Alcohol in the Body
(Ch. 10)
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DEVELOPMENT OF ALCOHOLIC BEVERAGES
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Alcoholic beverages date back as far
as 8000 BC
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Fermentation, the process by which
certain yeast act on sugar in the presence of water, is the basis for all
alcoholic beverages
C6 H12 O6 (glucose) --> C2 H5 OH (ethyl alcohol) + CO2
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Distillation is the procedure in which
the alcohol-containing solution is heated and the vapors collected and
again condensed into liquid form
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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
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Americans spend over $100 billion annually
on alcohol
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Wine sales have increased, beer sales
have leveled off, and sales of distilled spirits have decreased
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The beer industry is controlled by
a few big brewers (see Table 10.1 in your textbook)
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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.
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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.
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Ale requires a top-fermentation yeast,
warmer temperatures during fermentation and more malt and hops, producing
a more flavorable beverage.
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Malt liguor is brewed like lager but
aged longer, has less calories and 1-3% more alcohol
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"Light" beer is fermented at a cooler
temperature for a longer time; then the alcohol content is adjusted with
water.
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Imports represent about 5% of total
US sales (Corona being the largest selling import)
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Most American wine grapes were originally
transplanted from France and Spain. They are identified as generics or
varietals.
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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.
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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.
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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.
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Champagne is made by adding a small
amount of sugar as the wine is bottled and keeping the bottle tightly corked
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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.
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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.
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Scotch Whisky is the distillate of
fermented malted barley
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Blended Whiskys contain 2/3 straight
whiskey and 1/3 grain neutral spirits.
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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.
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When alcohol is formed, other related
substances, known as congeners (other alcohols, oils and oganic matter)
are formed.
III THE PHARMACOLOGY OF ALCOHOL
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Alcohol required no digestion and can
be absorbed unchanged from the stomach and small intestine.
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Absorption is affected by the concentration
of the alcohol and the presence of food and carbonated liquids. Gender
can influence metabolism
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Alcohol decreases the rate at which
humans "burn" fat for energy
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Alcohol is an CNS depressant, but its
use as an anaesthetic was discontinued because of some major disadvantages
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The effects of alcohol are dose-related
although one can develop behavioral and physiological tolerance
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Alcohol’s effects are influenced by
the user’s gender, weight, and speed of drinking
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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)
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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.
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The second enzyme system comes from
the effects of the liver microsomal enzymes (which work on ALL drugs or
foreign chemicals to the body).
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Alcohol works on the GABA receptor
complex (remember that GABA is an inhibitory neurotransmitter).
Alcohol potentiates the GABA receptor function.
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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.
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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.
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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.
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Alcohol does not distribute well into
fatty tissues.
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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.
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Hangover, a well-known after-effect
of alcohol consumption, may be a symptom of alcohol withdrawal. Some hangover
symptoms are reactions to congeners.
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Alcohol use is related to brain tissue
damage, heart disease, cancer and lower immunity.
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As a general rule, alcohol use (directly
or indirectly) affects every organ system of the body.
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brain damage - alcoholic dementia -
decline in intellect
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Wernicke-Korsakoff Syndrome - confusion,
ataxia, abnormal eye movements and Karsakoff's psychosis (inability to
remember recent events or to learn new information)
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Cirrhosis of the liver - liver cells
are replaced by fibrous tissue.
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FETAL ALCOHOL SYNDROME (FAS)
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FAS refers to physical and behavioral
abnormalities caused by the presence of alcohol during fetal development
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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.
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Among drinking mothers, FAS seems to
be occur 23 to 29 per 1000 births
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Spontaneous abortions are more likely
to happen when mothers drink heavily
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The Surgeon General recommends abstinence
during pregnancy
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TREATMENT PROGRAMS FOR ALCOHOLISM VARY
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Alcoholics Anonymous believes in the
disease mode; thus abstinence is the principal goal
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The medical approach to alcoholism
was stimulated by Jellinek’s stage theory
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Detoxification is the first procedure
to stabilize the alcoholic
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Aversion therapy involves providing
the alcohol abuser with an electric shock or chemical that makes alcohol
consumption unpleasant
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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
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Controlled drinking in which clients
monitor their own behavior is an approach that has come under much criticism
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Those who enter treatment programs
do a little better than those who do not
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Occupational alcohol programs have
been implemented by the military, the government, and industry