Week 3 Drunkenness and Alcoholism

Professor John Scott

“Despite expressions of substantial concern about ‘drug’ use, alcohol is by far the most popular mood-altering drug consumed in the United States today. In fact, two drugs – alcohol and tobacco – actually cause more physical, medical, social, and psychological problems than any other drugs” (Clinard and Meier 2004, 254)

What is alcohol? “Alcohol is a chemical substance created through processes of fermentation or distillation” (Clinard and Meier 2004, 255) “Alcohol is a naturally occurring chemical that is produced by the action of yeast on sugar. The chemical process that produces alcohol is called fermentation; chemicals from the sugar are converted into a substance that chemists call ethanol and most people know as alcohol” (Rooney 2013, 6) “Alcohol is a central nervous system depressant, although in smaller amounts it may appear to have a mild stimulant effect” (DASSA)

Stages

BAC

Likely Effects

Feeling of well-being

Up to .05 g%

•Talkative •Relaxed •More confident

Some raised risk

.05-.08 g%

•Talkative •Acts and feels self-confident •Judgment and movement impaired •Inhibitions reduced

Moderately raised state

.08-.15 g%

•Speech slurred •Balance and coordination impaired •Reflexes slowed •Visual attention impaired •Unstable emotions •Nausea, vomiting

Very elevated risk

.15-.30 g%

•Unable to walk without help •Apathetic, sleepy •Laboured breathing •Unable to remember events •Loss of bladder control •Possible loss of consciousness

Death

Over .30 g%

•Coma •Death

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Sparkling wine 100 ml 13% alc/vol

Regular beer 285 ml 4.9% alc/vol

Wine 100 ml 13% alc/vol

Fortified wine 60 ml 20% alc/vol

Spirits 30 ml 40% alc/vol

Standard drink measures

“In the United States • 1 standard drink = 0.5 oz (13.6 g) of pure alcohol • = 12 oz of beer or cooler • = 5 oz of wine • = 8-9 oz of malt liquor • = 1.5 oz of spirits (hard liquor) In the United Kingdom • 1 unit = 10 ml (8 g) of pure alcohol • = a third of a pint of beer that is 5-6% abv • = half a standard (175 ml) glass of wine that is 12% abv • = a single measure (25 ml) of spirits that is 40% abv In Australia • 1 standard drink = 10 g of pure alcohol • = 375 ml of beer that is 3.5% abv • = 100 ml of wine • = one nip (30 ml) of spirits”

{Source: Anne Rooney, Alcohol, Chicago: Britannica Digital Learning, 2012, 8}

{Source: World Health Organisation http://gamapserver.who.int/gho/static_graphs/gisah/Global_adult_percapita_consumption_2005.png}

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Cultural contradictions of alcohol “a determination of deviance requires more information than a simple statement about the presence of alcohol; this judgment also depends on information about the conditions under which people drink” (Clinard and Meier 2004, 255) “Many U.S. residents share a fundamental ambivalence about drinking. Many regard beverages with alcohol as permissible elements of many social situations; others regard drinking as impermissible behaviour virtually all the time and in every situation. Many people laugh at jokes about drunkenness and yet condemn drunken behaviour in public” (Clinard and Meier 2004, 255).

• People are drinking more than ever before • Alcohol consumption generally declines with age • Males drink more than females • Younger and younger children now experimenting

with alcohol • Binge drinking now associated with young people • Drinking varies by religion, culture, education and

income levels (higher education = higher rates of consumption, higher income level = higher consumption level)

• Religion – heaviest drinkers: Jewish, Catholic, Lutheran

• More drinking in larger cities than in small • Unmarried people higher consumption rates than

married people

Socialisation of drinking • People are socialised into drinking • Many drinking patterns inherited from previous generations • No universal patterns found across cultures • US - drinking not socially accepted at funerals • Ireland – drinking is important aspect of a wake • Australia – people usually go to pub to drink after formal

gathering after a funeral • NZ – alcohol important part of funeral ritual • Alcohol important part of meals for European cultures • Alcohol important to celebrations such as marriage, births,

sporting events etc • Alcohol served at important business luncheons

Drinking patterns in Australia • Drinking patterns generally declining • 83% population over 14 yrs identified as ‘recent drinkers’ • Harmful drinking associated with risky drinking • According to young people: drinking is positive activity, central

to Australian culture and identity, attractive as cheap and peer group activity, reject stereotypes of ‘out of control’ drinkers, do not think guidelines apply to them, prefer risks of drinking than social exclusion of not drinking, and drink to fit in

• Key deterrents are risks of drink driving, parental pressures and the responsibilities of work and study

• Problem with sports clubs serving of alcohol to under-age members in the presence of parents

• (both reports available at www.drinkwise.org.au/)

Is Bad Judgment the Cause and Effect of Adolescent Binge Drinking?

Types of drinkers

• Social or controlled drinkers – occasional drinker and drinks at social occasions to be sociable and to conform to social norms

• Heavy drinker – regularly consumes alcohol & large quantities • Alcoholic drinker – someone who needs to consume alcohol

regularly • Light drinkers • Frequent early evening drinkers • Heavy hotel-tavern drinkers • Club drinkers • Solitary drinkers • Party drinkers

The Problem drinker • Not necessarily an alcoholic or a heavy drinker • Problem drinker indicates a person whose drinking

causes problems in their personal, social, and professional lives

The effects of problem drinking • Ugly hangovers • Physical collapse • Blackouts • Nausea • Deteriorating interpersonal relationships • Encounters with police

Symptoms of chronic alcoholism: • Solitary drinking • Morning drinking • General physical deterioration • Preoccupied with drinking Direct biochemical effects - influence chronic disease either in a beneficial (e.g., protection against blood clot formation from moderate consumption) or harmful way (e.g., toxic effects ). Intoxication - powerful mediator for acute outcomes (accidents, injuries , death, domestic conflict and violence) Alcohol dependence - sustaining alcohol consumption, impacting chronic and acute consequences of alcohol (WHO Global Status Report on Alcohol 2004, 35-36)

Dangers of alcohol withdrawal

Symptoms commence 6-24 hrs after last drink: • Tremors • Nausea and vomiting • Anxiety and agitation • Depression • Sweating • Headaches • Difficulty sleeping (can last several weeks)

Source: http://www.dassa.sa.gov.au/site/page.cfm?u=122#effects

{Source: WHO Global Status Report on Alcohol 2004}

Social problems linked to alcohol consumption

• Physical and psychological dependency • Physical illnesses • Breakdown in social relationships • Poor work performance • Work related injuries • Absenteeism • Lower productivity • Unemployment • Lower parenting skills • Child abuse and neglect • Criminal activity • Domestic violence

2010 alcohol related offences: - 70,000 Australians victims of assault, 24,000 were victims of domestic violence

Intoxication risks • 30% of road accidents • 44% of fire injuries • 34% of falls and drowning’s • 16% of child abuse cases • 12% of suicides • 10% of industrial accidents

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{http://en.wikipedia.org/wiki/Alcoholic_beverage#External_links}

Drink driving

Health risks of alcohol

Diseases shown to be fully attributable to alcohol: • Alcoholic psychoses • Alcohol-dependence

syndrome • Alcohol abuse • Alcohol polyneuropathy • Alcohol cardiomyopathy • Alcohol gastritis • Alcohol liver cirrhosis • Excess blood alcohol • Ethanol and methanol toxicity

Diseases and health problems where alcohol plays a contributory role: • Gastrointestinal disorders • Pancreatitis • Liver disease • Haemorrhagic stroke • Nutritional deficiency • Impairments of the central nervous

system functions • Disorders of the endocrine system • Cardiovascular • Some birth defects • Some cancers.

Alcohol and pregnancy Physical characteristics of a child affected by fetal alcohol syndrome

Strategies to control alcohol consumption • Prohibition • Legal regulation

– Age limits on service: USA 21 yrs; Australia 18 yrs – Limits on blood alcohol levels for driving,

operating machinery, specific jobs (ie, mines, pilots, surgeons etc)

– Closing times for venues serving alcohol • Education

– National guidelines for safe drinking • Media

– Campaigns to highlight negative consequences of alcohol consumption (ie, drink driving, domestic violence etc)

• Social – Alcoholics Anonymous etc

“If you’re trying to lose weight, you probably need to stop drinking alcohol. You booze, you don’t lose.”

Recommended viewing

• Four Corners “Punch Drunk” investigative program on the impact of alcohol in Australia

• Broadcast on ABC • Screened Monday 25 February 2013, 8:30pm • Available for viewing at:

http://www.abc.net.au/4corners/stories/2013/02/25/3695353.htm

References: • Rooney, Anne. 2012. Alcohol, Chicago: Britannica

Digital Learning. • McDonald, T. 2010. Alcohol abuse costs $36 billion a

year: study, ABC Radio, August 24, 12:10pm. • Australian Bureau of Statistics. 2010-2011. Apparent

consumption of alcohol, Australia. • Australian Bureau of Statistics. 2012. Australian Social

Trends. • Drug and Alcohol Services South Australia. Alcohol and

its effects. • Heritage.org. Family fact of the week. Marriage’s

sobering effects.

Weblinks http://www.aihw.gov.au/alcohol-and-other-drugs/ Australian Institution of Health and Welfare, research on alcohol and other drugs http://www.who.int/gho/alcohol/en/index.html WHO Global Health Observatory http://www.who.int/substance_abuse/msbgisahweb.pdf WHO Global Information System on Alcohol and Health http://www.alcoolism.org/alcoolism_en/consumptioneffects.html Alcoholism.org http://www.bocsar.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/ab07.pdf/$file/ab07.pdf Costing alcohol-related injuries presenting to St Vincent’s Hospital Emergency Department – a methodological note http://www.bocsar.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/bb53.pdf/$file/bb53.pdf An analysis of alcohol and psycho-stimulant use from the 2007 National Drug Strategy household survey http://www.bocsar.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/CJB147.pdf/$file/CJB147.pdf The association between alcohol outlet density and assaults on and around licensed premises

http://www.bocsar.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/CJB137.pdf/$file/CJB137.pdf The impact of restricted alcohol availability on alcohol related violence in Newcastle NSW http://www.who.int/substance_abuse/alcstratenglishfinal.pdf World Health Organisation Global strategy to reduce the harmful effects of alcohol http://www.who.int/substance_abuse/publications/global_status_report_2004_overview.pdf World Health Organisation Global status report on alcohol 2004 http://www.who.int/substance_abuse/publications/en/australia.pdf World Health Organisation Global status report on alcohol 2004 – Australia http://www.who.int/substance_abuse/activities/gisah_indicatorbook.pdf World Health Organisation Global Information Status on Alcohol and Health http://www.health.gov.au/internet/drugstrategy/publishing.nsf/Content/34F55AF632F67B70CA2573F60005D42B/$File/mono64.pdf The costs of tobacco, alcohol and illicit drug abuse to Australian society in 2004/05 http://drinkwisewebsite.s3-ap-southeast-1.amazonaws.com/2011/10/AIHW-Drinking-Patterns-in-Australia-2001-20072.pdf Australian Institute of Health and Welfare Drinking patterns in Australia 2001-2007 http://drinkwisewebsite.s3-ap-southeast-1.amazonaws.com/2011/10/The-cultural.pdf ‘What a great night’: The cultural drivers of drinking practices among 14-24 year-old Australians