Alcohol is often not thought of as a drug - largely because its
use is common for both religious and social purposes in most
parts of the world. It is a drug, however, and compulsive
drinking in excess has become one of modern society's most
serious problems.
Beverage alcohol (scientifically known as ethyl alcohol, or
ethanol) is produced by fermenting or distilling various fruits,
vegetables, or grains. Ethyl alcohol itself is a clear, colorless
liquid. Alcoholic beverages get their distinctive colors from the
diluents, additives, and by-products of fermentation.
In Ontario, beer is fermented to contain about 5% alcohol by
volume (or 3.5% in light beer). Most wine is fermented to have
between 10% and 14% alcohol content; however, such fortified
wines as sherry, port, and vermouth contain between 14% and 20%.
Distilled spirits (whisky, vodka, rum, gin) are first fermented,
then distilled to raise the alcohol content. In Canada, the
concentration of alcohol in spirits is 40% by volume. Some
liqueurs may be stronger.
The effects of drinking do not depend on the type of alcoholic
beverage - but rather on the amount of alcohol consumed on a
specific occasion. The following table outlines the alcohol
content of various beverages. The right-hand column shows the
amount of alcohol consumed in each drink.
Beverage % alcohol Size of Grams of
by volume drink alcohol
ml oz
Alcohol- is rapidly absorbed into the bloodstream from the small
intestine, and less rapidly from the stomach and colon. In
proportion to its concentration in the bloodstream, alcohol
decreases activity in parts of the brain and spinal cord. The
drinker's blood alcohol concentration depends on:
* the amount consumed in a given time
* the drinker's size, sex, body build, and metabolism
* the type and amount of food in the stomach.
Once the alcohol has passed into the blood, however, no food or
beverage can retard or interfere with its effects. Fruit sugar,
however, in some cases can shorten the duration of alcohol's
effect by speeding up its elimination from the blood.
In the average adult, the rate of metabolism is about 8.5 g of
alcohol per hour (i.e. about two-thirds of a regular beer or
about 30 mL of spirits an hour). This rate can vary dramatically
among individuals, however, depending on such diverse factors as
usual amount of drinking, physique, sex, liver size, and genetic
factors.
Effects
The effects of any drug depend on several factors:
* the amount taken at one time
* the user's past drug experience
* the manner in which the drug is taken
* the circumstances under which the drug is taken (the place,
the user's psychological and emotional stability, the presence
of other people, the concurrent use of other drugs, etc.).
It is the amount of alcohol in the blood that causes the effects.
In the following table, the left-hand column lists the number of
milligrams of alcohol in each decilitre of blood - that is, the
blood alcohol concentration, or BAC. (For example, an average
person may get a blood alcohol concentration of 50 mg/dL after
two drinks consumed quickly.) The right-hand column describes the
usual effects of these amounts on normal people - those who
haven't developed a tolerance to alcohol.
100 Obvious intoxication in most people
Increased impairment of judgment, inhibition, attention, and control;
Some impairment of muscular performance; slowing of reflexes
150 Obvious intoxication in all normal people
Staggering gait and other muscular incoordination; slurred
speech; double vision; memory and comprehension loss
250 Extreme intoxication or stupor
Reduced response to stimuli; inability to stand; vomiting;
incontinence; sleepiness
350 Coma
Unconsciousness; little response to stimuli; incontinence;
low body temperature; poor respiration; fall in blood
pressure; clammy skin
500 Death likely
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Drinking heavily over a short period of time usually results in a
"hangover" - headache, nausea, shakiness, and sometimes vomiting,
beginning from 8 to 12 hours later. A hangover is due partly to
poisoning by alcohol and other components of the drink, and
partly to the body's reaction to withdrawal from alcohol.
Although there are dozens of home remedies suggested for
hangovers, there is currently no known effective cure.
Combining alcohol with other drugs can make the effects of these
other drugs much stronger and more dangerous. Many accidental
deaths have occurred after people have used alcohol combined with
other drugs. Cannabis, tranquillizers, barbiturates and other
sleeping pills, or antihistamines (in cold, cough, and allergy
remedies) should not be taken with alcohol. Even a small amount
of alcohol with any of these drugs can seriously impair a
person's ability to drive a car, for example.
Long-term effects of alcohol appear after repeated use over a
period of many months or years. The negative physical and
psychological effects of chronic abuse are numerous; some are
potentially life-threatening.
Some of these harmful consequences are primary - that is, they
result directly from prolonged exposure to alcohol's toxic
effects (such as heart and liver disease or inflammation of the
stomach).
Others are secondary; indirectly related to chronic alcohol
abuse, they include loss of appetite, vitamin deficiencies,
infections, and sexual impotence or menstrual irregularities.
The risk of serious disease increases with the amount of alcohol
consumed.
Early death rates are much higher for heavy drinkers than for
light drinkers or abstainers, particularly from heart and liver
disease, pneumonia, some types of cancer, acute alcohol
poisoning, accident, homicide, and suicide. No precise limits of
safe drinking can be recommended.
According to 1988 figures from Statistics Canada, 2,828 deaths
were directly attributable to alcohol in that year. There were,
however, an estimated 13,870 more deaths - five times as many -
indirectly caused by alcohol.
Tolerance and Dependence
People who drink on a regular basis become tolerant to many of
the unpleasant effects of alcohol, and thus are able to drink
more before suffering these effects. Yet even with increased
consumption, many such drinkers don't appear intoxicated. Because
they continue to work and socialize reasonably well, their
deteriorating physical condition may go unrecognized by others
until severe damage develops - or until they are hospitalized for
other reasons and suddenly experience alcohol withdrawal
symptoms.
Psychological dependence on alcohol may occur with regular use of
even relatively moderate daily amounts. It may also occur in
people who consume alcohol only under certain conditions, such as
before and during social occasions. This form of dependence
refers to a craving for alcohol's psychological effects, although
not necessarily in amounts that produce serious intoxication. For
psychologically dependent drinkers, the lack of alcohol tends to
make them anxious and, in some cases, panicky.
Physical dependence occurs in consistently heavy drinkers. Since
their bodies have adapted to the presence of alcohol, they suffer
withdrawal symptoms if they suddenly stop drinking. Withdrawal
symptoms range from jumpiness, sleeplessness, sweating, and poor
appetite, to tremors (the "shakes"), convulsions. hallucinations.
and sometimes death.
Alcohol and Pregnancy
Pregnant women who drink risk having babies with fetal alcohol
effects (known as fetal alcohol syndrome or FAS). The most
serious of these effects include mental retardation, growth
deficiency, head and facial deformities, joint and limb
abnormalities, and heart defects. While it is known that the risk
of bearing an FAS-afflicted child increases with the amount of
alcohol consumed, a safe level of consumption has not been
determined.
Who Uses Alcohol
In a 1990 nation-wide Gallup poll, 79% of adults reported they
had at some point drunk alcohol. A 1989 survey of adults in
Ontario found that 83% reported ever having used alcohol, with
55% saying they have five drinks or more at a single sitting and
10% reporting daily drinking.
Among young people between 12 and 19 years, a 1985 national
survey recorded 73% using alcohol at least once in the past year.
Of Ontario students in grades 7, 9, 11, and 13 polled in 1989,
66% admitted to alcohol use, with more than 80% of the grade 11
and 13 students saying they drank. More than one in five of all
those who drank said they did so more than once a week. Since the
legal drinking age in Ontario is 19, it appears that alcohol has
a high degree of social acceptance, whether legal or not.
Total alcohol consumption in Canada during 1988/89 reached 202.9
million litres. This corresponds to an average annual consumption
of 9.9 L of alcohol for each Canadian over the age of 15 - that
is to say, about 11 drinks per week or a little under two drinks
a day. Beer, making up 52% of the total volume, was the most
popular drink, with spirits in second place at 31 %, and wine a
distant third at 17%.
In recent years, Canadians have spent about $9.6 billion a year
for alcohol in retail stores and another estimated $2.6 billion
for alcohol consumed in taverns and restaurants.
There is a direct relationship between the overall level of
consumption within a population and the number of alcohol-
dependent people. A nation with a low per capita consumption rate
has a lower number of heavy users, whereas one with widespread
use and high per capita consumption has a proportionately higher
rate of alcohol-related diseases and deaths.
Most researchers agree that one in 20 drinkers in North America
has an alcohol dependency problem.
Alcohol and the Law
Alcohol legislation is a joint responsibility of the federal and
provincial governments, and many laws regulate its manufacture,
distribution, advertising, possession, and consumption.
In Ontario, marketing and consumption of alcohol is primarily
governed by the provincial Liquor Licence Act. It is an offence
for anyone under 19 years to possess, consume, or purchase
alcohol. It is also illegal to sell or supply alcohol to anyone
known to be or appearing to be (unless that person has proof
otherwise) under the age of 19. It is not illegal, though, for
parents or guardians to give an under-age child a drink at home.
Provisions similar to Ontario's apply in most other Canadian
provinces and in the Yukon and Northwest Territories, as well as
in many states in the United States.
The act also makes it illegal to sell or supply alcohol to a
person who appears to be intoxicated.
As well, anyone who sells or supplies alcohol to others - whether
these are patrons of a tavern or restaurant or guests in a
private home - may be held civilly liable if intoxicated patrons
or guests injure themselves or others.
The federal criminal law sets out a range of drinking and driving
offences. It is illegal, for example, to operate a motor vehicle,
boat, or aircraft while impaired by any amount of alcohol or
other drugs. The manner in which one drives, slurred speech or
physical incoordination, and the smell of alcohol may all be used
as evidence of a person's impairment.
It is also a criminal offence to drive with a blood alcohol
concentration (BAC) above .08% (which means with more than 80 mg
of alcohol in each 100 mL of blood in one's bloodstream)
The Criminal Code sets out complex provisions authorizing police
to demand breath samples or, in limited circumstances, blood
samples, from suspected drinking drivers. Those refusing to
comply can be convicted unless they have a reasonable excuse.
The Ontario Highway Traffic Act gives police broad powers to stop
drivers to determine if they have been drinking and to issue a
12-hour licence suspension if their BAC is above .05% (i.e.
higher than 50 mg of alcohol per 100 mL of blood).
Drinking and driving is by far the largest criminal cause of
death and injury in Canada. In 1988, there were 121,307 Canadians
charged with federal drinking and driving offences: 110,773 for
impaired operation of a motor vehicle; 1,194 for impaired
operation causing bodily harm; and 158 for causing death. Another
8,786 people were charged for failure or refusal to provide a
breath sample for testing. In all, 19,808 Canadians were jailed
for drinking and driving offences in 1988/89.
For more information, contact your nearest ARF office (consult
your local telephone directory), or call Drug and Alcohol
Information Line, Ontario Toll-free 1-800-lNFO-ARF
(1-800-463-6273), Metro Toronto 595-6111 9.00 am 9.00 pm except
holidays
A public information service of the Addiction Research Foundation
33 Russell Street, Toronto, Canada M5S 2S1
Copyright (c) 1971
Revised January 1991
Alcoholism and Drug Addiction Research Foundation, Toronto Canada
