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23 The Alcohols
C H A P T E R

*
Anthony J. Trevor, PhD

C ASE STUD Y

A 19-year-old college freshman began drinking alcohol in treatment because the upperclassmen called the college
at 8:30 pm during a hazing event at his new fraternity. police instead of calling 911. After the call was transferred
Between 8:30 and approximately midnight, he and several to 911, emergency medical technicians responded quickly
other pledges consumed beer and a bottle of whiskey, and and discovered that the young man was not breathing and
then he consumed most of a bottle of rum at the urging of that he had choked on his vomit. He was rushed to the
upperclassmen. The young man complained of feeling nau- hospital, where he remained in a coma for 2 days before
seated, lay down on a couch, and began to lose conscious- ultimately being pronounced dead. The patient’s blood
ness. Two upperclassmen carried him to a bedroom, placed alcohol concentration shortly after arriving at the hospital
him on his stomach, and positioned a trash can nearby. was 510 mg/dL. What was the cause of this patient’s death?
Approximately 10 minutes later, the freshman was found If he had received medical care sooner, what treatment
unconscious and covered with vomit. There was a delay might have prevented his death?

Alcohol, primarily in the form of ethyl alcohol (ethanol), has anxiety and fosters a feeling of well-being or even euphoria.
occupied an important place in the history of humankind for at However, alcohol is also the most commonly abused drug in
least 8000 years. In Western society, beer and wine were a main the world, and the cause of vast medical and societal costs. In
staple of daily life until the 19th century. These relatively dilute the United States, approximately 75% of the adult population
alcoholic beverages were preferred over water, which was known— drinks alcohol regularly. The majority of this drinking popula-
long before the discovery of microbes—to be associated with acute tion is able to enjoy the pleasurable effects of alcohol without
and chronic illness. Partially sterilized by the fermentation process allowing alcohol consumption to become a health risk. However,
and the alcohol content, alcoholic beverages provided calories and 8–10% of the general population in the United States has an
some nutrients and served as a main source of daily liquid intake. alcohol-use disorder. Individuals who use alcohol in dangerous
As systems for improved sanitation and water purification were situations (eg, drinking and driving or combining alcohol with
introduced in the 1800s, beer and wine became less important other medications) or continue to drink alcohol despite adverse
components of the human diet, and the consumption of alcoholic consequences related directly to their alcohol consumption suf-
beverages, including distilled preparations with higher concentra- fer from alcohol abuse (see also Chapter 32). Individuals with
tions of alcohol, shifted toward their present-day role, in many alcohol dependence have characteristics of alcohol abuse and
societies, as a socially acceptable form of recreation. additionally exhibit physical dependence on alcohol (tolerance
Today, alcohol is widely consumed. Like other sedative- to alcohol and signs and symptoms upon withdrawal). They also
hypnotic drugs, alcohol in low to moderate amounts relieves demonstrate an inability to control their drinking and devote
much time to getting and using alcohol, or recovering from its
effects. The alcohol-use disorders are complex, with genetic as
* well as environmental determinants.
The author thanks Susan B. Masters, PhD, the previous author of this
chapter, for her contributions.

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