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Physiology of the World’sSecond-Most Popular Drugp g
Kevin T. Strang, PhDf iDepartment of Physiology
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1. Cellular mechanism of ethanol effects
2. Effects of ethanol on the nervous systemy
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Alcohol Structure
CH
H OH MethanolCH
H OH Methanol
CH
H OHCH
EthanolCH
H OHCH
Ethanol
CH
H OHCH
CH
PropanolCH
H OHCH
CH
Propanol
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Alcohol Structure
H
C
H
H OH Methanol Ingestion blindness
CH
H OHCH
Ethanol THE alcoholCH
H OHCH
Ethanol THE alcohol
C
H
H OHC
H
C
H
PropanolM t “ th ” l h l hi hl
H H H
pMost “other” alcohols are highlytoxic to the body
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Ethanol Structure
•Clear, colorless liquid, miscible with H20 and Organics
H HThis end interacts anddissolves in water
Carbon-Hydrogen chainsdissolve in lipids(hydrophobic)
CH
HH OHC
H
H(hydrophilic)
( y p )
H H
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Basic Structure of Body CellsOur bodies are made of 75 trillion specialized cellsOur bodies are made of 75 trillion specialized cells
with phospholipid membranes, and aqueousenvironments inside and outenvironments inside and out.
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Basic Structure of Body Cells
Cell membranes are essentially oily bubbles formedfrom a bilayer of phospholipid moleculesfrom a bilayer of phospholipid molecules
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Basic Structure of Body Cells
Proteins are the machinery that determine thefunction of different cell types; they’re foundyp yfloating free and within membranes
Ion channels(Na+, K+, Ca+2)
Enzymes
Receptors
Signals
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Basic Structure of Body Cells
Proteins are made of amino acid chains:
20 different amino acids haveunique “R” groups:
S h d hili• Some are hydrophilic• Some are hydrophobic
3
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Basic Structure of Body Cells
Proteins are made of amino acid chains:
The “R”-group sequence determines the complex folding
d fi l h f t iand final shape of a protein.
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E h l’ i h i k
Ethanol Interacts with Cell ProteinsEthanol’s unique chemistry makesit a universal key that can interact
i h i hi f llwith protein machinery of cellsthroughout the body.
(hydrophobic)
CH
H OHCH
(hydrophilic)
HH OH
H( y p )
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Why Does Whiskey “Burn”?
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Why Does Whiskey “Burn”?
“TRPv1 (Vanillin1) receptor” (mouth, throat)throat)
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Why Does Whiskey “Burn”?
Heat, capsaicin…
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Why Does Whiskey “Burn”?
“ O !!”
Heat, capsaicin….and Ethanol!
“HOT!!”
Nerve signalNerve signalto brain
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Why Do People Drink Alcohol?
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Why Do People Drink Alcohol?
Euphoria/Mood elevationI i l fidIncrease social confidenceAnti-anxiety (“to relax”)AphrodesiacAphrodesiacEscape from problemsTo fit in with friends/familyy
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Why Do People Drink Alcohol?
Euphoria/Mood elevationI i l fidIncrease social confidenceAnti-anxiety (“to relax”)AphrodesiacAphrodesiacEscape from problemsTo fit in with friends/familyy
Because of great advertising?
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Why Do People Drink Alcohol?
Because of great advertising?
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Why Do People Drink Too Much?
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Why Do People Drink Too Much?
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This happens a LOT……but why?
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Eth l ff tWhy Do People Drink Too Much?
Ethanol affects synapses
Neuron signalsand networks
( x 100 billion!)
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Eth l ff tWhy Do People Drink Too Much?
Ethanol affects synapses
Neuron signals Synapses, Neurotransmittersand networks
( x 100 billion!)
Synapses, Neurotransmittersand Receptors
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Glut GABAGABA _
Glut+ +
GABA
Glut Glut+
_
N l thi ki d d b l f it tNormal thinking depends on a balance of excitatoryand inhibitory synaptic activity:
50% of the brain’s synapses use Glutamate50% of the brain s synapses use Glutamate 40% use GABA (gamma-amino-butyric acid)
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Glut GABAGABA _
Glut+ +
Glut Glut+
_
Well-documented pharmacological effects of ethanolp ginclude stimulation of GABA signaling and inhibitionof glutamate signaling.
As the dose goes up, your intelligence goes down……
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Glut GABAGABA _
Glut+ +
GABA
Glut Glut+
_Mood/Pleasure
SerotoninDopamine
Other Neurotransmitters: Ethanol stimulatesOther Neurotransmitters: Ethanol stimulatesbrain “reward” centers in a specific way….
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Glut GABAGABA _
Glut+ +
GABA
Glut Glut+
_Mood/Pleasure
SerotoninDopamine
….which can explain why:….which can explain why: Short-term: Drinking leads to more drinking Chronically: AddictionBoth related to “Rising Phase Effect”
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Rising Phase Effectnt
Moderate Dose and Rate
Con
ten
Elevated Dopamine:Reward/Euphoria
lcoh
ol
Depressed Dopamine:Craving/Dependence
lood
Al
Increasing Dose/Side Effects
Moderate Dose/Effects
g p
Bl
Time
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Rising Phase Effectnt
Binge Drinking
Con
ten
lcoh
ol
lood
Al
Increasing Dose/Side Effects
Moderate Dose/Effects
Bl
Time
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Rising Phase Effectnt
Binge DrinkingOptimized Drinking
Con
ten Optimized Drinking
lcoh
ol
lood
Al
Increasing Dose/Side Effects
Moderate Dose/Effects
Bl
Time
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If drinking a little makes you happy,does drinking a lot make you
really, REALLY happy?y, ppy(or depressed, or angry or horny?)
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Glut GABAGABA _
Glut+ +
Glut Glut+
_
Global depression model explaining situational p p gdependence of alcohol’s effect on mood and behavior:
ALCOHOL MYOPIA
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“Alcohol Myopia” Can Explain Variable Neural Effects
The basic idea:
Ethanol globally suppresses cognition, reducingthe mental focus of an individual to immediatethe mental focus of an individual to immediateinternal thoughts or external stimuli.
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“Alcohol Myopia” Can Explain Variable Neural Effects
The basic idea:
Ethanol globally suppresses cognition, reducingthe mental focus of an individual to immediatethe mental focus of an individual to immediateinternal thoughts or external stimuli.
Example: Study demonstrating that ethanol isNOT a good anti-anxiety drug….
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Alcohol, Anxiety, and Public Speaking
Volunteer subjectsi it d t t
Alcohol drinks Placebo drinksinvited to a party Placebo drinks
“In 15 minutes, you have to go on stage and give an impromptu speech:”What I dislike most about my body and physical appearance
Sit and think
ANXIETY ANXIETY
Easy slidesorting task
Moderate difficulty slide sorting task
Complicated slidesorting task
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Alcohol, Anxiety, and Public Speaking
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Myopia can boost your self-esteem!
ffrom:The Onion
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How Does Alcohol Affect Memory?
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Short-Term Long-TermMemory(“Working
gMemory(“Learning”)
LTP
memory”)(RAM)
(Hard-drive)
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Short-Term Long-TermLTP
Memoryg
Memory+LTP
REM SLEEPREM SLEEP
RECENT LEARNING RESEARCH
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Glut GABAGABA _
Glut+ +
Glut Glut+
_
AdenosineAdenosine
Alcohol affects neurotransmitters in a way ythat DOES make you go to “sleep” but…..
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…but it is actually more like surgical anesthesia
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…and may seem hilarious to your “friends”…
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…..but……
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Short-Term Long-TermMemory
gMemory+
LTP
REM SLEEPREM SLEEP
1. ETHANOL BLOCKS REM SLEEP
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2. ETHANOL INHIBITS LTP
Long-term potentiationat glutamate synapsesg y pis a cellular correlateof memory formation
Even at moderate dosesalcohol begins toalcohol begins to inhibit LTP….
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Inhibition of memory formation
Glut+
GABAGABA _
M
Glut Glut
+ + _Memory
+
Impaired long-term memory formation: p g yAfter a single drink, LTP is reduced 30%
At BAC of 0.2%, LTP is reduced 80%Total amnesia/blackout can occur at higher levels…
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Glut GABAGABA _
Glut+ +
GABAMemory
Glut Glut+
_
OTHER SIDE EFFECTS:I i d f ti (l d !)The Onion, June 21, 2007Impaired memory formation (low doses!)The Onion, June 21, 2007
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THE COLLEGE STUDENT’S GRAND DELUSIONGRAND DELUSION…
Study from Long-TermLTPParty fromy
5-11 pmg
MemoryLTP+
Party from11-2 am
REM SLEEPREM SLEEP
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Why Do Drunks Talk Loud, Fall Down,and Get the Bed Spins?and Get the Bed Spins?
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Glut GABAGABA _
Glut+ +
Glut Glut+
_
Global neural depression inhibits motor outputsand sensory inputs……
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Glut GABAGABA _
Glut+ +
GABA
What the…?
Glut Glut+
_
MotorO t t
SensoryInputs
SIDE EFFECT: Depression of motor output and sensory input 1. Loss of coordination (see drunk driving stats)
Output Inputs
1. Loss of coordination (see drunk driving stats)
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Glut GABAGABA _
Glut+ +
GABA
Glut Glut+
_
MotorO t t
SensoryInputs
SIDE EFFECT: Depression of motor output and sensory input 1. Loss of coordination (see drunk driving stats)
Output Inputs
1. Loss of coordination (see drunk driving stats)2. 8th Cranial Nerve especially sensitive
(“Dude, turn it up!”) (Field sobriety test) (Bed spins)
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Calling alcohol a “Drug” doesn’t mean it is evil….
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Calling alcohol a “Drug” doesn’t mean it is evil….
Prescription Illegal OTCOxycontin Cocaine TylenolProzac Ecstasy NyquilValium THC IpecacPenicillin Heroin AspirinPenicillin Heroin Aspirin
What do all “drugs” (and alcohol) have in common?What do all drugs (and alcohol) have in common?1. Sought-after effects2. Unintended side-effects3. The dose determines the effect/side-effect ratio
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Calling alcohol a “Drug” doesn’t mean it is evil….
In moderate doses (<1-2 drinks/day),alcohol appears to cause no harm*,and much evidence suggests that itand much evidence suggests that itmay have positive effects.
*EXCEPT in those who are pregnant, under 21,tibl t l h lior susceptible to alcoholism.
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AN HONEST ALCOHOL AD