Left Brain May Affect West Los Angeles College Co
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OVERVIEW
Whenit comes to using alcohol, it is extremely important that the college studentunderstands the risks. Many collegestudents binge drink while in college, affecting their abilities to learn andpossibly their futures. Drinking anddriving is heavily associated with risk of serious injury or death and youngpeople are at greatest risk. Researchindicates that even “moderate” drinking carries health risks and that one ortwo drinks a day is all that the human body can handle without problems.
This chapter also looks at tobaccoand caffeine use. Although, tobacco useis legal in this country, it is currently a hotly debated topic. Should its use be regulated? Tobacco is used by 29 percent of the U.S.population and most people become addicted before they are 18. This addiction carries with it numeroushealth problems. Chapter 9 introducesthe student to the facts with regard to tobacco use and to its consequences interms of both personal health and economic costs to society. The college student must be aware that thelonger they use tobacco, the harder it is to quit and the greater the cost totheir health. Chapter 9 also discussescaffeine intake, the most widely used drug in the U.S.
LEARNING OBJECTIVES
1. Discussthe alcohol use patterns of college students and overall trends in consumption.
2. Explainthe physiological and behavioral effects of alcohol, including blood alcoholconcentration, absorption, metabolism, and immediate and long-term effectsalcohol consumption.
3. Explainthe symptoms and causes of alcoholism, its cost to society, and its effects onthe family.
4. Explainthe treatment of alcoholism, including the family’s role, varied treatmentmethods, and whether alcoholics can be cured.
5. Discussthe social and political issues involved in tobacco use.
6. Discusshow the chemicals in tobacco products affect a smoker’s body.
7. Reviewthe health effects of smoking and smokeless tobacco.
8. Discussthe risks associated with using smokeless tobacco.
9. Evaluatethe risks that environmental tobacco smoke may pose to nonsmokers.
10. Summarizethe benefits, risks, and long-term health consequences associated with caffeineuse.
OUTLINE
I. Alcohol: An Overview.
A. Alcohol is the most popular drug used on collegecampuses.
1. It is estimated that 84% of college studentsuse alcohol.
2. Culture and tradition influence alcohol useon campuses.
3. Bingedrinking is defined as five drinks in one episode for men and four drinks inone episode for women. The purpose of binge drinking is to become intoxicated.Binge drinkers are more likely to have problems on campus.
4. There are several reasons why collegestudents are at particularly high risk for alcoholism and alcohol relatedproblems.
B. Alcohol use among Americans has beendeclining steadily since the 1970s. Usein 1998 represented a per capita decline in consumption of ½ gallon of purealcohol per person.
II. Physiologicaland Behavioral Effects of Alcohol.
A. The intoxicating substance found in beer,wine and liquor is ethyl alcohol or ethanol.
1. It is produced in a process calledfermentation.
2. Hard liquors go through another processcalled distillation.
a. The “proof” of an alcoholic beverage is twicethe percentage alcohol content.
b. Percentage of alcohol varies per beverage.
B. Behavioral effects vary with the individualand the setting.
1. Blood Alcohol Concentration is the ratio ofalcohol to total blood volume. (see Table 8.2)
a. It is used to measure the physiological andbehavioral effects of alcohol.
b. Learned behavioral tolerance is having a highBAC, but appearing sober.
c. About 20 percent of alcohol is absorbedthrough the lining of the
stomach. The other 80 percent is absorbed through the small intestine.
2. Several factors influence the speed ofabsorption:
a. The alcohol concentration of your drink andthe amount you consume.
b. The amount of food in your stomach. Food slows the absorption process.
c. Carbonation in the beverage causes theopening from the stomach to the small intestine to relax, emptying its contentsmore rapidly.
d. Your mood. Powerful moods like stress and tension cause the stomach to dump itscontents more rapidly.
2. Alcohol is metabolized in the liver where itis converted by alcohol dehydrogenase to acetaldehyde, which is a toxicchemical that can cause nausea and vomiting as well as liver damage.
4. Alcohol contains 7 calories per gram.
5. A drinker’s BAC depends on weight and bodyfat, the water content in body tissues, the concentration of alcohol in thebeverage consumed, the rate of consumption, and the volume of alcohol consumed.
6. Alcohol poisoning occurs when one drinkslarge amounts of alcohol in a short amount of time and can result in death due torespiratory depression or aspiration.
7. Women appear to have about half the alcoholdehydrogenase as men, meaning females have the central nervous system effectslonger than males.
8. Breathalyzer, urinalysis, and blood tests areused to determine BAC.
9. In some states, refusal to take the test willresult in the immediate revocation of the person’s driver’s license.
D. Immediate Effects.
1. The most dramatic effects occur within theCNS.
2. The CNS depression can cause vital functiondepression and even death.
3. Alcohol is a diuretic.
a. Dehydration can occur due to loss of waterfrom cerebrospinal fluid.
b. This dehydration occurs at the cellularlevel, so that the cells cannot function normally. This causes several symptoms such as the morning-afterheadaches.
4. A hangover can occur for many reasons.
a. Symptoms of hangover include headache, upsetstomach, anxiety,
depression, thirst, and in severe cases, adesire to crawl into a hole and
die.
b. Congeners are forms of alcohol that aremetabolized more slowly than ethanol and are more toxic.
c. Time is the only cure for a hangover. Ittakes 12 hours, sometimes longer.
5. Drug interactions are common with alcohol.(see Table 8.3)
E. Long-term effects have recently been thesubject of research.
1. Nervous System effects are directly relatedto amount of alcohol consumed and include:
a. Shrinkage in brain size and weight.
b. Loss of some degree of intellectual ability.
c. Damage to left brain may affect written andspoken language skills, logic,
and mathematical skills.
2. Moderate alcohol use (no more than 2 drinks aday) is associated with a reduced risk of coronary artery disease.
a. There is an increase in HDL
b. Alcohol has an antithrombotic effect, decreasingthe clotting factors associated with atherosclerosis.
3. One of the most common liver diseases relatedto alcohol abuse is cirrhosis of the liver, which is among the top ten leadingcause of death in the U.S.
a. Fatty liver is the first stage of liverdamage from heavy drinking.
b. Fibrosis, liver cells replaced by scartissue, is a further stage of deterioration.
c. Alcoholic hepatitis is a serious conditionfrom prolonged alcohol use. This can be fatal in itself or lead to cirrhosis.
4. Many different cancers are associated withheavy alcohol use, particularly cancers of the esophagus, stomach, mouth,tongue, and liver.
5. One compelling report demonstrated thatdrinkers of 3 or more drinks per day were at greater risk for breast cancer.
6. Alcohol abuse can cause gastric irritation,inflammation of the pancreas, decreased enzyme production, and block theabsorption of nutrients, in particular calcium.
7. Evidence also shows that alcohol can decreasethe effectiveness of the immune system.
F. Fetal alcohol syndrome (FAS) is associatedwith alcohol consumption during
pregnancy.
1. FAS is the third most common birth defect andthe second leading cause of mental retardation in the U.S. It is the most common preventable cause of mental impairmentsin the western world.
a. If alcohol is consumed during firsttrimester, it affects organ
development, if consumed during thirdtrimester, it affects brain
development.
b. Symptoms include mental retardation, smallhead, tremors, and abnormalities of the face, limbs, heart and brain.
2. Fetal alcohol effects (FAE) are seen inchildren with history of prenatal alcohol exposure but who do not have all thephysical and behavioral symptoms of FAS.
a. The signs of FAE in newborns are low birthweight and irritability.
b. There may also be permanent mental impairment
3. Alcohol can be passed to a baby throughbreast milk. It is recommended toabstain from alcohol or to wait at least 4 hours to nurse after drinking.
G. The leading cause of death for all age groupsfrom 5-45 is traffic accidents, 41% of which are alcohol-related.
1. Fatalities decreased among 15-20 years olds due to zerotolerance laws.
2. Many states have lowered the legal blood alcohol levelto 0.08 percent due to research that suggests that this level shows significantimpairment.
3. MADD and SADD are organizations to promote awareness ofthis problem.
4. There is a direct relationship between the bloodalcohol of the driver and the likelihood of an auto accident. A person with a BAC level of 0.10 percent isabout 10 times more likely to be in a car accident that a non drinker.
5. In 2002, 52% of fatally injured drivers had bloodalcohol levels over 0.08 percent.
III. Alcohol Abuse and Alcoholism.
A. Alcoholism affects all SES levels,professions, geographic locations, religions, and
races.
1. Alcoholics tend to have a number of behaviorsin common.
B. There are many theories on the causes ofalcoholism.
1. Biological and family factors are influencesin alcoholism.
a. Type 1 alcoholics are drinkers who had oneparent who was a problem
drinker and grew up in an environment thatencouraged heavy drinking.
b. Type 2 alcoholics are males who are thebiological sons of alcoholics.
2. Social and cultural influences have an effecton alcohol use.
a. Family history may play a role.
b. Factors such as urbanization may have aneffect on alcohol use.
C. Alcoholism affects the family as well as theindividual.
1. The code in dysfunctional families is “don’ttalk, don’t trust, don’t feel.”
2. Children in dysfunctional families generallyassume one of these roles:
a. The family hero.
b. The Scapegoat.
c. The lost child.
d. The Mascot.
D. The cost of alcoholism to society istremendous.
1. Crimes, medical expenses, accidents, andalcoholic treatment all contribute to
the cost. According to the NationalInstitute on Alcohol Abuse and Alcoholism,
in 1998 alcohol related costs to societywere at least $184.6 billion.
2. Emotional costs are not tangible, but stillhave an effect on society.
E. New studies show that there may be as manyfemale alcoholics as male alcoholics.
1.There appears to be several differences between male and female alcoholics.
IV. Recovery.
A. Family members of an alcoholic usually takeaction before the alcoholic does.
B. Treatment programs vary.
1. Private treatment facilities provide medicalassistance for withdrawal symptoms.
a. Delirium tremens occur in a small percentageof alcoholics.
b. Other symptoms vary from person to person.
c. Detoxification refers to the process by whichaddicts end their
dependence on the drug.
2. Family therapy, individual therapy, and grouptherapy are all used for alcoholic treatment.
3. Antabuse is a form of aversion therapy foralcoholic recovery.
4. Alcoholic Anonymous teaches people thatrecovery is a life-long process.
a. It is based on a “higher power.”
b. The road to recovery is taken one step at atime.
c. Al-Anon is an auxiliary group for thoseaffected by an alcoholic.
d. Alateen is an auxiliary group to helpadolescents who live with an
alcoholic parent.
e. Women for Sobriety is designed to meet thespecific needs of female alcoholics.
f. Secular Organizations for Sobriety is arecovery group without a spiritual emphasis.
C. Relapse occurs within the first three monthsin 60% of alcoholics.
1. A comprehensive, long-term plan can helpdecrease chance of relapse.
2. Many alcoholics refer to themselves asconstantly in recovery.
V. Our Smoking Society.
A. More than 430,000 Americans die each year of tobacco-related diseasesand 10 million
will suffer from diseases caused by tobacco. Tobacco is the probable cause of 25
diseases. One in every 5 deaths in the U.S. is smoking related.
1. The proportion of teen smokers has decreased in thepast few years. In 2001, almost 28.5percent were currently smoking.
2. Every day another 6,000 teens under the age of 18 smoketheir first cigarette.
B. Tobacco and social issues.
1. Advertising by tobacco companies have beengeared toward young people and women.
2. The financial costs of tobacco to society are high.
a. Health care costs, productivity costs, and other smoking related costsadd
to total financial costs of about$150 billion a year.
C. Smoking among college students has increased32% between 1991 and 1999.
VI. Tobaccoand Its Effects.
A. There are many health effects of tobacco.
1. Nicotine is the major psychoactive substancein tobacco.
2. Smoking is the most common form of tobaccouse and delivers nicotine and about 4,000 other chemical substances to the userand anyone who breathes in the environmental tobacco smoke. (See Table 8.4)
3. Tar is the thick, brownish sludge fromparticulate matter that condenses in the lungs. It contains cancer-causingagents such as benzopyrene and irritants such as phenol.
4. Nicotine and hydrogen cyanide impair theaction of cilia cells in the lungs, making it nearly impossible for the lungsto clear and contributing to “smokers cough”.
5. Many other gasses and chemicals are found intobacco; one of the most dangerous is carbon monoxide.
a. Carbon monoxide is present at levels about800 times higher than
considered safe by the EnvironmentalProtection Agency.
b. This can cause oxygen deprivation in many body tissues.
B. Tobacco comes in several forms.
1. Cigarettes, cigars, and pipes are used forburning and inhaling tobacco.
2. Clove cigarettes are about 60% tobacco, andare higher in tar, nicotine, and carbon monoxide than regular cigarettes. They also contain eugenol, which allowsdeeper inhalation, thereby increasing risk.
3. Cigar sales have increased dramatically in the last fewyears. Smoking even one a day increasesrisk for cancers, heart disease, and COPD.
4. Bidis are small hand-rolled, flavored cigarettes, madein India or Southeast Asia. They look similar to a marijuana cigarette, and are far more toxic thancigarettes.
5. About 5 million adults use smokeless tobacco. Chewingtobacco and snuff are two forms of smokeless tobacco.
a. Chewing tobacco contains tobacco leaves treated withmolasses and other flavorings.
i. It is placed in mouth and chewed or sucked to releasethe nicotine.
ii. Dipping is a similar method where the tobacco is placedbetween the lower lip and teeth to stimulate the flow of saliva and release thenicotine.
b. Snuff is placed inside the cheek or inhaled.
b. There are many risks associated with smokeless tobacco.
i. It is just as addictive as smoking tobacco.
ii. Leukoplakia, a white leathery patch inside the mouth,is a precursor to oral cancer.
iii. It is estimated that 75 percent of oral cancer casesresult from tobacco use.
iv. Warning signs include lumps in the jaw or neck, colorchanges or lumps inside the lips, white, smooth, or scaly patches in the mouthor on the neck, lips, or tongue, a red spot or sore that does not heal, anddifficulty speaking or swallowing.
v. Smokeless tobacco impairs the sense of taste and cancause tooth decay and gum disease.
vi. Users suffer the same withdrawal as do smokers.
C. Nicotine is a powerful CNS stimulant.
1. Nicotine causes many physiological reactions.
a. It produces an aroused state.
b. It stimulates production of adrenaline.
c. It causes an increase in heart rate and bloodpressure.
d. It decreases the stomach contractions thatsignal hunger, and decreases sensation in the taste buds, reducing hunger.
e. Many smokers eat less and weigh about 7pounds less than non-smokers.
2. Nicotine poisoning can occur for a beginningsmoker until tolerance develops.
a. Symptoms include dizziness, lightheadedness,rapid, erratic pulse,
clammy skin, nausea, vomiting anddiarrhea.
b. Tolerance to nicotine occurs rapidly, afterjust a few cigarettes.
c. Addiction to nicotine also occurs rapidly.
VII. Health Hazards of Smoking.
A. It is estimated that 30% of all cancers andmore than 85% of lung cancers are caused by tobacco.
1. Lung cancer is the leading cause of cancerdeath in the US.
2. Lung cancer takes from 10 to 30 years to develop, has a five yearsurvival rate of 13 percent and risk depends on:
a. Number of cigarettes smoked per day.
b. When you started smoking.
c. How deeply you inhale.
d. Occupational or domestic exposure to otherirritants, such as asbestos or radon.
3. Other cancers associated with tobacco includepancreatic cancer, and cancers of the lip, tongue, salivary glands, esophagus,kidney, bladder, and larynx.
B. Half of all tobacco-related deaths occur fromsome form of cardiovascular disease.
1. Smoking ages the arteries by about 10 years.
2. Smoking decreases HDL levels.
3. Platelet adhesiveness increases the risk ofblood clots.
4. Oxygen deprivation weakens tissues of theheart.
5. Risk goes down by 50% after one year ofquitting and drops to normal after 15 years.
C. Smokers are twice as likely as nonsmokers tosuffer a stroke.
D. Women who take birth control pills and smokecigarettes increase their risk of heart
attack by20 times that of nonsmokers. Thiscombination can also increase risk of blood clots, peripheral vascular diseaseand stroke.
E. There are several respiratory problemsassociated with smoking.
1. Chronic bronchitis is caused by inflamedlungs producing excess mucous.
2. Emphysema is a chronic condition wherealveoli are destroyed and oxygen intake is impaired.
a. Eighty-percent of all emphysema cases are dueto smoking.
F. Research has indicated that male smokers aretwo times more likely than nonsmokers to experience impotence which couldindicate oncoming cardiovascular disease.
G. Gum disease is three times more common insmokers than in nonsmokers.
H. Women who smoke have a greater risk forcervical cancer than do nonsmokers.
I. Women who smoke during pregnancy increaserisk of miscarriage, low birth weight, infant mortality and developmentalproblems.
VIII. Environmental Tobacco Smoke (ETS).
A. Environmental tobacco smoke is divided intotwo categories:
1. Mainstream smoke refers to the smoke drawnthrough tobacco while inhaling.
2. Sidestream smoke (secondhand smoke) refers tosmoke from the burning end of a cigarette or to smoke exhaled by the smoker.
B. Involuntary smokers, also called passivesmokers, breathe less smoke than smokers but are still exposed to dangerouschemicals. Secondhand smoke has higher levels of unhealthy chemicals than thesmoke the smoker inhales. Sidestreamsmoke has two times the tar as mainstream.
C. Involuntary smokers have increased risk ofseveral diseases.
1. Lung cancer and heart disease risk increaseswith exposure to sidestream smoke.
2. Sidestream smoke increases risk of bronchitisand pneumonia.
3. Children under the age of five are atgreatest health risks from sidestream smoke.
a. Children exposed to sidestream smoke have agreater risk of other
illnesses such as asthma, chest colds, anddecrease in pulmonary
performance.
b. They miss 33 percent more school days.
D. Several anti-smoking groups have emerged toreduce the hazards associated with passive smoking.
E. Forty-six states have sued the tobaccoindustry and in 1998 a settlement was reached where the tobacco industry willpay in excess of $200 billion as well as fund additional anti-smoking measures.(see list)
IX. Quitting.
A. Quitting smoking is very difficult.
1.Smokers must break the physical addiction to nicotine.
2.One-third of all smokers try to quit each year, but 90% fail.
B. Symptoms of nicotine withdrawal includeirritability, restlessness, nausea, vomiting, and intense cravings for tobacco.
C. Nicotine replacement products are oneway to help smokers break the addiction.
1. Nicotine replacement gum has been used toease withdrawal symptoms.
2. The nicotine patch helps relieve the smoker’sphysical craving for nicotine.
3. The FDA recently approved a nicotine nasal spray tohelp in quitting. It requires a prescription.
4. A nicotine inhaler is now on the market, but requires aprescription.
D. There are several other ways that are used tohelp smokers quit the habit.
1. Aversion therapy techniques attempt to reducesmoking by pairing the act of smoking with some sort of noxious stimulus.
2. Operant strategies involves pairing the actof smoking with an external stimulus such as a sounding buzzer to helpcondition the smoker into quitting when the stimulus is removed.
3. Self-control strategies view smoking as alearned habit associated with specific situations.
E. There are many benefits of quitting smoking.(See Figure 8.3)
1. The body begins to repair itself within hoursof quitting.
a. Carbon monoxide and oxygen levels return tonormal.
2. Within days, mucous which is clogging airwaysis broken up and eliminated.
3. Within ten smoke-free years, an ex-smoker canexpect to live out his or her normal lifespan.
4. Risks for several cancers, and several typesof heart disease drop considerably as well.
X. Caffeine.
A. Caffeine is the most popular and widelyconsumed drug in the US.
B. Caffeine is a drug derived from the chemicalfamily called xanthines.
1. Xanthines are mild CNS stimulants.
2. Levels of caffeine vary in beverages.
C. Chronic caffeine use and its attendantbehaviors is called caffeinism.
1. Withdrawal from caffeine if you are addictedwill cause a severe headache.
2. Caffeinism meets the requirements foraddiction.
No strong evidence exists to suggest that moderate caffeineuse (about 5 cups of coffee) produces harmful effects in healthy, nonpregnantpeople.