Chapter 11 Alcohol, Tobacco and Caffeine Unacknowledged Addictions

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Chapter 11 Alcohol, Tobacco and
CaffeineUnacknowledged Addictions

• Alcohol

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Alcohol a Dangerous Drug?

• Cocaine, heroin, marijuana, LSD, PCP.and others!
• Alcohol isnt considered because it is socially
  excepted
• Canadians consumed 7.1 liters
• comparable to US, Australia, and less than
  European countries

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Alcohol a Dangerous Drug?

• Can have some positive health benefits
• moderate use can be enjoyable
• However! Many tragedies associated with
  abuse..

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Alcohol and University Students

• Most popular drug on University campuses - 94.5
• In Ontario - 1/3 had more than 15 drinks per
  week!
• Live in residence
• lower grades
• 17 and 22 years of age

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Alcohol and University Students

• Be aware of drinking
• campus culture and tradition
• reduces tension
• celebrations
• social lubricant
• drinking games and binge drinking

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Drinking Alcohol and the Risks!!!!!!

• Exacerbates risks of suicide, automobile crashes
  and falls
• peers / university traditions encourage dangerous
  practices
• participate in dangerous behaviours..

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Physiological and Behavioural Effects of Alcohol

• ethyl alcohol or ethanol
• Fermentation - a process to produce ethanol - 14
  alcohol
• Distillation - increases alcohol content
• Proof - of alcohol
• Proof gunpowder proof / 50 alcohol gt 80 proof
  40 alcohol

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Behavioural Effects

• NOTE individual variation in alcohol tolerance
• alcohol is a depressant - acts on CNS by
  decreasing its activity
• depression is progressive/continuous

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Behaviours...

• Alcohol has different
• effects on
• sight visual acuity
• hearing
• speaking
• smell-taste
• pain reception
• motor skills

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Blood Alcohol Concentration (BAC)ratio of
alcohol to total blood volume

• at 0.02 (2 parts of alcohol for every 10,000
  parts of blood) relaxed good mood
• at 0.05 impaired - relaxation increases /
  some motor impairment / talkative
• at 0.08 impaired - euphoria / more motor
  impairment

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Blood Alcohol Concentration

• at 0.10 intoxicated - depression / further
  loss of motor skills / loss of judgement /
  drowsiness
• larger individuals lower BAC - greater blood
  volume
• alcohol invades muscle tissue to a greater extent
  than fatty tissue

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Learned Behavioural Tolerance

• Ability to modify behaviour to appear sober
• Acquired physiological and psychological
  tolerance
• No skills or functions enhanced by drinking
  alcohol

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Women and Alcohol

• Women have less alcohol hydrogenase
• greater sensitivity to the negative effects of
  alcohol
• higher BAC (30) for same body weight and alcohol
  consumed as a man

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Breathalyzer and Other Tests...

• Breathalyzer
• determine BAC via exhaled breath
• Urinalysis - concentration of unmetabolized
  alcohol in urine
• both used to determine level of intoxication
• Blood tests are most accurate

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The Morning After...

• NEXT DAY
• Congeners - forms of alcohol that metabolize more
  slowly - produce toxic by-products
• dehydration fluids are in the muscles and
  cerebral tissues
• hangover mitochondrial dehydration in CNS (loss
  of cerebrospinal fluid) headaches
• gastrointestinal irritation discomfort

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.. The night before

• rest / solid food / pain relievers (12 hours to
  recover)
• alcohol is a drug, therefore tolerance and
  withdrawal occur

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Long Term Effects

• Nervous System
• reduction in brain size and weight / left side
  language written spoken, mathematical skill and
  logic
• reduced intellectual ability
• binge drinking most damage

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Cardiovascular Disease

• effect on heart minimal (small amounts of alchol)
  may decrease cholesterol levels
• increases blood pressure
• heart rate
• cardiac output

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Hypertension and Stroke

• moderate alcohol
• consumption (red wine)
• increased HDL
• reduce hypertension
• Alcohol consumption (large
• quantity) causes
• hypertension
• stroke
• negative effects / out-weight good
• (moderate to heavy drinkers)

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Liver Disease

• cirrhosis liver cells die / top ten causes of
  deaths
• effects fat storage and transport in the liver /
  cells stop functioning
• fibroses damaged area develops scar tissue /
  cells function ineffectively
• alcoholic hepatitis inflammation of the liver /
  can lead to cirrhosis

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Cancer

• esophagus, stomach, mouth, tongue and liver
• breast cancer women between 34 59 / 3 to 9
  drinks/wk / 30
• males 12 increase for 1 drink per day 123
  for 2 drinks per day
• facilitates absorption of carcinogenic substances
  into sensitive tissues, i.e. tobacco
• alcohol-induced immunologic suppression
• synergistic effect with tobacco
• alcohol-induced outcomes, such as malnutrition,
  anemia

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Other Effects

• causes indigestion and heart burn
• damages mucous membranes stomach and intestinal
  irritation, absorption and chronic diarrhea

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Alcohol and PregnancyExcessive Drinking during
Pregnancy / Rate of Developmental
Disabilitiesalcohol passes directly into the
infant's blood stream

• BAC much greater than mother
• FAS - leading cause of development delays in
  Canada / North America
• during 1st trimester - organ development
• last trimester - CNS development

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Foetal Alcohol Syndrome (FAS)Physical and Foetal
Behaviour Difficulties

• sleeping / hyperactive
• learning disabilities
• dyslexic
• greater incidence of
• congenital heart disease
• spina bifida
• hip dislocation
• skeletal development

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Foetal Alcohol Effects (FSE) - Infants Exposed
to Prenatal Alcohol

• No FAS - symptoms
• effects 3/1000 children
• low birth weight
• irritability
• possible permanent mental impairment

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Alcoholism Alcohol Abuse

• Interferes with work, school or social and family
  relationships
• violation / law i.e., drunk driving
• approx. 2 in 10 Canadians / drinking problem
  resulting in physical health problems, financial,
  relationships
• 50 of Canadians problems with others people
  who drink
• loud, insulting, humiliation, argumentative,
  violent

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Social impact of alcohol

• motor vehicle accidents
• Pedestrian accidents
• Occupational accidents
• Home and recreational accidents
• Homicide
• Rape
• Marital problems
• Family violence/abuse
• Suicide

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Overall family patterns important

• Genetic link not found to date
• however - alcoholism 4 to 5 times greater in
  alcoholic homes
• Two Types Types of Alcoholics have been identified

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Type 1 Had at least One Parent Who was an
Alcoholic

• drinking at home was normal and encouraged
• avoids novelty/harmful situations
• concerned about the thoughts and feeling of
  others

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Type 2 males only / biological sons of
alcoholic fathers

• experiences both violence and drug abuse
• don't seek social approval / lack inhibition
• One alcoholic Parent 52 chance of developing a
  problem
• Two alcoholic Parents 71 chance of developing
  a problem

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Social and Cultural Factors and Alcoholism

• Social and Cultural Factors and Alcoholism
• part of traditions and cultural interactions
• may predispose people more than genetic potential
• Medication temporally escape!
• Stress disappointment unfulfilled
  expectations relationships depression

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Effects on the FamilyChildren have no idea of
what normal family life is like!!!!

• (dysfunctional)
• Victims of violence, abuse, neglect or incest
• low self-esteem and depression
• Adopt one of the following roles
• Family Hero too good to be true

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Effects on the FamilyChildren have no idea of
what normal family life is like!!!!

• Scapegoat - Draws attention through poor
  behaviours
• Lost Child passive and withdrawn in upsetting
  situations
• Mascot comic relief

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Recovery1 Assume Responsibility for Actions

• Intervention planned confrontation
• ( Family and trained therapist)
• Treatment Programs
• Symptoms delirium tremens (DTs)
• Long-term addicts medical treatment
  detoxification ( 7 to 21 days) physiological
  addiction
• psychological treatment starts ( 3 to 6 weeks)
• may require more time / repeated intervention!

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Family Therapy, Individual Therapy, and Group
Therapy

• determine underlying reasons for problem
• develop coping mechanisms
• Other types of treatment
• Drug Disulfiram (Antabuse) causes extremely
  unpleasant side effects when coupled with alcohol

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Alcoholics Anonymous (AA)

• private, nonprofit, self-help organization
  founded in 1935
• group support over 1 million members world wide
• lifetime problem
• AA ( Al-non) has other groups to help spouses,
  partners, children and friends
• Alateen help teens deal with alcoholic parents
• Relapse
• Success varies from Individual to Individual
• some recover other never recover others partially
  recover
• approx. 60 relapse
• pattern has to be broken promote self-esteem
  and personal growth

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Relapse

• Success varies from Individual to Individual
• some recover other never recover others partially
  recover
• approx. 60 relapse
• pattern has to be broken promote self-esteem
  and personal growth