Prepared by Mr. Shoup ALCOHOL - PowerPoint Presentation

1. Prepared by Mr. Shoup

2. ALCOHOLETHYL C2H60 or C2H5OH#1 KILLER FOR TEENS IN THE UNITED STATES1,825 college kids loss their life each year4,000 die from alcohol overdose per year under 21.88,000 people per year die from alcohol-2/3 are males1/3 OF THE POPULATION -NON-DRINKERS1/3 DRINK -RESPONSIBLE1/3 ABUSE OR ARE-PROBLEM DRINKERS44% of college students are binge drinkers. www.collegedrinkingprevention.gov?hmm

3. INTRODUCTION1 OUT OF 60 STUDENTS BORN TODAY WILL DIE FROM ALCOHOL USE OR ABUSE BY THE AGE OF 20.3 OUT OF 10 PEOPLE WILL BE IN AN ALCOHOL RELATED ACCIDENT.1 OUT OF 8-9 STUDENTS WHO START DRINKING WILL BECOME AN ALCOHOLIC TODAY.AT LEAST 70 LIVES ARE LOST PER DAY FROM ALCOHOL USE/ABUSE EVERY 53 SECONDS OF THE DAY, SOMEONE IS BEING KILLED BY DRUNK DRIVER.EVERY 90 SECONDS OF THE DAY, SOMEONE IS BEING INJURED FROM ALCOHOL RELATED CRASH. 500,000 injuries each year to college students.600,000 assaults per year among college students.1 PERSON EVERY 22-23 TO 30 MINUTES ARE KILLED FROM ALCOHOL USE/ABUSE PER DAYCOST TO THE ECONOMY AT LEAST 166+ BILLION DOLLARS PER YEAR IN LOST OF LIVES, MEDICAL EXPENSES, LOST OF WORK PRODUCTIVITY, PROPERTY DAMAGE, and REHABILITATION/PREVENTION PROGRAMS.

4. BRIEF HISTORYDISCOVERED BY ACCIDENT-NO REAL INVENTORSBIBLE: NOAH-VINEYARDWines-4200BC MESOPOTAMIA TIMES-NOW IRAQEGYPT,GREECE,ROMEDISTILLATION-AQUA-VITAE-WATER OF LIFE.2150BC CHINA ASTRONOMERS.NORTH AFRICANS DURING THE CRUSADES EUROPEANS LEARNED HOW TO DISTILL.16TH CENTURY-WIDELY KNOWN IN EUROPE.1785 4,000 PEOPLE DIE OF ALCOHOLISM IN 1 YEAR1794 Whiskey Rebellion-George Washington.1815 1/3 of population dying from alcoholism. (5 gallons per year) 65 million gallons.Mid 1880s Temperance Developed-John Wesley-Methodist Churchstates: ”that buying, selling and drinking of liquor unless absolutely necessary were evils to be avoided.”1919-18th Amendment-Prohibition of alcohol-All 48 states “DRY”1933-21st Amendment-Repelled Prohibition-Gov./State Control. TAXATION1980s to present-disease disorder concept-Alcoholism is a treatable disease/disorder.

5. CLASSIFICATIONDEPRESSANT:A DRUG THAT DECREASES THE CENTRAL NERVOUS SYSTEMVASO-DILATOR-CAUSES THE BLOOD VESSELS TO GET BIGGERCAUSES FALSE SENSE OF WARMTHRED FACE AND FEEL HOT Slang Names: Booze Sauce Brew Brew ski Hard Stuff

6. CREATION OF ALCOHOLTWO WAYS:1. FERMENTATION-NON-DISTILLEDBEERS, WINES, WINE COOLERS, CHAMPAGNE3-15% ALCOHOL light beers in the 2%-3%PROCESS OF AGEING INCLUDES FRUITS, GRAINS, AND VEGETABLE.SUGAR CONVERTED TO ALCOHOL BY ADDING YEAST.SULFER DIOXIDE ADDED TO WINES TO KILL BACTERIA

7. BEERFermentation Process:Brew of cereals, wheat, rice, corn, rye is put together making a “MASH”5 TYPES OF BEER-LAGER, ALE, BOCK, STROUT/PORTER AND PILSNERSTARCH COVERTED TO SUGAR BY ADDING BARLEY-MALT.MASH IS BOILED AND YEAST IS ADDED TO CONVERT SUGAR TO ALCOHOL-BEERHOPS IS ADDED TO GIVE BEER ITS FLAVOR AND PRESERVATIVE NATURE.LIGHT BEER-LOWER CONCENTRTION OF GRAINS IN WATER THAN REGULAR BEER-ALCOHOL CONTENT 2.3-3.3%MOST BEERS-3%-6% ALCOHOL (3.5-4%)MALT LIQUOR-6-8% ALCOHOL

8. WINE AND WINE COOLERSWINES COME FROM GRAPES and other fruitsMOST WINES-6%+12% ALCOHOL (15-16% tops)WINE COOLERS: WINE WITH FRUIT JUICES ADDED TO IT-CARBONATEDALCOHOL CONTENT 5%-6% HIGHER THAN A CAN OF (REGULAR BEER-3.5%)CHAMPAGNE-CARBONATED WINE

9. CREATION OF ALCOHOL BEVERAGES DISTILLATION GOING BEYOND THE AGEING PROCESS40% ALCOHOL-80 PROOF OR HIGHER.HEATED-DISTILLED-PROCESS OF HEATING, BOILING THE “MASH” AT 158 DEGREES (70 DEGREES CELSIUS).THE MIXTURE IS PUMPED INTO A STILL WHERE HEAT VAPORIZES THE ALCOHOLTHE ALCOHOL VAPORS ARE CAUGHT, COOLED, CONDENSED AND DRAWN OFF AS CLEAN WHISKEY-ALCOHOLWATER IS ADDED TO DECREASE THE PROOF

10. PROOFTHE AMOUNT OF ALCOHOL CONTENT PER VOLUME.EXAMPLES: 80 PROOF IS 40% ALCOHOL100 PROOF IS 50% ALCOHOL120 PROOF IS 60% ALCOHOL200 PROOF IS 100% ALCOHOL80 Proof100Proof80 Proof

11. WHAT IS IN A DRINK?½ OUNCE OF ALCOHOL IS EQUAL TO:1 CAN (12 oz) OF REGULAR BEER AT 3.5% ALCOHOL.4/5 OUNCES OF TABLE WINE AT 12% ALCOHOL1 SHOT GLASS(1.5 OUNCES) 80 PROOF-40% DISTILLED BEVERAGE-WHISKEY, GIN, VODKA, RUM, etc.8-9 ounces of malt liquor-~7% alcohol.6% BEER HAS MORE THAN ½ OUNCE OF ALCOHOL-3/4 OUNCE.

12. FACTORS THAT DETERMINES YOUR BLOOD ALCOHOL LEVELBAC or BAL#1 TYPE OF DRINK Fermentation drink vs Distillation drink Carbonated vs non carbonated drinksThe definition of a standard drink varies widely by country. In the USA a standard drink is equivalent to:One 12 fl oz. (355 mL) bottle of beer or wine coolerOne 5 fl oz. (148 mL) glass of wineOne mixed drink containing 1.5 fl. oz. (44 mL) of 80-proof hard liquor, such as gin, whiskey, or rum"Proof" is a measure of how much alcohol is in a given type of alcoholic beverage. In the United States, where the measure is commonly used, proof represents twice the percentage of alcohol by volume. 100 proof means 50% alcohol. 80 proof means 40% alcohol.The concept of a standard drink, that is 12 oz. beer, 5 oz. wine, .5-ounces or a "shot" of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey) is often not a good guideline for judging your own BAC. No two bartenders pour the same amount of alcohol and party hosts frequently pour more "Doubles" and drinks made with more than one type of liquor typically contain much more alcohol than the Standard Drink Type of Mix Used: Water and fruit juices mixed with alcohol slow the absorption process, while carbonated beverages will speed it up. Carbonated drinks speed alcohol through the stomach and intestine into the bloodstream, creating a more rapid rise in BAC.

13. Factors that determine Blood Alcohol Level (BAL)#2 RATE OF CONSUMPTION The number of drinks in a given time How Quickly You Drink: The faster an individual drinks, the quicker their peak BAC will raise and the more quickly they will become intoxicated. The liver metabolizes alcohol at a rate of approximately one standard drink per hour; 12 oz. beer, 5 oz. wine, .5-ounces or a "shot" of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey). If more than one drink per hour is consumed, the liver is unable to keep pace and more alcohol will circulate in the blood stream until the liver can catch up. The more alcohol in the blood, the higher the intoxication level.Alcohol Concentration Generally, the higher the alcohol concentration of a drink the faster the alcohol will be absorbed into the blood stream. One standard drink of hard liquor does have the same alcohol content as a regular beer. Since hard liquor is frequently less diluted (as in a shot) the effects will be noticed more rapidly.#3RATE OF ABSORPTION Empty Stomach vs. Full StomachFood in the Stomach:About 20 percent of alcohol is absorbed into the bloodstream directly through the walls of the stomach and 75-80 percent is absorbed into the bloodstream through the small intestine. When there is food in the stomach, alcohol is absorbed more slowly into the bloodstream. Food in the stomach slows the absorption of alcohol by preventing it from going directly to the small intestine which is where the majority of alcohol enters the blood stream. The effects of the alcohol will still occur but at a slower rate.It is a myth that food absorbs the alcohol. It does not. Drinking on a full stomach slows the absorption of alcohol because the stomach's pyloric valve, which connects the stomach and small intestine, closes to allow food to digest. The closed pyloric valve keeps alcohol in the stomach longer before it enters your small intestines.It follows that fatty foods are more effective in slowing alcohol absorption than are other foods because they are more difficult to digest. Carbohydrates are passed through the stomach more quickly causing both the food and alcohol to enter the small intestines more quickly than with high fat content foods. The pylorus valve may also go into spasm in the presence of concentrated alcohol, trapping the alcohol in the stomach instead of allowing it through to the small intestine. The drinker who downs several straight shots in an effort to get a quick high may actually experience a delayed effect.

14. Factors that determine blood alcohol level#4BODY SIZE & WEIGHT 100lb person vs. 200lb person. Which one has more mass and blood? Percentage of body fat?Body Weight:On average men have 76 c.c. of blood /kg body weight and in women it is 66 c.c. of blood /kg body weight. Not only do men have more blood in which to dilute alcohol by virtue of their greater size but even men of the same weight as women have slightly more blood in which to dilute alcohol. This is because muscle tissue contains more water than fat tissue, so men -- who have more muscle and less fat on the average than women -- can have about 10 percent more water in their bodies.#5 Gender-Sex Girls higher level of percentage of body fat than males Less stomach acid (ADH) than males Female sex hormone-estrogen- makes girls more sensitive to alcohol affects Less water in body than men Smaller OrgansMale Vs. FemaleIn general women reach higher BACs faster than men because they have less water in their bodies to dilute the alcohol and women also have more adipose tissue (fat), which is not easily penetrated by alcohol.

15. Factors that affect Blood Alcohol Level#6Age Elder people have a lower volume of blood than the bodies of younger peopleTeenager verses an adult-What is the difference?#7 Drugs in body with alcoholMedicationsMedications can amplify the effects of alcohol on your body. Aspirin, tranquilizers, anti-depressants, and cough medicines to name only a few can effect when mixed with alcohol.Alcohol ToleranceLong term drinkers develop tolerance to alcohol. One reason is that the liver becomes more efficient at metabolizing alcohol. In people with high tolerance to alcohol it takes more alcohol to produce the outward signs of intoxication. BAC is not affected by alcohol tolerance. Someone with higher alcohol tolerance is not safer to drive according the law.Fatigue, Stress & MoodAlcohol has a more pronounced effect on those who may be fatigued or under stress. Since alcohol is a depressant, someone who is depressed will likely become more depressed when drinking.#8AltitudeIt is commonly thought that higher altitudes will cause intoxication more quickly than at sea level. Studies for the Federal Aviation Administration do not confirm the common belief. Additionally, for those living at higher altitudes the body compensates for the thinner air by producing more blood in which to carry oxygen. More blood by weight provides more dilution of alcohol.

16. Factors that determines blood alcohol (BAC)#9Alcohol ToleranceLong term drinkers develop tolerance to alcohol. One reason is that the liver becomes more efficient at metabolizing alcohol. In people with high tolerance to alcohol it takes more alcohol to produce the outward signs of intoxication. BAC is not affected by alcohol tolerance. Someone with higher alcohol tolerance is not safer to drive according the law.#10Fatigue, Stress & MoodAlcohol has a more pronounced effect on those who may be fatigued or under stress. Since alcohol is a depressant, someone who is depressed will likely become more depressed when drinking.

17. Why girls get drunk faster and stay drunk longer?Less ADH-enzyme in the stomachLess water in body than a manHave more body fat than a manHave smaller organs than a man

18. SHORT TERM EFFECTS OF ALCOHOLCentral Nervous System1. Cerebrum-controls voluntary actions and the senses. 2. Cerebellum-controls balance and coordination 3. Medulla Oblongata-involuntary actions Example: Vomiting, cardiac/smooth muscles. Would this be rape?

19. SHORT TERM EFFECTS CONTINUED:SLURRED SPEECH-CEREBRUMBLURRED VISION-DISTANCE, COLORSBALANCE-STAGGERING-SKELETAL MUSCLESDECREASE JUDGEMENT-CEREBRUMDECREASE DECISION MAKING-CEREBRUMINCREASE HEART RATE-MEDULLA OBLONGATA -then decreaseINCREASE BLOOD PRESSURE-MEDULLA OBLONGATA- then decreaseSENSE OF WARMTH-VASO-DILATORBODY TEMPERATURE DROPS-HYPOTHERMIAMENTAL CONFUSION-CEREBRUMDECREASE REACTION TIME-MEDULLA OBLONGATATOLERANCEPSYCHOLOGICAL DEPENDENCEHANGOVER-BUILD UP OF TOXINS IN THE BRAINDEHYDRATIONThe only time I know where someone would put their head in the toilet. Besides a Bulimic person.

20. LONG TERM EFFECTSBLOOD CIRCULATION SLOWS DOWNRESPIRATION SLOWS DOWNSTUPOR-UNABLE TO WALK OR TALKUNCONSCIOUSALCOHOL POISONINGASPHYXIATION-GAG REFLEXCOMADEATHLIVER-HEPATITISLIVER CIRRHOSIS-#1 CAUSE OF DEATH FOR AN ALCOHOLICHEART DISEASESDifferent types of body cancersBRAIN DAMAGEREPRODUCTION SYSTEM PROBLEMS

21. Understanding Prenatal Alcohol Exposure Fetal Alcohol Syndrome-FAS Fetal Alcohol Spectrum Disorders-FASDPREVENTABLE BIRTH DEFECT THAT IS CAUSED BY A FEMALE DRINKING ALCOHOL DURING PREGNANCYAlcohol and Pregnancy do not mix2ND MOST COMMON BIRTH DEFECT IN THE U.S.OVER 40,000 BABIES PER YEAR1 in 100 babies. (40,000 babies FAS in our county.)1 in 1,000 babies is born with FAS.Catt. County 80,000 people, so there is approximately 80FAS cost yearly $6 billion dollarsOne FAS baby life time cost approximately $2 million dollars.NO DRINKING DURING PREGNANCY THERE WOULD BE NO SUCH DISORDER.

22. Fetal Alcohol Spectrum DisordersAbbreviated as “FASD”An umbrella term for a spectrum of disorders caused by prenatal alcohol exposure.Includes:Physical DisabilitiesMental DisabilitiesBehavioral DisabilitiesLearning DisabilitiesThese disabilities may range from mild to severe to a lifetime term.Any FASD is 100% preventable.

23. Fetal Alcohol Syndrome“FAS”The most severe end of them FASD spectrumThree criteria:Distinctive, abnormal facial featuresGrowth DeficienciesCentral Nervous System disorders-structural or functional

24. HOW DRINKING MAY DAMAGE YOUR UNBORN BABYFACIAL FEATURESAbnormal deformed facial featuresSmall widely spaced eye openingsUpturned noseVery small headsFlat and thin upper lipDroopy eyelidsFlat face Cleft plate

25. PHYSICAL DEFORMITIESJOINTSDEFECTIVE HEARTSMUSCULAR PROBLEMSINTESTINAL AND INTERNAL PROBLEMSNECKS STIFF AND CAN NOT ROTATE HEAD PROPERLYVERY SMALL IN HEIGHT WEIGHT AT BIRTHWEIGHT GAIN IS VERY SLOWSLOWER GROWTH RATE AFTER BIRTH

26. Brain-Mental AffectsReduced cognitive abilityLearning disabilitiesShort Attention SpanPoor social skillsLanguage difficultiesMemory difficultiesPERSONALITY PROBLEMSHYPERACTIVEMOODY POOR PARENT BONDING

27. BrainMental RetardationSmall uncompleted formed brainsPoor coordinationLimited mental developmentSeizures

28. Facts on Prenatal Alcohol ExposureWhen a pregnant woman drinks the alcohol goes from her body to the placenta across the umbilical cord to the fetus bloodstream.A mother’s drinking can affect all parts of a developing fetus-baby.The time and length the mother drinks during pregnancy to the amount of damage to the fetus.The more alcohol the pregnant mother drinks the greater the damage that can occur to the fetus.

29. Alcohol and Breast FeedingA breast feeding baby takes in alcohol in the breast milkIf a breast feeding mother has four or more drinks in a day, the alcohol her baby takes in may impair motor development-the babies ability to roll, sit, crawl, and to walk.

30. Who Is At Risk?Any woman of child bearing age, if she drinks during pregnancy. High risks:Substance abuseWomen with mental health problemsRecent drug useWoman with multiple sex partnersWomen victim of abuse and violenceDiscontinuing drinking during pregnancy or late in pregnancy, is better than not stopping drinking at all.

31. FASD-Life Long ProblemsLow self esteemPoor impulse-nerve controlDisruptive school experiencesIncomplete educationPsychiatric problemsInappropriate sexual behaviorCriminal ProblemsUnemployment

32. 90% suffered mental health problems60% had disrupted school experiences: suspensions, expelled or dropped out50% suffered confinement: for crime, and or mental health problems or drug use.50% demonstrated inappropriate sexual behavior30% had alcohol or other drug problemsLife Problems of FAS sufferers age 12 or older

33. The US Surgeon General WarningThe dangers of consuming alcohol during pregnancy are well documented and alcohol has earned its own U.S. Surgeon General Warning on the can or bottle.Alcohol consumed during pregnancy increases the risk of alcohol-related birth defects, including growth deficiencies, facial abnormalities, central nervous system impairment, behavioral disorders, and impaired intellectual development.No amount of alcohol consumption can be considered safe during pregnancy.Alcohol can damage a fetus at any stage of pregnancy. Damage can occur in the earliest weeks of pregnancy, even before a woman knows that she is pregnant.The cognitive deficits and behavioral problems resulting from prenatal alcohol exposure are lifelong.Alcohol related birth defects are completely preventable.

34. RememberPrenatal injuries from alcohol exposure are completely 100% preventableEducation and abstaining from drinking alcohol while pregnant can mean:NO BABY BORN WITH FASD OR FAS!

35. Drinking and Driving17,000-20,000 people killed each year involved alcohol.All 50 states are now 21 years for drinking age.Total cost of alcohol use by youth $58 billion dollars lostCost $216.22 a person from alcohol useAverage 1 person within every 30 minutes is killed 21-23 minutes someone is injured from alcohol abuse3 out of 10 people will be in a alcohol related crashMales higher risk 25% Females lower risk 12%Fatal crashes: 12am(midnight) to 3:00am involve alcoholFatal crashes are more at night 3Xs greater, than during the day. 63% to 19%Youth that drink before age 15 are 4Xs more likely to develop alcohol dependence than those who begin drinking at age 21Youth that drink before the age of 14 are 7Xs more likely than those who began drinking after age 21 to report being in a motor vehicle crash-3-4Xs more likely to drink and drive drunk.

36. DefinitionsDWAI-DRIVING WHILE ABILITY IMPAIREDNYS-.05-.07LICENSE SUSPENSION 90 days or more over 21years of ageUNDER 21-LICENSE REVOCATION for one year.$300-$500.00+DWI-DRIVING WHILE INTOXICATEDNYS .08 AND UPLICENSE REVOCATION-REVOKED 6 MONTHS/1YR UNDER 21-1 YEAR REVOCATION $500-$1,000 PLUS LAWYER FEESZERO TOLERANCE LAW-UNDER THE AGE OF 21.02-.07 (.05-DWAI) YOU DRINK AND DRIVE YOU LOSE LICENSELICENSE REVOKE-1 YEAR + $325 FEELeandra's Law: Drunk driving felony with child in car under 16 years of age. Punishment: up to 4 years in jail and or $5,000 dollar fine.

37. Drunk Driving-Felony with child in car under the age of 16 years. Punishment in NYS:Up to 4 years in jail and or $5,000 fine. Interlock Device could be assigned.

38. BLOOD ALCOHOL LEVELS BAL-MEN BAL-WOMANFemaleMale

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40. MOST COMMON TIME FOR ALCOHOL RELATED FATALITIESMidnight to 3:00 amSuper bowl Sunday 58.5%New Years Day 57%Labor Day 55.5%Christmas New Years Holiday 52.3%

41. DRINKING LAWS UNDER AGE DRINKING LAWS MISREPRESENTING SOMEONE UNDER AGE 21 Examples: False ID, False Passport, False Drivers License$200.00 FINE FIVE DAYS IN JAIL CIVIL PENALTY $85.00Note: the judge makes the fine and penalties, so it may be less or more. Age may depend too!UNDER AGE PURCHASEGoing to the store and misrepresenting your ageVIOLATION $100.00 $350.00 $750.00 LICENSE IS SUSPENDED/REVOCATION 30+ COMMUNITY HOURSNote: the judge makes the fine and penalties, so it may be less or more. Age may depend too!UNLAWFUL DEALING WITH A MINORENDANGERING THE WELFARE OF A MINOR$1,000.00 1 YR. JAIL/ $85.00 CIVIL PENALTYNote: the judge makes the fine and penalties, so it may be less or more. Age may depend too!

42. DRINKING LAWSUNDER AGE POSSESSI0N$50.00 FINE ALCOHOL COUNSELINGALCOHOL IS CONFISCATED30+ COMMUNITY HOURSNote: the judge makes the fine and penalties, so it may be less or more. Age may depend too!PARTY-EVERYONE AT THE PARTYPUBLIC NUISANCE$1,000.00 1 YR. $85 CIVIL PENALTYNote: the judge makes the fine and penalties, so it may be less or more. Age may depend too!Dram Shop Act

43. Alcoholism12-14 million Alcoholics today 1 out of 8 drinkers A disease and or disorder characterized by uncontrollable drinking habit of alcoholic beveragesA person suffering from alcoholism can not stop drinking due to dependence.Addicted to alcoholEach alcoholic has a different drinking pattern

44. Warning signs of AlcoholismPerson needs to drink more and more to get the same affect-TOLERANCEPerson is willing to drink alonePerson drinks to relieve tensions or to escape problemsPerson loses time from workPerson needs a drink at certain time of the day

45. Warning signs continuedPerson makes promises to quitPerson denies drinking, lies, covers up, or makes excusesPerson has black outs or memory lossesPerson’s family members worry about their drinking and are ashamedAvoids and distrust peopleMay become skid row

46. Effects of Alcoholism on Family and FriendsOne alcoholic person affects 4-7 other people family and friends around them.Causes anger and resentmentInsecurity-can not depend on the alcoholicDenialGuilt feelingsBlame each otherMoney problemsCommitment problems-being on time or showing upDivorce and or separation

47. Children of AlcoholicsRisk of becoming an alcoholic-GeneticsMay marry alcoholicsDo not feel good about themselves Things to do or not to do:Do not argue with an alcoholicDo not make threatsDo learn about alcoholismDo offer support for helpRemember alcoholism is a diseaseFind time to get out and have fun with friends

48. Where to go for helpAlcoholics Anonymous-AA An self help organization for men and women who help out one and an other to stay soberVolunteer-12 point system Alcoholics Anonymous, a support group commonly used for those undergoing treatment, in many cases helps alcoholics to recover without recourse to formal treatment or facilitates sustained remission in those who have completed formal treatment. Al-Anon Self help organization for adults, relatives, friends and family members can go, to help deal/live with the alcoholic and or to understand alcoholism. Al Ateen: For students(12-19) to understand how to deal with the alcoholic parent or friend. Discuss problems dealing with the alcoholic and how to handle different situations with an alcoholic.ACOA-Adult Child Of Alcoholics-One or more parents or guardian that has an alcoholic parent for children to go to.Others:Clergy, Doctors, Teachers, School Counselors, Hospitals

49. Treatment.Treatment is administered in specialized residential treatment facilities, separate units within general or psychiatric hospitals, outpatient clinics, and physicians' offices.Earlier and better treatment has led to encouragingly high recovery rates. In addition to managing physical complications and withdrawal states, Treatment involves individual counseling and group therapy techniques aimed at complete and comfortable abstinence from alcohol and other mood-changing drugs of addiction. Addiction to other drugs, particularly tranquilizers and sedatives, poses a major hazard to alcoholics. Disulfiram, a drug that produces a violent intolerance for alcohol as long as the substance remains in the body, is sometimes used after withdrawal. Drugs such as naltrexone and acamprosate may be used, in combination with psychosocial treatment, to reduce the chances for relapse to alcohol dependence. L.B., LeCLAIR BISSELL, M.S., M.D.; rev. by G.E.W., GEORGE E. WOODY, M.D