ALCOHOL IN BRIEF

 This information is provided courtesy of Erowid.



Overview



Drug Class: Sedative/Hypnotic
Alcohol is often not thought of as a drug - largely because its use is common for both religious and social purposes in most parts of the world. It is a drug, however, and compulsive drinking in excess has become one of modern society's most serious problems.

Beverage alcohol (scientifically known as ethyl alcohol or ethanol) is produced by fermenting or distilling various fruits, vegetables, or grains. Ethyl alcohol itself is a clear, colorless liquid. Alcoholic beverages get their distinctive colors from the diluents, additives, and by-products of fermentation.

Beer is fermented to contain about 5% alcohol by volume (or 3.5% in light beer). Most wine is fermented to have between 10% and 14% alcohol content; however, such fortified wines as sherry, port, and vermouth contain between 14% and 20%. Distilled spirits (whisky, vodka, rum, gin) are first fermented and then distilled to raise the alcohol content. In Canada, the concentration of alcohol in spirits is 40% by volume. Some liqueurs may be stronger.

The effects of drinking do not depend on the type of alcoholic beverage - but rather on the amount of alcohol consumed on a specific occasion. The following table outlines the alcohol content of various beverages. The right-hand column shows the amount of alcohol consumed in each drink.

Beverage % alcohol
by volume		 Size of drink (ML) Size of drink (OZ) Grams of Alcohol
Beer (bottle) 5 341 12 13.4
Beer (can) 5 355 12.5 14.0
Light beer (bottle) 3.5 341 12 9.4
Light beer (can) 3.5 355 12.5 9.8
Wine 12 142 5 13.4
Fortified wine 20 56.8 2 8.9
Spirits 40 28.4 1 8.9


How Alcohol Works



Alcohol is rapidly absorbed into the bloodstream from the small intestine, and less rapidly from the stomach and colon. In proportion to its concentration in the bloodstream, alcohol decreases activity in parts of the brain and spinal cord. The drinker's blood alcohol concentration depends on:
  • the amount consumed in a given time
  • the drinker's size, sex, body build, and metabolism
  • the type and amount of food in the stomach.
Once the alcohol has passed into the blood, however, no food or beverage can retard or interfere with its effects. Fruit sugar, however, in some cases can shorten the duration of alcohol's effect by speeding up its elimination from the blood.

In the average adult, the rate of metabolism is about 8.5 g of alcohol per hour (i.e. about two-thirds of a regular beer or about 30 ml of spirits an hour). This rate can vary dramatically among individuals, however, depending on such diverse factors as usual amount of drinking, physique, sex, liver size, and genetic factors.

Metabolism of Alcohol in Women


Women become more intoxicated than men on the same amount of alcohol, even when they weigh the same. This is because women have less muscle tissue which contains the body fluid that dilutes alcohol and because women's bodies more quickly process alcohol through the stomach and into the bloodstream.

Research has shown that women lack a stomach enzyme, alcohol dehydrogenase, which usually acts as a protective barrier and acts to break down the alcohol before it is absorbed. Without this enzyme, alcohol enters women's bloodstreams in a higher concentration. Alcoholic women have virtually none of this enzyme.

Women are less able to predict the effects of consuming a given amount of alcohol. Day-to-day variability in response to alcohol occurs due to the effects of the menstrual cycle. Greater susceptibility to alcohol's influence occurs just before menstruation.

The less a woman weighs, the longer it takes her body to be clear of alcohol. The presence of birth control pills has also been shown to slow metabolism of alcohol.

Health-related complications from alcoholism seem to develop at an accelerated rate in women; a phenomenon termed "telescoped development." Serious health problems can occur in women after a shorter history of heavy drinking with lower levels of alcohol intake than men.

Seventy-five percent of men and 55% of women have used drugs and/or alcohol prior to an assault.

Effects

The effects of any drug depend on several factors:
  • the amount taken at one time
  • the user's past drug experience
  • the manner in which the drug is taken
  • the circumstances under which the drug is taken (the place, the user's psychological and emotional stability, the presence of other people, the concurrent use of other drugs, etc.).

It is the amount of alcohol in the blood that causes the effects. In the following table, the left-hand column lists the number of milligrams of alcohol in each deciliter of blood - that is, the blood alcohol concentration, or BAC. (For example, an average person may get a blood alcohol concentration of 50 mg/dL after two drinks consumed quickly.) The right-hand column describes the usual effects of these amounts on normal people - those who haven't developed a tolerance to alcohol.


BAC (ma/dL) Effect

  1. Mild intoxication
    Feeling of warmth, skin flushed; impaired judgment;
    decreased inhibitions

  2. Obvious intoxication in most people
    Increased impairment of judgment, inhibition, attention, and control;
    Some impairment of muscular performance; slowing of reflexes

  3. Obvious intoxication in all normal people
    Staggering gait and other muscular in coordination; slurred
    speech; double vision; memory and comprehension loss

  4. Extreme intoxication or stupor
    Reduced response to stimuli; inability to stand; vomiting;
    incontinence; sleepiness

  5. Coma
    Unconsciousness; little response to stimuli; incontinence; low body temperature; poor respiration; fall in blood pressure; clammy skin

  6. Death likely



What is a safe level of drinking?


For most adults, moderate alcohol use--up to two drinks per day for men and one drink per day for women and older people--causes few if any problems. (One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.)

Certain people should not drink at all, however:


  • Women who are pregnant or trying to become pregnant
  • People who plan to drive or engage in other activities that require alertness and skill (such as using high-speed machinery)
  • People taking certain over-the-counter or prescription medications
  • People with medical conditions that can be made worse by drinking
  • Recovering alcoholics
  • People younger than age 21.

Hangovers



Drinking heavily over a short period of time usually results in a "hangover" - headache, nausea, shakiness, and sometimes vomiting, beginning from 8 to 12 hours later. A hangover is due partly to poisoning by alcohol and other components of the drink, and partly to the body's reaction to withdrawal from alcohol. Although there are dozens of home remedies suggested for hangovers, there is currently no known effective cure.

Combining Alcohol and Other Drugs



Combining alcohol with other drugs can make the effects of these other drugs much stronger and more dangerous. More than 150 medications interact harmfully with alcohol. These interactions may result in increased risk of illness, injury, and even death Alcohol's effects are heightened by medicines that depress the central nervous system, such as sleeping pills, antihistamines, antidepressants, anti-anxiety drugs, and some painkillers. In addition, medicines for certain disorders, including diabetes, high blood pressure, and heart disease, can have harmful interactions with alcohol. If you are taking any over-the-counter or prescription medications, ask your doctor or pharmacist if you can safely drink alcohol.

Short Term Effects



Positive
  • relaxation
  • mood lift
  • lowered inhibitions / reduced social anxiety
  • analgesia (kills pain)
Neutral
  • slurred speech
  • flushed skin
  • drowsiness, sleepiness
  • nystagmus, difficulty focusing eyes
  • tolerance with repeated use within a few days
Negative
  • decreased coordination
  • nausea, vomiting (vomiting while unconscious can kill)
  • reduced impulse control
  • emotional volatility (anger, violence, sadness, etc)
  • frequent urination (more with beer or wine), diuretic effect
  • dizziness and confusion
  • blackouts and memory loss at high doses
  • coma and death at extreme doses
  • brain and liver damage (cirrhosis) with heavy use
  • lowered inhibitions and increased confusion can lead to unwanted and negative sexual encounters (date rape)
  • hangover, lasting 12-36 hours, from mild to severe after heavy use
  • fetus damage in pregnant women at high dose or frequency

Long-term effects


Long-term effects of alcohol appear after repeated use over a period of many months or years. The negative physical and psychological effects of chronic abuse are numerous; some are potentially life-threatening. Some of these harmful consequences are primary - that is, they result directly from prolonged exposure to alcohol's toxic effects (such as heart and liver disease or inflammation of the stomach). Others are secondary; indirectly related to chronic alcohol abuse, they include loss of appetite, vitamin deficiencies, infections, and sexual impotence or menstrual irregularities. The risk of serious disease increases with the amount of alcohol consumed. Early death rates are much higher for heavy drinkers than for light drinkers or abstainers, particularly from heart and liver disease, pneumonia, some types of cancer, acute alcohol poisoning, accident, homicide, and suicide. No precise limits of safe drinking can be recommended.




Tolerance and Dependence


People who drink on a regular basis become tolerant to many of the unpleasant effects of alcohol, and thus are able to drink more before suffering these effects. Yet even with increased consumption, many such drinkers don't appear intoxicated. Because they continue to work and socialize reasonably well, their deteriorating physical condition may go unrecognized by others until severe damage develops - or until they are hospitalized for other reasons and suddenly experience alcohol withdrawal symptoms. Psychological dependence on alcohol may occur with regular use of even relatively moderate daily amounts. It may also occur in people who consume alcohol only under certain conditions, such as before and during social occasions. This form of dependence refers to a craving for alcohol's psychological effects, although not necessarily in amounts that produce serious intoxication. For psychologically dependent drinkers, the lack of alcohol tends to make them anxious and, in some cases, panicky. Physical dependence occurs in consistently heavy drinkers. Since their bodies have adapted to the presence of alcohol, they suffer withdrawal symptoms if they suddenly stop drinking. Withdrawal symptoms range from jumpiness, sleeplessness, sweating, and poor appetite, to tremors (the "shakes"), convulsions, hallucinations and sometimes death.

Alcohol and Pregnancy


Pregnant women who drink risk having babies with fetal alcohol effects (known as fetal alcohol syndrome or FAS). The most serious of these effects include mental retardation, growth deficiency, head and facial deformities, joint and limb abnormalities, and heart defects. While it is known that the risk of bearing an FAS-afflicted child increases with the amount of alcohol consumed, a safe level of consumption has not been determined.

Who Uses Alcohol?


In a 1990 nation-wide poll, 79% of adults reported they had at some point drunk alcohol. A 1989 survey of adults found that 83% reported ever having used alcohol, with 55% saying they have five drinks or more at a single sitting and 10% reporting daily drinking. There is a direct relationship between the overall level of consumption within a population and the number of alcohol- dependent people. A nation with a low per capita consumption rate has a lower number of heavy users, whereas one with widespread use and high per capita consumption has a proportionately higher rate of alcohol-related diseases and deaths. Most researchers agree that one in 20 drinkers in North America has an alcohol dependency problem.

The Law


Alcohol sales are regulated in the United States. Though alcohol is available over the counter:
  • Only those over the age of 21 are legally allowed to purchase alcohol.
  • It is illegal to purchase alcohol for a minor.
  • It is legal to brew beer and ferment wine for personal consumption without a license.
  • In order to sell beer or wine, a license is required.
  • It is federally illegal to distill hard alcohol (even for personal consumption) without a license.
  • It is illegal in most states to drive (or operate vehicles) with a blood alcohol content of over a certain level (.08 in some states, .1 in others)

Facts about Alcohol

  • More than 100,000 deaths in the United States each year are attributable to excessive alcohol consumption. Causes directly or indirectly related to alcohol deaths include drunken driving, cancer, stroke, cirrhosis of the liver, falls and other adverse effects.
  • The economic cost of alcohol abuse was estimated to cost the United States $166.5 billion in 1995.
  • In 2000, heavy drinking was reported by 5.6% of the population aged 12 and older, or 12.6 million people.
  • More than 40% of separated or divorced women were married to or lived with a problem drinker or alcoholic, compared with less than 20% of separated or divorced men.
  • Youth who drink alcohol are 7.5 times more likely to use any illicit drug, and 50 times more likely to use cocaine than young people who never drink alcohol.
  • Alcohol kills five times more teenagers than all other drugs combined.
  • Among adult current drinkers, more than half say they have a blood relative who is or was an alcoholic or problem drinker.
  • Across people of all ages, males are four times as likely as females to be heavy drinkers.
  • In 1999, there were nearly 2 alcohol-related traffic deaths per hour, 43 per day and 303 per week. That is the equivalent of 2 jetliners crashing week after week.
  • Among full-time workers, heavy drinkers and illicit drug users are more likely than those who do not drink heavily or use illicit drugs to have skipped work in the past month or have worked for three or more employers in the past year.
  • Traffic crashes are the greatest single cause of death for every age from six through 33. About 45% of these fatalities are in alcohol-related crashes.
  • All states now have legal intoxication levels of 0.02 or less for drivers under age 21 - far below the 0.08 or 0.10 levels required for people 21 and older.
  • Underage drinking costs the United States more than $58 billion every year - enough to buy every public school student a state-of-the-art computer.
  • Almost half of Americans ages 12 and older reported being current drinkers of alcohol in the 2000 survey (46.6%). This translates to an estimated 104 million people.
  • Problem drinkers average four times as many days in the hospital as nondrinkers, mostly because of drinking-related injuries.
  • Alcohol kills 6.5 times more youth than all other illicit drugs combined.
  • 50% of high school seniors report drinking in the past 30 days and 32% report being drunk at least once in the same period.
  • Drivers age 21-29 drive the greatest proportion of their miles drunk.

Alcohol-Related Emergencies


Under normal circumstances, people are responsible about their alcohol use and problems don't usually develop. But, what if someone is drunk and an "alcohol-related emergency" does occur? What do you do? Here are some basic, but essential, procedures you can follow in a situation where someone is drunk:
  • Stay calm and don't communicate any feelings of anxiety.
  • Before approaching or touching the person, explain what you intend to do in a direct and reassuring manner.
  • Keep the person still and comfortable. Don't let him/her walk unattended.
  • Do not administer any food, drink or medication -- including aspirin or vitamins -- which may cause stomach distress.
  • Do not ridicule or threaten the person.
  • Do not let the person sleep on his/her back. Death from choking on inhaled vomit may result. Place the person on his/her side, with one arm extended above the head. Keep a sober person nearby to watch for signs of trouble.
Remember, only time will help to sober a person who is intoxicated. Walking, black coffee or a cold shower will not help. The best remedy is time, rest and nursing a tender stomach. Drinking plenty of water at the end of a night of alcohol drinking can significantly reduce both the hang-over the next morning and the negative side-effects of alcohol poisoning.

Seek medical attention if:
  • The person is unconscious and cannot be wakened
  • Breathing is irregular and/or shallow
  • You suspect alcohol has been mixed with other drugs
  • Skin is clammy or pale

More Helpful Information

  • Drink Water to Avoid Hangovers
    The best hangover remedy is to make sure to drink water while you're drinking alcohol. Ideally this means interspersing an occasional glass of water while you're drinking. But even if you can't do this...drink a large glass of water before bed and set another next to your bed to drink from in the middle of the night. Despite the simplicity of this method, most people don't do it.

  • Avoid Mixing Hard Liquor with Beer/Wine
    Combining multiple types of alcohol together is more likely to lead to nausea and/or vomiting. Mixing hard alcohol with beer or wine is particularly problematic, especially if the hard alcohol is added later.




  • Alcohol Takes a While to be Absorbed
    For those without a lot of experience drinking, it's important to know that alcohol takes a while to be absorbed into the bloodstream after drinking. Practically, this means that if you drink too fast, by the time you first notice effects, the alcohol which has yet to be absorbed could be enough to make you sick. Pace yourself.


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