Alcohol and Drug Problems
The overuse or abuse of alcohol (alcoholism) or other drugs is called substance abuse. It is common and costly. It can cause or worsen many medical problems and can destroy families and lives.
If you think you may have a problem with drugs or alcohol, take a short quiz to evaluate your symptoms:
Alcohol abuse causes over 100,000 deaths in the United States and Canada each year. It is the drug most commonly abused by children ages 12 to 17. Alcohol-related motor vehicle accidents are the leading cause of death in teenagers. People who drink alcohol are more likely to engage in high-risk sexual behavior, have poor grades or job performance, use tobacco products, and experiment with illegal drugs. Alcohol and drug use may be an unconscious attempt at self-treatment for another problem, such as depression.
You have an alcohol problem if your use of alcohol interferes with your health or daily living. You develop alcoholism if you physically or emotionally depend on alcohol to get you through your day.
Long-term heavy drinking damages the liver, nervous system, heart, and brain. It also can lead to high blood pressure, stomach problems, medicine interactions, sexual problems, osteoporosis, and cancer. Alcohol abuse can also lead to violence, accidents, social isolation, jail or prison time, and difficulties at work and home.
Symptoms of an alcohol problem include personality changes, blackouts, drinking more and more for the same "high," and denial of the problem. A person with an alcohol problem may gulp or sneak drinks, drink alone or early in the morning, and suffer from the shakes. He or she may also have family, school, or work problems or get in trouble with the law because of drinking.
The use of alcohol with medicines or illegal drugs may increase the effects of each.
Alcohol abuse patterns vary. Some people drink and may be intoxicated every day; others drink large amounts of alcohol at specific times, such as on the weekend. It is common for someone with an alcohol or drug problem to call in sick for work on Monday or Friday. He or she may complain of having a virus or the flu. Others may be sober for long periods and then go on a drinking binge that lasts for weeks or months.
Someone with alcohol dependence may suffer serious withdrawal symptoms, such as trembling, delusions, hallucinations, and sweating, if he or she stops drinking suddenly ("cold turkey"). Once alcohol dependence develops, it becomes very difficult to stop drinking without outside help. Medical detoxification may be needed.
Drug abuse includes the use of illegal drugs—such as marijuana, methamphetamines, cocaine, heroin, or other "street drugs"—and the abuse of legal prescription and nonprescription drugs. Some people use drugs to get a "high" or to relieve stress and emotional problems.
Drugs like ecstasy (MDMA), ketamine, GHB, Rohypnol, and LSD, which are known as "club drugs," may be found at all-night dances, raves, trances, or clubs. Club drug use accounts for increasing numbers of drug overdoses and emergency room visits. Inhalants like nitrous oxide may also be used at these clubs. Drugs come in different forms and can be used in different ways. They can be smoked, snorted, inhaled, taken as pills, put in liquids or food, put in the rectum or the vagina, or injected with a needle. Teens and young adults may be at risk for becoming victims of sexual assault or violent behavior in situations where these drugs are used.
Some nonprescription medicines, such as cold medicines that have dextromethorphan as an ingredient, are being abused by teens and young adults as a way to get a "high." Glue, shoe polish, cleaning fluids, and aerosols, are common household products with ingredients that can also be used to get a "high."
In the United States and Canada, approximately 40% of adults will use an illegal drug at some time during their lives. This does not include the use of alcohol or prescription medicines. Many people abuse more than one illegal substance at a time.
Drug dependence or addiction occurs when you develop a physical or emotional "need" for a drug. You are unable to control your use of a drug despite the negative impact it has on your life. You may not be aware that you have become dependent on a drug until you try to stop taking it. Drug withdrawal can cause uncomfortable and sometimes dangerous symptoms. The usual treatment is to gradually reduce the dose of the drug until you can completely stop using it.
Some groups of people are more likely than others to have problems related to alcohol or drug abuse. These groups include:
- Teenagers and young adults. Approximately one-half of all high school seniors in the U.S. admit to having used alcohol or an illegal drug. Substance abuse in this age group increases the risk of involvement in crime, high-risk sexual behavior, accidents, and injuries. Teens that use alcohol and drugs are more likely to have poor school performance and have higher dropout rates.
- Although women are less likely than men to abuse alcohol, they are more likely to have alcohol-related health problems, such as liver disease.
- Women are more likely to have problems with prescription medicines. More than two-thirds of all tranquilizers are prescribed for women. Tranquilizers, sedatives, pain medicines, and amphetamines are abused most often by women.
- Alcohol and drug abuse in women increases the risk of developing other health problems, such as osteoporosis or depression.
- Women who abuse alcohol and drugs attempt suicide four times more frequently than nonabusers.
- Adults older than age 65. Drug abuse in this age group is a problem because of the high number of prescription medicines and the lack of coordination between health professionals. Signs of alcohol or drug abuse may be mistaken for other disease problems or simply overlooked as a symptom of "aging." Many older adults "self-medicate" with alcohol to help relieve sleep problems, depression, and other problems. Alcohol abuse is more common than drug abuse in older adults. Alcohol contributes to automobile accidents and other types of severe injury in this group of people.
- Low-income populations. Drug and alcohol abuse is a problem for many minorities, including disabled adults, the homeless, and minority populations.
- Babies. Drug and alcohol use during pregnancy can cause birth defects and increase the risk of infant mortality. Babies are more likely to have learning disabilities and social and behavioral problems when their mothers use alcohol or drugs during pregnancy. Babies with mothers who use alcohol are at risk for problems from fetal alcohol syndrome.
- Children. Studies show that children who are exposed to drug abuse in the home, especially methamphetamine, have higher rates of depression, anxiety, post-traumatic stress, anger, and alcohol and drug abuse. They also are more likely to have learning problems and do poorly in school.
Recognizing a problem
The CAGE screening questionnaire is used to screen for alcohol abuse and dependence in adults. It is not used to diagnose the disease but only to indicate whether a problem may exist. If you answer "yes" to even 1 of the questions, you may have a problem with alcohol.
The CAGE questionnaire consists of four questions about your use of alcohol:1
- Have you ever felt you ought to Cut down on your drinking or drug use?
- Do you get Annoyed at criticism of your drinking or drug use?
- Do you ever feel Guilty about your drinking or drug use?
- Do you ever take an Early-morning drink (eye-opener) or use drugs first thing in the morning ("a little hair of the dog that bit you") to get the day started or eliminate the "shakes"?
There is a strong connection between the use of drugs and alcohol and high-risk sexual behaviors. This increases a person's chance of getting sexually transmitted diseases (STDs), hepatitis C, and human immunodeficiency virus (HIV).
If you think you might have a drinking problem, take a short quiz to evaluate your symptoms:
Use the Check Your Symptoms section to decide if and when you should see a doctor.
Health Tools help you make wise health decisions or take action to improve your health.
|Interactive tools are designed to help people determine health risks, ideal weight, target heart rate, and more.|
|Interactive Tool: Do You Have a Drinking Problem?|
If you are concerned about your own alcohol or drug use:
- Recognize the early signs that alcohol or drug
use is becoming a problem. The CAGE questionnaire consists of four questions
about your use of alcohol.1 Answering "yes" to even
one of these questions may mean that you have an alcohol or drug problem.
- Have you ever felt a need to Cut down on your drinking or drug use?
- Have you ever been Annoyed at someone who has criticized your drinking or drug use?
- Have you ever felt Guilty about something you've done when you've been drinking or high?
- Have you ever take an Early-morning drink (eye-opener) or use drugs first thing in the morning ("a little hair of the dog that bit you") to get the day started or eliminate the "shakes"?
- Make an appointment with your health professional to discuss the problem.
- Attend a meeting of Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), self-help groups devoted to helping members get sober and stay that way. Call Alcoholics Anonymous or Narcotics Anonymous for the times of scheduled meetings.
If you are concerned about another person's alcohol or drug use:
- Never ignore the problem. Discuss it as a medical problem.
- Let the other person know you will support his or her efforts to change.
- Ask whether he or she would accept help. Don't give up after the first "no"—keep asking. If he or she agrees, act that very day to arrange for help. Call a health professional for an immediate appointment, or call Alcoholics Anonymous for the times of scheduled meetings.
- Participate in confrontation if it is needed.
- Attend a few meetings of Al-Anon, a support group for family members and friends of alcoholics. Read some 12-step program information.
If you are concerned about an older family member's alcohol or drug use:
- Make an appointment for a medical evaluation if you notice a decline in the person's mental alertness or ability to perform self-care functions.
- Go to the appointment with the person and discuss recent and long-term drinking or drug use problems with the health professional.
- Participate in confrontation if it is needed.
- Provide support for the person during detoxification or other treatment.
- Help set up community services in the home, if needed. Older adults may benefit from such community services as home care, nutritional programs, transportation programs, and other services.
- Help with decision-making. Many older people with substance abuse problems are unable to process information or effectively communicate their decisions.
If you are concerned about a teenager's alcohol or drug use problem:
- Make an appointment for a medical evaluation for your teen if he or she shows signs of substance abuse.
- Go to the appointment with your teen and discuss recent and long-term drinking or drug use with the health professional.
- Participate in confrontation if it is needed.
- Provide support for your teen during detoxification or other treatment.
out what services are available in your area.
- Discuss the need for a referral to your employee assistance program with your human resources department, if you have the service available.
- Speak with your teen's school counselor or resource officer.
- Go to the Web site http://drugstrategies.org/teens/programs for information about teen drug treatment programs across the United States.
- Contact the National Clearinghouse for Alcohol and Drug Information (NCADI) at 1-800-729-6686 or online at www.health.org for information about treatment programs in your area.
- Help with decision-making. Many teenagers who have alcohol or substance abuse problems are unable to process information or effectively communicate their decisions.
Symptoms to Watch For During Home Treatment
Use the Check Your Symptoms section to evaluate your symptoms if your alcohol or drug problem becomes more frequent or severe.
Some alcohol and drug abuse problems can be prevented.
- Do not drink alcohol or use drugs if you are pregnant. Drinking or using drugs before trying to become pregnant and during pregnancy increases your baby's chances of being born with birth defects and fetal alcohol syndrome.
- Talk to your children about the effects of alcohol and drugs. Children are less likely to use alcohol or other drugs if their parents teach them early (during the elementary school years) about the effects of alcohol and drugs. Set a good example for your children by not abusing alcohol or using drugs.
- Encourage your teenager to avoid alcohol and drugs. Drinking or using drugs during the teen years can harm growth and development. It can also cause some teens to develop substance abuse problems later in life. Drug use in this age group increases the chance that your teen will be involved in crime, high-risk sexual behavior, accidents, and injuries.
- Provide nonalcoholic beverages at parties and meals. Don't give your children the impression that you have to have alcohol to have a good time as an adult.
- Cut down on your drinking. Safe levels are: less than 2 drinks a day for men and 1 drink a day for women. One drink is 12 fl oz (360 mL) of beer, 5 fl oz (150 mL) of wine, or 1.5 fl oz (45 mL) of hard liquor. Do not drink every day.
- Look for signs of mental stress. Try to understand and resolve sources of depression, anxiety, or loneliness. Don't use alcohol or drugs to deal with these problems.
- Ask your pharmacist or health
professional whether any of your current medicines can cause dependence.
- Be especially aware of pain medicines, tranquilizers, sedatives, and sleeping pills. Follow the instructions carefully and do not take more than the recommended dose.
- Make sure that your health professionals are aware of medicines prescribed by another health professional. Use only one pharmacy when getting your prescriptions filled.
- Do not regularly use medicines to sleep, lose weight, or relax. Seek nondrug solutions.
- Do not suddenly stop taking any medicine without your health professional's supervision.
- Do not drink alcohol when you are taking medicines. Alcohol can react with many medicines and cause serious complications.
- Do not smoke or use other tobacco products. Many people relate tobacco use to alcohol and drug use. For more information, see the topic Quitting Smoking.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:
- How often do you drink or use drugs? What drugs do you use?
- Do you use alcohol and other drugs, both prescription and nonprescription, at the same time?
- Do you sometimes drink or use more than you mean to?
- What types of alcohol or drugs do you use? How much do you use each day?
- Do you drink or use drugs when you feel "stressed"?
- Do you drink or use drugs when you are alone?
- Can you drink or use more of a certain drug now than you used to be able to?
- Have you tried to cut back on your drinking or drug use, but were unable to?
- Have you had a drink or used drugs today?
- How old were you when you first used alcohol or drugs?
- When did you use the highest dosage of alcohol or drugs in your life?
- Have you ever had a blackout while drinking or using drugs?
- Is alcohol or drug use causing problems with your work, your school, or in your family?
- Have you ever been treated for a seizure or an irregular heartbeat?
- How often have you changed jobs in the past 5 years?
- Does anyone else in your immediate family have an alcohol or drug abuse problem?
- Have your family or friends ever told you they thought you had a problem with alcohol or drugs?
- Have you ever been treated for a similar problem in the past?
- Have you or anyone else in your family ever been treated for depression?
- Have you ever thought about or tried to commit suicide?
- Have you ever tried to harm yourself or thought of suicide while drinking or using drugs?
- Have you ever abused a child or intimate partner while using alcohol or drugs?
- Have you ever been hospitalized for a drug or alcohol problem? If so, be prepared to discuss the details with your health professional.
- What prescription and nonprescription medicines do you take? Bring a complete list with you to your appointment.
- Do you have any health risks?
|Author||Jan Nissl, RN, BS|
|Editor||Susan Van Houten, RN, BSN, MBA|
|Associate Editor||Tracy Landauer|
|Primary Medical Reviewer||Martin Gabica, MD - Family Medicine|
|Specialist Medical Reviewer||H. Michael O'Connor, MD - Emergency Medicine|
|Last Updated||January 14, 2010|
Last Updated: January 14, 2010