Section 3 Long-Term Risks of Alcohol Objectives Before class begins, write the objectives on the board. Have students copy the objectives into their notebooks at the start of class. 1. Focus Warm-Up Myth/Fact Call on a few volunteers to share their answers. Restate correctly as fact any other common misconceptions of alcoholics that students reveal, such as Alcoholics have a character flaw (which might be restated as Alcoholics have a disease ). Tell students they will learn more about alcoholics and alcoholism in this section. Teaching Transparency W51 Section 3 Objectives Identify five serious physical effects of longterm alcohol abuse. Describe the three stages of alcoholism. List in order three steps taken during recovery from alcoholism. Vocabulary fetal alcohol syndrome cirrhosis alcoholism tolerance dependence addiction reverse tolerance detoxification withdrawal rehabilitation Long-Term Risks of Alcohol Myth Alcoholics sleep on park benches and wear shabby clothes. Fact Alcoholics come from all cultures, backgrounds, and levels of education. In what ways does the media contribute to this myth about alcoholics? How else does the media shape people s perception of alcoholics? Damage to the Body Adults over age 21 who use alcohol responsibly usually are not at risk of developing long-term health problems related to alcohol. But heavy drinking can cause serious damage to the body over time. Long-term alcohol abuse may harm the brain, liver, heart, and digestive system. Furthermore, drinking any amount of alcohol during pregnancy may permanently harm the developing baby. Connect to because the teenage years YOUR LIFE are a critical time in brain development Sensitive Issues Some students might try to identify classmates or others with the various descriptions of problem drinkers. Make sure students do not publicly identify and embarrass any individual. Students who have alcoholic family members may feel uncomfortable during class discussions. Stress that all members of a family in which alcoholism occurs will not necessarily become alcoholics. Recognizing the problem and knowing the warning signs of problem drinking are helpful in avoiding the disease. 386 Chapter 15 386 Chapter 15 TEENS Are Asking... Q: I read that the effects of alcohol on the brain are cumulative. Does that mean drinking one drink a day for ten days is as harmful as drinking ten drinks in two hours? A: The effects of alcohol are cumulative in that the brain damage done during a single bout of drinking adds to any prior damage. Drinking one drink vs. ten drinks at a time is a different matter. Drinking ten drinks in Brain Damage Long-term alcohol abuse destroys nerve cells in the brain. Destroyed nerve cells usually cannot grow again. The loss of many nerve cells causes permanent changes that impair memory, the ability to concentrate, and the ability to make sound judgments. These losses interfere with normal everyday functions. Effects on the brain can be especially damaging for underage drinkers. When teens drink, they expose the brain to alcohol during a critical time in its development. Teenage drinkers may suffer long-term learning and memory problems. Connect to YOUR LIFE Why are teens especially vulnerable to brain damage caused by alcohol? two hours is binge drinking. Research shows that binge drinking can permanently damage parts of the brain responsible for judgment, impulse control, and memory formation. The brains of teens are more susceptible to damage from binge drinking than the brains of adults. For a lightweight person, drinking ten drinks in an hour could result in coma or even death.
2. Teach L3 L2 EL Reading/Note Taking 15-3 Adapted Reading/Note Taking 15-3 Fetal Alcohol Syndrome Pregnant women who drink put the health of their future children at risk. Fetal alcohol syndrome is a group of birth defects caused by the effects of alcohol on an unborn child. Babies born with this syndrome may suffer from heart defects, malformed faces, delayed growth, poor motor development, and mental retardation. Some show only brain and behavioral problems, without the other physical effects. Tragically, drinking during pregnancy is the leading preventable cause of mental retardation in the United States. Even small amounts of alcohol consumed during pregnancy can cause brain damage. Any woman who is planning to become pregnant, or who is already pregnant or breast-feeding, should not drink any alcohol. Liver Damage Alcohol interferes with the liver s ability to metabolize, or break down, fats. As a result of heavy drinking, the liver begins to fill with fat, which blocks the flow of blood in the liver. The fat-filled liver cells die, leaving behind useless scar tissue. This disease, called cirrhosis (sih ROH sis), may lead to liver failure and death. Heavy drinkers also may suffer from alcoholic hepatitis, an inflammation of the liver caused by the toxic effects of alcohol. It too can cause the drinker to die. Heart Disease Excessive drinking contributes to heart disease, the leading cause of death in the United States. Over time, alcohol causes increased blood pressure and heart rate, irregular heartbeat, and a buildup of fatty deposits in the heart muscle. Digestive Problems Ongoing drinking also irritates the tissues that line the digestive system, causing inflammation. Repeated irritation increases the risk of cancers of the mouth, tongue, esophagus, and stomach. recurring diarrhea. chronic indigestion, heartburn, or ulcers. FIGURE 8 Drinking any amount of alcohol during pregnancy may cause fetal alcohol syndrome. This boy, shown with his adoptive parents, has severe symptoms. Healthy liver Liver damaged by cirrhosis FIGURE 9 A healthy liver contains smooth tissue. The liver of a heavy drinker contains useless scar tissue. Damage to the Body L3 Teacher Demo Bring to class a few labels from alcoholic drinks, such as beer or wine bottles, that include warnings for pregnant women. After students have had a chance to read the warnings, ask them whether they think the warnings are an effective way of making women aware of the dangers of alcohol use during pregnancy. Challenge the class to brainstorm other ways pregnant women might be warned not to drink alcohol. L4 Active Learning Encourage interested students to learn more about fetal alcohol syndrome, such as its incidence in the United States and what is being done to help prevent it. Have students share what they learn by creating a poster to display in the classroom. L1 Active Learning Ask for a volunteer to lie down on a piece of butcher paper while another student uses a marker to trace the outline of the volunteer s body. Then have the students work closely with their textbooks to mark on the traced outline any areas of the body that are affected by long-term alcohol abuse. Students can also list on the paper the diseases associated with alcohol abuse. Have students title their work and decorate their outlines using color and collage materials. Alcohol 387 L2 Less Proficient Readers Pair less proficient readers with more proficient readers, and have each pair make a graphic organizer to show how alcohol can damage the body. Graphic organizers should include long-term effects of alcohol on the brain, liver, heart, and digestive system. You may want to have the students write their lists on the board or an overhead transparency so they can share them with the class. Alcohol 387
Chapter 15, Section 3 Alcoholism EL Building Media Literacy The terms alcoholism, tolerance, dependence, and addiction are easily confused. Write the terms on the board, and then ask: What type of media could you search for more detailed definitions of these terms? (Sample answers: dictionaries, encyclopedias, medical reference books, nonfiction books about alcoholism, medical Web sites) Ask students to search the different types of media for definitions of the terms and decide which type of media is most useful for this purpose. L3 Addressing Misconceptions The Nature of Alcoholism Many people think that alcoholics drink because they are irresponsible or morally weak. In fact, research shows that alcoholism is a complex disease involving serious social and psychological problems. It may also have a biochemical component that can be genetically transmitted. Help students understand that the progression of alcoholism can be stopped because it is a treatable disease. L2 Visual Learning: Figure 10 Have students read the caption and examine the photos. Call on a volunteer to answer the caption question. Ask: If the two teens whose brain scans are shown here were doing a math test, which teen do you think would get a lower score? (the heavy drinker) Caption Answer the brain of the nondrinker FIGURE 10 Teenage drinking affects the brain dramatically in the short term. Shown here (in red) is brain activity in two teens asked to perform the same task. Interpreting Photos Which brain has more activity? Alcoholism People who can no longer control their use of alcohol suffer from the disease known as alcoholism. Physically, an alcoholic s body requires alcohol to function. Psychologically, alcoholics consider drinking a regular, essential part of coping with daily life. Changes to the Brain With repeated use of alcohol, its effects in the brain become reduced the body has developed tolerance to alcohol. Tolerance causes a drinker s body to need increasingly larger amounts of alcohol to achieve the original effect. With increasing tolerance, the body will eventually develop dependence the brain develops a chemical need for alcohol and cannot function normally without it. Finally, addiction results the drinker no longer has control over his or her drinking. Alcohol addiction is characterized by a craving, or strong emotional need, to use alcohol. Because alcoholics can no longer control their alcohol use, they must receive help to recover from this disease. Scientists have found that during addiction, the structure and the chemistry of the brain changes addiction is a disease of the brain. Who Is at Risk? Anyone who drinks is at risk of becoming an alcoholic. However, some people seem to be at higher risk than others. For example, alcoholism is four to five times more common among the children of alcoholics than in the general population. The reason for this is likely a combination of the influence of genetics and the environment in which a person grows up. Attitudes towards drinking and the availability of alcohol in the home play a strong role in determining whether or not a person will develop a drinking problem. Underage drinking also increases a person s risk of becoming an alcoholic. Alcoholism and Brain Activity 15-year-old Non-drinker 15-year-old Heavy Drinker 388 Chapter 15 Focus On ISSUES L3 Early Drinking and Alcoholism Tell students that the younger teens are when they start drinking, the more likely they are to become alcoholics. Ask: Does this mean that early drinking causes alcoholism? (At least some students are likely to say yes. ) Explain that the link between early drinking and alcoholism means only that the two are correlated, or tend to occur together. A teen who drinks may not end up an alcoholic, or may end up an alcoholic for reasons other than early drinking. Then tell students that both alcoholics and teens who start drinking early have higher-than-average rates of psychiatric problems. Ask: Based on this fact, how do you think early drinking and alcoholism might be related? (Sample answer: Both might be caused by the same psychiatric problems.) 388 Chapter 15
The Stages of Alcoholism Alcoholics progress through several stages as their dependence strengthens. What begins as problem drinking becomes absolute dependence, and finally, latestage alcoholism. Each stage may last weeks, months, or years. Teenage alcoholics tend to go through the stages faster than adult alcoholics. Stage 1: Problem Drinking Even a social drinker someone who occasionally drinks small amounts with meals, at parties, or on special occasions can become an alcoholic. If social drinkers start to use alcohol to try to relieve stress or escape from problems at home, school, or work, their drinking habit may quickly become a problem. Some warning signs of problem drinking are listed in Figure 11. Stage 2: Absolute Dependence At this stage, the drinker becomes totally dependent on the drug. Alcohol dominates the drinker s life. He or she usually cannot stop after one drink, and feels a constant need to drink. Some alcoholics are able to hide their problem and appear to be fine. Others show signs of excessive alcohol consumption. Signs of alcoholism may include frequent absences from work or school and strained relationships. Stage 3: Late Stage of Alcoholism During this stage, alcoholics rapidly lose their mental, emotional, and physical health. Because their entire lives revolve around drinking, they become isolated from society. Late-stage alcoholics also experience reverse tolerance for alcohol, a condition in which less and less alcohol causes intoxication. Serious health problems, including malnutrition, liver and brain damage, cancer, lung disease, and heart disease, are common among alcoholics. Without medical and psychological help, an alcoholic may die. Connect to YOUR LIFE How can you reduce your risk of alcoholism? Explain. A Problem Drinker s Self-Test Do you drink to avoid facing problems or when you are angry? Do you prefer to drink by yourself rather than with others? Do you try to stop drinking, but fail? Do you lie to others about how often or how much you drink? Do you ever forget whole blocks of time when you are drinking? Do you get drunk even when you do not intend to do so? Are your school grades dropping because of your drinking? Do you drink in the morning? Do you ever get into trouble when you drink? Is it important to you to show others that you can drink alcohol? Yes FIGURE 11 One or two yes answers to these questions may indicate a drinking problem. No L2 Visual Learning: Figure 11 Ask students to read the test questions in the figure. Discuss why yes answers indicate a drinking problem. For example, regarding the first question, explain that people who use alcohol to avoid problems or relieve stress tend to develop into problem drinkers. Encourage students to suggest positive solutions to these problem behaviors. L1 Active Learning Have students make a flowchart of the stages of alcoholism. Their flowcharts should sum up what occurs during the stages of problem drinking, absolute dependence, and late-stage alcoholism. Post students flowcharts in the classroom. L3 Journal Writing After students read about the stages of alcoholism on this page, urge them to think about what their lives would be like if they became alcoholics. Ask them to write a journal entry explaining how alcoholism would interfere with the attainment of their goals and their potential to live a full and happy life. Tell students they may keep their journal entries confidential. Connect to You can reduce your risk YOUR LIFE of alcoholism by not drinking. Anyone who drinks is at risk of becoming an alcoholic. Alcohol 389 L1 Special Needs Some students may be confused by the many terms relating to alcoholism, such as tolerance, reverse tolerance, dependence, and absolute dependence. To distill the information down into a single take-home message, have the students focus on the term alcoholism. Help students understand the concept of alcoholism by redefining it simply as a disease in which people cannot stop drinking. Also, make sure students understand the dangers of alcoholism and what factors appear to raise the risk of developing alcoholism. Alcohol 389
Chapter 15, Section 3 L2 Active Learning Ask each student to find a newspaper article that deals with emotional costs of alcoholism. For example, articles might describe alcohol-related vehicle crashes, homicides, or incidents of domestic abuse. Have students bring copies of the articles to class. Ask a few volunteers to organize the articles into categories (e.g., crimes, car crashes) and use them to make a bulletin board display. Treating Alcoholism EL Building Vocabulary To help students understand the term detoxification, tell them that the prefix de- means do the opposite of. Give students several examples of familiar words that begin with de-, such as decaffeinated, decode, decompose, decongestant, and defrost. For each word, ask students to explain how dechanges the meaning of the root word. Then challenge students to use this knowledge to define detoxification in their own words. (doing the opposite of poisoning the body, or the process of getting rid of poison from the body) L3 Building Health Skills Advocacy Ask students to make a brochure for other teens about Alateen. Brochures should encourage students who live with alcoholics to join Alateen. Brochures also should explain how Alateen can help them and how they can contact a local Alateen group. Arrange for students to place their brochures in community locations frequented by teens, such as shopping malls and concert venues. L3 Content Update Use the Web Code to access up-to-date information about alcoholism. Have students complete the Web activity. FIGURE 12 Alcoholism has many negative effects on families. 390 Chapter 15 Effects of Alcoholism on the Family Unpredictable behavior Embarrassment Violence Neglect Money problems Legal problems Divorce For: Updates on alcoholism Visit: www.scilinks.org/health Web Code: ctn-5153 and Health L3 Public Service Announcement Ask pairs of students to write a public service announcement (PSA) to educate people about the costs of alcoholism to the family Effects on Others Alcohol abuse and alcoholism affect many people other than the drinker. Consider some of the financial and emotional costs to society and individual families. Alcohol-related crimes, medical expenses, injuries, lost productivity on the job, and treatment programs cost the United States between 100 and 200 billion dollars annually. Alcohol is involved in approximately 150,000 deaths per year. Most of these deaths are due to violence committed under the influence of alcohol and to motor vehicle crashes involving drunk drivers. About one in every eight Americans grows up in an alcoholic family. Spouses and children of alcoholics live in homes filled with stress arising from uncertainty and embarrassment. In some cases, alcoholics verbally or physically abuse family members. Family life centers around the drinking member as the needs of other family members are ignored. Treating Alcoholism With appropriate treatment, the progress of alcoholism can be stopped. Alcoholics can lead productive, happy lives if they stop drinking completely. There are three stages in an alcoholic s recovery: acknowledging the problem, detoxification, and rehabilitation. Acknowledging the Problem In the first step of recovery, alcoholics must acknowledge their problem and ask for help. For some alcoholics, the shock of losing a job, being arrested, or being separated from their families motivates them to enter a treatment program. or society. Suggest that students focus on just one alcohol-related problem in their PSA. Give pairs a chance to present their PSAs to the rest of the class. 390 Chapter 15
Detoxification The next step in recovery is detoxification, which involves removing all alcohol from a person s body. The alcoholic will suffer from withdrawal, a group of symptoms that occur when a dependent person stops taking a drug. Withdrawal symptoms last from three to seven days. They include shakiness, sleep problems, irritability, rapid heartbeat, and sweating. The drinker also may see, smell, or feel imaginary objects. Severe withdrawal symptoms can be extremely dangerous, requiring medical care or a hospital stay. Rehabilitation After detoxification, the recovering alcoholic begins rehabilitation the process of learning to cope with everyday living without alcohol. During rehabilitation, alcoholics receive counseling to help them understand their disease and behavior. In some cases, the recovering alcoholic takes medications that may help prevent a return to alcohol use. Support Groups Community, religious, and health organizations often sponsor support groups for alcoholics. In one of the most successful groups, Alcoholics Anonymous (AA), recovering alcoholics offer encouragement and support to help other alcoholics stop drinking. Two other groups, Al-Anon and Alateen, are designed to help friends and family members of alcoholics. Al-Anon helps adult friends and family members learn how they can help in the alcoholic s recovery process. Alateen provides help for teenagers living with alcoholics. You can find the phone numbers for local AA, Al-Anon, and Alateen groups on the Internet or in a telephone book. FIGURE 13 Al-Anon members use understanding and education in their efforts to help alcoholics cope. 3. Assess Evaluate These assignments can help you assess students mastery of the section content. Section 3 Review Answers appear below. Teaching Resources Practice 15-3 Section 15-3 Quiz L2 Reteach Ask students to make an outline of the section, using the main headings as major topics and the subheadings as minor topics. Tell students to include the boldfaced sentences and the definitions of the vocabulary words in their outlines. L4 Enrich Teaching Resources Enrich 15-3 Health at School Section 3 Review Key Ideas and Vocabulary 1. What are five long-term physical effects of alcohol abuse? 2. What is cirrhosis? Explain how the disease can be fatal. 3. What is tolerance to alcohol? How does it relate to dependence? 4. Describe each stage of alcoholism. What happens during absolute dependence? 5. List in order three steps alcoholics must take to recover from their alcohol dependence. Health at School Support for Teens What kinds of school programs do you think would help teenagers who have drinking problems? What elements would the program need to be effective? Prepare an oral report to present to school officials. Critical Thinking 6. Evaluating Alcoholism only affects the alcoholic. Do you agree or disagree with this statement? Explain your answer. 7. Comparing and Contrasting How are the goals of Alcoholics Anonymous, Al-Anon, and Alateen similar? How are they different? Support for Teens Students may suggest different kinds of school programs, such as programs to educate teens about the dangers of drinking or programs to help teens learn refusal skills. To be effective, students might say a program needs the support of parents as well as teachers or that it must be relevant to today s teens. Ask permission for students to present their oral reports at a meeting of the school staff or school board. Section 3 Review 1. harm to the brain, liver, heart, and digestive system and fetal alcohol syndrome 2. a disease of the liver in which cells die and leave behind useless scar tissue; by leading to liver failure 3. Tolerance to alcohol occurs when a drinker s body needs more and more alcohol to achieve the original effect. Increasing Alcohol 391 tolerance leads to dependence, in which the brain cannot function without alcohol. 4. In stage 1, a person drinks to avoid facing problems and may try to stop drinking but fail. In stage 2, the drinker becomes totally dependent on alcohol. In stage 3, the alcoholic rapidly loses mental, emotional, and physical health. 5. acknowledging the problem, detoxification, and rehabilitation 6. Students should say they disagree with this statement. Alcoholism affects many people other than the drinker, including the drinker s family members. 7. All three groups aim to help people affected by alcoholism. Alcoholics Anonymous helps recovering alcoholics; Al-Anon helps adult friends and family members of alcoholics; Alateen helps teens who live with alcoholics. Alcohol 391