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There is a debate regarding the
discovery and evolution of alcohol consumption. However, today
its use is so widespread that most cultures exhibit regular use.
Even though it is our most used and abused mood-altering
substance, it is often not thought of as a drug. Because its use
is legal, attitudes and social expectations concerning alcohol
intake tend to minimize the issue of misuse.
Alcohol is classed a drug because
its main ingredient, ethanol, acts on the central nervous system
(CNS) as a depressant, slowing down activity. In addition to
alcohol, the classification "depressants" includes
benzodiazepines (e.g., Valium® and Ativan®) and barbiturates
(e.g., Seconal®). At low doses, alcohol may appear to act as a
stimulant, but this is because it affects brain areas
responsible for the control of inhibitions - as people lower
their inhibitions, they become more talkative and seem to have
more energy. At high doses alcohol causes lack of coordination,
slurred speech, and confusion. At toxic levels ingestion can
result in coma or death.
The term alcohol may refer to
rubbing alcohol, wood alcohol, or beverage alcohol. Although all
three may be consumed, toxic effects of rubbing and wood alcohol
tend to override the pleasant effects. Beverage alcohol (ethanol
or ethyl alcohol) is the form produced for oral consumption.
Through the process of fermentation or distillation various
forms and strengths of beverage alcohol are manufactured.
Depending on the product, alcohol is diluted with ingredients
which affect the strength, colour and consistency of the
beverage. Spirits such as vodka and whiskey contain about 40%
ethanol; port and sherry, 20%; wine, 12%; regular beer, 5%;
light beer, 4%; and coolers, 5 - 7%. A standard drink (0.6 oz.
of pure alcohol) is contained in 45 mL of spirits, 143 mL of
wine or 355 mL of regular beer.
When ingested, alcohol is absorbed
rapidly into the bloodstream from the stomach, small intestine,
and colon (see Figure 1.). The effects depend on the amount of
alcohol in the bloodstream - called the blood alcohol
concentration (BAC) The drinker's BAC depends on amount
consumed, length of time of consumption, as well as a person's
size, gender, build, metabolism and age. In the body, alcohol is
metabolized primarily by an enzyme in the liver and stomach.
This metabolism occurs at a constant rate of about one standard
drink per hour.
Effects of alcohol depend on not
only the physiology of the individual person but as well on:
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amount and
how it is taken
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what the
person expects and their previous drug experience
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the setting
or location, person's mental state, and other drugs used
As previously stated, alcohol has a
depressant effect on the central nervous system. Even after one
drink, many people will feel more relaxed. Drinking more can
make a person feel gregarious and possibly more self-assured,
although some people may become depressed, withdrawn and
hostile.
Blood Alcohol Concentrations (BAC),
even below the legal driving limit (in NS) of 0.08, can impair
thinking, judgement, reaction times and ability to estimate
distance. This negative impact on psychomotor function has
serious implications for drinking and driving.
Excess alcohol consumption may
cause a depression of brain activity to the point of coma and
death. Or the person may become unconscious, aspirate stomach
contents and suffocate. The risk of accidental overdose and
death is a particular concern with the adolescent whose pattern
of consumption is often rapid intake to achieve intoxication
rather than to just have a drink.
Death can occur when moderate
amounts of alcohol are taken with other depressant drugs such as
sleeping pills and tranquilizers because of their synergistic
CNS depressant effect. Even small amounts of alcohol taken with
these or other drugs such as cannabis or antihistamines can
seriously impair the user's ability to drive a car.
A bout of heavy drinking can cause
a hangover which some suggest is mild alcohol withdrawal.
Fatigue, headache, nausea, possibly vomiting and shakiness can
occur 8 to 12 hours after last use. Despite numerous "home
remedies" there is at present no effective cure for hangovers
other than time itself.
Blackouts are periods of memory
loss brought on by heavy drinking. Although the user is
conscious and functioning at the time, s/he will be unable to
remember activities or experiences which occurred during the
blackout.
"Grayout" refers to a drinker's
difficulty with recall of experiences which occurred during the
drinking period but who eventually can remember with reminders.
Other short-term effects include
increase in stomach secretions, dilation of surface blood
vessels with subsequent loss of body heat even though the person
may feel warm; increase in urine production and even some
accumulation of fat in liver cells.
Current research suggests that
moderate or occasional alcohol use (no more than two standard
drinks a day) in healthy adults is unlikely to result in
significant health problems. However, the adverse physical and
psychological effects of long term excessive use are numerous.
In particular, women and adolescents are more susceptible to
these effects than men.
Although cardiovascular benefits of
moderate alcohol consumption have been reported, the harmful
life and health impacts of heavy drinking can make encouraging
alcohol use a poor preventive measure. Better alternatives
include safe, well-established methods such as eating sensibly,
exercising regularly, and quitting smoking.
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Impact of Abuse on the Body |
Central
Nervous System
Cardiovascular and Circulatory System
Gastrointestinal System
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liver
disease - fatty liver, hepatitis, cirrhosis
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pancreatitis
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esophageal
varices
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diarrhoea
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malabsorption of food, nutritional deficiencies
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alcoholic
gastritis, ulcers
Reproductive
& Endocrine Systems
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in men,
impotence, sterility, atrophy of testes and enlargement of
breasts
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in women,
early menopause and menstrual irregularities are common
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premature
bone loss
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development
of diabetes; acute alcohol abuse can cause low blood sugar
especially in diabetics; ketoacidosis can also occur in
diabetics
Immune System
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cancer of
the throat, pharynx, mouth, and esophagus
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predisposition to lung infections such as pneumonia
-
lowered
inhibitions may lead to high risk sexual practices thus
increasing susceptibility to HIV
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evidence of
increased cancer risk for stomach, large bowel, pancreas,
lung, urinary tract, and breast
Fetal Alcohol Syndrome (FAS) and
Fetal Alcohol Effects (FAE) are terms used to identify a range
of permanent conditions (in a fetus or unborn child) caused by
alcohol consumption. A diagnosis of fetal alcohol syndrome
includes:
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confirmation of heavy drinking
during pregnancy
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growth retardation in the fetus
and infant
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central nervous system
involvement such as hearing disorders, mental retardation,
and brain malformation in the child
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characteristic facial features
of narrow eye width, thin upper lip and elongated, flattened
mid-face in the child
Fetal Alcohol Effects, milder than
the syndrome, include less well-defined effects such as
hyperactivity and learning disabilities.
Since it is currently impossible to
define safe levels of alcohol intake during pregnancy, the
wisest choice is not to drink at all during that time.
Alcohol is an addictive drug which
may cause the user to become both psychologically and physically
dependent. Psychological dependence refers to repeated ingestion
as the user begins to rely on alcohol's effects to help with
activities such as being social or getting to sleep. Physical
dependence is most often called alcoholism or addiction.
Addiction may be characterized by
the existence of preoccupation, compulsion to use, and risk of
relapse. The Central Nervous System adapts to the exposure to
alcohol and physical dependence emerges. The user develops
tolerance (need to consume more alcohol to achieve the desired
effect) and experiences withdrawal symptoms when drinking stops.
The severity of the withdrawal symptoms depends on the amount of
alcohol consumed and the length of time it is used.
Withdrawal symptoms occur as a
result of physical and/or psychological dependence on alcohol.
Symptoms can be mild, moderate, or severe depending on the dose
and duration of consumption and may begin within a few hours
after drinking stops. The user experiences symptoms which peak
within one to two days and subside in two to three days.
Symptoms may include:
Mild
Withdrawal
Moderate
Withdrawal
Severe
Withdrawal
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Uncontrollable agitation
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Gross tremor
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Anxiety
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Severe autonomic
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Seizure(s) activity
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Disorientation
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Delirium tremens
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Death
In treatment of addiction,
detoxification is the first step. Due to variations in
symptoms and possible complications, it is recommended
that the individual undergo a thorough assessment to
assist in the development of an appropriate and safe
treatment plan. Standard treatment of moderate to severe
withdrawal without complications includes subdued
surroundings and a regimen which includes medication
with the pharmacological equivalent to alcohol (a
benzodiazepine such as Librium® or Valium®).
Statistics for Drug Dependency
Services, Nova Scotia April 1, 1995 to March 31, 1996 showed
that alcohol was the most frequently used drug for 89.5% of male
clients, 62% of female clients, and 95% of adolescent clients.
A province-wide survey of junior
and senior high schools (1996) revealed that 20.8 % of grade 7's
and 77.5 % of grade 12 students consumed alcohol in the course
of the year that 30.3% of students consumed alcohol more than
once per month. During the four weeks prior to the survey, 28.4
% of students reported they drank five or more drinks at a
sitting on at least one occasion.
Alcohol sale and consumption is
governed under provincial statutes with the Nova Scotia Liquor
control Act. The legal drinking age in Nova Scotia is 19 years.
It is illegal for anyone under that age to possess, consume or
purchase alcohol. It is also illegal to sell or supply alcohol
to anyone under 19 years. Selling or supplying alcohol to any
person who appears to be intoxicated is also illegal. It is an
offence to drive a vehicle with a blood alcohol concentration of
0.08% or greater. Drinking and driving is by far the largest
criminal cause of death and injury in Canada.
Drug Dependency
Services
Central Regional Health Board
300 Pleasant Street
PO Box 896
Dartmouth, NS B2Y 3Z6
Phone: 1-902-424-5623
Fax: 1-902-424-0627
Addictions
Services
Eastern Regional Health Board
115 Alexandra Street
PO Box 640
Sydney, NS B1P 6H7
Phone 1:
1-902-563-2050
Phone 2: 1-902-563-2550
Fax: 1-902-563-2059
Addictions
Services
Northern Regional Health Board
199 Elliott Street
PO Box 359
Pictou, NS B0K 1H0
Phone:
1-902-485-4335
Fax: 1-902-485-7026
Addictions
Services
Western Regional Health Board
Yarmouth Regional Hospital
50 Vancouver Street
Yarmouth, NS B5A 2P5
Phone:
1-902-742-2406
Fax: 1-902-742-0684
Drug Dependency Services, Central
Region, 1999
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