Adapted from "Dealing with Alcohol" module, Pre-Service Health Training for Volunteer Binder, Peace Corps Office of Medical Services

BACKGROUND

Alcohol (ethanol) is a psychoactive drug that causes depression of the central nervous system (brain and spinal cord). It is a legal drug, readily available, and its use is generally accepted throughout the world. Alcohol, when consumed responsibly (e.g., with meals, at social gatherings, celebrations, and in religious ceremonies), is generally not harmful for healthy people. However, the potential for abuse of alcohol is quite great, and it is extremely difficult to alter a pattern of alcohol once it has been established. While seeming to relieve stress, alcohol has the potential of becoming psychologically and physically addictive. It is important that students realize that they are at risk for alcohol abuse.

ALCOHOL AND THE CULTURE

The use of alcohol is encouraged in some societies and prohibited in others. In most cultures there are methods for controlling drinking, but these vary and may not be obvious to a person unfamiliar with a particular culture.

WHY STUDENTS ARE AT RISK

Excessive or inappropriate use of alcohol is often associated with stress. An individual may begin or increase drinking after a loss, disappointment, change in environment, or because of loneliness. These stressors are common among students. Students are at particular risk for increasing alcohol use or developing an abusive pattern for a variety of reasons. Among them are:

• Stress of adjustment
• Depression
• Boredom
• Desire to please others
• Easy availability and low cost of alcohol
• Peer pressure
• Pressure form local culture
• Student may be a "novice drinker"
• Frequency of alcohol consumption in the local culture

Alcohol dependence often has a familial pattern and at least some of the transmission can be traced to genetic factors. The risk for alcohol dependence is 3-4 times higher in close relatives of people with alcohol dependence.

DEFINITIONS

Abuse: Misuse of a drug causing adverse consequences (physical, social or psychological)

Dependency: Relying on, being influenced by, or needing a particular drug.

Intoxication: A spectrum of alteration of behavior and/or conscious state caused by alcohol or drug ingestion.

Tolerance: The ability to endure continued or increasing use of a drug, thereby requiring larger doses to achieve the desired effects.

Withdrawal: A psychological and/or physical syndrome caused by the abrupt reduction in dose, or cessation of, a drug on which a person is dependent.

Detoxification: The process of safely removing a drug from the body.

EFFECTS OF ALCOHOL

Alcohol abuse has many behavioral and physical effects.

Behavioral effects can include:

• Irritability
• Moodiness
• Anxieties, loss of judgment
• Violent behavior
• Impulsiveness
• Inability to cope

Physical effects can include:

• Alterations of muscle coordination, tremors and convulsive disorders
• Liver damage
• Sexual dysfunction and impotence
• Heart disease
• Gastrointestinal irritation and ulcers
• Malnutrition
• Cancer of the mouth, esophagus, or stomach

SYMPTOMS OF ALCOHOL ABUSE

The essential feature of alcohol abuse is a maladaptive pattern of use manifested by recurrent and significant adverse consequences related to the repeated use of alcohol. Symptoms of abuse may include:

• Daily use of alcohol (particularly if required to function normally).
• Inability to reduce intake, despite efforts to do so.
• Increasing alcohol consumption.
• Neglectful appearance.
• Blackouts (loss of memory of events which occurred when intoxicated).
• Continued drinking despite having a serious physical disorder that is aggravated by alcohol.
• Violence when intoxicated.
• Unexplained injuries.
• Binge drinking (episodes of remaining intoxicated for days at a time).
• Drinking alone.
• Legal difficulties (e.g., DUI).
• Failure to meet obligations to family, friends, or at work.
• Erratic or compulsive behavior.
• Deterioration of physical or psychological functioning.

RESISTING SOCIAL AND CULTURAL PRESSURES TO DRINK

Some personal strategies, which may help, include:

• Understanding why you are choosing to use alcohol
• Making rules for oneself to guide drinking
• Setting personal limit for drinking, sticking to it, or drinking less
• Providing more non-alcoholic than alcoholic beverages for oneself, friends and guests
• Maintaining daily physical activity
• Drinking only with meals
• Making oneself aware of the impact one's drinking has on oneself and others

WHO HAS A DRINKING PROBLEM?

Positive responses to any of the following may indicate that a drinking problem exists:

• Can you drink more than other people without showing it?
• Do you have a drink at about the same time every day?
• Have you ever spoiled a party or outing by getting drunk?
• Have your family or friends talked to you about your drinking?
• Have you ever lost time from work because of your drinking?
• Do you need a drink in the morning?
• Do you ever wake up unable to remember what happened that night before?
• Do you take a drink before going to a party where drinks will be served?
• Do you ever drink enough to get high when you are alone?
• Has drinking become the most important and pleasurable of your activities?

GETTING HELP

A student's use of alcohol can become such a part of daily life, that it may not be recognized as a problem. Denial is a common defense which can also interfere with seeking help. However, few people struggling with alcohol can overcome that problem alone. Administrators should support treatment of alcohol abuse as both a medical and social/personal problem to be addressed. Students should be made aware of whether a discussion will be confidential.

Adapted from "Dealing with Alcohol" module, Pre-Service Health Training for Volunteers Binder, Peace Corps Office of Medical Services