TOPIC IV– SUBSTANCE ABUSE

A. ALCOHOL

Alcohol is colorless, tasteless clear liquid, which gives a burning sensation to the mouth,
esophagus and stomach. Like many drugs, alcohol is toxic. It can poison the human body if taken
in large amounts or in combination with other drugs. Alcohol is a depressant not stimulant.

There are two kinds of alcohol – methyl and ethyl alcohol. Methyl alcohol is very poisonous and
is not put in drinks but is use in some industries. Ethyl alcohol is used in alcoholic drinks, which
are made by breweries. This occurs when germs called yeast act on sugars in food to produce
alcohol and carbon dioxide. Fermented brews and spirits contain different amounts of alcohol. The
amount in beer is less than in other drinks. It varies from 2.5% to 8% in different countries.

Types of Drinkers

1.Occasional Drinker – drinks on special occasions or uses alcohol as a home remedy, takes
only a few drinks per year.
2.Frequent Drinker – drinks at parties and social affairs. Intake of alcohol may be once a week or
occasionally reaches three or four times per week, uses beverages to release inhibitions and
tensions.
3.Regular Drinker – may drink daily or consistently on weekends, usually comes from cultural
background where wine or beer is used with meals to enhance the flavor of the food.
4.Alcohol Dependent – drinks to have good time, excessive drinking occurs occasionally but
drinker may not become alcoholic.
5.Alcoholic – has lost control of his use of alcohol. Alcohol assumes primary goal in his life, even
to the exclusion of physical health and interests of family and society in general.

Motives for Drinking

1.Traditional – social and religious functions.

2.Status – symbol of success and prestige.
3.Dietary – dining incomplete without wine, integral part of today’s way of “gracious living”.
4.Social – release tensions and inhibitions so user can tolerate and enjoy another’s company.
5.Shortcut to Adulthood – user unsure of maturity, drinks to prove himself.
6.Ritual – fosters group feeling, cocktail parties, toasts made to brides, wishes for good health.
7.Path of least Resistance - doesn’t want to drink but doesn’t want to abstain so goes along with
everyone else.

EFFECTS OF ALCOHOL ON THE BODY

When a person drinks alcohol, it passes down to the stomach. Here, unlike foods we eat, it does
not need to be digested or broken down by juices in the stomach. It is absorbed easily into the
blood stream and most of it stays in the blood. While in the blood stream, the alcohol is carried
around the body many times as the heart pumps blood through the vessels. The alcohol stays in
the blood and can only be passed out of the body when the liver changes it. A healthy liver takes
approximately one hour to change the alcohol in one bottle of beer. While the liver is trying to
remove the alcohol, the alcohol is having effects on body functions.

The Brain and the Nervous System - The nerves are like telephone wires coming out of the
control system in the brain and spinal cord. They send and receive messages from all parts of the
body. Alcohol slows down the work of the brain cells and stops proper messages being sent to the
rest of the body. Alcohol stops people behaving correctly to other people. They may do whatever
comes first into their minds. They may say things that do not make sense or behave rudely to
others. They may also have feelings of increased personal or social power. This is because their
thinking is slowed down and not because it has sparked up. They are less able to cope with
situations where drinking is needed.

As the level of alcohol becomes higher in the blood, brain and nerve cells die from the poisonous
or toxic effects of the alcohol. Unlike other body cells, once a brain cell is destroyed it is never
replaced. As more and more of these brain cells are destroyed from repeated drinking over a
period of years, the person’s thinking becomes cloudy. His feelings about things also change. He
also will get a burning feeling and pain or numbness in his hands and feet from the death of nerve
cells. After heavy drinking, and when the pain killing effects of the alcohol are removed, the person
may suffer from a hangover. A hangover is the word used to describe the terrible pain and horrible
effects, which follow a period of heavy drinking.

Stomach and Intestines - Alcohol damages the stomach and intestines and makes them sore.
This can cause a burning sensation, nausea and vomiting. Sometimes there is bleeding.

Liver

a.The first thing the liver does is to turn part of the alcohol into fat. Some of this goes into the
blood, but a lot builds up in the liver cells. After drinking six (6) medium-sized glasses of beer
everyday for a few days, fat is formed in the liver.
b.To cope with the extra work of getting rid of the alcohol, the liver becomes larger.
c.As the liver enlarges, the person gets more used to the effects of alcohol in the body. A person
can drink larger amounts of alcohol without getting drunk. This effect is called tolerance to alcohol.
However, the alcohol is still doing its damage.
d.As the liver enlarges, it changes they way other drugs and medicines work in the body. So it can
be dangerous to take medicines with alcohol.
e.While the liver enlarges, some of the liver cells are damaged.
The liver can become permanently damaged. As the alcohol poisons the cells of the liver, they die.
If many of these cells die, the person may get what is called “ALCOHOLIC HEPATITIS”.
f.Scar tissue is formed where the liver cells die. This means the liver doesn’t work so well. This is
called “CIRRHOSIS”.
g.People with scarred livers can get a swollen abdomen, swollen feet and hands and may
bleeding from inside the body.
Waste products build up in the body and give a yellow color to the skin and eyes (jaundice). This
also affects the brain so that a person may become unconscious and die.

Heart and Muscles - Alcohol affects the heart and other muscles so that they become weaker
and less effective. This makes people tired and breathless.

Blood - The activity of the liver I trying to get rid of the alcohol results in many changes to the
blood – for example – blood sugar is lowered and blood fats are increased.

Kidneys - Alcohol decreased the ability of the kidneys to get rid of some waste products.

Sexual Activities - After the excessive use of alcohol, the ability to have satisfactory sexual
activity is decreased.

Malnutrition - The illness that occurs when a person doesn’t have enough food to eat or eats the
wrong kind of food. The person who drinks alcohol may suffer from malnutrition because:
a.He spends his time, money and energy in drinking. He may not eat the proper foods.
b.Drinking alcohol decreases a person’s desire to eat.
c.Alcohol burns the stomach and bowel so that food eaten is not used well by the body.
d.If the liver is damaged, some important vitamins are not produced.

Malnutrition in itself causes further liver damage, which makes the condition even worse. The
result of all these are that the heavy drinker gets weak because of lack of energy and body
building food. His body defenses are weakened against infections such as pneumonia, tropical
ulcers and tuberculosis. The person may get severely emotional disturbed. The nerves in his arms
or legs may be damaged so that he may not feel what he is touching. He may not walk properly
and may keep falling over.

Alcohol effect on General Behavior

Drinking affects a person’s behavior. Most of the changes are due to the effect of alcohol on the
brain and nerves. The effects of alcohol depend on how much there is in the blood. A large person
has to drink more than small person to produce the same level of alcohol in the blood.

Alcohol Effects on the Community

Because drinking affects people’s behavior, it has effects on the community as a whole.

a. Trouble in the Home – Heavy drinkers takes money needed for food, clothes and furniture.
This causes debts. Husbands and wife fight and

accuse each other of being unfaithful. There will be often be sexual problems. Children are badly
treated and badly fed. And drinking makes people lazy and they may not go to work. Women may
have to steal food to feed their families.
b. Trouble among Friends – The heavy drinker will often fight with his friend and may even kill
people.
c. Trouble at Work – The heavy drinker often does not go to work because he feels sick. He
sometimes works badly and hurts himself or others.
d. Trouble at Play – Heavy drinkers has a bad effect on sportsmen. Because alcohol affects the
brain, the drinker can not control his arms and legs well. A sportsman who has been drinking can
not play well as he should.
e. Trouble on Roads – The driver has lost his judgement, he is careless and takes risks.
Accidents result. A person who is drunk may walk onto the road and be killed by a motor vehicle.
f. Trouble with Crime – excessive drinking is the biggest cause of crime. People become
aggressive, fight, break into houses and steal.
g. Trouble with the Economy and the Nation - The economy is badly affected when people do
not go to work and production falls. Heavy demands are made on health services, the police force
and correctional institutions. Alcoholism is burden to the government.

Alcohol Dependence

A person who drinks a lot can become a dependent on alcohol. This means he can not live
without it. If he tries to stop drinking, he will have the shivers and shakes and feels very bad. He
may also experience acute anxiety or fear, delirium and hallucinations.

Prevention of Alcohol Problem

Solely treating people with medications can not control problem drinking and alcoholism.
Treatment should be coupled with proper education both in the schools and in the adult
community to develop the nation habits of moderation in the use of alcoholic beverages. It requires
investigation and testing of social policies on the control of the distribution of alcohol as well as the
effective implementation of these prevention policies.

TOBACCO

Facts about Tobacco Smoking

The use of tobacco is one of the foremost public health problems in the world today.
Tobacco had for centuries been used all over the world as a way of increasing the enjoyment of
life or as an aid in coping with some of its problem. The World Health Organization estimates that
around the world one person dies every 13 seconds from tobacco-related diseases. Doctor’s cite
50,000 scientific studies from various independent bodies that have proved beyond doubt that
smoking is responsible for around 90% of all cases of lung cancer, 95% of all cases of chronic
bronchitis and emphysema, and 25% of heart conditions in men under 65 years of age.

The World Health Organization Advisory Panel on Smoking and health estimates that at
least two million of 30 million Filipinos under 20 years of age today will eventually be killed by
smoking. Smoking threatens not only the adults, but also children – born and unborn. The
Philippine Obstetrical and Gynecological Society notes that premature in infants of mothers who
smoke is three times more common than in mothers. Spontaneous abortion is likewise more
common in smoking mothers.

Too often, the smoking habit begins in the early teens or even earlier. Becoming a smoker
may have the immediate value to some teenagers of being accepted by their peers, feeling more
mature because smoking is an adult behavior to the child providing level of psychological
stimulation and pleasure and might even serve the function of an cat of defiance to authority
figures.

General Effect of Tobacco Smoking

The effects of tobacco smoking consist primarily of ill-health and of human suffering. These
necessarily, too, the productivity of the work force, the need for medical care and other variables.
Thus smoking impairs society’s total well-being and posses substantial economic loss to the
nation.

Properties of Tobacco

Cigarette smoke contains over 2,000 different chemicals and gases which can produce coughing,
broncho spasm, increased mucus secretion.

NICOTINE – It is the most important active ingredient in controlled doses. It is an extremely toxic
substance. A typical cigarette contains 1-2 mg of nicotine. When smoked, less than 1 mg from
each cigarette is filtered or not depending on the characteristics of the filter, the depth and
frequency of inhalation and the length of the butt.

Effects of Smoking on the Following:

Cardiovascular System 
 Increases in heart attack risk with amount smoke
  Increases heart rates 15-25 beats with one to two cigarette.
  Constricts small arteries causing higher blood pressure.
  Increases chance of developing peripheral vascular diseases.
  Causes carbon monoxide from smoke to rob oxygen carrying potential of blood.
  Causes increase of free fatty acids in blood which may be related to heart attack.

Respiratory System 
 Increases risks of developing lung cancer ten-fold for the average of one pack a day
smoker.
  Increases lung cancer risk with amount, with length of time smoked and early age starting.
  Major factor identified in the development of lung cancer
  Only one in twenty lung cancer victims is saved from death per year
  Lung cancer deaths slightly exceed traffic deaths per year
  A major cause of chronic bronchitis
  Increases risk of dying of chronic bronchitis and emphysema about six fold.
  Tends to paralyze bronchial cilia and stimulate production of mucus. Eventually destroys
ciliary structure cleansing system predisposing to respiratory infections
  Increases in abnormal cell growth in bronchial tube walls with increase in basal cell layers
and thickening
  Causes closing of the bronchi, reducing effective breathing space.

Increased Mortality from other Causes 

 Increase cancer of the larynx, the mouth, bladder and the esophagus.
 Increase in ulcer deaths, death from cirrhosis.
 Increase in kidney problems.

Over all Morbidity and Mortality

 Greater incident of infant pre- maturity and mortality.
 Life expectancy is expected to reduce by about 14 minutes per cigarette smoked.

Reproductive System 
 Women who smoke during pregnancy increase the risk of still birth and prenatal mortality, and
the child physical and intellectual is delayed
 Women who smoke causes menopause in early age than in normal.
 Male smokers, penile arteries become constricted bringing about slower erection time,
impotence in 1 in 4 heavy smokers versus 1 in 12 non- smokers. Smoking fathers may beget
children who may suffer from brain tumor, leukemia and other abnormalities due to decreased
number of spermatozoa.

Measures to Reduce Smoking

Government support of anti-smoking campaign demonstrates commitment to the eradication of

health problems related to smoking and public influences and attitudes to smoking. Successful
programs to reduce the prevalence of tobacco use by young people need a combination of
legislative measures and health education including:

 prohibition of sales in minor

 prohibition of smoking in schools and other places frequented by the young
 restriction on advertising and promotion of tobacco products especially those aimed at young
people
 health education at both primary and secondary levels of schools
 use of fiscal policies to increase the price of tobacco products
 health warnings on cigarette packets
 Collaboration with the media to deglamorize the image of the smoker.