I. Alcohol

Objectives:

  1. Alcohol defined as ethanol.
  2. Pathways of alcohol.
  3. Alcohol affects major organs of the body.
  4. Describe BAC.
  5. Identify interactions of alcohol with common over-the-counter drugs.

Alcohol is produced by yeast cells acting upon carbohydrates in fruits and grains.  It mixes quickly and easily with water and is also referred to chemically as ethanol or ethyl alcohol, which is the agent in all beverage alcohol. Alcohol is a depressant, not a stimulant, a drug that decreases the activity of the central nervous system and lowers the level of activity of many body functions.  Alcoholismis the disease of being addicted to the depressing effects of ethanol.

Pathways of Alcohol

Alcohol enters the body through the mouth/throat.  It then enters the stomach where 20-25% is absorbed.  Absorption takes place slowly, even though it requires no digestion.  The intestines rapidly and completely absorb remainder of alcohol, moving it through the larger blood vessels to the liver.  The liver then mixed with blood from the hepatic artery; some metabolized in the bloodstream each time it passes through, but the part that remains in the blood continues to affect other organs as the blood circulates through the body.  The liver works on alcohol first and just accumulates the fat in foods until it has eliminated the alcohol. The right side of the heart is affected first, then the left side, as the blood circulates the alcohol through the body.  The lungs respiration can be affected as the blood circulates through them.  The brain is the most influenced by alcohol in the blood.  Alcohol in the blood reaches the brain within minutes after it is consumed.

Alcohol is eliminated from the body:

  • Lungs and kidneys:  About 10% is eliminated through the breath and urine, saliva, and sweat.
  • Liver:  About 90% is broken down here at a rate of about ½ ounce every hour.

 These affects of alcohol will affect a person’s ability to drive a motor vehicle:  reduces the ability to judge speeds, distances and angles, encourages the driver to take foolish risks, break laws, makes the driver forget to fasten a seatbelt, turn on headlights, use turn signals, observe stop signs, slows reaction time in stopping and turning, limits vision, eyes become blurred, can’t focus, reduces ability to judge one’s own condition, causes sleepiness, increases anger toward other drivers.

The severity of these effects depends largely on blood alcohol concentration(BAC), a measurement of the level of alcohol in the bloodstream see table 1.  The BAC is measured in milligrams of alcohol per 100 milliliters of blood, or milligrams percent.  For instance, a BAC of .10% means of concentration of one drop of alcohol per 1,000 drops of blood.  BAC levels may be determined by taking a blood sample to measure the alcohol concentration.  A second method is to measure the concentration of alcohol in expired air (breath), using a Breathalyzer device.  Approximately 2% of alcohol ingested is excreted directly in the breath.  Because this rate is so constant, the amount of alcohol in the blood stream can be approximated by measuring the amount of alcohol present in a sample of expired air from the lungs. 

BAC levels are affected by food:  Eating food while drinking alcohol slows down absorption by delaying the opening of the stomach.  Eating a meal before drinking may reduce the peak alcohol level by as much as 50%.  The best foods to consume are fatty foods and those high in protein rather than foods high in carbohydrates. 

Rate of absorption of alcohol:   This happens at a rate of 1/2 oz. per hour for the average man.  This translates to a 12 oz beer, a 5-6 oz glass of wine, 1 1/4 oz of 80 proof whiskey that can be metabolized or eliminated per hour.

TIME IS THE ONLY REAL FACTOR THAT REDUCES INTOXICATION.

Table 1: Blood Alcohol Concentration and its Effects for 150 pound male
Drinks               BAC (Percent)                    Effects Per Hour                                            
2 to 3                0.05                                Louder, more outgoing
4 to 5                0.10                                Judgment affected  
8                      0.20                                Appears drunk, reaction time/coordination affected
12                      0.30                                 Can’t walk, can’t button coat, may fall asleep at bar
Beyond this could result in much more severe medical problems including coma or death

*1 drink = 0.6 ounces (17.7 ml) of ethanol = 1 1/4 ounces of 80 proof liquor = 6 ounces of wine = 12 ounces of beer. 

Effects On Target Organs

BRAIN: Reaches into and depresses certain areas of the brain.  Added drinks reach deeper knocking out control centers one by one.  Sequence is:  1. judgment and inhibitions 2. Reaction time and coordination 3. Vision, speech, balance, 4. Walking and standing 5. Consciousness 6. Breathing and heartbeat 7. Life

EYES: Eye muscles relax, making it difficult to focus. The result can be blurred vision. In large amounts, alcohol can reduce the ability to see to the right and left.

PANCREAS: Pancreas lining can swell, which can block the passage to the small intestine. Chemicals needed in the small intestine to aid digestion cannot get through. The chemicals begin to digest the pancreas itself, causing pain, vomiting, and possible death.

LIVER: The liver changes alcohol to water, carbon dioxide and energy (oxidation). About one ounce of alcohol an hour is oxidized. Until the liver has time to oxidize all the alcohol, it keeps passing through all parts of the body. Over a period of time the liver becomes swollen and tender, which can keep the liver from working properly and bring on diseases that can kill. An alcohol-damaged liver can also reduce the production of substances that clot blood and help stop bleeding. 

*Approximate Blood Alcohol Percentage In One Hour
**This chart is only a guide. Reactions to alcohol will vary depending upon such factors as
food in the stomach, medications, mood, and fatigue.

Alcohol and other medications:

Mixing alcohol with other drugs can produce dangerous side effects.  It is especially dangerous to drive under the influence of alcohol and other drugs because of the increased impairment due to both.  Mixing alcohol with other depressants dangerously increases the depressant effect on the body.  Alone many prescription and nonprescription drugs impair the ability to drive a motor vehicle. 

The effects of common types of alcohol and drug interaction: 

Minor pain remedies (aspirin and Tylenol) Aspirin are gastric irritants with alcohol can result in gastric hemorrhage.  Tylenol can be toxic to the liver in large doses and can result in liver damage when combined with alcohol.

Antidepressants:  Alcohol may either counteract the drug’s effect or enhance it, depending upon the particular drug; results could be severe in some cases.

Opiates (morphine, heroin, codeine) When mixed with alcohol all are sedatives and may increase each other’s depressant effects.  

Barbiturates:  Alcohol and barbiturates potentate each other and coma or respiratory arrest may occur at doses of each drug in combination that would not be fatal for either drug taken alone.

Stimulants (caffeine, nicotine, amphetamines, cocaine):   The behavioral effects of alcohol and stimulant combinations are unpredictable, but the impairments in judgment associated with either alcohol or stimulant intoxication are likely to be enhanced by their combined use. Stimulants do not cancel the intoxication and impairment due to alcohol. 

GHB:  (Liquid ecstasy). It is colorless, odorless liquid.  Life threatening and acute effects are potentiated by alcohol and other drugs. 

 Rohypnol:  (Date rape drug) Produces near-universal amnesia of events while under the influence when taken with alcohol, and makes some users fearless and aggressive; hence its use as a date rape drug.

Anyone who drinks should check with a doctor or pharmacist about possible problems with drug and alcohol interactions.   It is especially dangerous to drive under the influence of alcohol and other drugs. 

Alcohol and Disease

Long-term use of alcohol damages the body. People who consume alcohol in large amounts and over long periods of time may be more likely than nonusers to suffer from high blood pressure and some forms of heart disease.

Cirrhosis develops from long term effects of alcohol on the liver.  Cirrhosis results in severe impairment of liver function and can be fatal.

Children born to women who drink during pregnancy may suffer from fetal alcohol syndrome (FAS), a condition that can cause physical and mental disabilities in newborn babies. Immediate effects of FAS are low birth weight, below-average length, cleft palate, general weakness, and heart defects. The long-term effects include lack of coordination, slow growth, and learning difficulties due to mental retardation, weak attention span, and hyperactivity.

Summary:

  1. The best foods to consume are fatty foods and those high in protein rather than foods high in carbohydrates. 
  2. Mixing alcohol with other drugs can produce dangerous side effects. It is especially dangerous to drive under the influence of alcohol and other drugs because of the increased impairment due to both.
  3. Mixing alcohol with other depressants dangerously increases the depressant effect on the body.
  4. Stimulants do not cancel the intoxication and impairment due to alcohol.
  5. Time is the only real factor that reduces the effect of alcohol.