Alcohol Use
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The use of alcohol is a part of the social fabric of many cultures in the world and has been so since ancient times. There are many and varied uses and outcomes of such use, some of which are closely related to the health beliefs and practices. Ethnographers have long described these, and medical anthropologists in recent years are actively engaged in dealing with the subject in practical and applied ways. It is important at the outset to recognize that there is much more to alcohol than alcoholism and that much drinking has nothing to do with drunkenness or alcoholrelated problems. Furthermore, even colleagues in other disciplines generally agree that nothing less than a biopsychosocial perspective is necessary if one is to understand alcohol and its effects. Nevertheless, there are important implications that are specific to the field of medical anthropology.
ALCOHOL
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ALCOHOL USE
Several types of alcohol are known, but ethanol is of special interest to anthropologists, having long been an influential component of many beverages among a large portion of the world’s population. A relatively simple chemical compound (C2H5OH), it often occurs naturally without human intervention, although the hominid imagination has resulted in manifold elaborations and refinements of the basic processes of fermentation and distillation. In fermentation, it is microorganisms that convert carbohydrates to sugars, with ethanol as a by-product. Distillation results from the heating of a fermented liquid, whereby ethanol can be further concentrated because it has a boiling-point lower than that of water. Although we routinely speak as if people drank alcohol, it is widely recognized that fermented beverages (beers, ales, wines, pulque, chicha, hard cider, and a variety of other brews) contain less that 20% ethanol (by volume), usually less that half that much. Distilled beverages (spirits or liquor) contain between 40% and 90%, usually in the lower part of that range. There is an
enormous variety of beverages that contain alcohol based on a vast range of raw materials, additives, aging, and other considerations. Ethanol readily diffuses into the blood and hence through the body. A psychoactive (or mind-altering) effect is commonplace with minute concentrations; such changes in thought and action are usually recognized and often actively sought and valued. There are marked differences in those effects depending on the dose, the drinker, and the setting. In terms of dose, the overall volume of a drink and the concentration of ethanol within it determine how much alcohol has been ingested. Being water-soluble, a given amount is more readily dispersed through a small body, or one with less fat. Because of adaptive changes that occur in the brain, previous repeated alcohol experience can enhance the body’s tolerance to alcohol, lessening its behavioral impact. The presence of food delays absorption, and carbonation, exercise, or altitude accelerate it. The psychoactive quality of alcohol relates to its effect on neurotransmitters in t
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