ for the first 2 years after getting a car licence </li></ul><ul><li>0,5 ‰ after the first two years. </li></ul>Austrian permille limits on drinking and driving: <ul><li>Moped drivers: 0,1 ‰ till age 20 </li></ul><ul><li>then 0,5 ‰ </li></ul>0,8 ‰: driving licence will be taken away by the police even if you were just riding your bicycle!
    21. 22. Effects at different permille levels Loss of consciousness, reduction in heart beat and respiration, coma, possible death 3-4‰ Substantial impairment in vehicle control Vomiting ■ Major loss of balance, possible loss of conciusness ■ risk of freezing outside - body temperature declines 2 ‰ Reduced ability to maintain lane position and brake appropriately Clear deterioration of reaction time and control ■ Slurred speech, poor coordination, and slowed thinking 1‰ Concentration ■ Short-term memory loss ■ Speed control ■ Reduced information processing capability (e.g., signal detection, visual search) ■ Impaired perception Muscle coordination becomes poor (e.g., balance, speech, vision, reaction time, and hearing) ■ Harder to detect danger ■ Judgment, self- control, reasoning, and memory are impaired 0,8‰ Reduced coordination, reduced response to emergency driving situations  double risk of having a car accident ! Exaggerated behavior, may have loss of small-muscle control (e.g., focusing your eyes), impaired judgment, usually good feeling, lowered alertness, release of inhibition 0,5‰ Decline in visual functions (rapid tracking of a moving target), decline in ability to perform two tasks at the same time (divided attention) Some loss of judgment, relaxation,slight body warmth, altered mood 0,2‰ Predictable effects on driving Typical Effects Blood Alcohol Concentration (BAC)
    22. 23. The golden rule of 0,5 Per mille <ul><li>Girls (55 kg) have 0,5 ‰ 30 min. after </li></ul><ul><li>1 big beer ( 0,5l) </li></ul><ul><li>a big glass of wine ( 0,25l) </li></ul><ul><li>or 3 glasses spirits (6cl) </li></ul><ul><li>Boys (65 kg) have 0,5 ‰ 30 min. after </li></ul><ul><li>2 small beers (0,6 l) </li></ul><ul><li>or 0,3 l wine </li></ul><ul><li>or 4 glasses spirits (8cl) </li></ul>
    23. 24. What affects my BAC? <ul><li>How fast a person’s BAC rises varies with a number of factors: </li></ul><ul><li>The number of drinks. </li></ul><ul><li>How fast you drink. </li></ul><ul><li>Your gender. </li></ul><ul><li>Your weight. </li></ul><ul><li>Food in your stomach. </li></ul><ul><li>How often you drink (induction of enzymes and tolerance) </li></ul>
    24. 25. <ul><li>900.000 drink quantities of Alcohol that can be dangerous </li></ul>Who uses alcohol? Source : Handbuch Alkohol 2001 -Österreich
    25. 26. 5% of Austrians are alcoholics: 330.000! Females 1/3 Males 2/3 Source : Handbuch Alkohol 2001 -Österreich
    26. 27. A PROBLEM DRINKER typically: <ul><li>Drinks to get drunk. </li></ul><ul><li>Tries to solve problems by drinking. </li></ul><ul><li>Experiences changes in personality; may become loud, angry or violent, OR silent, remote or reclusive. </li></ul><ul><li>Drinks when he or she should not - before driving, going to class or work. </li></ul><ul><li>Causes others problems -- harms himself or herself, family, friends or strangers. </li></ul>
    27. 28. An ALCOHOLIC typically: <ul><li>Spends a lot of time thinking about drinking and planning where and when to get the next drink. </li></ul><ul><li>Keeps bottles hidden for quick pick-me-ups. </li></ul><ul><li>Starts drinking without conscious planning and loses awareness of the amount consumed. </li></ul><ul><li>Denies drinking. </li></ul><ul><li>Drinks alone. </li></ul><ul><li>Needs to drink before facing a stressful situation. </li></ul><ul><li>May have &quot;blackouts&quot; -- cannot remember what he or she did while drinking, although he or she may have appeared normal to people at the time. </li></ul><ul><li>Goes from having hangovers to more dangerous withdrawal symptoms, such as delirium tremens (&quot;DTs&quot;), which can be fatal. </li></ul><ul><li>Has or causes major problems -- with police, an employer, family or friends. </li></ul>
    28. 29. Daily recommended maximum number of drinks <ul><li>24g </li></ul>http://www.api.or.at/akis/kurzinfo/hrmgef.htm ½l beer or ¼l wine 16g both genders = 20 g
    29. 30. Drinking Alcohol in Moderation: Better Health & Longer Life <ul><li>Moderate consumption of alcohol appears to be beneficial to reducing or preventing even more diseases and health problems: </li></ul><ul><li>coronary heart disease (CHD) </li></ul><ul><li>heart attack </li></ul><ul><li>stroke </li></ul><ul><li>high blood pressure </li></ul><ul><li>diabetes, bone fractures and osteoporosis, dementia and others… </li></ul><ul><li>Men who drink in moderation tend to live about two years longer than abstainers. </li></ul>http://www2.potsdam.edu/hansondj/HealthIssues/1107279468.html
    30. 31. Coffee? Sleep? Cold bath? Take a Walk? The only thing that reverses the effects of alcohol is time! I feel so bad….
    31. 32. Critical Signs for Alcohol Poisoning <ul><li>Mental confusion, stupor, coma, or person cannot be roused. </li></ul><ul><li>Vomiting. </li></ul><ul><li>Slow breathing (fewer than eight breaths per minute). </li></ul><ul><li>Irregular breathing (10 seconds or more between breaths). </li></ul><ul><li>Hypothermia (low body temperature), bluish skin color, paleness. </li></ul>
    32. 33. What to do if someone needs help <ul><li>Don‘t leave him alone </li></ul><ul><li>Talk to him, calm him down if necessary </li></ul><ul><li>Get him in the fresh air, but watch that he doesn‘t get cold (hypothermia) </li></ul><ul><li>Offer tee or water </li></ul><ul><li>If he has lost conciousness </li></ul><ul><li>check his airways are free from vomit, </li></ul><ul><li>check if he is breething </li></ul><ul><li>put him in the safety position to avoid he soffocates himself </li></ul><ul><li>Pinch his arm to verify his reflexes </li></ul><ul><li>If he doens‘t react in any way call the ambulance ( 144 ) or a doctor ( 141 ) </li></ul>safety position
    33. 34. Think before you drink! <ul><li>In Austria who‘s brought to the hospital and get diagnosed with „ acute alcohol intoxication/ poisoning“will be charged 451 € for the ambulance and </li></ul><ul><li>537€ for every day in the hospital </li></ul><ul><li>social insurance will not refund it! </li></ul>
    34. 35. Where do I get informations and help? <ul><li>wienXtra-jugendinfo . Babenbergerstraße 1, 1010 Wien Tel.: 01 1799 E-Mail: [email_address] www.jugendinfowien.at (mit rat&hilfe-Forum) </li></ul><ul><li>ChEck iT! Gumpendorfer Straße 8, 1060 Wien Tel.: 01 585 12 12 www.checkyourdrugs.at </li></ul><ul><li>dialog 10 Gudrunstraße 184, 1100 Wien </li></ul><ul><li>Tel.: 01 604 11 21 www.dialog-on.at </li></ul><ul><li>Gratis Mädchentelefon : 0800 21 13 17 </li></ul><ul><li>Talkbox of MAG ELF : talkbox@m11.magwien.gv.at </li></ul><ul><li>Kinder- und Jugendanwaltschaft Wien : 01 707 70 00 </li></ul><ul><li>Or [email_address] </li></ul><ul><li>Anton-Proksch-Institut </li></ul><ul><ul><li>Wiedner Hauptstraße 105, 1050 Wien </li></ul></ul><ul><ul><li>Tel.: 01 544 43 76, www.api.or.at </li></ul></ul>
    35. 36. <ul><li>Prevention campaign &quot;Nachdenken statt Nachschenken&quot; 2007 </li></ul><ul><li>Increased controls in sales of alcoholic drinks </li></ul>Alcohol abuse: What we are doing http://www.nachdenkenstattnachschenken.at/www/
    36. 37. Alcohol self test        True   7. I never drink alcohol when I am alone  8. I never ride a bicycle or moped after drinking  6. If I have to go to school the next day I drink less alcoholics or none  5. I never had a memory loss (black out) after drinking  4. If I don’t feel like drinking nobody can convince me to  3. Sometimes I don’t drink alcohol for weeks  2. I get along with people and situations as well with or without drinking alcohol Not true  1. When I go out at night, I still know the next day how many drinks I had
    37. 38. I am done…

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