Chapter 9 Alcohol. Fermentation Yeast recombines the carbon, hydrogen, and oxygen of sugar into ethyl alcohol and carbon dioxide. Forms the basis.

Chapter 9Alcohol

Fermentation Yeast recombines the carbon, hydrogen, and oxygen of sugar into

ethyl alcohol and carbon dioxide. Forms the basis of all alcoholic beverages

Raw materials Fruit contains sugar and will ferment with the addition of yeast Cereal grains contain starch rather than sugar, and before

fermentation can begin the starch must be converted to sugar. This is accomplished by making malt, which contains enzymes that convert starch into sugar.

Yeast has a limited tolerance for alcohol When the concentration reaches 12-15% the yeast dies and

fermentation ceases

Fermentation Products

Distilled Products• To obtain alcohol concentrations above 15 percent, distillation

is necessary. • Distillation is a process in which the solution containing

alcohol is heated, and the vapors are collected and condensed into liquid form again.

• Alcohol has a lower boiling point than water, so there is a higher percentage of alcohol in the distillate ( the condensed liquid) than there was in the original solution.

• In the United States the alcoholic content of distilled beverages is indicated by the term proof. The percentage of alcohol by volume is one- half of the proof number: for instance, 90- proof whiskey is 45 percent alcohol.

Production process: In American beer the primary grain is barley, which is malted by

steeping it in water and allowing it to sprout. The sprouted grain is then slowly dried to kill the sprout but preserve the enzymes formed during the growth. This dried, sprouted barley is called malt, and when crushed and mixed with water, the enzymes convert the starch to sugar.

Hops are added with yeast to give beer its distinctive flavor

Most beer sold in the United States is mass-produced by the two largest brewers Imported beers and microbreweries are growing in popularity Who's the country's biggest brewer?

Beer

Lager (Most common type in U.S.) Most of the beer sold today in America is lager, from the

German word lagern, meaning “ to store.” Uses a type of yeast that settles to the bottom of the mash to

ferment Cool temperature and slower fermentation Ale

Uses a top-fermentation yeast Warmer temperature and shorter fermentation In general, ales have a stronger taste and lagers the lighter

taste favored by most American beer drinkers.

Because most American beer is sold in bottles or cans, the yeast must be removed to prevent it from spoiling after packaging. This is usually accomplished by heating it ( pasteurization), but some brewers use microfilters to remove the yeasts while keeping the beer cold. The carbonation is added at the time of packaging.

Types of Beer

Light beer Light beers have about 10 percent less

alcohol and 25 to 30 percent fewer calories.

The mash is fermented at a cooler temperature for a longer time, so that more of the sugars are converted to alcohol.

Then the alcohol content is adjusted by adding water, resulting in a beverage with considerably less remaining sugar and only a bit less alcohol.

Types of Beer

Production: Made from fermented grapes Produced by both small and large

wineries

Most wines contain about 12% alcohol

Factors in quality include Selection and cultivation of grapevines Good weather Timing of harvest Careful monitoring of fermentation and aging

Wine

Generics vs. varietals Generics usually have names taken from European land areas where

the original wines were produced: Chablis, Burgundy, and Rhine are examples.

Varietals are named after one variety of grape, which by law must make up at least 51 percent of the grapes used in producing the wine. Chardonnay, Merlot, and Zinfandel are some examples.

Red vs. white Most white wines are made from white grapes, although it is possible

to use red grapes if the skins are removed before fermentation. Red wines are made from red grapes by leaving the skins in the

crushed grapes while they ferment. “ Blush” wines such as white zinfandel have become quite popular.

With the zinfandel grape, which is red, the skins are left in the crushed grapes for a short while, resulting in a wine that is just slightly pink.

Varieties of Wine

Sparkling wines Because carbon dioxide is produced during fermentation,

it is possible to produce naturally carbonated sparkling wines by adding a small amount of sugar as the wine is bottled and then keeping the bottle tightly corked. French champagnes are made in this way, as are the more expensive American champagnes, which might be labeled “ naturally fermented in the bottle,”

Fortified wines Sealing the wine in charred oak casks for aging further refined its

taste, and soon sherry was in great demand throughout Europe. Other fortified wines, all of which have an alcohol content near 20 percent, include port, Madeira, and Muscatel.

Varieties of Wine

Grain neutral spirits Clear, tasteless, nearly pure alcohol (190 proof) produced by distillation Sold as Everclear to consumers and used in research Used to make various beverages

Gin: distillate filtered through juniper berries and then diluted with water . By filtering the distillate through juniper berries and then diluting it with water, a medicinal- tasting drink was produced. First called “ jenever” by the Dutch and “ genievre” by the French, the British shortened the name to “ gin.” Gin became a popular beverage in England and now forms the basis for many an American martini.

Vodka: mixture of grain neutral spirits and water

Contains relatively few congeners When alcohol is formed, other related substances, known as congeners,

are also formed. These may include alcohols other than ethanol, oils, and other organic matter. Luckily they are present only in small amounts, because some of them are quite toxic.

Grain neutral spirits contain relatively few congeners and none of the flavor of the grains used in the mash.

Distilled Spirits

Whiskey Distillate of fermented grain Distilled at a lower proof (160) and so contains

more congeners and some flavor from the grain Whiskey accumulates congeners during aging, at

least for the first five years, and the congeners and the grain used provide the variation in taste among whiskeys.

Types of whiskey include: Rye whiskey Corn whiskey (bourbon) Blended whiskey

Distilled Spirits

Before American Revolution At the time of America’s revolution against the English in the late

1700s, most Americans drank alcoholic beverages and most people favored these beverages compared with drinking water, which was often contaminated.

Drunkenness was viewed as misuse of positive product

After American Revolution Alcohol itself viewed as the cause of serious problems Alcohol was first psychoactive substance to become demonized in

American culture

Early U.S. Views on Alcohol Use

Benjamin Rush As a physician, Rush had noticed a relationship between heavy

drinking and jaundice ( an indicator of liver disease), “ madness” ( perhaps the delirium tremens of withdrawal) and “ epilepsy” ( probably the seizures seen during withdrawal).

All of those are currently accepted and well documented consequences of heavy alcohol use. However, Rush also concluded that hard liquor damaged the drinker’s morality, leading to a variety of antisocial, immoral, and criminal behaviors.

Rush believed that this was a direct toxic action of distilled spirits on the part of the

For the first time this condition was referred to as a disease ( caused by alcohol), and he recommended total abstinence from alcohol for those who were problem drinkers. brain responsible for morality.

Temperance Movement

Temperance societiesInitially promoted abstinence from distilled spirits onlyTemperance societies were formed in many parts of the country, at first among the upper classes of physicians, ministers, and business people. In the early 1800s, it became fashionable for the middle classes to join the elite in this movementPeople “ took the pledge” to avoid spirits and to be temperate in their use of beer or wine.With societies continued consumption of beer and wine, and related problems, the temperance workers now advocated total abstinence from all alcoholic beverages, and pressure grew to prohibit the sale of alcohol altogether.

Temperance Movement

States began passing prohibition laws in 1851 The first state prohibition period began in 1851 when Maine passed

its prohibition law. Between 1851 and 1855, 13 states passed statewide prohibition

laws, but by 1868 9 had repealed them. The National Prohibition Party and the Women’s Christian

Temperance Union ( WCTU), both organized in 1874, provided the impetus for the second wave of statewide prohibition, which developed in the 1880s. From 1880 to 1889 7 states adopted prohibition laws, but by 1896 4 had repealed them. By 1917, 64% of Americans lived in “dry” territory

Between 1907 and 1919, 34 states enacted legislation enforcing statewide prohibition, whereas only 2 states repealed their prohibition laws.

But a state prohibition law did not mean that the residents did not drink. They did, both legally and illegally. They drank illegally in speakeasies and other private clubs.

Prohibition

Federal prohibition 18th Amendment (1919): banned the sale of alcohol It soon became clear that people were buying and selling alcohol

illegally and that enforcement was not going to be easy. The majority of the population might have supported the idea of Prohibition, but such a large minority insisted on continuing to drink that speakeasies, hip flasks, and bathtub gin became household words.

Outcomes of Prohibition included: Organized crime became more organized and profitable Alcohol dependence and alcohol-related deaths initially declined and

remained lower until the end of prohibition, with the greatest decline at the beginning.

Prohibition

Repealed by the 21st Amendment (1933)

Reasons for the repeal: Alcohol taxes had been a major source of revenue Concerns that widespread disrespect for Prohibition laws

encouraged a general sense of lawlessness not just among the bootleggers and gangsters but also in the public at large. The Great Depression, which began in 1929, not only made more people consider the value of tax revenues but also increased fears of a generalized revolt.

Outcomes of repeal included: Alcohol per capita sales and consumption increased Returned to pre-Prohibition levels after World War II

Prohibition

Regulation after 1933 After national Prohibition, control over alcohol was returned to the

states. Some states remained dry initially

but most allowed beer sales Mississippi was the last dry state

allowed alcohol purchase and consumption in 1966 In 1970s, drinking ages were lowered to 18–19 in 30 states

but raised again to 21 following safety concerns in the 1980s Congress authorized the Transportation Department to

withhold a portion of the federal highway funds for any state that did not raise its mini-mum drinking age to 21.

Taxation Federal and state taxes and licensing fees = about half the price of an

alcoholic beverage When taxes go up, consumption goes down

but not dramatically – These taxes have not increased since 1991

Regulation and Taxation

Consumption patterns are influenced by cultural factors For example, both the Irish and the Russian cultures are associated

with heavy drinking, especially of distilled spirits; Mediterranean countries like Italy and Spain have been characterized by wine consumption

Trends in U.S. alcohol consumption Similar to other drugs, alcohol use peaked in 1981 and then

declined American consumption per person per year:

Beer (27 gallons or over 1 gallon of alcohol) Spirits (0.75 gallon of alcohol) Wine (0.33 gallon of alcohol)

Alcohol Consumption Patterns

U.S. Alcohol Consumption

Figure 9.1 Per Capita Ethanol Consumption by Beverage Type, United States, 1977– 2009. (note: peak alcohol consumption in 1981,about the same time illicit

drug use peaked)

Regional differences in the U.S. One third of U.S. population abstain The two-thirds who use alcohol consume an amount that averages out

to about three drinks per day. Most don’t drink anything near that amount, in fact, another consistent finding is that half the alcohol is consumed by about 10 percent of the drinkers. Whites are more likely to drink than blacks, Northerners more than southerners, Younger adults more than older, Catholics and Jews more than Protestants, Nonreligious more than religious, Urban more than rural, Large city dwellers more than small city residents, And college educated people more than those with only a high school or

grade school education.

U.S. Alcohol Consumption

U.S. Alcohol Consumption by State

Figure 9.2 Shows estimated overall alcohol consumption combining beer, wine, and distilled spirits ( about half the total U. S. alcohol consumption comes from beer) for each state, based on sales. Nevada and New Hampshire have the highest per capita sales, along with the District of Columbia.

Stress index: Drinking rates higher in states

where people experience a great deal of social stress and tension (as in cities) and who approve of the use of alcohol to release tension and stress drink more and have more drinking problems.

Overall, both the stress index and the drinking norms were significantly correlated with indicators of heavy drinking and alcohol related arrests.

U.S. Alcohol Consumption

Gender differences Males more likely to drink than

females The difference in proportions of those

who have drunk alcohol in their lifetimes is not great, but 58 % of males and 46 % of females report current ( past month) drinking.

Males more likely to drink more When “ binge” drinking is defined as

having five or more drinks on the same occasion, males are more likely than females to report binge drinking within the past 30 days ( 32 % of males versus 15 % of females).

About 7 % of males and 3.5 % of females report “ heavy” drinking, defined as binge drinking on five or more separate days during the past month.

U.S. Alcohol Consumption

12 Person Beer Bong

Cultural “Glorification” of Binge Drinking (video)

Drinking among college students College students drink more

than their nonstudent peers Many campuses have banned

sale and advertising of alcohol Many fraternities have banned

keg parties Despite this, alcohol use has

not changed significantly In fact, there has been a

slight increase in binge drinking and driving after drinking since 2002.

U.S. Alcohol Consumption

Cultural “Glorification” of Binge Drinking (video)

Standard drink has about 0.5 ounces of pure alcohol (equivalents) ≈12 ounces of beer ≈ 4 - 5 ounces of wine ≈ 1 – 1.5 ounces of 100 - 80 proof spirits

What is One Drink?

Absorption Most absorbed in the small intestine

Some absorbed in the stomach Slower if there is food (especially protein and fat) or water in the

stomach Faster in the presence of carbonated beverages

Distribution Blood alcohol concentration (BAC)

measure of the concentration of alcohol in blood, expressed as a percentage in terms of grams per 100 ml

Alcohol is distributed throughout body fluids but not fatty tissues Thus, a lean person will have a lower BAC than an fatter person of the

same weight

Pharmacology

Pharmacology

Ethanol Metabolism Liver metabolizes (alcohol

dehydrogenase) about 0.25 ounces of alcohol per hour

If rate of intake = rate of metabolism, BAC is stable

If rate of intake exceeds rate of metabolism, BAC increases

About 90 percent is metabolized in the liver About 2 percent of alcohol is excreted unchanged

Breath Skin Urine

Alcohol Acetaldehyde Acetic acid

Alcoholdehydrogenase

Aldehydedehydrogenase

Alcohol Metabolism

+ +

Metabolism is based on a stable rate Exercise, coffee, and other strategies do not speed up the rate of

metabolism

Liver responds to chronic intake of alcohol by increasing enzyme activity Contributes to tolerance among heavy users (alcohol gets

preferential treatment in metabolism, other drugs do not)

For heavy alcohol users When alcohol is present, metabolism of other drugs is slower When alcohol is not present, metabolism of other drugs if faster

Alcohol Metabolism

Women may be more susceptible than men to the effects of alcohol after consuming the same amount

Explanations: Absorption: women tend to weigh less and have a higher

proportion of body fat Thus, women absorb a greater proportion of the alcohol they

drink Metabolism: alcohol dehydrogenase is less active in women

Sex Differences

In general, alcohol is a central nervous system depressant

Exact mechanism of action is not clear Alcohol has many effects on the CNS (Cognitive, Sensory, and

Locomotor) Alcohol enhances the inhibitory effect of GABA at the GABA-A

receptor Similar to barbiturates and benzodiazepines - This would

explain the similarity of behavioral effects among these three different kinds of chemicals. But alcohol has many other effects in the brain, so it has been very difficult to determine a single mechanism. No matter what neurotransmitter or receptor or transporter is examined,

alcohol appears to alter its function in some way.

Mechanism of Action

Because alcohol’s ability to enhance GABA inhibition at the GABA- A receptor occurs at very low doses, this mechanism probably has special importance. Remember that GABA is a very widespread inhibitory

neurotransmitter, so alcohol tends to have widespread inhibitory effects on neurons in the brain.

At higher doses alcohol also blocks the effects of the excitatory transmitter glutamate at some of its receptors, so this may enhance its overall inhibitory actions.

Alcohol also affects dopamine, serotonin, and acetylcholine neurons - One of the oldest and chemically simplest psychoactive drugs also seems to have the most complicated set of effects on the nervous system.

Mechanism of Action

Mood changes can include: euphoria reduced anxieties reduced inhibitions – disruption of normal critical thinking

Effects are dose-dependent Blood alcohol concentration determines effects For example:

At low blood levels, complex and abstract behaviors may be disrupted

At higher blood levels, simpler behaviors may be affected

Behavioral Effects

Effects depend on the time course For example, effects are greater when BAC rises rapidly

Effects are influenced by the individual’s alcohol experience For example, a higher BAC is needed to impair a chronic heavy drinker

(CNS may adapt; and can adapt when intake is spaced over time)

Effects are influence by expectations For example, placebo effects explain many of the

effects on social behavior

Behavioral Effects

BAC (%)

Behavioral Effects

0.05 Lowered alertness, release of inhibitions, impaired judgment

0.10 Slower reaction times, impaired motor function, less caution

0.15 Large, consistent increases in reaction time

0.20 Marked depression in sensory and motor capability, intoxication

0.25 Severe motor disturbance, staggering, great impairment

0.30 Stuporous but conscious—no comprehension of what’s going on

0.35 Surgical anesthesia; about LD1, minimal level causing death

0.40 About LD50

BAC and Behavioral Effects

Table 9.3

Behavioral EffectsOne important component of alcohol use is that drinking serves as a social signal, to the drinker and others, indicating a “time-out” from responsibilities, work, and seriousness.

After drinking, people tend to focus more on the here and now and to pay less attention to peripheral people and activities, and to long- term consequences. That might be why some people are more violent after drinking, whereas others become more helpful even if there is personal risk or cost involved.

The idea is that alcohol releases people from their inhibitions, largely because the inhibitions represent concerns about what might happen ….. whereas the intoxicated individual focuses on the immediate irritant or the person who needs help right now.

Approximately 40 percent of all traffic crash fatalities are linked to alcohol use

Driving Under the Influence

Risk of a fatal crash is dose-related At a BAC of 0.08 percent the relative risk of being involved in a fatal

crash is about three times as great as for a sober driver. Sharp increase in fatalities with BAC over 0.10 Single-vehicle fatalities are more likely to involve alcohol than are

multiple-vehicle fatalities.

Men are more likely than women to be involved in an alcohol-related fatal crash Any given car is more likely to have a male than a female driver, men

might take more chances when driving even when they’re sober, and male drivers are more likely than female drivers to have been drinking

The majority of alcohol-related individuals are not “problem drinkers” – the highest rate is among 21-24 yr olds.

Driving Under the Influence

Sexual behavior Alcohol use may enhance interest in sex but impair physiological

arousal Linked to risky sexual behavior

Blackouts Alcohol-induced blackouts are periods during alcohol use in which the

drinking individual appears to function normally but later, when the individual is sober, he or she cannot recall any events that occurred during that period.

A danger sign of excessive alcohol use

Crime and violence Alcohol use is statistically related to:

Homicide Assault, including family violence, sexual assault, and date rape Suicide

Behavioral Effects

Peripheral circulation Dilation of peripheral blood vessels

drinkers lose body heat but feel warm

Fluid balance Alcohol has a diuretic effect that:

Increases urine flow Lowers blood pressure in some individuals

Hormonal effects Chronic alcohol abusers can develop a variety of hormone-related

disorders For example, disrupted reproductive functioning

Physiological Effects

Two pieces of advice: If someone drinks enough to pass out

Do not leave the person alone Place her or him on side and monitor

breathing or take to ER immediately If someone drinks enough to vomit

S/he should stop drinking Vomiting reflex is suppressed at BACs

above 0.20 and can quickly reach lethal levels

Acute Physiological Toxicity

Alcohol overdose is relatively common and dangerous

Hangovers are not well understood

Symptoms: upset stomach, fatigue, headache, thirst, depression, anxiety, and

general malaise

Possible causes: alcohol withdrawal, exposure to congeners, cellular dehydration,

gastric irritation, reduced blood sugar, and/or the accumulation of acetaldehyde

What is a Hangover?

Brain tissue loss and cognitive impairment Wernicke-Korsakoff syndrome

Heart disease: Cardiomyopathy, heart attack, hypertension, stroke Although moderate alcohol use may reduce heart attack risk

Liver disease: Hepatitis, fatty liver, cirrhosis

Chronic Toxicity in Heavy Users

Fetal Alcohol Syndrome (FAS) Facial and developmental abnormalities associated with mother’s alcohol use

during pregnancy Related to peak BAC and to duration of alcohol exposure Prevalence: 0.2–1.5 per 1,000 births

Diagnostic criteria (one must be present)

1. Growth retardation before and/or after birth

2. Pattern of abnormal features of the face and head

3. Evidence of CNS abnormality

Fetal Alcohol Syndrome

Fetal alcohol effects All alcohol-related developmental abnormalities associated with

prenatal alcohol exposure Prevalence: 80–200 per 1,000 births

Drinking during pregnancy increases risk of spontaneous abortion

Data do not prove that low levels of alcohol use during pregnancy are safe or that they are unsafe

Alcohol and Pregnancy

Abstinence syndrome is medically more severe and more deadly than opioid withdrawal If untreated, mortality can be as high as 1 in 7

Stages of withdrawal: Stage 1: tremors, rapid heartbeat, hypertension, heavy sweating, loss of

appetite, insomnia Stage 2: hallucinations (auditory, visual, and/or tactile) Stage 3: delusions, disorientation, delirium Stage 4: seizures

Detoxification should be carried out in an inpatient medical setting Sedatives given in stage 1 or 2 prevent stages 3 and 4

Withdrawal Syndrome

Alcoholics Anonymous view Alcohol dependence as a progressive disease characterized by loss

of control over drinking Only treatment is abstinence from alcohol Disease model: alcohol dependence is the primary disease and not

the result of another underlying cause

Alternative view: APA explicitly defines alcohol abuse and dependence Alcohol dependence is a complex psychosocial disorder Cognitive and genetic factors are of current scientific interest

Dependent Behaviors