Drug Awareness

Responsible party hosts know that holiday celebrations don't have to center on alcoholic drinks. Good cheer can be experienced with few alcoholic beverages or none.
“The best parties are those that are well planned and take into account who's on the guest list”, said Jerry Jaker, executive director of the Minnesota Institute of Public Health in Mounds View, Minn. The best parties let guests know that "a drink" doesn't necessarily mean an alcoholic drink. Especially with children and nondrinkers present, it's important to offer an attractive variety of nonalcoholic beverages. In fact, with children on hand, strongly consider an alcohol-free party.
As a party host, let your guests know up front that they don't have to have an alcoholic beverage. If you offer drinks upon their arrival, begin by listing a range of nonalcoholic beverages followed by drinks with alcohol. An excellent approach is to avoid letting alcohol dominate your entertainment. You can welcome guests and "break the ice" by directing them to people they know or to games or activities that will engage them. Once they're relaxed they can choose a beverage based on taste rather than a need to relieve social anxiety. The nonalcoholic drink should be presented as equally appealing as an alcoholic beverage. For instance, offering wine in long-stemmed crystal glasses appears more attractive than soda pop offered in cans. The possible implication: Wine is more important and thus more desirable.
A great way to prevent over-served guests is to designate someone to serve drinks. “Do not have an open bar”, Jaker suggests, “because people tend to imbibe more when pouring their own drinks. A bartender can limit the amount, frequency and stiffness of the drinks.”
Party hosts need not offer guests a limitless supply of alcoholic drinks; figure on one or two drinks per guest who drinks. Nothing can ruin a party faster than an inebriated guest who becomes obnoxious, unruly or ill. Intoxicated guests can change the mood of a party. People start feeling uncomfortable and often think they have to watch what they say or do.
"When Uncle George gets tipsy, it's neither comical nor cute," said Jaker. "You don't want to laugh off Uncle George." Always be on alert for signs of excessive drinking. If necessary, inform the overindulgent guest that he or she has had enough, and do it graciously. Enlist the help of a spouse or friend if necessary to get the message across.
Bear in mind it's not always the number of drinks that impairs driving ability. As few as two drinks may compromise driving ability for some guests. Medication, body weight, amount of food eaten, fatigue, health, and mental attitude can all play a factor in the way a body responds to alcohol. You can help prevent guests from drinking too much by limiting salty, thirst-inducing appetizers. Generous helpings of cheese, meat, vegetables, and fruits are nutritious and help absorb alcohol.
If in spite of your best efforts a guest has drunk too much, do everything possible to prevent him or her from driving. That might mean asking a sober guest to drive an impaired one home or having the person stay in your home until they're sober.
Holiday parties offer adults an opportunity to serve as good role models for children. "In homes where alcohol is not the focus of holiday celebrations, children are less likely to grow up thinking that drinking is the key ingredient to having a good time," said Kris Vanhoof-Haines, a prevention services specialist at Hazelden in Center City, Minn. "Kids are keenly aware of persons whose anti-drinking talk conflicts with their behavior. Parents need to walk their talk when it comes to alcohol use. Kids really question and challenge their parents when they're being sent mixed messages."
Alive & Free is a health column that provides information to help prevent and address substance abuse problems and is reprinted with permission. It is created by Hazelden, a nonprofit agency that offers a wide range of info and services on addiction.

Patricia used to approach the holidays with an overwhelming sense of dread, because she never knew what her alcoholic brother might do to ruin them. As Thanksgiving floral arrangements gave way to sparkling Christmas ornaments and the drone of holiday music, her stomach would clench more each day and her mood would grow darker.

"Some years were just awful," she recalls. "So often my brother would show up drunk and make a scene at family gatherings. He'd scare his kids, embarrass his wife, and break my mother's heart over and over again. One year he got arrested a week before Christmas for driving under the influence and for disorderly conduct. I remember that we called the judge to ask if they could keep him in jail until after the holidays. We all breathed a collective sigh of relief when they did just that. We could finally relax and enjoy ourselves knowing he was safe but unable to spoil things for everyone."

Thankfully, those painful memories are distant ones now because Patricia's brother--after 25 years as a practicing alcoholic--stopped drinking 20 years ago. "But it took me several years after he went into treatment to trust him and his recovery," she says. "For a long time, I still prepared myself for the worst, half expecting another midnight phone call saying he had been in an accident."

The holiday scene Patricia describes today, however, is right out of a Norman Rockwell painting. "My brother is a grandfather now, and he is like an excited little boy, eagerly watching his grandkids open the gifts he laboriously and lovingly picked out for each of them. I'm so grateful that my parents got to experience his sobriety and witness the profound changes he made in his life before they died."

Patricia says her own involvement in the Twelve Step program of Al-Anon has helped her understand that addiction is truly a disease that affects the entire family. She says recovery has allowed her to unearth the meaning of the holiday season and reclaim it as the joyous and contemplative occasion it was meant to be.

In autumn, the early settlers of our country gathered and evaluated their harvest, preparing themselves for the challenging winter months ahead as they gave thanks for the bounty their hard work brought them. "This is how I view Twelve Step recovery and Thanksgiving now," Patricia says. "I welcome it as a time to take stock of past experiences and meditate on the lessons I've learned--seeing those lessons as my 'harvest,' my protection for any future difficulties. Then I find ways to express my gratitude for all I've been given."

Two years after her brother began recovery, for example, Patricia gave him a little music box for Thanksgiving that played "We've Only Just Begun," thanking him for rekindling the flame of family that was almost extinguished by the winds of his alcoholism.

Patricia describes herself as a spiritual person who sees Christmas as another opportunity for deep reflection. "To me, Christmas is about love, acceptance and expectancy--a symbol of birth and hope," she says. "I try to carry through with the 'attitude of gratitude' that I learned about in Twelve Step recovery, and use Christmas as a time to help others."

Some years she and her husband and daughter play "secret Santa" and buy gifts for a family in need. Sometimes they serve meals at a homeless shelter or take an elderly friend out for a holiday lunch. She also likes to write letters of appreciation at Christmas to the special people in her life, letting them know what gifts they are to her.

"Recovery has been transformative for me, for my brother, and for my whole family," she says. "Twenty years ago, I hated the holidays and feared what my brother would do. But then he sobered up and I got my big brother back. Along the way, I discovered the Twelve Steps. I guess miracles really do happen. Isn’t that what the holidays are all about?”

Chances are good that the words Mark Twain wrote for the Atlantic Monthly in 1874 still ring true for those who parent and work with teens: "When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much he had learned in seven years."

As much as we want to believe otherwise, when it comes to heart-to-heart talks, teens will usually turn to each other for advice and consolation instead of their parents or teachers. That's why TeenCentral.net--an interactive and confidential Web site that delivers crisis intervention services and advice to teens 24 hours a day--receives over two million hits each month from teens all over the world.

The professional counselors who monitor the site explain to parents that, while they understand how overwhelming it can be for parents to have a kid in crisis, they are committed to protecting the anonymity of the site's teen visitors and cannot reveal what is discussed between teens. This confidentiality makes it possible for teens troubled about things like sex, drinking, drugs, eating disorders, dating issues, or loneliness to talk honestly, get support from their peers, and receive sound advice and direction from the experts who counsel them. It is the experts' belief that when a troubled youth is helped, the whole family can benefit.

The Web site was the brainchild of "KidsPeace," an organization that has been helping kids in crisis since 1882. Today, KidsPeace has 65 centers nationwide that employ more than 2,500 people, including doctors and childcare professionals, child and adolescent development experts from Harvard Medical School and Brown University, and many others who are committed to the mission of "giving hope, help, and healing to children facing crisis." As young people share their stories, they are guided through a process of problem identification, information, and crisis-resolution techniques.

This approach has been so successful that KidsPeace produced a book that represents 500,000 of the stories shared at the Web site. In "I've Got This Friend Who . . ." (Hazelden, 2007), six fictitious and composite teens talk with each other about the high-risk pressures and problems they face every day. Woven into the dialogue are valuable pieces of information about the various issues discussed, including advice on where to go and how to get help if they or some of their friends are in need of it. Self-tests and personal stories help readers identify and clarify their own issues, while helping them develop the self-confidence and strength they need in order to make changes.

In the midst of a discussion about drinking, for example, readers are given a list of warning signs to determine if a friend might be abusing alcohol. As the teen "authors" talk about their own thoughts and experiences, they share ideas about how to best help a friend in trouble and how they can say "no" to alcohol and other drugs without getting embarrassed or ostracized by their peers.

Since the book's "authors" are composites of so many voices, every teen reader should be able to identify with at least one of them. Karen, the "devil's advocate," is smart, outspoken, and independent. Ryan is a popular athlete who is also involved in student government and theater. Eric is a "nerd" who worries about fitting in. Ashley, the youngest at 13, questions which values are worth compromising in order to be accepted. Emile, the oldest at 18, is a street-smart kid who wants to straighten out.

"Every day, millions of teens navigate the turbulent seas of growing up in an increasingly complex world where they face an assault of problems and challenges that often require split-second decisions," explained Lewis Lipsitt, the national director of the KidsPeace Lee Salk Center for Research. "Making the right choices at the moment of truth is often a difficult, confusing, and even frightening proposition. But it is critical and can affect the rest of their lives."

For more information, visit KidsPeace.org or TeenCentral.net. Learn more online about the KidsPeace book, "I've Got This Friend Who . . . " or call 800-328-9000.

Alive & Free is a health column that provides information to help prevent and address substance abuse problems and is reprinted with permission. It is created by Hazelden, a nonprofit agency that offers a wide range of info and services on addiction.

A small circle of men listened attentively as their counselor at a mission in St. Paul announced their assignment. Their faces might have belonged to anyone--professionals with post-graduate degrees or homeless individuals who constantly struggle. But they were late-stage, chronic alcoholics, the kind who huddle beneath city bridges in the December cold or who simply revolve through local detox centers and shelters. All were searching for a reason to hope.
A week earlier, the counselor had asked each of them to write a prayer. Everyone managed to come up with something, except one. The counselor asked if he had written something, and the man shook his head and stared dismally at the floor. Years on the street immersed in alcohol and gloom had left him isolated, estranged from everyone, especially a divine power.
Days later, after hours of talking, listening and searching, the group assembled again and the counselor asked the man if he brought his prayer. "Yes," he said, to everyone's surprise. He then recited his prayer: "Whoever made me, keep me safe."
It was a powerful prayer, strong in its simplicity and in what it revealed about the person who said it. It confirmed that at the core of every human being burns a spirit searching for healing and connection with a source of strength and goodness beyond ones self.
Most addiction treatment programs support the belief that recovery from addiction involves making peace with one's spiritual self. Spirituality could be called the essence that moves us toward a sense of connectedness with the universe or God, with others, and with our self. Treatment professionals have long known that addiction affects every part of a person--physical, mental, emotional, social and spiritual.
The Twelve Steps of AA help recovering persons let go of their addictive selves. The program recognizes the spiritual task and it is with spirit that we find strength and identity. We discover power that comes from something larger than our self. We feel a source of wisdom that can guide us as we grow and change. Perhaps the message we need to bring forth is as simple as the homeless man’s six-word prayer. It is a message of simplicity and humility. To be humble means to be in touch with the earth and all who inhabit it--to be reconciled and made whole.

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Alive & Free is a health column that provides information to help prevent substance abuse problems and address such problems. It is created by Hazelden, a nonprofit agency based in Center City, Minn., that offers a wide range of information and services on addiction. For more resources, email or call Hazelden at 800-257-7810 (outside the US 651-213-4200).

There is an old song that goes "Make new friends, but keep the old. One is silver and the other gold." As we grow more solidly into who we are ultimately becoming, some friendships refashion themselves to accommodate our changes, some friendships have to fade away, and sometimes new and healthier friendships emerge when we let go of a toxic relationship.

"When I was using, it was very clear who my friends were; they were the people I could get high with and the folks who provided the dope," said a recovering drug addict and alcoholic. "Now that I'm sober I realize I never really had any true friends. I learned through AA that friendship takes work and it's not just about me." For people in recovery from alcoholism, a healthy friendship can be a lifeline to sobriety, just as an unhealthy relationship can be a threat to hard-won abstinence. "It is crucial for recovering people to discern between relationships that are affirming and those that keep them stuck in old roles," said Rosemary Hartman, supervisor of Hazelden's Family Services. "If one friend is in recovery and one isn't, there's a power differential." It's often hard for older people in recovery to let go of unhealthy friendships, because friends may have a long history with each other that includes many positive memories, and it's harder in later years to meet new friends, said Hartman. She said recovering people of all ages should ask themselves, "When do I spend time with this person? Have I always used with him or her and do they encourage me to use more? Does this person affirm my efforts to stay sober?"

Saying goodbye to a friend can be painful, but members of a recovery group can often help because they are also working to maintain healthy relationships in their sobriety. Hartman suggested that, in addition to their regular groups, men and women might benefit from attending an all-male or all-female group where they can meet new friends. "If you started using at age 14, most of your friendships will be based on using and you'll have little practice on how to make friends," she said. "Recovery groups are safe places to practice new skills. Focus on forming friendships that allow you to be the kind of person you want to be."

Recovery means change, not just for the person who embarks on the recovery journey, but for his or her friends and loved ones, too. Choosing whether to continue a relationship is an important part of recovery, but the better the choices are, the more solid recovery--and friendship--will be.

Alive & Free is a health column that provides information to help prevent substance abuse problems and address such problems. It is created by Hazelden, a nonprofit agency based in Center City, Minn., that offers a wide range of information and services on addiction. For more resources, email or call Hazelden at 800-257-7810 (outside the US 651-213-4200).

Under a banner called the Amethyst Initiative, 130 college presidents are asking the nation to consider lowering the legal drinking age.
”Twenty-one is not working," notes the initiative in its official statement. The group also states that binge drinking by young people continues, despite current laws. The initiative has inspired an informed and dispassionate public debate over the effects of the 21 year-old drinking age.
College presidents have a right to be concerned. Consider these statistics for students between the ages of 18 and 24: Nearly 1,700 die each year from alcohol-related traffic accidents and other unintentional injuries. More than 696,000 are assaulted by students who have been drinking. And 31 percent of students in this age group could be diagnosed as alcohol abusers.
Yet there's no evidence that lowering the drinking age would solve any of these problems. In addition, lowering the drinking age would undercut the gains made since 1988, when 21 became the minimum legal drinking age in all 50 states.
Since then, according to the U.S. Department of Transportation, more than 18,000 lives have been saved by decreases in alcohol-related traffic accidents. Those accidents are the leading cause of death in young people.
"The research clearly shows that raising the legal drinking age to 21 saves lives," says Marty Harding, a prevention specialist for Hazelden. "When faced with a proposal to undo decades of this progress, why would we do it?"
William Cope Moyers, executive director of Hazelden's Center for Public Advocacy, a binge drinker in college and a recovering alcoholic, recalls that his life was shaped by the drinking culture on his campus.
"What happened to me was caused by the simple fact that alcohol was readily available in an environment where the checks and balances of home life suddenly had vanished," Moyers notes in a recent blog entry. "Drinking was part of the culture on campus, in the fraternity house and at mealtime. That it was legal only helped to foster that culture, especially among newly minted 18-year-old college freshmen like me.
"Twenty-one is not working, according to the college presidents' statement," Moyers adds. "But from my own experiences a long time ago, 18 never worked either."
Any national debate about solutions to college drinking problems is welcome. Let that debate focus on creating new norms for alcohol use among young people--and ways to make the current laws work.
Published December 12, 2008. Alive & Free is a health column that provides information to help prevent substance abuse problems and address such problems. It is created by Hazelden, a nonprofit agency based in Center City, Minn., that offers a wide range of information and services on addiction. For more resources, email or call Hazelden at 800-257-7810 (outside the US 651-213-4200).

Nearly 71% of Americans agree that health insurance should cover the cost of addiction treatment - yet most consumers have no idea if their own health insurance would pay for substance abuse treatment, according to the first-ever "Public Attitudes Toward Addiction Survey" from Hazelden.
With the passage of the U.S. Mental Health Parity Law last October and the Obama administration now designing its agenda on healthcare issues, it's striking that most Americans agree addiction treatment should be part of healthcare reform. Most Americans (78%) understand drug addiction is a chronic disease; and 56% say their company doesn't have an Employee Assistance Program to help deal with problems involving alcohol or other drugs. .
Nearly one-third of Americans responding reported past abuse of alcohol or drugs in their immediate family - and 44% of those reported more than one family member with a drug problem. A third of the families which reported a drug problem in their immediate family say that a majority of their family members have problems with drugs. .
When you expand the questions to include both immediate and extended family, virtually half of Americans surveyed reported three or more family members have experienced a problem with drugs during their lives. .
The Hazelden survey also indicated that Americans will want changes in how their government and businesses handles addiction and treatment: 79% feel the War on Drugs has not been successful. 83% agree that much more should be done to prevent addiction and believe that first-time drug offenders should get chemical dependency treatment rather than prison time. Most respondents (77 percent) agree that many addicts who complete treatment go on to lead useful lives. .
Hazelden's survey revealed that stigma still remains toward people who are addicted to alcohol and other drugs. The words used by those surveyed when asked to describe people who have problems with drugs included: "sinner," "irresponsible," "selfish, "stupid," "uncaring," "loser," "undisciplined," "washed up" and "crazy." The single highest negative consequence reported of having a family member with a drug problem was "embarrassment/social stigma." .
"What Hazelden's new survey brought home to me is that Americans understand addiction is a disease, yet much more work must be done to explain how effective treatment can be for addicts and to bring an end to the stigma that prevents addicts from pursuing treatment," says William Cope Moyers, executive director of Hazelden's Center for Public Advocacy. .
“The good news is - effective treatment for addiction exists, people in recovery lead useful lives and insurance could, and should, cover addiction treatment. Let's work together to help improve public understanding of America's No. 1 health problem - addiction to alcohol and other drugs." .
Hazelden, a national nonprofit organization founded in 1949, has helped tens of thousands of people reclaim their lives from the disease of addiction. .

Some people worry about their alcohol use but are not convinced that they need help. To cut through the confusion, it helps to understand the difference between alcohol abuse and alcohol dependence. Making this distinction can help you think clearly about a "drinking problem"--and allow you to get the kind of help that makes a difference.

The American Psychiatric Association defines alcohol abuse as drinking that leads to "clinically significant impairment or distress." For example: neglecting major responsibilities at work, school or home, drinking in hazardous situations, such as driving while intoxicated, drinking that leads to recurrent legal problems, such as arrests for disorderly conduct or continued drinking even when it leads to recurrent social problems such as violent arguments.

Those consequences are serious enough. But alcohol dependence can involve any of them and goes on to include: Tolerance (drinking in greater quantities in order to achieve a desired level of intoxication), Withdrawal (feeling symptoms of illness such as anxiety, nausea, vomiting, trembling, confusion, seizures and hallucinations when alcohol is not available) and Compulsive use (drinking that continues even after a person makes repeated promises to quit or experiences significant problems that relate directly to alcohol use).

In short, dependence has two dimensions. One is psychological--the belief that alcohol is essential to functioning in daily life. The other one is physiological--feeling extreme discomfort when access to alcohol is delayed or denied. Alcoholics Anonymous defines alcoholism simply: "a physical compulsion, coupled with a mental obsession to drink."

A common scenario is for drinkers to move from casual alcohol use to abuse and then to dependence. In plain English, the difference is really a matter of degree - when drinkers start having tolerance and withdrawal, they are at a point where they move into dependence. However, drinkers do not always follow a fixed path from abuse to dependence. Some remain abusers all their lives. And others cross the line to dependence soon after their first drink. Finally, it's not the amount of alcohol consumed that defines the difference between abuse and dependence. Instead, we measure the problem by the impact of drinking on somebody's life. The real question is: What's your level of impairment and distress?

Alcohol abusers may be more episodic in their problems, but they pose the same grave danger to themselves as well as the general public. If they're involved in an alcohol-related accident, they may be court ordered to undergo a addiction assessment or attend substance abuse education classes. If they seek addiction treatment they generally find their way into an outpatient program. This may contrast with people who are dependent on alcohol, or those who cannot drink safely at all. The depth of their drinking problem may call for intensive inpatient treatment--a residential program that removes them from the people, places and things associated with their alcohol use.

Alive & Free is a health column that provides information to help prevent and address substance abuse problems. It is created by Hazelden, a nonprofit agency that offers a wide range of info and services on addiction.

When police found Bradley McCue, a student from Michigan State University, he was unconscious, his nose was painted red, and the words "24 shots" were scribbled across his forehead. Witnesses said that he drank 24 shots of liquor in less than two hours. He died of acute alcohol intoxication--also known as alcohol poisoning.

Cases such as McCue's are rare. However, each year alcohol poisoning deaths on college campuses gain national attention. And the National Council on Alcoholism and Drug Dependence, Inc., reports that hundreds die each year from acute alcohol intoxication. Research reveals that binge drinking is common among college students. In 1997, the Harvard School of Public Health published the results of its College Alcohol Study. The bottom line: one in five college students binge drinks frequently.

Blood alcohol levels skyrocket during binge drinking. People who weigh 160 pounds and take a single drink raise their blood alcohol level .025 percent. But the blood alcohol levels of inexperienced drinkers, or those sensitive to alcohol elevate faster and acute intoxication can result more quickly. Women can overdose after drinking lesser amounts than men.

"If you binge drink six or eight drinks within an hour, this can take you to a blood alcohol level that is potentially fatal by sedating the breathing mechanism or causing cardiac irregularity," says Max Schneider, MD, chairman of NCADD's Board of Directors. It's important to remember that the amount of alcohol in standard servings of wine (5 oz.), beer (12 oz.) and distilled spirits (1.5 oz., 80 proof) is the same.

Alcohol poisoning quickly affects the bodily functions that sustain life. As a depressant, alcohol slows breathing, heart rate and blood pressure. If blood alcohol levels rise sharply in a short time, the areas of the brain that control these functions can be sedated--literally put to sleep. When that happens, people lose consciousness and can die.

We can respond to this problem on two levels. The first is to prevent binge drinking. The second is to know the symptoms and appropriate emergency procedures such as calling 911. According to the NCADD, signs and symptoms of alcohol poisoning include:

• Unconsciousness or semi-consciousness.
• Slow breathing--eight breaths or less per minute, or lapses of more than eight seconds between breaths.
• Cold, clammy, pale or bluish skin.
• A strong odor of alcohol.

Alive & Free is a health column that provides information to help prevent substance abuse problems and address such problems. It is created by Hazelden, a nonprofit agency based in Center City, Minn., that offers a wide range of information and services on addiction. For more resources, email or call Hazelden at 800-257-7810 (outside the US 651-213-4200).