Alcohol

Summary

The amount of time and alcohol it takes to poison people’s bodies can vary, depending on their weight and size, tolerance for alcohol, how quickly they consume drinks, and the type of alcohol they are drinking.

Many of us are no strangers to alcohol and its effects. At one time or another, having one drink—or one too many—might have made you or someone you know happy, giddy, uninhibited, relaxed, tired, depressed, or even sick.

Fortunately, few of us learn firsthand the effects of alcohol poisoning. Like any drug, alcohol can be toxic, or poisonous, to those who overuse it or consume more than their bodies can handle safely.

Alcohol poisoning, or an alcohol overdose, results from consuming a large amount of alcohol in a short period of time. Also known as “binge drinking,” this practice remains a daunting problem on college campuses nationwide. Though research and survey results vary, it is estimated that approximately two out of five college students have engaged in binge drinking at least once.

The amount of time and alcohol it takes to poison people’s bodies can vary, depending on their weight and size; tolerance for alcohol; how quickly they consume drinks and the type of alcohol they are drinking; their level of fatigue and stress; and whether and how much they ate before drinking. Binge drinkers generally consume five or more standard alcoholic drinks in one sitting primarily for the purpose of getting drunk.

Once the intake of alcohol exceeds the body’s limit, a person can pass out. Excessive amounts of alcohol hinder the brain’s ability to control breathing. People with alcohol poisoning can slip into a coma, suffocate, or choke to death on food or their own vomit. Therefore, alcohol poisoning, like any other kind of poisoning, always should be treated as a medical emergency.

How do I know if it’s alcohol poisoning?

What if you are unsure whether someone has had a little too much to drink or actually been poisoned by alcohol? Look for the following symptoms of an alcohol overdose:

• Slow or irregular breathing (fewer than eight breaths per minute, or 10 seconds or more between breaths)
• Cold, pale, or bluish skin
• Rapid pulse
• Vomiting while awake or asleep
• Unresponsiveness when spoken to, prodded, or pinched
• Semi-consciousness or unconsciousness

If someone appears to have passed out from drinking, take it seriously. Don’t assume that the person is just “sleeping it off.” If you can’t awaken the person or get a response, call for medical assistance immediately—you could save a life.

While you’re waiting for help, do not leave the person alone. Stay close and turn the person on his side to prevent choking if vomiting occurs. Also, monitor breathing and perform mouth-to-mouth resuscitation if breathing stops. Don’t try to sober the person up with something to eat or drink.

The best way to avoid alcohol poisoning is to control your drinking. If you are going to drink, know your limits and pace yourself. Avoid bingeing or drinking on an empty stomach. If you suspect that you or a friend has a drinking problem, acknowledge the problem and seek help before it’s too late.

By Anne Wright

©2000-2021 Carelon Behavioral Health

Source: National College Alcohol Study Finds Significant Increase in Frequent Binge Drinkers, Harvard School of Public Health

Summary

Some alternative treatments:

• Yoga
• Acupuncture
• Nutrition

Alcohol use disorder is progressive and can be deadly. Treatment includes both inpatient and outpatient programs, family counseling, and self-help meetings, such as Alcoholics Anonymous (AA). Over the years, many alternative treatment methods have been developed to help the overall health of the person and to work with existing therapies. For some people the results have been very good. But more research is needed.

What is alternative and complementary medicine?

It comes from years of home remedies and other professional disciplines. The focus of these methods is to aid changes that usher in good health and well-being. The Complementary Medical Association lists the eight tenets of this philosophy:

1. Good health is a state of emotional, mental, spiritual, and physical balance.
2. The mind and body are tied.
3. The body is able to heal itself.
4. Treating the root causes of a problem is more important than treating the symptoms.
5. Active self-help and health education are a major part of success.
6. Communication between the person with alcohol use disorder, medical doctor, and other health practitioners is needed.
7. Each person is an individual and must be treated as such.
8. Environmental and social influences can have a major effect on a person’s physical and emotional make-up.

What alternative methods can help with alcohol use disorder?

Yoga uses physical postures and controlled breathing to lengthen the spine and make it stronger, and increase its ability to bend with ease. It calms the mind, helps with focus, and develops patience. It can also lead to a greater sense of control when having cravings, trouble sleeping, being upset, etc. Regular practice is needed to get these good results.

Biofeedback is a scientific way of learning to lower tension. Practitioners use tools to give a person feedback right away about the level of tension in their body. People practicing it often say they gain psychological faith in themselves when they learn to control their emotions. It has been found to be useful in many aspects of treatment.

Massage can let tension go and help energy balance and flow. It can give deeper levels of relaxation and peace, and a greater sense of self.

Meditation includes many types. All work to quiet the mind and aid relaxation and mental clarity. It helps people focus and quiet negative thoughts that fill their mind and cause stress.

Acupuncture is a part of Asian medicine developed in China more than 2,500 years ago. It is the act of placing fine needles into specific points on the skin, which helps healing, cuts cravings for drinking, and eases withdrawal symptoms. It may also lower worry and sadness that lasts.

Spiritual practice can play a big role in recovery from addiction. For many people, gaining greater insight into their spiritual side helps them see their purpose in life. The founding rule of AA is that something greater than you (a higher power) can help heal and fix your life. Prayer and meditation is encouraged in AA.

Nutrition. Alcohol keeps your body from getting vital nutrients. Those who overuse it may not have the right amount of a number of vitamins and minerals. Your doctor may tell you to take vitamin supplements that can help cut cravings, control blood sugar fluctuations, and decrease stress from drinking.

Alcohol use disorder is a serious disease. Knowing the many care choices will add to the chances of recovery. If you are having a problem with drinking, talk with a trusted friend, doctor, or clergy member.

Resources

Al-Anon Family Groups
www.al-anon.alateen.org

Alcoholics Anonymous World Services, Inc. (AA)
Main site: www.aa.org
Online support groups: www.aa-intergroup.org

National Council on Alcoholism and Drug Dependence, Inc.
http://ncadd.org

Substance Abuse and Mental Health Services Administration
www.samhsa.gov

By Drew Edwards, M.S., Ed.D.

©2012-2019 Carelon Behavioral Health

Reviewed by Enrique B. Olivares, M.D., Director of Addiction Services, Beacon Health Options

If you or a loved one is considering treatment for an alcohol use disorder, the following information may help.

Types of treatment

Inpatient and residential programs traditionally last three to eight weeks and provide highly structured treatment services, including group therapy, individual therapy and alcohol education. Professional staff are available around the clock to manage any acute medical and psychological problems.

Alternatively, some individuals receive short-term inpatient detoxification services before being transferred to an outpatient setting. Typically, outpatient programs offer the following services:

• Intensive outpatient programs (IOPs) provide alcohol education and group and individual therapy. IOPs typically engage the person with alcohol use disorder for two to three hours per day for up to five days per week and were developed as alternatives to inpatient programs.
• Day hospital programs, which allow the person with alcohol use disorder to participate in treatment during the day and maintain their family roles in the evening, offer similar programs as IOPs.
• Low-intensity outpatient services provide counseling sessions (group sessions, individual sessions, and—if necessary—family or couples therapy) once or twice per week. For many, low-intensity programs are intended as maintenance therapy after the person with alcohol use disorder has received initial inpatient or intensive outpatient treatment.

Components of quality treatment

• Medical management. Addressing the physical and psychiatric needs of people with alcohol use disorder is imperative. A skilled addictive disease physician or psychiatrist trained in addictions can properly diagnose alcohol use disorder and related psychiatric conditions and provide safe detoxification. 
• Alcoholics Anonymous (AA). Most mainstream inpatient and outpatient treatment programs encourage people with alcohol use disorder to attend AA meetings on a regular basis. It was, after all, a group of recovering peers that began the movement to consider alcohol use disorder a disease. AA offers an understanding and spiritual dimension that encourages forgiveness of self and others.
• Cognitive-behavioral therapy (CBT). This treatment strategy aims to change maladaptive thoughts and emotions such as craving for alcohol, depression, and anxiety. CBT helps the patient identify high-risk situations for relapse, learn, and rehearse strategies for coping with those situations, and recognize and cope with craving.
• Motivational enhancement therapy (MET). This method, which is based on the principles of motivational psychology, strives to motivate the client to use his own resources to set reasonable goals and make lifestyle changes. The counselor encourages the client to set goals, and attempts to maintain or increase the client’s motivation to initiate or to continue implementing change.

Which is best?

Research has found that the treatment forms outlined above produce roughly the same results. The key seems to lie in individualizing treatment to the particular needs of the patient or client.

Experienced substance use disorder professionals look at three dimensions to determine treatment intensity, duration, and form:

1. Severity of illness
2. Motivation of the patient
3. Level of social and family support

These three dimensions must be thoroughly evaluated before making a treatment recommendation. Individuals with severe alcohol use disorder will require medical detoxification. Similarly, those who also have medical or psychiatric conditions may require extended hospital care. However, the system does not always work according to these criteria. For instance, a young and relatively healthy adult who is poorly motivated and lives alone may need a residential program until support and motivation can be developed. 

If you are considering treatment for yourself or if you are trying to help a friend or family member, consider the three dimensions because participating in a level of treatment that is inadequate is a recipe for failure.

By Drew Edwards, M.S., Ed.D.

©2003-2021 Carelon Behavioral Health

Summary

• Mix of substance use disorders and mental health disorders
• Treatment should be well planned and client-centered

The term co-occurring disorders or COD means having at least one mental illness along with one or more substance use disorder. But there is nothing simple about having this condition. The two or more disorders will negatively impact each other. This requires that each disorder be treated separately but also at the same time. Recovery is not an easy process, but it is a goal that can be reached.

Types of COD

Substance use disorder can occur along with any mental illness. Some of the more common mental health issues linked with COD include:

• Depression
• Anxiety
• Schizophrenia
• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)

Other disorders related to mood, anxiety, sleep, eating, and personality also often occur with COD.

Some common classes of substance use disorders include:

• Alcohol
• Nicotine
• Caffeine
• Cannabis
• Cocaine
• Amphetamines
• Sedatives
• Opioids

People with COD can have any mixture of substance use disorders and mental health disorders, but at least one of each.

Risks of COD

People with COD have certain higher risks than people with a single disorder. They also tend to be in poorer health and have a greater chance of relapse. Some of this is due to not taking or responding to treatment as well. The time and cost involved in this treatment is also higher.

Among these increased risks are:

• Violence
• Physical illness
• Psychosis
• Hospitalization
• Homelessness
• Unemployment
• Incarceration
• HIV/AIDS

Screening for COD

About half of all people with severe mental illnesses also have substance use disorders. The rate of people with substance use disorders who have mental illnesses is even higher. Despite these facts, screening for COD can be a challenge. A mental health service may not be able to spot substance use disorder. A substance use treatment center may not be able to spot mental illness. The screening process should decide whether or not the person needs to be further assessed. This assessment is then performed by a mental health doctor or other trained health care worker.

Treatment and recovery

Treatment for COD must target each disorder by itself and at the same time. This may occur in one setting or a number of settings. Treatment should be well planned and client-centered. This means the person with COD needs to be involved with all aspects of care. The type of care will depend on the types of substance use and mental disorders. It should also be tailored to the person’s unique needs and goals.

COD takes a toll on those who have it and on those around them. Coping skills must be taught to the individual as well as to her support group. Progress may be slow and sometimes hard to measure. The chance of relapse seems to always be right around the corner. Setbacks should be met with support rather than blame. The person will respond to praise much more than to guilt. Recovery is a long process that will require a group effort. It is not an easy task but it is well worth it.

Resources

Alcoholics Anonymous
www.aa.org

Narcotics Anonymous
www.na.org

National Alliance on Mental Illness
www.nami.org

Substance Abuse and Mental Health Services Administration
www.samhsa.gov

By Kevin Rizzo

©2022 Carelon Behavioral Health

Summary

• The two often co-exist.
• Dual diagnosis means you are at greater risk.
• Both need to be treated together.

Many times substance use disorders co-exists with bipolar disorder. When these two illnesses appear at the same time in one person, it is called a dual diagnosis. One study showed that as many as 60 percent of people with bipolar also have a drug problem. Drinking problems were shown to affect twice as many people with bipolar than those who only have depression.

The reason for this is not fully known. It is thought that bipolar and drug use affects the same chemicals in the brain. Some studies suggest that people with bipolar may try to treat themselves, or “self-medicate” through drug use. Also, the impulsivity and raised mood state of mania may support or lead to drug use. Having a bipolar diagnosis is a risk factor for, and may lead to, substance use disorder. At the same time, substance use disorder may create symptoms of bipolar. Also, there may be linked genetic and hereditary factors as both bipolar and drug problems run in families.

Risks

Studies show that people with this dual diagnosis have a greater chance of:

• Social withdrawal
• Violence
• Homelessness
• Unemployment
• Hospitalization
• Incarceration
• Physical illness
• Psychosis
• HIV/AIDS

Treatment is more difficult with two disorders. Medicine compliance is a problem. People who are dual diagnosed are more likely to relapse than those with just one disorder. Problem drinking worsens the symptoms of bipolar. However, these two comorbid illnesses can be successfully treated. Finding the right treatment program, medications, and support of others goes a long way toward progress and stability.

Medications for bipolar disorder

There are three main mood stabilizers used in treating bipolar. These are lithium, carbamazepine (sometimes called Tegretol), and valproate (sometimes called Depakote®).

1. Lithium is most often used for single diagnosis bipolar. Some studies have shown lithium to be less helpful when there is also a drinking problem.
2. Carbamazepine is an anticonvulsive used in the care of bipolar. It also helps control withdrawal symptoms.
3. Valproate, like alcohol, has been linked to liver failure in rare cases. But studies have shown it to be mostly safe and useful for help with bipolar and a drinking problem. Care should be used in young women. Studies have shown a potential for polycystic ovary syndrome or congenital defects  for infants who were exposed to it in the womb.

Mood stabilizing antipsychotics

Some cases of a bipolar disorder call for antipsychotics. They are helpful in controlling acute manic or mixed episodes.

Zyprexa® is useful for treating severe mania. It can be injected to give fast relief of symptoms. Side effects include weight gain and may increase the chance of heart disease and diabetes.

Abilify® and Seroquel® are alternatives to Zyprexa®, and are less likely to give the same such side effects. Latuda® has shown efficacy in bipolar depression. Saphris® has also shown results in bipolar disorder. They are both useful in treating mild or severe cases of acute mania. Other antipsychotics sometimes taken include Risperdal® and Geodon®.

Medication for substance use disorders

Naltrexone is showing some promise in lowering alcohol addiction. It is also used in relapse prevention for opiate use. Other medications indicated for alcohol use disorder are Acamprosate (Campral) and Disulfiram (Antiabuse).  

Unified treatment

Successful treatment for people with a dual diagnosis calls for both to be treated at the same time. This is because bipolar and drug overuse affects each other. Focusing on just one problem may give temporary results. The chances for relapse and a hospital stay greatly increase if both aren’t being treated at the same time.

This includes:

• Counseling and group therapy
• Social interaction and support
• Education and motivation
• Staying active
• Accountability
• Goal setting and monitoring
• Taking care of stress
• Behavioral and coping skills

It also includes family and community help. People with bipolar and substance use disorders cannot help themselves alone. Often they do not even know how their illness affects others because they cannot see the results of their actions. Dual diagnosis treatment is a lifelong process. It is vital that family members give nonstop support and seek involvement in treatment.

Patience and support work better than guilt and blame. Positive reinforcement is needed to help people beat the harmful feelings they have toward themselves and their condition. Al-Anon Family Groups offer education and support. With treatment and support bipolar and substance use disorders can be controlled and a healthy, meaningful, and productive life is possible. 

Resources

Al-Anon Family Groups
https://al-anon.org/

The Balanced Mind Foundation
www.dbsalliance.org/site/PageServer?pagename=bmpn_landing

Depression and Bipolar Support Alliance
www.dbsalliance.org

Dual Diagnosis Website
http://users.erols.com/ksciacca/

National Institute of Mental Health Medications Booklet
www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml

By Kevin Rizzo

©2012-2019 Carelon Behavioral Health

Source: National Alliance on Mental Illness, /www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=54&ContentID=23049; National Institute on Alcohol Abuse and Alcoholism, http://pubs.niaaa.nih.gov/publications/arh26-2/103-108.htm; National Institute of Mental Health, www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml; American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

Reviewed by Cynthia Scott, MD, Physician Advisor, Beacon Health Options

Many people with drinking problems cannot tell when their drinking is out of control. You likely have a drinking problem when your body depends on alcohol to function and your drinking is causing problems with your health, social life, family or job. Recognizing that you have a drinking problem is the first step toward being alcohol-free.

Talk with your health care provider about your drinking. They can help you find the best treatment.

Are you ready to change?

You may have tried to stop drinking many times in the past and feel you have no control over it. Or you may be thinking about stopping, but you’re not sure if you’re ready to start.

Change takes place in stages over time. The first stage is being ready to change. Important stages that follow include:

• Thinking about the pros and cons of stopping drinking
• Making small changes and figuring out how to deal with the hard parts, such as what to do when you’re in a situation where you would normally drink
• Stopping drinking
• Living an alcohol-free life

Many people go back and forth through the stages of change several times before the change really lasts. Plan what you will do if you slip up, and try not to be discouraged.

Lifestyle changes that can help

Here are some tips to help you control your drinking:

• Stay away from people you normally drink with or places where you would drink.
• Plan activities you enjoy that do not involve drinking.
• Keep alcohol out of your home.
• Follow your plan to handle your urges to drink. Remind yourself why you decided to quit.
• Talk with someone you trust when you have the urge to drink.
• Create a polite but firm way of refusing a drink when you are offered one.

Getting help from others

After talking about your drinking with your health care provider or an alcohol counselor, you will likely be referred to an alcohol support group or recovery program. These programs:

• Teach people about alcohol misuse and its effects
• Offer counseling and support about how to stay away from alcohol
• Provide a space where you can talk with others who have drinking problems

You can also seek help and support from:

• Trusted family members and friends who do not drink
• Your place of work, which may have a program that can help employees with personal issues such as alcohol use
• Support groups such as Alcoholics Anonymous

Alcohol withdrawal

You may be at risk for symptoms of alcohol withdrawal if you stop drinking suddenly. If you are at risk, you will likely need to be under medical care while you stop drinking. Discuss this with your health care provider.

Source: U.S. National Institutes of Health, www.nih.gov

Summary

• Snack on appetizers.
• Drink non-alcoholic beverages.
• Find alternative places for get-togethers.

“Happy hours” have become one of the most common forms of after-work entertainment among co-workers. In some cases, these occasions provide important opportunities for building and sustaining professional relationships that can become important to our careers. They also provide the opportunity to maintain connections with co-workers we may not otherwise see outside of the office.

So if your choice is not to drink, are you destined to be excluded from these after-work get-togethers? The answer should be a resounding “No!” Drinking alcohol is a personal choice. You have the right to attend social functions without feeling pressured to drink. Admittedly, in the case of happy hours, this may be more difficult, since alcohol is usually the “main event” of the gathering. But it doesn’t have to be. Remember that restaurants and bars use alcohol as a vehicle to entice customers inside, and ultimately the real purpose of gathering with co-workers after a hard day is talking and relaxing outside of the office.

Nevertheless, the desire to “blend in” with your co-workers may be strong. Here are some tips for enjoying happy hour without the alcohol:

• Look at those happy hour advertisements more closely. Chances are the bar or restaurant is also offering appetizers at reduced prices. Snacking on these foods will give you something to do while some of your co-workers drink.
• Many bars and restaurants offer non-alcoholic beverages “on the house” to encourage the use of “designated drivers.” Take advantage of these freebies.
• Surround yourself with other non-drinkers who wish to socialize without the alcohol.
• Above all, do not feel that you have to “apologize” for your decision not to drink. Your choice requires no explanation.

If you wish to avoid traditional happy hour events entirely, suggest after-work gathering places where alcohol is not the main focus. Go to coffeehouses or places where you can relax to local music performances. Suggest after-work activities that involve physical activity, such as fitness classes, jogging or working out at the gym. Start a book club and serve coffee and snacks in your home while enjoying good conversation.

The decision not to drink doesn’t have to make you into a social pariah. You may find that taking the initiative to find alternatives to the traditional happy hour scene will be met with enthusiasm from others who also may be anxious for a change of pace.

By Barbara A. Gabriel

©2000-2021 Carelon Behavioral Health

Summary

• Resist the pressure to drink or serve alcohol at every social event.
• Decide that drinking and driving is not an option. 

The period between Thanksgiving and New Year’s Eve, according to Mothers Against Drunk Driving, is one of the most unsafe times of year to be on the roads due to alcohol-related injuries and deaths.

Why are the holidays more dangerous than other times of the year?

• More people drink during the holidays due to many parties and other festivities.
• Many Americans don’t drink except around the holidays and therefore have a lower tolerance for alcohol. As a result, these people often underestimate their level of impairment and sometimes even drive when they shouldn’t. When arrested for drunk driving, these people often show a relatively low blood alcohol content although they are very intoxicated.
• Because there are more parties and socially acceptable events to drink during the holidays, many problem drinkers and people with alcohol use disorder say that they feel more “normal,” and therefore drink more often. Because they have a high tolerance for alcohol they drink large amounts before showing the effects, although they are, in fact, too impaired to drive.
• The holidays are busy and stressful. People are hurrying more than normal and winter road conditions in many areas of the country make driving more dangerous. Add alcohol to this scenario and you have a recipe for disaster.

Avoiding an alcohol-related disaster

Follow these tips for a safe holiday season:

• Resist the pressure to drink or serve alcohol at every social event. Just because it’s there does not require that you drink it. There is no law stating that alcohol is a necessary ingredient for holiday cheer.
• If you want to serve alcohol to your guests, offer nonalcoholic drinks as well. Make your guests feel as comfortable choosing a nonalcoholic drink as they would choosing alcohol. You can do this by putting nonalcoholic drinks in a prominent, easily accessible place and by asking guests what they would like to drink, instead of pointing them to the bar or handing them an alcoholic drink when they arrive.
• If you or your friends are going to a party and plan to use alcohol, decide in advance who will be the designated driver. Decide that drinking and driving is not an option.
• If you are going to drink, decide ahead of time how many drinks you will have and stick to it.

By Drew Edwards, M.S., Ed.D.

©1999-2021 Carelon Behavioral Health

Summary

• Choose a designated driver.
• Serve food with alcohol.
• Take keys from impaired guests.

Almost 30 percent of all traffic fatalities in the United States each year are alcohol related. In spite of this fact, driving under the influence of drugs or alcohol, particularly around the holidays, continues to plague our nation.

When sober and thinking rationally, nearly everyone agrees that no one should ever drive while impaired. The problem is that the decisions about whether or not to drive are often made by revelers after they have had too much to drink. Alcohol, like all other drugs of potential overuse, fools the brain by creating a false sense of confidence and control. Studies show that even occasional drinkers routinely overestimate their ability to drive and perform complex motor functions. Unfortunately, this poor judgment costs thousands of lives each year.

What you can do to prevent impaired driving

• If you or your friends are going out and plan to use alcohol, decide in advance who will be the designated driver. Agree in advance that driving under the influence is not an option.
• If you are hosting a party where alcohol or drugs are present, collect car keys from your friends who drink or use drugs. That way, when they are ready to leave, they must get a second opinion on whether they’re sober enough to drive home.
• Make your guests feel comfortable choosing not to partake in anything that impairs or distorts judgment. You can do this by presenting nonalcoholic drinks in a prominent, easily accessible place and by asking them what they would like to drink instead of pointing them to the bar or handing them an alcoholic drink when they arrive.
• Always serve food with alcohol. High-protein and complex-carbohydrate foods like cheese and meats are best because they stay in the stomach longer, thus slowing the rate at which the body absorbs alcohol.
• Stop serving alcohol about 2 hours before the party is over. Guests then have time for their bodies to metabolize the alcohol.

When the party’s over

If one of your guests is impaired, you cannot let her drive because she could hurt or even kill herself or others. This can be a difficult situation and may even cause a scene.

Try these suggestions:

• Be proactive. If you notice that a guest is impaired, try to make arrangements to get him home before the party ends.
• Stay calm. Don’t argue or shout. If your intoxicated guest becomes belligerent, change the subject or distract her. This will buy you some time to come up with another approach. You don’t want her storming away mad, especially with her car keys in hand.
• Call a family member or friend to come and get him—preferably before the party ends.
• Suggest that you or a sober friend drive him home and you will arrange to get his car back to him the next day.
• Offer to let the impaired guest stay overnight. This may sound inconvenient, but you could be saving a life.
• Arrange for a taxi and, if necessary, pay the fare. It’s hard to object to a free ride.
• If all else fails, tell her you will call the police if she tries to drive. It’s far better than calling the ambulance.

Remember that drunk driving kills thousands of people per year. Don’t let this happen to someone you know.

By Drew Edwards, M.S., Ed.D.

©2001-2019 Carelon Behavioral Health

Source: Centers for Disease Control and Prevention, ﾓInjury Prevention and Control: Motor Vehicle and Safety.ﾔ http://www.cdc.gov/motorvehiclesafety/impaired_driving/impaired-drv_factsheet.html

Summary

• Don’t go it alone.
• Treat your parent with respect.
• Be calm and communicate your expectations clearly.

Someone once said, “It’s hard raising your parents.” But sometimes the children must insert themselves into the center of a problem when a parent is overusing alcohol.

Being the child of someone with alcohol use disorder seems like a lose-lose situation. You can ignore the problem and keep the peace. Or you can confront the problem and possibly create a crisis. Anger and hurt feelings seem inevitable. Let’s look at both options.

Denial of a problem is the single most common defense against dealing with alcohol use disorder in a family. Because of the shared family history, buttons are easily pushed and feelings can be hurt. So ignoring the problem seems like the easiest thing to do. But that makes an alcohol problem worse. Here’s how. By doing nothing, we seem to approve of the behavior. Then when the problem blows up and a crisis occurs, the parent who is overusing alcohol says something like, “No one has ever complained about my drinking before.” But by then the damage has been done.

Confronting the problem head-on is very hard to do, but it is the most loving thing to do. It is a bit like pulling a bandage off a wound. Pulling it slowly may be less painful than ripping it off at once, but the actual hurt can last longer.

When a parent has an alcohol problem, the whole family has a problem. It is particularly hard for a child of any age to see their parent overuse alcohol. So they usually keep their feelings inside. They also avoid confrontation because they feel as if they are being disloyal to their parent, or ungrateful. These emotions are strong and not easily overcome.

What to do

• Don’t go it alone. Talk with other family members and ask them how they see things.
• Set a specific time to talk with your parent. In other words, make an appointment.
• Treat your parent with respect. Tell them you love them and are worried about them.
• Focus most of your attention and concern on your relationship with them, not the alcohol.
• Stop enabling the problem by making excuses or covering up for your parent’s behavior.
• When a parent who overuses alcohol sees that their drinking has hurt their child they are more interested in seeking help.
• When you talk with your mom or dad about their drinking, avoid judgment and stick to facts and feelings: “I found you passed out on the sofa yesterday afternoon and it scared me.”
• Be specific. Say, “I want you to quit drinking.”
• Be calm and communicate your expectations clearly.
• Offer help and support.

Talking with a parent about alcohol use disorder is a process, not an event. If you want help or more information, contact a behavioral health or addiction professional in your community.

Remember that having alcohol use disorder doesn’t change all the good and wonderful things about your mom or dad. Remind them of how important they are to you.

Resources

Adult Children of Alcoholics World Service Organization

Al-Anon Family Groups

National Association for Children of Alcoholics

By Drew Edwards, M.S., Ed.D.

©2012-2021 Carelon Behavioral Health

Summary

• Common signs of alcohol overuse in teens
• What to do

Every weekend, teens all over the United States are hanging out with their friends, watching movies, going to parties, and getting drunk.

Alcohol misuse and overuse continues to devastate the lives of teens and their families. According to the National Institute on Drug Abuse, more than 30 percent of high school seniors report being drunk within the last 30 days. The trend of teen drinking is very troubling because more kids are binge drinking than ever before. For boys, binge drinking is defined as consuming five or more drinks of any alcohol in one setting. For girls it is four drinks. There is nothing moderate or healthy about teenage drinking. Teens usually drink to get drunk.

For teens, alcohol problems can come crashing in like a tsunami or develop slowly over the course of several months. Parents must understand the tremendous pressure teens place on each other to drink. Knowing this will make you more aware of the signs of alcohol overuse.

Common signs of alcohol overuse in teens

• Significant change in mood or attitude
• Unexplained weight change
• Change in eating habits
• Change in sleep patterns
• Decline in school attendance and dropping grades
• Losing interest in activities that used to be important
• Defiance or rebelliousness
• Violations of curfew and other family rules
• Lying
• Argumentative, highly defensive, blaming others for problems
• Withdrawal from family activities
• Change of friends
• Secrecy about new friends or whereabouts
• Missing money or valuables from household

What to do

Many parents assume that drinking alcohol is a normal part of adolescence and that their child will simply grow out of it. They might not. Don’t make the mistake of waiting for your child to hit bottom, because that may be jail, serious injury, or even death. Here are some practical steps you can take:

• Learn more about the signs and symptoms of alcohol and substance use disorder.
• Look at your alcohol use. Make sure that you are setting a good example for your child.
• Don’t go it alone. Ask for help. Let a trusted friend, family, or clergy member in on the problem.
• Get involved with your teen. It’s not too late to develop a close bond with him.
• Tell her you love her and that you refuse to lose her to drugs or alcohol. Research shows that parents who remain connected to their child can avoid many of these kinds of problems.
• If your child denies drinking but seems intoxicated or tells you an unbelievable story contrary to the evidence, a simple breath test will detect alcohol. These disposable breath tests are available at drug stores or online.
• Have a zero tolerance policy for drug or alcohol use for your kids. Explain the consequences clearly.
• When a substance abusing teen has to face the consequences of his actions, he is more interested in seeking help.
• Never make excuses for your child’s behavior or cover up the evidence.
• Confront your child directly. Stick to facts and feelings: “I found this alcohol in your room and I am afraid that I may lose you.”
• Never bluff. Be willing to follow through on any actions or promises you make. Be sure to communicate your expectations clearly and calmly.
• Contact a behavioral health or addiction expert in your community for information about education and treatment programs.

If you are concerned about your teen, talk with your doctor or to a counselor in your community.

By Drew Edwards, M.S., Ed.D.

©2012-2019 Carelon Behavioral Health

Reviewed by Enrique B. Olivares, M.D., Director of Addiction Services, Beacon Health Options

Summary

Before forming an opinion about someone with substance use problems, consider these common myths.

“Those who overuse substances have a moral flaw.”

“People with alcohol and substance use disorders don’t want to quit—if they did, they would just stop using.”

“Locking up all the people who overuse substances will solve the problem.”

These and many other myths about drug use add to the problem. The stigma tied to drug use discourages treatment for addiction and limits chances for work, housing, and social relationships. Although drug use has a deep, harmful impact on society, it is not an insurmountable problem. Become part of the answer by helping to stop stigma.

Identifying the problem

Most American families have been touched in some way by a loved one with problems with drugs or drinking. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use & Health, 24.6 million Americans aged 12 or older said they had used an illicit drug during the month before the survey.

Unfortunately, many people who have problems with drug use will come across stigma that hinders them from integrating back into society. Police, the legal system, ER staff, and even family members and friends can keep the stigma going, and stigma limits the attention and resources dedicated to solving problems linked to substance use. “Stigma is about discrimination,” says Ivette Torres, Director of Consumer Affairs for SAMHSA’s Center for Substance Abuse Treatment.

Separating myth from fact

Stigma comes from the myths about drug use. Before forming an opinion about someone with substance use problems, think over these common myths:

Myth: Those who overuse substances have a moral flaw—they could will themselves to stop using if they wanted to quit.

Fact: One common and false stereotype about people with substance use disorders is that they are all social misfits and outcasts. “Stigma can also get at the idea that the person is weak of character or untrustworthy,” explains Jim Beek, a SAMHSA information officer. In reality, “normal” people deal with drug use issues, which can touch whole families. Drug and alcohol dependence meet the standards for treatable, chronic health issues; dependence is not simply a matter of choice. “One of the biggest and most pervasive myths is that … a user can stop using alcohol or drugs by willing themselves to,” agrees Torres. “Society at large has to accept addiction treatment and begin to look at it as a public health issue.”

Myth: Addiction is not reversible: Once an addicted to a substance, it is always that way.

Fact: Many people don’t realize how helpful programs and services can be in treating substance use disorder. In fact, drug addiction treatment works as well as established medical treatments for other illnesses such as diabetes and asthma, the Physician Leadership on National Drug Policy has reported. Another study found that for each dollar invested in treatment, taxpayers saved $7 in future costs, according to the National Institute on Drug Abuse.

Unfortunately, the shame tied to being labeled or viewed negatively by others can keep people from seeking care. “Stigma is a factor,” Torres notes. “That’s why you see so many individuals speaking out, saying, ‘Recovery is possible. I am an example of that.’’’ And luckily, new choices, such as the prescription addiction treatment drug buprenorphine, can help stop the stigma linked to lining up outside a clinic.

Myth: Harsher criminal penalties for using drugs or increasing efforts to cut off the drug supply will solve the problem.

Fact: This common wisdom is at odds with research showing the effectiveness of treatment. And, keep in mind that there is no “silver bullet” when it comes to solving drug use problems. While a blend of things such as treatment, parental influence, and education programs can help, taken alone, “get tough” approaches don’t address the underlying social and family issues linked to drug use.

You can help

While views about people with drug problems and treatments have gotten better, we still have a long way to go toward skillfully addressing these issues. You can help by facing your own attitudes. If you know someone who may have a drug problem, treat him with concern, dignity, and respect. Rather than turning your back or getting angry, offer your support.

Resources

National Institute on Drug Abuse
www.drugabuse.gov

Physician Leadership on National Drug Policy
www.plndp.org

Substance Abuse and Mental Health Services Administration
www.samhsa.gov/

By Kristen Knight

©2022 Carelon Behavioral Health

Alcohol overuse is on the rise in the United States and Canada. People from every racial, social, and ethnic group, along with men and women of all ages, are at risk. Plainly stated, alcohol overuse can affect anyone.

Yet there are some risk factors that make certain people more likely to have a problem than others. People with a family history of an alcohol use disorder (mainly among males), depression, or anxiety are more likely to overuse it. Also children who grow up with adults who drink often are more likely to over use alcohol. Children who were not raised with people who drink are less likely to develop a drinking problem.

Social acceptance

Over the last 30 years alcohol use has become more common. At one time, drinking was reserved for special events such as weddings and holidays or to celebrate a success or anniversary. Getting drunk was frowned upon. Many people today don’t wait for an event to drink, and equate getting drunk to having a good time. Many young people believe that drinking is the only way to have fun.

What is drinking in moderation?

The American Medical Association has defined drinking in moderation. For healthy men, this is no more than two alcoholic drinks a day. For healthy women, it is no more than one drink per day. A drink is defined as a 12-ounce can of beer, five ounces of wine, or 1.5 ounces of hard liquor.

Keep in mind that certain people should avoid drinking, period. Such people include pregnant women, those who run machinery, people on certain medications and anyone under the age of 21.

Defining alcohol use disorder

There are many varying definitions of alcohol use disorder. Some define overuse by how much or how often someone drinks. One more way is to look at what happens to your life as a result of drinking. It is a pattern of drinking that leads to harmful results.

Signs of alcohol use disorder

• Getting drunk
• Lying about drinking
• Lack of interest in family activities
• Mood swings
• Feeling too sad, angry, or nervous
• Conflicts with family members about drinking
• Failed tries to quit or cut back
• Poor job performance, late, or absent often
• For students, a drop in grades and attendance
• Legal problems such as traffic tickets, DUI, or arrests for alcohol-related conduct
• Poor moral judgment, loose sexual behavior, cheating, unsafe, forceful, or violent actions

What is an alcohol use disorder?

Many people drink in moderation and never have problems. For others, drinking becomes a major part of their life. An alcohol use disorder includes high tolerance for drinking and withdrawal symptoms during periods of going without. A typical person with an alcohol use disorder will drink often enough to keep from going into withdrawal.

But, many experts believe that alcohol use disorder is not simply about tolerance, or physical dependence, or how much or how often someone drinks. For some, the better question is “what happens to your life when you drink?” World-renowned alcohol expert Mark Gold, MD, observed that alcohol-dependent people “organize their life” around drinking. This is often at the cost of other priorities.

Being drunk can harm anyone’s judgment and actions. For most people, when drinking conflicts with their values or morality, the ensuing guilt and regret serves as a wake-up call. These painful emotions should lead to a good behavior change. For example, if a young man drank too much at a dinner party and flirted with his friend’s wife, he should feel regret and shame. In this situation, most men would commit to limit their use of alcohol or stop drinking. But a person with an alcohol use disorder may make excuses and not accept that drinking had harmed his judgment. Continuing to drink in spite of bad results is a telltale sign of a serious alcohol problem.

The bottom line

If drinking is causing conflicts in your life, talk with a friend or someone you trust. Ask them how they see you when you are drinking. If you need help, get it. Your family doctor, local mental health worker, or Alcoholics Anonymous (AA) are good places to start.

By Drew Edwards, M.S., Ed.D.

©2012-2022 Carelon Behavioral Health

Alcohol overuse is on the rise in the United States and Canada. People from every racial, social, and ethnic group, along with men and women of all ages, are at risk. Plainly stated, alcohol overuse can affect anyone.

Yet there are some risk factors that make certain people more likely to have a problem than others. People with a family history of an alcohol use disorder (mainly among males), depression, or anxiety are more likely to overuse it. Also children who grow up with adults who drink often are more likely to over use alcohol. Children who were not raised with people who drink are less likely to develop a drinking problem.

Social acceptance

Over the last 30 years alcohol use has become more common. At one time, drinking was reserved for special events such as weddings and holidays or to celebrate a success or anniversary. Getting drunk was frowned upon. Many people today don’t wait for an event to drink, and equate getting drunk to having a good time. Many young people believe that drinking is the only way to have fun.

What is drinking in moderation?

The American Medical Association has defined drinking in moderation. For healthy men, this is no more than two alcoholic drinks a day. For healthy women, it is no more than one drink per day. A drink is defined as a 12-ounce can of beer, five ounces of wine, or 1.5 ounces of hard liquor.

Keep in mind that certain people should avoid drinking, period. Such people include pregnant women, those who run machinery, people on certain medications and anyone under the age of 21.

Defining alcohol use disorder

There are many varying definitions of alcohol use disorder. Some define overuse by how much or how often someone drinks. One more way is to look at what happens to your life as a result of drinking. It is a pattern of drinking that leads to harmful results.

Signs of alcohol use disorder

• Getting drunk
• Lying about drinking
• Lack of interest in family activities
• Mood swings
• Feeling too sad, angry, or nervous
• Conflicts with family members about drinking
• Failed tries to quit or cut back
• Poor job performance, late, or absent often
• For students, a drop in grades and attendance
• Legal problems such as traffic tickets, DUI, or arrests for alcohol-related conduct
• Poor moral judgment, loose sexual behavior, cheating, unsafe, forceful, or violent actions

What is an alcohol use disorder?

Many people drink in moderation and never have problems. For others, drinking becomes a major part of their life. An alcohol use disorder includes high tolerance for drinking and withdrawal symptoms during periods of going without. A typical person with an alcohol use disorder will drink often enough to keep from going into withdrawal.

But, many experts believe that alcohol use disorder is not simply about tolerance, or physical dependence, or how much or how often someone drinks. For some, the better question is “what happens to your life when you drink?” World-renowned alcohol expert Mark Gold, MD, observed that alcohol-dependent people “organize their life” around drinking. This is often at the cost of other priorities.

Being drunk can harm anyone’s judgment and actions. For most people, when drinking conflicts with their values or morality, the ensuing guilt and regret serves as a wake-up call. These painful emotions should lead to a good behavior change. For example, if a young man drank too much at a dinner party and flirted with his friend’s wife, he should feel regret and shame. In this situation, most men would commit to limit their use of alcohol or stop drinking. But a person with an alcohol use disorder may make excuses and not accept that drinking had harmed his judgment. Continuing to drink in spite of bad results is a telltale sign of a serious alcohol problem.

The bottom line

If drinking is causing conflicts in your life, talk with a friend or someone you trust. Ask them how they see you when you are drinking. If you need help, get it. Your family doctor, local mental health worker, or Alcoholics Anonymous (AA) are good places to start.

By Drew Edwards, M.S., Ed.D.

©2012-2022 Carelon Behavioral Health