This section briefly examines some of the most well-known and frequently used drugs-caffeine, alcohol, nicotine, cocaine, marijuana, and designer drugs. This section is not intended to be all inclusive. There is a wide range of other substances that are potentially dangerous if misused or abused. Because these drugs are so frequently used, it is important for you to understand their positive and negative effects to make decisions based on information rather than myth.
Caffeine
Caffeine is probably the most commonly used drug in American society. Each day millions of Americans drink, chew, or ingest approximately 4 mg of caffeine for every 2.2 pounds of body weight. Approximately 3% of the population consumes 600 mg or more of caffeine daily. Caffeine is a stimulant that speeds heart rate, temporarily increases blood pressure, and disrupts sleep. It also relieves drowsiness, helps in the performance of repetitive tasks, and improves work ability. Negative effects include insomnia, anxiety, heart dysrhythmias, gastrointestinal complaints, dizziness, and headaches.
The active ingredient in caffeine belongs to a group of drugs with similar structures known as xanthines. Xanthines include a substance found in cacao beans, which are used to make chocolate, and in tea leaves. In the past, caffeine consumption was thought to cause birth defects, breastfeeding problems, cardiovascular disease, cancer, and fibrocystic breast disease. Current research has found no substantial association with these conditions .However, pregnant and nursing women should consume no more than two cups of coffee a day and should consume tea and caffeinated soft drinks in moderation (less than 300 mg per day). Furthermore, women who suffer from premenstrual tension (PMS) should eliminate caffeine. Research has indicated that women who drink one half to four cups (25 to 200 mg) of caffeinated tea a day were twice as likely to suffer PMS symptoms as women who drank none at al1.
The majority of adults can consume relatively low doses of caffeine (the equivalent of two to three cups of coffee per day) safely. Approximately 10% of the adult population experiences caffeinism, a condition in which frequent high-dose use causes psychological and physical problems. Doses as low as 250 mg per day can produce restlessness, nervousness, excitement, insomnia, flushed face, diuresis, muscle twitching, rambling thoughts and speech, and stomach complaints. Doses greater than 1 gram per day can cause muscle twitching, rambling thoughts and speech, heart dysrhythmias, and motor agitation. Higher doses can cause ringing in the ears and flashes of light.
It is easy to consume a great deal of caffeine. By becoming familiar with the amount of caffeine in a product and restricting consumption to less than 400 mg of caffeine per day, you can benefit from the effects of the drug without suffering any negative aspects.
Alcohol
Alcohol use is pervasive. Alcohol is a drug that is deemed socially acceptable by many. At the same time, no other drug causes so much physical, social, and emotional damage to individuals and to families. People drink alcoholic beverages in many situations and for many reasons. They drink when they are among friends and when they are upset or depressed. People drink to enhance a romantic mood, to put themselves at ease in social situations, and to celebrate special occasions. In addition, people drink because their role models drink and because the advertising industry has convinced them that alcohol contributes to self-enhancement. Unfortunately, the devastation associated with alcohol is often not mentioned. Because society has labeled alcohol appropriate and even necessary for some occasions, abstinence may seem unrealistic for many people.
As with many drugs, there are times and places where medicinal and health reasons are associated with alcohol use. Current research suggests that moderate amounts of alcohol may help reduce the risk of heart disease. The possible benefits and pleasures of use of alcoholic beverages do not eradicate the dangers that result from misuse or abuse. Nearly half of all annual traffic deaths are the result of accidents involving alcohol consumption. This does not include permanent physical injuries and emotional damages that result from alcohol-induced traffic accidents and deaths nor does it include the increased number of violent acts associated with alcohol intoxication. Drinking of alcohol, if it occurs, ought to be approached responsibly, with the individual recognizing the potential for harm to them self and others.
Although there are several types of alcohol, the intoxicating agent in all alcoholic drinks is ethyl alcohol, a colorless liquid with a sharp, burning taste. The percentage of alcohol in a beverage is measured by its proof, which is twice the percentage of alcohol. A beverage that is 40% alcohol has a proof of 80. The blood alcohol concentration (BAC) is the percentage of alcohol content in the blood. This percentage determines the alcohol’s effect on the individual . The more quickly the alcohol is absorbed, the quicker the BAC increases.
Alcohol enters the bloodstream quickly from the stomach and even more quickly from the small intestine. In the stomach, food inhibits absorption of alcohol. Food does not affect absorption in the small intestine. Other factors that affect the rate of absorption and effect of alcohol are the following:
Rate of consumption: How quickly is the beverage consumed? Large amounts of alcohol quickly consumed expose the brain to higher peak concentrations, altering perceptions and response times.
Type of beverage: Beer and wine contain substances that slow the rate of absorption, thus the effects are experienced more slowly than when drinking distilled spirits, even when the same amount of alcohol is consumed. Carbonated beverages added to liquor speed absorption, but diluting them with water slows the process.
Body weight: Body weight and body composition do not influence the rate of absorption, but they do influence the effects of alcohol. More weight and! or more muscle mass (muscle has more fluid volume than fat) results in a greater distribution of the alcohol, lowering its concentration in the body and weakening the effects.
Tolerance to alcohol: Some individuals seem to remain sober, whereas others react very quickly to the same amount of alcohol. One drink for a novice may have the same effect as three drinks for a more experienced drinker. This indicates that the experienced drinker’s body is adapting to the alcohol at the cellular level and encourages increased consumption. Tolerance consists of an increase in the rate of alcohol absorption metabolism, as well as a reduced response to the drug. It is the reduced response that is frequently associated with physical and psychological dependence .Increased tolerance to alcohol can result in a decreased response to other drugs, specifically other central nervous system depressants.
Alcoholism is a disease in which an individual loses control over drinking. According to a definition approved by the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine, alcoholism is a “primary, chronic disease with genetic, psychosociaL and environmental factors influencing its development and manifestations. The disease is often progressive and fatal.”6 An alcoholic is a person who suffers from the disease of alcoholism. For alcoholics, alcohol increasingly becomes the focus of their life, and family, social, work, and/or school responsibilities become less important and are eventually disrupted by the desire and need for alcohol. Some alcoholics make this transition very rapidly, whereas others maintain the appearance of being only a social drinker for many years. Unfortunately, predetermining who will have trouble with alcohol is impossible. Alcoholism crosses all social and economic barriers and can include clergy, medical doctors, high school students, college students, and professors.
There is no single, accepted reason why any person becomes an alcoholic. Most researchers think that no single factor is responsible, but that a variety of events, genetic tendencies, and situations work together and result in alcoholism for some individuals. The medical model of alcoholism includes biological or genetic explanations of abuse. The medical model views alcohol abuse as uncontrollable because of physiological differences between alcoholics and nonalcoholics. Each year, more research seems to link alcoholism to an inherited susceptibility or predisposition for the disease. Children of alcoholic parents are four times more likely to become alcoholics even when raised by nonalcoholics.
Psychologists look for alcohol problems based on criteria, such as family, gender, and personality. Sociologists seek explanations in cultural values and attitudes and family structure. Consideration has been given to the possibility of an “addictive personality”-one that is prone to addiction associated with alcohol or other drugs or behaviors (such as compulsive gambling). At this time there is little agreement on the characteristics of an individual who will be alcoholic and whether any collection of characteristics is the cause or the result of alcoholism. In reality, no one knows for sure who will or why they will become alcoholic. Any consumption of alcohol places alcoholics, if they know they are or have the potential to be alcoholics, at risk.
Treatment for alcoholism is often long term. The course of treatment usually occurs in three stages:
(1) detoxification (eliminating the alcohol from the body)
(2) medical care (attending to any health related problems)
(3) changing long-term behavior (helping the recovering alcoholic overcome long established drinking patterns and destructive behaviors).
Several sources provide long-term medical and psychological support to people with drug or alcohol problems.
Alcoholics remain alcoholics for life, regardless of whether they drink or not. Recovering alcoholics must therefore be careful about any products they consume, including medicines and mouthwashes, which sometimes contain alcohol. Currently an estimated 10 million adults and 3 million adolescents under the age of 18 are alcoholics.
Alcohol use has been demonstrated to have a strong association with crime and violence. Data clearly indicate that homicide is more likely to occur in a situation in which drinking has occurred. In this same study all incidents of spousal and child abuse were correlated with drinking. A Canadian study9 found that at least 42% of violent crimes involved alcohol. In addition, 75% of suicide attempts involved alcohol use.
Tobacco Products
All tobacco products, including cigarettes, cigars, pipes, and smokeless tobacco contain the drug nicotine. Nicotine is an addictive substance and an alkaloid poison. It affects the body by increasing heart and respiratory rates, elevating blood pressure, increasing cardiac output and oxygen consumption, and constricting the bronchi (the two main branches of the trachea that lead to the lungs). Nicotine is inhaled by anyone smoking a tobacco product. With smokeless tobacco, nicotine is absorbed through membranes of the mouth and cheek.
Some components of cigarette smoke are known as carcinogens (substances that cause cancer or enable the growth of cancer cells). Nicotine, tars, and carbon monoxide are all found in cigarette smoke. The tar in tobacco is a black, sticky, dark fluid composed of thousands of chemicals. Many of the chemicals found in tar are cancer causing. Carbon monoxide is a deadly gas emitted in the exhaust of cars and in burning tobacco. The carbon monoxide level in cigarette smoke is 400 times greater than what is considered safe in industrial settings. Carbon monoxide binds to hemoglobin more readily than oxygen, interfering with the ability of blood to transport oxygen to the body. Carbon monoxide impairs the nervous system and increases the risk of heart attacks and strokes.
The addictive nature of nicotine has recently come under substantial public scrutiny. Some experts consider nicotine to be as addictive as cocaine and other drugs. Tobacco is considered the leading preventable contributor to disease and early death in the United States (heart disease and cancer specifically) and is listed as a primary risk factor for heart disease by the American Heart Association. Cigarettes are responsible for 440,000 deaths annually. Because of the health risks and because of what is seen by many as an effort on the part of tobacco companies to intentionally increase nicotine addiction to increase sales of cigarettes, some people suggest that tobacco should be made an illegal drug.
Cigarettes have long been the primary focus and the major tobacco product studied as pertains to disease. This is probably because more people use tobacco in the form of cigarettes than any other form. This does not mean that other types of tobacco use are not detrimental to health. The use of smokeless tobacco is quite prevalent among adolescents and young adults. Athletes have set the example for a number of years for smokeless tobacco use. Smoke less tobacco is less likely to initiate the cancer process in lungs, but daily use for 3112 years significantly increases the risk of developing oral cancers (cancers of the mouth and throat). Long-term users have a 50% greater chance of developing oral cancer than nonusers.
Effects of smoking on the nonsmoker
Passive smoking is the inhalation by a nonsmoker of cigarette smoke from the environment. The most common form of inhaled smoke is side stream smoke, which results from burning tobacco products (the end of the lighted tip of a cigarette). Side stream smoke has higher concentrations of nicotine and other carcinogenic agents than the smoke inhaled by the smoker. Many studies have shown that passive smoking can cause cancer in nonsmokers. Nonsmokers married to smokers have a 30% greater risk of lung cancer and are more likely to experience heart attacks than nonsmoking spouses of nonsmokers. There are no “safe” levels of exposure to cigarette smoke, and there are no “safe” tobacco products.
Advantages of Quitting
Smoking is an extremely strong addiction. When individuals stop smoking, their risk of developing heart disease and some kinds of cancer (if not already present in the body) eventually decreases to that of nonsmokers; in other words, some of the effects of smoking are reversible. To quit completely, many people require the help of trained professionals. Although quitting is difficult, the health benefits gained far outweigh the problems.
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