Alcohol

(See: Drugs in American Society, 5th, 6th, 7th, 8th, and 9th editions, Erich Goode, McGraw-Hill, 1999/2005/2008/2012/2014. Chapters 4/8, and Drugs, Society, and Human Behavior (7th ed), Ray and Ksir, Mosby, 1993. Chapters 9 and 10 and the disclaimer). Statistics are gathered from the various surveys discussed, especially: Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

Monk Tasting Wine
(This image is in the public domain because its copyright has expired: PD-old)

The alcoholic is the typical addict:

History, Chemistry and Variety

Ancient History:

Alcohol was discovered in 8327 B.C. on a warm afternoon by "Grog" who returned to his cave and drank the fermented milk of a coconut that had been cracked and left out in the sun. ;-) (it's a joke)

How much did they drink in medieval Europe?

Fermentation:

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)

DATE MATERIAL FERMENT DISTILLATE ORIGIN
800 BC rice
millet		 Tehoo Sautchoo China
rice
molasses
palm sap		 Toddy Arrack Ceylon
India
mare's milk Kumiss Arika Tatars
mare's milk Kefir Skhou Caucasus
rice Sake Sochou Japan
500 AD Honey Mead Distilled Mead Brittain
1000 AD Grape Wine Brandy Italy
1100 AD Oats
Barley		 Beer Usqubaugh Ireland
1200 AD Grape Wine Aqua Vini Spain
1300 AD Grape Wine Cognac France
1500 AD Barley Beer Whisky
Aqua Vitae		 Scotland

Distillation Technology

  • By 17th Century: 95% Alcohol possible
  • Variety of grains used==> Grain Neutral Spirits ("Everclear")
  • Variety of uses now: add to gasoline, industrial solvent, and (of course)-- beverages
  • Proof at which distillation occurs==> Taste
  • Proof==> twice the percentage of Alcohol: British army-- add to gunpowder and ignite==> "pooooff!" (57% alcohol)
  • Higher the proof, lower the by-products: Congeners, other alcohols (methyl, isopropyl), oils.

  1. Whiskey became Common by 1500
  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)

Consumption

Beer

(Do you Need Beer?) (We Want Beer)

Types

Breweries and the Consumption of Beer

 Beer and culture: (a new section just getting started)

Wine

Types

Other Variations

Fortified wines

Consumption

Alcohol consumption, overall

WWW Links: Sites Relating to Alcohol Use and Consumption

Absorption and Metabolism

Impact on CNS

Acute Objective effects

BAC/BAL

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 (local copy)

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

Other Acute Objective Effects

Chronic Objective Effects

Other Effects: Alcohol worse than heroin and cocaine?

Subjective Effects

Drunken Comportment: MacAndrew and Edgerton
(1969, 1976) (See: Social and Cultural Aspects of Drinking)

Aggression and Violence

Sexual Behavior: Same patterns and variations

Consumption and Control in the USA

National Alcohol Prohibition (1920-1933)

prohibition disposal
(http://commons.wikimedia.org/wiki/File%3A5_Prohibition_Disposal(9).jpg)

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

Did it Work?

Lessons

  1. Problems of lack of regulation- Licensing and state regulation now control central elements of production and distribution
  2. Question the effectiveness of Criminalization
  3. 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.

Prohibition Resource Page: http://www.authenticwinecountry.com/Prohibition

Use Today

Alcohol Justice: The Alcohol Industry and Policy Database

Gallup poll (local copy) 1939 1947 1976 1990 2010
Drinker (last year) 58% 63% 71% 57% 67%
abstain 42% 37% 29% 43% 33%
  • 2000: 47% report having used alcohol in the past month, 20% listed as binge drinkers.
  • 2005: 51.8%
  • Slightly more than half (52.1 percent) of Americans aged 12 or older reported being current drinkers of alcohol in the 2012 survey, which was similar to the rate in 2011 (51.8 percent). This translates to an estimated 135.5 million current drinkers in 2012. (2012 NSDUH)
  • Nearly one quarter (23.0 percent) of persons aged 12 or older in 2012 were binge alcohol users in the 30 days prior to the survey. This translates to about 59.7 million people. The rate in 2012 was similar to the rate in 2011 (22.6 percent). (2012 NSDUH)
  • In 2012, heavy drinking was reported by 6.5 percent of the population aged 12 or older, or 17.0 million people. This percentage was similar to the rate of heavy drinking in 2011 (6.2 percent). (2012 NSDUH)
  • Most Drinking: Lighter drinks (wine and beer), 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

Drinking in the USA

Goode, Erich. 2014. Drugs in American Society, 9th edition. McGraw-Hill: St. Louis

Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

SES % of Households (2010 data: Gallup poll)
Over $75,000 81%
$50,000-75,000 78% (more frequently, too) social expectations? 
$30-50,000 66%
$20-30,000 51%
Under $20,000 46% (18% regularly)
  • Education: Higher the level of education, more likely to drink regularly--rates are increasing in recent years
    • 2013 NSDUH:
      • Among adults aged 18 or older, the rate of past month alcohol use increased with increasing levels of education. Among adults in 2013 with less than a high school education, 36.5 percent were current drinkers. In comparison, 69.2 percent of college graduates were current drinkers.
      • Among adults aged 18 or older, rates of binge and heavy alcohol use varied by level of education. Among adults in 2013, those who had graduated from college were less likely than those with some college education but no degree to be binge drinkers (23.1 vs. 26.4 percent) or heavy drinkers (6.0 vs. 7.6 percent).
      • Young adults aged 18 to 22 who were enrolled full time in college were more likely than their peers who were not enrolled full time (i.e., part-time college students and persons not currently enrolled in college) to report current, binge, or heavy drinking. Among full-time college students in 2013, 59.4 percent were current drinkers, 39.0 percent were binge drinkers, and 12.7 percent were heavy drinkers. Among those not enrolled full time in college, these rates were 50.6, 33.4, and 9.3 percent, respectively.
      • The pattern of higher rates of current alcohol use, binge alcohol use, and heavy alcohol use among full-time college students compared with rates for others aged 18 to 22 has remained consistent since 2002.
      • Binge Alcohol Use among Adults Aged 18 to 22, by College Enrollment: 2002-2013

    2005 NSDUH: 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:
    • In 2013, an estimated 57.1 percent of males aged 12 or older were current drinkers, which was higher than the rate for females (47.5 percent). Among youths aged 12 to 17, however, the percentage of males who were current drinkers (11.2 percent) was similar to the rate for females (11.9 percent). The rates for male and female youths were lower than those reported in 2012 (12.6 and 13.2 percent, respectively).
    • Among young adults aged 18 to 25, an estimated 62.3 percent of males and 56.9 percent of females were current drinkers in 2013. In this age group, 44.4 percent of males and 31.4 percent of females reported binge drinking in 2013. In 2013, the rate of binge drinking among females aged 18 to 25 was lower than the rate reported in 2012 (33.2 percent). The rate of binge alcohol use in 2013 among males in this age group was similar to the rate in 2012 (45.8 percent).
    • Binge Alcohol Use among Adults Aged 18 to 25, by Gender: 2002-2013
      binge drinking by gender 2002-2013

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).

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).

Current National Survey on Drug Use & Health

  • Religion (see also: James B. Holt, Jacqueline W. Miller, Timothy S. Naimi and Daniel Z. Sui. 2006. Religious Affiliation and Alcohol Consumption in the United States. Geographical Review , Vol. 96, No. 4 (Oct., 2006), pp. 523-542. Article Stable URL: http://www.jstor.org/stable/30034136.

Religion Percentage Problems
Judaism Most drink relatively few problems for those who drink
Non-Christian 80%  
No religion 80%  
Catholics 78%  
Protestants 61%  
Southern Baptist 55% Many problems attached to those who drink

East Coast 54.0%
West Coast 50.7%
Midwest 55.7%
South 48.2%
  • Age (NSDUH 2013):
    • In 2013, rates of current alcohol use were 2.1 percent among persons aged 12 or 13, 9.5 percent for persons aged 14 or 15, 22.7 percent for 16 or 17 year olds, 43.8 percent for those aged 18 to 20, and 69.3 percent for 21 to 25 year olds. The estimates for persons aged 14 or 15 and those aged 16 or 17 were lower than those reported in 2012 (11.1 and 24.8 percent, respectively).
    • Among older age groups, the prevalence of current alcohol use decreased with increasing age, from 67 percent among 26 to 29 year olds to 53.1 percent among 60 to 64 year olds and 41.2 percent among people aged 65 or older.
    • Rates of binge alcohol use in 2013 were 0.8 percent among 12 or 13 year olds, 4.5 percent for 14 or 15 year olds, 13.1 percent for 16 or 17 year olds, 29.1 percent for persons aged 18 to 20, and peaked at 43.3 percent for those aged 21 to 25. The estimates for persons aged 14 or 15, 16 or 17, and 21 to 25 were lower than those reported in 2012 (5.4, 15.0, and 45.1 percent, respectively).
    • Rates of heavy alcohol use in 2013 were 0.1 percent among 12 or 13 year olds, 0.7 percent for 14 or 15 year olds, 2.7 percent for 16 or 17 year olds, 8.5 percent for persons aged 18 to 20, and peaked at 13.1 percent for those aged 21 to 25. The estimates for persons aged 18 to 20 and 21 to 25 were lower than those reported in 2012 (10.0 and 14.4 percent, respectively).
    • The rate of current alcohol use among youths aged 12 to 17 was 11.6 percent in 2013. Youth binge and heavy drinking rates were 6.2 and 1.2 percent, respectively. The rates for current and binge youth alcohol use were lower than those in 2012 (12.9 and 7.2 percent, respectively).
    • In 2013, the rate of current alcohol use was 59.6 percent among young adults aged 18 to 25, which was similar to the rate in 2012 (60.2 percent). The rate of binge drinking in 2013 was 37.9 percent for young adults. Heavy alcohol use was reported by 11.3 percent of persons in this age group. The binge and heavy drinking rates were lower than the rates in 2012 (39.5 and 12.7 percent, respectively).
    • The prevalence of current, binge, and heavy alcohol use in 2013 was lower among adults aged 65 or older (41.7, 9.1, and 2.1 percent, respectively) than among all other adult age groups. These rates among adults aged 65 or older were similar to the current, binge, and heavy drinking rates in this age group in 2012 (41.2, 8.2, and 2.0 percent, respectively).

Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Age: 2013



  • Race and Ethnicity
  1. African Americans: High abstinence, low rate of heavy drinking, high risk of problems
  2. Hispanics: High abstinence, high rates of heavy drinking, high rates of problems
  3. Asians: Highest rate of abstainers, lowest rate of heavy drinking, lowest rate of problems ("Flushing")
  4. Native Americans: Great deal of variation, extremely high rates of problems
  5. Whites: High use rates. Heaviest: Irish (most likely to drink and high rate of problems) Italians, Northern WASPs, Slavs, Germans. Low rates: Latins and Southern Whites.
  6. 2013 NSDUH:
  • Among persons aged 12 or older, whites in 2013 were more likely than other racial/ethnic groups to report current use of alcohol (57.7 percent). The rates were 47.4 percent for persons reporting two or more races, 43.6 percent for blacks, 43.0 percent for Hispanics, 38.4 percent for Native Hawaiians or Other Pacific Islanders, 37.3 percent for American Indians or Alaska Natives, and 34.5 percent for Asians.
Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Race/Ethnicity: 2013


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
        • DSM-V: Alcohol Use Disorder (see NIAA and criteria)
    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
  • Early Cure?
  • Is Alcoholism Reversible?
  • Moderate Drinking for the Alcoholic?
    • Abstention as deviant in many setting
    • Doesn't work for all
  • How many (~30%): 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
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