Alcohol Use Disorder Overview

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What has been recognized as a significant consequence of alcohol use disorder (AUD) in terms of public health?

It induces a higher prevalence of psychological disorders.

It contributes less to mortality than illicit drugs.

It is considered the leading cause of preventable death. (correct)

It solely affects individuals without wider societal implications.

Which population group has been identified with the highest prevalence of alcohol use disorder (AUD)?

Hispanics

African Americans

Caucasians

Native Americans (correct)

What criteria must be met for a diagnosis of alcohol use disorder (AUD) according to the DSM-5?

A combination of behavioral and psychological evaluations only.

At least two of the identified DSM-5 behavioral criteria. (correct)

Only one behavior from the DSM-5 criteria.

A minimum of six behaviors present within a year.

Which historical event specifically targeted alcohol consumption in the United States?

The constitutional ban on the sale of alcoholic beverages from 1920 to 1933. Signup and view all the answers

What is one of the four main behavioral effects associated with alcohol use disorder (AUD)?

Altered physiological effects Signup and view all the answers

What is the estimated Blood Ethanol Concentration (BEC) produced by the consumption of one standard drink by a 70-kg person?

30 mg% Signup and view all the answers

Which metabolic factor is primarily induced by heavy ethanol consumption and contributes to hepatic disease?

CYP2E1 induction Signup and view all the answers

What effect does ethanol have on the gastrointestinal (GI) tract?

Enhances the release of endotoxin due to gram-negative flora Signup and view all the answers

What compound is predominantly formed during the metabolism of ethanol by alcohol dehydrogenase?

Acetaldehyde Signup and view all the answers

Which metabolic pathway is impacted by the metabolism of ethanol and methanol, particularly in producing ketone bodies?

Tricarboxylic acid cycle Signup and view all the answers

What is a characteristic symptom of delirium tremens following alcohol withdrawal?

Tachycardia Signup and view all the answers

Which channels are enhanced during acute ethanol effects according to the information provided?

G protein–coupled inwardly rectifying K+ channels Signup and view all the answers

Which state is NOT commonly associated with negative emotional symptoms during acute withdrawal?

Euphoria Signup and view all the answers

What is the primary treatment approach for individuals experiencing delirium tremens?

Intensive care monitoring Signup and view all the answers

What type of channel is inhibited by acute ethanol effects according to the consensus?

L-type Ca2+ channels Signup and view all the answers

Which physiological condition do individuals with AUD experience during acute withdrawal?

Negative emotional states Signup and view all the answers

What must be managed in patients experiencing delirium tremens?

Nutritional and electrolyte deficiencies Signup and view all the answers

What should be the primary treatment for patients with mild respiratory depression due to ethanol intoxication?

Careful observation Signup and view all the answers

Which neurotransmitter receptor function is inhibited by ethanol, contributing to its depressive effects?

Glutamate ionotropic receptors Signup and view all the answers

Which of the following CNS depressants is NOT likely to exacerbate symptoms when taken with ethanol?

Caffeine Signup and view all the answers

What is a potential method for removing ethanol from the blood?

Performing hemodialysis Signup and view all the answers

Which system is known to mediate the rewarding effects of ethanol?

Dopaminergic system Signup and view all the answers

In the treatment of acute ethanol intoxication, if absorption is incomplete, which procedure may be considered?

Stomach lavage Signup and view all the answers

What is a common observation period for a patient in the emergency room following ethanol ingestion?

4 to 6 hours Signup and view all the answers

Which type of receptor does ethanol enhance the function of, promoting inhibitory transmission?

Cys-loop ligand-gated ion channels Signup and view all the answers

Study Notes

Ethanol: A Brief History and Current Perspective

Ethanol (CH₃CH₂OH) is a two-carbon alcohol rapidly absorbed into the bloodstream.
It's the oldest recreational drug, contributing to more morbidity, mortality, and health costs than other illicit drugs.
Alcohol Use Disorder (AUD) is categorized under Substance Use Disorder (SUD) encompassing mild, moderate, or severe classifications. AUD diagnosis requires at least two criteria from the 11 criteria present in a twelve-month period.
High AUD prevalence globally, particularly in Native American communities.
Alcohol-related deaths are among the top three preventable causes in the U.S.
Binge drinking (4+ drinks for women, 5+ for men in ~2 hours) is the most common, costly, and dangerous pattern, responsible for 77% of excessive alcohol use costs.
Ethanol use dates back to 10,000 BCE, with increasing industrialization leading to organized efforts to discourage heavy drinking in the 1800s, including prohibition in the U.S. (1920-1933).

Metabolism of Ethanol

Ethanol is absorbed readily from the stomach and small intestine, distributing into total body water.
Gastric and liver alcohol dehydrogenase (ADH) metabolize ethanol to acetaldehyde, then to acetic acid, requiring NAD+.
Ethanol metabolism follows zero-order kinetics at high blood ethanol concentrations (BECs) and first-order kinetics at low BECs.
Genetic variants of ADH and ALDH influence AUD risk.
Increased hepatic NADH:NAD+ ratio from ethanol oxidation impacts other metabolic processes, leading to fatty acid synthesis, lactate accumulation, and potentially, liver damage.
CYP2E1 is another pathway, impacted by acute and chronic alcohol consumption, contributing to pharmacokinetic tolerance.

Methanol

Methanol (CH₃OH), or wood alcohol, is a harmful industrial solvent.
Ingesting small amounts can cause significant harm, ranging from blindness to death.
Methanol is metabolized to formaldehyde, then to formic acid, which damages peripheral tissues.
Fomepizole, an ADH inhibitor, is used in methanol and ethylene glycol poisoning to slow methanol metabolism to formic acid.

Acute Ethanol Intoxication and Treatment

Factors affecting blood ethanol concentration (BEC) include body weight, composition, absorption rate.
BECs are estimated by measuring ethanol in expired air. Legally permissible BEC for operating a motor vehicle is 80 mg% in most states.
Intoxication signs progress from initial stimulation to impaired judgment, coordination, speech, and potentially memory loss (blackouts).
Treatment depends on severity; mild cases involve observation, severe cases require intubation and/or hemodialysis.

Chronic Effects of Ethanol

Hangover symptoms (headache, thirst, nausea) are related to ethanol withdrawal, dehydration, or mild acidosis.
Long-term heavy drinking can cause Wernicke-Korsakoff syndrome, a degenerative disorder due to thiamine deficiency characterized by confusion, ataxia, and eye abnormalities.
Alcohol-related cognitive impairment may stem from disrupted synaptic plasticity.

Neurocircuitry and Stages of AUD

The basal ganglia and ventral striatum (nucleus accumbens) are implicated in the binge-intoxication stage of AUD, due to incentive salience and reinforcement.
Chronic alcohol use involves decreased functioning in reward systems and stress response systems in the brain, driving craving.

Alcohol Use Disorder (AUD) and Genetics

AUD's heritability is approximately 50-60%, highlighting the importance of genetic factors.
Genes related to ethanol metabolizing enzymes (ADH and ALDH) significantly impact AUD susceptibility.

Pharmacotherapies for Alcohol Use Disorder

FDA-approved medications like disulfiram, naltrexone, and acamprosate are utilized to manage AUD, although these may be used in combination with behavioral and social support in clinical protocols..
Disulfiram inhibits acetaldehyde dehydrogenase, leading to negative experiences with alcohol and reducing consumption.
Naltrexone, an opioid receptor antagonist, reduces rewarding properties of alcohol.
Acamprosate may modulate neurotransmission, particularly effective in abstinent patients.

Teratogenic Effects: Fetal Alcohol Spectrum Disorders

Ethanol readily crosses the placental barrier and impacts fetal development.
Fetal exposure to high levels of ethanol can result in Fetal Alcohol Syndrome (FAS),
characterized by craniofacial abnormalities, CNS dysfunction, and growth deficiencies.
A wide spectrum of alcohol-related effects is present, ranging from partial FAS characteristics to neurodevelopmental complications collectively termed fetal alcohol spectrum disorders.

Other Effects of Ethanol

Ethanol has adverse consequences for organ systems, including but not limited to the esophagus, stomach, intestines, pancreas, heart, kidneys, bone structure, immune system, reproductive organs, and lungs.
Overall, a multifaceted and complex interplay between consumption and health outcomes.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz explores key aspects of Alcohol Use Disorder (AUD), including its public health implications, diagnosis criteria, and historical context. It also covers the metabolic effects of alcohol on the body and the behavioral effects associated with AUD. Test your knowledge on these crucial topics related to alcohol consumption.