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Alcohol and Substance Abuse
Alcohol Abuse is a pattern of drinking excessively despite the negative effects of alcohol (beer, wine, liquer).


Substance Abuse
is a pattern of harmful use of any substance (drugs, inhalants, etc.) for mood-altering purposes.

Both can cause harm to one’s health, interpersonal relationships, and/or ability to work.

 
Alcohol
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Alcohol is Ethyl Alcohol, or Ethanol, a colorless volatile flammable liquid, C2H5OH that is the intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches.

Alcohol is metabolized extremely quickly by the body.  Unlike foods, which require time for digestion, alcohol needs no digestion and is quickly absorbed.   Alcohol gets the VIP treatment in the body by absorbing and metabolizing before most other nutrients.  About 20% is absorbed directly across the walls of an empty stomach and can reach the brain within one minute.  Once alcohol reaches the stomach, it begins to break down, which reduces the amount of alcohol entering the blood by approximately 20%.  In addition, about 10% of the alcohol is expelled in the breath and urine.  The level of alcohol in body fluids is dependent on three distinct processes - absorption, distribution, and elimination.


 
Alcohol is rapidly absorbed in the upper portion of the small intestine. It then travels to the liver via the veins and capillaries of the digestive tract, then to the right side of the heart, the lungs and then into the general circulation. It is rapidly distributed throughout the body water. The rate of absorption varies according to:
 - The nature of the drink: carbonated drinks are absorbed faster, but very strong drinks sedate the stomach and are absorbed more slowly;
 - The presence of food in the stomach which tends to delay absorption by delaying gastric emptying.

Alcohol is mostly absorbed from the intestine. During passage throughout the circulation some alcohol will move in and out of the blood stream into the tissues until equilibrium is attained. Organs with a rich blood supply such as lungs, kidneys and brain will initially receive a proportionally higher amount of alcohol, and may have higher blood alcohol concentrations in the initial phase than tissues with a lower blood flow. 

Alcohol is eliminated in two different ways, mostly by breakdown in the liver and other tissues but a small amount is excreted in breath, saliva, urine, feces and sweat (~3%). The rate of elimination is not dependent on the concentration of alcohol present, but varies from 0.0103 to 0.026 gram per cent per hour in light to moderate drinkers and may be more than 0.27 grams % per hour in heavy drinkers.  If more alcohol arrives in the liver than the enzymes can handle, the excess alcohol travels to all parts of the body, circulating until the liver enzymes are finally able to process it, which is a good reason not to consume more than one drink per hour.  The liver cells are the only cells in our body that can produce enough enzymes to oxidize alcohol at an appreciable rate.  Though alcohol affects every organ of the body, its most dramatic impact is on the liver.  The liver cells normally prefer fatty acids as fuel, and package excess fatty acids as triglycerides, which they then route to other tissues of the body.  However, when alcohol is present, the liver cells are forced to first metabolize the alcohol, letting the fatty acids accumulate, sometimes in huge amounts.  Alcohol metabolism permanently changes liver cell structure, which impairs the liver's ability to metabolize fats.  This explains why heavy drinkers tend to develop fatty livers.


For moderate drinkers, alcohol does not suppress food intake, and may actually increase appetite.  Chronic alcohol consumption appears to have the opposite effect.  Alcohol causes euphoria, which depresses appetite, so that heavy drinkers tend to eat poorly and become malnourished.

Alcohol is very rich in energy, packing 7 calories per gram.  But like pure sugar or fat, the calories are void of nutrients.  The more calories an individual consumes in alcohol, the less likely it is that they will eat enough food to obtain adequate nutrients.  To make matters worse, chronic alcohol abuse not only displaces calories from needed nutrients, but also interferes with the body's metabolism of nutrients, leading to damage of the liver, digestive system, and nearly every bodily organ.

Alcohol works in the body as a depressant, slowing the brain's function.  The more someone drinks, the more the central nervous system slows down, sometimes to a dangerous point.  As little as two beers or drinks can impair coordination and thinking.  With prolonged drinking of alcohol, the brain and other bodily organs are permanently damaged.

High Blood Pressure: Excessive alcohol use can raise your blood pressure to an unhealthy level. Reducing alcohol consumption will reduce blood pressure readings by a few points on both the systolic and diastolic numbers. High blood pressure is directly related to the occurrence of stroke.

Stroke: Heavy drinking is linked to both ischemic and hemorrhagic stroke. Ischemic stroke occurs when an artery is blocked to the brain thus causing damage and/or death to the brain tissue due to the cutoff of the oxygen and nutrient supply. Approximately 88% of strokes are Ischemic. Hemorrhagic stroke occurs when a diseased blood vessel bursts and allows blood to leak into the brain. This sudden increase in pressure causes damage to the brain cells and can lead to unconsciousness and even death. The most common cause is high blood pressure.

Cardiomyopathy: Cardiomyopathy is a general term for a group of diseases that abnormally enlarge, thicken or stiffen heart muscle and reduce pumping effectiveness. Heart failure occurs when the heart cannot pump enough blood to meet the body's oxygen needs. Drinking alcohol in large quantities has a toxic effect on the hearts muscle. It's mostly seen in men ages 45-55 but can occur in anyone who drinks alcohol over long periods of time.



With moderate drinking, the liver can process alcohol fairly safely.  However, heavy drinking overtaxes the liver resulting in serious consequences.  A liver clogged with fat causes liver cells to become less efficient at performing their necessary tasks, resulting in impairment of a person?s nutritional health.  Fatty liver is the first stage of liver deterioration in heavy drinkers, and interferes with the distribution of oxygen and nutrients to the liver?s cells.  If the condition persists long enough, the liver cells will die, forming fibrous scar tissue (the second stage of liver deterioration, or fibrosis).  Some liver cells can regenerate with good nutrition and abstinence, however in the last stage of deterioration, or cirrhosis, the damage to the liver cells is the least reversible.


Arthritis

Increases risk of gouty arthritis

Cancer

Increases the risk of cancer in the liver, pancreas, rectum, breast, mouth, pharynx, larynx and esophagus 

Fetal Alcohol Syndrome

Causes physical and behavioral abnormalities in the fetus

Hyperglycermia

Raises blood glucose

Hypoglycemia

Lowers blood glucose, especially for people with diabetes

Kidney Disease

Enlarges the kidneys, alters hormone functions, and increases the risk of kidney failure

Nervous Disorders

Causes neuropathy and dementia; impairs balance and memory

Obesity

Increases energy intake, but not a primary cause of obesity

Psychological disturbances

Causes depression, anxiety and insomnia

 

Moderate use of alcohol can be an enjoyable, safe experience if used with caution. If you do choose to drink, sip each drink slowly, and always consume alcohol with food.  Spaces drinks out to no more than one drink per hour, and consume plenty of water in between drinks.  Never drink while pregnant and never drive when intoxicated.

  • Do you have a problem with Alcohol?
  • Have you ever felt you should cut down on your drinking?
  • Have people annoyed you by criticizing your drinking?
  • Have you ever felt bad or guilty about your drinking?
  • Have you ever had a drink the first thing in the morning to steady your nerves or get rid of a hangover?

If you answered Yes to one question, you may have a problem with alcohol.  More than one Yes answer makes it highly likely that a problem exists.  If you feel you have a problem with alcohol, please see your health professional right away.  Effective treatment is available.


Responsible drinking means that you take precautions with your drinking so that it does not harm yourself, your family, or society at large.


Drinking, like eating, or any social activity, has some guidelines to help the participant get more enjoyment out of the activity. Gobbling down half a chocolate cake at a party would not be considered responsible eating or even polite in most cultures. The same goes for drinking. Responsible choices concerning sensible drinking may mean not drinking, such as when a person is sick, taking medications or being the designated driver. Responsible drinking means that you never have to feel sorry for what has happened while you were drinking. Basically, this means not becoming drunk. The following are some hints to help you drink responsibly and derive more enjoyment and pleasure from drinking if you choose to consume alcohol.

1. Know your limit. If you do not already know how much alcohol you can handle without losing control. Most people find that no more than a drink an  hour will keep them in control of the situation and avoid drunkenness.

2. Eat food while you drink. It is particularly good to eat high protein foods such as cheese and peanuts, which help to slow the absorption of alcohol into the circulatory system.

3. Sip your drink. If you gulp a drink for the effect, you are losing a pleasure of drinking, namely tasting and smelling the various flavors. This is particularly true for premium beers and fine wines.

4. Accept a drink only when you really want one. At a party, if someone is trying to force another drink on you, ask for ice or drink a non-alcoholic beverage.

5. Respect the rights of individuals who do not wish to drink. It is considered impolite to attempt to get people to drink who do not wish to. They may abstain for religious or medical reasons, because they are recovering alcoholics, or they just may not like the taste and effect it has on them.

6. Cultivate taste. Choose quality rather than quantity. Learn the names of fine wines, whiskeys, and premium beers. Learn what beverage goes with what foods.

7. Skip a drink now and then. When at a party, have a non-alcoholic drink between the alcoholic one to keep your blood alcohol concentration down. Space your alcoholic drinks out to keep the desired blood alcohol concentration.

8. Be aware of unfamiliar drinks. Such drinks as Long Island Ice Teas, Zombies and other fruit and rum drinks can be deceiving, as the alcohol is not always detectable, and it is difficult to space them out.

9. Make sure that drinking improves social relationships rather than impairs them. Serve alcohol as an adjunct to an activity rather than as the primary focus.

10. Appoint a designated driver. Have someone available who will not be drinking and will drive all drinkers home. This is critical if the person has consumed more than one drink per hour.

A standard drink of alcohol is equal to:

  • One 12-oz bottle of beer or wine cooler.  Different beers may have different ranges of alcohol content.  For instance, malt liquer has more alcohol content than most other brewed beverage.
  • One 5-oz glass of wine.
  • 1.5-oz of 80-proof distilled spirits, like vodka or whiskey

Binge drinking is the modern nickname for drinking alcoholic beverages with the primary intention of becoming intoxicated by heavy consumption of alcohol over a short period of time. It is a kind of purposeful drinking style that is often done in groups. A binge on alcohol can occur over hours or last up to several days.

Avoid Drinking Games.  The point of drinking games is to get drunk and to get drunk fast.  The same goes for pounding or funneling your drink - it gets you drunk quick.

Slow Down!  What's the rush?  Think about drinking for quality, not quantity.  Need help slowing down?  Space your drinks by alternating with non-alcoholic beverages.  Nurse your drink and make it last.

Eat first.  With food in your stomach, alcohol gets absorbed more slowly.  This will keep you from getting intoxicated as quickly.

Learn more about how alcohol affects you.  Check with your health care provider or an alcohol education program to get a blood alcohol chart for a person of your size and gender.

Consider the consequences.  Think about the risks of getting drunk, and especially the risks of binge drinking.





Tolerance
Tolerance means that over time you have to drink more to get the same buzz you used to get.  Tolerance is not a good thing.  It results in greater health risks; it make drinking much more expensive; and can be a warning sign that a person is becoming dependent on alcohol.

Blackouts
Ever hear of someone who can't remember the night before, or can't remember how he or she got home from a party?  This is not good.  Blackouts are caused by the intake of alcohol in which long term memory creation is impaired or there is a complete inability to recall the past. 'Blacking out' is not to be confused with 'passing out,' which means loss of consciousness.

Making Mistakes
If a person drinks enough, the alcohol in the brain gets in the way of his or her ability to process information.  People in this state can't think clearly or use good judgment.  The likelihood that they'll drive a vehicle, get into a fight, or engage in unprotected sex is greatly increased.

Alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:

 - Failure to fulfill major work, school, or home responsibilities

 - Drinking in situations that are physically dangerous, such as while driving a car or operating machinery

 - Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk

 - Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking.

Alcoholism, or alcohol dependence, is the most severe form of alcohol abuse. It is a chronic disease characterized by the consumption of alcohol at a level that interferes with physical and mental health and with family and social responsibilities. An alcoholic will continue to drink despite serious health, family, or legal problems.

Alcoholism can happen at any age and is generally defined by these symptoms:
 - Craving for a drink and a need for more drinks
 - Not being able to stop drinking once drinking has begun
 - Feeling withdrawel symptoms like nausea, tremors, sweatiness, and anxiety after stopping drinking.

Alcoholism is influenced by both genetic and environmental factors. Alcoholism is chronic: It lasts a person's lifetime. It usually follows a predictable course and has recognizable symptoms.

Alcohol abuse and alcoholism cut across gender, race, and ethnicity. Nearly 14 million people in the United States are dependent on alcohol. More men than women are alcohol dependent or have alcohol problems. Alcohol problems are highest among young adults ages 18-29 and lowest among adults ages 65 and older. Also, people who start drinking at an early age have a greater chance of developing alcohol problems at some point in their lives.

Alcohol's effects vary with age. Slower reaction times, problems with hearing and seeing, and a lower tolerance to alcohol's effects put older people at higher risk for falls, car crashes, and other types of injuries that may result from drinking. More than 150 medications interact harmfully with alcohol.

Alcohol also affects women differently than men. Women become more impaired than men do after drinking the same amount of alcohol, even when differences in body weight are taken into account. In addition, chronic alcohol abuse takes a heavier physical toll on women than on men. Alcohol dependence and related medical problems, such as brain, heart, and liver damage, progress more rapidly in women.

Substances
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Also known as “opioids,” the term “narcotic” comes from the Greek word for “stupor” and originally referred to a variety of substances that dulled the senses and relieved pain. Though some people still refer to all drugs as “narcotics,” today“narcotic” refers to opium, opium derivatives, and their semi-synthetic substitutes. A more current term for these drugs, with less uncertainty regarding its meaning, is “opioid.” Examples include the illicit drug heroin and pharmaceutical drugs like OxyContin®,Vicodin®,codeine, morphine, methadone, and fentanyl.  The poppy plant is the source for all natural opioids, whereas synthetic opioids are made entirely in a lab.
More Information on Narcotics
Heroin
Hydrocodone
Hydromorphone
Methadone
Morphine
Opium
Oxycodone (OxyContin)


Stimulants speed up the body's system.  Stimulants are diverted from legitimate channels and clandestinely manufactured exclusively for the illicit market.

More Information on Stimulants
Amphetamines
Cocaine
Khat
Kratom
Methamphetamine


Depressants will put youto sleep, relieve anxiety and muscle spasms, and prevent seizures.  Generally, legitimate pharmaceutical products are diverted to the illicit market.
More Information on Depressants
Barbiturates
Benzodiazepines
GHB (Date Rape Drug)
Rohypnol (Date Rape Drug)

Hallucinogens are found in plants and fungi or are synthetically produced and are among the oldest known group of drugs used for their ability to alter human perception and mood.
More Information on Hallucinogens
Ectasy/MDMA ("Molly")
Ketamine
LSD (Acid)
Peyote and Mescaline
PCP (Angel Dust)
Psilocybin (Mushrooms)


Marijuana is a mind-altering (psychoactive) drug, produced by the Cannabis sativa plant. Marijuana contains over 400 chemicals. THC (delta-9-tetrahydrocannabinol) is believed to be the main chemical ingredient that produces the psychoactive effect.  Marijuana is a dry, shredded green/brown mix of flowers, stems, seeds, and leaves from the Cannabis sativa plant. The mixture typically is green, brown, or gray in color and may resemble tobacco.
More Information on Marijuana
Cheeba Chews

K2/Spice
K2 or “Spice” is a mixture of herbs and spices that is typically sprayed with a synthetic compound chemically similar to THC, the psychoactive ingredients in marijuana.
More Information on K2/Spice


Salvia
Salvia divinorum is a perennial herb in the mint family that is abused for its hallucinogenic effects.
More Information on Salvia




Inhalants are invisible, volatile substances found in common household products that produce chemical vapors that are inhaled to induce psychoactive or mind altering effects.  Although other abused drugs can be inhaled, the term inhalants is reserved for the wide variety of substances—including solvents, aerosols, gases, and nitrites—that are rarely, if ever, taken via any other route of administration.

DEA Information on Inhalants

Products Abused as Inhalants

Volatile solvents—liquids that vaporize at room temperature
 - Industrial or household products, including paint thinners or removers, degreasers, dry-cleaning fluids, gasoline, and lighter fluid
 - Art or office supply solvents, including correction fluids, felt-tip marker fluid, electronic contact cleaners, and glue

Aerosols—sprays that contain propellants and solvents
 - Household aerosol propellants in items such as spray paints, hair or deodorant sprays, fabric protector sprays, aerosol computer cleaning products, and vegetable oil sprays 

Gases—found in household or commercial products and used as medical anesthetics
 - Household or commercial products, including butane lighters and propane tanks, whipped cream aerosols or dispensers (whippets), and refrigerant gases
 - Medical anesthetics, such as ether, chloroform, halothane, and nitrous oxide (“laughing gas”)

Nitrites—used primarily as sexual enhancers
 - Organic nitrites are volatiles that include cyclohexyl, butyl, and amyl nitrites, commonly known as “poppers.” Amyl nitrite is still used in certain diagnostic medical procedures. When marketed for illicit use, organic nitrites are often sold in small brown bottles labeled as “video head cleaner,” “room odorizer,” “leather cleaner,” or “liquid aroma.”

Synthetic stimulants that are marketed as “Bath Salts” are often found in a number of retail products. These synthetic
stimulants are chemicals. The chemicals are synthetic derivatives of cathinone, a central nervous system stimulant,
which is an active chemical found naturally in the khat plant.

DEA Information on Bath Salts




What Are Anabolic Steroids?
“Anabolic steroids” is the familiar name for synthetic variants of the male sex hormone testosterone.  The proper term for these compounds is anabolic-androgenic steroids (AAS)—“anabolic” referring to muscle-­‐building and “androgenic” referring to increased male sexual characteristics. Anabolic steroids can be legally prescribed to treat conditions resulting from steroid hormone deficiency, such as delayed puberty, as well as diseases that result in loss of lean muscle mass, such as cancer and AIDS.  Anabolic steroids are synthetically produced variants of the naturally occurring male hormone testosterone that are abused By some athletes, bodybuilders, and others in an attempt to promote muscle growth, enhance athletic or other physical performance, and improve physical appearance.

How Are Anabolic Steroids Abused?
Anabolic steroids are usually either taken orally or injected into the muscles, although some are applied to the skin as a cream or gel.  Doses taken by abusers  may be 10 to 100 times higher than doses prescribed to treat medical conditions.  Steroids are typically taken intermittently rather than continuously, both to avert unwanted side effects and to give the body’s hormonal system a periodic chance to recuperate.  Continuous use of steroids can decrease the body’s responsiveness to the drugs (tolerance) as well as cause the body to stop producing its own testosterone; breaks in steroid use are believed to redress these issues.  “Cycling” thus refers to a pattern of use in which steroids are taken for periods of weeks or months, after which use is stopped for a period of time and
then restarted.  In addition, users often combine several different types of steroids and/or incorporate other steroidal or non-­steroidal supplements in an attempt to maximize their effectiveness, a practice referred to as “stacking.”

What Are the Other Health Effects of Anabolic Steroids?
Steroid  abuse may lead to serious, even irreversible, health problems. Some of  the most dangerous consequences that have been linked to steroid abuse include kidney impairment or failure; damage to the liver; and cardiovascular problems including enlargement of the heart, high blood pressure, and changes in blood cholesterol leading to an increased risk of stroke and heart attack (even in young people). Steroid use commonly causes severe acne and fluid retention, as well as several effects that are gender-­ and age­‐specific:
• For men—shrinkage of the testicles (testicular atrophy),  reduced sperm count or infertility, baldness, development of breasts (gynecomastia), increased risk for prostate cancer
• For women—growth of facial hair, male-­pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice
• For adolescents—stunted growth due to premature skeletal maturation and accelerated puberty changes, and risk of not reaching expected height if steroid use precedes the  typical adolescent growth spurt.

DEA Information on Steroids




Whether it be a long day working or just trying to keep after not getting enough sleep, energy drinks are consumed to give extra energy, increased alertness, and improve mental and physical awareness.  Marines may choose these drinks as a way to get full energy before they start work or go to the gym.  Energy drinks most often contain high amounts of caffeine and sugar and have large portion sizes.  These drinks are not designed to be sipped slowly like coffee; therefore, the body doesn’t have time to absorb and process it.

Energy drinks are NOT RECOMMENDED to enhance athletic performance due to dangers of dehydration and harmful side effects.  Sports drinks are beverages that restore the fluid balance and prevent dehydration after vigorous exercise. Most people only need to replenish with water after exercise.

More Information About Energy Drinks


Dispose Unused Rx

Turn in your unused, expired prescriptions for safe disposal at the Provost Marshal's Office, Building 3, Marine Corps Base, Camp Lejeune.  The PMO Prescription Drug Drop Box is only for the turn in of "prescription/over-the-counter medication."  No liquids, illegal narcotics, needles or biological wastes are to be dropped off for disposal.  The PMO Prescription Drug Drop Box is located within the lobby of PMO, Building 3, and is available to service members, familiy members and civilians of the II MEF/MCIEAST military community 24 hours a day, 7 days a week.

Links
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Above the Influence. It’s a state of mind. It’s about being yourself and not letting negative influence get to you. Pressure to drink, do drugs or do anything that goes against who you are in order to fit in—that’s negative influence.


Drug Enforcement Administration.  The mission of DEA is to enforce the controlled substances laws and regulations of the United States and bring to the criminal and civil justice system of the United States, or any other competent jurisdiction, those organizations and principal members of organizations, involved in the growing, manufacture, or distribution of controlled substances appearing in or destined for illicit traffic in the United States; and to recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances on the domestic and international markets.