Alcohol in the Body

(Ch. 10)

  1. DEVELOPMENT OF ALCOHOLIC BEVERAGES
  1. Alcoholic beverages date back as far as 8000 BC
  2. Fermentation, the process by which certain yeast act on sugar in the presence of water, is the basis for all alcoholic beverages

  3.                                        C6 H12 O6 (glucose) --> C2 H5 OH (ethyl alcohol) + CO2

  4. Distillation is the procedure in which the alcohol-containing solution is heated and the vapors collected and again condensed into liquid form
  5. Alcohol content of distilled beverages is indicated by the term proof. The percentage of alcohol by volume is 1/2 of the proof number (Ex. 90 proof whiskey is 45% alcohol)
II THE ECONOMICS OF ALCOHOL
  1. Americans spend over $100 billion annually on alcohol
  2. Wine sales have increased, beer sales have leveled off, and sales of distilled spirits have decreased
  3. The beer industry is controlled by a few big brewers (see Table 10.1 in your textbook)
  4. Beer is made by adding barley malt to other cereal grains such as ground corn or rice. The enzymes in the malt change the starches in these grains into sugar; the solids are filtered out, yeast is added and fermentation begins. Hops from the female plant (dried blossoms) are added to give beer its flavor.
    1. most beer sold today in America is lager (from the German word "to store"). In most commercial beers today, alcohol content is a little over 4%. Yeast is removed (or killed) by pasteurization or microfilters.
    2. Ale requires a top-fermentation yeast, warmer temperatures during fermentation and more malt and hops, producing a more flavorable beverage.
    3. Malt liguor is brewed like lager but aged longer, has less calories and 1-3% more alcohol
    4. "Light" beer is fermented at a cooler temperature for a longer time; then the alcohol content is adjusted with water.
  5. Imports represent about 5% of total US sales (Corona being the largest selling import)
  6. Most American wine grapes were originally transplanted from France and Spain. They are identified as generics or varietals.
    1. Generics usually have names taken from Euroopean land areas where the original wines were produced: Chablis, Champagne. Burgundy, Bordeaux and Rhine. They are blended wines from whatever grapes are available and during the processing they are made to taste something like the traditional European wines from those regions.
    2. Varietals are named after one variety of grape that by law must make up at least 51% of the grapes used in producing the wine: Chardonnay, Pinot noir and Zindanfel are some examples. They are usually expensive wines.
    3. Most table wines are relatively dry, but some are sweeter than others. As a general rule, lighter foods such as broiled fish call for a light, dry, white wine. Red wine would be considered appropriate with steak.
    4. Champagne is made by adding a small amount of sugar as the wine is bottled and keeping the bottle tightly corked
    5. Sherry is made by adding brandy to wine and aging this mixture. Other fortified wines, all of which have an alcohol content near 20% include port, Madeira and Muscatel.
    6. Part of the increase in per capita wine consumption in the mid-1980s was due to the wine cooler (wine + carbonated beverage). Wine coolers have replaced beer as a common "gateway" alcoholic beverage for many beginning drinkers.
  1. Scotch Whisky is the distillate of fermented malted barley
  2. Blended Whiskys contain 2/3 straight whiskey and 1/3 grain neutral spirits.
  3. Grain neutral spirits are distillates of whatever grain is available at a cheap rate. They are of 190 proof (95% pure alcohol). Large quantities are now added to gasoline. Gin and Vodka are produced similarly.
  4. When alcohol is formed, other related substances, known as congeners (other alcohols, oils and oganic matter) are formed.
III THE PHARMACOLOGY OF ALCOHOL
  1. Alcohol required no digestion and can be absorbed unchanged from the stomach and small intestine.
  2. Absorption is affected by the concentration of the alcohol and the presence of food and carbonated liquids. Gender can influence metabolism
    1. Alcohol decreases the rate at which humans "burn" fat for energy
  3. Alcohol is an CNS depressant, but its use as an anaesthetic was discontinued because of some major disadvantages
  4. The effects of alcohol are dose-related although one can develop behavioral and physiological tolerance
  5. Alcoholís effects are influenced by the userís gender, weight, and speed of drinking
    1. 90% of alcohol is metabolized in the liver. The primary metabolic system is the enzyme alcohol dehydrogenase, which converts alcohol to acetaldehyde. Acetaldehyde is converted by aldehyde dehydrogenase to acetic acid (acetaldehyde is very toxic)
    2. The amount of alcohol that can be metabolized is constant at about 0.25 to 0.5 ounces per hour (a good estimate is 0.50 oz./hr. AND 1 drink = 0.50 oz. of alcohol). REMEMBER, the major factor determining the rate of alcohol metabolism is the activity of the enzyme alcohol dehydrogenase.
    3. The second enzyme system comes from the effects of the liver microsomal enzymes (which work on ALL drugs or foreign chemicals to the body).
    4. Alcohol works on the GABA receptor complex (remember that GABA is an inhibitory neurotransmitter). Alcohol potentiates the GABA receptor function.
    5. The experimental drug RO 15-4513, was used to demonstrate the effect of alcohol on the GABA receptor complex - the drug antagonizes alcohol's enhancement of GABA action.
    6. Blood Alcohol Concentration (BAC) is the number of grams of alcohol in 100 ml of blood. It is expressed in percentage (refer to table 10.2 and 10.3). On average, a person experiences a 0.017/hr. decline in BAC.
    7. Remember: 1 drink = 0.50 oz. of alcohol; and alcohol is removed from the liver at a CONSTANT rate of 0.25-0.50 oz. of alcohol/hr (or 0.017 BAC/hr.). Therefore, over the course of an evening, if your rate of intake equals your rate of metabolism, you will maintain a stable BAC.
    8. Alcohol does not distribute well into fatty tissues.
  6. Alcoholism has been shown to result in a number of sexual problems (in studies, there appears to be a difference in actual physiological response and the perception of this response). Recent studies show that there is an increase blood flow to the genitals which gives the sensation of sexual arousal. HOWEVER, testosterone production becomes suppressed - decreasing libido.
  7. Hangover, a well-known after-effect of alcohol consumption, may be a symptom of alcohol withdrawal. Some hangover symptoms are reactions to congeners.
  8. Alcohol use is related to brain tissue damage, heart disease, cancer and lower immunity.
  9. As a general rule, alcohol use (directly or indirectly) affects every organ system of the body.
    1. brain damage - alcoholic dementia - decline in intellect
    2. Wernicke-Korsakoff Syndrome - confusion, ataxia, abnormal eye movements and Karsakoff's psychosis (inability to remember recent events or to learn new information)
    3. Cirrhosis of the liver - liver cells are replaced by fibrous tissue.
  1. FETAL ALCOHOL SYNDROME (FAS)
  2. FAS refers to physical and behavioral abnormalities caused by the presence of alcohol during fetal development
  3. Criteria are applied to determine FAS, but the diagnosis is a matter of judgement. There are three primary criteria for diagnosing FAS: 1) growth retardation before and/or after birth, 2) a pattern od abnormal features of the face and head, and 3) evidence of CNS abnormalities.
  4. Among drinking mothers, FAS seems to be occur 23 to 29 per 1000 births
  5. Spontaneous abortions are more likely to happen when mothers drink heavily
  6. The Surgeon General recommends abstinence during pregnancy
  1. TREATMENT PROGRAMS FOR ALCOHOLISM VARY
  1. Alcoholics Anonymous believes in the disease mode; thus abstinence is the principal goal
  2. The medical approach to alcoholism was stimulated by Jellinekís stage theory
  3. Detoxification is the first procedure to stabilize the alcoholic
  4. Aversion therapy involves providing the alcohol abuser with an electric shock or chemical that makes alcohol consumption unpleasant
  5. Naltrexone has been found to be useful in reducing craving for alcohol. Teaching people how to cope with peer pressure and high risk situations as well as alternative behaviors is another therapeutic approach
  6. Controlled drinking in which clients monitor their own behavior is an approach that has come under much criticism
  7. Those who enter treatment programs do a little better than those who do not
  8. Occupational alcohol programs have been implemented by the military, the government, and industry