The overuse or abuse of alcohol (alcoholism) or other drugs is
substance abuse. It can cause
or worsen many medical problems and can destroy families and lives.
If you think you may have a problem with drugs or alcohol, take a short
quiz to evaluate your symptoms:
Alcohol abuse causes over 100,000 deaths in
the United States and Canada each year. It is the drug most commonly abused by
children ages 12 to 17. Alcohol-related motor vehicle accidents are the leading
cause of death in teenagers. People who drink alcohol are more likely to engage
in high-risk sexual behavior, have poor grades or job
performance, use tobacco products, and experiment with
illegal drugs. Alcohol and drug use may be an
unconscious attempt at self-treatment for another problem, such as
You have an alcohol problem if
your use of alcohol interferes with your health or daily living. You develop
alcoholism if you physically or emotionally depend on alcohol to get you
through your day.
Long-term heavy drinking damages the
liver, nervous system, heart, and brain. It can lead to
high blood pressure, stomach problems, medicine
interactions, sexual problems, osteoporosis, and cancer. Alcohol abuse can also
lead to violence, accidents, social isolation, jail or prison time, and
problems at work and home.
Symptoms of an alcohol problem
include personality changes, blackouts, drinking more and more for the same
"high," and denial of the problem. A person with an alcohol problem may gulp or
sneak drinks, drink alone or early in the morning, and suffer from the shakes.
He or she may also have family, school, or work problems or get in trouble with
the law because of drinking.
The use of alcohol with medicines or
illegal drugs may increase the effects of each.
patterns vary. Some people drink and may be intoxicated (drunk) every day. Other people drink large amounts of
alcohol at specific times, such as on the weekend. It is common for someone
with an alcohol or drug problem to call in sick for work on Monday or Friday.
He or she may complain of having a virus or the flu. Others may be sober for
long periods and then go on a drinking binge that lasts for weeks or
alcohol dependence may suffer serious
withdrawal symptoms, such as trembling, delusions,
hallucinations, and sweating, if he or she stops drinking suddenly ("cold
turkey"). After alcohol dependence develops, it becomes very hard to stop
drinking without outside help. Medical
detoxification may be needed.
Drug abuse includes the use of illegal
drugs—such as marijuana, methamphetamines, cocaine, heroin, or other "street
drugs"—and the abuse of legal prescription and nonprescription drugs. Some
people use drugs to get a "high" or to relieve stress and emotional
Drugs like ecstasy (MDMA), ketamine, GHB, Rohypnol, and
LSD, which are known as "club drugs," may be found at all-night dances, raves,
trances, or clubs. The use of club drugs accounts for increasing numbers of drug
overdoses and emergency room visits. Inhalants like nitrous oxide may also be
used at these clubs. Drugs come in different forms and can be used in different
ways. They can be smoked, snorted, inhaled, taken as pills, put in liquids or
food, put in the rectum or the vagina, or injected with a needle. Teens and
young adults may be at risk for becoming victims of sexual assault or violent
behavior in situations where these
drugs are used.
medicines, such as cold medicines that have dextromethorphan as an ingredient,
are being abused by teens and young adults as a way to get a "high." Glue, shoe polish, cleaning fluids, and aerosols, are common household products with ingredients that can also be used to get a "high."
In the United States and Canada, approximately 40% of adults will use an
illegal drug at some time during their lives. This does not include the use of
alcohol or prescription medicines. Many people abuse more than one illegal
substance at a time.
Drug dependence or addiction occurs when you
develop a physical or emotional "need" for a drug. You are unable to control
your use of a drug despite the negative impact it has on your life. You may not
be aware that you have become dependent on a drug until you try to stop taking
it. Drug withdrawal can cause uncomfortable and sometimes
dangerous symptoms. The usual treatment is to gradually reduce the dose of the
drug until you can completely stop using it.
Some groups of people are more
likely than others to have problems related to alcohol or drug abuse. These
Alcohol is part of many people's lives and may have a place in cultural and family traditions. It can sometimes be hard to know when you begin to drink too much.
There is a strong connection between the use of drugs and
alcohol and high-risk sexual behaviors. This increases a person's chance of
sexually transmitted infections (STIs),
hepatitis B, and
human immunodeficiency virus (HIV).
you think you might have a drinking or drug problem, take a short quiz to evaluate your
Check your symptoms to decide if and when
you should see a doctor.
Health Tools help you make wise health decisions or take action to improve your health.
The use of alcohol and drugs can affect your behavior. Here are some questions to think about:
Based on your answers, the problem may not improve without medical
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
If you are with a person who is drunk or high, it's a good
idea to seek medical help right away if:
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Being dependent on alcohol or drugs
means that you have a physical or emotional dependence on the substance. When
you are dependent on a substance:
Based on your answers, you need
or other emergency services now.
Severe withdrawal symptoms may
Mild withdrawal symptoms may
The risk of a suicide attempt is
If you are concerned about your
own alcohol or drug use:
If you are concerned about another person's alcohol or drug
If you are concerned about an older family member's alcohol or
If you are concerned about a teenager's alcohol or drug use
Call your doctor to
evaluate your symptoms if your alcohol or drug problem becomes more frequent or
Some alcohol and drug abuse problems can
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to
answer the following questions:
Other Works Consulted
Ewing JA (1984). Detecting alcoholism: The CAGE
questionnaire. JAMA, 252: 1905-1907.
December 23, 2011
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Peter Monti, PhD - Alcohol and Addiction
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