COMMON TRAITS OF ADULT CHILDREN OF ALCOHOLICS

Adult children of alcoholics may:

·         Have difficulty identifying normal behavior

·         Have difficulty following a project from beginning to end

·         Lie when it would be just as easy to tell the truth

·         Judge themselves without mercy

·         Have difficulty having fun

·         Take themselves very seriously

·         Have difficulty with intimate relationships

·         Overreact to changes over which they have no control

·         Constantly seek approval and affirmation

·         Fell that they are different from other people

·         Be super-responsible or super-irresponsible

·         Be extremely loyal, even in the face of evidence that the loyalty is undeserved

·         Tend to lock themselves into a course of action without considering the consequences

Experts agree that adult children of alcoholics who believe they have come to terms with their feelings can sometimes face lingering problems.  Support groups to contact include Al-Anon, Adult Children of Alcoholics Foundation.

CURRENT ALCOHOL CONCERNS

Adult Children of Alcoholic  Parents

In recent years a new dimension of alcoholism has been identified – the unusually high prevalence of alcoholism among adult children of alcoholics (ACOAs).  It is estimated that these children are about four times more likely to develop alcoholism than children whose parents are not alcoholics.  Even the ACOAs who do not become alcoholics may have a difficult time adjusting to everyday living.  Janet Geringer Woitiz, author of the best-selling book Adult Children of Alcoholics, describe thirteen traits that most ACOAs exhibit to some degree.

In response this concern, support groups have been formed to help prevent the adult sons and daughters of alcoholics from developing the condition that afflicted their parents.  If a stronger link for an inherited genetic predisposition to alcoholism is found, these groups may play an even greater role in the prevention of alcoholism.

Women and Alcohol

For decades, women have consumed less alcohol and had fewer alcohol-related problems than men.  At present, evidence is mounting that a greater percentage of women are choosing to drink and that some subgroups of women, especially young women, are drinking more heavily.  An increased number of admissions of women to treatment centers may also reflect that alcohol consumption among women is on the rise.

Studies indicate that currently there are almost as many female as male alcoholics.  However, there appear to be differences between men and women when it comes to alcohol abuse: (1) More women than men can point to a specific triggering event (such as divorce, death of a spouse, a career change, or children leaving home) that started them drinking heavily. (2) Alcoholism among women often starts later and progresses more quickly than alcoholism among men.  (3) Women tend to be prescribed more mood-altering drugs than men.  So women face greater risk of drug interaction or cross-tolerance.  (4) Nonalcoholic men tend to divorce their alcoholic spouses nine times more often than nonalcoholic women divorce their alcoholic spouses.  Thus alcoholic women are not as likely to have a family support system to aid them in their recovery attempts.  (5) Female alcoholics do not tend to receive as much social support as men in their treatment and recovery.  (6) Unmarried, divorced, or single-parent women tend to have significant economic problems that may make entry into a treatment program especially difficult.  (7) women seem to be more susceptible than men to medical complications resulting from heavy drinking.  In light of the generally recognized educational, occupational, and social gains made by women during the last two decades, it will be interesting to see whether these male-female differences continue.  What’s your best guess?

Alcohol Advertising

Every few years, careful observers can see subtle changes in the ways the alcoholic beverages industry markets its products.  Recently, the marketing push appears to be directed toward minorities (through advertisements for malt liquor and fortified wines), women (through wine and wine cooler ads), and youth (through trendy, young adult-orieted commercials), and spiffy websites.

On the college campus, aggressive alcohol campaigns have used rock stars, beach party scenes, athletic event sponsorships, and colorful newspaper supplements as vehicles to encourage the purchase of alcohol.  Critics claim that most of the collegiate advertising is directed at the “below age 21” crowd and that the prevention messages are not strong enough to offset the potential health damage to this population.  How do you feel about alcohol advertising on your campus? If you’re a nontraditional age student, do you find the advertising campaigns amusing or potentially dangerous.?

PROBLEM DRINKING AND ALCOHOLISM

Problem Drinking

At times the line separating problem drinking from alcoholism is difficult to distinguish.  There may be no true line, with the exception that alcoholic is unable to stop drinking.  Problem drinking is a pattern of alcohol use in which a drinker’s behavior creates personal difficulties or difficulties for other people.  What are some of these behaviors? Examples might be drinking to avoid life stressors, going to work intoxicated, drinking and driving, becoming injured or injuring others while drinking, solitary drinking, morning drinking, and occasional blackout, high-risk sexual activity, and being told by others that you drink too much.  For college students, two clear indications of problem drinking are missing classes and lowered academic performance caused by alcohol involvement. 

Problem drinkers are not always heavy drinkers; they might not be daily or even weekly drinkers.  Unlike alcoholics, problem drinkers do not need to drink to maintain “normal” body functions.  However, when they do drink, they (and others around them) experience problems sometimes with tragic consequences.  It’s not surprising that problem drinkers are more likely than other drinkers to eventually develop alcoholism.

Alcoholism

In the early 1990s a revised definition of alcoholism was established by a joint committee of experts on alcohol dependence.  This committee defined alcoholism as follows:

Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.  The disease is often progressive and fatal.  It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial.  Each of these symptoms may be continuous or periodic.

This definition incorporates much of the knowledge gained from addiction research during the last two decades.  It is well recognized that alcoholics do not drink for the pleasurable effects of alcohol but to escape being sober.  For alcoholics, being sober is stressful.

Unlike problem drinking, alcoholism involve a physical addiction to alcohol.  For the true alcoholic, when the body is deprived of alcohol, physical and mental withdrawal symptoms become evident.  These withdrawal symptoms can be life threatening.

Uncontrollable shaking can progress to nausea, vomiting, hallucinations, shock, and cardiac and pulmonary arrest.  Uncontrollable shaking combined with irrational hallucinations is called delirium tremens (DT), an occasional manifestation of alcohol withdrawal.

The complex reasons for the physical and emotional dependence of alcoholism have not been fully explained.  Why, when more than 100 million adults use alcohol without becoming dependent on it, are 10 million or more others unable to control its use?

Could alcoholism be an inherited disease? Studies in humans and animals have provided strong evidence that genetics plays a role in some cases of alcoholism.  Two forms of alcoholism are thought to be inherited: type 1 and type 2.  Type 1 is thought to take years to develop and may not surface until midlife.  Type 2 is a more severe form and appears to be passed primarily from fathers to sons.  This form of alcoholism frequently begins earlier in a person’s life and may even start in adolescence.

Genetics may also help protect some Asians from developing alcoholism.  About half or all Far East Asians produce low levels of an important enzyme that helps metabolize alcohol.  These people cannot tolerate even small amounts of alcohol.  Genetic factors pertaining to the absorption rates of alcohol in the intestinal tract have been hypothesized to predispose some Native Americans to alcoholism.  It is likely that more research will be undertaken concerning the role of genetic factors in all of chemical dependence.

The role of personality traits as conditioning factors in the development of alcoholism has received considerable attention.  Factors ranging from unusually low self-esteem to an antisocial personality have been implicated.  Additional factors making people susceptible to alcoholism may include excessive reliance on denial, hypervigilance, compulsiveness, and chronic levels of anxiety.  Always complicating the study of personality traits is the uncertainty of whether the personality profile is a predisposing factor (perhaps from inheritance) or is caused by alcoholism.

Codependence

Within the last decade, a new term has been used to describe the relationship between drug-dependent people and those around them – codependence.  This term implies a kind of dual addiction.  The alcoholic and the person close to the alcoholic are both addicted, one to alcohol and the other to the alcoholic.  People who are codependent often find themselves denying the addiction and enabling the alcohol-dependent person.

Unfortunately, this kind of behavior damages both the alcoholic and the codependent.  The alcoholic’s intervention and treatment may be delayed for a considerable time.  Codependent often pay a heavy price as well.  They often become drug- or alcohol-dependent themselves, or they may suffer a avariety of psychological consequences related  to guilt, loss of self-esteem, depression, and anxiety.  Codependents may at increased risk for physical and sexual abuse.

Researchers continue to explore this dimension of alcoholism.

Denial and Enabling

Problem drinkers and alcoholics frequently use the psychological defense mechanism of denial to maintain their drinking behavior.  By convincing themselves that their lives are  not affected by their drinking, problem drinkers and alcoholics are able to maintain their drinking patterns.  A person’s denial is an unconscious process that is apparent only to rational observers.

Formerly, it was up to alcoholics to admit that their denial was no longer effective before they could be admitted to a treatment program.  This is not the case today.  Currently, family members, friends, or coworkers of alcohol-dependent people are encouraged to intervene and force an alcohol-dependent person into treatment.

During treatment, it is important to chemically dependent people to break through the security of denial and admit that alcohol controls their lives.  This process is demanding and often time-consuming, but it is necessary for recovery.

For family and friends of chemically dependent people, denial is part of a process known as enabling.  In this process, people close to problem drinker or alcoholic inadvertently support drinking behavior by denying that a problem really exists.  Enablers unconsciously make excuses for the drinker, try to keep the drinker’s work and family life intact, and in effect make the continued abuse of alcohol possible.  For example, college students enable problem drinkers when they clean up a drinker’s messy room, lie to professors about student’s class absences, and provide class notes or other assistance to a drinker who can’t keep up academically.

Alcohol counselors contend that enablers are an alcoholic’s worst enemy because they can significantly delay the onset of effective therapy.  Do you know of a situation in which you or others have enabled a person with an alcohol problem?

Alcoholism and the Family

Considerable disruption occurs in the families of alcoholics, not only from the consequences of the drinking behavior (such as violence, illness, and unemployment), but also because of the uncertainty of the family’s role in causing and prolonging the situation.  Family members often begin to adopt a variety of new roles that will allow them to cope with the presence of the alcoholic in the family.  Among the more commonly seen roles are the family hero, the lost child, the family mascot, and the scapegoat.  Unless family members receive appropriate counseling, these roles may remain intact for a lifetime.

Once an alcoholic’s therapy has begun, family members are encouraged to participate in many aspects of the recovery.  This participation will also help them understand how they are affected by alcoholism.  If therapy and aftercare include participation in Alcoholics Anonymous (AA), family mambers will be encouraged to become affiliated with related support groups.

Helping the Alcoholics: Rehabilitation and Recovery

Once an alcoholic realizes that alcoholism is not a form of moral weakness but rather a clearly defined illness, the chances for recovery is remarkably good.  It is estimated that as many as two-third of alcoholics can recover.  Recovery is especially enhanced when the addicted person has a good emotional support system, including concerned family members, friends, and employer.  When this support system is not well established, the alcoholic’s chances for recovery are considerably lower.

AA is a voluntary support group of recovering alcoholics who meet regularly to help each other get and stay sober.  Over 100,00 groups exist in 150 countries worldwide.  AA encourages alcoholics to admit their lack of power over alcohol and to turn their lives over to a higher power (although the organization is nonsectarian).  Members of AA are encouraged not to be judgmental about the behavior of other members.  They support everyone with a problem caused by a alcohol.

Al-Anon and Alateen are parallel organizations that give support to people who live with alcoholics.  Al-Anon is geared toward spouses and other relatives, and Alateen focuses on children of alcoholics.  There are 28,000 Al-Anon groups and 3000 Alateen gropus worldwide.  Both organizations help members realize that they are not alone and that successful adjustments can be made to nearly every alcoholic-related situation.  AA, Al-Anon, and Alateen chapter organizations are usually listed in the telephone book or in the classified sections of local newspapers.  You can locate Al-Anon and Alateen on the Web at www.al-anon.alateen.org.

For people who feel uncomfortable with the concept that their lives are controlled by a higher power, secular recovery programs are becoming popular.  These programs maintain that sobriety comes from within the alcoholic.  Secular programs strongly emphasize self-reliance, self-determination, and rational thinking about one’s drinking.  Secular Organizations for Sobriety (SOS) and Rational Recovery are examples of secular recovery programs.

Drugs to Treat Alcoholism

Could there be a medical cure for alcoholism? For nearly 50 years, the only prescription drug physicians could use to help drinkers stop drinking was disulfiram (Antabuse).  Antabuse would cause drinkers to become extremely nauseated whenever they used alcohol.

In 1995 the Food and Drug Administration approved the drug naltrexone (ReVia) that works by reducing the craving for alcohol and the pleasurable sensations felt when drinking.  Combining naltrexone with conventional behavior modification has shown promising results.  Additionally, the use of antidepressants by some alcoholics has been especially helpful during treatment.

PROGRESSIVE STAGES OF ALCOHOL DEPENDENCE

Early

·         Escape drinking

·         Binge Drinking

·         Guilt feelings

·         Sneaking drinks

·         Difficulty stopping once drinking has begun

·         Increased tolerance

·         Preoccupation with drinking

·         Occasional blackouts

Middle

• Loss of control
• Self-hate
• Impaired social relationships
• Changes in drinking patterns (more frequent binge drinking)
• Temporary sobriety
• Morning drinking
• Dietary neglect
• Increased blackouts

Late

• Prolonged binges
• Alcohol used to control withdrawal symptoms
• Alcohol psychosis
• Nutritional disease
• Frequent blackouts

ORGANIZATIONS THAT SUPPORT RESPONSIBLE DRINKING

The serious consequences of irresponsible use of alcohol have led to the formation of a number of concerned citizen groups.  Although each organization has a unique approach, all attempt to deal objectively with two indisputable facts.  Alcohol use is part of our society, and irresponsible alcohol use can be deadly.

Mothers Against Drunk Driving

Mothers Against Drunk Driving (MADD) is a national network of over 600 local chapters in the United States and Canada.  This organization attempts to educate people about alcohol’s effects on driving and to influence legislation and enforcement of laws related to drunk drivers.

Students Against Destructive Decisions

Many students have known the acronym SADD to stand for the youth group Students Against Driving Drunk or Students Against Destructive Decisions.  Recently, the group has restructured itself to expand beyond drunk driving to include other high-risk activities that are detrimental to youth, such as underage drinking, drug use, drugged driving, and failure to use seat belts.  Founded in 1981, this organization now has millions of members in thousands of chapters throughout the country.  Remaining central to the drunk driving aspect of SADD is the “Contract for Life,” a pact that encourages students and parents to provide safe transportation for each other if either is unable to drive safely after consuming alcohol.  This contract also stipulates that no discussion about the incident are to be started until both can talk in a calm and caring manner.

BACCHUS and GAMMA Peer Education Network

BACCHUS (Boost Alcohol Consciousness Concerning the Health of University Students) began in 1975 as an alcohol-awareness organization at the University of Florida.  Run by student volunteers, this organization promoted responsible drinking among college students who chose to drink.  It was not an anti-alcohol group, but a “harm reduction” group.  Over the years, hundreds of chapters were formed on campuses across the country.

When supports of BACCHUS realized that many students interested in alcohol awareness were from fraternities and sororities, they developed GAMMA (Greeks Advocating Mature Management of Alcohol) to join BACCHUS to form a peer education network.  Campuses are now able to choose BACCHUS, GAMMA, or any other acronym or name for their groups.

With the broadening of the original BACCHUS organization has come an expansion of the health issues this group addresses. Originally, the focus was on alcohol abuse and prevention.  Now the BACCHUS and GAMMA Peer Education Network confront a variety of student health and safety issues.

Other Approaches

Other responsible approaches to alcohol use are surfacing nearly every day.  Even among college fraternity organizations, attitudes toward the indiscriminate use of alcohol are changing.  Many fraternity rush functions are now conducted without the use of alcohol, and growing numbers of fraternities are alcohol-free.

Another encouraging sign on college campuses is the increasing number of alcohol use task forces.  Although each of these groups has its own focus and tittle, many are meeting to discuss alcohol-related concerns on their particular campus.  These task forces often try to formulate detailed, comprehensive policies for alcohol use across the entire campus community.  Membership on these committees often includes students (on-campus and off-campus, graduate and undergraduate), faculty and staff members, academic administrators, residence hall advisors, university police, health center personnel, alumni, and local citizens.  Does your college have such a committee?

HOSTING A RESPONSIBLE PARTY

Some people might say that no party is totally safe when alcohol is served.  These people are probably right, considering the possibility of unexpected drug synergism, overconsumption, and the consequences of released inhibitions.  Fortunately, an awareness of the value of responsible party hosting seems to be growing among college communities.  The impetus for this awareness has come from various sources, including respect for an individual’s right to choose not drink alcohol, the growing recognition that many automobile accidents are alcohol-related, and the legal threats posed by host negligence.

Responsibly hosting parties at which alcohol is served is becoming a trend, especially among college-educated young adults.  The Education Commission of the States’ Task Force on Responsible Decisions about alcohol has generated a list of guidelines for hosting a social event at which alcoholic beverages are served.

In addition, using a designated driver is an important component of responsible alcohol use.  By planning to abstain from alcohol or to carefully limit their own alcohol consumption, designated drivers are able to safely transport friends who have been drinking.

ALCOHOL-RELATED SOCIAL PROBLEMS

Alcohol abuse is related to a variety of social problems.  These problems affect the quality of interpersonal relationships, employment stability, and the financial security of both the individual and the family.  Clearly, alcohol’s negative social consequences lower our quality of life.  In financial terms the annual cost of alcohol abuse and dependence has been estimated at more than $185 billion.

Accidents

The four leading causes of accidental deaths in the United States (motor vehicle collisions, falls, drownings, and fires and burns) have significant statistical connections to alcohol use.

Motor Vehicle Collisions

Data from the National Highway Traffic Safety Administration (NHTSA) indicate that in 2001 over 17,000 alcohol-related vehicular crash deaths occurred.  This figure represented 41% of the total traffic fatalities for 2001.  Although 17,000 remains an unacceptably high figure, this total represented a 13% reduction from the nearly 20,000 alcohol-related fatalities reported in 1991.

Presently in the United States, an alcohol-related car crash fatality occurs every 30 minutes.  Every 2 minutes, an alcohol-related car crash injury happens.  An estimated 275,000 people were injured in such crashes in 2001.  In 2000, the NHTSA reported that approximately 1.5 million drivers were arrested for drunk driving, reflecting an arrest rate of 1 for every 130 licensed drivers in the United States.

Our response to drunk driving has been for all states to raise the minimum legal drinking age to 21 years.  This was accomplished in the mid-1980s.  another response was a federal law that President Clinton signed in October 2000.  This law required all states to lower their drunk driving standard to 08% BAC by October 1, 2003 or the states would risk losing federal highway funds.  Do you know if your state has enacted a .08% law? You can search the MADD website at www.madd.org to find out current .08% BAC law information.

Other programs and policies are being implemented that are designed to prevent intoxicated people from driving.  Many states have enacted zero tolerance laws to help prevent underage drinking and driving.  Also included have been efforts to educate bartenders to recognize intoxicated customers, to use off-duty police officers as observers in bars, to place police roadblocks, to develop mechanical devices that prevent intoxicated drivers from starting their cars, and to encourage people to use designated drivers.

The use of designated drivers has received some of the credit for the significant reduction in drunk driving deaths mentioned earlier.  However, there may be downside to this solution.  Some health professionals are concerned that the use of designated drivers allows the nondrivers to drink more heavily than they might otherwise.  In effect, designated drivers “enable” drinkers to be less responsible for their own behavior.  The concern is that this freedom from responsibility might eventually lead to further problems for the drinkers.  What do you think?

Falls

Many people are surprised to learn that falls are the second leading cause of accidental death in the United States.  Alcohol use increases the risk for falls.  Various studies suggest that alcohol is involved in between 18% and 53% of nonfatal falls.

Drownings

Drownings are the third leading cause of accidental death in the United States.  Studies have shown that alcohol use is implicated in 21% to 47% of these deaths.  High percentages of recreational boaters have been found to drink alcohol while boating.

Fires and Burns

Fires and burns are responsible for an estimated 5000 deaths each year in the United States, the fourth leading cause of accidental death.  This cause is also connected to alcohol use: studies indicate that half of burn victims have BACs above the legal limit.

Crime and Violence

Have you noticed that most of the violent behavior and vandalism on your campus is related to alcohol use? The connection of alcohol to crime has a long history.  Prison populations have large percentages of alcohol abusers and alcoholics: people who commit crimes are more likely to have alcohol problems than are people in the general population.  This is especially true for young criminals.  Furthermore, alcohol use has been reported in 53% to 66% of all homicides, with the victim, the perpetrator, or both found to have been drinking.  In rape situations, rapists are intoxicated 50% of the time and victims 30% of the time.

Because of the research methodological problems, pinpointing alcohol’s connection to family violence is difficult.  However, it seems clear that among a large number of families, alcohol is associated with violence and other harmful behavior, including physical abuse, child abuse, psychological abuse, and abandonment.

Suicide

Alcohol abuse has been related to large percentages of suicides.  Alcoholism plays a large role in 30% of completed suicides.  Also, alcohol use is associated with impulsive suicides rather than with premeditated ones.  Drinking is also connected with more violent and lethal means of suicide, such as the use of firearms.

For many of these social problems, alcohol use impairs critical judgement and allows a person’s behavior to quickly become reckless, antisocial, and deadly.  Because most of use wish to minimize problems associated with alcohol use, acting responsibly when we host a party is a first step in this direction.

ALCOHOL-RELATED HEALTH PROBLEMS

The relationship of chronic alcohol use to the structure and function of the body is reasonably well understood.  Heavy alcohol use causes a variety of changes to the body that lead to an increase in morbidity and mortality.

Research shows that chronic alcohol use also damages the immune system and the nervous system.  Thus chronic users are at high risk for a variety of infections and neurological complications.  Additionally, many alcoholics suffer from malnutrition, in part because they do not consume a variety of foods.  With the deterioration of the liver, stomach, and pancreas, chronic heavy drinkers also have poor absorption and metabolism of many nutrients.

Fetal Alcohol Syndrome and Fetal Alcohol Effects

A growing body scientific evidence indicates that alcohol use by pregnant women can result in birth defects in unborn children.  When alcohol crosses the placenta, it enters the fetal bloodstream in a concentration equal to that in the mother’s bloodstream.  Because of the underdeveloped nature of the fetal liver, this alcohol is oxidized much more slowly than the alcohol in the mother.  During this time of slow detoxification, the developing fetus is certain to be overexposed to the toxic effects of alcohol.  Mental retardation frequently develops.

This exposure has additional disastrous consequences for the developing fetus.  Low birth weight, facial abnormalities (e.g., small head, widely spread eyes), and heart problems are often seen in such infants.  This combination of effects is called fetal alcohol syndrome.  Recent estimates indicate that the full expression of this syndrome occurs at a rate of between 1 and 3 per 1000 births.  Partial expression (fetal alcohol effects [FAE]) can be seen in 3 to 9 per 1000 live births.  In addition, it is likely that many cases of FAE go undetected.

Is there a safe limit to the number of drinks a woman can consume during pregnancy? Since no one can accurately predict the effect of drinking even small amounts of alcohol during pregnancy, the wisest plan is to avoid alcohol altogether.

Because of the critical growth and development that occur during the first months of fetal life, women who have any reason to suspect they are pregnant should stop all alcohol consumption.  Furthermore, women who are planning to become pregnant and women who are not practicing effective contraception must also consider keeping their alcohol use to a minimum.

THE PHYSIOLOGICAL EFFECTS OF ALCOHOL

First and foremost, alcohol is classified as drug – a very strong CNS depressant.  The primary depressant effect of alcohol occurs in the brain and spinal cord.  Many people think of alcohol as a stimulant because of the way most users feel consuming a serving or two of their favorite drink.  Any temporary sensations of jubilation, boldness, or relief are attributable to alcohol’s ability as a depressant drug to release personal inhibitions and provide temporary relief from tension.

Factors That Influence the Absorption of Alcohol

The absorption of alcohol is influenced by several factors, most of which can be controlled by the individual.  These factors include the following:

·         Strength of the beverage.  The stronger the beverage, the greater the amount of alcohol that will accumulate within the digestive tract.

·         Number of drinks consumed.  As more drinks are consumed, more alcohol is absorbed.

·         Speed of consumption.  If consumed rapidly, even relatively few drinks will result in a large concentration gradient that will lead to high blood alcohol concentration.

·         Presence of food.  Food can compete with alcohol for absorption into the bloodstream, slowing the absorption of alcohol.  When alcohol absorption is slowed, the alcohol already in the bloodstream cab be removed.  Slow absorption favors better control of blood alcohol concentration.

·         Body chemistry.  Each person has an individual pattern of physiological functioning that may affect the ability to process alcohol.  For example, in some conditions, such as that marked by “dumping syndrome,” the stomach empties more rapidly than is normal, and alcohol seems to be absorbed more quickly.  The emptying time may be either slowed or quickened by anger, fear, stress, nausea, and the condition of the stomach tissues.

·         Gender.  Women produce much less alcohol dehydrogenase than men do.  This enzyme is responsible for breaking down alcohol in the stomach.  As a result, women absorb about 30% more alcohol into the bloodstream than men, despite an identical number of drinks and equal body weight.

Three other reasons help to explain why women tend to absorb alcohol more quickly than men of the same body weight: (1) women have proportionately more body fat than men.  Since alcohol is not stored easily in fat, it enters the bloodstream relatively quickly. (2) Women’s bodies have proportionately less water than men’s bodies of equal weight.  Thus alcohol consumed does not become as diluted as in men. (3) Alcohol absorption is influenced by a woman’s menstrual cycle.  Alcohol is more quickly absorbed during the premenstrual phase of a woman’s cycle.  Also, there is evidence that women using birth control pills absorb alcohol faster than usual.

With the exception of a person’s body chemistry and gender, all factors that influence absorption can be moderated by the alcohol user.

Blood Alcohol Concentration

A person’s blood alcohol concentration (BAC) rises when alcohol is consumed faster than it can be removed (oxidized) by the liver.  A fairy predictable sequence of events takes place when a person drinks alcohol at a rate faster than one drink every hour.  When the BAC reaches 0.05%, initial measurable changes in mood and behavior take place.  Inhibitions and everyday tensions appear to be released, while judgement and critical thinking are somewhat impaired.  This BAC would be achieved by a 160-pound person consuming about two drinks in an hour.

At a level of 0.10% (one part alcohol to 1000 parts blood), the drinker typically loses significant motor coordination.  Voluntary motor function becomes quite clumsy.  At this BAC, most states consider a drinker legally intoxicated and thus incapable of safely operating a vehicle.  Although physiological changes associated with this BAC do occur, certain users do not feel intoxicated or do not outwardly appear to be impaired.

As the BAC rises from 0.20% to 0.50%, the health risk of acute alcohol intoxication increases rapidly.  A BAC of 0.20% is characterized by the loud, boisterous, obnoxious drunk person who staggers.  A 0.30% BAC produces further depression and stuporous behavior, and the drinker becomes so confused that he or she may not be capable of understanding anything.  The 0.40% or 0.50% BAC produces unconsciousness.  At this level, a person can die, since the brain centers that control body temperature, heartbeat, and breathing may virtually shut down.

An important factor influencing the BAC is the individual’s blood volume.  The larger the person, the greater the amount of blood into which alcohol can be distributed.  Conversely, the smaller person has less blood into which alcohol can be distributed, and as a result, a higher BAC will develop.

Sobering Up

Alcohol is removed from the bloodstream principally through the process of oxidation.  Oxidation occurs at a constant rate (about ¼ to 1/3 ounce of pure alcohol per hour) that cannot be appreciably altered.  Since each typical drink of beer, wine, or distilled spirits contains about ½ ounce of pure alcohol, it takes about 2 hours for the body to fully oxidize one typical alcoholic drink.

Although people may try to sober up by drinking hot coffee, taking cold showers, or exercising, the oxidation rate of alcohol is unaffected by these measures.  Thus far the FDA has not approved any commercial product that can help people achieve sobriety.  Passage of time remains the only effective remedy for diminishing alcohol’s effects.

First Aid for Acute Alcohol Intoxication

Not everyone who goes to sleep, passes out, or becomes unconscious after drinking has a high BAC.  People who are already sleepy, have not eaten well, are sick, or are bored may drink a little alcohol and quickly fall asleep.  However, people who drink heavily in a rather short time may be setting themselves up for an extremely unpleasant, toxic, potentially life-threatening experience because of their high BAC.

Although responsible drinking would prevent acute alcohol intoxication (poisoning), it will never be a reality for everyone.  As a caring adult what would you know about this health emergency that may help you save a life – perhaps even a friend’s life?

The first real danger signs to recognize are the typical signs of shock.  By the time these signs are evident, a drinker will already be unconscious.  He or she will not be able to be aroused from a deep stupor.  The person will probably have a weak, rapid pulse (over 100 beats per minute).  The skin will be cool and dump, and breathing will be increased to once every 3 or 4 seconds.  These breaths may be shallow or deep but will certainly occur in an irregular pattern.  Skin will be pale or bluish.  (in the case of a person with dark skin, these color changes will be more evident in the fingernail beds or in the mucous membranes inside the mouth or under the eyelids.)  whenever any of these signs are present, seek emergency medical help immediately.

Involuntary regurgitation (vomiting) can be another potential life-threatening emergency for a person who has drunk too much alcohol.  When a drunker has consumed more alcohol than the liver can oxidize, the pyloric valve at the base of the stomach tends to close.  Additional alcohol remains in the stomach.  This alcohol irritates the lining of the stomach so much that involuntary muscle contractions force the stomach contents to flow back through the esophagus.  By removing alcohol from the stomach, vomiting may be a life-saving mechanism for conscious drinkers.

An unconscious drinker who vomits may be lying in such a position that the airway becomes obstructed by the vomitus.  This person is at great risk of dying from asphyxiation.  As a first-aid measure, unconscious drinkers should always be rolled onto their sides to minimize the chance of airway obstruction.  If you are with someone who is vomiting, make certain that his or her head is positioned lower than the rest of the body.  This position minimizes the chance that vomitus will obstruct the air passages.

It is also important to keep a close watch on anyone who passes out from heavy drinking.  Party-goers sometimes make a mistake of carrying these people to bed and then forgetting about them.  Monitoring the physical condition of anyone who becomes unconscious from heavy drinking is crucial because of the risk of death.  Observe the person at regular intervals until he or she appears to be clearly out of danger.  This may mean an evening of interrupted sleep for you, but you could save a friend’s life.  Are you aware of any recent alcohol-related death among U.S college students?

THE NATURE OF ALCOHOLIC BEVERAGES

Alcohol (also known as ethyl alcohol or ethanol) is the principle product of fermentation.  In this process, yeast cells act on the sugar content of fruits and grains to produce alcohol and carbon dioxide.

The alcohol concentration in beverages such as whiskey, gin, rum, and vodka is determined through a process called distillation.  These distilled beverages are expressed by the term proof, a number that is twice the percentage of alcohol by volume in a beverage.  Thus 70% of the fluid in a bottle of 140 proof gin is pure alcohol.  Most proofs in distilled beverages range from 80 to 160.  The familiar pure grain alcohol that is often added to fruit punches and similar beverages has a proof of almost 200.

The nutritional value of alcohol is extremely limited.  Alcohol beverages produced today through modern processing methods contain nothing but empty calories about 100 calories per fluid ounce of 100-proof distilled spirits and about 150 calories for each 12-ounce bottle or can of beer.  Clearly, alcohol consumption is significant contributor to the additional pounds that many college students accumulate.  Pure alcohol contains only simple carbohydrates; it has no vitamins and minerals and no fats or protein.

“Lite” beer and low-calorie wines have been introduced in response to concerns about the number of calories that alcoholic beverages provide.  They are not low-alcohol beverages but merely low-calorie beverages.  Only beverages marked “low alcohol” contain a lower concentration of alcohol than the usual beverages of that type.  Recently, manufacturers have introduced a new form of beer called low carbohydrate beer.

The popular new ice beers actually contain a higher percentage of alcohol than other types of beer.  This is due to a production process that chills the fermented mixture sufficiently to allow ice crystals to form.  When the ice crystals are removed, the beer contains a higher percentage of alcohol.

ALCOHOL USE PATTERNS

From magazines to billboards to television, alcohol is one of the most heavily advertised consumer products in the country.  You cannot watch television, listen to the radio, or read a newspaper without being encouraged to buy a particular brand of beer, wine, or liquor.  The advertisements create a warm aura about the nature of alcohol use.  The implications are clear: alcohol use will bring you good times, handsome men or seductive women, exotic settings, and a chance to forget the hassles of hard work and study.

With the many pressures to drink, it’s not surprising that most adults drink alcoholic beverages.  Two-thirds of all American adults are classified as drinkers.  Yet one in three adults does not drink.  In the college environment, where surveys indicate that 85% to 90% of all students drink, it’s difficult fro many students to imagine that every third adult is an abstainer.  Although many college students assume that drinking is a natural part of their social life, others are making alternative choices.

Alcohol consumption figures are reported in many different ways, depending on the researchers’ criteria.  Various sources support the contention that about one-third of adults 18 years of age and older are abstainers, about one-third are light drinkers, and one-third are moderate-to-heavy drinkers.  As single category, heavy drinkers make up about 10% of the adult drinking population.  Students who drink in college tend to classify themselves as light-to-moderate drinkers.  It comes as shock to students, though, when they read the criteria for each drinking classification.

Moderate drinking Refined

Alcohol research and health defines moderate drinking as no more than two drinks each day for most men and one drink each day for women.  A drink is defined as one 12-ounce regular beer, 5 ounce glass of wine, or 1.5 ounce 80 proof distilled spirits.  These cutoff levels are based on the amount of alcohol that can be consumed without causing problems, either for the drinker or society.  (The gender difference is due primarily to the higher percentage of body fat in women and to the lower amount of an essential stomach enzyme in women.)  elderly people are limited to no more than one drink each day, again due to a higher percentage of body fat.

These consumption levels are applicable to most people.  Indeed, people who plan to drive, women who are pregnant, people recovering from alcohol addiction, people under age 21, people taking medications, and those with existing medical concerns should not consume alcohol.  Additionally, although some studies have shown that low levels of alcohol consumption may have minor psychological and cardiovascular benefits, nondrinkers are not advised to start drinking.

Binge Drinking

Alcohol abuse by college students usually takes place through binge drinking.  This practice refers to the consumption of five drinks in a row, at least once during the previous 2-week period.  College students who fit the category of “heavy period” rarely consume small amounts of alcohol each day but instead binge on alcohol 1 or 2 nights a week.  Some students openly admit that they plan to “get really drunk” on the weekend.  They plan to binge drink.

Binge drinking can be dangerous.  Drunk driving, physical violence, property destruction, date rape, police arrest, and lowered academic performance are all closely associated with binge drinking.  The direct correlation between the amount of alcohol consumed and lowered academic performance results in impaired memory, verbal skills deficiencies, and altered perceptions.  Frequently, the social costs for binge drinking are very high, especially when intoxicated people demonstrate their level of immaturity.  How common is binge drinking on your campus?

In response to the personal dangers and campus trauma associated with the binge drinking, colleges and universities are fighting back.  Some colleges are conducting local alcohol education campaigns that feature innovative posters and materials displayed on campus.  In the future, expect to see increasing efforts to reduce binge drinking on your campus to make it a safer environment.

For many students who drink, the college years are a time when they will drink more heavily than at any other time in their life.  Some will suffer serious consequences as a result.  These years will also mark the entry into a lifetime pf problem drinking for some. 

CHOOSING TO DRINK

Clearly, people drink alcoholic beverages for many different reasons.  Most people drink alcohol because it is an effective, affordable, and legal substance for altering the brain’s chemistry.  As inhibitions are removed by the influence of alcohol, behavior that is generally held in check is expressed.  At least temporarily, drinkers become a different version of themselves more outgoing, relaxed, and adventuresome.

TAKING CONTROL OF ALCOHOL USE

The push for zero tolerance laws, the tightening of standards for determining legal intoxication, and the growing influence of national groups concerned with alcohol misuse show that our society is more sensitive than ever to the growing misuse of alcohol.

People are concerned about the consequences of drunk driving, alcohol-related crime, and lowered job productivity.  National data indicate that per capital alcohol consumption has gradually dropped in the United States since the early 1980s.  alcohol use remains the preferred form of drug use for most adults (including college students), but as a society, we are increasingly uncomfortable with the ease with which alcohol can be misused.