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 get drunk 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.
Drugs
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."
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.
High-risk groups
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.
Women.
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"?
Do you have any of the following symptoms that require emergency treatment?
Call 911 or other emergency services immediately.
Seek care immediately if you or someone you know:
Becomes
unconscious after drinking alcohol or taking
drugs.
Has a history of heavy drinking and has severe
withdrawal symptoms, such as confusion and severe
trembling. Severe withdrawal symptoms, such as delirium tremens (DTs), can
cause death.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
If you suspect the alcohol or drug problem is related to:
Have you ever had a blackout while using alcohol or
drugs?
If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.
Home Treatment
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.
Check
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 http://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.
Prevention
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 Tobacco Use.
Saitz R, et al. (2003). Addressing alcohol problems in
primary care: A cluster randomized, controlled trial of a systems intervention.
Annals of Internal Medicine, 138: 372–382.
Other Works Consulted
Ewing JA (1984). Detecting alcoholism: The CAGE
questionnaire. JAMA, 252: 1905-1907.
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
Saitz R, et al. (2003). Addressing alcohol problems in
primary care: A cluster randomized, controlled trial of a systems intervention.
Annals of Internal Medicine, 138: 372–382.
