Alcohol use

Definition:
Alcohol, specifically ethyl alcohol (ethanol), is produced by fermenting the starch or sugar in various fruits and grains. Alcoholic beverages produced by fermentation and distillation include beer (usually about 5% alcohol), wine (usually 12 to 15% alcohol), and hard liquor (which is about 45% alcohol). Related topics include: alcohol and diet, alcoholism, and alcohol withdrawal state.

Alternative Names:
Beer consumption; Wine consumption; Hard liquor consumption

Information:

HISTORY AND INCIDENCE
Archaeological evidence has shown that humans have consumed alcoholic beverages since prehistoric times. Neolithic tribes are believed to have consumed berry wine in 6400 B.C. The discovery of the distillation process, during the twelfth century, made it possible to make drinks with higher alcohol content (hard liquor) than may be achieved by fermentation alone.

Second only to caffeine, alcohol is used by more people and in larger quantities than any other substance. It has served a variety of purposes as cultures and societies have evolved over the years. Alcohol use has been touted, casually accepted, denounced, and unsuccessfully outlawed.

It is estimated that 70% of American high school seniors have consumed some form of alcoholic beverage within the past month, despite the fact that the legal age for alcohol use ranges between 18 to 21 years of age across the country.

Approximately 20% of adolescents may be categorized as "problem drinkers." This group includes those adolescents who get drunk and/or who experience negative consequences as a result of their drinking behavior. Such consequences may include accidents related to alcohol use or trouble with the law, family members, friends, school, or dates.

Up to 7% of adolescents are considered alcoholic or dependent on alcohol. This means that they experience withdrawal symptoms when they try to stop or decrease their drinking and drink compulsively despite negative consequences.

In the past, men have traditionally drunk more than women, but this is less and less true.

Alcohol use is primarily influenced by attitudes developed during childhood and adolescent years and therefore associated with parental attitudes and behaviors toward drinking in or outside the home, peer influence, societal influences, and family relationships.

Recent data also suggests a genetic predisposition to alcohol use-related disorders.

EFFECTS

Alcohol is absorbed quickly, as it does not require digestion by the stomach. Roughly 90% of alcohol consumed is absorbed by the small intestine. Absorption rates for alcohol depend on the amount and type of food in the stomach. For example, high carbohydrate and high fat foods decrease absorption rates. A carbonated or effervescent alcoholic beverage, like champagne for example, will be absorbed faster.

The effects of alcohol may appear within 10 minutes after consumption and peak at approximately 40 to 60 minutes. Alcohol remains in the bloodstream until it is broken down by the liver. If an individual consumes alcohol at a faster rate than it can be broken down by the liver, the blood alcohol concentration level rises. When ingesting the same amount of alcohol as a man, a woman will have a higher blood alcohol concentration because of gender-related physiological differences.

Each state has its own legal definition for alcohol intoxication which is defined by blood alcohol concentration. The BAC is defined as grams of alcohol per deciliter of blood and the legal limit usually falls between 0.08 and 0.10 in most states. Different levels lead to different effects:

  • 0.05 produces disinhibition and facilitates social interactions
  • 0.10 results in slurred speech
  • 0.20 is associated with euphoria as well as motor impairment
  • 0.30 produces confusion
  • 0.40 leads to stupor
  • 0.50 is associated with coma
  • 0.60 results in respiratory paralysis and death

As a central nervous system (CNS) depressant, alcohol depresses the respiratory (breathing) rate, heart rate, and the control mechanisms in the brain. The effects of such CNS depression may include:

  • impaired ability to perform complex tasks (such as driving)
  • reduction of inhibitions which may lead to embarrassing behavior
  • reduction in anxiety
  • decreased attention span
  • impaired short-term memory
  • impaired motor coordination
  • prolonged reaction time
  • less rapid thought processing
If a pregnant woman drinks, alcohol can adversely affect the developing fetus causing birth defects or fetal alcohol syndrome (a devastating disorder marked by mental retardation and behavioral problems).

ASSOCIATED HEALTH RISKS
  • alcohol-related motor vehicle accidents
  • other accidents including falls, drownings, and fire-related incidents
  • increased risk for suicide
  • increased risk for homicide
  • decreased use of adequate birth control measures
  • increased risk for unplanned or unwanted pregnancy
  • decreased use of safer sex behaviors
  • increased risk for sexually transmitted diseases
  • the baby is at risk for fetal alcohol syndrome if a pregnant woman drinks
  • alcoholism or alcohol dependence
  • chronicliver disease
  • increased risk of head and neck, as well as stomach cancers

WHEN ABUSE BECOMES DEPENDENCE

Individuals who consume alcohol (and/or live with individuals who consume alcohol) may want to seek help for themselves or loved ones if the following occur in association with drinking behavior:

  • driving citations or accidents (DUI)
  • decreased interest or performance levels at work, school
  • increased absenteeism from work, school
  • increased social isolation
  • increased tolerance to amount of alcohol consumed: more alcohol is needed to produce the same effect
  • inability to decrease or stop alcohol consumption
  • signs of withdrawal, such as tremors, appear when attempting to stop
  • defensive or hostile about alcohol use
  • lying or being secretive about alcohol use
  • neglecting appearance
  • neglecting proper nutrition
  • involved in violence, either as perpetrator or victim
It is also important to remember that some individuals are at higher risk for alcoholism due to a family history of alcoholism, stressful lifestyles, peer or cultural influences, and psychological factors such as anxiety, depression, or simply low self-esteem.

CALL YOUR HEALTH CARE PROVIDER IF
  • you are concerned about your personal alcohol use or that of a family member.
  • you are interested in more information regarding alcohol use, alcohol abuse, or support groups.
  • you are unable to reduce or stop your alcohol consumption, in spite of attempts to stop drinking.
Other resources include local Alcoholics Anonymous or Ala-teen groups (see alcoholism - support group), SMART Recovery, Moderation Management (for problem drinkers who want to cut down), public or private mental health agencies, school or work counselors, student or employee health centers, local hospitals, and some churches.

Review Date: 1/29/2002
Reviewed By: Benoit Dubé, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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