PSYC 223 - Alcohol (TWO)

3 questions asked in relation to drug usage

• On how many occasions have you used X…

  • In your lifetime?

  • During the past 12 months?

  • During the last 30 days?

Question to ask when assessing frequency of being drunk

How many times have you ever had 5+ drinks in a row over the past 2 weeks?

Alcohol content (ABV) of regular beer vs light beer

• Regular beer: 5% alcohol content

• Some light beers: 4.2% alcohol content

Standard drink

Roughly 14 grams of pure alcohol

How many ounces are in a standard drink of beer, wine, and distilled spirits (and their ABVs)?

• 12 ounces of regular beer (5% alcohol)

• 5 ounces of wine (12% alcohol)

• 1.5 oz. distilled spirits (40% alcohol)

Each beverage portrayed in a survey represents ________________________

one standard drink

3 reasons that people drink (positive)

1. Socialize

2. Celebrate

3. Relax

3 questions that researchers/psychologists ask about alcohol?

1. Why does alcohol cause us to act and feel differently?

2. How much is too much?

3. Why do some people develop alcohol use disorder?

Binge drinking

4 or more drinks for women and 5 or more drinks for men over the course of a few hours (typically 2)

Binge drinking typically leads to a BAC of _________ in _____ hours

0.08 g/dL, 2

What does the definition of binge drinking not account for?

Does not account for differences in BMI, age, etc. (i.e. average weight individuals do not reach BAC limit after ⅘ drinks in 2 hours)

High intensity drinking?

Defined as consuming at least twice the typical binge drinking threshold (8 or more for women and 10 or more for men)

What does high intensity drinking account for?

accounts for the fact that some individuals drink at levels 2-3 times the 4+/5+ binge threshold

Individuals who engage in binge drinking about more likely to report what 4 things?

1. Getting drunker than those closer to the standard binge cutoff

2. Experience impaired control

3. Engage in risky behaviors with academic or occupational consequences

4. Experience physical dependence

There are _______ alcohol users aged 12 or older

134.3 million

There are ______ binge alcohol users (______% of alcohol users)

57.9 million, 43.1

There are _______ heavy alcohol users (____% of binge alcohol users and _____% of alcohol users)

14.5 million, 25.1, 10.8

Teen binge drinking trends before and after the pandemic

• Teen binge drinking remains before pre-pandemic levels, but still the highest

• Among people aged 12 or older, the percentage who engaged in binge drinking in the past month declined from 21.7% in 2021 to 20.1% in 2024

High-intensity drinking in young adults

High-intensity drinking was reported by 9.5% of young adults in the past 2 weeks

High-intensity drinking in college vs. non-college young adult

Prevalence of high-intensity drinking in the past 2 weeks was similar for college (5.2%) and noncollege (7.8%) young adults

What group of young adults are more likely to engage in high-intensity binge drinking?

19-20 year olds who attended a 4 year college and did not live with their parents were significantly more likely to engage in high-intensity binge drinking than other young adults

Southern vs. northern states with alcohol consumption

Southern states consume less alcohol than the northern states

Does alcohol consumption vary by geographic area in the US?

Yes

In what region of the US are underage and binge drinking highest? In what area are they lowest?

1. Highest: northwest

2. Lowest: Southeast

3 alcoholic beverage preferences ranked from greatest to least - are levels similar or different?

1. Beer

2. Wine

3. Liquor

• Levels are very similar

3 epidemiological explanations for drug use trends

1. Generational forgetting

2. Reintroduction of old drugs and continuous introduction of new drugs into the populace keeps our drug problems alive

3. Epidemiological leg effect

Generational gorgetting

Explanation for the observation that latter/current generations seem to “forget” the hazards of using a particular drug in the previous generation, maybe because they were “too young” to get the message

Caffeinated Alcohol Beverages (CAB)

not deemed “safe” by FDA in 2010

Hard seltzer

popularized in 2018 after 30 years on the market - it is popular among “health-conscious drinkers” for being low calorie

Epidemiological lag effect

Forces of drug containment are always playing catch up with the forces of encouragement and exploitation

3 types of alcohol

1. Isopropyl alcohol (rubbing alcohol)

2. Methyl alcohol (methanol)

3. Ethyl alcohol (ethanol)

Isopropyl alcohol

has strong disinfecting properties but is entirely unsafe for drinking and can cause severe toxic effects if swallowed in large quantities

Methyl alcohol

industrial-strength solvent used to make products such as paint removers, antifreeze, etc.

2 qualities of methyl alcohol

1. More extreme and toxic

2. Ingesting it can result in permanent blindness or cause death

Ethyl alcohol

• Only type of alcohol that is safe for consumption

• Can be used as a fuel additive or as an industrial solvent

How does ethyl alcohol act in the body?

Depresses the CNS by enhancing the effect of GABA

How is ethanol obtained?

Ethanol is obtained by using yeast or bacteria to ferment sugars

What happens to ethanol after the fermentation process?

Ethanol is distilled to increase the alcohol percentage

2 types of ethanol

1. Undistilled ethanol (fermented alcohol)

2. Distilled ethanol

Undistilled ethanol

only gone through the fermentation process and is not clarified or defined in any way (i.e. beer, wine, and cider)

Fermented beverages do not exceed ____% alcohol by volume unless they have been modified externally

15

Distilled ethanol

fermented ethanol that has been put through a distillation or purification process - done to raise the alcohol by volume ration (ABV)

Purpose of the distillation process

Distillation process separates the alcohol from the fermented brew so that it becomes much more concentrated

Distilled drinks usually range from ____% to ____% ABV; most drinks are about ___% ABV (i.e. vodka, gin, brandy, etc.)

20, 95, 40

Oldest drink in the world and date

Egypt barely beer is probably the oldest drink in the world with its origin in Egypt prior to 4200 BC

7000 BC alcohol event

the production of  a prehistoric mixed fermented beverage of rice, honey, and fruit (neolithic village of Jiahu in Henan province)

2000 BC alcohol event

unique cereal beverages (Shang and Western Zhou Dynasties)

1600-1050 BC alcohol event

downfall of Egyptian and Chinese empires and dynasties attributed to excessive alcohol use

460-320 BC alcohol event

Grecian scholars issued advisories on drunkenness and moderate drinking

Plato view on alcohol

no use under age 18, between 18-39 use in moderation, no restrictions for use by those older than 40

Aristotle and hippocrates view on alcohol

Both critical of drunkenness

11th century AD alcohol event

Simeon Seth, a physician in the Byzantine Court, wrote that drinking wine to excess caused inflammation of the liver, a condition he treated with pomegranate syrup

Drinking patterns of most people

Most people abstain or drink “moderately” placing them at “low” risk for alcohol use disorders

Moderate drinking for men and women definition

• Men: 2 drinks/day

• Women: 1 drink/day

What is special about alcohol in college students?

Drinking is the most prevalent substance used and abused by college students

AUDIT (Alcohol Use Disorder Identification Test

Brief screening tool used to assess

1. Consumption levels

2. Drinking behaviors

3. Drinking/alcohol related problems

Purpose of AUDIT

identify individuals who may be consuming at high enough levels to manifest problems

Early detection purpose in alcohol disorders

Increases the likelihood of getting assistance sooner to reduce hazardous drinking

AUDIT-C (AUDIT-consumption)

Scores only the first 3 questions of the AUDIT

AUDIT-C is scored on a scale of ____ to _____ (scores of 0 reflect ________)

0, 12, no alcohol use

In men, a score of ____ or more is considered positive on the AUDIT-C

4

In women, a score of ____ or more is considered positive on the AUDIT-C

3

What does a higher AUDIT-C score mean?

Generally, the higher the AUDIT-C score, the more likely it is that the patient’s drinking is affecting his/her health and safety

How is each AUDIT question scored (for questions 1-8)?

AUDIT score for each question range from 0 to 4, with the first response for each questions (e.g. never) scoring 0, the second (e.g. monthly) scoring 1, the third (e.g. monthly) scoring 2, the four (e.g. weekly) scoring 3, and the last (e.g. daily or almost daily) scoring 4

How is each AUDIT question scored (for questions 9-10)?

For questions 9 and 10, which only have 3 responses, the scoring is 0, 2 and 4 (from left to right)

What AUDIT score (or more) is associated with harmful or hazardous drinking?

8

A score of what (or more) is likely to indicate alcohol dependence (different in men and women)?

• 13 or more in women

• 15 or more in men

When did the FDA begin overseeing drugs in the US?

Since the beginning of the 20th century

What did the FDA release in 1970? Under what act?

In 1970, the FDA released the drug classification schedules, or drug schedules, under the Controlled Substance Act (CSA)

Higher numbers on the drug classification schedules means what?

Lower risk of addiction and safe medical use

3 qualities of schedule I drugs

1. High potential for abuse

2. No currently accepted medical use in the US

3. Lack of accepted safety for use of the drug under medical supervision

4 examples of schedule I drugs

1. Cannabis

2. Heroin

3. Hallucinogens

4. Ecstasy

3 qualities of schedule II drugs

1. High potential for abuse

2. Currently accepted medical use in the US

3. Abuse may lead to severe psychological or physical dependence

3 qualities of schedule III drugs

1. Potential for abuse less than schedule I and II drugs

2. Currently accepted medical use in the US

3. Abuse may lead to moderate or low physical dependence or high psychological dependence

3 qualities of schedule IV drugs

1. Lower potential for abuse less than schedule III drugs

2. Currently accepted medical use in the US

3. Abuse may lead to limited physical or psychological dependence relative to schedule III substances

3 qualities of schedule V drugs

1. Low potential for abuse relative to schedule IV substances

2. Currently accepted medical use in the US

3. Abuse may lead to limited physical or psychological dependence relative to schedule IV substances

What is considered a “safe” amount of alcohol consumption

While past observational studies suggested potential health benefits from light-to-moderate alcohol consumption, newer, more robust research finds that the safest level of drinking for overall health is none

What do health advisories suggest about alcohol consumption?

Health authorities advise that if you do not already drink, you should not start for health reasons

Alcohol’s effects vary from person to person, depending on a variety of factors, including what 5 factors?

1. How much you drink

2. How often you drink

3. Your age

4. Your health status

5. Your family history

People who drink too much over a long period of time may experience alcohol’s longer term effects which can include what 10 factors?

1. Alcohol use disorder

2. Increased cancer risk

3. Reduced inhibitions

4. Slurred speech

5. Motor impairment

6. Confusion

7. Memory and concentration problems

8. Coma

9. Breathing problems

10. Death

How can bioavailability be estimated?

Blood alcohol content (BAC)

BAC units

mg alcohol/100 (mL) of whole blood

2 factors needed for BAC determinatino

1. Gender for calculating % alcohol absorbability

2. Determine amount of alcohol consumed in mg

Males % alcohol absorbability

75% of weight in grams * 1000mL of H2O

Females % alcohol absorbability

66% of weight in grams * 1000mL of H2O

BAC calculation

alcohol consumed/alcohol absorbability

2 ways that BAC can be reported

1. X mg/100mL

2. Percentage X/1000%

Our body metabolizes alcohol at a rate of about ______________

15 mg/100 mL of blood

If you know your BAC what can you approximate?

You can approximate how long it will take to go to 0mg/100mL or 0.00%

Moderate drinking definition (for men and women)

up to 1 drink per day for women and up to 2 drinks per day for men

Binge drinking

a pattern of drinking that brings BAC levels to 0.08 g/dL

Binge drinking amount of drinks and timeframe for men and women

• 4 drinks for women in about 2 hours

• 5 drinks for men in about 2 hours

How does the Substance Abuse and Mental Health Services Administration (SAMHSA) define binge drinking?

5 or more alcoholic drinks for males or 4 or more alcoholic drinks for females on the same occasion on at least 1 day in the past month

Heavy alcohol use

binge drinking on 5 or more days in the past month

Alcohol effects on the brain

alcohol interferes with the brain’s communication pathways, which can change mood and behavior, and make it harder to think clearly and move with coordination

What 4 neurotransmitters are affected by alcohol?

• GABA

• Glutamate

• Dopamine

How is GABA affected by alcohol?

alcohol stimulates GABA receptors, thereby increasing GABA

How is glutamate affected by alcohol?

alcohol inhibits glutamate NMDA receptors in the VTA, nucleus accumbens, amygdala, hippocampus, and and cerebellum → upregulation of glutamate receptors causing hyperexcitability

How are opioids used to treat alcohol use disorder?

naltrexone, an opioid blocker, is actually used to reduce the pleasure experienced when drinking

How does alcohol affect dopamine?

 reduces the inhibitory effect of GABA neurons in the nucleus accumbens and ventral pallidum that project to the VTA → less inhibition in the VTA causing an increase in neuronal activation and high levels of dopamine in the nucleus accumbens