Alcohol Addiction & Abuse

Alcohol is a substance that results from sugars and starches undergoing a process called fermentation. These sugars and starches come from fruits and grains. Fermentation begins when yeast is added to these sugars. As the yeast “eats” the sugar, a by-product (alcohol) is created.

[caption id="attachment_11356" align="aligncenter" width="640"] Other common names for alcohol include ethanol, ethyl alcohol, fermentation alcohol and grain alcohol.[/caption]

It is a clear, colorless, volatile liquid that is able to mix completely with water. Alcohol is flammable and has a burning taste and a strong, powerful smell like ether.

[caption id="" align="aligncenter" width="2000"] Alcohol absorption begins in the stomach, into the bloodstream and eventually into the body's tissues.[/caption]

The rate at which alcohol is absorbed into the body varies from person to person and varies based on a number of factors including a person’s sex, age and weight. The level of intoxication may depend upon the amount and type of food that the person ate prior to drinking alcohol as well.

Excessive alcohol consumption over a long period of time causes serious physical, mental, professional and social problems. The repercussions of these problems extend beyond just the person themselves - affecting a person’s family, friends, neighbors and the community to which they belong as well as affecting their job, co-workers, employers and the overall safety in and around their workplace.

Screening Cut-Off and Alcohol Detection Times

The average legal cut off limit for BAC (blood alcohol concentration) is 0.08% but it varies from state to state. The NTSB (National Transportation Safety Board) has proposed bringing this legal limit down to 0.05% for all 50 states. They claim that at 0.05% BAC, some visual and cognitive impairment can already be observed in many drivers. Please see BAC effects further down for more detailed information on the effects of alcohol at different BAC levels.

On average, upon consumption, detection times for alcohol are as follows:

Blood Saliva Urine Hair 12 hours 6-12 hours 6-24 hours (up to 5 days with EtG) 7-90 days with EtG

DEA Drug Class

Alcohol is not included in the Controlled Substance Act and will therefore not be found under any of the DEA Schedules I, II, III, IV and V. Along with tobacco, alcohol is legal to use. They are two of the deadliest yet most widely used drugs in the United States.

Alcohol Drug Type

Yes, alcohol is a drug and is considered a depressant. Depressants slow down vital functions and intoxication symptoms manifest as unsteady movement, slurred speech, disturbed perceptions and slow reaction time. Alcohol’s “mild” depressant effects kick-in when a person consumes more than the body can handle. At “overdose levels”, the more severe depressant effects begin to show including toxicity (the body begins to expel the poison thru vomiting), pain tolerance, unconsciousness or coma and worst - death. These reactions depend upon the amount of alcohol a person consumes and how quickly.

Categories of Alcohol

There are two main categories of alcoholic beverages, 1) Fermented beverages made from fermenting fruits, grains and other sugars like honey and 2) Distilled beverages made from distilling fermented beverages. A sub-category, fortified wines, is made from blending categories 1 and 2, usually wine + brandy.

Fermented Beverages

• Beer – Beers are made from fermenting grains like barley, wheat, rice, corn, sorghum, rye and millet. The Japanese “sake” is actually a beer fermented from rice.
• Wine - The term wine alone is generally used for fermented grapes. Wine is either red or white depending on the type of grape used and whether the skin is left on. Wines made from other fruits are called by that particular fruit’s name (peach wine, plum wine, apple wine etc.) Wines fermented from the sap or nectar of various species of palms and other plants are typically called by their local names, like pulque (from the agave plant), Lambanog (from coconut), maple wine or birch sap wine.
• Mead – Made from fermented honey.

Distilled Beverages

• Rum – Distilled from fermented molasses or sugarcane juice.
• Whiskey – Distilled from fermented grains like corn, barley or rye. In short, it is distilled beer.
• Brandy – Distilled from fermented fruit juices and aged in oak barrels. In short, it is distilled wine.
• Vodka – Made by distilling beer or wine to up to 90%+ alcohol content until no traces of the original fruit or grain is discernible in the taste. It is then diluted by water down to 40% alcohol.
• Gin – Made by adding juniper berries in the process of making vodka.
• Tequila – Made by distilling pulque and aging in oak barrels.
• Liqueurs – Made by adding sugar to brandy along with different flavorings added like herbs, fruits or flowers.

Fortified Wines

• Port – Port is made up of wine from grapes grown exclusively in the Douro Valley, Portugal and fortified by Aguardente, a neutral grape spirit.
• Sherry – Sherry is made up of wine fermented from Palomino, Pedro Ximenez or Moscatel grapes and fortified by adding neutral grape spirit from Airen grapes grown in the La Mancha region. Varying harvesting, fermentation, fortification and aging processes produce the 6 types of Sherry wines namely, Manzanilla, Fino, Amontillado, Palo Cortado, Oloroso, Pedro Ximenez and Moscatel.
• Madeira – About 85% of all Madeira produced are from the red grape variety Negra Mole (dry), and the rest from any of the 4 major white grape varieties Bual and Malvasia (for the sweeter wines) and Sercial and Verdelho (for dry). Fortification is achieved with the addition of a neutral grape spirits

Alcoholic Beverages and Their Alcohol ContentAlternative Names of Alcohol

• Booze
• Cold One
• Fire Water
• Grandpa’s Cough Syrup
• Hard Stuff
• Poison
• Liquid Courage
• Sauce
• Spirits

Side Effects of Alcohol

When alcohol is absorbed into the body, it affects many vital organs including the brain. The parts of the brain that alcohol affects are those that are responsible for motor functions, judgment, memory and speech. These effects are what we perceive as the common signs of drunkenness like difficulty walking, impulsive behavior, memory lapses and slurred speech. Long-term over-consumption can actually shrink the frontal lobes, eventually leading to impaired thinking abilities.

[caption id="attachment_15699" align="aligncenter" width="900"] Drug-Drug Interactions Chart[/caption]

This kind of information is especially relevant to employers, safety managers, workplace supervisors and other key employees who are responsible for implementing their organization’s Drug Free Workplace programs. Having trusted employees well-trained and in place to spot or recognize drug or alcohol impairment in the workplace is a critical component for the program to succeed. It is not as simple as smelling the alcohol on somebody’s breath. Having close working relationships with the other employees, a safety manager for example will be able to tell, even from across the room, minute changes in behavior that may be due to alcohol intoxication, hopefully before anything untoward happens in the workplace. If an employee is suspected of being drunk on the job, its important to perform an EtG alcohol test to protect the safety of the employee and the company.

Short Term Side Effects of Alcohol Use

Most adults will not suffer from any detrimental effects from consuming a small amount (1 or 2 servings) of alcohol per day. In fact, at this low level of consumption, alcohol may even help lower the risk of heart disease and dementia.

Above safe doses however, and depending upon a person’s weight and recent food intake (if any), the short term effect is that brain activity begins to slow down. This reduced brain activity is evidenced by feelings of relaxation, partial loss of inhibitions, loss of concentration, slower reflexes and poor coordination. Other short term effects of excess alcohol intake may include:

• Slurred speec
• Drowsiness
• Sleep disruption
• Low body temperature
• Becoming emotional
• Nausea and vomiting
• Reduced bladder and bowel control
• Blackout/memory loss
• Unconsciousness

Long Term Effects Alcohol Use

Over consumption of alcohol over a long period of time will slowly cause brain cells to die, eventually leading to disorders of the brain and reduced mental and physical functions. Alcohol tolerance also begins to set in, and the body becomes too accustomed to alcohol that it requires higher and higher doses without even experiencing the short term effects that should ideally signal the person to stop drinking. Other long-term effects of alcohol abuse include:

• Addiction/alcoholism/dependence
• Alcohol tolerance
• Heart disease
• Liver cirrhosis
• Pancreatitis
• Convulsions
• Death
• Depression
• Erratic behavior
• Emotional instability
• Hallucinations
• Mood swings
• Permanent brain damage

Alcohol Dependence (Alcoholism)

Alcohol tolerance is a long term effect of alcohol abuse. It can lead to dependence. Alcohol dependence is when a person is mentally and physically addicted to alcohol, constantly craving a drink in order to get by. Alcoholism is a chronic disease. It is a not a simple case of weakness. Signs of alcoholism may include:

• Inability to stop drinking or control how much to drink
• Need to drink more to get the same effect
• Having alcohol withdrawal symptoms when not drinking (anxiety, feeling sick to the stomach, shakiness and sweating)
• Spending longer and longer time drinking and recovering from it
• Giving up other activities in order to drink
• Continuing to drink despite the physical problems it brings and the damage it does to relationships and social/professional life

While it is not a supervisor’s or a safety manager’s job to diagnose alcoholism, knowing the signs will go a long way towards ensuring that nobody slips past their notice. The ultimate goal is to be able to refer employees to the EAP (Employee Assistance Program) after having gone through the proper procedures as outlined in the organization’s Workplace Drug Testing Policy. This should include sending the concerned employee for an appropriate drug test perhaps under the provisions stated for random drug testing or reasonable suspicion testing, etc.

BAC Effects

The table below is lifted from the CDC website under Impaired Driving Facts. It shows the effects of alcohol on a person’s driving abilities and at what level BAC these effects can be observed.

Blood Alcohol Concentration (BAC)* Typical Effects Predictable Effects on Driving .02% - About 2 alcoholic drinks** .05% - About 3 alcoholic drinks** .08% - About 4 alcoholic drinks** .10% - About 5 alcoholic drinks** .15% - About 7 alcoholic drinks**

• Some loss of judgment
• Relaxation
• Slight body warmth
• Altered mood
• Decline in visual functions (rapid tracking of a moving target)
• Decline in ability to deal with two tasks at the same time (divided attention)
• Exaggerated behavior
• May have loss of small-muscle control (e.g., focusing your eyes)
• Impaired judgment
• Usually good feeling
• Release of inhibition
• Less alert
• Reduced coordination
• More difficulty tracking moving objects
• Difficulty steering
• Reduced response to emergency driving situations
• Muscle coordination becomes poor (e.g., balance, speech, vision, reaction time, and hearing)
• Harder to detect danger
• Judgment, self-control, reasoning, and memory are impaired
• Concentration
• Short-term memory loss
• Speed control
• Reduced information processing capability (e.g., signal detection, visual search)
• Impaired perception
• Clear deterioration of reaction time and control
• Slurred speech, poor coordination, and slowed thinking
• Reduced ability to maintain lane position and brake appropriately
• Less muscle control than normal
• Possible vomiting (unless this level is reached slowly or a person has developed a tolerance)
• Significant loss of balance
• Substantial impairment in vehicle control, attention to driving task, and in necessary visual and auditory information processing

* The number of drinks listed represents the approximate amount of alcohol that a 160-pound man would need to drink in one hour to reach the listed BAC in each category.

** A standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol. Generally, this amount of pure alcohol is found in 12 ounces of beer (5% alcohol content), 8 ounces of malt liquor (7% alcohol content), 5 ounces of wine (12% alcohol content), 1 shot of 80 proof (40% alcohol content) distilled drinks like whiskey gin, vodka, rum.

History of Alcohol

Alcoholic drinks from fermented fruit, grains and honey have been around for thousands of years. The following is an interesting timeline showing when alcohol figured in the history of human civilization:

• 8000 BC: Domestication of barley and rice. Persia and the Middle East were producing a fermented drink from honey and wild yeasts.
• 7000 BC: Earliest evidence of wine fermented from rice, fruit and honey in Neolithic Jiaju, China.
• 6000 BC.: It is believed that grapes began to be cultivated for making wine in Georgia, the mountainous regions between the Caspian Sea and the Black Sea. They also found chemical traces of alcohol at the Chalolithic site in Areni-1.
• 5000 BC: Some evidence of possible wine production during Neolithic Greece was found at the archeological site in Dikili Tash.
• 4000 BC: Wine making was an established practice in Mesopotamia or what is now Iraq.
• 3000 BC: Ancient Egypt was producing wine and herb-based beer. Wine became a major player in Mediterranean trade relations that also included Mesopotamia, Anatolia and Assyria at the time. They were also using wine in early Bronze Age Greece in Minoa and Mycenea.
• 2700 BC: They were worshiping a wine goddess in Babylon. In India between the 3rd and 2nd millennium BC, they had an alcoholic drink distilled from barley and rice called “sura”.
• 2000 BC: They found sealed bronze vessels containing cereal-based alcohol in Shang and Western Zhou. In the same period they were brewing beer from wheat and barley in Hierankopolis, Egypt.
• 1000 BC: The Kushite Kingdom was using sorghum beer for their rituals. Mead and various beers fermented from grains, including barley beer, were popular all over Europe during the Iron Age.
• 900 BC: South American cultures were using chicha beer made from maize.
• 625 BC: The Prophet Muhammad directs his followers to abstain from consuming alcohol.
• 600 BC: Massalia was founded in France.
• 2nd-1st Century BC: The wine trade in the Mediterranean flourished.
• 2nd Century AD: The Romans began cultivating grapes in Mossel Valley, Germany to produce wine. France became a major wine-producing region.
• 13th Century AD: Ancient Mesoamerica used Pulque, a viscous, milky alcoholic drink fermented from the sap of the maguey plant. The Aztec called it “ixtac octli” or white liquor.
• 1791: Whiskey Tax or the Act of 1791 was enacted into law against distilled whiskey in the U.S. The Whiskey Tax was repealed in 1802.
• 1850s: The “cocktail” was invented in New York by a group of bartenders.
• 1884: In New York state, laws were enacted mandating public schools to incorporate anti-alcohol teachings into the curriculum. Other states soon followed.
• 1906: The labeling of alcohol-containing products was regulated under the Pure Food and Drug Act.
• 1910: The first drunk driving laws were introduced in New York.
• 1920-1933: Together, the 18th Amendment and the Volstead Act outlawed the production, transport and sale of alcoholic beverages in the United States. As a result, illicit alcohol trade flourished.
• 1933: The Prohibition Act was repealed, but those under 18 were restricted from possessing and/or consuming alcohol.
• 1935: Alcoholics Anonymous was born.
• 1944: The U.S. Public Health Service declares alcoholism as the 4th biggest health problem.
• 2000: A new federal law requires states to pass legislation that outlaws driving for people who test with a BAC of 0.08% or higher.