Chapter 11 Alcohol, Tobacco and Caffeine Unacknowledged Addictions

1. Chapter 11Alcohol, Tobacco and CaffeineUnacknowledged Addictions Alcohol

2. Alcohol a Dangerous Drug? • Cocaine, heroin, marijuana, LSD, PCP….and others! • Alcohol isn’t considered because it is socially excepted • Canadians consumed 7.1 liters • comparable to US, Australia, and less than European countries

3. Alcohol a Dangerous Drug? • Can have some positive health benefits • moderate use can be enjoyable • However! Many tragedies associated with abuse……..

4. 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

5. Alcohol and University Students • Be aware of drinking • campus culture and tradition • reduces tension • celebrations • social lubricant • drinking games and binge drinking

6. Drinking Alcohol and the Risks!!!!!! • Exacerbates risks of suicide, automobile crashes and falls • peers / university traditions encourage dangerous practices • participate in dangerous behaviours……..

7. 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 > 80 proof = 40% alcohol

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

9. Behaviours………... Alcohol has different effects on: • sight: visual acuity • hearing • speaking • smell-taste • pain reception • motor skills

10. 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

11. 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

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

13. 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

14. 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

15. 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

16. ….. The night before • rest / solid food / pain relievers (12 hours to recover) • alcohol is a drug, therefore tolerance and withdrawal occur

17. 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

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

19. 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)

20. 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

21. 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

22. Other Effects • causes indigestion and heart burn • damages mucous membranes = stomach and intestinal irritation, absorption and chronic diarrhea

23. 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

24. 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

25. Foetal Alcohol Effects (FSE) - Infants Exposed to Prenatal Alcohol • No FAS - symptoms • effects 3/1000 children • low birth weight • irritability • possible permanent mental impairment

26. 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

27. Social impact of alcohol: • motor vehicle accidents • Pedestrian accidents • Occupational accidents • Home and recreational accidents • Homicide • Rape • Marital problems • Family violence/abuse • Suicide

28. 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

29. 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

30. 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

31. 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

32. Effects on the Family:Children 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

33. Effects on the Family:Children 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

34. Recovery#1 Assume Responsibility for Actions Intervention – planned confrontation • ( Family and trained therapist) Treatment Programs: • Symptoms: + delirium tremens (DT’s) • 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!

35. 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

36. Alcoholic’s 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

37. 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