4 Stages of Alcohol Use

1
4 Stages of Alcohol Use

• Information taken from the Prevention Research
  Institute
• Prime for Life Risk-Reduction Program
• Presented by
• Terry Koons M.Ed.
• Associate Director for
• Health Promotion

2
Stage One Low Risk

• 0-2 Drinks Daily 0-3 in not Daily
• No more than one drink per hour
• No risk for impairment problems/long term health
  problems due to use.

3
Stage Two High Risk Infrequent

• 4 or more drinks in a sitting for a woman
• 5 or more drinks in a sitting for a man
• Move into Stage Two because of
• Celebration, Holiday, Special Occasion
• Warning Signs
• 2 or more blackouts in a month, short term
  memory loss, increased tolerance

4
Making High Risk Choices on a Regular Basis

• People who start to make high risk drinking
  choices on a regular basis will eventually move
  into Stage 3.
• Remember Stage 2 in Infrequent behavior or
  unplanned or unexpected behavior.
• If you are making high risk drinking choices on
  more than two occasions in a month that is a sign
  of moving into Stage3.

5
Stage Three Dependence

• The individual is dependent on the Drinking
  Ritual, they are not yet an alcoholic.
• Many in Stage 3 will have enablers who support
  their high risk drinking choices.
• All of their friends drink to the same level,
  have had judicial, legal, social, academic and
  financial problems.
• Other drug use may become more regular.
• This is where the gateway effect may come into
  play.
• NO ONE CAN STAY IN STAGE 3 FOREVER

6
Stage Three Dependence

• 50 of the people in Stage 3 will move back to
  low risk choices due to a life changing event.
• Of the 50 who remain in Stage 3 some will Die.
• Those who do not die or move back to low-risk
  will eventually move to Stage 4.
• Moving into Stage 4 is considered crossing the
  Trigger Level or the point at which a diagnosis
  could be made.

7
Stage Four Alcoholism

• The individual has crossed the Trigger Level
  into addiction.
• What are the Choices?
• Detox, treatment, rehab and aftercare.
• Continue behavior and die of what didnt kill
  you before.
• Develop and eventually die of an alcohol
  related illness.

8
Alcoholism

• Alcoholism is a common disease resulting from the
  complex interaction of genetic, social, and
  environmental factors. Chantel D. Sloan Vicki
  Sayarath, M.P.H., R.D. and Jason H. Moore, Ph.D.
• Alcohol addiction is a complex disease that
  results from a variety of genetic, social, and
  environmental influences. Alcoholism affected
  approximately 4.65 percent of the U.S. population
  in 20012002, producing severe economic, social,
  and medical ramifications (Grant 2004).

9
Family History

• Parent or Grandparent with alcoholism or alcohol
  related problems
• Unusual early response to alcohol
• Extended family members, brothers, sisters, aunts
  and uncles with alcoholism or alcohol related
  problems

10
Low-Risk Guidelines

• No to all 3 0-2 daily 0-3 if not daily
• no more that 1 per hour
• Yes to 1 2 not daily, no more
• than one per hour
• Yes to 1
• 2 or 3 0

11
Individual Differences

• Individual differences change how your body
  reacts to alcohol and increase impairment.
• Small body size/muscle mass
• Gender
• Age
• Altitude
• Other Drugs

12
Individual Differences

• Illness or Tiredness
• Empty Stomach
• Mental Health Status
• Whats High Risk About being Impaired?
• Whats Harmful About High Risk Drinking If People
  Dont Become Impaired?

13
What Is A Drink?

• 12oz. of Beer is equal to.
• 4-5 oz. of Wine is equal to
• Liquor
• 80 Proof (40 Alcohol)............................
  .............. 1-1/2 ounce shot
• 100 Proof (50 Alcohol). 1 ounce shot
• Carbonated mixers cause more impairment that
  food based mixers
• This is approximately one-half once of
  pure alcohol

14
What Is A Drink?

• Beer/Malt Liquor (8 alcohol) 6 Ounces
• 40oz bottle 6.4 drinks
• Wine
• Bottle (25.6 ounces at 10 alcohol).. 5
  standard drinks
• Magnum (64 ounces at 10 alcohol)...12.8
  standard drinks
• Box Wine is equal to 4-5
  standard bottles
• Wine Coolers(5-7 alcohol). . .8-10
  ounces
• Includes Bacardi Breezers, sky, ciders, etc.)
  Three 12ounce bottles at 7 alcohol 4.5
  drinks
• Number of Standard Drinks per Keg
• Keg (31 gallons, 12 ounce cups) 330
  standard drinks

15
Caring for a Drunk Person

• Cut them off!
• Provide high-protein foods bottled water.
• Keep your distance. Before approaching or
  touching, explain your intent and concern.
• Try to get as much info as you can about how much
  they have consumed and what other drugs they are
  using.
• Stay with someone who is vomiting. When laying
  down make sure to put him/her on their side.
• Monitor the persons breathing.
• If you are unsure you can handle the situation
  call 911.
• If the person is in a life threatening health
  crisis call 911.

16
Alcohol Overdose

• Warning Signs
• Difficulty Breathing- Slow, less than 8 breaths
  per minute or irregular with 10 or more seconds
  between each breath.
• Passed out or Stuporous- Semiconscious or
  unconscious and can not be awakened.
• Dehydrated- Bluish tint of the lips and
  fingernails.
• Cold and clammy skin.
• Vomiting while sleeping or passed out.
• For more info www.ohio.edu/alcohol

17
Medical Emergency Assistance

• What does MEA provide? 
• A Medical Emergency Assistance Program would
  allow a student experiencing an alcohol or other
  drug overdose to receive medical attention
  without judicial charge. It would also remove
  judicial charges for those who assisted the
  student in need if they had been in violation of
  an alcohol or drug policy.
•  
• How will MEA support current environmental
  strategies to reduce high-risk drinking?
• According to a recent survey, 94 of students
  surveyed said that they would not call for help
  in a medical emergency involving alcohol or other
  drugs. The students experiencing these
  emergencies did not receive any type of
  interventions. MEA will provide appropriate
  interventions to students experiencing medical
  emergencies, caringly confronting their high-risk
  behaviors.

18
MEA
19
Why Is High-Risk Use A Problem?

• Ohio University Students reported the following
  experiences from their own drinking
• 40 missed class at least once
• 32 had unplanned sexual activity
• 42 did something they regretted
• Ohio University Students reported the following
  experiences from other students drinking
• 58 had studying or sleep interrupted
• 58 had to baby-sit a drunk
• 10 were taken advantage of sexually
• Taken from the AOD Survey (Spring 2009)

20
OU vs. the National Average

• 73 of OU students reported having 5 or more
  drinks in the past two weeks. 2009
• The National Average from the 2006 CORE Survey is
  55.
• 55 of Miami U of Ohio reported having 5 or more
  in the last two weeks.
• OU students report having on average 13 drinks
  per week. The national average is
• 6 drinks per week.

21
Alcohol Edu Data 2008

• survey 1 survey 3
• Summer Fall
• High-Risk Drinkers 37.7 47
• 5 or more drinks on at least one occasion in the
  past two weeks
• Problematic Drinkers 12 18
• 10 or more drinks on at least one occasion in
  the past two weeks
• Totals 49.7 65

22
NIAAA Story

• http//abcnews.go.com/Health/MindMoodNews/story?id
  7051406page1

23
The Minimum Legal Drinking Age (MLDA)The
minimum legal drinking age (MLDA), also referred
to as the Age 21 laws, refers to the Uniform
Drinking Age Act of 1984. While state laws set
the legal drinking age in their own
jurisdictions, the Uniform Drinking Age Act
encouraged states to set the age at 21 by
restricting federal transportation funds from
those states that maintained a lower drinking age.
24
The Minimum Legal Drinking Age (MLDA)

• Citizen advocacy groups responded to this
  evidence by pressuring legislators to raise the
  MLDA back to 21, prompting passage of the Uniform
  Drinking Age Act of 1984. All states had restored
  an age-21 MLDA by 1988, once again providing
  researchers with many natural experiments to
  assess effects of these policy changes on alcohol
  consumption and related problems among.

25
A Brief History

• Following Prohibition, nearly all US states
  established an age-21 MLDA, a move designed to
  reduce youth access to and negative consequences
  of alcohol use. During the early 1970s, a trend
  toward lowering the MLDA to age 18, 19, or 20
  began in the United States, providing many
  natural experiments. Several studies in the 1970s
  demonstrated that motor vehicle crashes increased
  significantly among teens when the MLDA was
  lowered (Cucchiaro et al, 1974 Douglas et al,
  1974 Wagenaar, 1983, 1993 Whitehead, 1977
  Whitehead et al, 1975 Williams et al, 1974, as
  cited by the AMA.)

26
Topic Age 21/MLDA

• Shouldn't we lower the minimum legal drinking age
  to 18? The National Highway Traffic Safety
  Administration (NHTSA) estimates that through
  2002, the increase in the minimum legal drinking
  age has saved 21,887 lives in the 50 states.10
  NHTSA estimates that the current MLDA will
  continue to save 1,000 lives each year.14 While
  alcohol was involved in 60 percent of U.S.
  vehicular fatalities in 1982, the rate in 2005
  stood at 39 percent.13 
• Most studies show that there is an inverse
  relationship between MLDA and two outcomes
  alcohol consumption and traffic crashes. The
  success of the 21 MLDA has been achieved with
  minimal enforcement, yet it has been found that
  with increased enforcement efforts such as
  compliance checks, the sale of alcohol to minors
  can be cut by at least half.15 
• Taken from the Higher Education Center,
  HigherEdCtr_at_edc.org.

27
I've heard that the reduction in traffic deaths
has to do with the better safety measures,
tougher enforcement, and the use of designated
drivers. Is this accurate?

• After the age-21 MLDA was implemented,
  alcohol-involved highway crashes declined
  immediately (i.e., starting the next month) among
  the 18- to 20-year-old population. Careful
  research has shown declines are not due to
  enforcement of and tougher penalties for driving
  while intoxicated, but are directly a result of
  the legal drinking age.20 

28
Hasn't the minimum legal drinking age been
lowered before? What were the results of that
natural experiment?

• "Between 1970 and 1975, 29 states lowered their
  minimum drinking ages. Meanwhile, 13 states kept
  the legal age at 21."12 Researchers found a
  marked increase in alcohol-related teen car
  crashes in the states with reductions. "Once the
  21 age was restoredalcohol-involved highway
  crashes immediately declined in this age
  group."12 
• New Zealand lowered its minimum purchase age for
  alcohol from 20 to 18 in 1999. Researchers noted
  in 2006 that "significantly more
  alcohol-involved crashes occurred among 15- to
  19-year-olds than would have occurred had the
  purchase age not been reduced to 18 years. The
  effect size for 18- to 19-year-olds is remarkable
  given the legal exceptions to the pre-1999 law
  and its poor enforcement."11 
•  

29
MLDA

• After the minimum age was lowered, New Zealand
  researchers found that this change in the minimum
  drinking age "has resulted in increased
  presentations to the central city emergency
  department of intoxicated eighteen and nineteen
  year olds. A similar trend was seen in the 15-17
  year olds."5 Rates of drunk driving and
  disorderly conduct have also increased.8

30
Many youth under age 21 still drink, despite the
current legal drinking age. Doesn't that prove
that this policy is ineffective?

• While some youth may choose to consume alcohol
  before age 21, studies show that they consume
  less and suffer fewer secondary effects such as
  alcohol-related injuries when the drinking age is
  21.19 
• Studies also indicate that delaying onset of
  drinking will substantially reduce the risk of
  alcohol problems and dependence later on in
  life.18 Further, when the legal drinking age is
  21, those under age drink less than when the
  drinking age is lower, and they continue to drink
  less through their 20s.17 
• "There is also some 'trickle-down' effect in that
  when youth get alcohol they often give it to even
  younger teens."9  "When the legal age is 21, 19-
  and 20-year-olds can often obtain alcohol from
  their friends. When the drinking age was 18 and
  19, 17- and even 16-year-olds were often able to
  get alcohol from their friends. If the drinking
  age is lower, more alcohol will be available to
  younger high school students and perhaps even
  middle school students."20 

31
There seems to be support for lowering the legal
drinking age is this true?

• According to an ABC News/Washington Post poll
  conducted in 2005, the majority (78 percent) of
  Americans, youth and adults, support the age 21
  drinking law.4 In fact, 73 percent of young
  adults under the age of 34 oppose allowing 18- to
  20-year-olds to drink.4
• A 2001 Associated Press poll found that fully
  three-quarters of adults and teens alike thought
  the drinking age should be enforced more
  vigorously.3 
• "The current age restriction was signed into law
  by President Reagan on July 17, 1984. Its support
  today is nearly identical to its level then -- 79
  percent in a Gallup poll in June '84."4 

32
Alcohol Consumption Patterns of WomenWomen 21
to 34 years of age were least likely to report
alcohol-related problems if they had stable
marriages and were working full time.Women tend
to marry men whose drinking habits match their
own.Between 35 to 49 years of age, the heaviest
drinkers were divorced or separated women without
children.Between 50 to 64 years of age, the
heaviest drinkers were women whose
husbands/partners drank heavily.Women 65 and
older comprised less than 10 of drinkers with
drinking problems.
33
FAS

• Fetal alcohol syndrome
• Fetal alcohol effect
• Alcohol is the second leading cause of premature
  death in America.
• Approximately 176 billion is spent annually
  dealing with social and health problems related
  to alcohol use.

34
CAMY

• Center on Alcohol and Marketing to Youth
• From 2001 to 2006, the number of alcohol
  advertisements in national magazines fell by 22
  (from 3,616 to 2,831), while alcohol advertising
  spending in magazines peaked at 361 million in
  2004 but fell to 331 million by 2006.

35
CAMY

• From 2001 to 2006, alcohol advertising spending
  on television increased by 27 (from 779 million
  to 992 million), while the number of
  advertisements on television grew by 33 (from
  225,619 to 299,475).

36
CAMY

• Almost all youth overexposure to alcohol
  advertising occurs on cable. Almost two-thirds
  (63 percent) of the overexposing alcohol ad
  placements in 2007 were on cable television,
  which generated 95 percent of youth overexposure
  to alcohol advertising on television. Of the
  youth overexposure on cable in 2007, 53 percent
  came from beer advertising, and 41 percent from
  distilled spirits advertising.

37
CAMY
38
CAMY
39
CAMY
40
CAMY
41
CAMY