1. Ask the class to recall what they learned from the mouse simulations in Lesson 3 about which factors influence the response to alcohol.

Students should recall that the amount of alcohol, the time after consumption, and individual variation (genetic differences) all affect how a mouse (or a person) responds to alcohol.

2. Remind the students that those simulations looked at what happened after alcohol was taken into the body. Hold up the simulated alcoholic beverage (see Preparation) for the class to see. Remind students that this represents a beer (an alcoholic drink). Ask students to consider what things might influence a person’s decision to drink or not to drink the beer. Write their answers on the board.

3. Sort their answers into five categories:

• availability,
• family environment,
• peer pressure,
• media pressure, and
• legal restrictions.

Explain that these five categories influence a person’s decision to drink or not to drink alcohol.

The items in these five categories account for most of the environmental factors that influence a person’s decision to drink or not to drink. Other types of factors, including genetics, will be examined in Activities 2 and 3. Of course the effects of environment and genetics are not separated in time as discussed here; they interact with each other. When students are given an opportunity to discuss how the model represents, or fails to represent, reality, this fact can be brought out.

4. Inform students that they will be exploring these environmental factors and their contributions to the decision whether or not to use alcohol. In the activity, students will roll dice to model fictitious individuals’ decisions about drinking alcohol. Emphasize to students that they are going to model the behavior of fictitious individuals. The results of this activity do not reflect on their behavior or that of their classmates, family, or other acquaintances.

This activity models behavior. As a model, it has limitations. It is important to realize that students should not draw conclusions about the behavior of a friend or family member based on this activity. See How Can Controversial Topics Be Handled in the Classroom?.

5. Give each student a die and a copy of Master 4.1, Environmental Factors Influencing Alcohol Use and Nonuse.

Figure 4.2. Rolling dice can be used to model aspects of human behavior.

6. Explain to the class that they will roll the die 5 times for each individual and record the number of each roll in the spaces provided on Master 4.1. After the first roll, the student records the number in the space provided under the “Availability” factor on their handout. The results of rolls two through five are recorded on the handout in the spaces provided under “Family environment,” “Peer pressure,” “Media pressure,” and “Legal restriction,” respectively.

For a class of 30 students, we suggest that each student model two fictitious individuals, thus providing data for 60 total individuals. For classes with fewer than 30 students, adjust the number of individuals each student models appropriately. The larger the data pool, the more closely the data will approximate the known distribution.

Students will need these scores when they do Activity 2. Students should keep Master 4.1 handy.

7. Display a transparency of Master 4.2, Score Sheet for Modeling Alcohol Use. Ask students to record a score for each category based on the die rolls they recorded. Each student should then add the values for the five factors to obtain a total score for each modeled individual.
8. Next, display the overhead transparency of Master 4.3, Results for Modeling Alcohol Use. Summarize the results of the activity by constructing a histogram of the total scores for the entire class. Remember that each student will have data for two fictitious individuals.

Content Standard A:
Use mathematics in all aspects of scientific inquiry.

If you want to make this graphing exercise more interactive, you may draw a graph template on the chalkboard and have students add their own data to it. Students should place an X above the range corresponding to their calculated alcohol-use score. As more students add their Xs to the same score, they place their X above the preceding one, building up a histogram.

Figure 4.3. Sample histogram of class data for modeling alcohol use.

9. Ask students to interpret the graph. Guide the discussion with questions like the following:

• How are the scores distributed on the graph?

Even though class results will vary, the data should reflect a bell-shaped curve with scores ranging from a low of 0 to a high of 45.

If the data from a particular class do not yield a bell-shaped curve, this is an opportunity to discuss another limitation of the model. The class may benefit from a discussion of sample size in experiments or of probability.

• What do the low scores represent?

A fictitious individual with a score of 15 or less represents someone who doesn’t drink. It might help for students to refer to the transparency of Master 4.2, Score Sheet for Modeling Alcohol Use, when answering the next question.

• What factors are responsible for some individuals having scores of 15 or less?

No alcohol was available.

Little or no use of alcohol among peers.

Little exposure to or influence from the media.

Family and/or religious values discourage alcohol use.

Respect for laws that prohibit alcohol consumption by minors.

• Do you think this distribution accurately models the actual alcohol use in a population?

Students may suggest a number of reasons why this model fails to depict alcohol use in the population accurately. For example, the model includes only five variables to account for alcohol use and only describes two or three variations for each factor. Some students may suggest that genes may contribute to alcohol use. You may point out there is evidence for a genetic influence on alcohol abuse and alcoholism. This will be taken into account in the next two activities. However, there is no evidence that the decision to first consume alcohol has a genetic component.

10. Continue to display the graph on Master 4.3, Results for Modeling Alcohol Use, on the overhead projector. Ask students to refer to the completed graph to answer the following questions.

• How many individuals have scores of 15 or less and, consequently, chose not to drink alcoholic beverages?

Answers will vary depending on the data generated by the class.

• According to the Surgeon General, about 33 percent of the population report that they do not drink alcoholic beverages. Keeping this in mind, how many fictitious individuals would you expect not to drink?

If the class models a total of 60 individuals, 33 percent of that group, or 20 individuals, would not consume alcohol. You can easily revise that number based on the total sample size that your class generates.

• On the basis of your class’s data, is the number of individuals who choose to drink higher or lower than the predicted number?

The scoring for this model was designed so that approximately 33 percent of the scores would be 15 or lower. This correlates to the statistics for the population. In some classes, however, the number of fictitious individuals whose scores are 15 or less may be higher or lower than the predicted 33 percent who choose not to drink alcohol.

If your class’s results differ significantly from the predicted number, you can use this as an opportunity to discuss this limitation of this model. Discuss the effect of sample size and reliance on probability.

1. Ask students to recall what they learned in Lesson 3 about genetics and alcohol. What conclusions did they draw about the two different mice and why they responded differently to alcohol? Is it reasonable to suggest that humans, too, might vary in their response to alcohol?

Students should recall that Study 3 demonstrated that different strains of mice react differently to alcohol. These differences are largely attributable to differences in the genetic makeup of the two different mice strains. Students should predict (and are likely to have previous knowledge) that different individuals will respond differently to alcohol and that these differences, like those in the mice, may be affected by different genes.

2. Remind students that the die-rolling activity they just completed models a person’s decision whether to drink or not to drink alcohol. Tell the students that they will now be doing an activity that models whether a person who drinks alcohol will simply use alcohol appropriately or be more likely to abuse alcohol. Define alcohol abuse for students.

Alcohol abuse is characterized by consumption of excessive amounts of alcohol and is associated with social problems, but the individual does not experience intense cravings for or withdrawal from alcohol as with alcoholism.

3. Ask students to consider the question, Can someone who chooses not to drink alcohol abuse alcohol? On the basis of their responses, guide students to the conclusion that a person who does not consume alcohol cannot abuse alcohol.

Content Standard F:
Students should develop an understanding of personal health.

Students should realize that someone who does not drink alcohol will not be an abuser. Abuse of alcohol requires drinking alcohol. Therefore, nondrinkers will not participate in this activity.

4. Inform students that they will again use dice to model the behavior of the same fictitious individuals that they did in Activity 1. Display a transparency of Master 4.4, Modeling Genetic Influence, and give each student 1 die and 1 copy of Master 4.5, Factors Influencing Alcohol Use and Abuse.
5. Explain to students that if the individual or individuals whose behavior they modeled in Activity 1 belonged to the group of nondrinkers (those individuals with scores of 15 or less), they will not roll the die for that individual. Ask students to roll the die according to the directions on Master 4.4, Modeling Genetic Influence, to obtain a score for the genetic influence for each of their modeled individuals.
6. Instruct students to record the genetic influence factor for each individual in the appropriate space on Master 4.5, Factors Influencing Alcohol Use and Abuse. Also instruct them to transfer their scores from Activity 1 (recorded on Master 4.1) to the appropriate spaces on Master 4.5 (environmental factors) and add them to the genetic influence factor to obtain a final score for this activity.

7. Display the overhead transparency of Master 4.6, Results for Modeling Alcohol Abuse. Use the students’ final scores to construct a histogram of the data for the entire class.

As before, you may choose to have students add their own data to a graph. Again, you may wish to draw a graph template on the chalkboard and have students place an X above the range corresponding to their calculated alcohol score. As more students add their Xs to the same score, they place their X above the preceding one, building up a histogram.

Figure 4.4. Sample histogram of class data for modeling alcohol use and abuse.

Content Standard A:
Use mathematics in all aspects of scientific inquiry.

Because only individuals who chose to drink alcohol in Activity 1 are included in this modeling exercise, students will have different amounts of data to contribute to this graph. Some students will have data for one fictitious individual, other students will have data for two fictitious individuals, and some students may not be collecting data during this activity.

8. Ask the students to interpret the completed graph on the transparency. You may use the following questions to lead the discussion.

• How are the scores distributed on the graph?

Scores will range from a low of 20 to a high of 180. Since low scores from Activity 1 have been eliminated, we expect scores for this activity to cluster closer to the low of 20 than to the high of 180.

• If lower scores represent alcohol use and higher scores represent alcohol abuse, what factors contribute to alcohol abuse?

Students should mention the environmental factors associated with alcohol use from Activity 1, as well as the genetic factors modeled here.

The term “environmental factors,” as used in this model, refers to factors that are not physiological; they are cultural or social influences. As indicated in Activity 1, environmental factors that contribute to alcohol abuse include

• alcohol easily available,
• alcohol use or abuse by most or all of the individual’s peers,
• family’s view of alcohol use was positive or not discouraged,
• failure to obey legal restrictions against use by minors, and
• effective media advertisements portraying alcohol use in a positive light.

Genetic factors could include having combinations of genes that influence your susceptibility or reaction to alcohol.

• Explain that each roll of the die in this activity corresponds to having a version (allele) of a gene that either has no effect on alcohol use or promotes its use. In this simple model, we used two rolls of the die, simulating the contributions of just two genes.

In this model:

1. genetic influence factor of 1 = having both alleles of no effect
2. genetic influence factor of 2 = having one allele of no effect and one allele that promotes alcohol use
3. genetic influence factor of 4 = having both alleles that promote alcohol use

Alcohol abuse and alcoholism certainly involve the contributions from more than one gene. The exact number of genes that influence alcoholism is not known.

• In this activity, individuals who have scores of 120 or higher are considered to be alcohol abusers. By this measure, how many of the modeled individuals did abuse alcohol?

Results for your class will vary, but the graph should show approximately 10–15 percent of the original population with scores above 120.

• If, in the population, 10–15 percent of alcohol users go on to abuse alcohol, how many modeled individuals would you expect to be alcohol abusers?

The answer depends on how many individuals were modeled. For example, if the class modeled 50 individuals, then you would expect between 5 and 8 scores to be above 120 and therefore represent alcohol abusers.

• Do the results of the modeling activity accurately reflect the statistics for the population?

The scoring in this activity should yield results that are similar to the population statistics. However, results from individual classes will vary. This usually can be attributed to a small sample size. As before, if you do this activity in several classes, you might wish to pool the data.

• How does this model accurately reflect the behavior of alcohol use and abuse? How is it inaccurate?

The model is accurate in that it leads to about one-third of the population abstaining from alcohol use and 10 percent of users abusing alcohol. It also accurately reflects most of the important factors that influence alcohol use. The model is inaccurate in that it does not take into account interactions among the various factors. For example, it is not the case that environmental factors play a role only in the decision to use alcohol and not in the decision to abuse it. The genetic influence on alcohol use is also oversimplified. The model fails to stress the role that personal choice plays in an individual’s alcohol consumption.

1. Remind students that the die-rolling activity they just completed models a person’s use or abuse of alcohol. Explain that they will now complete an activity that models whether a person who abuses alcohol will go on to become an alcoholic individual.

Alcoholism is a disease characterized by physical dependence on alcohol. When alcohol use is discontinued, withdrawal symptoms occur. People who are alcoholic exhibit tolerance, meaning they need increasing amounts of alcohol to feel intoxicated. They feel a strong need or compulsion to drink and continue despite adverse consequences.

Content Standard F:
Students should develop an understanding of personal health.

2. Invite students to consider factors they think might influence whether a person continues to abuse alcohol or goes on to suffer from alcoholism. List their responses on the board.

Students will likely name a variety of things. Try to focus their responses on the

• presence or absence of a support system,
• ability to control their drinking,
• relative craving for alcohol,
• sensitivity of the brain to alcohol, and
• genetic risk.

The genetic risk factor refers to genes that place an individual at increased risk for becoming addicted to alcohol.

3. Remind the class that only individuals who were designated as alcohol abusers with a score of 120 or higher in Activity 2 will be used in this activity. Display the transparency of the completed graph from Master 4.6, Results for Modeling Alcohol Abuse, and ask students to recall how many modeled individuals abused alcohol.
4. Draw one stick figure on the board to represent each fictitious individual who was an alcohol abuser (a score of 120 or higher) from Activity 2. Assign a number to each fictitious individual. Explain to students that these drawings represent the alcohol abusers from Activity 2.
5. Explain that the procedure for this activity will be a little different from that of the previous activities because of the small number of fictitious individuals whose behavior is being modeled. Assign students numbers that correspond to each of the numbered stick figures. Each student should be assigned two numbers. For example, one student may be assigned numbers 1 and 2, another student assigned numbers 3 and 4, and so forth. Have students write the numbers for their assigned fictitious individuals on their copy of Master 4.7.

This strategy will allow all students to be involved in the activity even though the number of fictitious individuals is low. Several students will record data for the same fictitious individuals.

6. Give each student one copy of Master 4.7, Factors Influencing Alcohol Abuse and Alcoholism.
7. Complete the die rolling as a class. For each fictitious individual, the die needs to be rolled 5 times. After the first roll, students record the number in the space provided under “Support system” on their handout. Likewise, they record the results of rolls 2 through 5 under “Loss of control,” “Craving for alcohol,” “Brain sensitivity to alcohol,” and “Genetic addictive factors.” Have students take turns performing a single die roll.
8. Display a transparency of Master 4.8, Score Sheet for Modeling Alcoholism. Instruct students to assign a score for each of the five categories (for each individual) based on the die roll and the values listed on Master 4.7, Factors Influencing Alcohol Abuse and Alcoholism. Instruct students to add the five scores for each individual to obtain a total score.

Scores will range from 0 to 90 in this activity.

9. Display a transparency of Master 4.9, Results for Modeling Alcoholism. As before, construct a histogram of the results.

Because the number of individuals being modeled in this activity is low, the histogram bars will not be very high.

Figure 4.5. Sample histogram of class data for modeling alcohol abuse and alcoholism.

Content Standard A:
Use mathematics in all aspects of scientific inquiry.

10. Hold a class discussion to analyze the graph and interpret the results of the activity. Lead the discussion with the following questions.

• If in our society, one-half of alcohol abusers go on to become alcoholic, how many of the fictitious individuals would you expect to become alcoholic?

If one-half of alcohol abusers go on to become alcoholic, you can calculate the predicted number by multiplying the number of individuals modeled in Activity 3 by 50 percent (0.50).

• If a score of 45 or higher indicates the individual has progressed from an alcohol abuser to an alcoholic, how many of the fictitious individuals have progressed to being alcoholic?

Answers will vary. The possible scores for Activity 3 range from 0 to 90. Approximately half of the fictitious individuals modeled will fall into this category.

• Do the data from this activity accurately reflect the statistics from the population?

The data will vary considerably from class to class. The data collected in some classes may show no individuals who are alcoholic. Other classes may have data in which more than the predicted number of fictitious individuals are alcoholic.

If the data vary greatly from the predicted, you may find this to be an opportunity to discuss sample size and the limitations of a model such as this. If you are collecting and pooling data from several classes, you can discuss how larger sample sizes are more likely to match results from a large population of individuals.

• How does the number of individuals classified as alcoholic in this activity compare with the number of alcohol abusers? to alcohol users? to the general population?

Students should respond that the number of individuals classified as alcoholic is smaller than the number of individuals classified as alcohol abusers and is much smaller than the number of individuals in the initial population modeled in Activity 1.

This is a good opportunity to remind the class that not everyone who chooses to consume alcohol will develop a drinking problem, and not everyone who abuses alcohol will necessarily become an alcoholic.

• What factors are responsible for the individuals with the highest risk for alcoholism? (Display the transparency of Master 4.8, Score Sheet for Modeling Alcoholism, to help students respond to this question.)

In addition to those factors discussed in Activity 2, students may add the following:

• a lack of a support system, or the unwillingness of the individual to use such a system;
• loss of control that leads to heavy drinking;
• a craving for alcohol;
• a brain with a low sensitivity to alcohol that doesn’t set up blocks to alcohol consumption; and
• a genetic predisposition toward alcohol addiction.

• How does personal choice influence alcohol use, alcohol abuse, and alcoholism?

Students will list a number of factors and ways in which personal choice is important. Some of these responses may include the following:

Availability—Even if alcohol is readily available, an individual can still choose not to use it.
Peer pressure—An individual chooses his/her friends, and even when peers consume alcohol, the individual can still choose to be different.
Media pressure—Despite the tendency of TV, movies, advertisements, and music to portray alcohol use in a favorable light, an individual can choose to place these influences in perspective and resist their messages.
Family environment—Families may have positive or negative beliefs about alcohol use. Likewise, religious views may prohibit alcohol use or tolerate it in moderation. These views can be followed or resisted.
Legal restrictions—Minors considering alcohol use can choose to obey or disobey laws that restrict their access to alcohol.
Support system—If individuals realize that they are abusing alcohol, then they can turn to family or friends for support. If a personal support system is absent, then individuals can seek professional guidance and counseling. Such a decision can help prevent alcohol abuse from progressing to alcoholism.

• What factors might influence alcohol use, alcohol abuse, and alcoholism but do not involve personal choice?

Genetic factors that influence alcohol metabolism, brain sensitivity to alcohol, and risk for alcohol addiction are not under personal control.

1. Inform students that since they have completed the modeling activities to examine the range of alcohol use, alcohol abuse, and alcoholism in a small group of fictitious individuals, they will now explore how this range applies to the U.S. population. Tell students that there are approximately 200 million people between the ages of 13 and 65 in the United States.

Content Standard A:
Use mathematics in all aspects of scientific inquiry.

These calculations can be done either by students individually or as a class.

• If 33 percent of the population does not use alcohol, how many individuals do not use alcohol?

200 million x 0.33 = 66 million people do not use alcohol

• If 67 percent of the population uses alcohol, how many individuals use alcohol?

200 million x 0.67 = 134 million people use alcohol

• If 10 percent of alcohol users will become alcohol abusers, how many individuals are alcohol abusers?

134 million x 0.10 = 13.4 million people abuse alcohol

• If 50 percent of alcohol abusers will become alcoholic, how many individuals are alcoholics?

13.4 million x 0.50 = 6.7 million alcoholics

2. Display the transparency of Master 4.10, When Is Alcohol Use a Problem? Read over the transparency with the students. Explain that these simple questions screen for possible alcohol abuse or alcoholism. If a potential problem is identified, such an individual should see a doctor who has the training to more accurately diagnose the individual for alcoholism. Remind students that individuals diagnosed with alcoholism have options for achieving and maintaining a full recovery. Furthermore, all individuals, even those susceptible to alcoholism, have the option of choosing not to start drinking alcohol.

Figure 4.6. Distribution of alcohol nonusers, users, abusers, and alcoholics among Americans aged 13 to 65.