Alcohol

(See: Drugs in American Society, 5th, 6th, 7th editions, Erich Goode, McGraw-Hill, 1999/2005/2008. Chapters 4 and 8, and Drugs, Society, and Human Behavior (7th ed), Ray and Ksir, Mosby, 1993. Chapters 9 and 10 and the disclaimer)

• Psychoactive
• Taken for Effect
• Recreational
• Physical Dependence; Addicting in the Classic Sense
• Aside from nicotine and caffeine, most commonly used psychoactive substance
• Aside from cigarettes, most common form of drug addiction:

History, Chemistry and Variety

Ancient History:

How much did they drink in medieval Europe?

Fermentation:

• A natural process: Most fruits and airborne yeast
• Fruit--sugar + yeast and Water==> recombines carbon, hydrogen and oxygen to produce ethyl alcohol and carbon dioxide.
• C₆H₁₂O₆ (Glucose) + H₂O==(Yeast)==> C₂H₆OH (ethyl alcohol) + CO₂
• At about 15-20% ETOH the alcohol level kills the yeast and fermentation stops
• Alcohol's basic effects: Euphoria, Sedation, Narcosis, Pain relief. It is almost universally accepted in some form or other for some purpose or other.
• Cereal Grains can also be used: starch versus sugar- The Malting Process:

1. Malting (sprouting) produces enzyme
2. Slow drying kills sprout, preserves enzyme
3. Crush, mix with water, enzyme converts starch to sugar
4. Corn added to increase starch levels

Distillation and Distilled Spirits

(see: http://www.homedistiller.org/)

To produce higher levels of ETOH; heat mixture to evaporate alcohol, trap vapors in condensing coil-- Voila!: Hard Liquor (early distillation technology probably resulted in concentrations of about 50% (100 proof)

• Arabia ~800 A.D. (Alcohol is a derivative of the Arabian word for "finely divided spirit"-- the part of the wine derived from distillation.
• Only fermented beverages were known in Europe until the 10th Century when Italians began to distilled wine.
• Pure Ethyl Alcohol has been studied and used medicinally ever since.
• 13th Century professor of Medicine at Montpelier called it "Aqua Vitae" (Water of Life)
• In the 17th Century the Dutch came up with the name Brandy (Brandtwein): Burnt wine
• Whiskey (Irish-Gaelic equivalent for Aqua Vitae- visgebaugh):
• The Encyclopaedia Brittannica lists in its article on 'Alcoholic Beverages' the following dates and places of origin of several distilled alcoholic beverages. (credit to: http://www.bigfoot.com/~m_shapiro/cspirits.html--no longer active)

1. Whiskey became Common by 1500
   • Scotch whisky (no "e"): Scotch: (1) malted barley, malt is dried in kilns fired by peat, and the liquor is stored for at least 3 years in barrels originally used to transport sherry
2. Whiskey was Introduced to the Americas ~late 1700's
3. Became the chief export of settlements west of the Appalachian Mountains: Grain to expensive to transport. 10 bushels of corn could be reduced to 1 barrel of whiskey.
4. 1789: Elijah Craig of Bourbon, KY: Store whiskey in new, charred oak barrels: American bourbon. (Canadian whiskey: uncharred).
5. Whiskey: Typically distilled at less than 160 proof (grain flavors)
   • 51% of grain- rye==> straight rye whiskey
   • 51% of grain- corn==> bourbon
   • 80% corn===> Corn whiskey
   • Dilute to 120 proof: age 2 or more years=> acquire more flavors. Typically further dilution
   • Up until Prohibition: almost all whiskey in U.S.- bourbon, during Prohibition- Smuggled Canadian and Scotch: Lighter and Blended (2/3 straight whiskey, 1/3 GNS)

• Gin: alcohol filtered through juniper berries (jenever in Dutch; genievre by French; English shorten) (Mainly from corn)
• Schnapps originally was not as thoroughly distilled allowing flavor of grain or fruit to come through: "Slivovitz," "Kirsch" (New "peppermint " schnapps is flavored alcohol)
• Rum: distillate of the fermented product of molasses (sugar cane) (Slave trade).
• Vodka: Alcohol and water. All are the same. Heublin executive on pricing differences of their own brands: "That's a very embarrassing question. Shall we say it's a difference in pricing policy?"
• Liqueurs, Cordials, and further distilled liquor. Fortified, Brandy mixed with other flavors, diluted (20-25%) and sugar added. Increasing popularity (small quantities drank)
• Absinthe (and "getting high")(local)

(see also: Erowid) (The Old Absinthe Bar in New Orleans))

• Tequila: Ask Your Doctor (just for fun)
• About: Cocktails and Spirits

Consumption

Beer

• Barley malt (some rice or corn, even soy beans) and water
• Filter out solids and add yeast==> the Mash (at the
Brewhouse--link to Budwieser.com , navigate to the tour)
• Hops (a) (1) (2) added for flavor (1/4 lb for 31 gallon barrel)
(Hop vine chandelier at AB Brew House)
• Age after fermentation.
• Beershots
at Molecular Expressions

Types

• Lager: (to store)Yeast settles on bottom (4%)
• Ale: Top rising yeast, fermentation temperature warmer, higher concentrations of malt and hops-- more flavor.
• Malt Liquor: Aged longer, more flavor (6-8%)
• Light beer: 10% less alcohol, 30% fewer calories. Fermentation is done at lower temperatures==> More alcohol and less sugar. Add water.
• Dry and Ice beers: same, without diluting (1990's)
• Non-alcohol Beer (since prohibition, recent popularity)
• World's Strongest beer.

Breweries and the Consumption of Beer

• Pre 1920: Thousands of Breweries (over 60 here in St. Louis)
• 1933- about 750 left
• 1941- 507
• 1976- less than 50
• Mid 80's ~40
• Now: Increase- microbreweries
• 6 breweries dominate 90% of the market: Busch: Over 48% (2007); Budweiser alone: 14% (2003)
  • Market Share of Beers in 2003
  • USA fast becoming a two brewery country
  • Personal brewery tour
  • Budweiser or Budweiser?
• Light Beers: 30% of sales
• Foreign: around 5% and growing
• Micro's: limited distribution, although providing wider variety of choices
• Per Capita Consumption
  • Americans: 25 gallons/year (2003)
  • Irish and Australians: 30
  • Germans and Czechs: 40
  • Mexicans and Japanese: ~12
  • World's leading consumers of beer or not (1)? Or, try wikipedia for an answer.

• Beertown.org Beer Information and Education (Association of Brewers)
• American Brewery History Page

• Beer mats
• Beer Tossing Refrigerator
• Beer Labels
• Pedal-Powered Beer Pub
• Beer Shots Photo Gallery
• Oktoberfest 2008
• A Beer, Please, and a (Good) Menu (NY Times 6/24/09)

Wine

• Oldest form of alcohol
?
• Today, highly mechanized production
• But, still lots of small traditional vintners
• American vines brought from Europe. In the late 1800's, and again in the 1960's; massive disease destroyed many of the European (France, Spain, Italy) vines, so the American vines were re-introduced.
• Wines.com (searchable database!)
• About: Wine

Types

• Generics: European names, but blended (Chablis, Rhine, etc)
• Varietals: 51% of a specific grape. Individual bottles.
  • Other countries: more restrictive- region.
  • The Norton Grape: Missouri's claim to fame.
• Red wine: leave skin on during fermentation
• White: white grape, skin off
• Rose': leave skins for a couple of days, generics- mix red and white.
• Blush: juice of particular grapes is dark enough (Zinfandel)
• Sweet vs. Dry: sugar content, Sweeter wines are heavier- sweetness overrides harsh flavors.
• Dessert wines: special grapes or processing ("Eiswein" and "Auslese")

Other Variations

• "Sparkling" wines: Carbon Dioxide- natural byproduct- with additional sugar added.
• Champagne

1. "Methode Champagnoise": in individual bottle, tightly corked
2. Mass process
3. CO2 injected into generic wine during bottling

Fortified wines

Consumption

Alcohol consumption, overall

WWW Links: Sites Relating to Alcohol Use and Consumption

National Clearing House for Alcohol and Drug Information

National Institute on  Alcohol Abuse and Alcoholism

Alcoholic Drinks of the Middle Ages

Microbrewery and Brewpub Guide

Remy Martin Cognac

Perrier-Jouet

Hemp Beer

Hempen Ale (retired) (label)

DRCNet

The Wine Spectator

The Marin Institute: The Alcohol Industry and Policy Database

Bar TV (good source of information on various spirits and drinks)

Pony Express (soy) Beer

"Alcohol: Problems and Solutions" (www.alcoholinformation.org).

Absorption and Metabolism

• Alcohol requires no digestion
• 20% is absorbed in the stomach, most through small intestine
• CO₂, or empty stomach speeds absorption- etoh passes more rapidly into the small intestine.
• Alcohol is not stored by the body, the calories it provides are used first- tied to weight gain (you gain weight from the food you eat along with the alcohol)
• Fat cells versus muscle cells (alcohol is water soluble): Males vs. Females
• 90% metabolized by liver
• 2% excreted: urine, breath
• Enzyme: Alcohol Dehydrogenase: Alcohol=> acetaldehyde (acetaldehyde dehydrogenase) (problem)=> acetic acid.
• Most drugs, if consumed at high levels, metabolized at high levels.
• Alcohol: steady: 100 milligrams of alcohol per kilogram of body weight. About .33 oz. (about one drink) per hour. Constant.
• Some note of a second enzyme that is produced through chronic, heavy drinking-- permanent: speeds up metabolism.
• Stimulants: coffee, etc==> no effect
• Chronic use- destroys liver- impedes metabolism of other drugs

Impact on CNS

Acute Objective effects

• General Anesthetic
• Depressant
• Used until 1800's in surgery: replaced by nitrous oxide. Problem in controlling the effect of alcohol. Effective dose-- close to lethal dose. Slows blood clotting.
• Tied to GABA receptor complexes in the brain. Similar to neurotransmission processes that relate to an understanding of benzodiazepines.
• GABA produces an inhibitory function in the brain's neural processing. Seems alcohol and drugs like Valium enhance this activity.
• Hoffman-LaRoche labs: RO 15-4513 ?? "Sober-up" pill ??

BAC/BAL

• Number of grams of Alcohol per 100 ml. blood. (100mg./100ml. = .10% BAL)
• At lowest effective doses: Poorly learned behaviors deteriorate; at higher levels: inhibitions decline and behaviors elevate, critical thinking also declines
• The quicker the volume of etoh increase, the greater the effect, yet modified by "Behavioral Tolerance"
• Vomiting likely at .12%, especially if reached quickly.

BAL	Effect
.03	Dull and dignified
.05 (~2 beers in one hour)	Dashing and debonair
.1 (~4 beers in one hour	Dangerous and devilish
.2	Dizzy and disturbing
.25	Disgusting and disheveled
.3	Delirious and disoriented
.35	Dead drunk
.6 (~one quart of whiskey in one hour)	Probably DEAD

(adapted from Bogen in Ray and Ksir, 8th ed. 1999, p. 222)

• BAC Calculator (The Drink Wheel)
• BAC of .4==> LD50, BAC .8==> LD100
• 1 drink= ~ .5oz alcohol
• DWI: ~3 drinks in one hour, all other things equal
• 1 drink every hour (sipping): Theoretically "no problems" (normal liver)
• 6 drinks over 2 hours=> ~4 drinks in system: at least .1% BAL
• Rule of equivalency (a drink is a drink):
  • 1-12 ounce (5%) Beer =1-4 ounce glass of wine (15%)= 1 ounce of (80 proof) distilled spirits

• Erowids Alcohol Impairment Chart

Other Acute Objective Effects

• Blackouts: mechanism is questionable
• Sexual behavior:
1. Increases desire=> Expectancy (cultural conditioning)
2. Decreases capacity
3. For males: lowers testosterone levels
• Aggression:
1. Testosterone drop=>
2. Increase in Lutenizin (hormone)
3. Lutenizin=> direct impact on aggression/sex centers of brain
• Peripheral Circulation increases, Core temperature drops
• Fluid balance: suppresses ADH (anti-diuretic hormone)
1. "You don't buy beer, you only rent it" (Archie Bunker)
2. Link to hangover
• Hangovers
1. Germans: "wailing of cats" (Katzenjammer), French: "woody mouth" (gueule de boise), Swedes: "pain in the roots of my hair" (hont i haret) (Ksir, Hart, and Ray, Drugs, Society, and Human Behavior, 12th ed, 2008, page 220).
2. Element of withdrawal
3. Effect of congeners
4. Irritation, especially gastro-intestinal tract
5. Blood sugar levels
6. Dehydration

Aggression and Violence

Sexual Behavior: Same patterns and variations

• Exception 1784- Benjamin Rush: Alcoholism as a disease
• 1790: 5.8 gallons of grain spirits per person (2x current)
• Use rarely viewed as problematic: Family and community control
• Drinking: Matter of Choice (Drunk==> Sinner, Poor Choice==>Punish)

• First Temperance Society- 1808
• 1826: American Society for Promotion of Temperance: Moderation
• Use rose in 19th Century- 1830: 7.1 gallons=> more distilled. Viewed as vital to health and well-being (even for school children)
• 1830: National Movement- Abstinence (1.5 million members), success at limiting use in some settings.
• 1840: 3.1 gallons
• 1850-1920: Decline (except for Civil War years
• "Respectable" people: likely to oppose its use (no moderation- abstain or drunk)
• Lower classes and new ethnics: approve (Drinker==>Threat==>Enemy)
• 1900: 2 gallons
• 1920: 2.5 gallons

1. Feasibility of enforcement
2. Thought it would automatically reduce drinking
3. Seen as a solution to a variety of problems
4. "Temperance, Prohibition, Alcohol Control" (Harry G. Levine and Craig Reinarman, FROM PROHIBITION TO REGULATION: LESSONS FROM ALCOHOL POLICY FOR DRUG POLICY).
   

• Level of alcohol consumption? (current example)
• Historical overview of alcohol consumption
• "Alcohol Prohibition Was A Failure" by Mark Thorton, O. P. Alford III Assistant Professor of Economics at Auburn University, published by the CATO Institute, Cato Policy Analysis No. 157, http://www.cato.org/pubs/pas/pa-157.html
  • Per Capita Alcohol Consumption, 1900-1929 (http://www.cato.org/pubs/pas/images/pa-157a.gif)
• Realistic view: Cirrhosis deaths down, overall consumption down modestly ~1.5 gal.
• Image of increased use by late 1920's=> Urban vs. Rural patterns, Entertaining story.
• Other results
1. Shift to more potent forms (prior, beer dominates)
2. Less absolute alcohol, more potent forms
3. Toxic and dangerous substances ("Jake")
4. Crime and organized crime
5. Also, "decentralized production and distribution" outside of the major cities.

Alcohol Control after Prohibition: See "Shedding a Tier" from the St. Louis Post-Dispatch (4/28/05) for an account of contemporary revisions to the policies put in place to control alcohol production and sale after prohibition.

The Marin Institute: The Alcohol Industry and Policy Database

• Use rose following prohibition, peaked in 1980: 2.76 gal.
• Today (2005)- about 1.8-2.2 gal./person/year- pure alcohol (GNS)
• 1/3 abstain (Ray and Ksir 1993: Suggests relative stability over past few years)
• "Typical (mythical) drinker"-- 2-3 drinks a day (1.33 drinks per capita)
• 30% of those who drink account for as much as 80% of the alcohol consumed.  Of this group, 1/3 (10% of drinkers) consume 50% of the alcohol. (Levanthal,Charles. 1999.  Drugs, Society and Modern Behavior, 2nd edition.  Boston: Allyn and Bacon)

• 2000: 47% report having used alcohol in the past month, 20% listed as binge drinkers.
• 2005: 51.8%
• 1998 National Household Survey: 51.7% (112 million) report having used alcohol in the past month.
•  Approximately one-fifth (20.6 percent) of persons aged 12 years and older (46 million people) participated in binge drinking at least once in the 30 days prior to survey. This represents approximately 44 percent of all current drinkers. These 2000 estimates are all similar to the estimates for 1999.
• Heavy drinking was reported by 5.6 percent of the population aged 12 and older, or 12.6 million people.
• Most Drinking: Lighter drinks, far less distilled spirits.
• 21 year old laws in all states (1979 only 14): Impact- significant, fewer children and teens drinking (although no longer declining), Auto deaths down- 25-30% correlated with alcohol use (1990-50%).
• Current MTF Data
• Current National Survey on Drug Use & Health

• Education: Higher the level of education, more likely to drink regularly: 31% College Degree vs. 14% No high school degree.
  • 1999 NHS:

• Among persons 18 to 25 years of age, past month alcohol consumption was most prevalent among persons with a college education (74.0 percent) compared to 64.7 percent of persons with some college, 53.8 percent of those with only a high school diploma, and 46.1 percent of persons in this age group who lacked a high school degree. A similar pattern of increasing rateswith increasing educational attainment was seen for binge drinking, ranging from 34.0 percent among persons who had not completed high school to 43.0 percent of those with a college degree.
• As seen for young adults 18 to 25 years old, college graduates 26 years of age and older were most likely to report past month alcohol use (61.8 percent) compared to 32.6 percent of their peers with the least education.
• Binge drinking among persons 26 and older was equally likely between persons without a high school education and those with a college degree (16.7 and 16.1 percent, respectively).

• 2005 NHSDUH: Among adults aged 18 or older, the rate of past month alcohol use increased with increasing levels of education. Among adults with less than a high school education, 36.7 percent were current drinkers in 2005, significantly lower than the 69.4 percent of college graduates who were current drinkers. However, among adults aged 26 or older, binge and heavy alcohol use rates were lower among college graduates (18.9 and 4.9 percent, respectively) than among adults who had not completed college (21.9 vs. 6.0 percent, respectively).
  • College: Young adults aged 18 to 22 enrolled full time in college were more likely than their peers not enrolled full time (i.e., part-time college students and persons not currently enrolled in college) to use alcohol in the past month, binge drink, and drink heavily. Past month alcohol use was reported by 64.4 percent of full-time college students compared with 53.2 percent of persons aged 18 to 22 who were not enrolled full time. Binge and heavy use rates for college students were 44.8 and 19.5 percent, respectively, compared with 38.3 and 13.0 percent, respectively, for 18 to 22 year olds not enrolled full time in college.

    The pattern of higher rates of current alcohol use, binge alcohol use, and heavy alcohol use among full-time college students than the rates for others aged 18 to 22 has remained consistent since 2002.

• Current National Survey on Drug Use & Health
  
• Gender:

1. Males-70%; Females- 61% (1994-occasionally). 33% males vs. 17% females (daily or almost).
2. Men drink about 2x as much as females, have more problems
3. Women's drinking is increasing; more likely to drink alone. Male's drinking declining--yet daily use is still twice that of females.
4. 1999 NHS:

• With the exception of adolescents, males were more likely than females to report past month alcohol drinking. In 1999, 54.0 percent of males (ages 12 and older) were current drinkers compared to 41.1 percent of females.
• For the youngest age group (12 to 17), males and females had comparable rates of current alcohol use (19.2 percent of males and 18.1 percent of females).
• Among pregnant women age 15-44 years, 13.8 percent used alcohol and 3.4 percent were binge drinkers. These rates are substantially lower than the rates for nonpregnant women of that age (49.3 percent and 19.4 percent, respectively).

5. 2005: 58.1 percent of males aged 12 or older were current drinkers, higher than the rate for females (45.9 percent). However, among youths aged 12 to 17, the percentage of females who were current drinkers (17.2 percent) was higher than that for males (15.9 percent).

Among adults aged 18 to 25, an estimated 55.4 percent of females and 66.3 percent of males reported current drinking in 2005. These percentages are similar to 2004.

• Current National Survey on Drug Use & Health

• Age: Regular drinking peaks in the late twenties (31%), declines through middle age, and "dives" in old age (16%). Although many of the elderly suffer from the impact of previous use.
• Current National Survey on Drug Use & Health

• Race and Ethnicity

• Whites were more likely than any other race/ethnicity group to report current use of alcohol. An estimated 51.0 percent of whites reported past month use. The next highest rates were for persons of multiple races and Hispanics (41.8 percent and 39.9 percent respectively). The lowest current drinking rate was observed for Asians (31.9 percent).
• Binge alcohol use was least likely to be reported by Asians (10.5 percent). In 1999, binge alcohol use among American Indians/Alaska Natives, persons of multiple races, whites, and Hispanics ranged from 20 to 21 percent, while the rate for blacks was 16.5 percent.
• 2005 data:

2005 NHSDUH

• Current National Survey on Drug Use & Health

• Gays
• The Homeless

Alcoholism

• Defining the alcoholic:

1. Quantity/Frequency: 5oz.; ? Of individual variation, Moderate drinkers and problems; binge drinkers.
2. Psychological Dependence: Vague; Testing?; Signs?-- Answering yes to how many?
3. Physical Dependence: OK, but restrictive.
4. Life-Problems: Social setting; Who's defining?; Heavy use vs. No "objective" problems?

• Models

1. Moral: Free will; choice; lack of control; punish and therapy
2. Medical: Uncontrollable; Disease; Bio-genetic; Recover vs. Cure; Alcoholic=> different from moderate drinker. Seems applicable to some (twin studies, COA)
• Essential Difference? (TIQ, genetic marker?)
• Stages or Career
  • Jellineck: Alpha--inadequate, Beta-social dependence, Gamma-typical: emotional impairment, Psi-physiological, Delta-maintenance (sips all day), Epsilon-binge, Zeta-moderate, but problems when use.
  • One style does not fit all.
  • Supreme Court (1989): Not a disease (cannot be used as excuse--Vets and benefits).
  • DSM-IV: abuse or dependence
3. Behavioral: Social learning, reinforcement, and socio-cultural values/attitudes. Family structure and dynamics: Exposed early- diluted and small quantities- in conjunction with meals- abstaining accepted. Parents model appropriate use- heavy use unacceptable. No moral importance attached to use: Not proof of adulthood. Agreed upon "ground rules."
   • Self-definition.
   • Expectations.
   • Social norms

• Is Alcoholism Reversible?
• Moderate Drinking for the Alcoholic?
• Abstention as deviant in many setting
• Doesn't work for all
• How many (~20%): Practical issues and treatment?
  • RAND study (1976)(8 treatment center, chronic users-9 times typical drinker
  • At 18 months 70% improved: controlled use (even though abstinence was treatment goal).
  • At 4 years 41% of controlled had relapses, 30% of those who had abstained.
  • Yet, majority of those who were controlled stayed that way.

Marijuana

URL: http://www.umsl.edu/~keelr/180/alcohol2.html
Owner: Robert O. Keel rok@umsl.edu
References and Credits for this Page of Notes
Last Updated: Thursday, October 22, 2009 2:10 PM