PSY14 Alcohol

Alcohol Pharmacology 1. Enhancement of inhibitory transmission - via [blank_start]GABA(a) Rs, GIRKs[blank_end] (G coupled K+ channels) 2. Inhibition of excitatory transmission - [blank_start]NMDA R, ionotropic glu-Rs[blank_end] 3. Secondary effects on [blank_start]monoamine, opioid, ACh[blank_end] systems, second messengers 4. Effects on [blank_start]DA[blank_end] release in Nucleus Accumbens may mediate reward, dependence liability

Alcohol PK • Rapid [blank_start]absorption[blank_end] • Dose proportional [blank_start]exposures[blank_end] • [blank_start]Zero order[blank_end] elimination Alcohol PD/Alcohol metabolism - Alcohol to Acetaldehyde via [blank_start]Alcohol dehydrogenase[blank_end]* and CYP2E1 - Acetaldehyde to Acetic Acid via [blank_start]Aldehyde dehydrogenase[blank_end] -Acetic Acid to [blank_start]CO2 and H2O[blank_end] *Alcohol DH is [blank_start]rate[blank_end] limiting.

Factors Affecting Blood Alcohol Concentration (BAC) 1. How much alcohol is consumed 2. How [blank_start]quickly[blank_end] alcohol is consumed 3. [blank_start]Body Weight[blank_end] (heavier = lower BAC, lightweight is a literal...) 4. [blank_start]Women[blank_end] will have higher BACs than men because of lower body water content 5. [blank_start]Food[blank_end] slows down the speed at which alcohol isabsorbed in the body, and also reduces peak BAC. 6. [blank_start]Older people[blank_end] will have higher BACs than younger people because of lower body water content. 7. Alcohol [blank_start]content[blank_end] (diluted vs concentrated) may affect absorption 8. [blank_start]Drugs[blank_end] that slow down stomach emptying (e.g. opioids) will reduce peak BAC

BAC [blank_start]0.05[blank_end]% - drink driving limit BAC [blank_start]>0.10[blank_end]% - impaired perception, cognitive function, slower reaction times BAC [blank_start]>0.20[blank_end]% - amnesia, nausea BAC [blank_start]>0.40[blank_end]% - coma, death

Substance use disorders - epidemiology 1. Alcohol abuse: [blank_start]2.6[blank_end]% prevalence, highest user group [blank_start]16–24[blank_end] years, higher in [blank_start]males[blank_end] 2. Alcohol dependence: [blank_start]1.3[blank_end]% prevalence, highest user group 16–24 years, higher in males

Tolerance: • reduction in response to a drug after [blank_start]repeated[blank_end] administration • receptor/second messenger [blank_start]desensitization/downregulation[blank_end] • acute vs chronic tolerance • may lead to increased intake to get desired effects Dependence: • [blank_start]compulsive[blank_end] drug-taking behavior; loss of ability to [blank_start]control[blank_end] use; intrusion into [blank_start]normal[blank_end] activities; + tolerance + withdrawal Withdrawal: • rebound [blank_start]physiological[blank_end] effects upon cessation or reduction of drug intake • symptoms usually [blank_start]opposite[blank_end] to those produced by drug (e.g. insomnia, anxiety - BDZs, alcohol; sedation, depression - cocaine

Odds of adult alcohol dependence are reduced by 10% for each year drinking onset is delayed in adolescence.

"Types" of alcoholism: Type 1 (~75%): Genetic link [blank_start]weaker[blank_end]. Tend to start drinking heavily in [blank_start]response[blank_end] to setbacks, losses, or other outside circumstances. Equal in male and female. Tend to feel [blank_start]anxious[blank_end], shy, pessimistic, emotionally dependent. Drinking alcohol helps [blank_start]manage[blank_end] strong emotions (anxiety, depression). Type 2 (~25%) Genetic link [blank_start]weaker[blank_end]. Onset <[blank_start]25[blank_end]y. They drink [blank_start]regardless[blank_end] of what 's happening in their lives and often have a history of fights and arrests. More common in [blank_start]males[blank_end]. More sensation- and novelty-seeking, more [blank_start]impulsive[blank_end] and less [blank_start]socialized[blank_end]. Polysubstance abuse is common as part of an antisocial lifestyle.

Marketing and advertising normalizes and maintains a heavy drinking culture.

As alcohol price descreases, alcohol use increases.

Altering price/availability affects consumption/harm.

Cheaper alcohol, greater availability shifts the Ledermann curve shape to the [blank_start]right[blank_end], meaning more [blank_start]litres[blank_end] are consumed per drinkers. Dearer alcohol, less availability shifts the Ledermann curve shape to the [blank_start]left and up[blank_end], meaning [blank_start]more[blank_end] drinkers but [blank_start]less[blank_end] litres consumed.

Drug treatment of drug/alcohol dependence: Substitution treatment: • [blank_start]Methadone, buprenorphine[blank_end] for opioid dependence • [blank_start]Nicotine, varenicline[blank_end] for smoking Anti-craving medication: • [blank_start]Naltrexone (acamprosate)[blank_end] for alcohol dependence Antagonist/aversive medication: • [blank_start]Disulfiram[blank_end] for alcohol dependence Most effective options for treating dependence are [blank_start]social and psychological[blank_end]. Most effective options for preventing dependence are [blank_start]social, political and economic[blank_end]

The 5+ Solution For Alcohol 1. Raise alcohol [blank_start]prices[blank_end] • increase tax, minimum price per standard drink 2. Raise the [blank_start]purchase[blank_end] age 3. Reduce alcohol [blank_start]accessibility[blank_end] 4. Reduce [blank_start]marketing[blank_end] and advertising 5. Increase drink-driving [blank_start]counter-measures[blank_end]