Active IQ Level 2 Award in Alcohol Awareness (sample manual)

Manual
Level 2 Award in
Alcohol awareness
Version AIQ004332

Unit strength of different types of alcoholic drink
Alcohol content is measured in units and these units are calculated and determined by the strength of the
alcohol (alcohol by volume or ABV). One unit of alcohol is measured as 10ml or 8mg of pure alcohol.
The harmful effects of alcohol are related to the alcohol content and strength (ABV). It is the quantity of alcohol
consumed that is most detrimental to health.
The measures of alcoholic drinks have remained the same over the years (e.g. a pint, half, glass of wine,
single or double shot of spirit), but the amount of alcohol (alcohol strength) contained in the measures has
significantly increased.
An average bottle of wine used to be around 9% alcohol by volume (ABV) with six units in a bottle, but now
it is more likely to be double that volume; at around 13.5% or higher and may contain at least ten units of
alcohol. The same principle applies to beers, lagers and ciders. The impact of this is that many people may
be unwittingly drinking in excess of the recommended sensible drinking guidelines and consuming alcohol at
levels that may be hazardous or harmful to health (Lawrence and Bolitho. 2011).
Figure 1.1: Alcohol content and units of alcohol in some popular drinks
1 UNIT 1.5 UNITS 2 UNITS 3 UNITS 9 UNITS 30 UNITS
Normal beer
Half-pint
(284ml) 4%
Small glass of
wine (125ml)
12.5%
Strong beer
Half-pint
(284ml) 6.5%
Strong beer
Large bottle/cam
(440ml) 4.5%
Bottle of wine
(750ml) 12.5%
Bottle of spirits
(750ml) 40%
Single spirit shot
(25ml) 40%
Alcopops bottle
(275ml) 5.5%
Normal beer
Large bottle/can
(440ml) 4.5%
Large glass of
wine (250ml)
12.5%
Medium glass
of wine (175ml)
12.5%
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Social factors
The association between drinking alcohol and social occasions may also encourage the consumption of
alcohol and potential misuse.
Drinking and frequenting public houses has been a pastime for many generations of people; from the
workers on the fields or in the mines, to the poets, painters, artists, philosophers and some historic leaders.
Alcohol has played a key role in many social traditions over the centuries, such as the brewing and drinking
of strong ales to celebrate a good harvest or the celebration of the pillaging of a local village.
Celebration and social reinforcement
Alcohol has become something that is used by many people
to celebrate various achievements, successes and momentous
occasions.
For example:
• To wet the baby’s head.
• To herald the end of an old year and the start of a new year.
• To celebrate significant birthdays and ‘coming of age’.
• To celebrate significant events – weddings, anniversaries,
graduations, even funerals.
• To celebrate sporting occasions and jubilees.
The use of alcohol in social situations can often mask
overconsumption; for example if everyone is seen to be drinking
misuse becomes less visible (it is likely that a number of people
will be exceeding the recommended units at some social events).
Similarly, where people are drinking at the same (or perceived
same) pace, misuse may be hidden. Others may not observe
someone getting an extra drink or even side loading (using their
own alcohol from a bottle or hip flask in a handbag etc).
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Alcohol and work
Alcohol misuse may lead to a deterioration in work performance and productivity that, if unchecked, can
lead to losing the job. This in turn can have broader consequences affecting other areas of life including
relationships, life responsibilities (mortgages, family etc).
Problems at work (e.g. redundancy, bullying, long hours) may also contribute to developing a pattern of
alcohol misuse behaviour.
Alcohol and relationships
Alcohol misuse and alcohol dependence may also be contributory factors for problems in relationships. People
may become more argumentative when they misuse alcohol, affecting their relationships with family and
friends and potentially causing marital problems. Alcohol may affect relationships in different ways. It can
decrease sexual performance and it can reduce responsibility (the partner using alcohol may become less
responsible with money and they may spend more time using alcohol and less time at home; contributing to
disharmony). Alcohol is also cited in many cases of domestic violence and abuse.
Problems in relationships (personal and professional) may also contribute to a cycle of depression and anxiety
and, if alcohol is used to abate these uncomfortable feelings and improve mood, a vicious cycle may develop
(see figure 2. 1).
Another issue for relationships (any relationship, work, friends, partner, children, parents, community etc) is
that of co-dependency (a psychological condition, usually depicted by a ‘martyr’ or self-sacrificing’ role where
the co-dependent person seeks approval and compensates with unhealthy and excessive levels of caring
behaviour).
The term co-dependency has evolved from the work of Alcoholics Anonymous. Co-dependency requires one
person in the relationship to be dependent on the substance and the other person to be dependent on the
addicted person. Much of the energy of the non-substance dependent person is spent on fixing or maintaining
the behaviour of the substance-dependent person. The co-dependent person is dependent on the needs of,
or control by, the substance-dependent person. Unresolved co-dependency is linked with alcohol and other
addictive behaviour patterns including eating disorders.
Figure 2.1: Alcohol misuse and relationship cycle
Misuse of Alcohol
Drink to Improve Mood
Argumentive
Depressed or Anxious
Feelings
Problems in Relationships
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The brain
Cerebral cortex
Processes
thoughts
Reduces inhibitions (including fear, a safety
response).
Increases self-confidence.
User becomes more chatty and talkative.
Affects judgement and reduces the speed at
which information can be processed.
Can affect visual and auditory senses (seeing and
hearing).
Numbs physical pain.
Limbic system
Controls
emotions and
memory
Emotions tend to become exaggerated, i.e.
everyone becomes the person’s best friend or
maybe their worst enemy (aggression).
Cerebellum
Coordinates
body
movement
Movements become uncoordinated.
Balance may be affected (depending on the
quantity of alcohol consumed, the person may
be unable to stand or walk), their speech may be
slurred.
The heart
Pumps blood
around the
body
The blood vessels relax and dilate increasing
blood flow to the skin and tissues.
Blood pressure lowers.
Heart rate increases to compensate for reduced
blood pressure.
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Effects of Alcohol Misuse on the Body
Brain
Headaches, Blackouts, Delusions,
Paranoia, Forgetfulness, Impaired
Judgement, Decline in IQ, Dementia,
Epilectic fits, Wernickes disease (due
to vitamin deficiency), Haemorrhage,
Peripheral neuritis, Korsakoff’s
psychosis & Death
Lungs
A small amount of alcohol escapes unused
via the breath 2-4%
Liver
Fatty cells, tissue scarring jaundice,
hepatitis, irreversible cirrhosis- the liver
breaks down 90% of alcohol consumed.
Kidneys
A small amount of alcohol
escapes unused via urine
2-4%
Pancreas
Bad digestion, malnutrition,
early diabetes
Sweat Glands
A small amount of alcohol escapes unused via
sweat glands
Sex Organs
Nervous System
Male
Depressed testicular production, impotence, breast
growth due to female homones not brown down by liver
Peripheral neuritis- degeneration of the
nervous system supplying limbs
Throat
Pressure on portal circulation- risk of
haemorrage. Increased incidence of
cancer- 40x if smoker
Gullet
Corrosive effect- risk of cancer
Intestines
Muscles
Heart
Fingers
Nervous System
Bones
Degeneration, weakness, pain
Weak & ‘fatty’ heart, weakening
of heart muscles, high blood
pressure. Anaemias due to
decreased absorption of vitamins
Stomach
Gastritis, peptic ulcer
(direct corrosive effect)
Pins and needles
Inflammation (corrosion from alcohol)
Malfunctions, shakiness, tremors
Degeneration- risk of fracture
Female
Failure to ovulate, spontaneous abortion
Physical and emotional effects of withdrawing from alcohol
Not all drinkers experience withdrawal symptoms when they stop using alcohol, but for those who do, the
experience is very unpleasant. Withdrawal symptoms mostly affect people who are highly dependent on
alcohol. Alcohol dependent drinkers will sometimes have a drink to avoid experiencing these symptoms,
which is known as ‘relief drinking’ (Alcohol Concern, 2010).
Withdrawal symptoms usually commence three to six hours after the last drink and can last for up to a
week (Davies, 2009). They are relieved when alcohol is consumed. Table 3.1 summarises the physical and
psychological withdrawal symptoms.
Physical symptoms include:
• headaches
• nausea
• vomiting
• sweating
• hand tremors (the shakes)
• convulsions (Grand mal).
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