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.
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.
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 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.
Research has shown that no amount of alcohol is good for your health, even small amounts can be harmful. Try to drink less by paying attention to how much you drink, setting a weekly target, and making sure you do not have more than 2 standard drinks on any day.
In Canada, a standard drink is equal to:
- A bottle of beer (12 oz., 341 ml, 5% alcohol).
- A bottle of cider (12 oz., 341 ml, 5% alcohol).
- A glass of wine (5 oz., 142 ml, 12% alcohol).
- A shot glass of spirits (1.5 oz., 43 ml, 40% alcohol).
If you think you might have a problem with alcohol, talk to your doctor.
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.