1. MEN’S HEALTH H306 FALL 2014 Alcohol, Tobacco, and Illicit Drugs

2. What Is Addiction and What Are Its Effects? Continued involvement with a substance or activity despite ongoing negative consequences. The costs of alcohol, tobacco, and drug addiction exist on a personal as well as societal level. Addictive behaviors initially provide a sense of pleasure that the addict cannot achieve in other ways. Chemicals are responsible for the most profound addictions, along with mood changes.

3. Four common symptoms of addictions Compulsion: excessive preoccupation with the behavior and an overwhelming need to perform it Loss of control: the inability to reliably predict whether any isolated occurrence of the behavior will be healthy or damaging Negative consequences: physical damage, legal trouble, financial problems, academic failure, or family problems caused by the behavior Denial: the inability to perceive that the behavior is self-destructive

4. Alcohol: An Overview Alcohol and American Adults:  61 percent of Americans consume alcohol regularly  25 percent abstain from drinking Alcohol and College Students:  Approximately 63 percent of students have consumed alcoholic beverages in the past 30 days.  Almost half are classified as heavy drinkers.  Many students have a misperception about “normal drinking” behavior, and believe their peers drink more than they actually do.

5. Dangers of Alcohol Use and Abuse Alcohol abuse is common on college campuses.  Most popular drug among college students.  Almost half of college students engage in binge drinking. Alcohol profoundly affects the body.  Contains ethanol, an addictive drug that is absorbed throughout the whole gastrointestinal system.  The higher the alcohol concentration, the faster it is absorbed by the body.  Proof: Measure of the percent alcohol 80 proof whiskey = 40 percent alcohol  Mood also affects alcohol use; absorption is much faster when people are tense or stressed.

6. Alcohol: An Overview  Binge Drinking  A pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 gram-percent or above  Binge drinking is defined as consuming within 2 hours: 5 drinks in a row for a man 4 drinks in a row for a woman  Many colleges are trying to address the problem: Cognitive-behavioral skills training with motivational interviewing Social norms approach Working to change misconceptions

7. Alcohol: An Overview High-Risk Drinking and College Students  Why is binge drinking the number one cause of preventable death among undergraduate students? Alcohol exacerbates their already high risk for suicide, automobile crashes, and falls. Customs, norms, and traditions encourage dangerous drinking. Drinking is heavily advertised and promoted on campuses. Students are more likely to engage in drinking games. Students are more vulnerable to peer influences and peer pressure. College administrators often do not admit to a problem on campus.

8. Short-Term and Long-Term Alcohol Effects

9. Dangers of Alcohol Use and Abuse Drinking and driving is a major safety threat.  About 39% of all traffic deaths are alcohol related. Alcohol use can lead to alcoholism.  Problems are often denied by alcohol abusers.  Multiple symptoms are common, including the inability to stop drinking, feelings of guilt or remorse, and memory loss. Recovery from alcohol addiction is difficult.  People often experience many serious problems before they’re ready to deal with their addiction.  First step to recovery is regaining a sense of personal control and assuming responsibility for one’s actions.

10. Alcohol Use and Injuries  13 percent of emergency room visits by undergrads are for alcohol- related injuries  Patients with a BAC over 0.08% are 3.2 times more likely to have a violent injury than an unintentional injury.  Most people admitted to the ER are men aged 21 and over, most as a result of accidents or fights in which alcohol was a factor.

11. Alcohol and Sexual Decision Making  Alcohol lowers inhibitions, impairing the ability to make wise decisions regarding sexual activity  70 percent of college students admit to having engaged in sexual activity primarily as a result of being under the influence of alcohol.  Less likely to use safer sex practices  Risk of contracting sexually transmitted infections (STIs) or pregnancy increases among those who drink heavily

12. Alcohol Poisoning  Consuming large amounts of alcohol in a short period of time can be lethal.  Alcohol alone or mixed with another drug is responsible for more toxic overdose deaths than any other substance.  Deaths are caused by either central nervous system and respiratory depression or by inhalation of vomit or fluid into the lungs  Signs include inability to be roused; weak and rapid pulse; unusual breathing pattern; cool, damp, pale, or bluish skin.  Call 9-1-1 immediately

13. Drinking and Driving  2008, 32% of all traffic fatalities were alcohol related.  Many college students drink and drive.  In 2008, there were 11,773 alcohol-impaired driving fatalities in the United States.  This represents one alcohol-related fatality every 45 minutes  At BAC 0.10 a person is approximately 10 times more likely to be in an accident.

14. Alcoholism Identifying a Problem Drinker  Abuse interferes with work, school, and relationships.  Alcoholism (alcohol dependence) results when personal and health problems related to alcohol use are severe, and stopping alcohol consumption results in withdrawal symptoms.  Characterized by craving, loss of control, physical dependence, and tolerance

15. Alcoholism The Causes of Alcohol Abuse and Alcoholism  Biological and family factors  Alcoholism is 4 to 5 times more common among children of alcoholics  Heredity accounts for two-thirds of the risk for becoming an alcoholic.  Social and cultural factors  Family attitudes  Weakening of family links  Combination of heredity and environment

16. Alcoholism Costs to Society  It is estimated that alcohol is directly or indirectly responsible for over 25 percent of U.S. medical expenses and lost earnings  Cost of underage drinking is estimated at $61.9 billion annually.  Includes crashes, violent crime, FAS, high-risk sex, poisoning, psychosis, and treatment for alcohol dependence

17. Alcohol Content in Common Drinks

18. Blood Alcohol Levels in the Body Blood Alcohol Concentration (BAC)  Ratio of alcohol to total blood volume  The legal limit for BAC is 0.08 percent in all states.  Both breath analysis (breathalyzer tests) and urinalysis are used to determine whether an individual is legally intoxicated, but blood tests are more accurate.  Learned behavioral tolerance—though BAC may be quite high, the individual has learned to modify his behavior to appear sober

19. Approximate Blood Alcohol Concentration (BAC) and the Physiological and Behavioral Effects

20. Discussion E valuate Your Drinking Habits: How many alcoholic drinks do you have on a typical day when you are drinking? How often do you have six drinks or more on one occasion? How often during the last year have you been unable to stop drinking once you had started? How often during the last year have you failed to do what was normally expected from you because of drinking? How often during the last year have you needed a drink in the morning to get yourself going after a heavy drinking session? How often during the last year have you had a feeling of guilt or remorse after drinking? How often during the last year have you been unable to remember what happened the night before because you had been drinking?

21. Tobacco Use in the US Tobacco and Social Issues  Single most preventable cause of death  438,000 Americans die a year  50 times that of illegal drug deaths  Teen smokers = 27.5 percent of all smokers Advertising  $36 million per day spent on tobacco-related advertising.  Children and teens constitute 90 percent of new smokers.

22. Tobacco Use in the US Financial Costs to Society  $193 billion in annual health-related economic losses  $95 billion in medical expenditures College Students and Tobacco Use  In 2007, 19% reported having smoked in the past 30 days  “Social smokers” are those who smoke when they are with people, rather than alone.

23. Dangers of Tobacco Use Nicotine, a powerful stimulant, is the major psychoactive substance in tobacco products. When smoked, nicotine is released and inhaled into the lungs, along with tar and 4,700 other chemicals including arsenic, formaldehyde, and ammonia. Cigarette smoke also contains carbon monoxide, a dangerous gas. When smoked, its concentration is 800 times higher than the level considered safe.

24. Dangers of Tobacco Use Short-Term Effects and Risks of Nicotine Use  Aroused mental state.  Increased heart and respiratory rates.  Constricted blood vessels.  Reduced appetite. Long-Term Effects and Risks of Nicotine Use  Cancer.  Cardiovascular disease.  Respiratory diseases, especially emphysema.  Sexual dysfunction.  Gum disease. Nicotine poisoning is the symptoms experienced by new smokers; includes dizziness, rapid pulse, damp skin, nausea, and vomiting.

25. Dangers of Tobacco Use Secondhand smoke is air pollution from tobacco smoke.  Mainstream smoke is emitted from a smoker’s mouth. Sidestream smoke is emitted from the burning end of a product.  About 50,000 deaths occur each year from secondhand smoke. Quitting smoking is not easy.  90% of people who try to quit smoking fail.  Smokers often falsely believe they can “quit anytime.”  Nicotine is deeply addictive in the brain and body.  Consistent treatment and efforts can result in quitting.  Within 1 year of quitting, risks of major disease start to substantially reduce.

26. Short-Term and Long-Term Smoking Effects

27. Benefits of Quitting Smoking

28. Dangers of Drug Use and Abuse Drug misuse and abuse are huge societal problems. Drug misuse = using drugs for an unintended purpose. Drug abuse = excessive use of any drug. Drug use contributes to the death of 120,000 Americans yearly. Costs taxpayers more than $294 billion a year in preventable health care expenses, law enforcement, auto accidents, crime, and lost productivity.

29. Commonly Used Drugs Marijuana  Long-term studies show it causes lung damage.  Other risks include immune function suppression, blood pressure changes, and impaired memory.  Risks for women also include lower infant birth weight, higher miscarriage probability, and nervous system abnormalities in infants. Designer Drugs (“Club Drugs”)  Produced in chemical laboratories, made in private homes, sold illegally.  Commonly include Ecstasy (mood enhancer), GHB (tranquilizer), and Special K (anesthetic).  Dangers include brain damage, loss of consciousness, seizures, respiratory distress, and death.

30. Commonly Used Drugs Stimulants  Powerful drugs that stimulate the central nervous system.  Among the most addictive substances available.  Include cocaine (a naturally occurring stimulant) and amphetamines (synthetic agents). Depressants  Agents that depress central nervous system functions.  Include opiates such as morphine, codeine, and heroine.  Highly addictive, sometimes deadly, substances. Hallucinogens  Primary effects alter feelings, thoughts, and perceptions.  Mainly consumed for hallucinogenic side effects; all are illegal.

31. Commonly Used Drugs Inhalants  Chemicals that produce vapors that, when inhaled, create euphoric effects.  Include rubber cement, model glue, paint thinner, lighter fluid, varnish, wax, spot removers, and gasoline. Steroids  Artificial forms of the male hormone testosterone, used illegally to promote muscle growth and strength.  Many claims for their effectiveness are unfounded, and side effects can be serious and lifelong. Prescription Drugs  Abuse of prescription drugs has risen steeply in recent years.  When not taken as directed they can be extremely dangerous, especially when taken in high doses or combined wrongly.

32. Prevalence of Drugs among College Students

33. Prevalence of Drugs among College Students, continued

34. Overcoming Drug Abuse Vast body of evidence suggests that it’s almost inevitable that prolonged drug use will lead to addiction. Most addicts need specialized medical and psychological treatment to help them quit. Main treatments are drug programs combined with medications and behavioral therapy. Resources include hospitals, outpatient clinics, residential programs, and community-based 12-step programs.