Alcohol Facts

Accurate information about alcohol and alcohol problems is necessary for the public to get a true picture of what role alcohol plays in the health of the public. The following facts are based upon the scientific wisdom of the Center’s faculty members. For most, there are scientific references available. For others, the “facts” are the result of cumulative knowledge in the areas of addiction science and pharmacology.

To find information on a specific topic, please user our search function available on our home page.

Please note that the dates in parenthesis reflect the date in which the fact was first published on this site.

 *Copyright-protected. These sections cannot be printed or down-loaded without permission of the Director: Carlton Erickson, Director


 

  • 300. What are “alcopops”? Also known as “malternatives”, these are new hard lemonades and fruit-flavored malt beverages that are appealing to teenagers, some sources say. They have an alcohol content from 4-8%. There is some evidence that such beverages increase the amount consumed at each sitting, based upon their masking of the taste of hard alcohol, which might lead to more intoxication. Research on the level of use and consequences of these beverages is needed to make a determination of their value and dangers. (September 26, 2005)
  • 299. What is the market for medications to treat alcoholism? One source says 18 million people. But the NIAAA website states that alcoholism is “alcohol dependence”, a more specific definition, which at an estimated incidence of around 4% in the United States is approximately 11 million people who are alcohol dependent. Since the FDA is approving medications primarily for the treatment of alcohol dependent patients, the 18 million estimate is quite high. And the market is only as good as accessibility, which will be low until physicians appreciate that alcohol dependence is a disease that can be treated with prescription medications. (Sept. 19, 2005)
  • 298. Which brain neurotransmitter receptors are affected by alcohol? The easy answer is “most of them”, since ethanol affects most neurotransmitter systems. Recent research is focusing on glutamate, GABA, and NMDA brain receptors and how alcohol changes those receptors to produce its pharmacologic effects. Another recent study suggests that ethanol affects cannabis (i.e., for marijuana-like effects) binding sites, called CB1 receptors, in the brain. (September 12, 2005)
  • 297. A researcher recently commented on benzodiazepines (Valium, Xanax, etc) used for alcohol withdrawal: “unlike anticonvulsants — benzodiazepines have the potential to trigger relapse, and the interaction of benzodiazepine and alcohol can be fatal.” This mistaken impression is held by many who don’t understand the way benzodiazepines block potentially lethal withdrawal seizures during alcohol dependence treatment. Benzodiazepines are given carefully while alcohol levels are declining (not increasing), and giving these drugs therapeutically produces little likelihood of dependence. Then they are discontinued, so they have no potential to produce relapse, since the person is under treatment. Experience has shown that most patients never want to use benzodiazepines because of their exposure to them during detoxification. (September 5, 2005)
  • 296. Do women reduce or stop their consumption of alcohol during pregnancy? Most do, some don’t. Although a little research has implicated hormone and psychological changes as the reason why many women stop drinking during pregnancy, the exact percentage of those who do and why they do it is still unknown. Some women drink less, and a small percentage don’t reduce their drinking at all, suggesting they are dependent on alcohol and require intense intervention and treatment to reduce the harm to their babies. (August 29, 2005)
  • 295. There’s a popular drink in Holland and Belgium called “jenever” (“The Dutch National Drink”). It is a 38-50% distilled spirit, with over a hundred different flavors, which is drunk chilled, straight, or in various mixed drinks. It is similar to gin in other countries. Like other liquors, caution is advised because it is a smooth beverage and the effects are often felt after too much has been consumed. (August 22, 2005)
  • 294. Can alcohol increase stomach cancer? It has always made intuitive sense that because alcohol causes gastrointestinal irritation, particularly of the stomach and esophagus, that it might increase cancer risk. One study has suggested that acetaldehyde, the primary breakdown product of ethanol and a known carcinogen, does increase the incidence of upper gastrointestinal cancer. (August 15, 2005)
  • 293. Recently, the quality of research and the integrity of scientists have been questioned. For example, a report in the Journal of the American Medical Association stated that 16 percent of published studies were contradicted by later studies. In addition, another 16 percent of studies saw their findings weakened by subsequent discoveries. Although every professional field has its share of weak or shoddy workers (even medicine and law!), most published scientific studies are peer reviewed for quality control and represent merely steps along the path toward truth. It is reasonable for studies to contradict each other, since single findings are often not strong enough to form a solid, irrefutable conclusion. However, many studies over time will provide a clearer picture of whether a particular hypothesis has been proven or disproved. (August 8, 2005)
  • 292. About one-half to two-thirds of boating accidents are alcohol-related. Advertisements by the alcohol industry suggesting a “fun” relationship between alcohol and boating, therefore, are irresponsible. Although there is no direct evidence that alcohol advertising directly increases boating accidents, one could ask the question, “what is the value of such advertising, especially when the rate of alcohol-related boating accidents is so high?” (August 1, 2005)
  • 291. “I can’t be legally intoxicated because I only had two drinks!” This is a false statement often made by individuals who don’t understand alcohol pharmacology or who are trying to cover up the fact that they drank more than two drinks. What is a drink? One 12-ounce beer, one 5-ounce glass of wine, and one shot (1.5 ounces) of spirits are generally equivalent “beverage units”. Restaurants and bars, however, serve oversize or over-poured drinks, unless the drink comes pre-packaged (as in a bottle of beer). With wine, bars tend to give standard “doses” for a high price, to make money. With liquor, however, the more booze in a drink, the better it is! So be careful of two drinks – they may actually be three or four! (July 25, 2005)
  • 290. Is there a single question that can indicate unhealthy alcohol use? An interest among scientists and clinicians involves brief screening methods for problem drinking. One possibility is a question that asks about the frequency and amount of drinking. One question that seems to have high sensitivity and specificity is a question such as the following: “When was the last time you had more than X drinks in 1 day?” with X being 5 for men and 4 for women. An answer of “in the past three months” had a sensitivity of 85-82% and a specificity of %70-77 in men and women, respectively. There were similar findings when the question was asked face-to-face or by telephone. (July 18, 2005)
  • 289. A new federal report indicates that about 1 in three young adults (ages 21-25) have driven while under the influence of alcohol or other drugs. Is drinking and driving perceived to be so innocuous by young people, or are young people just risk takers? The continuing problem of youth drinking to excess and drinking and driving points out the fact that one generation cannot be targeted for prevention; rather, prevention and proper education are continuing efforts that require enormous work. Here’s a thought: why not make alcohol pharmacology a part of the science curriculum in elementary schools and teach it beginning as early as possible (first grade) and with new information added each year? (July 11, 2005)
  • 288. Can we find genes that cause alcoholism? The concept that a single or multiple gene(s) causes alcoholism is much more complex than we expected. The latest research on “genomics” is telling us that the interplay of several genes probably affects the risk of developing the disease. Some gene sequences will greatly enhance the risk of becoming alcohol dependent, while other sequences will only somewhat enhance the risk. Other sequences may somewhat lower the risk of developing the disease. (July 4, 2005)
  • 287. Naltrexone and acamprosate are two medications that help alcohol dependent patients reduce their craving for alcohol. Both of these drugs are approved for treatment, and their best use is that they reduce relapse in abstinence-based treatment programs. Naltrexone works through the endorphin system of the brain, whereas acamprosate works through the GABA/glutamate system. (June 27, 2005)
  • 286. Do alcohol ads promote underage drinking and binge drinking? Available research says “yes”, but this is a difficult phenomenon to study. With so many influences on youth, there may not be a direct causal effect of advertising on drinking. How do we know that the family, life stressors, or risk-taking behavior of underage people doesn’t promote drinking? To say that an advertisement promotes binge drinking is pretty difficult. On the other hand, if the ads have no influence, why are they there (billboards, subways, television)? If the alcohol industry is truly attempting to promote brand sales and loyalty, then does this have to be done where American youth can see such ads? (June 20, 2005)
  • 285. Does alcohol increase the risk of some types of cancer? Alcohol does seem to somewhat increase the risk of breast cancer, and oral, gastric, and intestinal cancers might also be facilitated by the drug. Interestingly, a recent review of several existing studies suggests that people who drink alcohol have a 27-percent lower risk of contracting non-Hodgkin’s lymphoma than non-drinkers. The complex effects of alcohol, including types of beverages, concentration and amount of alcohol consumed, interacting with genetic factors in the causes of cancer still require much more research for a final answer. (June 13, 2005)
  • 284. What? A powdered alcohol product? A powdered alcohol drink (called “subyou”) is sold in Germany and allegedly contains 4.8 per cent alcohol by volume. Packets are sold in gas stations, convenience stores, and bars. Whether such products will be popular is yet to be seen. A similar powdered product was available in the U.S. about 30 years ago and never caught on. (June 6, 2005)
  • 283. The World Health Organization (WHO) is beginning a worldwide study on alcohol use. A recent WHO report has stated that drinking causes at least 1.8 million deaths a year, or 4% of all worldwide deaths. “Public-health problems associated with alcohol consumption have reached alarming proportions and alcohol has become one of the most important risks to health globally,” the report said. (May 30, 2005)
  • 282. Are designated driver programs effective? Designating one person in a group of drinkers to be the sober driver for the evening sounds like a good idea. However, according to a report from the U.S. Task Force on Community Preventive Services, there is little evidence that such programs reduce drunk driving and alcohol-related crashes. Apparently few designated drivers actually abstain from drinking. In some cases, the least-intoxicated person is chosen to be the driver, which defeats the purpose of the program. (May 23, 2005)
  • 281. Disulfiram (Antabuse), a medication used for the reduction of “alcoholism”, is being used in clinical studies for the treatment of cocaine dependence. What possible reason would cause scientists to treat cocaine dependence with Antabuse? There is some (old) evidence that Antabuse affects dopamine function in the body, and cocaine is known to affect dopamine levels in cell synapses in the brain. It’s worth trying, since there is really no “magic bullet” for helping cocaine dependent patients. (May 16, 2005)
  • 280. A sustained release form of naltrexone is in clinical trials. Naltrexone is a medicine that reduces the possibility of relapse in alcohol dependent patients who are in abstinence-based treatment. The sustained release form is useful because one dose lasts about a month, thus increasing compliance in patients who might forget (or don’t want) to take a tablet every day. (May 9, 2005)
  • 279. Can reducing the supply of alcohol reduce drunk-driving deaths? Of course! There is plenty of research to suggest that this reasonable approach can have a positive outcome. The question is, does this work at the community level? And how does a community make this happen? Recent interesting research suggests that comprehensive, community-wide efforts in this area are effective. The next question becomes, how can the government motivate communities all across the nation implement such programs? (May 2, 2005)
  • 278. What, exactly, is binge drinking? Binge drinking is episodic drinking, meaning that people can consume a large number of drinks in a short period of time. Some researchers have defined “large number” as five drinks in a sitting. But is it binge drinking if a person drinks 40 bottles of beer in a 12-hour period? What about the person who drinks at a constant rate for three days during an outdoor festival, and then never drinks again for two weeks? Is this binge drinking or “alcoholism”? What about the person who drinks five drinks a day for a week while on a Caribbean vacation? It seems as if the definition of binge drinking needs clarification. (April 25, 2005)
  • 277. At what point will a drinking person be unable to safely drive a motor vehicle? While state laws set the blood alcohol content (BAC) limit at 0.08%, there is evidence that lower BACs can also affect driving skills. For example, there are some older British studies indicating that 0.04% can negatively affect driving skills. Add to this that everyone has a somewhat different response to alcohol, and we conclude that some people’s driving can be affected by low BACs, whereas other people are not significantly affected until their BAC reaches a higher level. States have set fixed limits, which is the statistical way of saying that most people will be impaired above a certain BAC. Wouldn’t it be nice if we could determine how sensitive every person is to alcohol, before they make a decision to drive? (April 18, 2005)
  • 276. Does drinking alcohol increase the quantity and quality of breast milk? This is another of the many myths that seem to be part of our folklore. Recent interesting studies indicate that drinking alcohol can actually reduce the quantity of breast milk, since alcohol affects the release of oxytocin and prolactin, two hormones involved in the production of milk. This doesn’t mean that nursing mothers shouldn’t drink at all, but should be careful, since some women are more affected by alcohol than others. (April 11, 2005)
  • 275. A recent study indicates that people with a variant of the DRD2 gene (a gene associated with dopamine function in the brain) may be more prone to receive pleasure from drinking. The implication is that people with this gene might drink more than people without the variant. Does this mean the gene variant may be the cause of alcohol dependence? No, since this gene merely relates to the pleasure associated with drinking, which is not the same as the genetic cause of alcohol dependence. (April 4, 2005)
  • 274. Think that medical personnel have the highest rate of alcohol problems? Not according to an interesting new survey that uses the Alcohol Cost Calculator. The highest likely number of problem drinkers (alcohol abusers and alcohol dependent employees) are in the mining and construction fields, with wholesale and retail employees next. In contrast, in government agencies and professional services such as law, medicine, and architecture, there is a much smaller percentage of workers with alcohol problems. (March 28, 2005)
  • 273. According to one study, malt-liquor drinkers are more likely to be homeless, unemployed, or receiving public assistance than those who drink other alcoholic beverages. The study also concluded that malt-liquor drinkers consumed more alcohol than other drinkers, in part because malt liquor has a higher alcohol content than beer and is sold in larger containers. (March 21, 2005)
  • 272. When state and federal budgets become tight, legislators look for ways to raise money. What better way than to increase taxes on cigarettes and alcohol (formerly called a “sin tax”)? Good studies indicate that raising taxes on these “addictive” substances does tend to lower the use of these products, especially among young people. Do increased taxes reduce dependence on these drugs? Not among those who already have the disease. (March 14, 2005)
  • 271. People observe that “drinking declines with age”. Why might this happen? First, alcohol misusers find as they get older that large amounts of alcohol are not as pleasurable as they used to be, and such amounts tend to cause more troublesome physical and mental effects. Thus abusers tend to moderate their drinking. In addition, alcohol dependent people are often in recovery at older ages. Is there much research on this topic? Not nearly enough. (March 7, 2005)
  • 270. How does alcohol cause death? Overdoses (leading to respiratory failure), drowning, drunk driving crashes, homicides, suicides, fire deaths, firearms accidents, and unintentional falls are ways in which alcohol is involved in deaths. According to a recent study, the risk of drowning is especially high in drinkers, over 3.5 times that of nondrinkers. (February 28, 2005)
  • 269. Does binge-drinking damage the brain? It is well-known that the brain is damaged by long-term, heavy drinking, as in older people who are alcohol dependent or heavy drinkers. It is less clear whether binge-drinking can damage the brain. A few studies have shown that binges of alcohol exposure in young animals can damage nerve cells. There is almost no direct evidence that this happens in humans. Such studies could be performed by brain imaging methods and are badly needed. (February 21, 2005)
  • 268. Recent binge-drinking deaths have highlighted the need for universities to find ways to reduce the often out-of-control drinking practices of college students. While binge-drinking is often considered a “right of passage” for college students, and restaurants and bars have a right to make a buck, at some point policy makers will have to make a decision about whether the consequences of heavy drinking are worth maintaining the status quo. In the meantime, alcohol manufacturers continue to pore lots of money into university athletic coffers through commercials and advertising during televised sports events. (February 14, 2005)
  • 267. A recent government study indicates that more than one in three people who have been alcohol dependent are now in recovery. This is surprising in light of the scarcity of formal treatment for alcohol dependence, and may be due to the effectiveness of twelve-step programs. (February 7, 2005)
  • 266. Are low calorie spirits less fattening and less “addicting”? A new low-calorie rum is designed to be to regular rum what light beers are to regular beers. Low-calorie rum would contain a different flavoring agent and only about 18% alcohol. It is clear that this “light rum” will probably boost rum sales, but such a beverage will also appeal to younger people. In addition, people will think they can drink more without gaining weight and with a reduced chance of alcohol abuse and “addiction”. In actuality, consumers will neither lose weight nor reduce the chances of alcohol dependence. (January 31, 2005)
  • 265. Is a person who drinks in the morning an alcoholic? Although most experts agree that an “eye opener” in the morning is a sign of alcoholism, this is not always true. What about the person who enjoys a Bloody Mary or Screwdriver in the morning while on vacation? What about the “graveyard shift” laborer who gets off work at 7 am and has a drink before going home to sleep for the day? What about a Mimosa (orange juice and champagne) the first morning of the honeymoon? Taken alone, these instances do not indicate alcohol dependence. Combined with other signs and symptoms of heavy drinking, these drinking episodes might be much more meaningful. (January 24, 2005)
  • 264. There are new hangover remedies available in pharmacies. Are these effective? No, these products are simply a waste of money, since controlled studies showing they are more effective than placebos (sugar pills) have not been done. Everyone has a favorite hangover remedy, and each one works based upon individual superstition. But there is nothing on the market that will overcome a hangover anymore than some herbal remedies will slow the aging process. Beware of those people who want to take your money! (January 17, 2005)
  • 263. What role do acetate and acetaldehyde (break-down products of alcohol) play in the production of “alcoholism” (alcohol dependence)? Very little, according to available research. Old ideas that acetaldehyde is a poison that leads to organ damage and perhaps brain damage, and that the rate at which acetaldehyde turns to acetate in the brain influences the onset of alcoholism, have not been substantiated by science. (January 10, 2005)
  • 262. Which is more “addictive”–alcohol or marijuana? According to available figures, about 10-12% of people who drink will become dependent on alcohol. The same source indicates that about 9% of people who smoke marijuana on a regular basis will become dependent on the drug. Both of these drugs are less “addicting” than others such as cocaine (~17%), heroin (~23%), and nicotine (~32%). But “addiction” is not the only factor in the use of these drugs–intoxication outcomes, lethality, and social consequences are also important. (January 3, 2005)
  • 261. A drug interaction can occur when beverage alcohol is mixed with cough medicines containing dextromethorphan, a mild opioid cough suppressant. The major interactive effect is one of increased depression leading to drowsiness and sleep. This interaction is significant in some people but not evident in other people, and there is no certain way to predict who will have the interaction and who will not. (December 27, 2004)
  • 260. A new animal study suggests that a brain chemical (called galanin) increases the tendency to overeat and is also linked to increased alcohol consumption. According to this research, galanin produces a “positive feedback loop” that increases craving for food and alcohol. (December 20, 2004)
  • 259. At least one major American university has recently banned alcohol in all frat houses and residences, in response to student alcohol overdose deaths. This, coupled with increased educational programs on campus, is part of the solution. But until young people are taught, at a very early age, to respect alcohol (and other drugs) for the danger that they can produce, college drinking and drugging will continue. (December 13, 2004)
  • 258. What causes a “beer belly”? According to a recent study by the Center for Alcohol Research in Denmark, people who drink large amounts of alcohol in one or two sittings are more likely to be apple-shaped. So is it beer, and is it binge-drinking? Actually, it’s more likely to be a combination of genetics and environment (for example, all types of alcoholic beverages, drinking patterns, nutrition, etc.). This is a very difficulty phenomenon to explain. (December 6, 2004)
  • 257. Can alcohol cause diabetes? We first have to recall that there are two types of diabetes: Type 1 and Type 2. Type 1 is a more severe type that appears to be an autoimmune disease where the body tries to reject the pancreas. Therefore the ability of the pancreas to produce insulin is greatly reduced or absent. Type 2 has more to do with obesity, inadequate exercise, or excessive sugar intake. There is some indication that heavy drinking can elevate fasting blood glucose levels, but whether alcohol causes this type 2 diabetes is still open to question. It is not likely that alcohol causes Type 1 diabetes. (November 29, 2004)
  • 256. Fast cars and booze are never a good combination. NASCAR’s recent decision, after dissociating themselves from tobacco advertising last year, to allow distilled spirits advertising on their cars, is puzzling. Some would say this sends a mixed message about drinking and driving to Americans, especially young people. Even more serious is that NASCAR’s website sells model cars with booze advertising on them. Is this another example of putting profits over public health? (November 22, 2004)
  • 255. Some recent animal research suggests that brain cells destroyed by long-time exposure to alcohol can be reversed when the animal (human?) is abstinent from alcohol for awhile. This finding seems to fly in the face of long-held beliefs that brain cells, once destroyed, cannot live again. But the excitement of research is that old beliefs can be wrong. We know by experience that sober alcoholics do get better in their cognitive function and memory, and brain scans even indicate that their brains begin to return to normal over time. The challenge now is to determine how much recovery occurs and how long it takes, and whether some people are immune to such recovery. (November 15, 2004)
  • 254. Recent student deaths related to alcohol have gotten some university administrators’ attention. Not all the deaths were related to alcohol overdose. Some were due to falls and other accidents associated with high consumption. It is critical that students receive some training on what alcohol can do pharmacologically, as well as what it can’t do. It is amazing that some students still do not know that alcohol can produce death via overdose. Wouldn’t a required campus course on basic effects of alcohol and other drugs be appropriate for all institutions of higher learning? (November 8, 2004)
  • 253. A recent trend is for more emergency room doctors to be screening patients for alcohol problems. This follows a lot of good research indicating that people showing up in emergency rooms are not only involved in alcohol-related incidents, but that at the time of injury they are more amendable to intervention about drinking problems. Society needs more opportunities such as this for physicians to be involved in reducing alcohol abuse and dependence. (November 1, 2004)
  • 252. Britain’s brewery giant Scottish & Newcastle (Kronenbourg and Foster brands) and Coors, maker of Carling Lager, are addressing binge drinking by voluntarily placing health warnings on their beer bottles. Next question: Why can’t brewers, wineries, and distillers around the world (including the U.S.) do the same? (October 25, 2004)
  • 251. A U.S. brewer recently launched a new caffeine-containing beer flavored with ginseng and fruit flavors. Why? Their reason is to “gain a larger market share of beer drinkers”. However, a case could be made that young people will look at this product as a way to drink more beer and remain alert, thereby falsely believing they can drink more before driving home. And how do we know whether the flavored beers might not entice even younger drinkers? Unfortunately, no studies have been done on the long-term demographics of drinkers of such beverages. But why have such research anyway? Brewers will make more money, which is the main reason for new products. (October 18, 2004)
  • 250. Recent alcohol overdose deaths have prompted university officials to take another look at alcohol use/availability on college campuses.Duh! Hasn’t alcohol always been a part of college life? The real challenge is to convince college students that alcohol can cause death! Amazingly, most college students do not realize the dangers of alcohol. Why is it so difficult to get a basic alcohol pharmacology course approved in university curricula? (The answer is: kids will be kids; I got through college while drinking, so my kids can; alcohol is not really that dangerous; beverage producers wouldn’t really try to hurt my kid,…blah, blah, blah.)(October 11, 2004)
  • 249. Can we track how much people drink? In Barcelona, Spain, bar patrons with a microchip implanted in their arm allows them to pay for alcoholic drinks without using cash or credit cards. While this might seem like a way to increase drinking because of convenience (or an invasion of personal privacy), the advantage might be in tracking alcohol use and abuse in alcohol-related car crashes, homicides, or overdose deaths. (October 4, 2004)
  • 248. Beware of a new hangover remedy purporting to “ward off alcoholism”! A product known as REBOUND is being advertised on the Internet, accompanied by 20-30 year-old studies (some of which are cited incorrectly) as a backdrop in an attempt to validate their product. In actuality, the studies they cite are no longer valid or popular, and some of those studies regarding the pharmacology of acetaldehyde have actually been disproven. Until a large number of studies on a product prove its efficacy in humans, any products marketed with such claims are simply a waste of money. This applies to any product not approved by the Food and Drug Administration. (September 27, 2004)
  • 247. What are “Jello shooters”? These are unpredictable alcohol concoctions. One common recipe is to mix a cup of water with a cup of your favorite spirit (usually vodka, and please don’t use 190-proof Everclear) along with a package of Jello. Freeze until firm. (And hope your party guests find them before your kids do…….) A typical shooter will contain the equivalent of 1-2 shots of “your favorite spirit” (depending on the size of the portion) and will produce intoxication in a short period of time. Be careful- because there is no standard recipe, these can be dangerous! (September 20, 2004)
  • 246. Why is there a genetic basis for alcohol dependence? Because the genetics of alcohol problems have been studied for over 20 years, and such studies have clearly shown that over 50% of the causes of alcohol dependence are related to the genetic tendency to develop the disease. Family, twin, and adoption studies implicate the hereditary nature of alcohol dependence. Exciting new findings are showing that neurotransmitter receptors in the brain (for GABA, serotonin, and other chemicals) are somehow involved in the vulnerability of people for the disease. (September 13, 2004)
  • 245. Moderate alcohol consumption could reduce the negative effects of a heart attack, according to a new study. Should physicians start recommending a drink a day for reducing the aftereffects of a heart attack? Of course not, since a single study (especially in animals) must be replicated many times, and the effects shown in humans. But alcohol in moderation does have proven beneficial effects on prevention of ischemic heart disease. (September 6, 2004)
  • 244. Can alcohol be taken in a vapor form? An expensive new alcohol-without-liquid (AWOL) device vaporizes alcoholic beverages to provide a new way to take alcohol. Long ago, scientists gave rodents alcohol in vapor chambers to produce high stable blood alcohol levels (BAL) for experimentation. The new AWOL device is scary, however, since vapor/BAL correlations have not been done for humans, as they have with oral alcohol intake. Thus it is not possible to predict BAL for drink/driving purposes, and new drug administration forms (remember crack, black tar heroin) tend to be overused and abused. Reaching lethal BALs with such devices should be rather easy. The upside? None. Companies selling such devices will make money, but for what purpose? Is snorting alcohol better than a good beer or a fine wine? (August 30, 2004)
  • 243. Another medication has been approved by the Food and Drug Administration for the treatment of alcohol dependence. Acamprosate, which seems to work through the GABA/glutamate systems of the brain’s pleasure pathway, apparently reduces relapse in alcohol dependent patients undergoing abstinence treatment. It may also reduce craving for alcohol. This drug has shown effectiveness for years in Europe, and recent U.S. studies have confirmed its effectiveness and relative safety. It joins naltrexone as the only drugs to directly affect the brain to reduce the symptoms of alcohol dependence. (August 23, 2004)
  • 242. Recent surveys indicate that driving deaths and injuries are at their lowest point in 38 years. Experts credit less drunk driving, increased use of seat belts, and more state DWI legal limits of 0.08 (compared to 0.10 previously). Is this a trend, or will the deaths and injuries rise again later? Over years, such phenomena tend to wax and wane, but scientists should be studying the exact reasons for improvement in the figures, and try to make safe strategies consistent from year to year. (August 16, 2004)
  • 241. More than 17 million Americans — 8.5 percent of the population — have alcohol-use disorders, and 4.2 million meet the criteria for other drug-use disorders, according to a new survey by the National Institute on Alcohol Abuse and Alcoholism. Approximately 5% of Americans are alcohol dependent – the technical term for “alcoholism”. (August 9, 2004)
  • 240. The health benefits of alcohol are always of concern to those who see only the dangerous side of the beverages. A recent review of existing studies by the National Institute on Alcohol Abuse and Alcoholism has determined that the health benefits of alcohol depend on a person’s age, gender, and overall medical history. The review found that for the general population, two drinks a day for men and one drink a day for women relate to lower mortality and are unlikely to cause harm. A standard “drink” is defined as 5 ounces of wine, 12 ounces of beer or 1.5 ounces of distilled spirits. (August 2, 2004)
  • 239. Does alcohol damage brain receptors? Whereas the long-term use of high amounts of alcohol is known to damage brain cells, it is not yet clear whether alcohol over the short term (as in binge drinking) can damage nerve cell neurotransmitter receptors. Certainly there is a negative effect of alcohol on memory, and sometimes long-lasting mental depression, and this suggests that the receptors might be affected. Permanent damage to such receptors has not as yet been demonstrated, however. (July 26, 2004)
  • 238. People often think that alcohol affects the kidney since increased urination usually accompanies drinking. Actually, alcohol increases urine volume through an effect on the anti-diuretic hormone of the pituitary gland in the brain. (July 19, 2004)
  • 237. Can a person with a chronic kidney problem drink alcohol? Long-term research and understanding in this area says that alcohol has very few direct effects on the kidney. However, if a person is taking drugs to treat kidney disease, or if drugs are being taken that are cleared primarily through the kidney, then alcohol could affect how those drugs work, and should probably be avoided. (July 12, 2004)
  • 236. Is it possible to measure brain alcohol levels without putting a probe in the brain or removing the brain? Yes, although the work has only been done so far in animals. A new method called magnetic resonance spectroscopy is able to measure the alcohol levels in different parts of the brain, and to plot its disappearance after individual doses. (July 5, 2004)
  • 235. New research has found that genes for two neurotransmitter receptors are probably involved in the causes of alcohol dependence. These two receptors, GABA-A, and a form of the gene that codes for the serotonin transporter (SER, 5-HT), may produce abnormalities in the mesolimbic dopamine system that cause people to be unable to stop drinking. (June 28, 2004)
  • 234. What about a genetic test for alcohol dependence? Presently, the only available tests are “paper-and-pencil” tests and “biomarkers”. Paper-and-pencil tests involve asking questions of people who are drinking too much or too often and using their answers to determine whether they have the disease. These are not medical tests. Presently available blood or urine biomarker tests cannot determine who has alcohol dependence, only whether a person has been drinking recently. Thus a genetic test would be an excellent medical test, and some genetic tests are under development. (June 21, 2004)
  • 233. Brain areas associated with the cause of alcohol dependence include the ventral striatum, the extended amygdala, the ventral tegmental area, the nucleus accumbens, and the frontal cortex. These technical terms describe brain areas that are involved in the production of alcohol dependence, including memory of the drug’s action, craving for the drug, and the pleasure of taking the drug. However, a “dysregulation” of these areas (meaning they aren’t working properly) is associated with the actual disease of alcohol dependence. (June 14, 2004)
  • 232. The “craving” associated with alcohol dependence has been localized to a brain area known as the orbitofrontal cortex, which basically lies behind the forehead. This area “lights up” in brain imaging studies when a person is feeling that they really want alcohol. (June 7, 2004)
  • 231. There is a complex interaction between drinking alcohol and smoking cigarettes. During treatment for alcohol dependence, it is difficult to obtain approval from patients to stop smoking as well. It’s almost as if the addictive process for alcohol and nicotine is not affected by alcohol treatment. The continuance of the addictive process is best seen by a person who continues smoking after giving up alcohol. (May 31, 2004)
  • 230. The old medicine disulfiram (Antabuse) does not work very well for treating alcoholism, primarily because alcoholics don’t like to take it. It makes a person sick when alcohol is drunk, and unless the person is being “punished” for drinking, there is no good reason to take Antabuse. Interestingly, Antabuse is turning out to be effective in reducing craving for cocaine in cocaine dependent people. (May 24, 2004)
  • 229. In adults, one ounce of whiskey (or gin, vodka, etc. – about 80 proof or 40% alcohol) is generally metabolized (broken down) in the body in about one hour. Remember that several drinks containing this amount drunk in less than an hour will accumulate, since it takes a full hour for each drink to be broken down. (May 17, 2004)
  • 228. Consumable alcohol is often dispensed in plastic containers. Why doesn’t it melt the plastic? Even though alcohol is known as a “solvent”, it solubilizes only those substances that it mixes with (certain pharmaceuticals, other liquids), but most plastics are designed to be inert or resistant to powerful chemicals. Ethanol does not have the same qualities as (for example) acetone, which is a powerful solubilizing agent for many solid chemicals. (May 10, 2004)
  • 227. Why is alcohol colorless and clear, like water, and why does it mix easily with water? The answers to these questions are as follows. Most pure chemicals are colorless. To have color, a molecule must have a chromophore (often a metallic ion) that gives it color. The fact that alcohol mixes easily with water is because it easily forms hydrogen bonds with water. (May 3, 2004; revised July 6, 2004)
  • 226. Often people talk a lot about “alcoholism” (better: alcohol dependence). Another separate problem that might cause just as much death, suffering, and economic cost to society is intentional alcohol abuse. This is not a disease, but is often seen in young people (e.g., college students), and others who make poor decisions about the use of alcohol. These individuals do not need treatment, but will usually respond to a change in environment, education, or punishment. (April 26, 2004)
  • 225. Evidence of stigma against alcohol dependent (“alcoholic”) people is all around us. It ranges from treatment centers having difficulty locating facilities in new neighborhoods (“not in my back yard”) to high-ranking administrators and policy-makers stating that “(alcoholism) is nature’s way of killing off the weak people”. History is too often forgotten – similar stigma existed for polio, leprosy, epilepsy, and tuberculosis over 50 years ago. Even today, there is stigma and prejudice against mentally-ill people in general, and addicts in particular. (April 19, 2004)
  • 224. There is a major interaction when alcohol and antihistamines are mixed. The same holds true with the benzodiazepine anti-anxiety/hypnotic class of drugs, the pain-killing opioid drugs, and with marijuana. This interaction is essentially an additive one, so that the depressant effects of the drugs are greater than either one alone. Although some have called these interactions “synergistic effects” (the effect is more than a simple summation of effects), this is extremely difficulty to measure. (April 12, 2004)
  • 223. Alcohol is a “lubricant”. What does this mean, it reduces friction between moving parts? No, unlike most lubricants that make things smoother between two materials, alcohol is a social “lubricant” that helps drinkers feel more comfortable around people. Obviously, this is true only in lower doses, since higher doses make people sleepy! (April 5, 2004)
  • 222. People can become “tolerant” to alcohol, meaning that it takes more and more alcohol over time to get the same effect as when alcohol was first used. How does this happen? There are two primary ways that tolerance to alcohol occurs. One is through an increased number of liver metabolizing enzymes, an adaptation of the body designed to get rid of toxins (“liver tolerance”). The other is through adaptation of brain cells to alcohol’s actions; through some as yet unknown mechanism, brain cells become less sensitive to alcohol (“cellular tolerance”). (March 29, 2004)
  • 221. Among the factors that influence blood alcohol levels after a fixed number of standard drinks (each containing the equivalent of 1.5 ounces of 80 proof ethanol, for example) are body weight, gender, genetics, amount of food in the stomach, rate of drinking, presence of other drugs that affect alcohol metabolism, and overall health of the individual. (March 22, 2004)
  • 220. Fetal problems produced by alcohol may occur because of reduced blood flow to the fetus; a toxic effect of acetaldehyde, the major breakdown product of alcohol; or alcohol-induced release of prostaglandins, chemicals released during tissue damage. (March 15, 2004)
  • 219. Several medications might cause severe drowsiness in the presence of alcohol. These include antianxiety agents (benzodiazepines such as Xanax, Valium), antihistamines (Benadryl, Claritin), and powerful pain-killers (opioids, such as Vicodin and Percocet). People using alcohol and one of these prescription drugs should be aware of such drug interactions and avoid driving. (March 8, 2004)
  • 218. Pregnant women, or those who think they might be pregnant, should not drink at all. While there is no scientific evidence for alcohol abstinence during pregnancy, this is the safest message. On the other hand, if a woman has a glass of wine now and then while pregnant, the likelihood of hurting her baby is extremely low. If a woman has one glass of wine before she knows she’s pregnant, she should not be consumed with guilt if the child grows up with a perceived cognitive deficit (even ADHD). There are more likely causes for such deficits than one alcoholic drink. (March 1, 2004)
  • 217. What brain areas are affected by high alcohol consumption? While the most noticeable and understandable effects are on the “memory center” (hippocampus) of the brain, other areas such as the cerebellum (muscle coordination center) are also negatively affected. (February 23, 2004)
  • 216. “Alcohol is a solvent that dissolves people” is an old quotation relating to the “addictive” effects of alcohol. Scientifically, it was formerly believed that alcohol caused nerve membranes to lose their structure, or “dissolve”. This has since been disproved. (February 16, 2004)
  • 215. Shouldn’t this be a warning label on a bottle of beer, whiskey, or wine? “Caution: users of this product may fall down, throw up, get sick, get punched out in bars, lose their lives, lose their jobs, lose their livers, and become so dependent that their lives become totally unmanageable”. For some people, that should be on the bottle! (Compliments of John T. O’Neill, LCDC.) (February 9, 2004)
  • 214. Women are more affected by alcohol than men. With similar amounts of alcohol, women are at higher risk for developing high blood pressure, suffering liver and pancreatic damage, and becoming considerably more impaired. (February 2, 2004)
  • 213. Blackouts after heavy drinking can be experienced by anyone, not just alcohol dependent (“alcoholic”) individuals. Many college students typically drink so much at one time that blackouts are frequent in this population. In any given group of heavy drinkers, some will experience blackouts and some won’t. This is due to biological variability – different people have different sensitivities to the effects of alcohol. (January 26, 2004)
  • 212. People who are alcohol dependent lack control over their drinking. An analogy is a patient with Type I diabetes who cannot control the levels on insulin. Disagree? Talk to an alcohol dependent patient who has unsuccessfully tried to stop drinking, has received the best treatment available, cannot stop drinking even with support in A.A., and has tried the latest anti-craving medications, without success. This is why we call it a disease. (January 19, 2004)
  • 211. Research shows that alcohol causes permanent problems with nervous system function. We know that people who drink heavily have memory loss, some confusion, and often problems with feelings and sensations in their hands and feet. “Heavily” does not mean two drinks per day; rather, “pints of spirits per day” is more like it. Although there is great variation from person to person, over the long term almost everyone will have some negative nervous system function with heavy daily drinking. (January 12, 2004)
  • 210. One remedy that is not recommended for hangover headache is acetaminophen (Tylenol, etc.), since it has been shown to cause liver damage in high doses. Although the drug does not significantly irritate the stomach, other pain-killers such as ibuprophen or aspirin are better because they do not produce liver damage and in normal doses will only cause heartburn in people with sensitive stomachs. (January 5, 2004)
  • 209. Several factors influence the absorption of alcohol from the stomach into the blood: a) the amount of food in the stomach, b) the rate of drinking, c) the amount of alcohol dehydrogenase (alcohol metabolizing enzyme) in the stomach lining, and d) the form of alcohol (“straight” or diluted, and type of diluting beverage). (December 29, 2003)
  • 208. “The alcohol went straight to my head” has some scientific validity. For reasons based upon absorption and distribution principles, alcohol levels after drinking are initially higher in the brain than in the blood. (December 22, 2003)
  • 207. Anytime anyone drinks a lot and then falls asleep, especially when there are other people and activity in the room, the person should be checked for signs of breathing difficulties. The lethal limit of alcohol in the blood for most people is around 0.40%, which is roughly the equivalent of 12 drinks (for women) or 16 drinks (for men). If the person is taking medications such as antihistamines, opioid pain-killers, or sedatives (such as Valium), then the lethal limit for alcohol is lowered considerably. (December 15, 2003)
  • 206. If alcohol “breaks down” (is metabolized) to water and carbon dioxide, why is it so toxic? Ethanol (the alcohol in beverages) is toxic because of its own molecular effects on tissues. In addition, its first breakdown product (acetaldehyde) is even more toxic. However, the liver metabolizes acetaldehyde very quickly through enzymatic action, to acetate, water and carbon dioxide. So the more alcohol consumed, the longer ethanol and acetaldehyde are in contact with tissues and the more damage will be done. (December 8, 2003)
  • 205. How much alcohol can cause withdrawal signs and symptoms? The answer is not simple, since it varies from person to person. Some experts believe that a hangover is a brief but not dangerous withdrawal period. On the other end of the spectrum are DTs (delirium tremens), where heavy drinkers experience hallucinations, muscle tremors, and seizures. Up to 30% of people can die during DTs. In drinkers who consume alcohol on a constant, heavy basis, and then stop drinking for a few days, withdrawal can consist of anxiety, sleeplessness, muscle pains, and craving for alcohol. (December 1, 2003)
  • 204. Is there a relationship between attention deficit hyperactivity disorder (ADHD) and alcohol dependence? Yes, but it is unlikely that ADHD is a cause of alcohol dependence. A recent study has shown that ADHD often precedes the onset of alcohol dependence, but only in less than about 30% of alcohol dependent patients. However, people with both disorders often have an earlier onset of alcohol dependence, compared to those without ADHD. (November 24, 2003)
  • 203. A new project called COMBINE is being funded by the federal government. Its goal is to determine the effectiveness of anti-craving medications and “talk therapy” such as Twelve Steps, counseling, etc. for alcohol dependence. A second goal is to determine the effectiveness of single versus double medication use. (November 17, 2003)
  • 202. A combination of naltrexone and acamprosate might work better than either one alone in reducing craving in alcohol dependent patients undergoing treatment. Naltrexone was approved for this purpose in 1994, whereas acamprosate (a drug available in Europe) is undergoing clinical trials in the U.S. These drugs work on different neurochemical systems in the brain, so that their beneficial effects might be additive whereas their side effects might not be additive. More studies are needed. (November 10, 2003)
  • 201. New brain scan research is showing that alcohol affects decision-making and judgment (the so-called “executive functions” of the brain) by reducing activity in the frontal lobes, where such functions reside. Interestingly, it appears that pre-existing (or alcohol-induced) impaired function of these same brain areas leads to the disease of alcohol dependence, making it impossible for the person to exert conscious will over whether they can stop drinking or not. (November 3, 2003)B
  • 200. The tragedy of drunk driving is very difficult to prevent. The most effective measure is to keep people from drinking at all. The next most effective measure is to keep them from driving after drinking: use designated drivers, taxi rides, make them walk, etc. But to expect a drinker to make a decision not to drive after they have been drinking is very difficult, since alcohol by its pharmacology reduces judgment and decision-making. Educating people about the dangers of drunk driving is also not effective, because many drunk drivers falsely believe they can drive safely. (October 27, 2003)
  • 199. One of the most important reasons for variability in a person’s response to a “drink” is the size of the drink. While bottled beer or small bottles of wine contain fixed volumes of liquid, when a person goes to a bar or makes drinks at home, the volume of beer, wine, or whiskey can vary tremendously. For example, tap beer comes in glasses that vary in size from around 8-22 ounces, yet each size is called a “drink”. Wine is pored into small or large glasses that are not always “full”. Finally, although a “jigger” of whiskey is usually about 1-1.5 ounces, some bartenders “free pour” whiskey, using their experience to approach the amount of a jigger. So beware when someone says, “I only had two drinks”. (October 20, 2003)
  • 198. Can the use of rubbing alcohol on the skin contaminate a blood sample to produce an abnormally high reading of blood alcohol concentration? Some rubbing alcohols contain ethanol (beverage alcohol), but most rubbing alcohols contain isopropyl alcohol, which does not usually register as beverage alcohol in most analytical procedures. Nevertheless, because of this slight possibility, most medical procedures now use betadine (a non-alcohol-containing disinfectant) to swab areas for blood collection. (October 13, 2003)
  • 197. What causes people to die from drinking high amounts of alcohol during their lifetime? Disregarding alcohol dependence (“alcoholism”), which occurs in 10% of drinkers, the main cause of death is liver cirrhosis. Interestingly, cirrhosis occurs in only about 20% of heavy drinkers (including alcohol dependent persons). The main causes of death which might be attributable to alcohol include pancreatitis, cancers of certain types (mouth, esophagus, stomach, possibly pancreatic and colorectal), nutritional problems, and weakening of the immune system. Alcohol may cause more deaths through overdose, car crashes, homicides, and suicides than are caused by the direct effects of the drug on the body. (October 6, 2003)
  • 196. “Sweat patches” are now being studied clinically to aid in tracking sobriety in recovering alcoholics and as indicators of compliance to treatment. These patches are similar to large bandaids that can be placed on the skin and left for several days. They pick up and hold alcohol in the sweat released through the skin. While they are not sufficiently accurate to be an indicator of blood alcohol concentrations, they are helpful in determining whether a person has consumed alcohol in the past several days. (September 29, 2003)
  • 195. About 80-90% of ingested alcohol is metabolized (broken down) by the liver. The rest is excreted in the breath, urine, or sweat. Although alcohol can be measured in any of these for indirect determination of blood alcohol, the best method is via a blood sample. Breath measures of alcohol are somewhat inaccurate depending on how the sample is taken and the type of analytical instrument. Urine alcohol levels are quite variable, and are therefore of no value for measuring precise blood alcohol, and sweat samples generally only indicate the presence or absence of alcohol in the body. (September 22, 2003)
  • 194. Somewhere between 0.08% and 0.10% (the former DWI limit), people begin to have trouble walking (“inability to walk a straight line”) or standing on one foot. They also often show nystagmus (eyeball drifting, and inability to focus on a moving target), and have trouble counting backwards or reciting the alphabet. Thus, “field-testing” for DWI consists of observation of several or all of these last five alcohol-related problems. (September 15, 2003)
  • 193. The Driving While Intoxicated (DWI) BAC of 0.08% (in most states) gives us a good place to start in understanding how alcohol disrupts motor coordination. Scientific studies have shown that the ability to drive begins to be affected at 0.05%. Most people understand that the ability to drive depends upon good judgment, ability to steer, ability to use the brakes, and lack of risk-taking. At 0.08% (DWI limit), there is significant reduction in judgment, increased risk-taking, and some disruption of muscle control. (September 8, 2003)
  • 192. The new low-carbohydrate diets recommend that no alcohol be consumed during the diet. Why is this? The reason is probably that several forms of alcohol have significant carbohydrate content (especially beer). On the other hand, gin and vodka have no carbohydrate content. Rather than indicating that some alcoholic beverages are OK and some are not, the general recommendation of “no alcohol” is a practical one, especially since all alcohol provides calories that are not necessary. In addition, alcohol tends to stimulate the appetite. (September 1, 2003)
  • 191. Does alcohol affect adolescent brains more than adult brains? This is a huge scientific question. Although there has been a relative lack of research on this topic, a few recent findings indicate that the earlier a person starts drinking, the greater likelihood there is of the person becoming alcohol dependent (“alcoholic”). On the other hand, genetics has not been factored into these studies. More research is necessary to come to a final conclusion. (August 25, 2003)
  • 190. Which is more dangerous – drinking two alcoholic drinks a day or 4 cups of coffee a day? Neither is dangerous, unless a) a person is very sensitive to the effects of alcohol, so that sleepiness occurs, b) drinks the alcohol and drives a vehicle (slight impairment), or c) is very sensitive to the effects of caffeine so that the coffee will produce mild anxiety or rapid heart rate. It is this lack of toxicity in most people that has made these beverages a tradition to consume in moderate quantities. (August 18, 2003)
  • 189. Is there any effect of alcohol on the body’s immune system? A few studies have suggested that drinking alcohol can reduce immune system function, leading to a greater chance of infections and autoimmune diseases. While this is a very understudied area, it makes sense that if alcohol had a major effect on the immune system, our society would have noticed such a correlation over the years, since alcohol is so widely used. The conclusion is, then, that alcohol probably has a minor, if any, effect on the human immune system. (August 11, 2003)
  • 188. What is “ale”? While many people think of ale as a type of beer, it is traditionally a malt beverage, darker, heavier, and more bitter than beer. Usually containing about 6% alcohol by volume, it has slightly higher alcohol content than beer, which can range from 3-5%. However, microbreweries in the U.S. are now making many types of ale that are simply another choice for customers who order “beer”. (August 4, 2003)
  • 187. Beverage alcohol is made from fermented materials: grapes (wine), hops (beer), rice (sake), corn (spirits), etc. Why are there no fermented beverages from some fruits or vegetables such as broccoli, asparagus, cantaloupe, cauliflower, etc.? In general, either these products have low levels of carbohydrates (esp. sugar), or their fermented products do not taste good (green bean wine?), or no one has attempted to make desirable alcoholic beverages from them. (July 28, 2003)
  • 186. Older terms for “hangover” are “wailing of cats” (German), “out of tune” (Italian), “woody mouth” (French), “workmen in my head” (Norwegian), and “pain in the roots of my hair” (Swedish). (July 21, 2003)
  • 185. There are several ways to report blood alcohol (ethanol) levels. (Ethanol is the drinking type of alcohol.) The standard reporting in legal cases is (for example) “.08%”, which means “.08 grams of ethanol in 100 milliliters of blood”. In animal research studies, scientists would use a different measure: “80 mg/dl”, which means the same as .08% but stands for “80 milligrams of ethanol in one deciliter of blood”. Other scientists might give their results in “millimoles of ethanol”. These differences grew out of tradition, and the use of different units of measure in different scientific disciplines. It can be confusing, even for the “alcohol researcher”. (July 14, 2003)
  • 184. Scientists often report their findings in human research studies in terms of “grams of alcohol administered” when discussing how much alcohol was given to experimental subjects. Why do they use such jargon and how many grams of alcohol are in a standard drink? Roughly 14 grams of alcohol is in a standard drink in the United States (1 beer, 1 glass of wine, 1 shot of spirits). “Grams” is used in this case because it is a universal measure when there is no standard drink around the world. (July 7, 2003; updated February 12, 2007)
  • 183. Is alcohol used in nail polish removers? No, not usually. The main ingredient in nail polish removers is acetone, another organic solvent. However, nail polish removers have been abused by people thinking they contain ethyl alcohol. Acetone, like alcohol, is also very toxic to many organs of the body. (June 30, 2003)
  • 182. Alcohol can cause the “jitters”. What are the “jitters”? “Jitters” is an old term for “shakes”. People generally don’t shake while under the influence of alcohol (unless they’re doing a drunken hula dance!). But heavy drinkers can have the “shakes” when their blood alcohol levels fall after being elevated for a long period of time. These “shakes”, usually accompanying a hangover, are a physical withdrawal sign, indicating the body is trying to compensate for the lengthy depression produced by alcohol. When the “shakes” become severe, this is a sign of “delirium tremens”, which can be associated with death in some cases. (June 23, 2003)
  • 181. The blood alcohol level that usually causes death (either through respiratory depression or aspiration of vomit into the lungs while asleep) is 0.4 grams per liter (0.08 is the legal limit for driving in most states). The danger of overdose is greatly enhanced with other central nervous system drugs, such as hypnotics (sleep-inducers) or anti-anxiety drugs. (June 16, 2003)
  • 180. Can mental depression cause alcohol dependence? There is no evidence that it can. Can alcohol dependence cause mental depression? Yes, depression often occurs after detoxification, but will generally get better and disappear over time, even if untreated. (June 9, 2003)
  • 179. Alcohol causes dehydration, particularly by blocking antidiuretic hormone in the pituitary gland. This leads to increased urination, causing a relative loss of water throughout the body. Even beer, in large quantities, can produce this effect. (June 2, 2003)
  • 178. An anti-seizure drug, topiramate, has recently been shown to promote abstinence in alcohol-dependent individuals. The apparent mechanism is an action in reducing dopamine release in the medial forebrain bundle through a direct action on glutamate function. More studies are needed to confirm the true clinical value of this drug and its exact mechanism of action. (May 26, 2003)
  • 177. Based upon several neurotransmitter systems that seem to be dysregulated (“not working right”) in the medial forebrain bundle (“pleasure pathway”) of the brain, scientists are speculating that there may be different treatments in the future for different types of alcohol dependence. Thus naltrexone works on the endorphin system, ondansetron (in clinical study) works on the serotonin system, and acamprosate (in clinical study) works on the glutamate and/or GABA systems. (May 19, 2003)
  • 176. There are early onset and late onset forms of alcohol dependence. The early onset one (before the age of 25) is more severe, more closely associated with genetic causes, and involves more male than female sufferers. This is called Type II or Type B. Type I or Type A is “late onset” alcohol dependence, and is probably driven more by sensitivity to alcohol and its effects in producing dependence. There is also a “very early onset” alcohol dependence, where people seem to become “hooked” with the very first drink (although there is almost no research on this type). (May 12, 2003)
  • 175. Alcohol dependence is just like other medical diseases. Some people have “what it takes” to get the disease, other people don’t. Having “what it takes” involves having a genetic tendency, plus other (as yet) unknown factors. (Remember, we’re not talking about voluntary alcohol abuse, as in college student drinking.) (May 5, 2003)
  • 174. How does caffeine counteract the effects of alcohol? The answer is “very poorly”! Caffeine is a mild stimulant. It has been estimated that it would take 20 gallons of coffee to sober up a severely intoxicated person! (Does this mean that they would stay awake because they had to pee all the time?) This is a poor “antidote” for too much alcohol! (April 28, 2003)
  • 173. Where in the brain does “craving” for alcohol arise? No one knows for sure, but a recently published paper suggests that craving (desire, urge) for alcohol arises in the orbitofrontal cortex, a part of the brain behind your forehead. This may be the major site of craving, or it could be only one of several brain areas involved in this sensation. (April 21, 2003)
  • 172. Why can’t aspirin be taken with alcohol? It can, but not every day when people are drinking every day. Aspirin (and similar pain-relievers) can be used to reduce hangover headache, or alcohol can be drunk by people who take aspirin every day for arthritis (for example), but too much alcohol and such pain-relievers can lead to stomach upset, and sometimes stomach ulcers. (April 14, 2003)
  • 171. What are “fetal alcohol effects”? These are some or lesser problems (compared to fetal alcohol syndrome, FAS) seen in a child, caused by a mother’s drinking during pregnancy. These could range from learning disabilities to some of the facial defects that are usually seen with FAS. Fetal alcohol effects are thought to occur with less drinking during pregnancy, compared to women who drink enough to produce FAS. (April 7, 2003)
  • 170. What are the effects of alcohol on the fetus? One in 1000 heavily-drinking women has a child with fetal alcohol syndrome (FAS) – severe birth abnormalities, including characteristic facial defects, sometimes missing fingers, toes, kidneys, small brain, and low IQ. These are permanent defects, which place the child at a severe disadvantage in growth and life adjustment. (March 31, 2003)
  • 169. There are phrases used with alcoholic drinks like “on the rocks” and “neat”. What do these mean? “On the rocks” means “booze with ice”. “Neat” means “pure liquor” (without ice). (March 24, 2003)
  • 168. Some people say “alcohol is a solvent”. What does this mean? Alcohol has chemical qualities that allow it to solubilize (place into solution) certain drugs that are not able to be dissolved in water. This is a chemical phenomenon that is not easy to explain. But some pharmaceutical agents require alcohol for this reason. This is why some liquid cold and vitamin remedies (which are easier to consume than tablets or capsules) are on the market, especially for older patients who cannot swallow tablets or capsules. (March 17, 2003)
  • 166. What is meant by “loss of inhibitions” with alcohol? Everyone’s behavior and personality is under some degree of restraint, because of prior experiences, laws, customs, personal beliefs, and values. The frontal brain areas, such as the prefrontal cortex, control these characteristics of the human character. Alcohol in certain “doses” depresses these brain areas, which relieves them from restraining behavior and “values”, and people behave in a manner that is different from their usual behavior. This “loss of inhibitions” is an early part of the condition known as “intoxication”. (March 3, 2003)
  • 165. Why can some people drink a lot of alcohol and never seem intoxicated? “Seeming” to be intoxicated is a very subjective thing. People might seem pretty normal (especially to those drinking with them!), but inside their head they are euphoric, dissociated from the real world, dizzy, nauseated, exhilarated, or all of the above. Most people, when they reach a blood alcohol level above 0.15% (5-6 drinks in a short period of time) will show signs of intoxication: slurring words, loss of balance, repetitive eye movements (nystagmus), and impaired judgment when placed in a situation where they have to make important decisions. A few people, however, have a great deal of natural “tolerance” (resistance to the effects of alcohol), so they will rarely appear intoxicated. (February 24, 2003)
  • 164. Children who have an alcohol dependent parent are 3-4 times more likely to become alcohol dependent. This means that since the national incidence of alcohol dependence is 5%, such children have a 15-20% chance of becoming alcohol dependent. The probability of becoming dependent if both parents are alcohol dependent has not been determined, but it is likely over 50%. (February 17, 2003)
  • 163. There are three times as many “alcoholic” men than “alcoholic” women in the United States. Why? There is no firm answer to this question, but the answer is not that men drink more than women. Further research should answer this question. (February 10, 2003)
  • 162. Alcohol is a “stomachic”. What does that mean? “Stomachic” is an old term that refers to the effects of alcohol on the stomach. The effects of alcohol on the stomach are two-fold: 1) it relaxes a person during a meal and increases digestion, and 2) in large amounts, it irritates the stomach lining and causes heartburn, irritation, and (perhaps) ulceration. More research has been performed on the negative effects of alcohol on the stomach than on the beneficial effects of alcohol on the stomach. (February 3, 2003)
  • 161. Alcohol is said to have protective effects on the heart. Is this best seen with red wine? Some recent studies have indicated that any type of alcohol (in moderation – not more than 2-3 drinks per day!) can reduce the risk of myocardial infarction. How alcohol produces this effect is not entirely known. As always, the harmful or dangerous effects of alcohol should be taken into consideration when making a decision to drink alcohol for any reason. (January 27, 2003)
  • 160. Why does alcohol make you nauseated (nauseous)? Alcohol has two effects that can make people feel like “barfing”, “hurling”, “throwing up” (medical term: vomiting). One is the direct effect of alcohol on sensitive stomach linings: it acts as a poison, causing a complex series of events that causes the body to try to get rid of the toxin. The second it is that it has a direct effect on the emetic (vomiting) center of the brain stem to stimulate vomiting. Everyone has a different sensitivity to each of these effects, leading to some people never becoming nauseated, and other people becoming nauseous with moderate drinking. (January 20, 2003)
  • 159. How can high school students overcome the “pressure” from others to drink alcohol? “No, thanks, I prefer Pepsi.” “I’ve tried it before but I got very sick.” “It’s illegal, and I really don’t want to break the law.” “I had a friend who drank and was in a car wreck. I don’t want to take the chance of that happening to me.” “I don’t need alcohol to have fun.” “I feel great, why would I want to drink something that can make me sick?” “My friends and I don’t believe in drinking. Why don’t you join us?” (January 13, 2003)
  • 158. What is alcohol “craving”? Although most of us have “craved” something in our lives (alcohol, certain types of food, comfort, sex, etc.), craving means different things to different people. It is likely that craving is not the same as alcohol dependence (“alcoholism”), for many alcohol-dependent people report that they do not always crave alcohol, but that they “need” alcohol most of the time. Scientists thus have a hard time measuring craving, and in many cases would prefer the words “urge” or “strong desire” to describe the constant seeking of a chemical or activity. (January 6, 2003)
  • 157. Wouldn’t getting rid of alcohol in the world reduce alcohol dependence? Probably, except that the brain “dysregulation” related to alcohol dependence would still be present, and might cause the person to use another drug or to express some other compulsive behavior. More research must be done to confirm this suggestion, however. (December 30, 2002)
  • 156. If alcohol dependence is a brain disease, what is wrong with the brain? It appears as if there is a neurochemical abnormality (perhaps caused by abnormal genes) in the mesolimbic dopamine system (“pleasure pathway”) of the brain. One or more of several neurotransmitter systems may be “dysregulated” (not working normally) in the pleasure pathway. Thus alcohol helps to “fix” these neuro-dysregulations, leading the person to subconsciously be unable to stop drinking without help. (December 23, 2002)
  • 155. How does alcohol cause alcoholism? Recent research findings indicate that alcohol doesn’t cause alcoholism. To appreciate this, people must understand that alcohol dependence (the scientific word for “alcoholism”) is a brain disease. This brain disease is expressed through the compulsive drinking of alcohol. Thus if a person never drinks alcohol, the disease will not be seen. (December 16, 2002)
  • 154. What is a “high-ball”? While this term is not used much anymore, most older Americans remember this alcoholic drink as a mixture of whisky or other liquor diluted with water, soda, or ginger ale, and served with ice in a tall glass. (December 9, 2002)
  • 153. What is “sloe gin”? While gin is a clear alcoholic spirit made from the fermentation of juniper berries, sloe gin is a cordial or liqueur flavored with sloe — a small, sour, blackish fruit of the blackthorn shrub. (December 2, 2002)
  • 152. We often hear that alcohol is an anesthetic. Is this true? An anesthetic in pharmacological terms is a drug that reduces pain. Loosely, alcohol reduces emotional pain by making people feel good (for a brief time). Technically, alcohol has characteristics of both local and general anesthetics. When applied directly to nerve cells in the laboratory, alcohol reduces nerve transmission, and therefore can reduce pain. This use occurs in medicine when alcohol is injected around nerves to calm severe pain. In the Civil War, alcohol was given orally to wounded soldiers on the battlefield to reduce severe pain during bullet removal and other operations. It is not as effective as today’s improved anesthetics, however. (November 25, 2002)
  • 151. Can alcohol cure a cold? This is a piece of erroneous folklore borne of the observation that sick people feel better when they drink. There is an old saying “When you have a cold, hang your hat on the bedpost, climb into bed, drink until two hats appear, and then your cold will be cured” (anonymous). In actuality, nothing cures a cold, but alcohol does appear in some liquid cold remedies, mainly as a solvent for analgesic and antihistamine ingredients. Of course, the alcohol has its own beneficial effect of sedation. (November 18, 2002)
  • 149. What is “brew”? This is another one of the many words in the English language that relates to alcohol (is it any wonder why alcohol is such a big part of American culture?). “Brew” is a colloquial name for “beer”. “Brew” also relates to the making of beer or other concoctions by steeping, boiling, and fermenting ingredients such as malts and hops. “Brewage” is a fermented liquor brewed from malt. (November 4, 2002)
  • 148. Does the beverage industry provide much money for researching the effects of their product? No, very little. Around 95% of the (rather minimal) research on alcohol and the problems it produces is funded by the federal government (National Institute on Alcohol Abuse and Alcoholism) in this nation. (October 28, 2002)
  • 147. Alcohol, in moderation, can save lives. One or two drinks per day is protective against atherosclerotic heart disease, some cancers, and (perhaps) some other diseases. Why don’t we use it more for such conditions? (October 21, 2002)
  • 146. Alcohol, like many other chemicals, is a poison. Used in excess, it can stop your breathing, it can rot your liver, and it can cause the fatal disease of “addiction”. Why, then, is it legal to sell and use? (October 14, 2002)
  • 145. Does alcohol cause you to feel “sexy”? Certainly! Shakespeare once wrote, “drink increases the desire, but takes away the performance”. Anyone who has drunk alcohol has experienced this effect, but few people realize that it is strongly based on dose and a person’s physiology and environment. Everyone responds differently to alcohol. One person may respond by feeling increased sexual desire, and be able to “perform” very well. Another person may feel “high”, but would never think of having sex while drunk. In general, however, the relaxation produced by alcohol (ranging from mild to extreme), is the reason for Shakespeare’s observation. (October 7, 2002)
  • 144. Does alcohol make you more “creative”? Of course! But how much of this “creativity” is “perception” and how much of it is real? No one knows. There are a lot of “alcoholic” Pulitzer-prize winning authors. Is their success due to alcohol, or is it due to intelligence, or is it due to being able to work longer hours without fatigue, because of alcohol? We need more research like this on alcohol’s effects! (September 30, 2002)
  • 143. Does alcohol make you “stronger”? Yes! But everyone knows that alcohol makes you attempt things that you wouldn’t do when you were sober. So, you might not hesitate to do some things (lift a heavy object, fight someone) when you have imbibed, which you might not have done before. But the research behind alcohol making you “stronger” is non-existent. Probably it would show that alcohol does not increase muscle strength. We need more research like this on alcohol’s effects! (September 23, 2002)
  • 142. Recent numbers from The University of Michigan’s “Monitoring the Future” project indicates that the following teenagers had used alcohol during the previous year: 43% of eighth-graders, 65% of tenth-graders, and 73% of twelfth-graders. Those who had “been drunk” in the past 30 days, according to this report, were 8% of eighth-graders, 24% of tenth-graders, and 32% of twelfth-graders. (September 16, 2002)
  • 141. What effect does alcohol have on the lungs? Unlike another highly “addictive” drug (nicotine) alcohol has no major effect on the lungs. And nicotine itself probably does not have a major effect on the lungs; rather, the cigarette, with its tars, carbon monoxide, and other ingredients play the largest role in increasing the risk for lung cancer with smokers. Interestingly, about 70-90% of heavy drinkers also smoke. (September 9, 2002)
  • 140. There are several reasons why alcohol helps people to have “fun”. First, it “disconnects” the frontal brain areas, so that people feel less inhibited about doing things. Second, it activates the pleasure pathway of the brain so that people actually feel good when they drink. Finally, it provides “euphoria”, or a sense of well-being. Of course, all of these effects are similar, but exactly how alcohol affects the brain to produce these actions is still under investigation. (September 2, 2002)
  • 139. Unfortunately, the word “alcoholic” means different things to many people. To the public, this word is usually pejorative, meaning someone who drinks too much, too often, and only cares about drinking. Many people drink “alcoholic-ly”, but usually only during brief periods. For example, college students often drink “alcoholic-ly”, but are simply having a good time. The more scientific term for “alcoholic” is “alcohol dependent”, which relates to pathological drinking in people who have a brain disease. (August 26, 2002)
  • 138. If you suffer “withdrawal” from alcohol, even a hangover, aren’t you an alcoholic? Absolutely not! Many people who drink too much alcohol (even one time!) suffer from hangover, and they are not alcoholic. Even people who drink very much, very often, and who suffer severe withdrawal symptoms, may not be alcoholic! “Alcoholism” is now scientifically defined as an “alcohol dependence” disease. Withdrawal is only one of several criteria that help diagnose alcohol dependence, so withdrawal from alcohol alone is not the same as “alcoholism”. (August 19, 2002)?
  • 137. What are other names for someone who drinks a lot? According to several dictionaries: drunkard, inebriate, sot, soak, bibber, bibbler, barfly, dipsomaniac, rummy, guzzler, swiller, soaker, sponge, boozer, boozehound, lush, souse, wino, alchy, juicehead, juicer, hooch hound, gin hound, swillbelly, swillpot, stew, stewbum, elbow-bender. All of these terms are now felt to be derogatory, for many peopleee (but not all) who drink a lot are known to have a chronic medical illness. (August 12, 2002)
  • 136. Why are so many Native Americans alcoholic? They may not be. We see more drinking among Native Americans, but this doesn’t mean they’re alcoholic. Remember that “alcoholism” is a broad, overused term that (to some people) means the same as problem drinking. But the better term for alcoholic today is “alcohol dependent”, and new research is indicating that some American tribes have a low rate of alcohol dependence, while other tribes have a higher rate of alcohol dependence. But to broadly state that all Native Americans have a high rate of alcohol dependence is probably wrong. (August 5, 2002)
  • 135. Why do some people who drink a lot become addicted to alcohol, and others who drink a lot do not? The easy answer is that some people have “what it takes” to become addicted (newer term: dependent). Some people have a vulnerability for the disease (some of which is genetic), while others will never develop the disease. Scientists are trying to understand exactly why this happens. (July 29, 2002)
  • 134. What is ondansetron? Ondansetron (Zofran) is a drug that is used for the treatment of nausea and vomiting. It has also been shown, in several studies, to reduce the “craving” in alcohol-dependent patients who have a more severe, genetically-driven form of the disease. If future research continues to confirm such results, the drug may be approved for the treatment of alcohol dependence, joining other drugs such as naltrexone as an aid to helping people who are trying to stop drinking. (July 22, 2002)
  • 133. What is nalmefene? Nalmefene (Revex) is an opioid antagonist that is on the market for the treatment of known or suspected opioid (for example, heroin) overdose. It is presently being investigated in human clinical studies for the treatment of alcohol craving. It has a similar effect as its more well-known chemical cousins, naloxone (Narcan) and naltrexone (ReVia). (July 15, 2002)
  • 132. Is liquor in any quantity good for you? Whereas good scientific studies have shown that wine (in moderation, 1-2 glasses per day) has health benefits, there are inconclusive studies about liquor (spirits, such as vodka or scotch) having such benefits. However, some studies indicate that alcohol, not wine alone, can be beneficial with modest consumption. Some physicians prescribe a glass of wine, beer, or warm sherry to aid sleep at bedtime in the elderly. And it makes sense that small amounts of alcohol can be useful as a relaxant and sleep-aid. (July 8, 2002)
  • 131. Can someone become “addicted” to Nyquil, which has 10% alcohol as an ingredient? Although the alcohol is added as a mild sedative, there is very little chance of a person becoming dependent on therapeutic doses (“when used as directed”). First, the quantity of alcohol is not sufficient to produce dependence. Second, we know that alcohol does not cause dependence, unless the person has the “vulnerability” for the disease (formerly known as “alcoholism”). (July 1, 2002)
  • 130. Why do different states have different legal limits for driving while intoxicated (DWI)? As most people know, the DWI limit varies from 0.08 to 0.10% among the states. There is clear evidence that most people are unable to safely drive a car at either level, but some states are more conservative than others. In actuality, there is strong scientific evidence that 0.05% (about 2-3 drinks per hour) is related to driving impairment, but the commercial alcohol lobby in the United States has so far been able to place profit over human safety in the eyes of state legislatures and Congress. The American Medical Association and Mothers Against Drunk Driving support an 0.05% DWI level, and this is the level allowed in most European nations. (June 24, 2002)
  • 129. Alcohol is flammable, which means that it will burn if set on fire. This quality is used in the production of canned fuels, which contain a jelly-like substance containing wood alcohol (methyl alcohol). This is not “drinking alcohol” (ethanol) and the canned fuels are sometimes carelessly used by people to produce intoxication. Methyl alcohol, however, is very toxic and can cause blindness. (June 17, 2002)
  • 128. What causes a “hangover”? The term hangover refers to the residual feeling of drug effects the day after using the drug. In the case of alcohol, the hangover is a “mini-withdrawal” from the massive depressant effects of the drug on body symptoms. This withdrawal is a state of hyperexcitability caused by the body’s systems trying to get back to normal. Thus, the heavy drinker experiences headache, upset stomach, early morning awakening, rapid heart rate, and other signs of nervous system excitation. (June 10, 2002)
  • 127. We often hear about “alcoholics” drinking a quart of spirits a day. How is this possible? Many drugs produce tolerance (resistance to the drug’s effects) by one of two major ways. Either the liver enzymes increase their activity to break down the drug, or the tissue (in this case, the brain) somehow becomes less sensitive to the drug’s effects. Both of these types of tolerance are at work when a person drinks large amounts of alcohol – leading to the eventual consumption of quantities that would kill a social drinker. (June 3, 2002)
  • 126. Can alcohol increase anxiety? Apparently yes, in small doses alcohol produces “disinhibition” of specific brain areas, leading to heightened arousal in brain areas involved in mood. Thus, in an already-anxious person, small non-sedating doses can increase anxiety. In higher doses, the well-known anti-anxiety effects of alcohol kick in. (May 27, 2002)
  • 125. What effect does alcohol have on the esophagus? The esophagus, the tube running from the mouth to the stomach, is sometimes heavily affected by chronic drinking, leading to “esophrygeal varices”. These are inflamed veins bulging into the esophagus that will bleed with the continued passage of alcohol and food. It is critical that the person stop drinking for proper treatment. (May 20, 2002)
  • 124. What does alcohol do to the prostate? Apparently, very little. Recent studies have shown that even heavy drinking does not increase the risk of prostate cancer. There is also apparently no relationship between drinking and benign prostate hypertrophy (BPH, enlarged prostate). (May 13, 2002)
  • 123. What does alcohol do to the pancreas? The pancreas is the main producer of insulin in the body. Problems with the pancreas lead to Type 1 diabetes. While large doses of alcohol do not cause diabetes, there is a problem with the pancreas that develops with some problem drinkers. The problem is chronic pancreatitis, a very painful condition that is difficult to treat. (May 6, 2002)
  • 122. Is alcoholism a “will power” problem? No, although people look at the willingness to use alcohol, especially to the point of intoxication many times a week, a “will power” problem. However, the simple excess use of alcohol is not alcohol dependence (the new term for “alcoholism”). People are alcohol dependent when they exhibit consistent clinical signs of inability to control their drinking, along with significant life problems. Such signs must meet certain diagnostic criteria established by the American Psychiatric Association. An alcohol-dependent person does not have a will power problem any more than someone who has high blood pressure of unknown cause. (April 29, 2002)
  • 121. Is alcoholism a “sin”? Of course not. Old-time thinking is still present in this nation, but research has now shown that alcohol dependence (the new term for “alcoholism”) is a brain disease much like epilepsy or schizophrenia. In other words, there is a pathology of the brain that causes a person to be unable to stop drinking. And just because a person has a disease does not mean that we are going to absolve them of the responsibility associated with what they do while under the influence of alcohol. But, they need treatment. (Intentional alcohol abuse, which is not a disease, could be called a “sin” by people who believe that alcohol is evil. However, such believers are now in the minority of the U.S. population.) (April 22, 2002)
  • 120. What percentage of the public is “alcoholic”? It is generally believed that 2/3 of the nation’s population drink alcohol (others are abstainers, recovered alcoholics, infants, etc.). Of those who drink, one in 10 will become alcohol-dependent. This works out to about 5% of the population, or about 14 million people. (April 15, 2002)
  • 119. Does drinking liquor in carbonated beverages increase the absorption of alcohol? Some old (and limited) research indicates that spirits mixed with tonics, colas, and other carbonated beverages do become absorbed faster through the stomach lining. The practical value of this, however, is unknown. No one knows exactly how the phenomenon occurs (if it does), and it is probably not noticeable when people are drinking mixed drinks, since most of the alcohol absorption occurs in the upper intestine. Thus a “controlled” study to measure the difference between straight spirits and carbonation-enhanced spirits would be only an academic exercise. (April 8, 2002)
  • 118. What is “moonshine”? Many people are too young to remember whiskey made “in the light of the moon” during prohibition in the United States, which lasted from 1920-1933. When the law prohibited alcohol from being manufactured and sold, many people learned how to make their own ethanol, usually by fermenting grain and mash, and producing what must have been a rather “raw” form of whiskey. This “moonshine” was used domestically and also sold on the “black market”. Some say this illustrates the willingness of people to break the law to obtain alcohol, and (along with the crime associated with obtaining and selling alcohol) was one of the reasons that prohibition was repealed. (April 1, 2002)
  • 117. Is alcohol hydrophilic or lipophilic? The root “philic” relates to “attraction”, and “hydro” and “lipo” relate to water and fat, respectively. So is alcohol more attracted to water or fat in the body? Actually, alcohol has an attraction to both, but more so to water than fat. Thus alcohol concentrates readily in any body tissue with high amounts of water (blood, blood in the brain, urine, sweat, heart, etc.). While alcohol readily concentrates in fat in the body, it leaves it very quickly as blood alcohol concentrations drop, so that there is no long-term storage of alcohol in the body. (March 25, 2002)
  • 116. When alcohol and water are mixed, which one forms the upper layer? Of course, neither one does, since alcohol and water mix perfectly. This is seen in all alcoholic beverages, where alcohol is always diluted with water. There is no 100% (200 proof) alcohol. All alcohol has a certain amount of water mixed with it. “Everclear” is about 99% alcohol, but still not 100%. (March 18, 2002)
  • 115. Isn’t alcohol craving the same as alcoholism? No, craving is a drug quality that makes a person want to drink more alcohol. This can occur in either volitional alcohol misuse or pathological alcohol dependence (“alcoholism”). Alcohol dependence (“alcoholism”) involves a compulsive “need” for the drug so that the person cannot stop without treatment or 12-step programs. (March 11, 2002)
  • 114. What is alcohol’s effect on the kidney? Actually the kidney is probably the organ that is least damaged by (even large) doses of alcohol. People tend to think the kidney is affected because urination increases when people drink alcohol. But increased urination is due to alcohol’s effect on blocking the pituitary’s anti-diuretic hormone. (March 4, 2002)
  • 113. Once a person’s brain cells are damaged by alcohol, can the brain repair itself if the person becomes abstinent? Brain scan studies suggest that brain anatomy begins to return to normal within six months of abstinence. However, cognitive function does not always return when the brain scans appear normal. More studies are being carried out to identify what parts of the brain are repaired first. (February 25, 2002)
  • 112. What is the amount of alcohol consumption that kills brain cells? It depends on the person. We know that decades of heavy drinking (as in alcohol abuse or dependence) can destroy brain cells (particularly in the memory part of the brain, the hippocampus). We also know that social drinking (several drinks a day) does not appear to injure brain cells. Just like any other pathology of the body, the susceptibility to damage is probably governed by many factors, such as genetic vulnerability. (February 18, 2002)
  • 111. Does everyone who is dependent on alcohol (“alcoholic”) have a history of alcohol abuse? Anecdotal (not scientific) evidence indicates that some people become alcohol dependent very early (there are 8 year old alcoholics), and sometimes with their very first drink. If this is true, then scientists must find out why and how some people become dependent (“addicted”) with first exposure to the drug. The answer will probably be found in genetics studies. (February 11, 2002)
  • 110. Does alcohol abuse lead to alcohol dependence (“alcoholism”)? Although it appears that many people progress from social drinking to alcohol abuse (misuse) to alcohol dependence, obviously not everyone who drinks heavily becomes an alcoholic. Evidence is beginning to emerge that abuse and dependence are two separate conditions. For example, a recent study of alcohol abusers and dependent drinkers found, in a long-term follow-up study, that only about 3% of abusers had become dependent after 5 years. (February 4, 2002)
  • 109. What is the lethal dose of alcohol in a woman? For both men and women, the lethal blood alcohol concentration (BAC) is approximately 0.4%. The qualified answer is approximately 10-14 beers or glasses of wine in a short period of time. While women metabolize alcohol more slowly than men (mainly because less alcohol is broken down by a stomach enzyme called gastric alcohol dehydrogenase), and while women have a higher fat/muscle ratio than men, the exact effect of these factors on a woman’s BAC is not known. It is known that a woman will have a greater BAC than a man after a certain number of drinks (estimated at 20-30% higher), but more research is needed to identify the most important contributors to this difference, and other factors in women that affect BAC. This is a complex issue. (January 28, 2002)
  • 108. What is the lethal dose of alcohol in a man? The lethal blood alcohol concentration (BAC) is approximately 0.4%. To achieve this, a 150-pound man would have to drink approximately 16-18 beverage units in about an hour. (A beverage unit is one beer, 5 oz of wine, or one drink containing about 1.5 ounces of 40% spirits. All of these have roughly the same amount of alcohol.) Thus, roughly one and a half pints of distilled spirits drunk in rapid fashion would probably produce a lethal BAC in an “average” 150-pound man. Factors that will change this include food in the stomach, drinking history, genetic sensitivity differences to alcohol’s actions, and fat/muscle ratio of the person. (January 21, 2002; revised February 20, 2007)
  • 107. Is alcohol found only in social beverages (beer, wine, spirits)? No, alcohol (ethanol) is also used as a solvent for pharmaceutical preparations. Thus liquid over-the counter and prescription products (such as cough medicines, cold remedies, and vitamin preparations) contain significant concentrations of alcohol. However, unless one drinks a whole bottle of such a product, there will be insignificant effects of alcohol (for example, a tablespoonful of Geritol or Nyquil will not cause intoxication). The amount of alcohol, not the concentration, is what produces the greater pharmacological effect. Caution, is needed, however, when mixing such products with other medicines, such as disulfiram (Antabuse) and some antibiotics. (January 14, 2002)
  • 106. Do people drink more on holidays? Alcohol is considered a social drink, and holidays are a time of planned parties. Thus alcohol drinking can be expected to increase during holidays, particularly around major holidays. The danger of this increased alcohol drinking is not an increase in the number of alcoholics, but rather problems that come with alcohol abuse: drunk driving, hangovers, and (in some people) aggressiveness, mental depression, and stomach upset. These are usually self-limiting problems that disappear after the holidays. However, parties should include non-alcoholic beverage choices. (January 7, 2002)
  • 105. Is the fetal alcohol syndrome (FAS) a100% preventable birth defect? It depends upon your point of view. FAS can occur in any woman who drinks heavily during pregnancy, but it does not appear in every woman who drinks heavily (it is not possible to predict which women are likely to have an FAS baby). And while some women who drink heavily are alcohol dependent, most are not. Thus it is certainly preventable in heavily drinking women who abuse alcohol (they will usually stop drinking during pregnancy), but an alcohol dependent woman will need treatment in order to stop drinking. Treatment is not effective overnight, thus her baby will likely have a high risk for FAS. (December 31, 2001)
  • 104. Women are more likely to have health problems compared to men who drink the same amount of alcohol per day. These include liver damage, pancreatic dysfunction, and high blood pressure. This may be the result of how a woman’s body handles alcohol; for example, one drink produces a higher blood alcohol level in women than in men. On the other hand, women are less likely than men to become alcohol dependent. The reason for this is unknown. (December 24, 2001)
  • 103. Alcohol dependence runs in families. While this suggests a genetic cause, many things run in families that are not genetic (for example, speaking Spanish). However, twin and adoption studies performed over the past two decades clearly indicate a genetic susceptibility for alcohol dependence in families. Alcohol dependence is not a genetic disease (which suggests destiny); rather, the tendency to become alcoholic is inherited. Thus alcoholism can skip generations, or affect only certain individuals in an alcoholic family. (December 17, 2001)
  • 102. A specific type of alcohol dependence appears to occur mostly in men. The so-called Type II alcoholism is also known as early onset alcoholism. It is a more severe form than the so-called Type I, which occurs in both men and women. Furthermore, there is a larger genetic component to the cause of Type II alcoholism, compared to Type I alcohol dependence. (December 10, 2001)
  • 101. How does increasing the price of alcoholic beverages affect alcohol consumption? Keeping in mind that there are two alcohol problems in the world, willful abuse and pathological dependence (“alcoholism”), increasing the difficulty in obtaining alcohol has been shown to reduce alcohol abuse but not alcohol dependence. People who really don’t need to drink will cut back on alcohol consumption (or give it up altogether), whereas people with the disease will use alcohol any way they can get it. (December 3, 2001)
  • 100. Does drinking alcohol at high altitude make a person more drunk than at sea level? This is an old belief, but there is no significant research on this topic in humans. In animals, changing the oxygenated hyperbaric pressure on animals does affect alcohol-induced intoxication, but these studies were not designed to answer practical questions such as the altitude question in humans. With limited research funds for alcohol studies, this is not likely to be studied in the near future. (November 26, 2001)
  • 99. Social use of alcohol is generally defined as use in social settings where no harm occurs to the user or others. Alcohol abuse occurs when alcohol is used in situations or amounts in which the user or others might be harmed (for example, while driving). Alcohol causes abuse, through its pharmacological actions on the brain. Alcohol does not cause alcohol dependence (“alcoholism”) – it is merely one drug through which a brain chemistry problem is manifested. (November 19, 2001)
  • 98. Alcohol shares with some other chemicals the distinction of being the oldest addicting drugs in the history of the world. Although no one knows for sure, alcohol may be older than marijuana and opium. There are records of Egyptian use of alcohol, and certainly the “lore” of alcohol’s use as an intoxicant is as old as recorded history. This has led some to suggest that man’s exposure to alcohol over the ages caused a brain susceptibility to alcohol dependence. This is not likely. (November 12, 2001)
  • 97. Alcohol dependence is now considered a brain disease. Why do people have trouble believing that? Since alcoholics are traditionally “treated” in Alcoholics Anonymous, there is a misperception that alcoholics can help themselves, and that alcoholism is a “did-it-to-yourself” problem. However, A.A. is actually a very structured way to help problem drinkers deal with their problem. When they get better, it is probably because they have learned to adjust the abnormal brain chemistry that is causing their disease. (November 5, 2001)
  • 96. What is the evidence that alcoholism is a disease? In 1954 (and again in 1965), the American Medical Association asserted that alcoholism is a disease. (A disease is an illness with a causative agent, and the victim has no/little control over its onset.) Also, if one compares alcoholism with other accepted medical diseases, it nicely fits the criteria: it has an onset of symptoms, it is involved with a pathological process (in this case in the brain), there are ways to diagnose it, and there are accepted medical treatments. Sadly, science has already recognized these characteristics but they are not yet understood by everyone. (October 29, 2001)
  • 95. What are the main effects of alcohol on the stomach? Alcohol is traditionally known as a “stomachic”, which means that social drinking can increase the appetite for food. It has also long been believed that alcohol can increase digestion, but this may be due to its relaxing effect, when a person has a couple of drinks before or during a meal. In higher “doses”, alcohol causes gastritis (inflammation of the stomach lining), which is one of the reasons for heartburn and nausea the day after binge drinking. Continual heavy drinking can lead to stomach ulceration. (October 22, 2001)
  • 94. How does alcohol interact with “club drugs”? This is a difficult question, and the only answer is “very unpredictably”. There are six main club drugs: methamphetamine, rohypnol, ketamine, GHB, ecstasy, and LSD. There are no established rules or observations for the interaction of alcohol with GHB, ecstasy, or LSD. Alcohol and methamphetamine will either increase or decrease each other’s actions, depending upon the dose of each and the timing of taking one with the other. The actions of alcohol and rohypnol and alcohol and ketamine will be additive, given that they are all depressant drugs. Beyond this, little is known about their interactions. The best advice is that they are dangerous when mixed, especially with higher doses of either one with another. (October 15, 2001)
  • 93. What does calling alcohol a “solvent” mean? A solvent is an agent that solubilizes (causes something to go into solution) some solids or liquids. Additionally, solvents will mix with some substances and not others. Thus, alcohol mixes easily with body fat so that it can penetrate almost all organs of the body. However, it mixes most easily with water, so that alcohol concentrations are highest in the blood (which is >90%water) after drinking. Alcohol is also used as a solvent in pharmaceuticals, which is why some products contain relatively high concentrations of alcohol (e.g., Nyquil, Geritol liquid, cough medicines, etc.). (October 8, 2001)
  • 92. Does alcohol taste good? Because it’s an organic solvent, it tends to have an unpleasant taste to most first-time users. Drunk straight as “absolute” alcohol (ethanol) it really “burns” on the way down, even for heavy-duty drinkers. However, humans have learned how to make alcoholic beverages through fermentation, which produces lower concentrations of alcohol, plus a generally pleasant taste. In beer, for example, it is hard to taste the alcohol. In brandy, the taste of alcohol is apparent, but in some sweetened drinks the alcohol taste is almost entirely masked. (October 1, 2001)
  • 91. Why not just punish alcoholics? That’ll teach them! Science has clearly shown that punishment is not the answer to alcohol dependence. Punishment does tend to reduce alcohol drinking (as in multiple DWIs), but only in those who still have control over their drinking (alcohol abusers). Those with the disease of alcoholism need empathy and treatment, for they have a brain disease that makes them unable to stop drinking without professional help or 12-step program success. (September 24, 2001)
  • 90. The problem with alcohol dependence (“alcoholism”) is not in the beer bottle, it’s not in the wine glass, it’s not in the margarita pitcher – it’s in the brain chemistry of the individual. Science is telling us that the drug is only the agent through which the disease is expressed. (September 17, 2001)
  • 89. How does alcohol cause behavioral and cognitive intoxication? Psychologists would say that alcohol causes a “disinhibition” (inability to control) of certain brain structures, such as the front part of the brain. Pharmacologists and neurobiologists might point to alcohol’s effects on multiple neurotransmitters in the brain, perhaps at the “receptor sites” for these chemicals in the areas between nerve cells, called “synapses.” In any case, such theories are in harmony with each other and do not indicate disagreement among scientists about alcohol’s effects. In truth, we still have much to learn about the answer to this question, and all types of research are important. (September 10, 2001)
  • 88. Alcohol causes shrinkage of brain tissue in people after long-term use of large amounts of alcohol, according to new brain-imaging studies. The shrinkage is due to the loss of brain cells, and the research is mixed with respect to recovery from this loss of brain cells. When people stop drinking, the shrinkage reverses itself, but it is still not clear whether this reversal parallels improved cognition or whether the damage is permanent. More research is needed! (September 3, 2001)
  • 87. Did you know that oral contraceptives (birth control pills) slow down the rate at which alcohol is removed from the body? A woman who is on the pill, then, can expect to feel intoxicated or sedated for a longer time than a woman who is not taking the pill. While some women may strongly feel this effect, others may not feel any difference while on the pill. (August 27, 2001)
  • 86. There is no evidence that alcohol produces any detrimental effects on the body or organ toxicity in single doses of 1-3 drinks per day. (A drink is defined as a standard beverage unit: one beer, one 5-ounce glass of wine, or one cocktail.) (August 20, 2001)
  • 85. Some people assume that alcohol has major detrimental or causative effects on all systems of the body, when consumed in high doses. However, there is still a lot of work to be done. Here are some systems/diseases where alcohol still needs to be studied to see if there is a major detrimental or causative effect: immune system, AIDS progression, breast cancer, throat/oral cancer, prostate cancer, sex hormone function, kidney function, gall bladder function, arthritis, and many more! Support alcohol research funding! (August 13, 2001)
  • 84. About 90% of ingested alcohol is eliminated by liver breakdown (to a chemical called acetaldehyde). Small amounts of alcohol itself are lost from the body through sweat, urine, and expired air. It is not possible to measure acetaldehyde in the blood or urine as an indicator of alcohol in the body, but it is possible to measure alcohol in sweat (sweat patches), urine (urinalysis), and air (breath analysis). The most accurate measure of blood alcohol content is through blood samples. The next most accurate is through breath analysis. Urinalysis is not very accurate, and sweat measurements are not accurate at all, giving only an indication that someone has used alcohol in the past several days. (August 6, 2001)
  • 83. Alcohol is the most toxic, but least potent, of all drugs. This means that it has toxic effects on almost every organ of the body (the kidney being an exception, for some unknown reason). However, its potency is low because it has toxic effects only in large doses (grams, as compared to most other drugs that work in milligram doses). In lower doses, however, it affects individual cells in some organs (brain, heart) through an as-yet-unknown way. (July 30, 2001)
  • 82. One of the biggest problems with alcohol dependence is a lack of recognition of alcohol problems and intervention in patients by physicians. Alcohol dependence is neglected in the education of U.S. physicians, and other health professionals, as well. But when physicians, who have great opportunities to affect patients’ drinking habits (or refer to treatment if necessary), are not trained about the effects of alcohol, then public health suffers. It has been clearly documented that for every dollar spent on treatment of alcohol dependence, seven health care dollars are saved. (July 23, 2001)
  • 81. One of the most widely used screening tests for problem drinking is the CAGE: – Have you ever felt the need to Cut down on your drinking? – Have you ever felt Annoyed by someone criticizing your drinking? – Have you ever felt Guilty about your drinking? – Have you ever felt the need for an Eye opener (a drink at the beginning of the day)? “Yes” answers to two or more of these questions suggests problem drinking and that more assessment of the individual is needed by a qualified professional. (July 16, 2001)
  • 80. Some people say that alcohol is a stimulant. Some people say that alcohol is a depressant. Some people say that alcohol is a poison. Some people say that alcohol is a disinfectant. Some people say that alcohol reduces anxiety. Some people say that alcohol is an antidepressant. Actually, alcohol produces all of those effects, but for relatively brief periods of time, and not very efficiently. The effects depend very much upon the dose and upon when alcohol is used. There are other, more specific drugs that do all of those things better, compared to alcohol. Thus, alcohol is not recommended for producing any of the above effects. (July 9, 2001)
  • 79. Some people say that alcohol is a food. Some people say alcohol is a drug. Some people say that alcohol is a poison. Some people say that alcohol is a pharmaceutical solvent. Why can’t it be all of those? (Actually, it is. There is nothing that says that a chemical can’t have several uses.) (July 2, 2001)
  • 78. Alcoholism is not a “too much, too often disease”. It is an “I can’t stop without help disease”. This means that one should not try to diagnose alcoholism by looking at a person’s drinking behavior (although drinking a lot may be a red flag that someone is alcohol dependent). Some people who drink very little are alcoholic, while others who drink a lot are not alcoholic. (June 25, 2001)
  • 77. Blood alcohol tests are generally quite accurate. Some conditions that can affect the accuracy of a blood sample (usually minimally) are putrefaction (fermentation of body tissues after death), dilution of blood by emergency survival methods (such as intravenous fluids), and extreme blood loss while alcohol absorption and metabolism are still continuing. (June 18, 2001)
  • 76. What happens at certain blood alcohol levels? At 0.1% (the legal drinking-and-driving limit in most states) a person’s ability to drive a car is significantly impaired; that is, there is a loss of judgment and some perception and muscle movement problems. At .2%, most people are “grossly intoxicated”; that is, they slur their speech and have difficulty walking. At .3%, most people will be on the verge of unconsciousness or be comatose. At .4%, death is possible. Of course, there is such variability between people that these are only “textbook” guidelines. Some people are very sensitive to alcohol’s effects, while others are more tolerant to its effects. (June 11, 2001)
  • 75. What does “blood alcohol level” mean? This is the amount of alcohol in a person’s blood, measured in “grams percent”. The legal drinking-and-driving limit in most states is 0.1 (.08 in many states), which means 0.1 grams of alcohol per 100 milliliters of blood. Sometimes it will be stated as 100 milligrams percent (mg%) or 100 milligrams per 100 milliliters of blood. Finally, the same amount can be designated as 100 milligrams per deciliter (mg/dl), which is 100 milliliters of blood. (June 4, 2001)
  • 74. What is the best remedy for a hangover? Obviously, don’t drink so much in the first place. But if you do have a great time at a party, then prevention of another type is in order. To overcome the dehydration and electrolyte imbalance, some people prefer a couple of large glasses of an electrolyte sports drink, or at least water and fruit juice. Also, taking acetaminophen (Tylenol) or another headache remedy (depending on the sensitivity of the stomach) will help ward off the headache. For stomach upset, a couple of antacid tablets will help a lot. Early morning awakening with your heart pounding? NOT more alcohol or a sedative tranquilizer! Just try to relax and wait for the symptoms to disappear. (May 29, 2001)
  • 73. Why does alcohol cause hangovers in some people but not other people? Scientists don’t really know, but we speculate that alcohol has a more “toxic” effect in some people. This “toxicity” is experienced as a small withdrawal syndrome in which certain body systems have been depressed by high amounts of alcohol. When the alcohol wears off, certain signs of excessive activity occur as the body tries to “normalize” its systems. Thus we see increased gastric acid (stomach upset), early morning awakening (a type of insomnia), plus other symptoms such as headache, dehydration, and electrolyte imbalance, which make people feel sick. (May 21, 2001)
  • 72. Alcohol has a mild antioxidant activity in “moderate doses” (1-3 drinks a day). This antioxidant activity tends to overcome the detrimental effects of free oxygen radicals in body tissues. These radicals might increase the risks for cancer, heart disease, and other age-related diseases. Thus drinking a couple of drinks a day has been said to reduce the risk of these diseases, particularly atherosclerotic heart disease. The other mechanism of this protection might involve alcohol-induced changes in good/bad cholesterol ratios in the blood. (May 14, 2001)
  • 71. The major negative effects of long-term alcohol consumption are fatty liver, cirrhosis (in susceptible persons), gastritis, short-term memory loss, Wernicke-Korsakoff syndrome (in susceptible persons), clinical depression, mild hypertension, pancreatitis (in susceptible persons), and cardiomyopathy (heart muscle degeneration). Very heavy drinkers will often have esophagyl varices (dilated veins in the esophagus), brain disease (loss of cognitive function, confusion, amnesia), and signs of liver disease. (May 7, 2001)
  • 70. One of the drugs that is being studied as a possible relapse prevention medication for treating alcohol dependence is acamprosate. This drug is being used in Europe to reduce craving and relapse in alcoholics, and it is currently in clinical trials in the U.S. This drug might work through the NMDA or glutamate systems in the brain to reduce craving and relapse in people who have undergone treatment for alcoholism and who wish to remain abstinent. Further studies will examine its earlier claims of effectiveness and low toxicity. (April 30, 2001)
  • 69. All drugs affecting the brain have a common general mechanism of action. That is, they all affect nerve cells (neurons) in some way. Some brain-affecting drugs reduce nerve cell function, while others increase nerve cell function. But it isn’t that simple. When a person falls asleep, some parts of the brain continue to function and are refreshed by the reduced activity of the body. In a similar manner, some brain areas are “disinhibited” when a depressant drug such as alcohol is working. The result is an energized feeling. (April 23, 2001)
  • 68. Motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) are two research-based treatment strategies for people with alcohol problems. It is not completely known whether these work better for alcohol abusing individuals or for alcohol dependent patients. A component of successful outcome with these therapies, as with other therapies, is the expertise and empathy of the counselor administering the treatment. (April 16, 2001)
  • 67. Alcohol has established beneficial effects on cardiac health. The apparent positive effects from 1-3 drinks per day focus on the reduction of atherosclerosis in coronary and other arteries. This is protective for thrombotic heart disease. On the other hand, clinicians believe that alcohol also breaks down heart muscle (cardiomyopathy) in higher doses, and in sensitive people. Such information can be useful in heavy drinkers who have a family history of heart disease. Advising them to cut back to 1-3 drinks per day can be beneficial to their health. (April 9, 2001)
  • 66. Alcohol and other drugs often don’t mix. Particular drugs that interact with alcohol include anti-anxiety medications (e.g., Valium, Xanax), anti-coagulants (blood thinners such as warfarin, or Coumadin), antidepressants (e.g., Elavil), some antihistamines (e.g., Benadryl, which produces drowsiness of its own), and anti-seizure medications (e.g., Dilantin). (April 2, 2001)
  • 65. Ethyl alcohol (ethanol) is grain alcohol, the main ingredient in alcoholic beverages. Methyl alcohol (methanol) is wood alcohol, a poison, used in some manufacturing processes. Isopropanol (isopropyl alcohol) is rubbing alcohol, used for disinfecting skin and medical instruments. All of these are simple molecules with a COH portion that distinguishes them from other organic compounds. Isn’t it amazing how such simple organic molecules can significantly affect our lives? (March 26, 2001)
  • 64. Unlike other drugs, alcohol has no single receptor site for its action in the brain. In reality, alcohol affects several receptors that exist for other brain chemicals to act upon. Thus alcohol is an interloper, working on whatever receptor sites it happens to connect with. Since alcohol is such a simple molecule, it activates (stimulates or blocks) a number of receptors, although in a somewhat unspecific fashion, since the receptors are usually designed for specific attachment by other drugs. Thus, it is not unexpected that alcohol has many central nervous system effects, which we collectively call “intoxication”. (March 19, 2001)
  • 63. The problem with including both willful alcohol abuse and pathological alcohol dependence under the general term of “alcoholism” is that this diffuses the powerful scientific evidence that alcohol dependence is a medical disease. Medical diseases require treatment. This means there must be adequate insurance to cover the newer research-based treatments for alcohol dependence. The scientific evidence that alcohol dependence is a brain disease requires more research to find exact causes and better treatments, including gene-based treatments. Thus, most research today utilizes the term alcohol dependence as synonymous with “alcoholism”. Alcohol abuse is not “alcoholism.” (March 12, 2001)
  • 62. Alcohol (ethanol) is made from fermentation of various plant products. For example, corn mash fermentation produces bourbon; potatoes produce vodka; hops and malt, wheat and other grains are used in beer production; rice for the Japanese wine sake; malted barley for scotch whiskey; grapes for the different wines; sugar cane for rum; grains and juniper berries for gin; and many fruits for sweet liqueurs. (March 5, 2001)
  • 61. There is great tradition with mixed drinks in America: “boiler-maker” (whisky with a beer chaser), “bloody Mary” (vodka and tomato juice), “screwdriver” (vodka and orange juice), “cocktail” (almost anything with spirits), “one for the road” (a dangerous drink order), “nightcap” (last drink of the evening), and many more. Like any other alcoholic drinks, these are fine when only one or two are consumed. But too many Long Island Iced Teas (multiple spirits) made with EverClear (absolute alcohol) can be fatal! (February 26, 2001)
  • 60. The idea that alcohol causes nerve cells to “melt” is an old theory, that was once used to help scientists understand how alcohol depresses nerve cell function. “Melting” referred to the action of alcohol on disorganization of the protein and fat molecules of the nerve membrane, causing the ionic pores to be disrupted. This disruption reduced nerve cell firing. Now we know that alcohol only passively affects the nerve membrane, mainly at high doses. (February 19, 2001)
  • 59. There is no credible research evidence for the following statements about alcohol use: 1) alcohol makes you more intoxicated at high altitudes, compared to sea level, 2) alcohol cures colds and intestinal infections, and 3) alcohol increases digestion of foods. (February 12, 2001)
  • 58. State legislatures have set a certain blood alcohol concentration (BAC) limit, above which a person is legally intoxicated and should not drive a motor vehicle. Many states have adopted a new lower BAC of 0.08%, compared to the previous level of 0.1%. Research studies are available to suggest significant impairment even at 0.05%, which is the recommended level adopted the American Medical Association. People can reach the 0.08% limit by simply drinking 3-4 drinks within approximately an hour. This is quite variable, however, between genders and depending on food in the stomach, prior drinking history, and genetic make-up. (February 5, 2001)
  • 57. Ethyl alcohol (ethanol, beverage alcohol) has many uses, in addition to its reputation as one of the most abused drugs. It is an ingredient in some rubbing alcohols (some brands use isopropyl alcohol instead), it has been used historically for reducing pain when used in field block anesthesia in trigeminal neuralgia (Tic douloureaux), it is a solvent in pharmaceutical preparations (e.g., liquid cold remedies), and it probably reduces atherosclerosis when drunk in moderation. (January 29, 2001)
  • 56. Alcohol is partially metabolized (broken down) in the stomach by an enzyme called gastric alcohol dehydrogenase (GADH). This is basically the same enzyme that metabolizes alcohol in the liver, but there is a lower concentration in the stomach lining. The levels of GADH are higher in men than women, so that when women drink, less alcohol is broken down in the stomach. Thus more alcohol passes into the upper intestine, the primary site of absorption. This is one of the reasons that blood alcohol levels are higher in women than in men after the same number of drinks. (January 22, 2001)
  • 55. How are genes related to alcohol dependence? Genes form proteins in the brain. In the brain’s neurotransmitter systems, proteins and enzymes (specialized proteins) are involved in the manufacture, release, and metabolism of chemicals that allow brain cells to communicate with one another. When such communication is disrupted between nerve cells in the “pleasure pathway”, dependence on alcohol (impaired control over drinking) can occur. This disruption is probably caused by abnormal gene regulation of protein function. (January 15, 2001)
  • 54. Is alcohol dependence a genetic disease? Yes, with qualifications. Genetics studies performed over the past 20-25 years have clearly shown that the tendency to become alcohol dependent (“alcoholic”) is inherited. In other words, genetic vulnerability coupled with unknown environmental factors is the cause of most types of alcohol dependence. Science has yet to fully understand the transmission of genetic vulnerability, and the specific environmental factors that trigger the disease. (January 8, 2001)
  • 53. What are the differences among alcoholic beverages? Beer, wine, and spirits contain different quantities of ethanol by weight or volume. Beer contains roughly 4-6% ethanol; wine, 10-13%; and spirits, 20-50%, with the majority being around 40% (80 proof). Some beverages are “lite” (beers and wines containing lower concentrations of ethanol), while some are “light” (in color) – white wine, vodka, gin, tequila. There is some evidence that these produce less hangover than darker beverages – red wine, bourbon, scotch. There is no evidence that people become addicted to spirits more readily than to beer or wine. Spirits, however, are more likely to produce death in overdose situations. (January 1, 2001)
  • 52. What are the similarities among alcoholic beverages? Of course, beer, wine, and spirits all contain ethyl alcohol (ethanol) as a product of fermentation in the manufacturing process. Beer (and sometimes wine) has natural carbonation, which may alter the absorption rate of ethanol. In general, one beer, one 5-ounce glass of wine, and 1.5 ounces of spirits contain similar amounts of alcohol (thus these are called “beverage units”). The ethanol in all alcoholic beverages is “handled” by the body identically – metabolism, effects on organs, etc. People can become dependent (“addicted to alcohol”) on any alcoholic beverage. (December 25, 2000)
  • 51. Are there different types of tolerance? There are many words to describe three basic types of tolerance.? Functional tolerance, caused by nerve cell adaptation to alcohol, is also called cellular or tissue tolerance.? Dispositional tolerance is seen when the liver’s breakdown enzymes increase in activity in response to alcohol. This is also called metabolic tolerance. Another type of tolerance is called learned tolerance, in which some people seem to “sober up” in special situations. (December 18, 2000)
  • 50. What is tolerance? Tolerance is the adaptation of the body to the effects of alcohol (or another drug). This means that a person must drink more and more alcohol to produce the same effects as the first time they drank. Not everyone becomes tolerant to alcohol, but when it occurs it can be significant. For example, some heavy drinkers consume over a quart of spirits per day. (December 11, 2000)
  • 49. What is the addiction potential of alcohol? Statistics tell us that about 5-6% of the U.S. population is dependent on alcohol. This is roughly 15-18 million people. Another way of looking at this is that one of every 10 people who drink in the U.S. develop dependence on alcohol. About 1/3 of the population does not drink (“population” includes children, old folks, and abstainers). (December 4, 2000)
  • 48. What are THIQs? The technical name for these is “tetrahydroisoquinolines”. According to a 1970s theory, THIQs are formed in the brains of alcoholics when they drink. THIQs have opioid-like pharmacological qualities, and presumably alcoholics became addicted to THIQs formed in their brains, rather than to alcohol itself. The theory generated many years of research, during which methods to measure tiny quantities of THIQs in humans were developed. However, scientists have had a difficult time finding THIQs consistently in alcoholics compared to non-alcoholic people. Thus, this theory has fallen out of favor among most scientists. (November 27, 2000)
  • 47. Can alcohol kill people? Alcohol is a very dangerous drug, in two important ways. First, people can overdose on alcohol and die either by suffocating on their vomit while drunk or sleeping, or because alcohol can shut down the brain areas that control breathing. Anyone who has a blood alcohol level of 0.35% or above is in danger of overdose (about 14-18 drinks in a rather brief period of time). Second, chronic heavy drinkers can die during withdrawal from (especially) high blood alcohol levels. (Death is usually due to seizures when the body experiences hyperexcitability during declining blood alcohol levels.) (November 20, 2000)
  • 46. Is everyone who drinks too much, too often, an alcoholic? No, because the latest diagnostic criteria for alcohol dependence (“alcoholism”), as listed in the Diagnostic and Statistical Manual, Edition IV, Text Revision (DSM-IV-TR, 2000) do not include amount consumed or duration of alcohol consumption as diagnostic criteria. The main difference between alcoholism (pathological alcohol dependence) and willful alcohol abuse is whether a person can stop when critical life events (e.g., loss of a job or a spouse) occur. If (s)he cannot, then by definition there is “impaired control” over alcohol use, the main diagnostic criterion of alcohol dependence. (November 13, 2000)
  • 45. Does alcohol kill brain cells? Yes, but only when large quantities are drunk over a period of many years. Thus, alcohol abusers and alcohol dependent individuals (collectively called “problem drinkers”) often suffer from Korsakoff Syndrome, amnesia, confusion, and dementia. This effect is due to alcohol toxicity on the hippocampus, or “memory” portion of the brain. Social drinking, however, does not kill brain cells. (November 6, 2000)
  • 44. Why does alcohol stimulate some people and make other people sleepy? Observation tells us that women generally become sedated with a few drinks, whereas men become “happy”. Obviously this is an overgeneralization. Alcohol affects people in different ways. This is probably due to differences in metabolism (break-down of the drug), rate of drinking, brain cell sensitivity, and other unknown factors. (October 30, 2000)
  • 43. Is alcohol a depressant or a stimulant? Pharmacologically, alcohol depresses nerve cells in the brain and body. However, the brain is so complex that when depression occurs somewhere in the brain, stimulation occurs to compensate for the imbalance. Thus, low doses of alcohol cause people to feel “high”, while higher doses cause sedation and sleepiness (and in high doses, unconsciousness). (October 23, 2000)
  • 42. What is “disinhibition”? This is a phenomenon produced by alcohol causing nervous system depression. The cortex (“thinking” portion of the brain) is depressed by low doses of alcohol. One function of the cortex is to maintain control over the rest of the brain. When alcohol depresses the cortex, the rest of the brain speeds up. Thus, the person feels more likely to take chances, there is loss of control over judgment, and the pleasure pathway is engaged, leading to a euphoric “high”. (October 16, 2000)
  • 41. Alcohol is classified as a central nervous system (brain and spinal cord) depressant. How, then, can alcohol cause someone to feel “high” or euphoric? Scientists are not sure, but the simple explanation is that alcohol causes “dis-inhibition” of parts of the brain that are normally held in check in people who are not intoxicated. In other words, alcohol causes a reduction in the inhibitory parts of the brain, thereby causing them to relax their influence on parts of the brain that can exhibit stimulation. We feel “high” when our cerebral cortex is more dis-inhibited, so we infer that alcohol has a major effect on depressing the cerebral cortex. (October 9, 2000)
  • 40. Impairment of driving is due to many effects of alcohol: reduced judgment, increased reaction time, a euphoric “high” that makes the person feel they can drive safely when in fact their ability is reduced, increased risk-taking, reduced ability to focus on roadway markers and other traffic, and (when the effects are wearing off) marked drowsiness that can lead to decreased attention and perhaps periods of “nodding off”. (October 2, 2000)
  • 39. In 1990, all states in the nation had an 0.1% blood alcohol concentration (BAC) legal limit for driving while intoxicated (DWI). In the late 1990’s a number of states lowered their DWI legal limit to 0.08%. This can be reached in most people by the continuous drinking of 3-4 standard drinks (defined as a beer, a glass of wine, a mixed drink), with women requiring less alcohol to reach the level than men. Research studies show significant driving impairment with BACs as low as 0.05%, which has been recommended by organizations such as the American Medical Association. Europe has stricter standards, ranging from 0% BAC (Norway) to 0.05% (England). Many European countries and some states/cities in the U.S. allow alcohol check-points, particularly during holidays, to catch drivers who have BACs that are too high. (September 25, 2000)
  • 38. Why is the absorption of alcohol slowed down when a person has food in the stomach? It is logical to think that food reduces the availability of alcohol to the stomach lining for absorption. However, since alcohol is absorbed more quickly from the upper intestine than from the stomach, it is more likely that food reduces the movement of alcohol from the stomach to the intestine. Alcohol does indeed reduce the rate of gastric emptying, therefore food delays the movement of alcohol to the intestine, and absorption is slowed down. (September 18, 2000)
  • 37. Unlike other drugs, alcohol has no specific receptor to activate in the brain. For example, cocaine’s receptor is called the dopamine transporter. Heroin’s receptor is called the opioid receptor(s), and the receptor for marijuana is called the cannabinoid receptor. Scientists used to think that alcohol “melted” (not a scientific term) the nerve membrane in a reversible way, but today scientists are inclined to believe that alcohol has affinity for certain receptors for other chemicals in the brain. For example, alcohol is known to affect the GABA receptor, the NMDA receptor, and probably others to produce its myriad of behavioral and toxicological effects. (September 11, 2000)
  • 36. Proper terminology is critical when discussing alcohol problems. “Alcohol use” is any use of alcohol. “Alcohol abuse” is intentional overuse of alcohol in cases of celebration, treatment of depression or anxiety, or in binge drinking (is it the alcohol that’s being abused?). In Europe, “alcohol misuse” is more common than “alcohol abuse”, and is slightly more accurate in that it is the person who is improperly using alcohol. Finally, “alcohol dependence” is the new term for alcohol addiction or “alcoholism”, in which the person cannot stop drinking in spite of adverse consequences. (September 4, 2000)
  • 35. Alcohol unfavorably interacts with many other drugs: benzodiazepines (such as Xanax, Valium, Librium), antidepressants (such as Prozac, Zoloft), insulin, anticoagulants, antihistamines, some antibiotics, and many others. In fact, many prescription drugs carry the label “Do not drink alcohol while taking this medication”. In general, alcohol can increase the effects of drugs that make people drowsy, can alter the metabolism (break-down) of drugs, or reduce the effectiveness of drugs. (August 28, 2000)
  • 34. Alcohol is the drug used most often by high school seniors. Even though such students cannot legally buy alcohol, over 90% of them have tried alcohol and almost one-third of them report that they have had more than 5 drinks at one time (binge drinking) in the past two weeks. With college students, over 40% report recent heavy drinking. On one college campus, an informal survey indicated over 90% of first-year students had drunk to intoxication in the previous month. (August 21, 2000)
  • 33. “Blackouts”, contrary to public knowledge, are not diagnostic of alcohol dependence (alcoholism). Blackouts are memory lapses caused by (usually) heavy drinking, where the individual does not pass out, but appears to act relatively normal during drinking. However, the next day, events that occurred during portions of the drinking period cannot be remembered. Blackouts probably occur because the function of the hippocampus, the part of the brain that registers memory, is depressed by alcohol. Whether the memories never get “registered”, or whether they become registered but cannot be retrieved, has not been determined. (August 14, 2000)
  • 32. One of the briefest intervention tests that can be used by physicians to discover whether a person has drinking problems is the CAGE questionnaire: Have you ever felt the need to Cut down on your drinking? Have you ever felt Annoyed by someone criticizing your drinking? Have you ever felt Guilty about your drinking? Have you ever felt the need for an Eye opener (a drink at the beginning of the day)? “Yes” answers to two or more of these suggest the possibility of alcohol dependence, although the answers should be discussed with a treatment specialist. (August 7, 2000)
  • 31. Alcohol dependence (“alcoholism”) is probably several diseases, each with a different cause. For example, some scientists talk about Type I and Type II alcoholics. Others have studied the differences between Types A & B alcoholism. It is also possible that brain chemistry differences could be involved in several types of alcoholism, leading to alcohol dependence associated with dopamine abnormalities in the brain’s pleasure pathway, or serotonin abnormalities, endorphin abnormalities, etc. (July 31, 2000)
  • 30. Geneticists estimate that about 60% of the causes of alcohol dependence are due to genes that lead to increased “vulnerability” to alcoholism. These genes probably affect some physiological component of the brain that is associated with the production of “impaired control,” the hallmark of alcohol dependence. (July 24, 2000)
  • 29. What is glutamate? Glutamate is an excitatory amino acid that is part of the transmitter systems that might be affected to produce alcohol’s “intoxication”. It is found throughout the brain, and may either be inhibited or enhanced by different doses of alcohol. (July 17, 2000)
  • 28. What is GABA? GABA, or gamma-amino butyric acid, is one of the major message-carrying chemicals called neurotransmitters in the brain. It is significantly affected by alcohol, causing various signs of “intoxication”. Since GABA’s action is to reduce the transmission of impulses between cells, it is called an “inhibitory” neurotransmitter. Thus alcohol either increases or decreases GABA function to produce the combination of inhibitory (e.g., impaired judgment) and excitatory (e.g. exhilaration) effects of alcohol on the major areas of the brain. (July 10, 2000)
  • 27. Alcohol’s effects on neurotransmitters (chemical transmission molecules) in the brain are not limited to one or just a few chemicals. While scientists agree that the alcohol molecule does not “activate” a single receptor in the brain, alcohol appears to work by affecting the receptors of several neurotransmitters. Among these are gamma-amino butyric acid (GABA), glutamate, n-methyl-d-aspartate (NMDA), endorphins, dopamine, serotonin, and acetylcholine. The myriad of effects on all these chemical systems probably explains the many effects of alcohol on the body. (July 3, 2000)
  • 26. Alcohol is a very poor drug for reducing a person’s anxiety or depression. These mental symptoms are caused by an inappropriate response to life events, and in many cases the causes are unknown. People drinking alcohol to reduce such symptoms often find that anxiety and depression are actually made worse by alcohol. Therefore the best treatment for these symptoms is medication prescribed by a doctor. In some cases, the symptoms go away after a period of time, or with the help of a therapist. (June 26, 2000)
  • 25. Two drugs are available to help alcoholics sustain behaviorally-produced abstinence. Naltrexone (available in 35 countries) was approved by the American FDA in 1994 to help alcoholics who want to stop drinking but have trouble with relapse (“slips”, inability to stop completely). It seems to work somehow on the endorphin system of the brain. Acamprosate is available in 37 countries and is in clinical studies in the United States. It helps alcoholics sustain abstinence, perhaps through an effect on the glutamate system of the brain. Both drugs are a significant improvement over Antabuse, a 50-year-old drug that works on the liver. (June 19, 2000)
  • 24. Binge or continual long-term drinking often causes withdrawal when a person stops drinking. Because alcohol is a depressant in the body, high doses reduce cell activity. When alcohol is removed from the cells, they recover in a way that produces a change in sensitivity toward stimulation. However, this attempt by the body to produce “normalcy” often leads to over-stimulation (“hyperactivity”), which is known as withdrawal. Thus, binge drinking leads to “hangover” (headache, increased stomach acidity, early morning awakening, etc.). Long-term heavy drinking leads to the “shakes”, delirium (hallucinations), and sometimes, seizures. Thus alcohol abusers or alcohol-dependent individuals must be detoxified (“detoxed”) to reduce the discomfort and possible deaths produced by withdrawal. Interestingly, some people are immune to hangovers or severe withdrawal, for unknown reasons. (June 12, 2000)
  • 23. What is the most accurate way to measure the amount of alcohol drunk by an individual? The body gets rid of alcohol in several ways: in the breath, urine, sweat, and by metabolism (breakdown) in the liver. Therefore people have tried to measure alcohol in the breath, urine, and sweat. The least accurate method is measurement of sweat alcohol, the next least accurate is measurement in urine, and the most accurate of the three is breath alcohol. However, the most accurate and sensitive measure of all is alcohol measured directly in the blood (or serum, which is the part of the blood without blood cells). (June 5, 2000)
  • 22. What is ALDH, as it refers to alcohol metabolism? After alcohol is broken down in the body to acetaldehyde by alcohol dehydrogenase and other enzymes, acetaldehyde is broken down broken down to acetate, carbon dioxide, and water by another liver enzyme, aldehyde dehydrogenase (ALDH). ALDH is the enzyme that is blocked by disulfiram (Antabuse), a drug used to deter drinking. Blockade of ALDH results in higher acetaldehyde levels when people drink, which makes them sick and is a deterrent to drinking in some people. (May 29, 2000)
  • 21. What is ADH, as it refers to alcohol metabolism? Most of the metabolism (breakdown) of alcohol is performed by the enzyme alcohol dehydrogenase (ADH), which is found mostly in the liver. Approximately 90-95% of all alcohol removal from the body is done by ADH. ADH is also found in other tissues, most notably the stomach lining, where it breaks down some of the alcohol that reaches the stomach. (May 22, 2000)
  • 20. “Problem drinking” is defined as any consumption of alcohol that results in significant risk of physical damage, psychological problems, accidents, legal problems, or other social problems. “Problem” drinking includes two DSM-IV related diagnoses: willful alcohol abuse and pathological alcohol dependence. Alcohol abuse is a significant social problem, leading to major economic impact associated with drunk driving, medical costs, job- and family-related problems, etc. Alcohol dependence is the disease of “alcoholism”, which also devastates lives and is a major burden on the legal, social, and medical systems of our society. (May 15, 2000)
  • 19. “Moderate use” of alcohol has been defined by the Department of Agriculture (and other sources) as 1-2 drinks per day – one drink for women, two drinks for men. The interest in “moderate” drinking is underscored by the research showing beneficial effects of moderate drinking on cardiovascular function, and perhaps on the prevention of Type II diabetes and occlusive (clot-related) strokes. Moderate drinkers are clearly at reduced risk for atherosclerotic heart disease, compared to alcohol abstainers and heavy drinkers. However, the mechanism of this protective effect is incompletely known. (May 8, 2000)
  • 18. “Social use” of alcohol consists of an occasional drink or two in the company of friends: a glass of champagne at a wedding, a cold beer after a softball game, or a glass of fine wine with a meal. Contrary to popular belief, social drinking does not kill brain cells, nor does it adversely affect any major body organ. Two-thirds of the U.S. population drinks alcohol, but the number of social drinkers has not accurately been measured, mainly because of the existence of several definitions of “social” drinking. (May 1, 2000)
  • 17. People often wonder how alcohol can be a legal, socially-accepted drug, while other drugs are illegal to possess, sell, or use. Alcohol’s use is historical, and to prohibit its sale and use would break a great deal of cultural, religious, and social traditions. Alcohol Prohibition, which occurred in the U.S. from 1920 to 1933, was generally considered a failure, for it spawned bootleg manufacturing operations and increased trafficking in illegal alcohol sales. Interestingly, the rate of alcohol use, abuse, and liver cirrhosis in the U.S. declined greatly during this period, but the number of alcoholics remained about the same. (April 24, 2000)
  • 16. Beverage alcohol (ethanol, ethyl alcohol, grain alcohol) is only one of several alcohols used by humans. Two others should not be consumed: methanol (methyl alcohol, wood alcohol) is often used in antifreezes for vehicles and is highly toxic (can cause blindness, primarily); and isopropanol (isopropyl alcohol), which is best known for its use as a disinfectant in rubbing alcohols. Ethanol is also used in rubbing alcohols, but it is adulterated with methanol or another ingredient to prevent people from drinking these products. (April 17, 2000)
  • 15. Fetal alcohol syndrome (FAS) is a major cause of birth defects around the world. In the U.S., conservative estimates are that each day about 3-4 children are born with FAS. FAS is the only permanent fetal syndrome caused by addicting drugs. This means that women who are dependent on alcohol and who cannot stop drinking during pregnancy have a great chance of permanently damaging their baby. The signs of FAS are complex, but include physical malformations, brain damage (mild to severe), and a probable shortened life span. (April 10, 2000)
  • 14. Beverage alcohol has major toxic effects on the following organs, with heavy drinking over many years: liver, heart, brain, gastrointestinal tract (stomach and intestines), and pancreas. These effects are, in order: fatty liver and cirrhosis, cardiomyopathy (breakdown of heart muscle), brain shrinkage and cell death (particularly memory areas), ulceration, and inflammation of the pancreas. (April 3, 2000)
  • 13. There are two major alcohol problems in the world, based upon new diagnostic criteria. The first is alcohol abuse, which is intentional alcohol overuse or misuse such as seen on college campuses, or in other cases with poor judgment about drinking too much, too often. The main characteristic of alcohol abuse is that people will moderate or stop their drinking when they decide that the adverse consequences are worse than the desirable effects of drinking. The second problem is pathological alcohol dependence, the disease of “alcoholism”. This is a brain-chemistry disease characterized by the inability to consistently stop drinking, even under adverse consequences. (March 27, 2000)
  • 12. Alcohol (ethanol) is one of the most organ-toxic (liver, brain, heart, gastrointestinal tract) drugs of all. It is also one of the least-potent (requires large quantities) of all drugs. This means that low doses are relatively non-toxic to organs yet still effective in producing euphoric effects, since the effects of low doses are seen first on mood and judgment. (March 20, 2000)
  • 11. Beverage alcohol contains ethyl alcohol (ethanol), a simple molecule consisting of two carbon atoms, 6 hydrogen atoms, and one oxygen atom. Because it is so small, it penetrates readily into every tissue of the body. In spite of its easy penetration, it does have specific effects on certain organs and parts of organs. For example, it acts more on some nerve cell parts than others. This may due to the higher sensitivity of these parts to ethanol, for unknown reasons. (March 13, 2000)
  • 10. How alcohol produces “intoxicating” effects on the brain is not entirely known. Three specific brain components, called neurotransmitter receptors, are being studied by scientists around the world. These receptors are the n-methyl-d-aspartate (NMDA) receptor, the gamma aminobutyric acid (GABA) receptor, and the nicotine (nicotinic) receptor. Blockade or enhancement of these neurotransmitter receptor systems may hold the answer to how alcohol produces its pharmacological actions. (March 6, 2000)
  • 9. Food significantly affects the absorption of alcohol from the stomach. Alcohol is absorbed much more rapidly from an empty stomach than from a full one. Food in the stomach slows absorption and also reduces gastric emptying time into the upper part of the intestine (duodenum), which is where alcohol is absorbed most rapidly. When alcohol stays in the stomach longer, it is also more vulnerable to being broken down by gastric alcohol dehydrogenase (GADH). (February 28, 2000)
  • 8. There are several alcohols used in products that people use on a daily basis: ethanol (ethyl alcohol, grain alcohol) is the one used in alcoholic beverages. Another, methanol (methyl alcohol, wood alcohol) is sometimes used in antifreezes and canned burning fuels. Isopropyl alcohol (isopropanol) is used as rubbing alcohol for disinfecting skin and instruments (although ethanol is also used for this purpose, check the label on the bottle). Glycerin is also technically an alcohol (glycerol), and is used in pharmaceutical preparations. The most toxic of these alcohols is methanol, which can cause blindness when ingested. (February 21, 2000)
  • 7. In low doses (1-2 drinks, but it varies among individuals), alcohol produces: relaxation, reduced inhibitions, impaired concentration, slowed reflexes, reduced reaction time, and reduced coordination. These effects are magnified as the number of drinks increases, until there is serious impairment, which can affect driving skills. This is because alcohol is primarily a depressant of the central nervous system. (February 14, 2000)
  • 6. Women metabolize (break down) alcohol more slowly than men because there is a smaller amount of alcohol metabolizing enzyme (alcohol dehydrogenase) in the stomach in women. Because less enzyme is present, more alcohol passes through the stomach to the duodenum, the main alcohol-absorbing portion of the gut. This effect, combined with a different fat/lean body makeup between men and women, leads to higher blood alcohol levels (BACs) in women than men after identical alcoholic drinks. (February 7, 2000)
  • 5. One “beverage unit” (BU; beer, wine, or spirits) drunk by a 150-pound man within roughly 20 minutes will produce a blood-alcohol concentration (BAC) of .025%, which is approximately one-third the drunk driving limit of .08% in Texas, or approximately one-fourth that in states which have a .1% BAC drunk driving limit. Keep in mind, however, that about one BU is lost per hour by being broken down in the liver (January 31, 2000)
  • 4. One standard “beverage unit” of alcohol consists of one 5-ounce glass of wine, one 12-ounce beer, or one cocktail containing 1.5 ounce of 80 proof spirits. All of these contain roughly the same amount of ethanol. (January 24, 2000)
  • 3. The estimated incidence of alcohol dependent people (“alcoholics”) in the United States is 5-6% of the population, or roughly 15-18 million individuals. (January 17, 2000)
  • 2. The main metabolizing (break-down) enzyme for alcohol is known as alcohol dehydrogenase. This produces a compound called acetaldehyde, which is in turn broken down by aldehyde dehydrogenase. Alcohol dehydrogenase is primarily found in the liver but also occurs in the stomach, and (in low concentrations) other organs of the body. (January 10, 2000)
  • 1. Beverage alcohol (ethanol, ethyl alcohol) is a simple compound consisting of carbon, hydrogen, and oxygen. These form a two-carbon chain which is metabolized (broken down) in the body by the liver into carbon dioxide and water. (January 3, 2000)