The Athlete
Drug Abuse
Alcohol Overview
STATISTICS
In the last 15 years in Asia
- India's alcohol consumption has risen by 171%;
- Indonesia's alcohol consumption has risen 500%.
Last month in Europe
- only 1 in 10 men and 1 in 5 women abstained from alcoholic beverages;
- the lowest rate of abstinence in the European Union was Denmark-2.1% for men and 6.1% for women;
- the highest rate of abstinence was Ireland-24.5% for men and 36.3% for women.
Last month in the United States
- about 113 million Americans (41% of the population) had at least a can of beer, a glass of wine, or a cocktail; 10-12 million of this group are considered heavy drinkers;
- about 3/4 of the 6 million college students had a drink and 1/2 of those were heavy drinkers.
In the last two weeks in the United States
- about 16% of 8th grade students had five or more drinks at one sitting (1999);
- about 31% of high school seniors had five or more drinks at one sitting (1999).
Yesterday
- about $220 million were spent at bars, restaurants, and liquor stores for those drinks;
- champagne toasts were made to 7,000 brides and grooms.
Also yesterday in the United States, unfortunately
- from 25% to 30% of all U. S. hospital admissions were due to direct or indirect medical complications from alcohol;
- about 1/2 the murder victims and 1/2 the murderers drank alcohol;
- more than 1/2 of the 300 rapes that occurred involved alcohol;
- alcohol was a factor in 40% of all violent crimes;
- about 20,000 crimes that occurred involved alcohol or other drugs.
And yesterday, in Europe
- between 4.5 million and 7.7 European children woke up in a house with parents who were problem drinkers;
- almost 30% of French men and 11% of French women drank excessively (over 28 drinks per week for men and 14 drinks per week for women).
And worldwide last year
- over 2 million people died due to alcohol;
- approximately 10% of all diseases and injuries were directly due to alcohol.
(SAMHSA, 1998; NCADI, 1999; Eurocare, 1999; NIAAA, 1999; Justice Department, 1998; Bureau of Alcohol, Tobacco, and Firearms, 1998; University of Michigan, 1999)
Overview
1. -The majority of people in almost every country, except for Islamic countries, consume alcohol.
2. -Two million people worldwide died last year due to alcohol.
3. -Since the process of fermentation occurs naturally, alcohol was discovered by chance.
4. -Over the centuries alcohol has been used as a food, as a medicine, as a sacrament, as a reward, as recreation, and to cover emotional and mental problems.
5. -Because alcohol also causes the most health and societal problems, such as the Gin Epidemic in England, its use has often been restricted or banned by almost every country but presently, because of demand, most restrictions have been overturned.
Alcoholic Beverages
6. -Though there are hundreds of different alcohols, ethyl alcohol (ethanol) is the main psychoactive ingredient in all alcoholic beverages.
7. -When yeast is added to certain fruits, vegetables, or grains, they ferment into alcoholic beverages.
8. -When grains ferment, beer is the result. When fruits ferment, wine is the result. More highly concentrated spirits are distilled from the original fermentation of grains, some vegetables such as potatoes (vodka), and from wine.
9. -Most wine is 12% alcohol; most beer is 4% to 7% alcohol; and most liquors and whiskeys are about 35% to 45% alcohol.
Absorption, Distribution, & Metabolism
10. -When alcohol is drunk, it is absorbed (even from the stomach in men), metabolized (mostly in the liver), and then excreted.
11. -The rate of absorption depends on body weight, sex, health, and a dozen other factors. Women usually absorb alcohol faster and get a higher BAC from the same amount drunk in comparison to men, so the effects on women are more damaging.
12. -About 2% to 10% of alcohol is excreted directly through the urine and lungs. The rest is metabolized and then excreted as carbon dioxide and water.
13. -Alcohol is metabolized at a defined continuous rate, so it is possible to determine what level of drinking will produce a certain blood alcohol concentration (BAC). A BAC of .08 to .10 defines legal intoxication in all 50 states.
Desired Effects, Side Effects, & Health Consequences
14. -The six levels of alcohol use are abstention, experimentation, social/recreational use, habituation, abuse, and addiction (alcoholism).
Low- to Moderate-Dose Episodes
15. -Small amounts of alcohol or occasional episodes of intoxication episodes are usually not harmful and have some positive cardiovascular benefits, mostly for men.
16. -The negative side of low to moderate drinking is accidents, unwanted pregnancies, sexually transmitted diseases, or legal problems.
17. -People who are pregnant or who have preexisting physical or mental health problems, allergies to alcoholic beverages, high genetic/environmental susceptibility to addiction, and preexisting abuse problems should avoid alcohol.
18. -Low-dose use can help digestion, promote relaxation, and slightly lower the risk of heart attacks or coronary artery disease (CAD).
19. -The psychological effects depend on the mood of the drinker and the setting where the alcohol is consumed.
20. -Since alcohol is a disinhibitor, low-dose use can increase self-confidence, sociability, and sexual desire. The disinhibition is mostly due to GABA, an inhibitory neurotransmitter.
21. -As the amount consumed increases, the initial desirable effects are often offset by unwanted side effects, such as physical and mental depression.
High-Dose Episodes
22. -Intoxication is a combination of blood alcohol concentration, psychological mood, expectation, and drinking history.
23. -As the blood alcohol concentration rises, effects go from lowered inhibitions and relaxation, to decreased alertness and clumsiness, to slurred speech and inability to walk, to unconsciousness and death.
24. -Blackouts are caused by heavy drinking and marked by loss of memory even though the drinker is awake and conscious.
25. -Hangovers are a withdrawal symptom of high-dose use.
Chronic High-Dose Use
26. -About 10% to 12% of drinkers progress to frequent, high-dose use; two to three times more men than women have a major problem with alcohol.
27. -Heredity, environment, and frequency of consumption help determine if a person will have a problem with their drinking.
28. -Tolerance and tissue dependence occur as the body, especially the liver, attempts to adapt to ever-increasing amounts of alcohol.
29. -Withdrawal after cessation of frequent high-dose use can be life threatening. Delerium tremens (DTs) is a life-threatening form of severe withdrawal that includes hallucinations and convulsions.
Addiction (alcoholism)
30. -About 10% to 12% of 140 million adult drinkers in the United States have developed alcohol addiction (alcoholism).
31. -Just 20% of drinkers consume 80% of all alcohol.
Classification
32. -There have been numerous attempts to classify alcoholism so the condition can be studied more systematically and strategies for treatment can be more realistic.
33. -Classifications vary from E. M. Jellinek’s gamma and delta alcoholics, to type I and II alcoholics, to type A and B alcoholics, and finally to the disease concept of alcoholism.
34. -Most current concepts look at addiction as a progressive disease that is caused by a combination of hereditary and environmental influences that are triggered and aggravated by the use of alcohol or other drugs.
Long-Term Effects of Addiction (alcoholism)
35. -The liver is the organ most severely affected. Problems include a fatty liver, alcoholic hepatitis, and cirrhosis (which is a scarring of the liver and is eventually fatal).
36. -Digestive effects of chronic drinking include ulcers, diarrhea, pancreatitis, bleeding, and malnutrition.
37. -Enlarged heart, high blood pressure, intracranial bleeding, and stroke are seen with frequent high-dose use.
38. -Heavy drinking can cause large loss of brain cells since alcohol is toxic to all cells. Dementia is also a possible effect.
39. -Alcohol can lower inhibitions and increase desire but as use increases, the physical ability to perform sexually is depressed.
40. -In moderate to heavy drinkers, the chance of breast cancer in women as well as the chance of mouth, throat, and esophageal cancer increase in both men and women especially if they also smoke.
Polydrug Abuse
41. -Most drug abuse involves more than one substance, especially alcohol, so the problems can by synergistic not just additive.
Other Problems
42. -Many people use alcohol to self-medicate their emotional depression but as drinking continues, it can induce depression.
43. -A large percentage of homicides, suicides, and accidents involve alcohol.
44. -Heavy drinking during pregnancy can cause birth defects, most notably fetal alcohol syndrome (FAS), that involves abnormal growth and mental problems. It is not known what level of drinking, if any, is safe during pregnancy.
45. -Alcohol is heavily involved in aggression, violence, and sexual assault, mostly from the lowering of inhibitions. The mood of the drinkers and the setting also affect violence.
Epidemiology
46. -Alcohol consumption varies from 3.1 gallons of pure alcohol a year in France, to 2.2 gallons in the United States, down to 0.1 gallons in a Moslem country, such as Algeria.
47. -Men drink more per episode than women and have a higher level of addiction. This is because of a combination of physiological differences and cultural mores.
48. -Given the same blood alcohol concentration (BAC), women have more health problems than men.
49. -The amount and frequency of alcohol consumption directly affects grades. About 28% of high school students and 45% of college students have five or more drinks at one setting.
50. -About 2.5 million older Americans have alcohol-related problems. As the drinker ages, the liver is less able to handle alcohol but even so, the elderly have the lowest prevalence of problem drinking and alcoholism.
51. -About 45% of the homeless have serious substance abuse problems, 23% have a mental illness, and 8% are infected with HIV or AIDS. Treatment must be brought to the homeless rather than expecting they will come in for treatment.
52. -Each ethnic group in the United States has unique drinking problems due to physiology and culture.
53. -Heavy drinking is lower in the African American community than the Caucasian or Hispanic communities. The Asian community has so many components that it is hard to make generalizations. There is also a wide variation in the Native American communities although in some groups, 5 of the 10 leading causes of death are due to alcohol.
Assessment
54. -The most widely used direct assessment tests for drug and alcohol problems are the Alcohol Severity Index and Addiction Severity Index. The Michigan Alcoholism Screening Test (MAST) used to be the most widely used screening test.
Conclusions
55. -The road to alcoholism can take 3 months, 30 years, or it may never occur. One has to recognize that alcohol is a psychoactive drug and can cause irreversible physiological changes that make one susceptible to alcoholism.
Information on Drug Abuse:
Information on Alcohol:
Epidemiology of Alcohol Consumption