Alcohol gets into the blood stream very quick and the more concentration zero order kinetics clear out at a constant rate regardless of consumption but shifts alcohol dehydrogenase gets saturated rate limiting acetaldehyde dehydrogenase fast because so toxic acetic acid oxidation reaction CO2 H2O Chapter 10 Alcohol Alcohol mixes with water and is highly lipid soluble diffuse across membranes we drink ethyl alcohol methyl lab isopropyl rubbing alcohol 70 to first order kinetics drink with food so there is more time to metabolize in the stomach energy empty calories no nutritional value but a lot of energy Driving law 08 BAC cut off high way funds to get states to comply Acute tolerance Chronic Tolerance Role of Expectation placebo effect Relationship between dose and withdrawal severity more doses stronger withdrawal symptoms Accidents and alcohol use 18 24 most risk 18 24 learning how to drive first experience alcohol Brain Damage loss of cells withdrawal hyper excite toxicity thymine deficiency alcohol fix cells alcohol depress sexual experience Fetal Alcohol Syndrome IQ problems physical defects leading cause of mental dehydration second trimester the most intense week 4 9 J shape curve drinking one or two drinks can possible help Twins 50 genetics Effects of alcohol on neuronal membranes nonspecific alters lipid composition interacts with polar heads of phospholipids disturbs the relationship of protein in membrane specific acts as NT binding site modifies gating mechanism inside channel direct interaction with channel protein stimulates Gs which is linked to adenylyl cyclase GABA Chronic effect neuroadaptive decrease in GABA subunits that make channel changes receptor changes so the number of receptor stays the same Type 1 self medication males and females after 25 high environment not novelty seeking can control drinking more guilt and fear no aggressive can stop it Type 11 Before 25 male for the feeling risk taker used to feel good novelty seekers inability to control drinking no guilt low levels of serotonin metabolites impulsivity and aggressive unable to stop mostly makes membrane more fluid thinner the things in the lipid bilayer move around Relationship with Glutamate Release glutamate increase hyper excite with withdrawal of alcohol metabolites DOPAC and HVA withdrawal has a decrease in dopamine Dopamine TABLE 10 3 Cloninger s Alcoholic Subtypes Low Sensitivity to Alcohol highly sensitive do not need to drink a lot low sensitivity more natural quality same as high tolerance something developed low sensitive drink a lot to feel affects more detrimental effects drug abuse Treatment The first hurdle denial Family and friends enablers Detoxification benzodiazepines sch as Librium and Valium get them off drugs Pharmacotherapeutic treatment drinking unpleasant and reduce alcohol s reward Naltrexone opioid receptor antagonist reduce alcohol consumption and craving improve abstinence Acamprosate not usually used CRF1 antagonist no approved yet Most effective is medical management with naltrexone of CBI behavioral