Study Notes on Alcohol Use and Abuse
Concept Overview
Alcohol and Alcoholic Beverages
Alcohol Consumption and Alcohol Abuse
Health and Behavioral Consequences of Alcohol Use
Risk Factors for Alcohol-Related Problems
Alcohol Use in Young Adults
Effective Approaches for Alcohol Prevention and Treatment
Using Self-Management Skills
Alcohol and Alcoholic Beverages
Alcoholic beverages contain ethanol (ethyl alcohol), which is a depressant.
Ethanol is an intoxicating and addictive drug that is often misused.
When blood alcohol concentration (BAC) is rising, it exhibits stimulant effects.
There is a large vocabulary for being drunk; there are more synonyms for the word drunk or intoxication than for any other word in the English language.
Alcohol Content in Drinks
Different alcoholic beverages can contain the same amount of alcohol despite differing volumes:
12 oz of beer with 5% alcohol = 0.48 oz of alcohol
5 oz of wine with 12% alcohol = 0.48 oz of alcohol
1½ oz of whiskey with 40% alcohol (80 proof) = 0.48 oz of alcohol
The manner in which these drinks are consumed can affect the BAC.
Factors Determining the Effects of Alcohol
Rate of consumption
What is in the stomach (food intake)
Body size/weight
Individual beliefs about alcohol’s effects
Drinking context
Sex differences in alcohol metabolism and effects
Rate of Alcohol Removal
A healthy adult metabolizes approximately 1–1.5 hours to break down 1 standard drink.
Blood alcohol concentration (BAC) is measured as a percentage, with the legal limit in all 50 states being 0.08%.
Patterns of Alcohol Consumption
Approximately 66.3% of the U.S. population aged 18 and older report alcohol use in the past year, making it the most widely used drug of abuse in the country.
Among drinkers:
95% develop a pattern of light or moderate drinking:
One drink per day or less for females
Two drinks or less for males
Nearly 24% of U.S. individuals aged 12 or older reported binge drinking in the past month, defined as:
Four or more drinks for females within a 2-hour period
Five or more drinks for males.
Alcohol Use Disorders (AUDs)
Binge drinkers are at increased risk for developing alcohol use disorders (AUDs).
Two key signs of AUDs include:
Alcohol tolerance: Needing more alcohol over time to achieve the same effect.
Alcohol withdrawal: Symptoms such as sweating, anxiety, tremors, and seizures when alcohol use is stopped after heavy drinking.
Health and Behavioral Consequences
The most significant health risk associated with alcohol consumption is liver disease:
Persistent heavy drinking can lead to fatty liver, which is likely reversible if drinking is stopped.
Continuing heavy drinking may result in alcoholic cirrhosis, leading to permanent liver damage.
Chronic heavy alcohol use can increase the risk of coronary heart disease and other cardiovascular problems.
Additional Health Risks
Alcohol consumption also heightens the risk for several diseases and conditions, including:
Cancers: Oral cavity, pharynx, esophagus, liver, larynx, colon, and female breast
Cardiovascular issues: Hypertension, cardiomyopathy, cardiac arrhythmia, congestive heart failure
Impaired immune function
Cognitive impairment: Both acute and long-term effects
Psychiatric disorders
Increases risk for accidents: motor vehicle crashes, falls, burns, drownings, interpersonal violence, and sexually transmitted infections.
Health Consequences for Females
Alcohol consumption elevates the risk of breast cancer and adversely affects the reproductive system.
In pregnant women, alcohol may cause fetal alcohol effects, including fetal alcohol syndrome (FAS).
Females tend to experience greater risks of liver, cardiovascular, and brain damage compared to males at similar consumption levels.
Health Benefits of Moderate Consumption
Evidence suggests that moderate alcohol intake correlates with a decreased risk for:
Coronary Heart Disease (CHD)
Type 2 diabetes
Certain types of stroke
The reduced risk may be linked with lifestyle characteristics of moderate drinkers, such as better diets and regular exercise.
Alcohol might play a protective role, but the extent of these benefits is widely debated; moderate consumption may not be safe for everyone.
People Who Should Consider Abstaining from Alcohol Use
Individuals under age 21
Athletes seeking peak performance
Women trying to conceive, pregnant, or nursing
Persons with an AUD or recovering from AUD
Individuals with a family history of alcohol-related problems
Individuals with medical/surgical conditions or on medications
Individuals with psychiatric issues or severe psychosis
Individuals driving, operating machinery, or involved in public safety
Individuals engaged in serious business activities or studying
Drinking and Driving
One of the greatest dangers of alcohol is drinking and driving.
Around 25% of fatal traffic accidents involve alcohol use by drivers.
The likelihood of causing an accident increases at a BAC of 0.04% (approximately one to two drinks for most people).
The likelihood of fatal or serious injury escalates significantly at a BAC of 0.08% or higher—the legal intoxication limit in all 50 states.
Effects of Blood Alcohol Concentration (BAC) on Driving Performance
BAC 0.02%:
Impaired vision and attention span.
Slower reaction time.
BAC 0.05–0.06%:
Reduced inhibitions and visual abilities; side vision impaired by 30%.
Impaired judgment leading to increased risk-taking.
Extended braking distance and reduced coordination.
Moderate impairments in driving performance.
BAC 0.08%:
Serious vision impairment, especially at night.
Overconfidence in driving ability and decreased concentration.
Impaired judgment; increased carelessness and muscle coordination.
Performance impairment at low speeds.
BAC 0.15%:
Gross motor impairment with a lack of physical control.
Blurred vision and loss of balance.
BAC 0.20%:
Disorientation and difficulty walking; nausea and vomiting.
Risk of loss of gag reflex and potential for blackouts.
BAC 0.30%:
Severe stupor and decreased respiration.
BAC 0.40%:
Coma potential; risk of death via respiratory arrest.
Factors Influencing BAC Values and Effect
Approximate BAC Estimates based on number of drinks consumed over a 2-hour period:
For Females:
1 drink: 120-pound - 0.02%; 140-pound - 0.06%
2 drinks: 120-pound - 0.06%; 140-pound - 0.10%
3 drinks: 120-pound - 0.10%; 140-pound - 0.15%
4 drinks: 120-pound - 0.15%; 140-pound - 0.19%
For Males:
1 drink: 180-pound - 0.004%; 200-pound - 0.001%
2 drinks: 180-pound - 0.03%; 200-pound - 0.02%
3 drinks: 180-pound - 0.06%; 200-pound - 0.04%
4 drinks: 180-pound - 0.09%; 200-pound - 0.06%
5 drinks: 180-pound - 0.12%; 200-pound - 0.08%
6 drinks: 180-pound - 0.15%; 200-pound - 0.10%
7 drinks: 180-pound - 0.17%; 200-pound - 0.13%
8 drinks: 180-pound - 0.20%; 200-pound - 0.15%
Prevention Efforts
Recommended prevention efforts to address alcohol-related issues include:
Lowering the legal BAC limit to 0.08%.
Raising the drinking age to 21.
Installation of ignition interlock devices for offenders convicted of DUI.
Availability of blood-alcohol self-tests.
Risk Factors for Alcohol-Related Problems
Key risk factors include:
Early age of drinking onset which leads to increased risk for future issues.
Existence of a family member with an alcohol-related problem, highlighting a genetic component to risk.
Environmental influences, such as
Parents and peers
Promotion of alcohol as a social lubricant
Media portrayals of drinking.
Alcohol on Campus 1
Excess alcohol consumption is a significant problem in most college environments.
Drinking is perceived as a rite of passage.
Binge drinking rates are notably high.
The college atmosphere contributes to this behavior:
No longer a traditional adolescence; can be described as extended adolescence or emerging adulthood.
The age limit of 21 often leads to underclassmen accessing alcohol from upperclassmen.
Drinking games and mixing alcohol with energy drinks further exacerbate consumption patterns.
Alcohol on Campus 2
Female college students are especially vulnerable to negative consequences related to alcohol use:
Increased likelihood of unwanted sexual behaviors.
Participation in drinking games, leading to consumption levels comparable to males.
Risks associated with social events, such as Spring Break.
Misconceptions about peer attitudes and behaviors around drinking lead to increased consumption.
Effective Approaches for Alcohol Prevention and Treatment
Traditional educational and confrontational methods are often ineffective.
Efficient prevention strategies focus on:
Motivational and skill-based approaches that encourage self-examination regarding drinking habits.
Developing strategies to moderate consumption or ensure abstinence.
Addressing and correcting misperceptions about drinking behavior on campuses.
Self-Management Tips
Recommended strategies to help reduce or quit alcohol use include:
List reasons for stopping or cutting down.
Set personal goals and establish a plan for achieving them.
Monitor drinking patterns (when, where, and how much).
Identify situations that trigger the desire to drink.
Limit time spent in drinking environments (such as bars or parties).
Designate nondrinking days and offer to be a designated driver.
Avoid the temptation to keep up with peers in drinking.