CHAPTER 4
An Introduction to Alcohol: Man’s Oldest Recreational Chemical
LEARNING OBJECTIVES
After studying this chapter, students should be able to:
• 4.1:
Understand the history of alcohol
• 4.2:
Understand the use of alcohol in present times
• 4.3:
Identify the scope of alcohol use in the United States today
• 4.4:
Describe the pharmacology, including subjective effects, of social use of alcohol
• 4.5: Comprehend the medical complications of social use of alcohol
CHAPTER OUTLINE
Why Do People Consume Alcohol?
A Brief History of Alcohol
Alcohol Today
How Alcoholic Beverages Are Produced Today
A Working Definition of Social Drinking
Scope of Alcohol Use in the World Today
The Pharmacology of Ethyl Alcohol
The Biotransformation of Alcohol
The Speed of Alcohol Biotransformation
The Alcohol-Flush Reaction
The Blood Alcohol Level (BAL)
Social Drinking and Stroke
Alcohol Use and Neurocognitive Effects
Other Consequences of Rare/Social Drinking
Paradoxical Rage Reaction
Drug Interactions Involving Social Alcohol Use
Alcohol Ingestion and Injury
Alcohol Use and the Diagnostic and Statistical Manual of Mental Disorders (5th Edition)
CHAPTER OVERVIEW
The purpose of this chapter is to review the mechanisms by which alcohol is introduced into the
body and its effects on the individual who drinks rarely or socially. This chapter also reviews the
reasons why an individual would engage in such alcohol use, and the consequences of even rare
or social drinking. It is also the hope of the author that this chapter will help to dispel the myth
that such drinking is entirely innocuous and safe, as many who drink socially would like to
believe.
DISCUSSION QUESTIONS
Break-Out Discussion #1:
The drinker’s goal? Young individuals who choose to drink, including those for whom alcohol use
is illegal, often drink to the point of losing consciousness, especially at parties where they are
drinking in the company of others. It is not unusual in such cases for others at the party to put
the individual to bed, to let him or her “sleep it off.” Unfortunately, the amount of alcohol
necessary to bring about a loss of consciousness is a significant fraction of the amount necessary
to cause respiratory arrest, and if the individual had alcohol in his or her system that had not
been absorbed when they were put to bed, that alcohol, when absorbed, might be enough to
cause respiratory arrest and death.
Was the person’s goal unconsciousness? Probably not, although in rare cases the individual does
start out with the goal of drinking to the point of losing consciousness. If the person consuming
Questions
1. If you were at a party and you noticed that a person at the party had lost consciousness,
would you call an ambulance for this person? Why or why not?
2. Who would be responsible for the consequences, should an individual come to harm while
intoxicated? If she or he should harm someone else?
3. Would any of your answers to the above questions change if the individual in question were
underage?
4. At what point does an individual’s participation in dangerous behavior while under the
influence of alcohol warrant social or legal sanctions? Are current laws too strict, or too lenient?
Why?
5. Suppose a sporting goods store were to sell a firearm to a person who was obviously
intoxicated, and that person subsequently shot a neighbor by accident. Who should be held
accountable? Would your answer be different if the person were to be sober at the time that
the firearm was purchased?
Discussion #2:
Relationship between alcohol use and suicide: Here are two apparently contradictory
statements: (1) Approximately 10% of persons with a substance use disorder eventually commit
suicide and (2) 40–60% of individuals who take their lives were intoxicated at the time of their
deaths. Closer inspection will reveal part of the reason for this apparent discrepancy, however.
However, many of those persons who decide upon ending their lives will use alcohol to help
them build up the courage to do so. Thus, 40–60% of those persons who end their lives are
Questions
2. Have you ever known of a person who ended his or her life
3
? Did that person have a
substance use disorder? Was that person under the influence of alcohol and/or drugs at the
time of their death? Is there reason to suspect that they might have been under the influence of
a chemical at the time of their death? Do you know somebody who is contemplating suicide at
this time
4
? Is this person misusing chemicals?
KEY CONCEPTS AND TERMS
Mead: Form of beer made from fermented honey
Distillation: Boiling wine, then collecting and cooling the steam to form a liquid with a higher
alcohol concentration that the original wine
Blackout: The condition resulting from consuming sufficient quantities of alcohol which then
interferes with the formation of memories in the individual’s brain
Aldehyde dehydrogenase: The family of enzymes that the body produces to rapidly break
acetaldehyde down into acetic acid
Alcohol flush reaction: A reaction in certain individuals that is the result of a genetic mutation
that prevents the liver from being able to produce sufficient amounts of aldehyde
dehydrogenase, thus allowing high levels of acetaldehyde to accumulate in the person’s blood
Blood alcohol level (BAL): Measurement of the alcohol concentration in the person’s blood or
exhaled breath
Mellanby effect: A phenomenon in which the individual’s subjective sense of intoxication
appears to be stronger while the BAL is still rising
Congeners: Flavoring agents mixed with liquors
Polyphenols: Family of natural, semisynthetic, and synthetic compounds that have chemical
similarities (essentially the phenol structures in the molecule). Some of these compounds are
useful for humans, while others are harmful, depending on the exact chemical structure of the
specific polyphenol molecule. Some of the nontoxic polyphenols are found in wine, helping to
give the wine a specific flavor
Sleep apnea: A breathing disorder in which the individual’s ability to breathe normally during
sleep is disrupted. Complications of sleep apnea can include hypertension, heart rhythm
disturbance, and possible death
Hepatoxicity: Toxic to the liver
Alcohol intoxication: When drinking alcohol has resulted in the state of intoxication
LO/STANDARDS CORRELATION CHART
A-head
LO
Standard – CACREP
Why Do People Consume
Alcohol?
A Brief History of Alcohol
4.1: Understand the
history of alcohol
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior
Alcohol Today
How Alcoholic Beverages
Are Produced Today
A Working Definition of
Social Drinking
4.2: Understand the
use of alcohol in
present times
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior
Scope of Alcohol Use in
the World Today
4.3: Identify the
scope of alcohol use
in the United States
today
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior
The Pharmacology of Ethyl
Alcohol
The Biotransformation of
Alcohol
The Blood Alcohol Level
(BAL)
Subjective Effects of
Alcohol on the Individual
Who Drinks Socially at
Normal Doses
4.4: Describe the
pharmacology,
including subjective
effects, of social use
of alcohol
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior
Medical Complications of
Alcohol Use for the
Individual Who Drinks
Socially
4.5: Comprehend the
medical
complications of
social use of alcohol
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
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Support for the cardiac and respiratory systems.
