Alcohol

Types of alcohol

ethanol, methanol, isopropanol

Ethanol

Clear, mostly odorless, water-soluable, consumed

Acts like a psychoactive drug (stiumulant, depressant, hallucinagenic)

Methanol

Soluable

Isopropanol

rubbing alcohol, cleaning agent

History

Argued to be the oldest psychoative drug

Long time social use

USD HHS Standards on alcohol

More than Men (4) women (3) drinks a day = high risk consumption

Fermantation

Yeast/bacteria consume sugar in fruit/wheat/vegetables and cause production of ethanol + carbon dioxide

Substance Use Disorders

Using substance even though problems occur

Substance Induced Disorder

Intoxication, withdrawl, or other mental disorders caused by use

True or false: Addiction being a behavioral disorder is ongoing

True

Alcohol related disorders

Alcohol use disorder, alcohol intoxication, alcohol withdrawl, alcohol induced disorders, unspecified

Alcohol related disorders symptoms

-A problematic pattern of alcohol use leading to clinically significant impairment or distress, manifested by at least two of the following

- alcohol taken in larger amounts or longer than intended

- Persistent desire or unsuccessful efforts to cut down or control use

- Cravings, or strong urges for alcohol

- Recurrent use resulting in failure to fulfill work/life obligations

-Recurrent use resulting in physical danger and around known hazards

-Use despite knowingly having an ailment from it.... And more

AUD Link Risk Enviormental risk

Cultural attitudes, availibility, stress levels, peer use, exaggerated positive outimes

AUD Link Risk Genetic and Physiological risk

40-60% of alcohol use disorders in families can be linked w genetic influences

Higher rate of AUDs in monozygotic (identical) twins compared todizygotic

~4-fold increase chance in children of individuals with AUDs

AUD Statistics

More than 70% of high-school aged Americanshave tried alcohol & ~54% have consumed to thepoint of intoxication

The 12-month prevalence of AUD in the U.S. is~5% among 12- to 17-year-olds and ~9% in 18+

Rates differ among men (~12.5%) and women(~5%) & decrease as we age

28.9 million people 12 and older had an AUD in 2023

Alcohol method of action

Binds to GABA receptors and acts as a neuromodulator

Can enhance activation of GABA receptors and reduce activity of NMDA receptors and voltage gated calcium channels (VGCC)

Neuropharmacology

Underlying plasticity mechanisms are altering the srength of inhibition in multiple brain regions (mesolimbic, limbic, frontal cortex

E/I balance being thrown off

Start eliminating GABA receptors because we have too many after long term use, to try and bring the body to a balanced state

absorption of alcohol

Mainly oral (injection and enemas can be used)

Only 10% absorbed by the stomach, the rest in upper GI

Distribution of alcohol

eTOh can easily move through tissue and blood, heads to liver

In blood, can get into any tissue and causes toxic effects on tissue

Metabolism of alcohol

Stomach enzymes (gastic alcohol dehygrogenase) starts breaking down alcohol

Majority occurs in liver = alcohol dehydrogenase (ADH) transforms it to acetaldehyde (toxic- long term use or too much too quicly makes people throw up as the body is trying to rid of the poison) and then aldehyde DH breaks that down to produce C02 and water

Elimination process of alcohol

Discards byproducts through urination

Small amount (non-dehydrogenated) is excreted as sweat, urine, and air

BAC

Blood alcohol content

Concentration of alcohol by weight in a volume of blood (usually 100mL)

BAC will increase if consumption outpaces metabolism/elimination

Equation for BAC

mg per ethanol / 100 mL of blood

ex: .08% = 80 mg / 100 mL

Quantifications for BAC

Transdermal path

Urinalysis

Blood/saliva - standard

Breath

Most postmortem tissue

Biobehavioral Effects of alcohol (RIPC

CNS Depressant

- Reduced inhibitions

-psychomotor impairment

-cognitive impairment

Legal BAC percentage for driving

.08%, intoxication isn't noticable until .15%

Tolerance

Biobehavioral alterations that occur in response exposure

How does tolerance occur

Slowly eliminating gaba receptors: function on gaba recprots so elimination makes people able to drink more because they are allowing less to come in with recuded receptors but are used to more coming in when there were a lot of receptors

Dependence

Physical and psychological, social/personal reinforcement, physical need

When alcohol and (blank) are mixed an increased impact on the bodys CNS

Cocaine

Create a toxic called cocaethylene

18-25 times more likely to die suddenly

Physical Toll

Liver

Cardivascular system, small intestine, colon, brain, nervous system, stomach, reproductive system

Alcohol withdrawl

Gabapentin can treat minor withdrawl like discomfort and cravings

mild, moderate, severe

Gabapentin

artificially activate GABA receptors so other alcohol effects don't take place

When were birth defects identified

1968

10 years after the anti-nasusea thalidomide disaster

Fetal Alchol Spectrum Disorder

Abnormal facial development, narrow eyes, small head size, cognitive and developmental problems

No known safe dose of alcohol that can be consumed while pregnant

Treatment methods for AUD

Gabapentine- artifically activate gaba receptors so other alcohol effects don't take place

Fluphenzine - shutting off breaking down ADH (makes people vomit but not too effective since people don't mind)

Therapy combined with medicine best results but no known magic bulltet

Ethanol has a Vd of ~0.6 L/kg. What does this tell us? Why can it get into tissue so well?

It is polarized making it easier to get into the blood and tissue, highly soluable, hydrophallic

Alcohol is classified as what type of psychoactive? Why does it also cause euphoric effects?

Depressant, Euphpric effect can manipulate dopamine