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Drugs & Society Chapters 7 & 8
This document summarizes key topics related to alcohol including: 1. The pharmacology of alcohol including how it is absorbed in the body and metabolized in the liver. Alcohol primarily impacts the limbic system part of the brain. 2. The behavioral effects of different blood alcohol content levels and types of alcoholism. Alcoholism is considered by some to have genetic and psychosocial risk factors. 3. The impacts of alcoholism on families including increased risks for children of alcoholics developing alcoholism or other disorders themselves. Family roles that sometimes develop in alcoholic families are also outlined. 4. The social costs of alcoholism including increased risks of violence, suicide, and accidents when alcohol is involved. W
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Drugs & Society Chapters 7 & 8
- 1. Alcohol Hanson Chapters 7& 8 SOC 204 Drugs & Society
- 2. Is someone closeto you an alcoholic? A. Yes, more than one person B. Yes, one person C. No Yes,m ore than one person Yes,one person No 56% 24% 20%
- 3.
- 4. Pharmacology • Absorption • Distribution •Metabolism • Mechanism of Action • BLOOD ALCOHOL CONTENT
- 5. Alcohol is metabolizedin your liver A. True B. False True False 0% 100%
- 6. Figure 7.1 Howalcohol is absorbed in the body. Data from Masters, S., and A. Trevor “The Alcohols.” In Basic and Clinical Pharmacology, 13th ed., edited by B. Katzung, 384–395. New York: McGraw-Hill, 2015.
- 7. You can increaseyour rate of metabolizing alcohol by exercise or by taking caffeine A. True B. False True False 88% 12%
- 8. Alcohol’s Effects • Alcoholacts on the cerebrum affecting ▫ Judgment ▫ Reasoning ▫ Inhibitions ▫ Motor activity ▫ Impairs the senses • Mouse Party
- 9. BAC (%) Behavioral Effects •0.05Lowered alertness, release of inhibitions, impaired judgment •0.10 Slower reaction times, impaired motor function, less caution •0.15 Large, consistent increases in reaction time •0.20 Marked depression in sensory and motor capability, intoxication •0.25 Severe motor disturbance, staggering, great impairment •0.30 Stuporous but conscious—no comprehension of what’s going on •0.35 Surgical anesthesia; about LD1, minimal level causing death •0.40 About LD50
- 10. Figure 7.2 Theprincipal control centers of the brain affected by alcohol consumption.
- 11. Alcohol primarily impactsthis part of the brain: A. Limbic system B. Cerebellum C. Cerebral cortex D. Basal ganglia Lim bicsystem Cerebellum Cerebralcortex Basalganglia 0% 0% 56% 44%
- 12. Alcohol sedates byincreasing glutamate’s action – an agonist response. A. True B. False True False 63% 38%
- 13. Alcoholism • Alcoholism ▫ Conditionin which an individual loses control over intake of alcohol • Substance Use Disorder ▫ Physical, social, intellectual, emotional, or financial problems resulting from the use of alcohol ▫ Withdrawal symptoms ▫ Tolerance ▫ Blackouts
- 14. Alcoholism • Some consideralcoholism to be a disease ▫ Compared to heart disease or diabetes ▫ 1956 American Medical Association declared it a disease ▫ Disease can be used as a legal defense ▫ Receive treatment rather than punishment
- 15. Early Characterizations ofAlcoholic Types by Jellinek (1960) • Alpha alcoholics: Mostly a psychological dependence • Beta alcoholics: Mostly socially dependent on alcohol • Gamma alcoholics: Most severe; suffers from emotional and psychological impairment • Delta alcoholics: Constantly losing control over the amount of alcohol consumed • Epsilon alcoholics: Constantly binge drinking and at times days at a time • Zeta alcoholics: Moderate drinker who becomes abusive and violent
- 16. Types of Alcoholicsby Moss and Colleagues in 2007 • Young Adult (31.5% of U.S. alcoholics): Young adult drinkers without major problems regarding their drinking • Young Antisocial (21% of U.S. alcoholics): Mid-20s, had earlier onset of regular drinking and alcohol problems, and come from heavy alcohol use families • Functional (19.5% of U.S. alcoholics): Middle-aged, well- educated, with stable jobs and families • Intermediate Familial (19% of U.S. alcoholics): Middle-aged, with 50% from families with multigenerational alcoholism • Chronic Severe (9% of U.S. alcoholics): Mostly middle- aged, high rates of antisocial personality disorder and criminality
- 17. Do you agreealcoholism is a disease? A. Yes B. No C. I’m not sure Yes No I’m notsure 0% 0%0%
- 18. I know thatfor the discussion Thursday, I have to interview two people A. Yep. On it. B. Noooo C. What discussion? Yep. On it. Noooo W hatdiscussion? 100% 0%0%
- 19. Alcoholism • Genetics ▫ 50-60%of alcoholism vulnerability has a genetic basis ▫ Environmental factors affect the impact of genetics
- 20. Alcohol and Genetics •Alcoholism is among the most inherited mental illnesses • Specific genes contribute to: (i) excessive consumption, (ii) diminished negative feedback, (iii) enhanced sense of pleasure, and (iv) diminished hangovers • However, environment is as important as genetics
- 21. Alcoholism • Psychosocial factors ▫20% of alcoholics have a mood or anxiety disorder ▫ Individuals are more likely to drink heavily when in a group ▫ Expectations about alcohol are predictors of dependence ▫ Associated with a greater number of sexual partners
- 22. Happy Tuesday to you! Thisis the Monday-est Tuesday ever. 57% 43% Happy Tuesday A. Happy Tuesday to you! B. This is the Monday-est Tuesday ever.
- 23. Alcoholism • Culture ▫ Attitudestoward alcohol affect rates of alcohol abuse
- 24. Culture and Alcohol(continued) • Some psychologists contend that both set and setting can often overshadow the pharmacological effects of most drugs, including alcohol. ▫ Set: An individual’s expectation of what a drug will do to his/her personality ▫ Setting: The physical and social environment where most drugs, including alcohol, are consumed
- 25. Culture and Alcohol •Culture provides how alcohol use is perceived (e.g., violation of norms, “normal” to drink, sexy, sophisticated, mature). • Cultural rules state how much one can drink and where one can drink. • Cultures provide ceremonial meaning to alcohol use. • Culture provides a model of alcoholism. • Culture provides attitudes and stereo- types regarding drinking behavior.
- 26. Distinctions Between “Wet”and “Dry Cultures “Wet” Cultures - In these cultures alcohol is integrated into daily life and activities (e.g., alcohol consumed with meals). In these cultures, abstinence rates are low and wine is largely the beverage of preference. European countries bordering the Mediterranean have traditionally exemplified wet cultures. “Dry” Cultures – Alcohol consumption is not as common during everyday activities. Abstinence is more common, however, when drinking occurs, it is more likely to result in intoxication. Scandinavian countries, the U.S., and Canada are examples of counties that are dry.
- 27. Alcohol Withdrawal • Characteristicsof alcohol withdrawal: ▫ Craving for alcohol ▫ Delirium tremens (DTs) ▫ Extreme arousal ▫ Auditory and visual hallucinations ▫ Physiological symptoms ▫ Cognitive symptoms
- 28.
- 29. Family Effects • Childrenof alcoholics ▫ Often experience sleep difficulties, depression, loneliness, and stomach problems ▫ Alienated from parents, have poor communication skills, less trust, and more emotional longing ▫ Attention deficit hyperactivity disorder (ADHD) • Adult children of alcoholics (ACOAs) ▫ Feelings of failure and self-deprecation ▫ Feel a great need to be in control
- 30. Addict • Behaviors ▫ Useof chemicals ▫ Abusive ▫ Controlling ▫ Withdrawal of love, attention, affection ▫ Blaming ▫ Anger ▫ Self- righteousness Underlying feeling: SHAME
- 31. Co-Dependent • Behaviors ▫ Rescuing ▫Excusing ▫ Denial ▫ Helplessness ▫ Martyr Underlying feeling: ANGER
- 32. Hero • Behaviors ▫ The“Good Kid” ▫ High achiever ▫ Successful ▫ Overly responsible ▫ Intellectual Underlying feeling: INADEQUACY
- 33. Scapegoat • Behaviors ▫ Actingout ▫ Defiant ▫ Peer-oriented ▫ Sullen, angry ▫ Irresponsible ▫ Chemical use ▫ Law breaking, truancy Underlying feeling: HURT
- 34. Lost Child • Behaviors ▫Withdrawn ▫ Loner ▫ Day dreamer ▫ Unnoticed Underlying Feeling: LONELINESS
- 35. Mascot • Behaviors ▫ Attention-getting ▫Humor ▫ Clowning ▫ Super cute ▫ Overly active ▫ Silly Underlying Feeling: FEAR
- 36. Which do youmost identify with? A. Addict B. Co-dependent C. Hero D. Scapegoat E. Lost Child F. Mascot AddictCo-dependent Hero Scapegoat LostChild M ascot 7% 4% 22% 15% 11% 41%
- 37. COSTS • Hero ▫ Compulsivedrive, pressure, suicide • Scapegoat ▫ Addiction, criminal behavior, drop out • Lost Child ▫ Isolation, abuse victim, eating disorders • Mascot ▫ Immaturity, distant relationships, manipulation
- 38. Alcohol and theFamily (1 of 3) • Important Key Terms: ▫ Codependency (or co-alcoholism): Behavior displayed by either addicted or nonaddicted family members (codependents) who identify with the alcohol addict and cover up the excessive drinking behavior, allowing it to continue and letting it affect the codependent’s life ▫ Enablers: Those close to the alcohol addict who deny or make excuses for enabling his or her excessive drinking
- 39. Alcohol and theFamily (2 of 3) • Children of alcoholics (COAs) are 2–4 times more likely to become alcoholics themselves. • Adult children of alcoholics (ACOAs) are 2–4 times more likely to develop alcoholism. • Approximately 9.7 million children age 17 or younger are living in households with one or more adults classified as having an alcohol abuse or dependence problem. ▫ Seventy percent of these children were biological, foster, adopted, or stepchildren. ▫ As a result, 6.8 million children, or about 15% of children aged 17 or younger, meet the formal definition of children of alcoholics.
- 40. Alcohol and theFamily (3 of 3) • COAs and ACOAs are more likely to marry into families where alcoholism is prevalent. • Twenty-five percent of American children are exposed to an alcoholic before the age of 18.
- 41. How’s your groupdoing? A. We rock. B. Working on it. C. We need help. D. Group? What group? W erock. W orkingon it. W eneed help. Group? W hatgroup? 20% 0% 10% 70%
- 42. Correlations with Violence As alcoholuse escalates, so does violence ▫ Domestic partner violence 66% ▫ Sexual Assault 37% ▫ Homicides 40% ▫ Child abuse 70% http://www.ph.ucla.edu/sciprc/pdf/ALCOHOL_AND_VIOLENCE.pdf
- 43. Suicide ▫ About 7%of alcoholics commit suicide ▫ 16% of men and 10% of women entering alcohol treatment have contemplated suicide ▫ 38% of people who hanged themselves had alcohol in their system ▫ 32% of veterans who attempted suicide were diagnosed with alcohol abuse or disorder
- 44. Accidents and Alcohol ▫Drinking while driving Emergency room admissions ▫ Fire-related fatalities ▫ Alcohol-related boating accidents ▫ Drowning fatalities YouTube
- 46. Helping the FamilyRecover (1 of 2) Important Key Terms: •Psychodrama: A family therapy system developed by Jacques Moreno in which significant interpersonal and intrapersonal issues are enacted in a focused setting using dramatic techniques. •Role-playing: A therapeutic technique in which group members play assigned parts to elicit emotional reactions. •Genogram: A family therapy technique that records information about behavior and relationships on a type of family tree to elucidate persistent patterns of dysfunctional behavior.
- 47. Helping the FamilyRecover (2 of 2) • Post-traumatic stress disorder (PTSD): A psychiatric syndrome in which an individual who has been exposed to a traumatic event or situation experiences psychological stress that may manifest itself in a wide range of symptoms, including re-experiencing the trauma, numbing of general responsiveness, and hyper-arousal.
- 48. Recovery from Alcoholism Treatmentof alcoholism: ▫ Denial as a psychological defense ▫ Easy to relapse (relapsing syndrome) without radical shift in lifestyle ▫ Alcohol rehabilitation and medical ramifications ▫ More emotionally fragile than other addicts
- 49. Withdrawal Important Key Terms: •Relapsing syndrome: Returning to the use of alcohol after quitting • Acute alcohol withdrawal syndrome: Symptoms that occur when an individual who is addicted to alcohol does not maintain his or her usual blood alcohol level • Delirium tremens (DTs): The most severe, even life-threatening, form of alcohol withdrawal, involving hallucinations, delirium, and fever.
- 50. Prohibition • Temperance Movement –view of alcohol • Prohibition • States 1851 • Federal 1919 • Repealed in 1933 • Since 1933, states regulate alcohol • Federal taxation
- 51. Who drinks andwhy • Cultural Differences • Trends in US • Regional Differences • Gender Differences • Drinking Among College Students
- 52. Total estimated U.S.per capita ethanol consumption in gallons per year by state, 2007 Source: Data from NIAAA © 2011 McGraw-Hill Higher Education. All rights reserved.
- 53. Alcohol Abuse AmongCollege and University Students CORE Institute (2008) research results: • Approximately 72% of college students consumed alcohol and 42% to 55% engaged in binge drinking within 30 days when survey was given. • College students consume an average of 5.4 alcoholic drinks per week. • Of all the drugs reported, alcohol was the most heavily abused on college campuses, followed by tobacco (44%) and marijuana (31%).
- 54. Alcohol Abuse AmongCollege and University Students (continued) Other studies found that … • The main reason given for binge drinking was “to get drunk.” • Males binge drink more than females. • For binge drinkers, the impact on impaired academic performance is just as great for women drinkers. • Being white, involved in athletics, or a resident of a fraternity or sorority made it more likely that a student would be a binge drinker.
- 55. Alcohol Abuse AmongCollege and University Students • On U.S. campuses, alcohol is a factor in 40% of all academic problems and 28% of all dropouts. • Seventy-five percent of male students and 55% of female students involved in acquaintance rape had been drinking or using drugs. • The transition into college is associated with a doubling of the percentages of those who drink for both males and females. • For heavier drinkers, grades suffered for both male and female students.
- 56. Women and Alcohol •Women possess greater sensitivity to alcohol, have a greater likelihood of addiction, and develop alcohol-related health problems sooner than men (e.g., stomach cancer, cirrhosis of the liver). • More women in alcohol treatment come from sexually abusive homes (70%) in comparison to men (12%).
- 57. Women and Alcohol(continued) • Three major reasons why women are more sensitive to the effects of alcohol: 1. Body size (men generally larger than women) 2. Women absorb alcohol sooner—women possess more body fat and body fat does not dilute alcohol 3. Women possess less of a metabolizing enzyme that gets rid of (processes out) alcohol
- 58. Women and Alcohol(continued) • Alcohol consumption patterns of women: ▫ Women 21 to 34 years of age were least likely to report alcohol-related problems if they had stable marriages and were working full time. ▫ Women tend to marry men whose drinking habits match their own. ▫ Between 35 to 49 years of age, the heaviest drinkers were divorced or separated women without children. ▫ Between 50 to 64 years of age, the heaviest drinkers were women whose husbands/partners drank heavily. ▫ Women 65 and older comprised less than 10% of drinkers with drinking problems.
- 59. Alcohol Consumption inthe United States • Alcohol consumption has dropped sharply since 1981. • What explains the steady decline in alcohol consumption during the past twenty years? ▫ Demographics ▫ Conservatism ▫ Decrease in social acceptability ▫ Increased awareness of risks ▫ Increased concerns for health
- 60. Figure 8.1 Current,binge, and heavy alcohol use among persons aged 12 or older, by age: 2014 Data from: Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Rockville, MD, 2015.
- 61. Additional Facts Regarding AlcoholUse/Abuse • Drinking and driving: On most weekend nights throughout the United States, 70% of all fatal single- vehicle crashes involve a driver who is legally intoxicated. • Income/wealth: Less affluent people drink less than more affluent individuals. • The average “alcoholic”: The largest percentage of alcoholics are secret or disguised drinkers who look very much like common working people. • On average: Most people who consume alcohol do not become problem drinkers.
- 62. Most college studentsreduce their binge drinking after graduating from college. A.True B.False True False 24% 76%
- 63. The younger oneis when drinking alcohol for the first time, the more likely one will become a problem drinker. A.True B.False True False 29% 71%
- 64. Underage Drinking • Underagedrinking is associated with premature death, disease, injury, property damage, motor vehicle crashes, alcohol-related crime and loss of productivity • There is a significant relationship between drinking before age 13 and suicide attempts
- 65. Underage Drinking • Highschool students who engaged in binge drinking were six times more likely to drink and drive ▫ 7.2% of 8th-grade students binge drink ▫ 16.3% of 9th-grade students binge drink ▫ 23.2% of 12th-grade students binge drink
- 66. Moderate alcohol drinkershave lower rates of cardiovascular disease than abstainers. A.True B.False True False 0%0%
- 67.
- 68. When someone passesout from alcohol use: A. Put them on their back B. Put them to bed and let them sleep it off C. Put them on their side Putthem on theirback Putthem to bed and let...Putthem on theirside 0% 0%0%
- 69.
- 70. There is asafe level of alcohol to consume while pregnant A. True B. False True False 86% 14%
- 72. Physiological Toxicity - Brain •Wernicke-Korsakoff syndrome develops because alcohol impedes the body’s ability to utilize thiamine (a B vitamin) • Alcohol use is associated with psychological symptoms: depression, anxiety
- 73. Physiological Toxicity -Liver • Three main conditions associated with alcohol: ▫ Fatty liver ▫ Alcohol hepatitis ▫ Cirrhosis • Cirrhosis is irreversible, even if alcohol use stops
- 74. Physiological Toxicity –Digestive System • In moderate amounts, alcohol aids digestion by increasing gastric juice in the stomach • Too much alcohol can irritate the stomach, leading to internal bleeding • Heavy alcohol use is implicated in acute pancreatitis • Alcoholics often have malnutrition because alcohol interferes with the body’s ability to utilize nutrients
- 75. Physiological Toxicity –Circulatory System • Moderate alcohol use reduces risk of heart disease, boosts good (HDL) cholesterol and helps prevent type 2 diabetes • Effects of heavy alcohol use: ▫ Degeneration of the heart muscle ▫ High blood pressure ▫ Cardiac arrhythmias ▫ Ischemic heart disease ▫ Strokes
- 76. Physiological Toxicity –Immune System • Studies show that moderate alcohol use reduces immunity • Alcohol interferes with white blood cells, particularly T lymphocytes, which help to resist infections