Health Effects of Alcohol

An Introduction To The Health Effects of Alcohol : 

An Introduction To The Health Effects of Alcohol A Small Dose of ™ Alcohol

What Is This? : 

What Is This? (CH3-CH2-OH)

Ethanol : 

Ethanol C H H H OH Ethyl Alcohol C H H

Methanol : 

Methanol C H H H OH Methyl Alcohol

Historical Development : 

Beer 10,000 years ago – accident from grain? 1100 AD guild formed devoted to brewing 1722 – a nourishing drink for potters and laborers created called Potter Wine 8,000 years ago – 5,000 years ago the vineyards 2,000 BC - Hammurabi ruler of Babylon sets rules for the sale and purchase of wine 1,500 BC Greek god of wine – Dionysus / Bacchus Historical Development

Historical Awareness : 

Alcohol Alchemist of the 16th century saw alcohol as the essence from distillation. The middle of the 18th century alcohol took on its current meaning of the intoxicating ingredient of many common beverages. Historical Awareness

Ancient Awareness : 

"You will conceive and bear a son…now then be careful to take no wine or strong drink and to eat nothing unclean". Bible - Judges 13:3-4 Ancient Awareness

Historical Perspective : 

’T is not the drinking that is to be blamed, but the excess. John Selden (1584–1654) In “Table Talk” 1689 Historical Perspective

Current Views : 

“Alcohol is the number one drug of choice among our Nation’s youth. Yet the seriousness of this issue does not register with the general public or policymakers.” Enoch Gordis, M.D. Director, National Institute on Alcohol Abuse and Alcoholism. Current Views

Production of Alcohol : 

Production of Alcohol Fermentation – Sugar to Alcohol and Carbon dioxide C6H12O6? 2(CH3-CH2-OH) + 2CO2

Some Current Facts : 

7.4% of adult population in U.S. alcoholic $185 Billion – cost of alcohol abuse in U.S. 100,000 deaths annual in U.S. related to $1.2 Billion spent on wine, beer and liquor advertisements in U.S. Some Current Facts

Fetal Alcohol Syndrome (FAS) : 

Fetal Alcohol Syndrome (FAS) Most common preventable cause of adverse CNS development 4,000-12,000 infants per year in US Characteristics Growth retardation Facial malformations Small head Greatly reduce intelligence

Fetal Alcohol Syndrome (FAS) : 

Fetal Alcohol Syndrome (FAS) 1 to 3 births per 1,000 world wide?? 1968 first association by French researchers at the University of Nantes Early 1970’s FAS as condition – University of Washington, Seattle WA, USA 4,000-12,000 infants per year in US

Fetal Alcohol Effect (FAE) : 

Fetal Alcohol Effect (FAE) Milder form of FAS 7,000-36,000 infants per year in US Characteristics Growth deficiency Learning dysfunction Nervous systems disabilities

Effects of Prenatal Alcohol : 

Effects of Prenatal Alcohol

Effects of Prenatal Alcohol : 

Effects of Prenatal Alcohol

FAS Child : 

FAS Child (National Geographic, George Steinmetz, Feb 1992)

Mouse – Scanning EM : 

Mouse – Scanning EM (National Geographic, George Steinmetz, Feb 1992)

Consumption : 

Consumption Have you ever drank alcohol? Why? Have you ever drank too much alcohol?

Health Effects : 

Health Effects What are the pleasant effects of alcohol? The adverse effects (toxicity)?

Acute Effects : 

CNS Depressant Depression of inhibitory control Vasodilation, warm, flushed, reddish skin Emotional outbursts Decreased memory & concentration Poor judgment Decreased reflexes Decreased sexual response Acute Effects

Long Term Adverse Effects : 

Obvious Alcoholism, death, cancer (oral cavity, esophagus, liver), fetal effects (FAS) Alcoholism Cirrhosis of liver, appetite loss, poor judgment Subtle Lost productivity, impaired performance, motor impairment, cost to society Long Term Adverse Effects

Alcohol & Cancer : 

Alcohol & Cancer Ethanol consumption increases risk of cancer Oral Cavity Pharynx and Larynx Esophagus Liver

Absorption : 

Rapidly absorbed from stomach, small intestine, and colon Maximal blood concentration within 30 to 90 minutes Can be absorbed through the lungs Absorption

Distribution : 

Uniformly distributed throughout tissues and body fluids Readily crosses placenta, to exposure fetus Distribution

Elimination : 

Urinary Excretion Exhalation Metabolism Elimination

Metabolism I : 

Metabolism I C H OH Ethanol H H C H H C H H H C O H = Acetaldehyde (ADH – Alcohol Dehydrogenase) ADH

Metabolism II : 

Metabolism II C H H H C O H = Acetaldehyde (ALDH – Acetaldehyde Dehydrogenase) ALDH Acetate C H H H C O OH =

Metabolism III : 

Metabolism III 80-90% Metabolized Rate is constant (not increased by concentrations in the blood) About 30 ml (1 oz) in 3 hours

Gender Differences : 

Gender Differences Females higher blood alcohol levels than males Males have higher stomach metabolism of alcohol than females

Genetic Variation in ALDH : 

Genetic Variation in ALDH Acetaldehyde Dehydrogenase (ALDH) varies in Caucasians, Blacks and Asians. 50% of Asians have inactive ALDH Elevated acetaldehyde cause increased flushing, tachycardia (elevated heart rate), nausea, vomiting & hyperventilation. Disulfiram – inhibits ALDH

Alcoholism - Disulfiram : 

Alcoholism - Disulfiram Alcoholism Treatment with Disulfiram Inhibits acetaldehyde dehydrogenase (ALDH) Elevated acetaldehyde cause increased flushing, tachycardia (elevated heart rate), nausea, vomiting & hyperventilation.

Alcoholism – Alcohol Dependence : 

Alcoholism – Alcohol Dependence Characterized by the following: Craving: A strong need, or compulsion, to drink. Loss of control: The inability to limit one’s drinking on any given occasion. Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking. Tolerance: The need to drink greater amounts of alcohol in order to “get high.” (from: U.S. Alcohol & Drug Information - http://ncadi.samhsa.gov/)

Alcoholism – Alcohol Dependence : 

Alcoholism – Alcohol Dependence Approximately 14 million Americans—7.4 percent of the population —meet the diagnostic criteria for alcohol abuse or alcoholism (from: U.S. Alcohol & Drug Information - http://ncadi.samhsa.gov/)

Alcohol Withdrawal Effects : 

Tremor Nausea Irritability Agitation Tachycardia Hypertension Seizers Hallucinations Alcohol Withdrawal Effects

Ethanol as Antidote : 

Ethanol as Antidote Antidote for Poisoning by: Methanol Ethylene glycol Diethylene glycol Inhibits metabolic activation by alcohol dehydrogenase (ADH)

U.S. Government Warning : 

U.S. Government Warning The Alcoholic Beverage Labeling Act of 1988 requires that the following health warning statement appear on the labels of all containers of alcohol beverages offered for sale or distribution in the United States: U.S. GOVERNMENT WARNING: (1) According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects. (2) Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery, and may cause health problems.

Regulatory Status : 

1981 - U.S. Surgeon General first advised that women should not drink alcoholic beverages during pregnancy. 1988 - U.S. requires warning labels on all alcoholic beverages sold in the United States. 1990 - U.S. Dietary Guidelines state that women who are pregnant or planning to become pregnant should not drink alcohol. 1998 - 19 states require the posting of alcohol health warning signs where alcoholic beverages are sold Regulatory Status