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Alcohol & Drug Counseling, Assessment and Prevention Services Resources

Alcohol 101

What is alcohol?

Alcohol is a central nervous system depressant. The term “depressant” often gets misused. In short, alcohol depresses, or slows down, the central nervous system. As one’s blood alcohol level goes up, the depressant effects get more pronounced.

Because the brain is a part of the central nervous system, we see the deficits in cognitive processing and motor coordination increase as an individual gets more intoxicated. A standard drink is any beverage that contains ½ oz. of ethyl alcohol. Most often the amount of ethyl alcohol in a beverage is expressed by the “proof,” which is two times the absolute percentage of ethyl alcohol. So, 80 proof hard alcohol contains 40% ethyl alcohol. To get ½ oz. of ethyl alcohol, one would need 1 ¼ oz. of 80 proof liquor – the standard drink for 80 proof alcohol described above.

How does alcohol travel through your system?

When you swallow a drink, the alcohol first travels to the stomach. There, some of the alcohol (approximately 20%) begins going through the stomach wall and into your bloodstream through a process called absorption.

The rest of the alcohol then travels to the small intestine, where it enters the bloodstream rapidly and completely, regardless of the food content in it. Therefore, once the alcohol reaches the intestine the rate of absorption is fairly standard.

What influences the rate of absorption?

How fast alcohol is absorbed from your stomach and intestine into your bloodstream will determine how quickly you will feel intoxicated. This rate of absorption is determined by a number of things that you may already know about:

Concentration: The higher the concentration of alcohol in your beverage, the faster it will be absorbed into your blood stream. For example, shots of liquor are absorbed faster than a bottle of beer. Also, beverages with effervescence will trigger the muscle between the stomach and the small intestine, called the pylorus sphincter, to open and thus will reach the small intestine quickly resulting in faster intoxication.

Food: When you have eaten recently and there is still food in your stomach, the movement of alcohol from the stomach to the small intestine will be delayed and thus absorption of alcohol will be slower than if you are drinking on an empty stomach. Foods high in protein slow are the most effective in slowing the absorption rate.

Rate: The faster you drink, the faster the alcohol will get into your bloodstream.

How does alcohol leave the system?

Approximately 90% of alcohol is broken down, or oxidized, in the body primarily by the liver, and to a lesser extent, in the stomach lining. The 10% alcohol that is not oxidized in the liver gets out of the body through sweat, breath or directly through urine. There are no significant differences in the rate of alcohol oxidation among individuals. Even more importantly, this process cannot be speeded up. Contrary to popular beliefs, neither several cups of strong coffee, or a cold shower, nor exercise will sober up an intoxicated person. For example, if someone reaches a blood alcohol level of .080, it will take this person five hours to return to a B.A.L. of .000. Because alcohol is primarily oxidized by the liver, excessive drinking damages the liver.

On a related note, some people think that making themselves vomit will get the alcohol out of their systems quickly. This is also a myth. Absorption happens so quickly (usually within 10 minutes), that by the time a person is vomiting, most of the alcohol consumed is already in the bloodstream. Vomiting, in fact, can be dangerous, particularly if enough alcohol has been ingested to disrupt motor behavior (e.g., choking on vomit can occur).

There are healthy choices to make while you are drinking (like drinking water or eating food) and students should be encouraged to do these things. These actions may decrease the likelihood of dehydration, headache due to dehydration, or stomach irritation; however, even though these actions are healthy choices, it will not make a person any more sober. Also, it is HIGH RISK to give water or food to a person who is passed out or highly intoxicated as they are at risk for airway blockage or asphyxiation.

Alcohol, nutrition, & healthy eating

Alcohol is actually a fermentation product of carbohydrates: both sugars and starches. In beverages or food, it supplies energy, or calories. Alcohol provides 7 calories for every gram, compared with 4 calories per gram of carbohydrate and protein, and 9 calories per gram of fat. A 1-ounce jigger or “shot” of vodka, for example, may be 40 to 50% alcohol, or up to ½ ounce of alcohol. That equals about 14 grams and contributes about 100 calories. The additional calories in beer, wine, or liqueurs come from carbohydrates.

The alcohol content of a single drink depends on the type of alcohol and the serving size. “Special” alcoholic drinks advertised on restaurant table tents usually contain more alcohol because they’re bigger. The calorie content also is determined by the amount of alcohol and, for mixed drinks, the other ingredients in the drink.

For healthy nutrition it may be wise to cut out alcohol. If you do drink regularly and wish to change your habits try these tips:

  • Choose low-alcohol or non-alcoholic drinks even if it is only occasionally. Strong lager can contain twice as many calories as low-alcoholic lager. (Alcohol Calorie Calculator)
  • Try to drink more slowly and pace yourself.
  • If you drink to relax why not try something else like going for a walk, jogging, swimming or dancing.

Blood Alcohol Level: What are the effects?

Blood Alcohol LevelEffects
0.01 - 0.03Mild relaxation; slight loosening of inhibitions; slight loss of social discomfort; mild intensification of mood.
0.05 - 0.06Small buzz; slight sedation; feelings of warmth & relaxation; loss of shyness; emotion and behavior can become exaggerated; fine motor skills decline; reaction time slows. There may be only minimal awareness of these effects. Driving is a risky choice.
0.08BAL limit for DUI in Washington State
0.07 - 0.09Fuzzy thinking; motor skills clearly impaired; speech may be noticeably impaired; sight and hearing acuity are reduced; judgment ability is slowed and reduced.
Ability to decide about further drinking is impaired and ability to evaluate and respond to sexual situations is diminished. (Warning: legally impaired consent is the same as NO CONSENT).
0.1 - 0.2Emotions unstable; perceptions, thinking, judgment, reaction time are all significantly impaired.
0.25 - 0.3Confusion, disorientation, dizziness, exaggerated emotions. All sense perceptions distorted. Numb. Severe risk of injury.
0.3 - 0.4Stupor; motor functions severely impaired; unable to stand/walk. Vomiting, incontinence are high risk. Loss of pain awareness. Impaired consciousness.
Risk of death.
0.4 +High risk of impaired circulation, respiration or heart rhythm. Coma and death due to anesthesia of brain areas and nervous system functioning are very possible.

Biphasic model: Is more really better?

Questions to think about:

  • Does “more” mean “better” when it comes to drinking alcohol?
  • Why do you feel initially energized, but tired and wanting to crash later on, after you’ve been drinking for a while?
  • What role does tolerance play in getting “high” from alcohol?

What is the Biphasic Response?

  • The biphasic response refers to the two physiological phases, or sets of effects, that alcohol produces. Feeling stimulated or excited is characteristic of the initial phase, followed by depressant effects, such as feeling tired.
  • The initial positive effects are associated with low but rising BALs. The second-phase effects are associated more with falling BALs (regardless of your peak BAL, although the effects are more profound when the peak is higher).

Here’s what to consider:

  • As it turns out, if you want to hold onto a good buzz and not lose steam midway through a party, you’re a lot better off drinking slowly and moderately (not pushing a BAL over0.055%) and getting rid of your tolerance.
  • You’re guaranteed a nasty hangover (one of the more unpleasant depressant effects) when you binge-drink (e.g., have a lot of drinks in a row, the way you may do if you play drinking games).
  • The more alcohol you drink and the higher your BAL, the more alcohol acts as a depressant instead of as a stimulant.
    The more tolerance to alcohol you’ve got, the less likely you are to experience the stimulating physiological effects of alcohol.
What is the Cultural Myth?
"If a few drinks make me feel good, a lot of drinks will make me feel even better." Some people believe the buzz they get from alcohol will continue to get even better if they keep drinking more and more.
01-chart
How Alcohol Really Works
Alcohol produces two differing effects or phases (Biphasic Response). In the first phase, common reactions are feeling stimulated - a little buzzed or excited. The physical depressant effect of alcohol occurs in the second phase because of intoxication. Common reactions in the second phase are slurred speech, decreased motor ability, impaired thinking and judgment.
02-chart
Tolerance: "It's not a good thing.."
The curved yellow line illustrates that as you develop tolerance, the buzz or positive feelings are less. The depressant or negative phase lasts longer and your risk for negative experience increases.
03-chart
It's About Balance:

The Point of Diminishing Returns (.055 BAL or less) usually gives people the experience they want from drinking. It is also the point when drinking more will not make you feel better or have a better time. You will just get more intoxicated and the negative risks of drinking will increase.
03-chart

_______________

Information from Brief Alcohol Screening and Intervention for College Students (BASICS): A Harm Reduction Approach by Linda A. Dimeff,John S. Baer, Daniel R. Kivlahan, and G. Alan Marlatt. Copyright 1999 by The Guilford Press. Permission to photocopy this handout is granted to purchasers of BASICS for personal use only (see copyright page for details).

Charts designed by InfoSoft Research, Inc. of Bellingham WA. Contact 360-714-0831 for permission to copy.

Alcohol expectancies: Positive and not-so-positive experiences

Many students acknowledge that both positive and not-so-positive things happen when socializing and drinking.

  • Enjoyable/positive aspects of drinking. What kinds of positive things do you associate with drinking? What kinds of positive things do students expect to get out of an experience which includes drinking?
    • Common answers: Fun, meeting new people, relax/de-stress, dancing, connect with someone to whom they are attracted, sexual opportunity or hook-up, getting ‘buzzed’.
  • Not-so-positive aspects of drinking. What are some less desirable or negative things that can happen when you are drinking? Have they said or done things when drinking that they would not have under different circumstances?
    • Common answers: Too drunk, hung over/sick, blackout/brownout, legal problems, spend too much money, lose personal items, academic problems, injury and fighting, regrets, sexual assault – not able to give/get consent.

Not everyone has the same list of positive or not-so-positive expectancies. What is important is to think about what kind of experience you want to have.

    • Having a good time includes not having a “bad” time (or negative experiences). Is this true?
    • Can some expectations be listed on both the positive and negative side?
    • Do the genders (men, women, trans) have different positive/negative expectations?
    • Do living groups have different positive/negative expectations? (Greeks, freshman in residence halls, athletes, seniors in off-campus housing, etc.)
    • Have you ever had alcohol do different things for you at different times?
  • When students are asked: What is the main reason students end up with not-so-positive experiences when socializing and drinking?

Common answers

      : Too intoxicated, too drunk, drank too much, didn’t keep track of my drinks

Often, maximizing the positive expectancies and minimizing not-so-positive alcohol expectancies is about understanding what you drink, where you drink, and how you drink.  It is about taking control and having the kind of experience you what to have.

See the “Where am I with alcohol?” and “Thinking about moderating your drinking” pages below for more information.

Alcohol expectancies: Is it in your cup or in your head?

In the 1970s and 1980s a group of researchers at the University of Washington wanted to better understand the experience of positive alcohol expectancies and how these are tied to the consumption of alcohol (see Dimeff, Baer, Kivlahan, & Marlatt, 1999; Hull & Bond, 1986; Marlatt & Rohsenow, 1980). In other words:

  • Is the positive experience psychological or physiological?
  • Is it really more about what’s in your head or what’s in your cup?

These are complex questions.  Think about social/environmental influences, physiological influences, and alcohol expectancies.

  • Physiological/Pharmacological influences
    • Alcohol is a drug, a depressant and it does have an effect, right? It is not a neutral or benign substance.
    • Are the ‘fun and social’ effects (positive expectancies/psychological effects) actually tied to the physiological (chemical/depressant) influence of the drug?
    • Can someone feel buzzed or tipsy from a non-alcoholic drink or tonic water alone?

 

  • Influences of set and setting
    • Can alcohol have different effects depending on the environment?
    • Are the effects of alcohol the same in different environments or with different people?
    • Do people feel the same after multiple beers at a large party as opposed to drinking a glass of wine at dinner with a small group of close friends?
    • Do they feel any different if they are drinking at a football game, as compared to watching it on TV by yourself?

How questions about alcohol expectancies were explored through research.  
The Balanced Placebo design

  • This experiment design helped to separate the “chemical effects of alcohol” from the “psychological effects of drinking.”
  • The experiment was conducted in a bar-like setting.
  • Placebo: a substance having no medication/drug that is administered for its psychological effect (like a sugar pill in a research trial).
  • The balanced placebo design involves two conditions in which subjects (college-aged students) received a beverage that was not what it seemed. Some expected to receive alcohol while others expected non-alcoholic drinks.

Image of the Barlab at University of Washington
The Barlab at the University of Washington

Four conditions in the balanced placebo design. These four conditions correspond to the numbers on the figure below:

1) Subjects expected to drink alcohol and actually received alcohol
2) Subjects expected to drink tonic water but actually received alcohol (drinks contained enough alcohol to get the subject to a BAL of .05-.07, there was a lot of lime juice to cover the taste of the vodka)
3) Subjects expected alcohol and received a tonic water (with alcohol only on the rim of the glass
4) Subjects expected tonic water and received tonic water.

image of the Balanced Placebo Design
Information Source:  Dimeff, Baer, Kivlahan, & Marlatt (1999). Brief alcohol screening and intervention for college students: A harm reduction approach. (p. 44-45). Guilford Press, NY.

 

Responses in the experiment: How do you think subjects acted/responded socially?

  • In condition 1 where subjects expected to receive alcohol and did receive alcohol, they acted as many might expect – more disinhibited. The subjects became more talkative, louder voice volume, and more social with each other.
  • In condition 4, where students expected to receive tonic water and did receive tonic water, they also as many might expect. This group primarily kept to themselves, was fairly quiet, and did not exhibit much disinhibition or increased social behaviors.
  • Condition 3 is our first introduction to the powerful impact of expectancies. Students who thought they were being served alcohol even though they weren’t began showing many of alcohol’s social effects – they became louder, more verbal, and more more social, like condition 1.
  • In condition 2, students who thought they were only drinking tonic water but received alcohol did not exhibit the social behaviors and effects one might expect from drinking alcohol. The depressant effects of alcohol were evident (i.e., reported feelings of fatigue, flushing, increased lack of coordination), but students made attributions about what they were experiencing to circumstances other than drinking alcohol (e.g. being tired, being clumsy, etc.).

Now…. back to the research question about alcohol expectancies:

  • Is the positive experience psychological or physiological?
  • Is it really more about what’s in your head or what’s in your cup?

Results: The expectancy or psychological effect is more powerful than the chemical or physiological effect of alcohol. In other words, it is not about what’s in your cup – it’s in your head! Note: This study has been replicated in numerous settings and the conclusions are widely accepted.

  • The social effects of drinking depend less on the actual alcohol content of the drink than on the prior perceptions and expectations that people bring to a drinking situation and the situation/environment itself.
  • Yes, the physiological effects of alcohol at a low BAL (.02 – 0.5) can be relaxing. As well, reaction time, cognitive judgment, and motor control all decrease due to alcohol use. There is an actual physiological effect.
  • But…When it comes to what students want, in terms of a positive social experience (fun, socializing, meeting people, etc.), it really is about psychological expectations and the social setting. Having a positive social experience is not reliant on the physiological effect of alcohol or what’s in the cup.

It’s good news! The expectancy effect is a positive thing for students.

  • The power of expectancies gives students control in their social situations, in that they don’t have to rely on drinking alcohol to have a good time.
  • Students can choose to drink, if they want to, but having a good time is about whom they are with and what they are doing – not about how much alcohol they drink.
  • This means students don’t have to have a bad time (experience the not-so-positive things) in order to have a good time.

Often, maximizing the positive expectancies and minimizing not-so-positive alcohol expectancies is about understanding what you drink, where you drink, and how you drink.  It is about taking control and having the kind of experience you what to have.

See the “Where am I with alcohol?” and “Thinking about moderating your drinking” pages below for more information.

Alcohol myopia

Myopia refers to a person being near-sighted. Alcohol myopia refers to how intoxication affects cognitive processing and occurs as a person’s Blood Alcohol Level (BAL) increases, resulting in a narrow focus on just the “here and now.” The usual concerns, values, thoughts, or rules may be out of “focus” at high blood alcohol levels. Alcohol myopia generally begins to appear at a BAL of about 0.55 to .065 and gets worse as BAL increases.

For example, the person who knows not to drive while intoxicated and espouses the virtues of calling a cab, may only focus on the fact that he or she is cold, tired, and wants to go home when he/she is very impaired. The result is that people may make choices that, when sober, they would not normally make – like drinking and driving.

Graphic of Alcohol Myopia

What does alcohol myopia look and feel like?

  • Can’t take in the full context of an environment. Can’t weigh pros and cons of a situation
  • Can only focus immediately on the “here and now”
  • Reaction and focus on the most salient issue at the present moment
  • Examples: fights, anger, mood swings, jumping to conclusions, sexual assault situations, and drunk driving

Questions for reflection

  • Can you think of any examples of alcohol myopia in your own experience or something that you have seen?
  • Do both women and men get alcohol myopia?
  • How does alcohol myopia play a part in regrettable sexual situations or even sexual assault?

Where am I with alcohol?

Here are some questions to ask yourself about your use of alcohol.

  • Is your personality different when you drink?
  • Do you drink to gain courage to face social situations?
  • Has your drinking ever caused you to miss classes or appointments?
  • Do you use alcohol as an escape when you are upset?
  • Is it hard for you to stop drinking after you have one or two drinks?
  • Do you always end up drunk, once you start drinking?
  • Have you tried and failed to drink less alcohol or drink none at all?
  • Do you sometimes have trouble remembering what you did while under the influence of alcohol? Do you regret doing some of the things you do remember?
  • Have friends or family members tried to express their concern about your drinking?
  • Has your class work suffered because of your drinking?

If you have answered YES to any of these questions, you might want to honestly examine your habits and assess the effect they may be having on your health, school work, social life and behavior.

What steps can you take?

  • Continue to use the ADCAPS website for more info
  • Take the e-CHUG online assessment
  • Come into Counseling Services for a free & confidential session
  • Talk with a confidant (friend, RA or RED, pastor, parent, or faculty member

Thinking about moderating your drinking?

Decide what you want from drinking alcohol.

  • Think about the pros and cons (short- and long-term) for moderating your use versus maintaining the status quo.
  • Also consider what you absolutely want to avoid when you drink.

Set drinking limits.

  • What’s your upper limit on the number of drinks you consume per week?
  • At what point do you decide you’ve had enough (consider a BAL limit)?
  • What’s the maximum number of days for drinking you will choose to give yourself?
  • Use standard guidelines to determine what constitutes one drink: 1 ¼ ounces of 80-proof spirits; 4 ounces of wine; 10 ounces of beer with 5% alcohol (“ice” beer and many “micro brews”); 12 ounces of beer with 4% alcohol (standard beer).

Count your drinks and monitor your drinking behavior.

  • Try it! Most people are surprised by what they learn when they actually count how much they drink.
  • Simply observe your behavior – this is like standing outside yourself and watching how you are acting when you are drinking.

Alter how and what you drink.

  • Switch to drinks that contain less alcohol (e.g., light beers).
  • Slow down your pace of drinking.
  • Space drinks further apart.
  • Alternate drinking nonalcoholic beverages with alcoholic drinks.

Manage your drinking in the moment.

  • Stay awake and on top of how you drink and what you’re drinking when you’re at a party.
  • Choose what’s right for you.

_______________________
Information from Brief Alcohol Screening and Intervention for College Students (BASICS): A Harm Reduction Approach by Linda A. Dimeff, John S. Baer, Daniel R. Kivlahan, and G. Alan Marlatt. Copyright 1999 by The Guilford Press. Permission to photocopy this handout is granted to purchasers of BASICS for personal use only (see copyright page for details).