Magazine article Addiction Professional

A Quick Course on Alcohol

Magazine article Addiction Professional

A Quick Course on Alcohol

Article excerpt

In my presentations around the country, I frequently am asked about how alcohol works in the body. Most addiction professionals have a good understanding of how excessive drinking causes problems in individuals and families, but they often are unaware of basic facts on alcohol pharmacology. Here's an overview:

* Alcohol is a simple organic molecule that mixes in water and fat--therefore, it distributes easily throughout the whole body when consumed.

* Although it is not very "potent" (large amounts are required in order to produce an effect), alcohol produces major behavioral, emotional, and cognitive effects, many of which are thought to be toxic.

* Alcohol produces greater acute effects on behavior and perception as blood alcohol levels climb with increased drinking.

* Unlike other drugs, alcohol has no specific receptor in the brain upon which it acts; therefore, it affects most receptors, such as those for opioids (like endorphins), cocaine (dopamine), and antidepressants (serotonin).

* Sophisticated research on "intoxication" is looking at specific parts of nerve cells that might be altered to produce alcohol's depressant and stimulant effects--especially GABA, glutamate, N-methyl-D-aspartate (NMDA), and nicotine receptors.

Blood alcohol concentrations

Here's an overview that should be of interest to adolescents. One standard "beverage unit" (BU) of alcohol is one five-ounce glass of wine (12% by volume), one 12-ounce beer (4.9% by volume), or one cocktail containing 1.5 ounces of 80 proof spirits (40% by volume). Each of these contains roughly 14 grams (about one-half ounce) of absolute alcohol. If a 150-pound man drinks one BU in an hour, this will produce a blood alcohol concentration (BAC) of about 0.025%, excluding any calculation for liver metabolism. This is approximately one-third the national drunk-driving BAC limit of 0.08%. So when this person drinks four BUs in an hour, alcohol is removed by the liver at a constant rate of 0.25 to 0.30 ounces of beverage alcohol per hour, and the BAC will decline by about 0.02% every hour. This is the value for relatively alcohol-naive drinkers.

For people with significant drinking experience, an increase in liver enzymes occurs so that the liver processes alcohol at higher rates, leading to significantly lower BACs. On the other hand, liver disease, some medications, and other factors might decrease the metabolism of alcohol, leading to higher-than-expected BACs. …

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