Background of Alcohol
- Alcohol is a psychoactive, depressant drug
- Holds significance in history, culture, and present society
- In 2023, 77% of adults living in Canada reported drinking at least one alcoholic beverage in the past 12 months
- In a 2022 survey of post-secondary students in Canada, 84.5% of students reported consuming alcohol in the past year
Ø 38% reported getting drunk on their most recent drinking occasion
Ø 39.1% reported intending to get drunk the last time they consumed
UNDERSTANDING CONCENTRATION
- Alcohol affects every individual differently
- Amount and percentage (along with several other factors)
affects intoxication - Three main types of alcohol:
Ø Beer: 3%-6
Ø Wine: 9%-14%
Ø Spirits/Hard Alcohol: >35%
UNDERSTANDING CONSUMPTION
- One standard drink = 13.6 grams of alcohol
- One drink for each type of alcohol has a different amount of liquid:
Ø Beer/cider/cooler (5%) = 12oz
Ø Wine (12%) = 5oz
Ø Spirit (40%) = 1.5oz - Alcohol = 7cals/gram
Ø One drink = ~100-120 cals
but this varies greatly depending on the type of drink
ABSORPTION
- Several factors determine the rate of alcohol absorption
(e.g., type of alcohol, age, sex, how fast you drink, how much/what
types of other food/drugs are in your system, etc.) - How does alcohol get into the bloodstream?
Ø Small amount absorbed by the oral mucosa
Ø ~20% through the stomach
Ø ~75% through upper part of the small intestine
Ø Remaining is absorbed by the GI tract
METABOLISM & EXCRETION
- While a small amount of ingested alcohol is metabolized in the stomach, the main place of metabolism is in the liver
Ø Converted into acetaldehyde, then to acetate
Ø ~2-10% of ingested alcohol is excreted (unchanged) by the lungs, kidneys, and sweat glands - When alcohol enters the brain, it affects neurotransmitters, creating many of the immediate effects of alcohol
- With chronic heavy use, alcohol’s effects on the brain can become
permanent
BLOOD ALCOHOL CONCENTRATION (BAC)
BAC: The ratio of alcohol in a person’s blood by weight, expressed as the
% of alcohol in a decilitre of blood; used as a measure of intoxication
- BAC depends on:
Ø Body weight
Ø Body fat %
Ø Biological Sex
Ø Rate of
metabolism
THE EFFECTS OF ALCOHOL (BAC)
0.01 - 0.05
- Relaxation; Mild euphoria; decreased alterness; reduced exhibition; impaired motor cognition and impairement.
Approximate time to metabolize: 2-3 hours
0.05 - 0.10
- Emotional instability; exaggerated feelings and behaviours; impaired reasoning, judgement and visual tracking; slowed reflexes and reaction time; sleepiness
Approximate time to metabolize: 3-6 hours
0.10 - 0.15
- Mood swings; aggression; impaired balance; slurred speech
Approximate time to metabolize: 7-10 hours
0.15 - 0.30
- Reduced sensation; depression; confusion; memory blackout
Approximate time to metabolize: 10 -20 hours
0.30+
- Unconsciousness; slowed heart rate and respiration; loss of temp regulation; death possible above 0.35
Approximate time to metabolize: 20+ hours
0.40+
- Respiratory arrest; death
THE IMMEDIATE EFFECTS OF ALCOHOL
Low concentrations:
- May include light-headedness, relaxation, and release of inhibitions
- May appear to act as a stimulant, enhancing assertiveness/social
behaviours (due to alcohol depressing inhibitory centres in the brain)
High concentrations:
- Interference with motor coordination, verbal performance, intellectual
functions, anger or irritability, senses become less acute
- At 0.20% BAC, most individuals are unable to function
v At 0.35%+ BAC, coma usually occurs and can be fatal
IMPACTS OF ALCOHOL
ON RISKY BEHAVIOUR
- Drinking more
- Other drugs
- Accidents
- Unwanted or unprotected sex
- Aggression
- Impaired driving
DRINKING AND DRIVING
- MADD Canada: ~10 impaired-driving charges/suspensions every hour
- Alcohol involved in 50%+ of motor-vehicle crashes among people aged
16- to 25 - Highest-risk age: those aged 19, who drive after consuming alcohol
- Dose-response: impairment starts at low BACs
Ø Slower reaction, reduced coordination - As BAC rises, crash risk spikes sharply
Ø BAC of 0.14% = 40x greater crash risk
ALCOHOL POISONING
- Consuming alcohol in large amounts over a short period of time can
rapidly raise one’s BAC into a lethal range - Alcohol—alone or in combination with other drugs—is responsible for
more toxic overdose deaths than any other drug - Death from alcohol poisoning may be caused by CNS and respiratory
depression or by inhalation of fluid/vomit into the lungs - The amount needed to make someone unconscious is very
close to a fatal dose
Ø BAC continues to rise, even if unconscious or asleep
Effects of Chronic Use of Alcohol
-Average lifespan of alcohol abusers is 10-12 years shorter than that of non-abusers
-Cirrhosis = liver cells are destroyed and replaced with fibrous scar tissue (fibrosis)
-Inflammation of pancreas causing nausea, vomiting, abnormal digestion, abdominal pain
-Cardiovascular problems (high blood pressure, weakening of heart muscle)
-Related to oral cancer, cancers of the esophagus, liver, stomach, pancreas, possibly breast cancer
-Linked to asthma, gout, diabetes, recurrent infection, nutritional deficiencies, nervous system diseasesoPsychiatric problems – paranoia, memory gaps
-Drinking during pregnancy can result in miscarriage, stillbirth, fetal alcohol syndrome, or alcohol-related neurodevelopmental disorder
Digestive System:
Liver
- Fatty liver (fat cell accumulation in the liver)
- Can occur within just a few days of heavy alcohol consumption
- Alcohol hepatitis (inflammation of the liver)
- Frequent cause of hospitalization and death in people with alcohol use disorder
- Cirrhosis (destroyed liver cells, scar tissue in liver)
- People with cirrhosis who continue to consume alcohol have only a 50% of surviving 5+ years
Digestive System (cont’d):
Pancreas
- Pancreatitis can occur after even 1 or 2 heavy binge drinking episodes
- Can be fatal or become a chronic condition
Gastrointestinal (GI) Tract
- Alcohol is a common cause of bleeding in the GI tract
- Cirrhosis can result in enlarged esophageal and rectal veins
- Painful irritation of stomach lining
Cardiovascular System
- No health benefits associated with alcohol consumption
- Alcohol can increase BP and ↑ risk of stroke and heart attack
- Some people with alcohol use disorder can develop cardiomyopathy
Brain Damage
- Long-term alcohol use can cause shrinkage of grey/white matter
- Reduced brain blood flow and slowed metabolic activity
- Alcohol dependence may cause mild-to-severe cognitive impairments
Ø E.g., memory loss, dementia, compromised problem-solving
Cancer
- Alcohol is a known human carcinogen
- Risk factor for developing breast, colon, rectum, esophagus, larynx, liver, mouth, or pharynx cancers
Mortality
- Alcohol consumption is related to > 200 conditions, diseases, and injuries
- ~5% of deaths worldwide are attributed to alcohol
Ø ~13.5% for those aged 20-39 - People with alcohol use disorder live ~15 years less on average
ALCOHOL USE DURING PREGNANCY
- Alcohol consumption in early pregnancy can cause a range of disabilities known as Fetal Alcohol Spectrum Disorder (FASD); the most severe diagnosis of FASD is Fetal
Alcohol Syndrome (FAS) - FAS is among the most common preventable causes of intellectual
disability in the Western world; children with FAS have a characteristic mix of birth defects including physical abnormalities and cognitive disabilities - Compared to FAS, ~3x as many babies are born with alcohol-related
neurodevelopmental disorder (ARND); children with ARND often have learning and behavioural disorders
CANADA’S UPDATED (2023) GUIDANCE ON ALCOHOL AND HEALTH
- Canada’s Low-Risk Alcohol Drinking Guidelines were published in 2011
reflecting the best evidence available at the time - Replaced in 2023 with Canada’s Guidance on Alcohol and Health
- Created to reflect the substantial advances in research and our
understanding of alcohol and health over the last decade - Aims to help people make well-informed decisions about their alcohol consumption and contribute to an evidence base for future alcohol policy and prevention resources
2011 VS. 2023 GUIDELINES
Canada’s Low-Risk Alcohol Drinking
Guidelines (2011)
1. Numerical limits were provided
for weekly and daily amounts of
alcohol use
2. Recommendations on
consumption differed for women
and men
3. Pregnant individuals should avoid
drinking
Canada’s Guidance on Alcohol and
Health (2023)
1. Recommends reducing alcohol
use, offering a spectrum
approach to help people make
healthier choices
2. Harm is experienced among
people of all sexes and genders
3. There is no safe level of alcohol
consumption
CANADA’S GUIDANCE ON ALCOHOL AND HEALTH
Drinking less is better
Aim to drink less
ALCOHOL – DEFINITIONS
- Binge drinking: Periodically drinking alcohol to the point of severe intoxication; about 4 drinks (for women) and 5 drinks (for men) consumed within a period of about 2 hours, brings BAC to 0.08%
- Alcohol misuse: Recurrent alcohol use that has negative consequences,
such as drinking in dangerous situations or drinking patterns that result in academic, professional, interpersonal, or legal difficulties - Alcohol use disorder (AUD): A disorder that first appeared in the DSM5, combining the previously distinct categories of alcohol abuse and alcohol dependence, diagnosed on a mild/moderate/severe
continuum
