Chapter 9

Alcohol• Acute effects

• Mechanisms of action

• Long-term effects

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Chemical structures of three commonly used forms of alcohol

(Ethanol)

Alcohol content

Blood alcohol concentration (BAC):

BAC: • 0.04%• 0.08%• 0.35%• 0.50%

Factors influencing absorption:• • • •

Blood levels of alcohol after oral administration

Why is there are a difference between the effect of alcohol on men and women?

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Metabolism of alcohol

Another enzyme: P450 liver enzyemes

Drug disposition tolerance Cross tolerance

9.11 The effects of chronic alcohol use on the liver

cirrhosis

Immediate Physiological Effects- Increases blood circulation to the skin - Decreases heart rate- Depresses REM sleep- Increased urination- Slurred speech

- Alcohol poisoning

Immediate Psychological Effects- Reduces anxiety- Impairs judgment- Memory deficits (blackouts)- Perceptual changes

- Decreases visual abilities- Decreases reaction time- Decreases eye-hand coordination

Physical dependence

Common symptoms

Delirium tremens

Box 9.1 Fetal Alcohol Syndrome (Part 1)

teratogen

Benefits of Moderate Alcohol Use

• mortality stats

– What kills the heavy drinkers?

– Why low among moderates?

• May help prevent dementia (moderate doses)

9.13 Alcohol’s effects on neuronal membranes

Effects of long-term use (abuse)

- Enzyme changes- P450 liver enzyme- Alcohol dehydrogenase

- Pharmacodynamic tolerance

- Sexual dysfunction

- Cognitive impairments- reasoning ability,

problem solving- inability to shift

attention to a new task

- memory - Korsakoff's

syndrome - Confabulation

Effects of long-term use (abuse)

9.18 A wide variety of individuals are alcoholics

Alcoholism

• What is alcoholism?

• Disease model– Genetics

– Environment

At risk for alcohol-related problems:• Men: 5 or more standard drinks in a day (or 15 or more per

week) • Women: 4 or more standard drinks in a day (or 8 or more

per week)

Some statistics for alcohol:• Among heavy drinkers, 1 in 4 has alcohol abuse or

dependence.• About 3 in 10 adults drink at levels that elevate health risks.• All heavy drinkers have a greater risk of:

– hypertension– gastrointestinal bleeding– sleep disorders – major depression – stroke– cirrhosis of the liver– Several cancers

9.19 Three-factor vulnerability model

Treatment for alcoholism• Denial factor

• Detoxification

• Program types

• Drug treatments– Antabuse– Naltrexone