Molecules that Changed the

World: Alcohol
CHEM100/CHEM100G

Dr Iman Kavianinia
i.kavianinia@Auckland.ac.nz
Summer School 2023– Lecture 2
Molecules that changed the world: Alcohol
Lecture 1
The Origin Of The Word ‘Alcohol’
Chemistry of Alcohol: Nomenclature and Classification
Where Does Alcohol Come From?
How do we make alcohol?
Lecture 2
How does alcohol affect your body?

Lecture 3
Can alcohol be used as a biofuel?

Lecture 4
How to detect alcohol?
Other use of alcohol?
Also – What is going to be in the exam?
How does alcohol affect my body?
How Is Alcohol Absorbed, Circulated, and Metabolized in
the Body?
 Alcohol is absorbed by simple diffusion into the blood.
 Diffusion is defined as the movement a substance from an area of high
concentration to an area of lower concentration until its concentration becomes
equal throughout a space
 The driving force to move alcohol across a membrane is the concentration
gradient.
negligible amount of alcohol is absorbed
1-Mouth:
into the blood directly through the the tongue and
mucosal lining of the mouth. 5- Heart: alcohol in the blood that is not
inactivated leaves the liver and joins with
the blood of the main circulation. heart
2-Stomach: approximately 20% of alcohol is pumps the alcohol all around the body
absorbed through the stomach wall into the blood over and over again
which then goes to the liver.

3-Small intestine: Approximately 80% of alcohol absorbed into the blood

alcohol is absorbed through the small intestine.
Alcohol is quickly absorbed by the small
intestine because of its large surface area
4- Liver:
through the stomach and small
intestine goes to the liver. Most of the
ethanol (80-90%) in the body is broken
down in the liver to carbon dioxide and
water
Why do we get drunk faster with bubbles?
 Alcohol is absorbed by simple diffusion into the blood.
 Diffusion is defined as the movement a substance from an area of high
concentration to an area of lower concentration until its concentration
becomes equal throughout a space
 The driving force to move alcohol across a membrane is the concentration
gradient.
 The carbonated drinks (carbon dioxide gas in a liquid) increase the pressure
inside the stomach, and small intestine which forces alcohol to get absorbed
more quickly in the bloodstreams.
Disclaimer: I am not telling you how to get drunk faster…
Does food slow down alcohol absorption?
 Food in the stomach will prolong gastric emptying time

• On an empty stomach, the alcohol is usually

absorbed in the blood within fifteen minutes
to two-and-a-half hours.
• On a moderate amount of food in your
stomach when you drink, alcohol absorption
slows down to thirty minutes to three
hours.
• On a full stomach, alcohol absorption ranges
from three to six hours.
•
How do we get rid of alcohol in our body?
 Liver works to clear alcohol from blood
 Liver makes alcohol dehydrogenase (ADH)
• Oxidise ethanol to acetaldehyde (more in the next few slides)
 One standard drink in New Zealand contains 10 grams of pure alcohol
 An average person’s liver can only break down around one standard drink of
alcohol per hour
 Processing of alcohol happens before processing of fatty acids
 So excess alcohol will lead to build up of fat in the liver (causing fatty liver)
Watch video
 Two enzymes are involved in clearing alcohol...
1. Alcohol dehydrogenase: our primary defence against alcohol. This enzyme
removes a pair of electrons along with two hydrogen atoms from alcohol to make
acetaldehyde H H C H
H 3C H 3
Alcohol dehydrogenases (ADH)
O O
H Acetaldehyde
ethanol

2. Acetaldehyde dehydrogenase: This enzyme removes another pair of electrons

(and a hydrogen atom) to allow water to bond with the acetaldehyde (in the form
of a hydroxy group) to make acetate.

H 3C H H 3C OH
Aldehyde dehydrogenase (ALDH) Krebs
O O Cycle
Acetaldehyde Acetic acid

Acetic acid then enters the aerobic respiration process (Krebs cycle) and breaks
down into carbon dioxide and water
The Genetics of Alcohol Metabolism

 The primary enzymes involved in alcohol metabolism are alcohol

dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH).

 Both enzymes occur in several forms that are encoded by different genes

 more active ADH variants or less active ALDH variants = more acetaldehyde

 Acetaldehyde is a toxic substance

 The gene responsible for "Asian glow" is associated with higher incidences of
esophageal cancer, heart attacks and osteoporosis.

Alcohol Res Health. 2007; 30(1): 5–13.

 Asian glow is predominantly due to an
inherited deficiency in the enzyme
aldehyde dehydrogenase 2 (ALDH2)

 The gene responsible for "Asian glow" is associated with higher incidences of
esophageal cancer, heart attacks and osteoporosis.

low, 1–8.9 units/week; moderate,

9–17.9 units/week; high, ≥18
units/week; where 1 unit = 22 g of
ethanol
Asian glow?
• Acetaldehyde is approximately 30 times
more toxic than alcohol
• Also cause face to become red
• Also violent hangover-like symptoms
(headache, trembling, feeling ill)

Table: Prevalence of inactive aldehyde

dehydrogenase (ALDH2*) in various ethnic
populations
What about drinking moonshine?

Often doped with industrial alcohol (e.g. methanol) and other chemicals

Watch video
Methanol poisoning
 If a person ingests methanol, ADH and ALDH will convert it to form
formaldehyde and then formate
• Formaldehyde is a carcinogen
• Formate causes blindness

H Alcohol (ADH) Aldehyde(ALDH)

dehydrogenase
dehydrogenases H 3C H H 3C OH
H 3C H
O O
O
H Acetaldehyde Acetic acid
Ethanol

H Alcohol (ADH) Aldehyde(ALDH)

dehydrogenase
dehydrogenases H H H OH
H H
O O
O
H Formic acid
Methanol Formaldehyde
Methanol poisoning – treatment
 Ethanol compete against methanol for binding to the enzyme ADH

 Acetaldehyde compete against formaldehyde for binding to ALDH

 Ethanol is metabolised at a slower rate than methanol

 So immediate treatment possible

• Injecting patients who accidentally drank methanol with ethanol

 Tie up ADH and ALDH to slow the metabolism of methanol-to-formaldehyde-

to-formic acid (formate)

 So that the kidneys have time to filter out the methanol which is then
excreted in the urine
Break
Distribution of ethanol in our body

 Alcohol is hydrophilic
 Distribute into fluids and tissues according to water content

Tissues with high water content (such as blood) will therefore have more
alcohol than tissues with a low water content (such as bone or fat)

Alcohol becomes more diluted when consumed by a person with a higher total
body water and results in a lower blood alcohol concentration
Total body water

 Age
• Younger person has proportionately more body water than an older person
of the same sex and weight
 Gender
• Women have more fatty tissue than males of equivalent weights
• Fatty tissue occurs in the body in place of body water
• Less body water among women as compared to men

 Body weight
• The heavier a person is the more water they have
Effect of ethanol in our body
 Effects of alcohol on human physiology
• Complex set of responses
• Nervous system depressant
• Interferes with specific neuroreceptors

 Gamma-aminobutyric acid (GABA) receptor: Prevents firing of neurons that

produce tenseness, which lead to ‘calming effect’
 Increases dopamine: Feeling of well-being
 Interference with glutamate receptors: Disrupts signals that control muscles,
which leads to the feeling of relaxation and inability to control muscles. In
severe cases this can slow heart and breathing rates and cause death
 N-methyl-D-aspartate (NMDA): It is a type of glutamate receptor involved
with memory formation. Alcohol therefore interferes with short term
memory formation
It all depends on the concentration

10–50 • Slight intoxication

mg/100 mL • May have no observable signs of intoxication
• Laboratory testing may reveal some effects
30-120 • Mild euphoria, increase sociability, talkativeness
mg/100 mL • Increased self confidence, lower inhibitions
• Lower sensory perception (e.g. hearing)
• Loss of fine motor skills
• Slowed information processing
It all depends on the concentration

90–250 • Emotional instability (dissatisfaction)

mg/100 mL • Mental confusion
• Memory impairment
• Impaired balance and coordination
• Sedation, drowsiness
180-300 • Disoriented to time and place (confusion)
mg/100 mL • Exaggerated emotional state
• Double-vision
• Motor incoordination worsens, apathy, sleepy
• Anesthesia
It all depends on the concentration

250-400 • Loss of motor function

mg/100 mL • Response to stimuli decrease
• Stupor, unconsciousness
• Vomiting, incontinence
• Hypothermia
350-500 • Unconsciousness and may lead to coma
mg/100 mL • Depression of reflexes
• Impairment of respiration and circulation
• Could result in death
 Among people aged 15-49, alcohol use was the leading health risk factor across
the globe in 2016, with 3.8% of all female deaths and 12·2% of all male deaths
attributable to alcohol use.
Watch video
Long-term effects of alcohol
 Malnutrition
• Calories from alcohol lack nutrients
• Alcohol interferes with digestion and
absorption of vitamins from food
 Deficiency of B-complex vitamins
• Amnestic syndrome
• Severe loss of memory for both
long and short term information
 Cirrhosis of the liver
• Liver cells engorged with fat and
protein impeding functioning
• Cells die triggering scar tissue which
obstructs blood flow
• Liver disease and cirrhosis rank 12th
in US causes of death.
 Damage to endocrine glands and
pancreas
 Heart failure
 Erectile dysfunction
 Hypertension
 Stroke
 Capillary hemorrhages
• Facial swelling and redness,
especially in nose
 Destruction of brain cells
• Especially areas important to
memory
What happen if we become dependent on alcohol?
Treatment of alcohol abuse and dependence

 In-patient hospital treatment

• Detoxification
• Withdrawal from alcohol under medical supervision
• Therapeutic results of hospital treatment are not superior to those of
out-patient treatment

 Alcoholics Anonymous (AA)

• Largest self-help group for problem drinkers
• Regular meetings provide support, understanding, and acceptance
• Promotes complete abstinence
• Although some studies have shown AA participation predicts better
outcome, recent studies suggest AA no more effective than other forms of
therapy.
Treatment of alcohol abuse and dependence

 Cognitive and Behavioral Treatments

• Patient and family reinforce behaviors inconsistent with drinking
• Avoid places associated with drinking
• Teach problem drinker how to deal with uncomfortable situations
• Refusing the offer of a drink
• Controlled drinking
• Belief that problem drinkers can consume alcohol in moderation
• Avoid total abstinence
• Guided self-change

 Medications
• Antabuse (disulfiram)
• Produces nausea and vomiting if alcohol is consumed
• Other medications include naltrexone, naloxone, & acamprosate
• Most effective when combined with CBT
Watch video
Key Points
 Alcohol is absorbed by simple diffusion into the blood.
 The driving force to move alcohol across a membrane is the concentration
gradient
 The carbonated drinks forces alcohol to get absorbed more quickly in the
bloodstreams.
 The type of food and the quantity of food that are present in your digestive
tract when you consume alcohol have the most direct effect on the rate of
alcohol absorption.
 Liver makes alcohol dehydrogenase (ADH) that helps to clear alcohol from
blood
 The primary enzymes involved in alcohol metabolism are alcohol
dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH).
 If a person ingests methanol, ADH and ALDH will convert it to form toxic
formaldehyde
 Many factors including body weight, gender and age influence body’s ability to
absorb and tolerate alcohol.