Taking Control of Alcohol Use Session 1: About Alcohol Use. This workbook accompanies the e-course Taking Control of Alcohol Use and is for the exclusive use of clients and customers of Homewood Human Solutions.
About alcohol use About the course The effects of alcohol can be extremely serious even fatal both to you and to others. Consider the following: Have you ever felt you should cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt bad or guilty about your drinking? Do you drink alone when you feel angry or sad? Does drinking ever make you late for work? Does drinking worry your family? Do you ever drink after telling yourself you won t? Do you ever forget what you did while you were drinking? If you answered yes to any of these questions, you may need to start Taking Control of Your Alcohol Use. Even if you answered no to all of the above questions, if you encounter drinking-related problems with your job, relationships, health, or the law, you should review the contents of this course. Alternatively, you may be a spouse, partner, child, sibling, co-worker, or employer to someone with an alcohol problem; if so, this course could be informational. Goals of the course The course will help you decide whether your drinking is problematic, borderline, or social in its usage patterns. If your drinking is problematic or in the borderline areas, treatment options will be presented. How much is too much? Drinking alcohol is very common. About two-thirds of adults have a drink at least occasionally, while the other one-third don t drink at all. Of those who do drink, the vast majority use alcohol very moderately, and will never have serious problems with it. For them alcoholic beverages are simply that: beverages to be enjoyed now and then as a part of a meal or a social occasion. But you must remember that alcohol is a drug. And as with any drug, it can be dangerous if you consume too much. How much is too much? It is difficult to say exactly because it can vary depending on whether you are a man or a woman, your age, your weight, and a number of other factors. But as a general rule, it is probably safe to drink no more than 1 or 2 drinks per day with at least 2 days each week when you don t consume any alcohol at all. This is the amount that most people drink. In fact, only about 8% of men and 4% of women drink more than 3 drinks per day. How many drinks do you have each day? 2
How does my body absorb alcohol? When you consume an alcoholic beverage, the alcohol passes from your mouth into your stomach and small intestine, where it is absorbed into the bloodstream. The amount of alcohol at any point in time in your bloodstream is called your Blood Alcohol Level. The faster you absorb the alcohol, such as drinking quickly or drinking on an empty stomach, the higher your blood alcohol level will be, and the greater the effects of the alcohol will be. Once in your bloodstream, the alcohol is circulated through your liver and on to your heart, lungs and brain. Your body eliminates alcohol very slowly, about 10ml per hour. For example, if a 160 pound man drinks 4 pints of beer over a period of 4 hours, his blood alcohol level will continue to rise until well after he has finished drinking, and it will take until the middle of the afternoon of the next day before it is completely eliminated from his body. The consequences Most people know that drunk driving is dangerous, and that alcoholics may get liver disease. Yet few people really understand how many areas of your life and health can be harmed by alcohol, and how quickly and easily this can happen. Most of the short-term effects of alcohol are registered in your brain, such as feeling drunk or having slurred speech. But over time, heavy drinking can damage your relationships, your job, your intelligence, and your physical and emotional health. The damage is gradual, occurring slowly over a period of years, so that you may not even notice that it is happening. But friends and family and coworkers may see it. Here is a step-by-step guide to how heavy drinking affects your body and your life. As soon as you take your first drink of alcohol, it begins to affect your brain. It affects your judgement and your physical coordination. As you consume more, it causes blurred vision, slurred speech, and loss of balance. And if you drink too much at one time, it can cause unconsciousness, or a coma, and even death. After years of heavy drinking, the brain loses brain cells and shrinks, which eventually reduces intelligence and impairs memory. In fact, the mental abilities of a 30 year old heavy drinker can resemble those of an 80 year old nondrinker. Heavy drinking also damages nerve cells outside of the brain. The first symptom is usually muscle weakness or pain and tingling in the arms and legs. Alcohol also irritates and damages the sensitive tissue of your digestive system. It irritates the stomach lining, causes ulcers and sometimes internal bleeding. Because alcohol contains a high level of calories with no nutritional value, it causes premature aging of the face and body, weight gain, and nutritional deficits. To make matters worse, alcohol prevents the body from fully absorbing and using even those vitamins and nutrients that are available. When alcohol is consumed, the liver gives priority to getting rid of it, and in the process does not perform its normal work, such as getting rid of fats and body waste products. As a result, heavy drinkers tend to accumulate fat in the liver and bloodstream. The liver itself becomes fatty, and enlarges, contributing to a beer belly appearance. And if the heavy drinking continues, liver cells will die off, being replaced by scar tissue which is known as cirrhosis. As living liver tissue is replaced by scarred tissue, the liver is less able to filter impurities from the bloodstream, including the alcohol. Alcohol also impairs the body s ability to fight off diseases and infections. This leaves the body more vulnerable to infections, illnesses, and cancers. In fact, heavy drinkers are 40 times more likely to develop cancer of the throat, tongue, or mouth. And if you are a heavy drinker, and you get injured or ill, your recovery and your healing will be impaired because of the alcohol. 3
In the reproductive system, men who drink heavily deplete their supply of testosterone, the male sex hormone, and this can lead to a loss of body hair, enlarged breasts, shrinking testicles, and impaired sexual performance. In women, heavy drinking can lead to increased rates of gynecological problems and increased rates of miscarriage and birth defects. It is important to note that alcohol consumed by a pregnant woman directly affects the fetus, and there is no known safe level of drinking during pregnancy. Summary In short, once alcohol is consumed, it is rapidly distributed throughout your body, where it affects virtually every organ system. While there is evidence of some health benefits from drinking 1 or 2 drinks per day, heavy drinking will put your health at risk. The good news is that many of these damaging effects can be reversed when a heavy drinker cuts down or stops drinking altogether. But, the bad news is that the longer you wait before getting your drinking under control, the more permanent, pervasive, and serious the damage becomes. Social and Psychological Problems The damaging physical effects of heavy drinking are only part of the picture. Heavy drinkers are also at risk for many other kinds of problems. Risk-Taking and Accidents Alcohol affects your judgment and slows your reflexes. This can lead to falls or to accidents with vehicles or machinery. It works like this: Recall, the first organ of your body affected by alcohol is your brain. And among the first of the brain s functions to be altered by the alcohol is your judgement. This means that after just a couple of drinks, your judgement is impaired, you become overconfident, and you are more likely to take stupid and dangerous actions. Sometimes the result of these actions is only embarrassment. But other time, the results are much more serious, including legal consequences, injury to self or others, and even death. All of this is made worse because alcohol is affecting your judgement. So you cannot see what is really happening to yourself because your ability to judge your own behavior is impaired. This is why heavy drinkers often say that they feel misunderstood or unfairly treated or harassed. Other people can see that your behavior is stupid or harmful, but when you are drinking you cannot see this yourself. Mood Heavy drinking also affects your mood. After one or two drinks, you might feel less inhibited and a bit happier. But alcohol is actually a depressant, and any more alcohol will cause these good feelings to turn bad and any bad feelings to become worse. And as these feelings get worse, the only way to cope seems to be to take another drink. But remember, alcohol affects your memory so you tend to only remember the first drink or two when you felt happy, and you forget the rest of the drinks that made you feel bad. This is why many heavy drinkers have both an alcohol problem and are depressed. Relationships and career Finally, heavy drinking can damage your relationships and your career. On average, heavy drinkers have higher rates of separation and divorce and more problems in their careers than people who don t drink excessively. One reason why these relationships are problematic is because the alcohol is often consumed as a way to cope with problems and the drinker makes no attempt to find better ways to handle things. It s just easier to let things go, to take a break, and to forget. So things begin to fall apart sometimes a little at a time, sometimes faster. 4
Eventually: Heavy drinking makes it impossible to be a good parent. This can result in family problems, child abuse, or neglect Friends pull back or drift away Problems start showing up on the job or at school like making mistakes, avoiding responsibilities, or not showing up at all Money problems increase too much money is spent on alcohol, and on paying for the problems or the poor decisions that the heavy drinking causes What can you do? After hearing this message, we hope that you are beginning to understand that heavy drinking severely threatens your health, your relationships, your family, and your career. The good news is many of the effects of heavy drinking can be reversed and that help for alcohol problems is effective and available. The first step is to recognize that you may have a problem. So ask yourself: Have you ever wondered whether you drink too much or whether alcohol is harming you or putting you at risk? Do friends or relatives express concern about your drinking or are you annoyed when people criticize your drinking? Do you feel guilty about your drinking and think you should cut down but find that you are unable to do so? The information in this course: Taking Control of Alcohol Use, can help you determine whether or not your drinking is putting you at risk for developing problems, and it can help you decide whether cutting down on alcohol, or eliminating it altogether, are reasonable and wise choices for you. As well, you should consider speaking with an EFAP counselor. Many of the clinicians are experts in the treatment of alcoholrelated disorders and they can help you determine if you have a problem, or if someone you know has a problem, and they can help you take steps to change alcohol-related patterns. The next step is up to you. 5
True or False? Some facts about alcoholism What do you know about alcohol use? Try this True/False quiz. Note: Many of these facts and statistics are taken from Canadian Profile 1999 (http://www.ccsa.ca/index. asp?menu=statistics&id=43 and http://www.ccsa.ca/indexf.asp?menu=statistics&id=43 ) published jointly by the Canadian Centre on Substance Abuse (http://www.ccsa.ca/) and the Centre for Addiction and Mental Health (http://www.camh.net/). 1. True or false? Alcoholics drink because of psychological problems. 2. True or false? Divorce, job loss, death of a loved one, or other life issues can make someone alcoholic. 3. True or False? Chemically dependent people feel guilty and ashamed of their abuse but are too weak willed to stop. 4. True or false? One out of every twenty Canadians (5 %) report having problems with their drinking. 5. True or false? More than 6500 Canadian lost their lives as a result of alcohol consumption in 1995. 6. True or false? Impaired driving is a major cause of death. 7. True or false? About one in ten Canadian workers drinks at some time in the workplace. 8. True or false? Annual productivity losses in Canada due to alcohol abuse are estimated at $4 billion. 1. False. Psychological problems can be a pre-condition, or a consequence, of alcoholism but they are not a requirement. 2. False. If this were so, all of us would be alcoholics. What is true is that these issues can contribute to increased use patterns for someone who is already alcoholic. 3. False. Both the Canadian and American Medical associations identify alcoholism as a disease. Therefore, asking an alcoholic to stop drinking is like asking a person with diabetes to stop being diabetic. 4. False. The number is actually higher. One in ten (specifically, 9.2 %) report having problems with their drinking. 5. True. It is estimated that 6, 503 Canadians (4,681 men and 1,823 women) lost their lives as a result of alcohol consumption in 1995, and 80,946 were hospitalized (51,765 men and 29,181 women) due to alcohol in 1995-96. Motor vehicle accidents, alcohol liver cirrhosis and suicide accounted for the largest number of alcohol-related deaths, while accidental falls, alcohol dependence syndrome and motor vehicle accidents accounted for the largest number of alcohol-related hospitalizations. 6. True. Among fatally injured drivers in 1996, 42% had some alcohol in their blood and 35% were over the legal limit of.08% blood alcohol concentration (BAC). 7. False. The number is higher. About one in five Canadian workers drinks at some time in the workplace. 8. True. Annual productivity losses in Canada due to substance abuse have been estimated at $4.1 billion for alcohol. 6