Hanson, 13 ed Alcohol

1. Alcohol
Hanson Chapters 7 & 8
SOC 204 Drugs & Society

2. Is someone close to you an alcoholic?
A. Yes, more than one person
B. Yes, one person
C. No
Yes,m
ore
than
one
person
Yes,one
person
No
56%
24%
20%

3. Alcohol
• Fermentation
• Distillation
• Proof

4. Pharmacology
• Absorption
• Distribution
• Metabolism
• Mechanism of Action
• BLOOD ALCOHOL
CONTENT

5. Alcohol is metabolized in your liver
A. True
B. False
True
False
0%
100%

6. Figure 7.1 How alcohol is absorbed in the body.
Data from Masters, S., and A. Trevor “The Alcohols.” In
Basic and Clinical Pharmacology, 13th ed., edited by B.
Katzung, 384–395. New York: McGraw-Hill, 2015.

7. You can increase your rate of metabolizing
alcohol by exercise or by taking caffeine
A. True
B. False
True
False
88%
12%

8. Alcohol’s Effects
• Alcohol acts on the
cerebrum affecting
▫ Judgment
▫ Reasoning
▫ Inhibitions
▫ Motor activity
▫ Impairs the senses
• Mouse Party

9. BAC (%)
Behavioral Effects
•0.05 Lowered alertness, release of inhibitions, impaired
judgment
•0.10 Slower reaction times, impaired motor function, less
caution
•0.15 Large, consistent increases in reaction time
•0.20 Marked depression in sensory and motor capability,
intoxication
•0.25 Severe motor disturbance, staggering, great impairment
•0.30 Stuporous but conscious—no comprehension of what’s
going on
•0.35 Surgical anesthesia; about LD1, minimal level causing
death
•0.40 About LD50

10. Figure 7.2 The principal control centers of the brain affected by alcohol
consumption.

11. Alcohol primarily impacts this part of
the brain:
A. Limbic system
B. Cerebellum
C. Cerebral cortex
D. Basal ganglia
Lim
bicsystem
Cerebellum
Cerebralcortex
Basalganglia
0% 0%
56%
44%

12. Alcohol sedates by increasing
glutamate’s action – an agonist
response.
A. True
B. False
True
False
63%
38%

13. Alcoholism
• Alcoholism
▫ Condition in which an individual loses control over
intake of alcohol
• Substance Use Disorder
▫ Physical, social, intellectual, emotional, or financial
problems resulting from the use of alcohol
▫ Withdrawal symptoms
▫ Tolerance
▫ Blackouts

14. Alcoholism
• Some consider alcoholism to be a disease
▫ Compared to heart disease or diabetes
▫ 1956 American Medical Association declared it a
disease
▫ Disease can be used as a legal defense
▫ Receive treatment rather than punishment

15. Early Characterizations of Alcoholic
Types by Jellinek (1960)
• Alpha alcoholics: Mostly a psychological dependence
• Beta alcoholics: Mostly socially dependent on alcohol
• Gamma alcoholics: Most severe; suffers from emotional
and psychological impairment
• Delta alcoholics: Constantly losing control over the
amount of alcohol consumed
• Epsilon alcoholics: Constantly binge drinking and at
times days at a time
• Zeta alcoholics: Moderate drinker who becomes abusive
and violent

16. Types of Alcoholics by Moss and
Colleagues in 2007
• Young Adult (31.5% of U.S. alcoholics): Young adult
drinkers without major problems regarding their drinking
• Young Antisocial (21% of U.S. alcoholics): Mid-20s, had
earlier onset of regular drinking and alcohol problems,
and come from heavy alcohol use families
• Functional (19.5% of U.S. alcoholics): Middle-aged, well-
educated, with stable jobs and families
• Intermediate Familial (19% of U.S. alcoholics):
Middle-aged, with 50% from families with
multigenerational alcoholism
• Chronic Severe (9% of U.S. alcoholics): Mostly middle-
aged, high rates of antisocial personality disorder and
criminality

17. Do you agree alcoholism is a disease?
A. Yes
B. No
C. I’m not sure
Yes
No
I’m
notsure
0% 0%0%

18. I know that for the discussion
Thursday, I have to interview two
people
A. Yep. On it.
B. Noooo
C. What discussion?
Yep.
On
it.
Noooo
W
hatdiscussion?
100%
0%0%

19. Alcoholism
• Genetics
▫ 50-60% of alcoholism vulnerability has a genetic
basis
▫ Environmental factors affect the impact of
genetics

20. Alcohol and Genetics
• Alcoholism is among the most inherited
mental illnesses
• Specific genes contribute to: (i) excessive
consumption, (ii) diminished negative
feedback, (iii) enhanced sense of pleasure, and
(iv) diminished hangovers
• However, environment is as important as
genetics

21. Alcoholism
• Psychosocial factors
▫ 20% of alcoholics have a mood or anxiety disorder
▫ Individuals are more likely to drink heavily when
in a group
▫ Expectations about alcohol are predictors of
dependence
▫ Associated with a greater number of sexual
partners

22. Happy Tuesday to
you!
This is the
Monday-est
Tuesday ever.
57%
43%
Happy Tuesday
A. Happy Tuesday to you!
B. This is the Monday-est
Tuesday ever.

23. Alcoholism
• Culture
▫ Attitudes toward alcohol affect rates of alcohol
abuse

24. Culture and Alcohol (continued)
• Some psychologists contend that both set and
setting can often overshadow the
pharmacological effects of most drugs,
including alcohol.
▫ Set: An individual’s expectation of
what a drug will do to his/her
personality
▫ Setting: The physical and social
environment where most drugs,
including alcohol, are consumed

25. Culture and Alcohol
• Culture provides how alcohol use is perceived (e.g.,
violation of norms, “normal” to drink, sexy, sophisticated,
mature).
• Cultural rules state how much one can drink and where
one can drink.
• Cultures provide ceremonial
meaning to alcohol use.
• Culture provides a model of
alcoholism.
• Culture provides attitudes and stereo-
types regarding drinking behavior.

26. Distinctions Between “Wet” and “Dry
Cultures
 “Wet” Cultures - In these cultures alcohol is
integrated into daily life and activities (e.g., alcohol
consumed with meals). In these cultures,
abstinence rates are low and wine is largely the
beverage of preference. European countries
bordering the Mediterranean have traditionally
exemplified wet cultures.
 “Dry” Cultures – Alcohol consumption is not as
common during everyday activities. Abstinence is
more common, however, when drinking occurs, it
is more likely to result in intoxication.
Scandinavian countries, the U.S., and Canada are
examples of counties that are dry.

27. Alcohol Withdrawal
• Characteristics of alcohol withdrawal:
▫ Craving for alcohol
▫ Delirium tremens (DTs)
▫ Extreme arousal
▫ Auditory and visual hallucinations
▫ Physiological symptoms
▫ Cognitive symptoms

28. Impacts of Alcohol
Individual
Family Society

29. Family Effects
• Children of alcoholics
▫ Often experience sleep difficulties, depression,
loneliness, and stomach problems
▫ Alienated from parents, have poor communication
skills, less trust, and more emotional longing
▫ Attention deficit hyperactivity disorder (ADHD)
• Adult children of alcoholics (ACOAs)
▫ Feelings of failure and self-deprecation
▫ Feel a great need to be in control

30. Addict
• Behaviors
▫ Use of
chemicals
▫ Abusive
▫ Controlling
▫ Withdrawal of
love, attention,
affection
▫ Blaming
▫ Anger
▫ Self-
righteousness
Underlying
feeling:
SHAME

31. Co-Dependent
• Behaviors
▫ Rescuing
▫ Excusing
▫ Denial
▫ Helplessness
▫ Martyr
Underlying
feeling:
ANGER

32. Hero
• Behaviors
▫ The “Good Kid”
▫ High achiever
▫ Successful
▫ Overly
responsible
▫ Intellectual
Underlying
feeling:
INADEQUACY

33. Scapegoat
• Behaviors
▫ Acting out
▫ Defiant
▫ Peer-oriented
▫ Sullen, angry
▫ Irresponsible
▫ Chemical use
▫ Law breaking,
truancy
Underlying
feeling:
HURT

34. Lost Child
• Behaviors
▫ Withdrawn
▫ Loner
▫ Day dreamer
▫ Unnoticed
Underlying Feeling:
LONELINESS

35. Mascot
• Behaviors
▫ Attention-getting
▫ Humor
▫ Clowning
▫ Super cute
▫ Overly active
▫ Silly
Underlying Feeling: FEAR

36. Which do you most identify with?
A. Addict
B. Co-dependent
C. Hero
D. Scapegoat
E. Lost Child
F. Mascot
AddictCo-dependent
Hero
Scapegoat
LostChild
M
ascot
7%
4%
22%
15%
11%
41%

37. COSTS
• Hero
▫ Compulsive drive, pressure, suicide
• Scapegoat
▫ Addiction, criminal behavior, drop out
• Lost Child
▫ Isolation, abuse victim, eating disorders
• Mascot
▫ Immaturity, distant relationships,
manipulation

38. Alcohol and the Family (1 of 3)
• Important Key Terms:
▫ Codependency (or co-alcoholism):
Behavior displayed by either addicted or
nonaddicted family members (codependents)
who identify with the alcohol addict and cover
up the excessive drinking behavior, allowing
it to continue and letting it affect the
codependent’s life
▫ Enablers: Those close to the alcohol addict
who deny or make excuses for enabling his or
her excessive drinking

39. Alcohol and the Family (2 of 3)
• Children of alcoholics (COAs) are 2–4 times more likely to
become alcoholics themselves.
• Adult children of alcoholics (ACOAs) are 2–4 times more
likely to develop alcoholism.
• Approximately 9.7 million children age 17 or younger are
living in households with one or more adults classified as
having an alcohol abuse or dependence problem.
▫ Seventy percent of these children were biological,
foster, adopted, or stepchildren.
▫ As a result, 6.8 million children, or about 15% of
children aged 17 or younger, meet the formal definition
of children of alcoholics.

40. Alcohol and the Family (3 of 3)
• COAs and ACOAs are more likely to marry
into families where alcoholism is
prevalent.
• Twenty-five percent of American children
are exposed to an alcoholic before the age
of 18.

41. How’s your group doing?
A. We rock.
B. Working on it.
C. We need help.
D. Group? What group?
W
erock.
W
orkingon
it.
W
eneed
help.
Group?
W
hatgroup?
20%
0%
10%
70%

42. Correlations with
Violence
As alcohol use escalates,
so does violence
▫ Domestic partner
violence 66%
▫ Sexual Assault 37%
▫ Homicides 40%
▫ Child abuse 70%
http://www.ph.ucla.edu/sciprc/pdf/ALCOHOL_AND_VIOLENCE.pdf

43. Suicide
▫ About 7% of alcoholics commit
suicide
▫ 16% of men and 10% of women
entering alcohol treatment have
contemplated suicide
▫ 38% of people who hanged
themselves had alcohol in their
system
▫ 32% of veterans who attempted
suicide were diagnosed with
alcohol abuse or disorder

44. Accidents and Alcohol
▫ Drinking while driving
Emergency room
admissions
▫ Fire-related fatalities
▫ Alcohol-related
boating accidents
▫ Drowning fatalities
YouTube

46. Helping the Family Recover
(1 of 2)
Important Key Terms:
•Psychodrama: A family therapy system developed by
Jacques Moreno in which significant interpersonal and
intrapersonal issues are enacted in a focused setting using dramatic
techniques.
•Role-playing: A therapeutic technique in which group
members play assigned parts to elicit emotional reactions.
•Genogram: A family therapy technique that records
information about behavior and relationships on a type of family
tree to elucidate persistent patterns of dysfunctional behavior.

47. Helping the Family Recover
(2 of 2)
• Post-traumatic stress disorder (PTSD):
A psychiatric syndrome in which an individual who has
been exposed to a traumatic event or situation
experiences psychological stress that may manifest itself
in a wide range of symptoms, including re-experiencing
the trauma, numbing of general responsiveness, and
hyper-arousal.

48. Recovery from Alcoholism
Treatment of alcoholism:
▫ Denial as a psychological defense
▫ Easy to relapse (relapsing syndrome) without
radical shift in lifestyle
▫ Alcohol rehabilitation and medical
ramifications
▫ More emotionally fragile than other addicts

49. Withdrawal
Important Key Terms:
• Relapsing syndrome: Returning to the use of
alcohol after quitting
• Acute alcohol withdrawal syndrome: Symptoms
that occur when an individual who is addicted to alcohol
does not maintain his or her usual blood alcohol level
• Delirium tremens (DTs): The most severe, even
life-threatening, form of alcohol withdrawal, involving
hallucinations, delirium, and fever.

50. Prohibition
• Temperance
Movement – view of
alcohol
• Prohibition
• States 1851
• Federal 1919
• Repealed in 1933
• Since 1933, states
regulate alcohol
• Federal taxation

51. Who drinks and why
• Cultural Differences
• Trends in US
• Regional Differences
• Gender Differences
• Drinking Among College Students

52. Total estimated U.S. per capita ethanol consumption in gallons per year by
state, 2007
Source: Data from NIAAA
© 2011 McGraw-Hill Higher Education. All rights reserved.

53. Alcohol Abuse Among College
and University Students
CORE Institute (2008) research results:
• Approximately 72% of college students consumed
alcohol and 42% to 55% engaged in binge drinking
within 30 days when survey was given.
• College students consume an average of 5.4 alcoholic
drinks per week.
• Of all the drugs reported, alcohol was the most heavily
abused on college campuses, followed by tobacco (44%)
and marijuana (31%).

54. Alcohol Abuse Among College and
University Students (continued)
Other studies found that …
• The main reason given for binge drinking was “to get
drunk.”
• Males binge drink more than females.
• For binge drinkers, the impact on impaired academic
performance is just as great for women drinkers.
• Being white, involved in athletics, or a resident of a
fraternity or sorority made it more likely that a student
would be a binge drinker.

55. Alcohol Abuse Among College and
University Students
• On U.S. campuses, alcohol is a factor in 40% of all academic
problems and 28% of all dropouts.
• Seventy-five percent of male students and 55% of female
students involved in acquaintance rape had been drinking or
using drugs.
• The transition into college is
associated with a doubling of the
percentages of those who drink for
both males and females.
• For heavier drinkers, grades
suffered for both male and
female students.

56. Women and Alcohol
• Women possess greater sensitivity to alcohol,
have a greater likelihood of addiction, and
develop alcohol-related health problems sooner
than men (e.g., stomach cancer, cirrhosis of the
liver).
• More women in alcohol treatment come from
sexually abusive homes (70%) in comparison to
men (12%).

57. Women and Alcohol (continued)
• Three major reasons why women are more sensitive
to the effects of alcohol:
1. Body size (men generally larger than women)
2. Women absorb alcohol sooner—women possess
more body fat and body fat does not dilute
alcohol
3. Women possess less of a metabolizing enzyme
that gets rid of (processes out) alcohol

58. Women and Alcohol (continued)
• Alcohol consumption patterns of women:
▫ Women 21 to 34 years of age were least likely to
report alcohol-related problems if they had stable
marriages and were working full time.
▫ Women tend to marry men whose drinking habits
match their own.
▫ Between 35 to 49 years of age, the heaviest drinkers
were divorced or separated women without children.
▫ Between 50 to 64 years of age, the heaviest drinkers
were women whose husbands/partners drank
heavily.
▫ Women 65 and older comprised less than 10% of
drinkers with drinking problems.

59. Alcohol Consumption in the
United States
• Alcohol consumption has dropped sharply
since 1981.
• What explains the steady decline in alcohol
consumption during the past twenty years?
▫ Demographics
▫ Conservatism
▫ Decrease in social acceptability
▫ Increased awareness of risks
▫ Increased concerns for health

60. Figure 8.1 Current, binge, and heavy alcohol use among persons
aged 12 or older, by age: 2014
Data from: Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the
2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Rockville, MD, 2015.

61. Additional Facts Regarding
Alcohol Use/Abuse
• Drinking and driving: On most weekend nights
throughout the United States, 70% of all fatal single-
vehicle crashes involve a driver who is legally
intoxicated.
• Income/wealth: Less affluent people drink less than
more affluent individuals.
• The average “alcoholic”: The largest percentage of
alcoholics are secret or disguised drinkers who look
very much like common working people.
• On average: Most people who consume alcohol do not
become problem drinkers.

62. Most college students reduce their
binge drinking after graduating
from college.
A.True
B.False
True
False
24%
76%

63. The younger one is when drinking
alcohol for the first time, the more
likely one will become a problem
drinker.
A.True
B.False
True
False
29%
71%

64. Underage Drinking
• Underage drinking is associated
with premature death, disease,
injury, property damage, motor
vehicle crashes, alcohol-related
crime and loss of productivity
• There is a significant
relationship between drinking
before age 13 and suicide
attempts

65. Underage Drinking
• High school students who engaged in binge
drinking were six times more likely to drink and
drive
▫ 7.2% of 8th-grade students binge drink
▫ 16.3% of 9th-grade students binge drink
▫ 23.2% of 12th-grade students binge drink

66. Moderate alcohol drinkers have
lower rates of cardiovascular
disease than abstainers.
A.True
B.False
True
False
0%0%

67. Physiological Toxicity
• Overdose
• Hangover

68. When someone passes out from
alcohol use:
A. Put them on their
back
B. Put them to bed
and let them sleep
it off
C. Put them on their
side Putthem
on
theirback
Putthem
to
bed
and
let...Putthem
on
theirside
0% 0%0%

69. Fetal Alcohol Syndrome

70. There is a safe level of alcohol to
consume while pregnant
A. True
B. False
True
False
86%
14%

72. Physiological
Toxicity - Brain
• Wernicke-Korsakoff
syndrome develops
because alcohol impedes
the body’s ability to
utilize thiamine (a B vitamin)
• Alcohol use is associated with psychological
symptoms: depression, anxiety

73. Physiological Toxicity - Liver
• Three main conditions associated
with alcohol:
▫ Fatty liver
▫ Alcohol hepatitis
▫ Cirrhosis
• Cirrhosis is irreversible, even if
alcohol use stops

74. Physiological Toxicity – Digestive System
• In moderate amounts, alcohol aids digestion by
increasing gastric juice in the stomach
• Too much alcohol can irritate
the stomach, leading to internal
bleeding
• Heavy alcohol use is implicated in acute pancreatitis
• Alcoholics often have malnutrition because alcohol
interferes with the body’s ability to utilize nutrients

75. Physiological Toxicity – Circulatory System
• Moderate alcohol use reduces risk of heart
disease, boosts good (HDL) cholesterol and
helps prevent type 2 diabetes
• Effects of heavy alcohol use:
▫ Degeneration of the heart muscle
▫ High blood pressure
▫ Cardiac arrhythmias
▫ Ischemic heart disease
▫ Strokes

76. Physiological Toxicity – Immune System
• Studies show that
moderate alcohol use
reduces immunity
• Alcohol interferes
with white blood
cells, particularly T
lymphocytes, which
help to resist
infections