Scenario cards Alcohol overdose cards (available from your local AHS Addictions and Mental Health office)

Transcription

1 CALM Lesson 1 Alcohol 101 Description In this lesson, students discuss the alcohol-related choices that they face. They review the effects of alcohol (physical, mental and emotional) and the potential consequences (physical and social) of alcohol use. They also learn some harm reduction techniques. Content and time (75-minute lesson) 1. All those burning questions about alcohol (40 minutes) 2. Consequences activity (30 minutes) 3. Closure: Key messages ( 5 minutes) Required materials Scenario cards Alcohol overdose cards (available from your local AHS Addictions and Mental Health office) Note to teachers This is the first lesson of a series of three lesson plans. Each can be taught on its own, but the lessons are best taught in sequence. For other approaches to teaching students to think critically about alcohol, please refer to the Social Studies lessons, which are also available to teachers. 1

2 1. Making informed decisions about alcohol (40 minutes) Sometimes people consider alcohol to be a taboo topic, especially when it comes to youth who are underage. But it is important to acknowledge that your students might be regularly faced with the choice of whether to drink or not. If they choose to drink, they will be faced with another choice: how much? Discussion: Reasons for and against drinking There are reasons for and against drinking and reasons why students may choose to drink moderately or to drink too much. Take some time to discuss these reasons with students: if they have thought about them outside of the social situations in which they are faced with drinking decisions, they will be better prepared to make considered, careful choices. Be sure to explore the physical, mental and emotional consequences of each choice. We have outlined some examples in a table below; some of them may match answers from your students. Remember to include a discussion about the relative importance of each consequence. For example, there may be only two negative consequences of choosing not to drink and seven positive consequences: however, those two negative consequences may significantly outweigh the seven positive consequences. 2

3 Choice Possible Positive Consequences Possible Negative Consequences Not to Drink Avoid both long-term and short-term harm associated with alcohol use Avoid social embarrassment Can be responsible and assist others who are drinking in a party setting Continue to make positive decisions Choose the best option for health of your mind and body Have fun and maintain judgment and co-ordination Experience peer pressure to drink Feel like you don t fit in Drink Drink Too Much Get a temporary feeling of well-being, relaxation Experience positive results of less inhibition Feel pleasant sensation of warmth Feel pleasant emotions more intensely Have fun Bond with friends Mark a rite of passage (marks the transition to adulthood; gives you knowledge, understanding and experience that is associated with being an adult) Feel depressant effects Experience negative results of less inhibition Lose some judgment and self-control Lose memory, reasoning ability, and caution Suffer slight impairment of balance, speech, vision, hearing and reaction time Behave in exaggerated ways and feel unpleasant emotions more intensely Believe that you are functioning better than you really are Look like a sloppy drunk Have difficulty walking, lack physical control Experience blurred vision and poor balance Become emotionally erratic Go from feeling euphoric to feeling dysphoric (anxious and restless) Feel dazed, confused or otherwise disoriented with severely impaired judgment Experience nausea and vomiting Black out (you are unable to remember what has happened) Lose consciousness (you pass out suddenly and are difficult to awaken) Risk asphyxiation from choking on vomit and risk seriously injuring yourself in a fall or other accident May not feel pain if you injure yourself To make good decisions, consider both the pros and cons. 3

4 Discussion: All those burning questions about alcohol Students need to be aware of their choices and corresponding consequences, but they also need good, accurate information on which to base their decisions. Ask your students the following questions and create discussion with their answers. Be sure to provide students with the correct and accurate answers to the questions. Be sure to debunk any common myths that their discussion may raise and provide the facts. Note to teachers The following list of questions is by no means exhaustive, but it will give you a start for the important information. You know your school and the current trends in your school, so feel free to add questions that you feel are relevant. Be sure to encourage your students to talk to an adult they trust for more information, such as their parents, a teacher, or a counsellor. You may also suggest they visit a trustworthy website. Your students may feel that their experiences differ from the typical effects of alcohol described below. It is important to hear their experiences and discuss how these experiences may still fit with the facts provided here. For example, students may say that a cup of coffee helps them get sober sooner. However, there is a difference between feeling sober and actually recovering normal functioning of the body. Coffee may make them feel more alert and awake (and therefore sober ), but that is due to the physiological effects of caffeine. They do not feel as sleepy, but the other effects of alcohol remain. This is not the same as being sober, which requires the removal of alcohol from the blood. The body can eliminate one standard drinking unit of alcohol every one-and-a-half to two hours. There is no way to speed up this process. 1. How do I get drunk? When you take a drink, about 20% of the alcohol is absorbed by your stomach; the remaining 80% is absorbed in your small intestine. After the alcohol is absorbed, it enters your bloodstream and is carried throughout your body. Your body simultaneously works to remove the alcohol from the bloodstream. You don t need to drink much before you are taking in alcohol faster than your body can remove it. When this happens, your blood alcohol concentration (BAC) goes up. The increase in BAC soon causes you to feel the physical effects of alcohol. Ultimately, many of the effects of alcohol act on your brain. Alcohol affects the different regions of the brain in different ways: Alcohol first affects the frontal lobes of your cerebral cortex, where thought processing and consciousness are centred. In these lobes are the behavioural inhibitory centres. Alcohol depresses these inhibitory centres, which means you become less inhibited. Alcohol slows your ability to process information from your eyes, ears, mouth, and other senses. It becomes difficult to think clearly as alcohol inhibits thought processes. Next, alcohol affects the cerebellum, your centre of movement and balance, resulting in a staggering, off-balance gait. 4

5 Finally, alcohol affects the medulla or brain stem, which is the area of the brain that handles such automatic functions as breathing, consciousness and maintaining body temperature. It can slow breathing and lower body temperature and even affect the heartbeat. It is the loss of these automatic functions that can cause unconsciousness, coma and death. 2. Why do I get a headache after drinking? Alcohol has a dehydrating effect. When you drink it, your body increases urine production in order to eliminate the ethanol. The resulting dehydration causes headaches, dry mouth, and lethargy. Dehydration also causes fluids in the brain to be less plentiful. This can be mitigated by drinking water after consuming alcohol. Alcohol's effect on the stomach lining may account for the nausea that might accompany your headache. 3. Why do I say and do things I never intended to when I m drunk? The answer to this question goes back to what we learned about the brain in the first question. Alcohol depresses (slows down) different parts of the brain, including the part that controls inhibition, reasoning and judgement. This is the part of your brain that allows you to make good decisions or, for example, to think before you speak. Since alcohol depresses the inhibitory and reasoning centres, you are less likely to think before you act or speak. 4. Why do I pass out? The answer to this question also goes back to our earlier discussion of the brain. Excessive drinking leads to a high concentration of alcohol in the blood, and eventually this affects the brain stem, the part of our brain that controls automatic functions like maintaining the heart rate and breathing. This is very serious: passing out, in plain language, is your body shutting down. But passing out is not the only sign of alcohol poisoning. Other signs include mental confusion vomiting seizures slow breathing (fewer than eight breaths per minute) irregular breathing (10 seconds or more between breaths) hypothermia (low body temperature), bluish skin colour and paleness This is a good time to talk to your class about the alcohol recovery position. If you feel it is appropriate, ask your class if they would know what to do if they or a friend had alcohol poisoning. Do they know how to keep their friends safe? Demonstrate the alcohol recovery 5

6 position, and allow them to practise with one another. Feel free to use the alcohol recovery pamphlet to supplement this discussion. 5. How much alcohol is too much? Many different factors affect a person s level of intoxication, so it is difficult to gauge exactly how much is too much. What is known is that it takes one-and-a-half to two hours for your body to metabolise one standard drink (see below for definition of a standard drink). It is important to note that there are a large number of factors that greatly affect how your body may react to alcohol. For example, if you drink at a rate faster than your body can eliminate alcohol or mix alcohol with other substances such as energy drinks, you are at an increased risk of harm. For that reason, Health Canada has released low-risk drinking guidelines. Not all alcohol is created equal. Serving sizes and alcoholic strength vary and often contain more alcohol than one standard drink. These guidelines refer to standard drinks of beer, wine, spirits and coolers which contain approximately 13.6 g of pure alcohol. The following are roughly equal to one standard drink: a 345-ml (about 12 ounces) bottle of 5% strength beer, cider or cooler a 140-ml (about 5 ounces) glass of 12.5% strength wine a 40-ml (about 1.5 ounces) shot of 40% strength spirits This can be a good time to ask students what types of choices and behaviour they have seen among adults who demonstrate responsible use of alcohol. Their answers could include setting limits and sticking to them alternating alcoholic drinks with caffeine-free, non-alcoholic beverages, such as juice, pop or water eating before or while you are drinking drinking slowly, no more than two standard drinks in a three-hour period avoiding risky situations and activities drinking below the maximum limits if you are not used to alcohol, have a low tolerance for alcohol or have a low body weight 6. Is there a difference in the way alcohol affects women and men? In general, if a woman and a man drink the same amount of alcohol, the woman feels stronger effects and feels the effects sooner. This is because women have a lower body water content. Alcohol is more diluted in a man s body, more concentrated in a woman s. The way alcohol is processed by women s bodies is also different from the way it is processed by men s. These differences cause women to feel intoxicated more quickly than men do. 6

7 7. How do I sober up quickly? You can t. The bottom line is that only time can help you sober up. The time it usually takes for your body to remove one standard unit of alcohol is one-and-a-half to two hours. Coffee helps you feel more awake, a shower refreshes you, and eating feeds you, but none of these helps you to get sober. After an extremely heavy night of drinking, it is possible to still be drunk the next morning even if you don t feel like you are. 8. How long do I have to wait before I can drive? There are so many factors that affect how alcohol is metabolized and absorbed into the bloodstream that there is no one definitive answer. That being said, five 12-ounce beers represent five standard drinks, which would take a total of 7.5 to 10 hours to fully clear out of the bloodstream. It is worth reminding students that with graduated licensing, the law does not tolerate any alcohol in the bloodstream. 2. Consequences activity (30 minutes) In this activity, you will lead your students through some of the typical and real consequences that people experience after making the choice to drink, not to drink, or to drink too much. The intent is to help students recognize that there are more consequences than just feeling hung over or drinking and driving. As a word of caution, it is important to emphasize that the situations presented are hypothetical. Your students may recognize behaviour that they or others have exhibited while drinking. Remind them to respect other people s privacy by not using real names and events in this activity. Ask up to six volunteers to take turns standing at the front of the room, one at a time. Fully explain what students are volunteering for so that they are not unpleasantly surprised. Each volunteer will assume the role of someone who has been faced with a choice about drinking. The rest of the class will read a sign describing something that the volunteer did while he or she was drinking. The volunteer is not allowed to look at their sign and should not be aware of the contents of the sign. Six proposed signs are outlined below; however, please feel free to use the consequences brainstormed earlier in class if you think they would resonate better with students. I drank too much and threw up all over the couch and the people sitting on it. I didn t drink and played well at my basketball game the next day because I wasn t hung over. I drank and had fun with friends. I drank too much and betrayed a friend. I didn t drink and felt a little left out from my friends who were drinking. I drank and my judgment became impaired and I kissed someone I didn t want to. 7

8 The object of the game is to have the class treat the volunteer according to the role he or she has assumed. The class can give hints about events that occurred, without being obvious or directly stating what happened. They might say, for example, Don t you remember what you said to me? I was sitting right beside you when it happened! I can t believe you went with him. Even though the situations are hypothetical, stress the importance of refraining from using hurtful comments. The volunteer can also ask specific questions about his or her behaviour, such as, Was I rude to you? Did I hurt you? Did we leave alone or with other people? This student will attempt to guess what the sign says he or she is supposed to have done. You may also allow the class to indicate if he or she is hot, warm or cold in guessing. The game is played until the volunteer guesses the behaviour described on the sign. You can repeat the game using other volunteers. Debrief with students the effects of their choices: How do the choices and consequences make you feel? Do your friend s potential reactions and judgments influence your decisions? Is the consequence positive or negative? Does gender have an impact on the consequences? If you find that students are sharing personal experiences, try to bring the conversation back to a more general context. Remind everyone of the importance of confidentiality when describing events that involve others. Closure: Key messages (5 minutes) Alcohol shouldn t be a taboo topic, especially when it comes to youth who are underage. Many teenagers will be faced with the choice of whether or not to drink. If they choose to drink, they will be faced with another choice: how much? There are reasons for and against any choice they make: to drink or not, to drink moderately or to drink too much. It is important that students understand the reasons they might have to make any one of these choices, and that they have the information they need to make better decisions. 8

9 HANDOUT / REFLECTION Note to teacher: This handout contains instructions to you that should be deleted before you reproduce it for distribution. Short-Term Effects of Alcohol So what happens when you have a few drinks? Why do bad things seem to happen more often when people drink? Remember that a glass of wine, bottle of beer and 1.5 ounces of hard liquor all have the same alcohol content. No matter what you drink (beer, wine, spirits),it s all the same to your body. When you swallow alcohol, it goes into your stomach and small intestine and is absorbed by the bloodstream. The bloodstream takes the alcohol throughout the body and to the brain. The brain is the one organ in our bodies that controls every function we have, for example, breathing, sight, memory, balance, talking, texting. Since alcohol is a depressant, it depresses the central nervous system. Alcohol reaches the brain and has the following effects on people. 1 to 2 drinks: Person happy, friendly, self-confident, and relaxed Caution, memory and thinking affected Feeling relaxed and not so shy and self-conscious anymore, person is more talkative and outgoing Liquid courage 3 to 4 drinks: Judgment impaired reduced ability to assess speed, time and distance Some loss of physical co-ordination Person less able to make decisions about capabilities and may take chances Think about things you have seen people do after drinking that they said they d never do. 5 to 6 drinks: Hearing and touch affected Eye muscles relax can lead to blurred vision slower pupil constriction in response to glaring lights double vision impaired depth perception and focusing reduced peripheral vision 9

10 Think of some experiences people have that show that alcohol affects the senses. For example, a person falls and sprains their ankle but doesn t feel the pain until next morning, someone burns afinger and only notices it the next day, the music at a drinking party has to be turned up louder. 7 to 8 drinks: Balance and co-ordination affected can lead to difficulty with walking and other motor activities Reaction time continues to deteriorate May have abrupt mood swings and reduced ability to tolerate frustration May be extremely friendly to outright aggressive Perception of pain reduced Note to teacher: Explain that this is the person at the party who people notice because she or he is staggering, falling down or breaking things. 10+ drinks: Vital centres of brain are affected, whole system could shut down Heart and breathing become depressed Loss of consciousness may occur Breathing may stop and death can result Note to teacher: At this stage, explain alcohol poisoning and describe the recovery position. How much alcohol it takes for a person to lose consciousness will vary from person to person and depends on many factors: age gender size mood tolerance food in the body setting health Alcohol does not affect everyone the same way. It will have different effects on the same person at different times. The more you drink, the more you put yourself at risk for experiencing problems. 10