Chapter 8 Summary

Summary
What Makes an Alcoholic Beverage?

• Drinkable alcohol is obtained from the fermentation of sugar in some natural products such as grapes, apples, honey, or molasses. The result is some form of wine. • Beer is obtained from barley, after the starch has first been converted into sugar, fermented along with other grains and hops, and aged. • To obtain very strong alcoholic beverages, it is necessary to boil the fermented liquid and condense it later ~--bfcooling. This process, called distillation, results in alcohol concentrations of up to 95 percent, and the products are known as distilled spirits or liquors.
Alcohol Use through History • The history of alcohol use dates back many thousands of years; the process of fermentation is very simple, and its discovery was probably accidental. • Distillation techniques were perfected during the Middle Ages, with brandy being the first distilled spirit. In later centuries, gin gained popularity in Europe, as did whiskey in the United States. • Serious concern about the adverse consequences of alcohol consumption arose in the late 1700s and took root in the United States as a temperance movement. This movement addressed primarily the drinking of distilled spirits. • The differentiation among forms of alcohol drinking became blurred during the nineteenth century, as temperance advocates began to promote a total ban on alcohol consumption. National Prohibition was the law in the United States from 1920 to 1933. • Since the end of Prohibition, government regulation has been carried out chiefly through education and the taxation of alcohol. Patterns of Alcohol Consumption Today • The demographics of alcohol consumption reveal a large disparity in the drinking habits of the population. About a third do not drink at all, and only about 30 percent of those who drink account for 80 percent of all the alcoholic beverages consumed in the United States. • Peak alcohol consumption occurs at ages t\venty-one to 1:\venty-\:\vo. The Pharmacology of Alcohol • Alcohol is a very small molecule, eas ily soluble in both water and fat. Its absorption into the bloodstream

is extremely rapid. The breakdown of alcohol is handled by two special enzymes in the stomach and liver. • The rate of alcohol biodegradation is constant, so alcohol can leave the body only at a specific pace, no matter what the quantity taken in. • The effective level of alcohol in the body is measured by the blood-alcohol concentration (BAC) level, which adjusts for differences in body weight and the time since ingestion of the last alcoholic beverage.
Effects of Alcohol on the Brain

• Although alcohol affects several neurotransmitters in the brain, it is presently agreed that the principal effect is stimulation of the GABA receptor. • Generally, the neural effect of alcohol proceeds downward, beginning with inhibition of the cerebral cortex, then that of lower brain regions. Inhibition of respiratory systems in the medulla, usually accomplished at BAC levels in the neighborhood of 0.50 percent, results in asphyxiation and death.
Acute Physiological Effects • Alcohol at very high levels produces life-threatening consequences and at moderate levels produces a loss of body heat, increased excretion of water, an increase in heart rate and constriction of coronary arteries, disturbed patterns of sleep, and serious interactions with other drugs. Acute Behavioral Effects

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• On a behavioral level, serious adverse effects include blackouts, significant impairment in sensorimotor skills such as driving an automobile, and an increased potential for aggressive or violent acts. Particular attention has been directed toward these problems within a college student population, • The relationship benveen alcohol consumption and sexual desire and performance is a complex one, with differences being observed for men and women.
Alcohol and Health Benefits

• The accumulated evidence of medical research has indicated that there is a reduced risk for coronary heart disease and stroke with moderate consumption of alcohol. Possible health benefits include a reduction of risk for diabetes, dementia, and rheumatoid arthritis.

Chapter a

Alcohol: Social Beverage/Social Drug

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• Moderate alcohol consumption has been defined as no more than one drink per day for women and no more than two drinks per day for men . There should be zero tolerance for alcohol consumption among pregnant women.

Strategies for Responsible Drinking

• Despite the potential for alcohol consumption to produce adverse effects, most people can drink alcohol in a responsible way that avoids these harmful consequences. However, the risk of alcohol dependence is always present.

Key Terms acetaldehyde, p. 202 acetaldehyde dehydrogenase,p. 202 aceti c acid, p. 202 alcohol dehydrogenase,
p. 202

antidiuresis, p. 206

antidiuretic hormone (ADH ), p. 206 aqua vitae, p. 194 balanced placebo design , p. 210 barley malt, p. 193 blackout, p. 208

blood-alcohol concentration (BAC), p. 203 brewing, p. 192 congeners, p. 207 distillation, p. 193 distilled spirits, p. 194 ethyl alcohol, p. 192

fermentation, p. 192 mash, p. 193 oxidation, p. 202 temperance movement, p. 195

Endnotes
l. Pinel, John P. J. (2003 ). Biopsychology (5th ed.). Boston: Allyn and Bacon, p. 38 1. 2. Warren , Kenneth R., and Hewitt, Brenda G. (2010). NIAAA: Advancing alcohol research for 40 years. Alcohol Research and Health, 33 , 5-1 7. 3. Gibbons, Boyd (199 2, February). Alcohol: The legal drug. National Geogra phic Magazine, pp. 2-35. McGovern, Patrick E. ; Glusker, Donald L. ; Exner, Lawrence J. ; and Voigt, Mary M . (1996). Neolithic resinated wine. Nature, 38 1, 480-48 1. Roueche, Berton (1963). Alcohol in human culture. In Salvatore P. Lucia (Ed.), Alcohol and civilization. N ew York: McGraw-Hill, pp . 167-1 82. Vallee, Bert L. ( 1998, June) . Alcohol in the western world . Scientific American, pp. 80-85. 4. Sournia, Jean-C harles ( 1990). A history of alcoholism. Cambridge, MA: Basil Blackwell, pp. 14-50. U.S. Department of Health , Edu cation, and Welfare ( 1978) .
10. Lender, Mark E., and Martin, James R. (1 982). Drinking in America: A history. New York: Free Press, p. 107. Okrent, Daniel (2010). Last call: The rise and fall of Prohibition . New York: Scribner. 11. Blocker, JackS. (2006, February) . Did Prohibition really work? Alcohol prohibition as a public health innovation. American Journal of Public Health, pp. 233-24 3. Lerner, Michael A. (2007) . Dry Manhattan. C ambridge, MA: Harvard University Press. Musto, David F. (1996, April ). Alcohol in American history. Scientific American, pp. 78- 83. Sournia, History of alcoholism, p. 122. 12. Alcohol and Tobacco Tax and Trade Bureau, U.S. Department of the Treasury, Washington, DC . U.S. D epartment of Health and Human Services (2000). Alcohol and health (Tenth Special Report to the U.S. Congress) . Rockville, MD: National Institute on Alcohol Abuse and Alcoholism, p. 370 . Industry Surveys ( 1997, September 11 ). Alcoholic beverages and tobacco, p. 16. 13 . U.S. D epartment of Health and Human Services (2000). Alcohol and health, pp. 341-354. / 14. G ibbons, Alcohol, p. 7. 15 . Garfield, C raig F. ; C hung, Paul J. ; and Rathouz, Paul J. (2003 ). Alcohol adve rtising in magazines and adolescent reade rship. Journal of the American Medical Association, 289, 2424-2429. Hanson , Glen R., and Li, Ting-Kai (2003 ). Public health implications of excessive alcohol consumption. Journal of the American Medical Association, 289, 1031- 1032. National Association of C onvenience Stores (2008). T hat's the spirit- U.S . alcohol sales growing. www.nacsonline.com. US top five beer companies ranked by prime-time network television advertising outlays in dollars with th e top three network TV programs ranked by beer ad expenditures. Adweek (200 3, April2l ), p. SR14.

Perspectives on the history of psychoactive substance use,
5. pp. 67- 75. Grimes, William (1993 ). Straight up or on the rocks: A cultural history of American drink. New York: Simon and Schuster, p. 36. Musto, David F. ( 1996, April ). Alcohol in American history. Scientific American, pp. 78- 83. Lender, Mark E. , and Martin, James K. (1982). Drinking in America: A history. New York: Free Press, pp . 13-14. First in war, peace- and hooch, by G eorge! (2000, D ecember 7) . Newsday, p. A86 . G rimes, Straight up, p. 51. Quoted in Sournia, Jean-C harles ( 1990) . A history of alcoholism. Cambridge, MA: Bas il Blackwell, p. 29. Lincoln, Abraham ( 184 211989). Address to th e Washingtonian Temperance Society of Springfield, Illinois. Speeches and writings, 1832-1 858 . New York: Library of America, p. 84.

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8. 9.

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Part Three

Legal Drugs in Our Society