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Chapter 2 What is Alcohol?This section explains what alcohol is and how it affects people. The history, chemical composition, and medical effects are discussed. What is alcohol?Found in nature, alcohol is a complex chemical compound created in several ways. Of the four general types, ethanol, made from plant material is the only form that humans can consume. And, since a weak form of beer can be a by-product of any bread, alcohol has been around for quite some time as archeological evidence shows. Most alcohol is categorized as fermented or distilled. To make fermented alcohol, start by mashing and heating plant material, adding sugar and yeast, and allowing the alcohol to develop. Start with grains such as barley or wheat and ferment; you will get a member of the beer family. Start with grapes and you will make wine. Fermented products usually top out at a 14% of alcohol by volume, simply because the chemical relationship between sugar and yeast will not allow it to go much higher. Beer and wine are the most popular types of fermented products, although ciders, meads, and fruit wines fall into this category. Distilled beverages are made from a fermented base. A plant material such as a corn is fermented and then distilled by adding water to the base, and heating it under pressure. The steam is captured by a series of tubes, and when cooled almost pure alcohol is left, picking up the taste of the original mash. Alcohol can be further distilled and refined, increasing the volume of alcohol compared to water each time it occurs. Distilled beverages range from 15% alcohol to almost 100% alcohol by volume. Because of this, distilled beverages pack more of a punch then the fermented ones. Distilled beverages are normally aged after production, as the taste can be quite harsh. All spirits such as vodkas, gins, rums, whiskeys, and cordials are distilled beverages. A third category of beverages called blended does exist. Most blends start with a fermented beverage such as wine, and then add back in the corresponding distillate making port. However, since their alcohol content is closer to distilled beverages, you can safely treat them as such. Alcohol straight out of the bottle may also contain other additives hidden as trade secrets. Usually, it contains water, remnants of the original flavor agent, and additional flavors, both natural and artificial, to give the items taste a boost. The neon colored cordials may contain color additives as well. Moreover, preservatives such as sulfites may have been added as well. Additional ingredients or additives are listed on ingredient panels on the back of the bottle, but labeling laws are not consistent across products, and imported items may be exempt. For further information, check with your liquor sales representative, especially for common allergens such as sulfites which customers may inquire about. How does Alcohol affect the Body? As soon as a person takes a drink, some of the alcohol enters the bloodstream directly from the mouth. The rest passes to the stomach and small intestine where it is absorbed, by passing through the cell walls and into the bloodstream. Alcohol circulates until the liver can break it down. Since the liver can only break down approximately one drink per hour, the remaining alcohol keeps circulating in the bloodstream until the liver can process it. This circulating alcohol, which enters into, and interferes with, the workings of the body’s cells, causes the characteristics of intoxication. Once broken down, it is excreted as urine through the bladder. Within three minutes of taking a drink, alcohol via the blood stream has begun to hit the brain. Alcohol and the initial ingredients used in the fermentation process do have some health benefits ?in small doses. Moderate use of alcohol seems to have a beneficial affect on coronary heart disease acting as a “roto-router?for the arteries. Alcohol may also prevent some types of strokes, but heavy drinking increases the risk of other types. A drink can help customers relax and unwind. Alcohol has some pain relief benefits, although the amount needed for severe pain is close to coma levels. Paired with food, wines and beers can elevate the taste of some dishes. Wine has long been used in religious ceremonies, cementing its relationship with special landmarks in people’s lives. If a little alcohol is good, then a lot of alcohol can be bad. It seems, especially for women, alcohol can increase blood pressure. Heavy drinkers and alcoholics are at significant risk for alcoholic hepatitis or cirrhosis of the liver, and some forms of cancer. Alcohol can also interfere with fetal development, and most popularly prescribed medications. Alcohol acts on the brain as a depressant, shutting down the higher reasoning centers causing a loss of control and inhibitions. After the higher reasoning centers are involved, alcohol will go to work in the cerebral cortex and neural base functions: the automatic part of the brain that controls breathing, heart rate, and the digestive track. Once this section is shut down, the patient is in a coma, near death, and very hard to resuscitate. Alcohol also acts as a diuretic. To process the alcohol, the liver pulls water from cells, increasing the customer's thirst. As water depletes, the person’s thirst will increase ?causing them possibly to drink more alcohol. The diuretic properties also interfere with normal bladder control, causing the need to urinate more often depleting more water out of the system.
Alcohol causes the blood vessels near the surface of the skin to expand, creating a flush, and a sense of warmth to the person drinking. Customers at this level perceive the ambient room temperature as being very warm. For those who are heavy drinkers, repeated damage could result in permanent flushing of the skin. Alcohol also interferes with the body's ability to regulate blood sugars. Because alcohol takes priority over sugar, the liver focuses on breaking down alcohol allowing excess sugar to circulate within the blood stream. The sugar overload influences appetite, as well as causing headaches and later hangovers, as the sugar continues to travel in the bloodstream waiting for the alcohol to leave. Once the alcohol is gone, it takes the now overworked liver a few more hours to process the sugar before the final side effects of the drinking is gone. Blood Alcohol Content (BAC) is the amount of alcohol compared to blood in a person’s body at a point in time. A BAC of .10 means that for every 1000 drops of blood, one drop of alcohol is present. The only way to measure a person’s BAC accurately is with a breathalyzer test or by drawing blood ?two measuring devices not usually found in the local watering hole. Since BAC is dependant upon the amount of blood in a person’s body, heavier and taller customers will have a lower BAC then a smaller, lighter person after the same number of drinks. Body composition ?an athlete versus the same weight couch potato ?influences blood volume and BAC as well. Since there is no way of knowing anyone’s exact BAC at any given time: most establishments use two different tests for approximating BAC levels. The first method is from a BAC behavior chart. By comparing a patron’s behavior with the chart, an approximate level can be determined. This method, known as “probable cause?by law officials, shows the behavior with the associated BAC level. This chart is based on averages and each person is different and may be affected by alcohol differently each time they drink. On the following pages, some factors that may affect absorption of the alcohol and BAC levels are listed. If it seems that the person is behaving as if they have reached levels higher than .20, immediate medical treatment may be needed to stop the person from drinking and to allow medical supervision while the liver processes the remaining alcohol. BAC Level ?and Effects on the PersonThe following chart gives the external cues that correlate to the approximate BAC level.
The other way to calculate BAC is to use standard drink charts. The charts are based on a person’s approximate weight ?and their sex, as men metabolize alcohol at a slower rate than women do. The charts include the number of drinks per hour, less the amount (.0015 BAC) metabolized by the liver. Again, these charts are approximations, each individual person may metabolize at a slightly different rate. When using the charts, make sure that you look at the correct one: pick the one with the correct number of drinks over the number of hours they have been in the bar. A person who drinks five drinks in one hour is going will be more intoxicated then a person who drinks those same five drinks over the course of five hours. As each hour goes by, the liver metabolizes the alcohol, lessening the amount in the blood stream. Some standard drink charts are included in this chapter. Factors Owners can Influence.While each person reacts differently to alcohol, there are ways that a bar owner can help to slow the rate of absorption down. Food will slow alcohol’s passage into the small intestine. Amazingly, the old bar standbys; fried, fatty foods slow the alcohol the most. Some items include chicken wings and strips, battered vegetable appetizers and breaded fried cheese nuggets. Selling appetizers with pitchers of beer is one way to slow down the absorption rate for a customer. Suggest food whenever someone orders a drink. For late nights after the cook goes home, frozen pizzas and pizza ovens may be a great addition for behind the bar. They also increase sales for the establishment as well.
Carbonation, those fuzzy bubbles help speed the alcohol through the stomach and into the small intestine. Bartenders should carefully serve Champagne and any soda-based drinks as it will speed up the customer’s rate of intoxication. Amount of alcohol in the drink. The drink families have different amounts of liquor within them. For example, a rum and coke is one alcohol mixed with soda. A martini is made of gin and vermouth, two alcohols plus the garnish. A long Island Ice Tea is made by combining several alcohols with soda. Every bartender needs to know how to count drinks and how much liquor is going into each glass. Managers need to create recipes and standard measures for each drink that allows accurate counting by the servers. If a bartender over-pours or does not follow the recipe, then the customer may become intoxicated sooner than expected because of the extra alcohol within the drink.
Factors Owners cannot Influence.Certain factors are out of an owner's control, and the following factors can influence the same customer differently each time they drink. By training servers to watch for the visual cues of intoxication from the BAC chart, bartenders can adjust service.
Since the liver can only process one drink per hour, a guest who consumes multiple drinks within an hour risks the alcohol stacking up in the bloodstream, much like a series of planes circling an airport. As each hour of drinking goes by, more and more alcohol stacks up. For example, Joe enters your bar and drinks three beers over the course of 2 hours ?or one drink every 40 minutes. His table would look like this. Hour Drink In Drink Out Net drinks In blood stream 1 1.5 1 .5 2 1.5 1 1 3 0 1 0
When Joe leaves, he has the equivalent of one drink still in his bloodstream. One hour after he leaves, the alcohol will finally metabolize out. Now, Sam enters into your bar and drinks six beers over the course of 2 hours or one every 20 minutes. His table would look like this. Hour Drink in Drink out Net drinks In blood stream 1 3 1 2 2 3 1 4 3 0 1 3 4 0 1 2 5 0 1 1 6 0 1 0
Now, when Sam leaves, he has the equivalent of four drinks still in his bloodstream, and may, depending upon his size and your state’s BAC limits, be legally drunk. It will also take him 4 hours to metabolize the alcohol before it is completely out of his system. If Joe and Sam are sitting next to each other, then Sam should start exhibiting the signs of intoxication much faster than Joe does. Assuming that they weigh about 220 pounds then their relative BAC levels are: Joe Sam BAC 1 hour .009 .018 BAC 2nd hour .002 .070 Joe, according to the chart, at the end of the second hour would probably be loosing his tie, while Sam could be showing marked lapses in judgment and his coordination may be impaired. Obviously, while he is not legally drunk, his driving ability would be impaired. Customer drinking rates ?how fast they drink ?is a major part of how intoxicated that they get. Bar owners who want to have customer friendly, yet legally responsible bars will try to influence this rate any way possible through the strategies listed in the second section of this book. Binge drinking is where a customer will drink very rapidly in a short period, to increase the affects of alcohol. Binge drinking much like Sam in the previous example, will show the signs of intoxication at a much faster rate since they are purposely allowing the alcohol to stack up in the blood stream. Binge drinking is popular with college students, especially those who are under aged, and when they turn 21, they may bring this practice into the bar scene. Alcohol can pass through muscle tissue, but not fat. So, leaner, athletically built customers may have a lower BAC then a customer with more body fat, even though the two weigh the same. The bigger, and generally heavier the customer, the more blood in their body, thus drink for drink, their BAC chart shows lower levels than a smaller person. This one factor dramatically affects the BAC charts and how they are calculated for each person. Since it is rude to ask customers their weight, servers need to be able to size up a customer before checking a chart. The older people get, the more their enzymes and liver tends to slow down. Older patrons may also be on medication that affects how the alcohol is absorbed. As mentioned in the sidebar earlier, the presence of female hormones makes a difference in how the liver metabolizes alcohol. Women are also smaller, and have more body fat than a male of the same size. Most medications, both prescription and over the counter, will interfere with the metabolism of the alcohol, or the alcohol will cancel out the benefits of the medication. If someone is on medication, they should not consume alcohol without their doctor’s approval. Unfortunately, you cannot ask your customers for detailed printouts from their pharmacy before serving them. If you see a customer who is taking pills at the bar, or who looks under the weather, a careful caution may be in order. Illegal drugs affect the absorption rate of alcohol. Some will slow the metabolism down, while other illegal drugs combined with alcohol will cause drowsiness and possible loss of consciousness. Treat all customers who look “high?when they arrive as being intoxicated. A customer who is calm and happy will probably have a lower BAC rate than a guest who is upset. In some cases, the emotional disturbance may be from outside of the bar; loss of job, family crises, and they seek alcohol for solace. These customers may need a shoulder to cry on instead of additional drinks. Sometimes the disturbance is from inside of the bar ?the home team is losing ?and the customers need a gentle reminder to keep things in perspective. Managing the customer’s consumption by using the factors listed above will help you create your Responsible Beverage Service. Chapter 2 ?Manger To-Do Check Sheet
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