CHOOSING TO DRINK

Clearly, people drink alcoholic beverages for many different reasons.  Most people drink alcohol because it is an effective, affordable, and legal substance for altering the brain’s chemistry.  As inhibitions are removed by the influence of alcohol, behavior that is generally held in check is expressed.  At least temporarily, drinkers become a different version of themselves more outgoing, relaxed, and adventuresome.

TAKING CONTROL OF ALCOHOL USE

The push for zero tolerance laws, the tightening of standards for determining legal intoxication, and the growing influence of national groups concerned with alcohol misuse show that our society is more sensitive than ever to the growing misuse of alcohol.

People are concerned about the consequences of drunk driving, alcohol-related crime, and lowered job productivity.  National data indicate that per capital alcohol consumption has gradually dropped in the United States since the early 1980s.  alcohol use remains the preferred form of drug use for most adults (including college students), but as a society, we are increasingly uncomfortable with the ease with which alcohol can be misused.

COLLEGE AND COMMUNITY SUPPORT SERVICE FOR DRUG DEPENDENCE

Students who have drug problems and realize they need help might select assistance based on the services available on campus or in the surrounding community and the costs they are willing top pay for treatment services.

One approach to convince drug-dependent people to enter treatment programs is the use of confrontation.  People who live or work with chemically dependent people are being encouraged to confront them directly about their addiction.  Direct confrontation helps chemically dependent people realize the effect their behavior has on others.  Once chemically dependent people realize that others will no longer tolerate their behavior, the likelihood of their entering treatment programs increases significantly.  Although effective, this approach is very stressful for family members and friends and requires the assistance of professionals in the field of chemical dependence.  These professionals can be contacted at a drug treatment center in your area.

Treatment

Comprehensive drug treatment programs are available in very few college or university health centers.  College settings for drug dependence programs are more commonly found in the university counseling center.  At such a center the emphasis will probably be not on the medical management of dependence but on the behavioral dimensions of drug abuse.  Trained counselors and psychologists who specialize in chemical dependence counseling will not work with students to (1) analyze their particular concerns, (2) establish constructive ways to cope with stress, and (3) search for alternative ways to achieve new “highs”.

Medical treatment for the management of drug problems may need to be obtained through the services of a community treatment facility administered by a local health department, community mental health center, private clinic, or local hospital.  Treatment may be on an inpatient or outpatient basis.  Medical management might include detoxification, treatment of secondary health complications and nutritional deficiencies, and therapeutic counseling for chemical dependence.

Some communities have voluntary health agencies that deliver services and treatment programs for drug dependent people.  Check your telephone book for listings of drug-treatment facilities.  Some communities have drug hot lines that offer advice for people with questions about drugs.

Costs of Treatment for Dependence

Drug-treatment programs that are administered by colleges and universities for faculty and students usually require no fees.  Local agencies may provide either free services or services based on a sliding scale.  Private hospitals, physicians, and clinics are the most expensive forms of treatment.  Inpatient treatment at a private facility may cost as much as $1000 per day.  Since the length of inpatient treatment averages 3 to 4 weeks, a patient can quickly accumulate a very large bill.  However, with many types of health insurance policies now providing coverage for alcohol and other drug dependencies, even these services may not require additional out-of-pocket expenses. 

DRUG TESTING

Society’s response to concern over drug use includes the development and growing use of drug tests.  Most of the specimens come from corporations that screens employee for commonly abused drugs.  Among these are amphetamines, barbiturates, benzodiazepines (the chemical bases for prescription tranquillizers such as Valium and Librium), cannabinoids (THC, hashish, and marijuana), methaqualone, opiates, (heroin, codeine, and morphine), and PCP.  With the exception of marijuana, most traces of these drugs are eliminated by the body within a few days after use.  Marijuana can remain detectable up to 30 days after use.

How accurate are the results of drug testing? At typical cutoff standards, drug test will likely identify 90% of recent drug users.  This means that about 10% of recent users will pass undetected.  (These 10% are considered false negatives.)  Nonusers whose drug tests indicate drug use (false positive) are quiet rare.  (follow-up tests on these false positive would nearly always show negative results.)  human errors are probably more responsible than technical errors for inaccuracies in drug tests.

Recently, scientists have been refining procedures that use hair samples to detect the presence of drugs.  These procedures seem to hold much promise, although certain technical obstacles remain.  Watch for refinements in hair sample drug testing in the near future.

Most Fortune 500 companies, the armed forces, various government agencies, and nearly all athletic organizations have already implemented mandatory drug testing.  Corporate substance abuse policies are being developed, with careful attention to legal and ethical issues.

Do you think that the possibility of having to take a drug test would have any effect on college students’ use of drugs?

SOCIETY’S RESPONSE TO DRUG USE

During the last 25 years, society has responded to illegal drug use with growing concern.  Most adults see drug abuse as a clear danger to society.  This position has been supported by the development of community, school, state, and national organizations directed toward the reduction of illegal drug use.  These organizations have included such diverse groups as Parents Against Drugs, Partnership for a Drug-Free America, Mothers Against Drunk Driving (MADD), Narcotics Anonymous, and the U.S Drug Enforcement Administration.  Certain groups have concentrated their efforts on education, others on enforcement, and still others on the development of laws and public policy.  Famous people, such as athletes, are also speaking out against drug use.

The personal and social issues related to drug abuse are very complex.  Innovative solutions continue to be devised.  Some believe that only through early childhood education will people learn alternatives to drug use.  Starting drug education in the preschool years may have a more positive effect than waiting until the upper elementary or junior high school years.  Recently, the focus on reducing young people’s exposure to gateway drugs (especially tobacco, alcohol, and marijuana) may help slow down the move to other addictive drugs.  Some people advocate harsher penalties for drug use and drug trafficking, including heavier fines and longer prison terms.

Others support legalizing all drugs and making governmental agencies responsible for drug regulation and control, as is the case with alcohol.  Advocates of this position believe that drug-related crime and violence would virtually cease once the demand for illegal products is reduced.  Sound arguments can be made on both sides of this issue.  What’s your opinion?

In comparison with other federally funded programs, the “war on drugs” is less expensive than farm support, food stamps, Medicare, and national defense.  However, it remains to be seen whether any amount of money spent on enforcement, without adequate support for education, treatment, and poverty reduction, can reduce the illegal drug demand and supply.  The United States now spends nearly $18 billion annually to fight the drug war.  About $11 billion is spent on law enforcement (supply reduction) and $6 billion on education, prevention, and treatment (demand reduction).

COMBINATION DRUG EFFECTS

Drugs taken in various combinations and dosages can alter and perhaps intensify effects.

A synergistic drug effect is a dangerous consequence of taking different drugs in the same general category at the same time.  The combination exaggerates each individual drug’s effects.  For example, the combined use of alcohol and tranquilizers produces a synergistic effect greater than the total effect of each of the two drugs taken separately.  In this instance a much-amplified, perhaps fatal sedation will occur.  In a simplistic sense, “one plus one equals four or five.”

When taken at or near the same time, drug combination produce a variety of effects.  When two or more drugs are taken and the result is merely a combined total effect of each drug, the result is an additive effect.  The sum of the effects is not exaggerated.  In a sense, “one plus one plus one equals three.”

When one drug intensifies the action of a second drug, the first drug is said to have a potentiated effect on the second drug.  One popular drug-taking practice during the 1970s was the consumption of Quaaludes and beer.  Quaaludes potentiated the inhibition-releasing, sedative effects of alcohol.  This particular drug combination produced an expensive but potentially fatal drunklike euphoria in the user.

An antagonistic effect is an opposite effect one drug has on another drug.  One drug may be able to reduce another drug’s influence on the body.  Knowledge of this principle has been uwseful in the medical treatment of certain drug overdoses, as in the use of tranquillizers to relieve the effects of LSD or other hallucinogenic drugs.