THE SCIENCE OF FEELING GOOD & FEELING BAD WITH ALCOHOL

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THE SCIENCE OF FEELING GOOD & FEELING BAD WITH ALCOHOL Professor David W. Craig Department of Chemistry Hobart and William Smith Colleges 7:30 8:30 pm Tuesday, October 17, 2006 Geneva Room Alcohol Awareness Week Lecture Series

Behavioral and Sensation Manifestations of Alcohol Ingestion With 1 to 2 drinks (.01-.05 g/dl BAC) -- euphoria and perceived reduction in anxiety With.06-.10 g/dl BAC -- judgement and motor coordination impaired, sometimes increased aggression With.20-.25 g/dl BAC) -- sedation With 0.30 g/dl BAC -- memory impairment and loss of consciousness With 0.40 to.50 g/dl BAC -- depressed respiration, coma, death *BACs for inexperienced adult user SOURCE: Eighth Special Report to the US Congress on Alcohol and Health, US Dept. of HHS (1993), p 89

What Factors Determine a Person s Blood Alcohol Concentration (BAC in g/dl)? Number of Drinks Consumed Body Size and Build Sex Time Past Drinking Experiences Is Stomach Empty or Full? SOURCE: Estes and Heinemann, Alcoholism: Development, Consequences and Interventions, C. V. Mosby Co. (1986)

Ethyl Alcohol CH 3 -CH 2 -OH Dose Number of drinks consumed 12 oz Beer 3.6-4.0% alcohol contains 13-17g alcohol 4 oz Wine 12-14% alcohol contains 14-17g alcohol 1-1.5 oz 86 proof Whiskey contains 13-19g alcohol Body size, build, and sex determines the volume accessible to ethanol Chemical Solubility Completely soluble in water Somewhat soluble in fat 30x more soluble in water that in fat Proportion water in the body: Men.58, Women.49 SOURCE: Eighth Special Report to the US Congress on Alcohol and Health, US Dept. of HHS (1993), p 89

Time How rapidly can ethanol be absorbed? Rate of absorption is dependent on: concentration gradient between gut and blood surface area of contact degree of vascularization Effect of Food on Absorption food dilutes alcohol in the digestive system fatty foods are slow to digest and slow to move from the stomach to the small intestine SOURCE: Estes and Heinemann, Alcoholism: Development, Consequences and Interventions, C. V. Mosby Co. (1986)

Time How rapidly can ethanol removed? Ethanol clearance is zero order the rate of clearance is independent of the ethanol concentration Average ethanol clearance rates For moderate drinkers -.017 g/dl/hr Drinkers consuming >60 drinks/month -.020 g/dl/hr 80% of adult population >.012 g/dl/hr SOURCE: National Highway traffic Safety Administration, http://www.nhtsa.dot.gov/people/injury/alcohol/bacreport.html

Major Pathway for Alcohol Metabolism NAD Ethanol NADH Alcohol DH NAD Acetaldehyde NADH Aldehyde DH Biosynthesis Acetic Acid CO 2 + H 2 O Release to Blood SOURCE: Eighth Special Report to the US Congress on Alcohol and Health, US Dept. of HHS (1993)

Estimation of BAC Calculation of BAC for inexperied drinkers -- The American Happy Hour Experience Drinks male Weight lb 187 Frac H2O 0.58 Time (hr) BAC (g EtOH/dL Blood) 1 0.25 0.020 2 0.5 0.040 3 0.75 0.060 In experiment, subjects drink 1.5oz shots of 80proof scotch on 15min intervals, measuring BAC 15min after each dose of alcohol. Ref: National Highway traffic Safety Administration http://www.nhtsa.dot.gov/people/injury/alcohol/bacreport.html

Effect of Rate of Ingestion of 10 Drinks on BAC (following a light meal) Absorption Elimination 0.14 0.12 0.1 0.08 0.06 0.04 5 drinks/hr 2 drinks/hr 1 drink/hr 0.02 0 1 hr 2 hr 3 hr 4 hr 5 hr 6 hr 7 hr 8 hr 9 hr 10 hr SOURCE: Estes and Heinemann, Alcoholism: Development, Consequences and Interventions, C. V. Mosby Co. (1986) p 95

Alcohol Affects Neuro-transmitter Function in the Brain Increases Dopamine concentration Increases Serotonin release Stimulates Opiate Neuropeptide Release Potentiates GABA receptor function Inhibits Glutamate receptor function SOURCE: Eighth Special Report to the US Congress on Alcohol and Health, US Dept. of HHS (1993), p 86-94

Affect on Dopamine, Serotonin, and Endogenous Opiates (.01-.05.05 BAC) Dopamine simulates pleasure centers and functions in positive reinforcement alcohol increases Dopamine concentrations in nucleus acumbens and other reward centers Serotonin functions in mood, sleep, and positive reinforcement alcoholics and thrill seekers have low serotonin levels and alcohol consumption ( and thrill activities) brings theses levels up to normal. Serotonergic drugs lead to reduced alcohol consumption by alcoholics. Endorphins and Enkephalins are natural neural peptides that bind to opiate receptors and produce euphoric effects. Endorphins and Enkephalins are released by the brain when exposed to alcohol Euphoria seems to stimulate further drinking SOURCE: Eighth Special Report to the US Congress on Alcohol and Health, US Dept. of HHS (1993), p 86-94

Affect on GABA function (~>.06 BAC) GABA is major inhibitory neurotransmitter controlling arousal state as well as sensory and motor activity Alcohol Potentiates GABA receptor function Major Site of Affects include: medial septal nucleus -- controls arousal state Purkinje neurons in cerebellar cortex -- controls sensory and motor activity SOURCE: Eighth Special Report to the US Congress on Alcohol and Health, US Dept. of HHS (1993), p 86-94

Affect on Glutamate Function (~>.2 BAC) Glutamate is major excitatory neurotransmitter Inhibits glutamate receptor function Impaired Glutamate Receptor Function Causes: cognitive impairment and amnesia inability to learn new information SOURCE: Eighth Special Report to the US Congress on Alcohol and Health, US Dept. of HHS (1993), p 86-94

Alcohol and Sex Physiological responses Erections slower to rise and quicker to fall Reduction in vaginal lubrication Psychological Perceptions 45% of men and 68% of women say alcohol enhances sexual enjoyment Rutgers study (2-3 standard drinks) Subjects who thought they drank alcohol were most highly aroused (those that did not actually get alcohol were slightly less aroused) Subjects who expected tonic but actually got alcohol were less aroused than those that expected alcohol but did not. SOURCE: Braun, Stephen, Buzz: The Science and Lore of Alcohol and Caffeine, Penguin Books, 1996.

Effect of Chronic Use Tolerance Functional Tolerance -- changes in number and type GABA and Glutamate receptors Acute Tolerance -- occurs within a drinking session Metabolic Tolerance Withdrawal increased Anxiety within hours -- GABA seizures -- Glutamate Dependence changes in Dopamine and Serotonin function appear to be long lasting SOURCE: Eighth Special Report to the US Congress on Alcohol and Health, US Dept. of HHS (1993), p 94-100 Alcohol Alert, 28, National Institute on Alcohol Abuse and Alcoholism, (1995)

What Causes a Hangover? Pounding Headache Caused by reduced blood pressure in cranial vessels General Lethargy Caused by buildup of lactic acid and acidosis by release of acetic acid Hypersensitivity to Light and Sound Alcohol withdrawal leads to increased excitability, depressed mood, and sensitivity to stimuli Queasy Stomach Empty stomach, overly acidic Also due to withdrawal What about taking a drink to relieve hangover symptoms? SOURCE: Braun, Stephen, Buzz: The Science and Lore of Alcohol and Caffeine, Penguin Books, 1996.

Differences Between Men and Women Women are smaller than men Women have lower total body water content (49%) than men (58%) of comparable size Gastric ADH lower in women virtually nonexistent in alcoholic women Fluctuations in gonadal hormone levels during the menstrual cycle may affect the rate of alcohol metabolism SOURCE: Alcohol Alert #10, NIAAA (1990)

Estimation of BAC Calculation of BAC for inexperied drinkers -- The American Happy Hour Experience male female Weight lb 187 120 Frac H2O 0.58 0.49 Drinks Time (hr) BAC BAC 1 0.25 0.020 0.039 2 0.5 0.040 0.078 3 0.75 0.060 0.118 In experiment, subjects drink 1.5oz shots of 80proof scotch on 15min intervals, measuring BAC 15min after each dose of alcohol. Ref: National Highway traffic Safety Administration http://www.nhtsa.dot.gov/people/injury/alcohol/bacreport.html

BAC distribution of HWS students returning home late at night Distribution of BAC levels of HWS students returning home late at night 70 Percent of Students 60 50 40 30 20 10 0.00.01 -.05.06 -.07.08 -.09 >=.10 Blood Alcohol Concentration (g/dl) Data collected from 1,263 randomly selected students returning to residence halls late at night between 11pm and 3am during Spring `03, Fall `03, Spring `04, Fall `04, and Spring 05 terms. BAC measurements were collected every night of the week (59% of sample from school nights, 41% from weekend nights). Men are 53% of the sample and women are 47% of the sample.

BAC distribution of HWS students returning home late at night Distribution of BAC levels of HWS students returning home late at night School Night (N=742) Weekend Night (N=519) 90 80 70 Percent of Students 60 50 40 30 20 10 0.00.01 -.05.06 -.07.08 -.09 >=.10 Blood Alcohol Concentration (g/dl) Data collected from 1,263 randomly selected students returning to residence halls late at night between 11pm and 3am during Spring `03, Fall `03, Spring `04, Fall `04, and Spring 05 terms. BAC measurements were collected every night of the week (59% of sample from school nights, 41% from weekend nights). Men are 53% of the sample and women are 47% of the sample.

BAC distribution of HWS students returning home late at night Distribution of BAC levels of HWS students returning home late at night Males (N=665) Females (N=583) 70 Percent of Students 60 50 40 30 20 10 0.00.01 -.05.06 -.07.08 -.09 >=.10 Blood Alcohol Concentration (g/dl) Data collected from 1,263 randomly selected students returning to residence halls late at night between 11pm and 3am during Spring `03, Fall `03, Spring `04, Fall `04, and Spring 05 terms. BAC measurements were collected every night of the week (59% of sample from school nights, 41% from weekend nights). Men are 53% of the sample and women are 47% of the sample.