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  University of Idaho
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  Psychology Dept.
  University of Idaho
  Design - P&D

Hello everyone and welcome back. In our past sections we have been discussing some background information that is related to substance abuse particularly different types of drugs. In this section we begin talking about one specific type of drug.  That is ethanol or what is also called alcohol. So let's begin by going to slide two.

As you can see there are many different types of alcohol. The one we commonly consume is called ethanol or C2 H5 OH but there are a variety of other types such as, methanol and isopropyl alcohol. Consuming either one of these even in small amounts can cause major damage within the system including blindness, problems with the liver, etc.

Let's look at alcohol (ethanol) on slide three. As you can see, the chemical structure is C2 H5 OH. I now would like to provide you with little background related to ethanol

As we can see in slide four, when we look at alcohol and the written record, fermentation to create alcohol dates back to at least 4200 BC. Currently today, ethanol is the second most used drug in the world next to caffeine. Luxembourg tops the list for legal purchases at 12.6 liters per person and Latvia tops the list for legal, illegal, and homemade purchase with consumption at 16 to 20 liters per person.
Whites have the highest rates of alcohol consumption in the world and Americans consume twice as much alcohol in the 1830's as they do now.

What about college students? They are always a great group! As we can see in slide five, college students drink on average, approximately four billion cans of beer per year. Of these, 360,000 of twelve million undergraduates will die from some kind of alcohol related cause while in school.  Deaths include auto accidents, other injuries, and of course from alcohol poisoning. Current research indicates that nearly half of all the college students today are binge drinkers. And on average, a student will spend nearly nine hundred dollars per year on alcohol while generally your books yearly only cost around four hundred fifty dollars.

Now, there is a wide variety of social problems that are correlated with alcohol. Some of these are listed in slide six. In general alcohol is correlated with crime. Three major groups where it really has an impact are domestic violence, rape, and driving while intoxicated behavior. The economic costs are also huge. Approximately 82 billion dollars is lost annually in productivity, 18 billion for alcohol related problems, and 9.9 for other drug problems. Generally, the burden for alcohol and drug problems also falls on the population that doesn’t use alcohol or drugs. That is, the taxpayer.

Now, not all alcohol use is bad. As we can see in slide seven, current research has indicated there are therapeutic effects when alcohol is consumed in moderation, that is, one drink or less per day.  Further, it does not depend upon the beverage. If you consume more though, that is when you begin to damage your body parts. Minimal age drinking laws also have mixed effects even though they have been implemented across most states. Most laws related to drinking and driving have minimum impacts on changing behavior even though everyone says they do. Basically, the research is very clear over a wide variety of different studies. What you get are short term reductions in drinking and driving behavior then the behavior goes back to normal. However, the combination of all of these, the changes in the population base and the aging of the youth culture as we have today have resulted in reductions of drinking and driving behavior across the system. However, no one particular thing can be related to having caused that drinking and driving reduction.

So what about ethanol? Ethanol as we can see in slide nine is a very simple molecule and it is generally classified as a CNS depressant. It contains no vitamins, no minerals, or anything else. All it contains is two hundred and ten calories per ounce. It also requires no digestion and once you get it into the system it stays there until it is metabolized (which makes it a very unique substance).

After alcohol is ingested and absorbed it easily goes throughout the body. It crosses the blood-brain barrier, and also crosses the placenta and will even enter the blood stream of a developing fetus. Essentially, once you get alcohol into the system it goes to all cells and impacts ALL cells.

Now there is a wide variety of behavioral effects that are associated with alcohol consumption and some of these are listed in slide eleven. They are not inclusive; there are many, many other things that occur as well. In general, as you start to increase your blood alcohol concentration at very low levels you begin to get changes in vision. At 0.03 you begin to get changes in inhibition, and 0.05 is really the level you are trying to get, that is the classic "buzz." Here you are also beginning to decrease motor coordination ,and as you continue your consumption, you get a continued decrease in motor coordination.  Ultimately there is a severe loss of judgment until you finally pass out, go into a coma, and then you die. Again, all of these impacts depends upon how much of the drug they consume.

There is also a wide variety of variables or factors that will influence blood alcohol concentrations.  These are shown on slide twelve. So let's just walk through these and get an idea about how they work.

The first of these is the concentration that is consumed (shown in slide thirteen). In general, the greater the concentration, the faster it enters the bloodstream of the individual. For example, a beverage on the rocks is better than not being on the rocks (in soda). However, if the concentration becomes too great, it can actually decrease bloodstream entry. That is, the gastrointestinal system shuts down, and as a result of that you get an irritated stomach and assorted other things.

Proof of the beverage (slide fourteen) is also important. This is basically the amount of alcohol per volume of water. If you have a hundred percent solution of alcohol and no water you have two hundred proof alcohol. This only exists in airless environments because air contains some amount of moisture. So, usually without some specific or specialized equipment you can usually get about one hundred ninety proof. In general, fifty percent alcohol and fifty percent water gives you one hundred proof. Forty percent alcohol and sixty percent water will give you eighty proof. This (proof) is not the same as the concentration. So the greater the proof the faster the entry into the blood system. However, again, if you get it too high, you can actually decrease the entry of the alcohol into the system until basically the concentration is reduced.

The next major variable is shown in slide fifteen. Basically, the faster you drink the faster your blood alcohol concentration rises.

Carbon dioxide shown on slide sixteen also has an impact. Basically, what carbon dioxide does is make ethanol cross mucosal membranes faster than straight alcohol. That is, it makes you drunk faster. So, Scotch and soda will actually get you drunk faster than Scotch and water.

The sex of an individual will also have an impact and this is shown in slide seventeen. In general, if a male and female are the same body weight, the female will get drunk faster than the male. There are several reasons for this difference and are shown on slide eighteen. First, women have less alcohol dehydrogenase, which is a liver enzyme, than men. Consequently, alcohol is metabolized slower. Men also have more muscle to fat ratios than women. The more muscle means the more blood in solution and that dilutes the ethanol and lowers the BAC. In addition, sorry ladies, women have more body fat than men. Fat contains little blood in solution. Less solution means a higher the BAC. So in general, if you have a person who is the same weight but just a different sex, men will have a lower blood alcohol concentration than women.

Tolerance is also going to be important and this is shown in slide nineteen. In general, the greater the tolerance the better the person will function when under the influence even though the blood alcohol concentration is still the same. That is, the person will actually do better than the person who has not had as much tolerance to the drug.

Altitude (shown in slide twenty) will also have an impact. In general, the greater the altitude, the faster the ethanol crosses the mucosal membranes. So, you get drunk faster.

Circadian rhythms will also influence how drunk you get.  Generally, you get drunker at the same time (11am) during the day than in the evening.

As we can see in slide twenty-two, basically you are drunker on the ascending side of the blood alcohol concentration curve than at the same level on the descending side. This is shown in graphic form on slide twenty-three. The next question is, why? The reason is, as we see in slide twenty-four, the neurons have adapted somewhat on the descending side, that is, you are beginning to develop some aspects of tolerance even though it may only be at one time.

Fructose and other substances will also have an impact on blood alcohol concentrations. As we see in slide twenty-five, fructose will actually increase the metabolism of the liver. Not a lot but it does some. This will slightly, and the emphasis is on slightly, decrease the blood alcohol concentration.

And finally, RO-15-4513 and other types of substances (shown in slide twenty-six). Generally, these types of substances tend to block the actual effects of the alcohol on the receptor site. That is, you have the same blood alcohol concentration but you have no behavioral effects. These have been around for quite a while.  However, they are not generally available on the market due to liability issues and lawsuits of somebody having a problem and actually causing a car wreck and then what do they do? You go after the drug maker who is making the compound.