Overview

Alcohol and drug use: Overview

Some people who drink alcohol, use recreational or illegal substances (drugs), use prescription medicines not as prescribed, or use non-prescription medicines or household products in ways they weren't intended may develop substance use disorder. One of the signs of substance use disorder is that you keep using alcohol or substances even though you know it's causing problems in your life. Another sign is that you have a strong need or craving to drink or use substances.

Using alcohol or other substances can affect your health, work, school, and relationships. It can change how well you make decisions, how well you think, and how quickly you can react. And it can make it hard for you to control your actions. In young people, using alcohol or other substances can affect their general health, physical growth, and emotional and social development.

Alcohol

You may have alcohol use disorder if drinking alcohol affects your health or daily activities. You may be dependent on alcohol if you physically or emotionally need alcohol to get you through your day.

Symptoms of alcohol use disorder include personality changes, blackouts, drinking more to get the same effect, and denial of the problem. If you have alcohol use disorder, you may gulp or sneak drinks, drink alone or early in the morning, and have the shakes. You may also have family, school, or work problems or get in trouble with the law because of drinking.

Alcohol use patterns vary. Some people drink and may be intoxicated every day. Other people drink large amounts of alcohol at specific times, such as on the weekend. Others may be sober for long periods and then go on a drinking binge that lasts for weeks or months.

People who are dependent on alcohol may have withdrawal symptoms, such as sweating and feeling sick to their stomach, feeling shaky, and feeling anxious. In rare cases, severe symptoms of withdrawal can occur such as delirium tremens, or DTs. Treatment for withdrawal from alcohol requires medical care.

The use of alcohol with medicines or other substances may increase the effects of each.

Recreational and illegal substances

People who use cannabis or illegal substances, such as methamphetamines, cocaine, heroin, or other "street drugs," may develop substance use disorder. They may use substances to get a "high" or to relieve stress and emotional problems.

Substances like ecstasy (MDMA) and date rape drugs, such as gamma-hydroxybutyrate (GHB), flunitrazepam (Rohypnol), and ketamine, are often used at all-night dances, raves, trances, or clubs. These substances are known as "club drugs." They can cause poisoning and be especially dangerous when combined with other substances or alcohol. Inhalants like nitrous oxide may also be used.

These substances come in different forms and can be used in different ways. They can be smoked, snorted, inhaled, taken as pills, put in liquids or food, put in the rectum or the vagina, or injected with a needle.

Prescription and non-prescription medicines

Some people use prescription medicines, like opioids (such as Oxyneo and Dilaudid), benzodiazepines (such as Valium and Xanax), and stimulants (such as Ritalin and Adderall), in ways they were not prescribed.

Some non-prescription medicines, such as cold medicines that have dextromethorphan as an ingredient, are being used as a way to get high. What effects these substances may have on your health depend on the type, strength, and amount of these substances you use and whether you take them with other substances or alcohol. The use of prescription and over-the-counter medicines with alcohol or other substances may increase the effects of each substance.

Household products

Glue, shoe polish, cleaning fluids, and aerosols are common household products with ingredients that are also being used to get high.

Signs of substance use disorder

Signs of substance use disorder depend on the substance you use and how it affects you. Not all substances affect people the same way. One of the signs that your substance use may be becoming a problem is that you take more of it over longer periods of time and need more to feel "high." Another sign is that you spend a lot of time trying to get the substance, and you give up other activities to do this. When you have substance use disorder, you or others may notice some changes in your behaviour. You may be moody, have problems sleeping, or pay less attention to how you dress or look. Or you may lie, steal, or hide things from people and act sneaky.

You may have substance use disorder if your substance use affects your health or daily activities. You may be dependent on substances if you physically or emotionally need them to get you through your day. You may not be aware that you have become dependent on a substance until you try to stop taking it. People who are dependent on substances may have withdrawal symptoms, such as sweating and feeling sick to their stomach, feeling shaky, and feeling anxious.

Substance use disorder in older people may go unnoticed, since the signs may be similar to those of aging. Older adults often take medicines, such as sleep medicines and painkillers, that can lead to substance use disorder.

Health risks of alcohol and substance use

When you use alcohol or other substances, you may be putting your health and safety at risk.

Alcohol or substance use can:

• Make car crashes more likely. If you drink and drive, or if you drive while you are high, you can easily hurt yourself or others.
• Lead to unprotected sex and/or sexual assault. This can lead to pregnancy and sexually transmitted infections (STIs), including HIV.
• Increase the risk of overdose, injury, and death.
• Cause you to do things you wouldn't usually do. You may say things that hurt your friends. Or you may do something illegal that could result in paying a large fine or going to jail, like being arrested for driving while intoxicated.
• Affect your work or schoolwork. It can cause you to lose your job or drop out of school.
• Change how you feel about your life. It can lead to depression and suicide.
• Cause mood swings and affect your sleep and your ability to think, learn, reason, remember, and solve problems.
• Harm many organs and systems in the body, such as the liver, pancreas, heart, brain, and nervous system.
• Contribute to the development of some cancers, such as cancers of the mouth, throat, esophagus, liver, colon, and breast.
• Cause high blood pressure, stomach problems, or sexual problems.
• Cause harm to a developing baby (fetus) if alcohol or other substances are used during pregnancy.

Recognizing a problem

Alcohol

Alcohol is part of many people's lives and may have a place in cultural and family traditions. So it can sometimes be hard to know when you begin to drink too much.

If you think you might have a problem with alcohol, talk to your doctor.

Other substances

A person might not realize that their substance use is a problem. They might not use substances in large amounts. Or they might go for days or weeks between using substances. But even if they don't use substances very often, their substance use could still be harmful and put them at risk.

If you think you might have a problem with other substances, talk to your doctor.

Self-Care

If you are concerned about your own or another person's alcohol or drug use, learn what steps to take to help yourself or someone else.

• Never ignore the problem.
• Know the signs of substance use. These include new problems at work or school.
• Make an appointment with a doctor or another health professional, such as a counsellor, to discuss it as a medical problem.
• Find out when support groups, such as Alcoholics Anonymous (AA), LifeRing, Narcotics Anonymous (NA), or SMART Recovery, meet. These self-help groups help members get sober and stay that way. There are also support groups for family members and friends. Call them for the times of scheduled meetings.
• Ask the other person if they would accept help. Don't give up after the first "no." Keep asking. If the person agrees, act that very day to arrange for help.
• Provide support for another person during detoxification or other treatment.
• Help set up community services in the home, if needed. Older adults may benefit from services like home care, nutritional programs, transportation programs, and other services.
• Help with decision-making. Many people who misuse substances can't process information or communicate their decisions well.
• Check out what services are available in your area.
  • Talk to your human resources department about getting a referral to your employee assistance program, if your employer offers it.
  • Visit Wellness Together Canada online at www.wellnesstogether.ca to learn about treatment programs in your area. Talking to someone about your feelings about substance use can help.

Ways to reduce harm from substance use

Although there is no amount of alcohol or drug use that is safe, there are some things you can do to reduce your risk of serious health problems and injuries caused by alcohol or drug use.

• Avoid risky situations and activities. Don't drink or get high and drive, and don't get in a car with a driver who has been drinking or using drugs.
• Make a plan to get home safely. For example, choose a designated driver, have money to pay for a taxi or bus fare, or call a loved one for a safe ride home.
• Don't take over-the-counter or prescription medicines that interact with alcohol. And don't take these medicines with drugs or other harmful substances.
• Don't use alcohol or drugs if you're pregnant or trying to get pregnant. These substances can increase your baby's chance of being born with a birth defect or fetal alcohol syndrome.
• Don't mix alcohol with drugs or other harmful substances.
• Don't use alcohol or drugs to try to make yourself feel better. Using alcohol or drugs may make your problems worse and may cause you to do things that you normally wouldn't do, like hurt yourself or others.
• Be aware at all times of your surroundings and the people around you.
• Limit how much you use alcohol or other substances. The more you use, the greater the risk of getting sick, hurt, or in trouble.

Reducing harm from alcohol

• Have a meal or a snack with a drink. Don't drink on an empty stomach.
• Drink slowly. Don't have more than 2 standard drinks in any 3-hour period.
• Have a glass of water or other non-alcoholic, caffeine-free beverage (such as a soft drink or fruit juice) between drinks.

Reducing harm from drugs

• Ask your pharmacist or doctor whether any of your current medicines can cause dependence.
  • Be especially aware of pain medicines (such as opioids), tranquilizers, sedatives, and sleeping pills. Follow the instructions carefully, and do not take more than the recommended dose.
  • Make sure that your doctors are aware of medicines prescribed by another doctor. Use only one pharmacy when getting your prescriptions filled.
• Don't share needles, syringes, and other equipment (such as cookers, cotton, cocaine spoons, or eyedroppers) with others if you use drugs. Be aware of who you get your supplies from. Be sure the supplies haven't been used before. If you use dirty needles or equipment, you can get hepatitis, HIV, or other serious infections.
• Be aware of who you get your drugs from. Drugs can vary greatly in strength depending on who you get them from.
• Be aware of how a drug might affect you, especially if you stopped using the drug and then started using again. You may not be able to handle the same amount of the drug as you could before.
• Don't leave your beverage unattended or accept a drink from an open container.
• Create a safe environment. If you use drugs, make sure you do it in a place where other people are around so you can get help if you need it.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• Symptoms occur more often or are more severe.

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