50 10.4 Substance Use and Abuse

Learning Objectives

  1. Define the terms “substance,” “abuse,” and “addictive.”
  2. Describe physical and mental effects associated with smoking and frequent or heavy drinking.
  3. List the risks of using drugs.
  4. Know how to get help if you have a substance use habit to break.

Substance is the word health professionals use for most things you might take into your body besides food. When people talk about substances, they often mean drugs—but alcohol and nicotine are also drugs and are considered substances.

Substances—any kind of drug—have effects on the body and mind. People use these substances for their effects. But many substances have negative effects, including being physically or psychologically addictive. What is important with any substance is to be aware of its effects on your health and on your life as a student, and to make smart choices. Use of any substance to the extent that it has negative effects is generally considered abuse.

First, consider your own habits and attitudes with the Substance Use Self-Assessment.

Substance Use Self-Assessment

Check the appropriate boxes.

Daily Sometimes Never
1. I smoke cigarettes or use smokeless tobacco.
2. I drink beer or other alcohol.
3. I have missed a class because I was hung over from drinking the night before.
4. I have taken a medication that was not prescribed for me.
5. I have used an illegal drug.

Write your answers.

  1. If you smoke cigarettes, how many a day do you usually smoke?

    __________________________________________________________________

    __________________________________________________________________

  2. If you drink alcohol (including beer), on how many days in a typical week do you have at least one drink?

    __________________________________________________________________

    __________________________________________________________________

  3. If you drink at parties or when out with friends, how many drinks (or beers) do you typically have at one time?

    __________________________________________________________________

    __________________________________________________________________

  4. If you use a pharmaceutical or illegal drug, how often do you take it?

    __________________________________________________________________

    __________________________________________________________________

  5. Are your habits of smoking, drinking, or using other drugs affecting your studies or grades?

    __________________________________________________________________

    __________________________________________________________________

Smoking and Tobacco: Why Start, and Why Is It So Hard to Stop?

Everyone knows smoking is harmful to one’s health, and that smoking causes cancer and lung and heart disease. Most adult smokers continue smoking not because they really think it won’t harm them but because it’s very difficult to stop.

If you have never smoked or used smokeless tobacco, feel good about your choices. But read this section anyway because you may have friends now or in the future who smoke, and it’s important to understand this behavior. If you do smoke, even only rarely as a “social smoker,” be honest with yourself—wouldn’t you like to stop if you thought you could without suffering? Simply by being in university now, you’ve shown that you care about your future and your life. You likely care about your health, too.

Many young smokers think there is plenty of time to quit later. Social smokers, who may have a cigarette only occasionally with a friend, usually think they won’t develop a habit. But smokers are fooling themselves. Nicotine is a very addictive drug. Admitting this to yourself is the first step toward becoming smoke free.

First, the good news. Stopping smoking brings immediate health benefits, and the benefits get better over time. Just twenty minutes after quitting, your heart rate drops. After two weeks to three months, your heart attack risk begins to drop and your lung function begins to improve. After one year, your added risk of coronary heart disease is half that of a smoker’s. And every year your health continues to improve[1].

Tips for Stopping Smoking

Stopping isn’t easy. Many ex-smokers say it was the hardest thing they ever did.

However, you know it’s worth the effort. And it’s easier if you think it through and make a good plan. There’s lots of help available. Before you quit, the National Cancer Institute suggests you START with these five important steps[2]:

  1. S = Set a quit date.
  2. T = Tell family, friends, and coworkers that you plan to quit.
  3. A = Anticipate and plan for the challenges you’ll face while quitting.
  4. R = Remove cigarettes and other tobacco products from your home, car, and work.
  5. T = Talk to your doctor about getting help to quit.

To get ready, download this booklet to help you quit smoking; “On the road to Quitting‘, published by Health Canada.

When You Really Crave a Cigarette

Remember that the urge to smoke will come and go. Try to wait it out. Use these tips:

  • Keep other things around instead of cigarettes. Try carrots, pickles, sunflower seeds, apples, celery, raisins, or sugar-free gum.
  • Wash your hands or the dishes when you want a cigarette very badly. Or take a shower.

  • Learn to relax quickly by taking deep breaths.

    • Take ten slow, deep breaths and hold the last one.
    • Then breathe out slowly.
    • Relax all of your muscles.
    • Picture a soothing, pleasant scene.
    • Just get away from it all for a moment.
    • Think only about that peaceful image and nothing else.
  • Light incense or a candle instead of a cigarette.
  • Where you are and what is going on can make you crave a cigarette. A change of scene can really help. Go outside or go to a different room. You can also try changing what you are doing.
  • No matter what, don’t think, “Just one won’t hurt.” It will hurt. It will undo your work so far.
  • Remember that trying something to beat the urge is always better than trying nothing.

Get Help to Stop Smoking

A lot of people are not able to stop smoking by themselves, so don’t feel bad if you aren’t successful the first try. Ask your doctor about other ways to stop. Maybe nicotine-replacement therapy is what you need. Maybe you need prescription medication. Stop by the Student Health Services at the University of Saskatchewan and learn about smoking cessation programs. Your doctor and other health professionals at your school have a lot of experience helping people—they can help you find what works for you.

What’s the Big Deal about Alcohol?

Of all the issues that can affect a student’s health and success in university, drinking causes more problems than anything else. Everyone knows what happens when you drink too much. Your judgment is impaired and you may behave in risky ways. Your health and studies are likely to be affected.

Most university students report drinking at least some alcohol at some point in time—and even those who do not drink are often affected by others who do. Here are a few facts about alcohol use among university students[3].

  • Assault. 10% of surveyed undergraduate students indicated that had experienced alcohol-related violence.
  • Sexual abuse. Over 14% of those surveyed indicated that they had unplanned sexual relations due to alcohol.
  • Alcohol abuse and dependence. 32% of undergraduates aged 18-24, reported drinking at a dangerous level in the past year.
  • Academic problems. Negative consequences were reported by the students who drank: 31.6% reported being unable to perform daily activities, 18.8% reported missing class, and 32.9% reported study interruptions.

So why is drinking so popular if it causes so many problems? You probably already know the answer to that: most university students would say they have more fun when drinking. It is unlikely that they’re going to stop drinking just because someone lectures them about it.

Like everything else that affects your health and happiness—eating, exercise, use of other substances—drinking is a matter of personal choice. Like most decisions we all face, there are trade-offs. The most that anyone can reasonably ask of you is to be smart in your decisions. That means understanding the effects of alcohol and deciding to take control.

Myths about Alcohol[4]

Myth: I can drink and still be in control.

Fact: Drinking impairs your judgment, which increases the likelihood that you will do something you’ll later regret such as having unprotected sex, being involved in date rape, damaging property, or being victimized by others.

Myth: I can sober up quickly if I have to.

Fact: It takes about two hours to eliminate the alcohol content of one drink, depending on your weight. Nothing can speed up this process—not even coffee or cold showers.

Myth: I can manage to drive well enough after a few drinks.

Fact: The effects of alcohol start sooner than people realize, with mild impairment (up to .05 Blood Alcohol Content) starting to affect speech, memory, attention, coordination, and balance.

Myth: Beer doesn’t have as much alcohol as hard liquor.

Fact: A 12-ounce bottle of beer has the same amount of alcohol as a standard shot of 80-proof liquor (either straight or in a mixed drink) or 5 ounces of wine.

University Alcohol Awareness Programs

The University of Saskatchewan has recognized the problems resulting from underage and excessive alcohol use, and in recent years they have supported resources to help students become more aware of the problems of binge drinking as a student. What’s Your Cap? is one such resource that seeks to “raise awareness and knowledge of the risks involved with the over consumption of alcohol and promote a culture of moderation on the University of Saskatchewan campus.” Visit the website at whatsurcap.ca for a host of resources and information.

The goal of these resources is not to preach against drinking. You’ll be able to learn more about the effects of alcohol on the body and mind. You’ll learn about responsible drinking versus high-risk drinking. You’ll be able to access resources that will help you think about your own attitudes and learn coping strategies to help prevent or manage a problem.

Video – Understanding Addiction as a Disease (length 3:40)

How Much Alcohol Is Too Much?

There’s no magic number for how many drinks a person can have and how often. If you’re of legal drinking age, you may not experience any problems if you have one or two drinks from time to time. According to Health Canada, ‘heavy drinking’ occurs when a male consumes 5 or more drinks (4 for females) per occasion, at least once a month during the past year[5].

As with most things that can affect your health and your well-being as a student, what’s important is being honest with yourself. You’re likely drinking too much or too often if

  • you have missed classes or work because you were hung over or overslept after drinking;
  • your friends or family members have hinted that you drink too much, or you’ve hidden your drinking from others;
  • your drinking is causing trouble in a relationship;
  • you can’t remember what you did or said while drinking;
  • you need to drink to have a good time at a party or with friends;
  • you’ve driven a car when you know you shouldn’t have after drinking;
  • you binge drink (consume five or more drinks at a time).

Pressures to Party

Most of us can remember times when we were influenced by our friends and others around us to behave in some way we might not have otherwise. Say, for example, I have a big test tomorrow, and I’ve been studying for hours, and just when I knock off to relax for a while, a friend stops by with a six-pack of beer. I’d planned to get to bed early, but my friend pops open a beer and sticks it in my hand, saying it will help me relax. So I tell myself just one, or maybe two—after all, that’s not really drinking. And let’s say I stop after two (or three) and get to bed. Maybe I don’t sleep quite as well, but I still pass the test in the morning. So—was that peer pressure or my decision?

There are no easy answers! What matters is that you think about your own habits and choices and how to take control of your own life.

Read this case study about a student who joins a university club and feels pressured to drink. You may be very different from him—maybe you’re older and work full time and are taking night courses—but you still should be able to relate to his issues. As you answer the questions about his situation, think about how the same questions might also apply to someone in your own situation.

Case Study

Pressured to Drink

When John decided to stay at the university residences’, he knew there would likely be drinking in his hall. He had had a few beers at parties through high school but had never binged and felt there was nothing wrong with that as long as he kept it under control. But he was surprised how much alcohol flowed through the residence, and not just at parties—and the house advisor just seemed to look the other way. He wanted to fit in, so he usually had a few whenever his roommate or others called him away from studying. One night he definitely drank too much. He slept late, missed his first two classes, and felt rotten most of the day. He told himself he’d drink only on weekends and only in moderation. Being underage didn’t bother him, but his grades hadn’t been all that great in high school, and he didn’t want to screw up his first year in university. But it was only one day before some of the older students from his residence interrupted his studying again and stuck a beer in his hand. He didn’t know what to do.

  1. Is John at risk for developing any problems if he tries to fit in with the drinkers while promising himself he would drink only moderately? Why or why not?

    __________________________________________________________________

    __________________________________________________________________

  2. If John decides to hold firm and drink only on weekends when he didn’t have to study, is he still at any risk for developing a problem? Why or why not, depending on what circumstances?

    __________________________________________________________________

    __________________________________________________________________

  3. If John decides to tell his friends he does not want to drink, what should he say or do if they continue to pressure him?

    __________________________________________________________________

    __________________________________________________________________

What to Do

If you think you may be drinking too much, then you probably are. Can you stop—or drink moderately if you are of age—and still have fun with your friends? Of course. Here are some tips for enjoying yourself in social situations when others are drinking:

  • Drink only moderately (if above legal age) and slowly. Your body processes alcohol at a rate of about one drink an hour—drinking faster than that leads to problems. Sip slowly. Set yourself a limit and stick to it.
  • Drink a mixer without the alcohol. It tastes just as good or better. Alternate alcoholic drinks with nonalcoholic ones to slow down the pace.
  • Rather than just standing around with others who are drinking, stay active: move about and mingle with different people, dance, and so on.
  • If someone tries to make you uncomfortable for not drinking, go talk to someone else.

Because drinking is a serious issue in many places, it’s a good idea to know what to do if you find yourself with a friend who has had too much to drink:

  • Stay with the person if there is any risk of him hurting himself (driving, biking) or passing out. Take away his keys if necessary.
  • If he passes out after drinking a great deal of alcohol fast and cannot be awakened, get medical help.
  • An intoxicated person who falls asleep or passes out on his back is at risk of choking on vomit—roll him on his side or face down.
  • Do not try to give him food or other substances in an effort to sober him up.
  • Don’t put him in a cold shower, which could cause unconsciousness.

If You Feel You Need Help

Visit Student Health Services or talk with your university counselor. They understand how you feel and have a lot of experience with students feeling the same way. They can help.

Prescription and Illegal Drugs

People use drugs for the same reasons people use alcohol. They say they enjoy getting high. They may say a drug helps them relax or unwind, have fun, enjoy the company of others, or escape the pressures of being a student. While alcohol is a legal drug for those above the drinking age, most other drugs—including the use of many prescription drugs not prescribed for the person taking them—are illegal. They usually involve more serious legal consequences if the user is caught. Some people may feel there’s safety in numbers: if a lot of people are using a drug, or drinking, then how can it be too bad? But other drugs carry the same risks as alcohol for health problems, a risk of death or injury, and a serious impact on your ability to do well as a student.

As with alcohol, the choice is yours. What’s important is to understand what you’re doing and make smart choices. What’s the gain, and what are the risks and costs?

While society may seem to condone drinking, and the laws regarding underage drinking or being drunk in public may not seem too harsh, the legal reality of being caught with an illegal drug can impact the rest of your life. Arrest and conviction may result in being expelled from university—even with a first offense. A conviction is a permanent legal record that can keep you from getting the job you may be going to university for.

Although the effects of different drugs vary widely, a single use of a drug can have serious effects and consequences. Even if you’re told that a pill is a prescription medication whose effects are mild or safe, can you really be sure of the exact ingredients and strength of that pill? Do you fully understand how it can affect you with repeated use? Can it be addictive? Could it show up on an unexpected random drug test at work?

Table 10.1 “Common Prescription and Illegal Drugs on Campuses” lists some of the possible effects of drugs used by university students. Good decisions also involve being honest with oneself. Why do I use (or am thinking about using) this drug? Am I trying to escape some aspect of my life (stress, a bad job, a boring class)? Could the effects of using this drug be worse than what I’m trying to escape?

Table 10.1 Common Prescription and Illegal Drugs on Campuses[6]

Drug and Common Names Intended Effects Adverse Effects Common Overdose Effects
Anabolic Steroids Muscle development Liver cancer, sterility, masculine traits in women and feminine traits in men, aggression, depression, mood swings —
Barbiturates Reduced anxiety, feelings of well-being, lowered inhibitions Addiction; slowed pulse and breathing; lowered blood pressure; poor concentration; fatigue; confusion; impaired coordination, memory, and judgment Coma, respiratory arrest, death
Prescription Opioids: OxyContin, Vicodin, Demerol Pain relief, euphoria Addiction, nausea, constipation, confusion, sedation, respiratory depression Respiratory arrest, unconsciousness, coma, death
Heroin Pain relief, anxiety reduction Addiction, slurred speech, impaired vision, respiratory depression Respiratory failure, coma, death
Morphine Pain relief, euphoria Addiction, drowsiness, nausea, constipation, confusion, sedation, respiratory depression Respiratory arrest, unconsciousness, coma, death
Ritalin Stimulant: mood elevation, increased feelings of energy Fever, severe headaches, paranoia, excessive repetition of movements and meaningless tasks, tremors, muscle twitching Confusion, seizures, aggressiveness, hallucinations
Amphetamines: Dexedrine, Benzedrine, methamphetamine Stimulant: mood elevation, increased feelings of energy Addiction, irritability, anxiety, increased blood pressure, paranoia, psychosis, depression, aggression, convulsions, dizziness, sleeplessness Convulsions, death
Cocaine, Crack Stimulant: mood elevation, increased feelings of energy Addiction, paranoia, hallucinations, aggression, insomnia, and depression, elevated blood pressure and heart rate, increased respiratory rate, insomnia, anxiety, restlessness, irritability Seizures, heart attack, death
Ecstasy Stimulant: mood elevation Panic, anxiety, depression, paranoia, nausea, blurred vision, increased heart rate, hallucinations, fainting, chills, sleep problems Seizures, vomiting, heart attack, death
Marijuana, Hash Euphoria Impaired or reduced comprehension, altered sense of time; reduced ability to perform tasks requiring concentration and coordination; paranoia; intense anxiety attacks; impairments in learning, memory, perception, and judgment; difficulty speaking, listening effectively, thinking, retaining knowledge, problem solving —
LSD Hallucinogen: altered states of perception and feeling Elevated blood pressure, sleeplessness, tremors, chronic recurring hallucinations (flashbacks) —

Resources for Help

If you have questions or concerns related to drug use, your doctor or Student Health Services can help. Check these Web sites for additional information:

Key Takeaways

  • Excessive drinking or substance abuse is a common—but unhealthy—response to the stresses of university life. While the decisions are yours, it’s important to understand the effects of tobacco, alcohol, and drugs and how they impact your life.
  • Quitting smoking is hard, but it’s clearly worth it—and lots of help is available. If you’re a smoker, make this the year you become proud of yourself for quitting.
  • If you like to drink, be honest with yourself. How much does drinking enrich your life, and how much do the effects of drinking interfere with your life? Make smart decisions so that you live your life to its fullest without regrets about losing control.
  • Avoiding drugs can be a complicated issue, certainly not as simple as simply deciding to say no. But you’ve already made the decision to attend university, and that’s a smart decision. Make smart choices in other areas of your life as well.

Checkpoint Exercises

  1. “Social smoking”—having a cigarette just every now and then with a friend—may not have significant health effects, but why is this still a problem?

    __________________________________________________________________

  2. For each of the following statements about drinking, circle T for true or F for false:

    T F After a few drinks, you can sober up more quickly by eating or drinking coffee.
    T F A fourth of university students experience academic consequences from their drinking.
    T F A 12-ounce beer has about half the alcohol of a standard shot of 80-proof liquor.
    T F Moderate drinking is defined as no more than four drinks a day for men or two drinks a day for women.
    T F A night of heavy drinking affects your thinking ability for up to two weeks afterward.

  3. If smoking marijuana relaxes you, can it minimize the stress you may feel over time in your life? Why or why not?

    __________________________________________________________________

 

  1. Health Canada. (2012). On the road to Quitting - Guide to becoming a non-smoker. Retrieved from: http://healthycanadians.gc.ca/publications/healthy-living-vie-saine/non-smoker-adult-non-fumeur-adulte/index-eng.php ↵
  2. National Cancer Institute. (2008). Clearing the Air: Quit Smoking Today. Retrieved from: https://smokefree.gov/sites/default/files/pdf/clearing-the-air-accessible.pdf ↵
  3. Adlaf, E.M., Demers, A. & Gliksman, L. (2004). Canadian Campus Survey 2004. Toronto, ON: Centre for Addiction & Mental Health. Retrieved from: http://www.camh.ca/en/research/research_areas/institute-mh-policy-research/Documents/CCS_2004_report.pdf ↵
  4. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol Myths. Retrieved from: http://www.collegedrinkingprevention.gov/SpecialFeatures/alcoholMyths.aspx ↵
  5. Statistics Canada. (2015). Heavy Drinking, 2013. Retrieved from: http://www.statcan.gc.ca/pub/82-625-x/2014001/article/14019-eng.htm#n1 ↵
  6. Centers for Disease Control and Prevention. (2016). Common Prescription and Illegal Drugs on Campuses. Retrieved from: http://www.cdc.gov/DataStatistics/ ↵

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