Substance Abuse, Use and Dependence
Learning Objectives:
Discern if you have a substance abuse issue;
How to deal with pressure to party;
Identify if a friend or roommate has a substance use problem and learn how to help.
“I can’t be there for other people unless I’m there for myself. I can’t really work to push our movement without really investing in myself. By investing in yourself you’re also investing in your community.”
—Dior Vargas, queer Latina mental health advocate and activist
Substance is the word health professionals use for most things you might take into your body besides food. When people talk about substances, they often mean drugs—but alcohol and nicotine are also drugs and are considered substances. Substances—any kind of drug—have effects on the body and mind. People use these substances for their effects. But many substances have negative effects, including being physically or psychologically addictive. What is important with any substance is to be aware of its effects on your health and on your life as a student, and to make smart choices. Use of any substance to the extent that it has negative effects is generally considered abuse.
First, consider your own habits and attitudes with the Substance Use Self-Assessment.
Your Turn: Activity
SUBSTANCE USE SELF-ASSESSMENT
On a sheet of paper or document, indicate Daily, Sometimes or Never to the following statements:
I smoke cigarettes or use smokeless tobacco;
I drink beer or other alcohol;
I have missed a class because I was hung over from drinking the night before;
I have taken a medication that was not prescribed for me;
I have used an illegal drug.
Answer the following questions:
If you smoke cigarettes, how many a day do you usually smoke?
If you drink alcohol (including beer), on how many days in a typical week do you have at least one drink?
If you drink at parties or when out with friends, how many drinks (or beers) do you typically have at one time?
If you use a pharmaceutical or illegal drug, how often do you take it?
Are your habits of smoking, drinking, or using other drugs affecting your studies or grades?
SMOKING & TOBACCO: WHY IS IT SO HARD TO STOP?
Everyone knows smoking is harmful to one’s health, and that smoking causes cancer and lung and heart disease. Most adult smokers continue smoking not because they really think it won’t harm them but because it’s very difficult to stop.
Many young smokers think there is plenty of time to quit later. Social smokers, who may have a cigarette only occasionally with a friend, usually thinking they won’t develop a habit. Nicotine is a very addictive drug. Admitting this to yourself is the first step toward becoming smoke free.
First, the good news. Stopping smoking brings immediate health benefits, and the benefits get better over time. Just twenty minutes after quitting, your heart rate drops. After two weeks to three months, your heart attack risk begins to drop and your lung function begins to improve. After one year, your added risk of coronary heart disease is half that of a smoker’s. And every year your health continues to improve.
Just Keep Quitting
Stopping isn’t easy. Many ex-smokers say it was the hardest thing they ever did. However, you know it’s worth the effort. And it’s easier if you think it through and make a good plan. There’s lots of help available. Before you quit, the National Cancer Institute suggests you START with these five important steps:
S = Set a quit date;
T = Tell family, friends, and coworkers that you plan to quit;
A = Anticipate and plan for the challenges you’ll face while quitting;
R = Remove cigarettes and other tobacco products from your home, car, and work;
T = Talk to your doctor about getting help to quit.
To get ready, download this booklet to help you quit smoking: On the Road to Quitting, http://bit.ly/C20QuittingGuide
GET HELP TO STOP SMOKING
A lot of people are not able to stop smoking by themselves, so don’t feel bad if you aren’t successful on the first try. Ask your doctor about other ways to stop. Maybe nicotine-replacement therapy is what you need. Maybe you need prescription medication. Stop by the Center for Wellness and Wellbeing, https://bit.ly/smcwellbeing, at Santa Monica College. Your doctor and other health professionals at your school have a lot of experience helping people—they can help you find what works for you.
WHAT’S THE BIG DEAL ABOUT ALCOHOL?
Of all the issues that can affect a student’s health and success in college, drinking causes more problems than anything else. Everyone knows what happens when you drink too much. Your judgment is impaired and you may behave in risky ways. Your health and studies are likely to be affected.
Most college students report drinking at least some alcohol at some point in time—and even those who do not drink are often affected by others who do. Here are a few facts about alcohol use among college students:
Assault. 10% of surveyed undergraduate students indicated that had experienced alcohol- related violence;
Sexual abuse. Over 14% of those surveyed indicated that they had unplanned sexual relations due to alcohol;
Alcohol abuse and dependence. 32% of undergraduates aged 18-24, reported drinking at a dangerous level in the past year;
Academic problems. Negative consequences were reported by the students who drank: 31.6% reported being unable to perform daily activities, 18.8% reported missing class, and 32.9% reported study interruptions.
So why is drinking so popular if it causes so many problems? You probably already know the answer to that: most college students would say they have more fun when drinking. It is unlikely that they’re going to stop drinking just because someone lectures them about it.
Like everything else that affects your health and happiness—eating, exercise, use of other substances— drinking is a matter of personal choice. Like most decisions we all face, there are trade-offs. The most that anyone can reasonably ask of you is to be smart in your decisions. That means understanding the effects of alcohol and deciding to take control.
Myths About Alcohol
Myth: I can drink and still be in control.
FACT: Drinking impairs your judgment, which increases the likelihood that you will do something you’ll later regret such as having unprotected sex, being involved in date rape, damaging property, or being victimized by others.
Myth: I can sober up quickly if I have to.
FACT: It takes about two hours to eliminate the alcohol content of one drink. Nothing can speed up this process—not even coffee or cold showers.
Myth: I can manage to drive well enough after a few drinks.
FACT: The effects of alcohol start sooner than people realize, with mild impairment (up to .05 Blood Alcohol Content) starting to affect speech, memory, attention, coordination, and balance.
Myth: Beer doesn’t have as much alcohol as hard liquor.
FACT: A 12-ounce bottle of beer has the same amount of alcohol as a standard shot of 80-proof liquor (either straight or in a mixed drink) or 5 ounces of wine.
Video
Only one in nine people in the United States gets the care and treatment they need for addiction and substance abuse. A former Director of National Drug Control Policy, Michael Botticelli is working to end this epidemic and treat people with addictions with kindness, compassion and fairness. In a personal, thoughtful talk, he encourages the millions of Americans in recovery today to make their voices heard and confront the stigma associated with substance use disorders. https://bit.ly/addictionisadisease
How Much Is Too Much Alcohol?
There’s no magic number for how many drinks a person can have and how often. If you’re of legal drinking age, you may not experience any problems if you have one or two drinks from time to time. According to Health Canada, ‘heavy drinking’ occurs when a male consumes 5 or more drinks (4 for females) per occasion, at least once a month during the past year[5].
As with most things that can affect your health and your well-being as a student, what’s important is being honest with yourself. You’re likely drinking too much or too often if you:
Missed classes or work because you were hung over or overslept after drinking;
Have friends or family members who have hinted that you drink too much, or you’ve hidden your drinking from others;
And your drinking habits are causing trouble in a relationship;
Can’t remember what you did or said while drinking;
Need to drink to have a good time at a party or with friends;
Have driven a car when you know you shouldn’t have after drinking;
Binge drink (consume five or more drinks at a time).
PRESSURED TO PARTY
Most of us can remember times when we were influenced by our friends and others around us to behave in some way we might not have otherwise. Say, for example, I have a big test tomorrow, and I’ve been studying for hours, and just when I knock off to relax for a while, a friend stops by with a six-pack of beer. I’d planned to get to bed early, but my friend pops open a beer and sticks it in my hand, saying it will help me relax. So I tell myself just one, or maybe two—after all, that’s not really drinking. And let’s say I stop after two (or three) and get to bed. Maybe I don’t sleep quite as well, but I still pass the test in the morning. So—was that peer pressure or my decision?
There are no easy answers! What matters is that you think about your own habits and choices and how to take control of your own life.
Read this case study about a student who joins a college club and feels pressured to drink. You may be very different from him—maybe you’re older and work full time and are taking night courses—but you still should be able to relate to his issues. As you answer the questions about his situation, think about how the same questions might also apply to someone in your own situation.
Your Turn: Activity
IDENTIFYING SUBSTANCE ABUSE
Read the scenario below and answer the following questions.
Pressured To Drink
When John decided to stay at the college residences’, he knew there would likely be drinking in his hall. He had had a few beers at parties through high school but had never binged and felt there was nothing wrong with that as long as he kept it under control. But he was surprised how much alcohol flowed through the residence, and not just at parties—and the house advisor just seemed to ignore what was going on. He wanted to fit in, so he usually had a few whenever his roommate or others called him away from studying.
One night he definitely drank too much. He slept late, missed his first two classes, and felt rotten most of the day. He told himself he’d drink only on weekends and only in moderation. Being underage didn’t bother him, but his grades hadn’t been all that great in high school, and he didn’t want to screw up his first year in college. But it was only one day before some of the older students from his residence interrupted his studying again and stuck a beer in his hand. He didn’t know what to do.
Is John at risk for developing any problems if he tries to fit in with the drinkers while promising himself he would drink only moderately? Why or why not?
If John decides to hold firm and drink only on weekends when he doesn't have to study, is he still at any risk for developing a problem? Why or why not, depending on what circumstances?
If John decides to tell his friends he does not want to drink, what should he say or do if they continue to pressure him?
What to do
If you think you may be drinking too much, then you probably are. Can you stop—or drink moderately if you are of age—and still have fun with your friends? Of course. Here are some tips for enjoying yourself in social situations when others are drinking:
Drink only moderately (if above legal age) and slowly. Your body processes alcohol at a rate of about one drink an hour—drinking faster than that leads to problems. Sip slowly. Set yourself a limit and stick to it;
Drink a mixer without the alcohol. It tastes just as good or better. Alternate alcoholic drinks with nonalcoholic ones to slow down the pace;
Rather than just lounging around with others who are drinking, stay active: move about and mingle with different people, dance, and so on;
If someone tries to make you uncomfortable because you’re not drinking, go talk to someone else.
Because drinking is a serious issue in many places, it’s a good idea to know what to do if you find yourself with a friend who has had too much to drink:
Stay with the person if there is any risk of them hurting themselves (driving, biking) or passing out. Take away their keys if necessary;
If he passes out after drinking a great deal of alcohol fast and cannot be awakened, get medical help;
An intoxicated person who falls asleep or passes out on their back is at risk of choking on vomit— roll them on their side or face down;
Do not try to give him food or other substances in an effort to sober him up;
Don’t put him in a cold shower, which could cause unconsciousness.
When you Need Help
Visit the Student Health Services Center or talk with your college counselor. They understand how you feel and have a lot of experience with students feeling the same way. They can help;
Be sure someone always knows where you are and you have a safety plan, https://bit.ly/partysafeplan, in place;
Use the buddy system, https://bit.ly/buddysystemforparties, when partying, and never leave a buddy behind.
Off-Prescription and Illegal or Unregulated Drugs
People use drugs for the same reasons people use alcohol. They say they enjoy getting high. They may say a drug helps them relax or unwind, have fun, enjoy the company of others, or escape the pressures of being a student. While alcohol is a legal drug for those above the drinking age, most other drugs— including the use of many prescription drugs not prescribed for the person taking them—are illegal. They usually involve more serious legal consequences if the user is caught. Some people may feel there’s safety in numbers: if a lot of people are using a drug, or drinking, then how can it be too bad? But other drugs carry the same risks as alcohol for health problems, a risk of death or injury, and a serious impact on your ability to do well as a student.
As with alcohol, the choice is yours. What’s important is to understand what you’re doing and make smart choices. What’s the gain, and what are the risks and costs?
While society may seem to condone drinking, and the laws regarding underage drinking or being drunk in public may not seem too harsh, the legal reality of being caught with an illegal drug can impact the rest of your life. Arrest and conviction may result in being expelled from college—even with a first offense. A conviction is a permanent legal record that can keep you from getting the job you may be going to college for.
Although the effects of different drugs vary widely, a single use of a drug can have serious effects and consequences. Even if you’re told that a pill is a prescription medication whose effects are mild or safe, can you really be sure of the exact ingredients and strength of that pill? Do you fully understand how it can affect you with repeated use? Can it be addictive? Could it show up on an unexpected random drug test at work?
Read through these: Common Drugs on College Campuses, https://bit.ly/campusdruguse, lists some of the possible effects of drugs used by college students. Good decisions also involve being honest with oneself. Why do I use (or am thinking about using) this drug? Am I trying to escape some aspect of my life (stress, a bad job, a boring class)? Could the effects of using this drug be worse than what I’m trying to escape?
Keep Asking for Help Until you get Some
If you have questions or concerns related to drug use, your doctor or Santa Monica College’s Student Health and Wellness Center, https://bit.ly/smcwellnesscenter, can help
Check these Websites for additional information:
Drug Information Online, http://bit.ly/C20DrugInfo;
Drug and Alcohol Helpline: 1-800-565-8603;
Substance Abuse and Mental Health Services Administration, https://www.samhsa.gov/;
National Harm Reduction Coalition, https://harmreduction.org.
Key Takeaways
Excessive drinking or substance abuse is a common—but unhealthy—response to the stresses of college life. While the decisions are yours, it’s important to understand the effects of tobacco, alcohol, and drugs and how they impact your life;
Quitting smoking is hard, but it’s clearly worth it—and lots of help is available. If you’re a smoker, make this the year you become proud of yourself for quitting;
If you like to drink, be honest with yourself. How much does drinking enrich your life, and how much do the effects of drinking interfere with your life? Make smart decisions so that you live your life to its fullest without regrets about losing control;
Avoiding drugs can be a complicated issue, certainly not as simple as simply deciding to say no. But you’ve already made the decision to attend college, and that’s a smart decision. Make smart choices in other areas of your life as well.
Substance use and abuse not only takes its toll on the body but also contributes to problems in college, at work, and in the future. You may need to make a smart decision between short-term pleasures and long-term success;
Since many stressors are unavoidable in life, we all need to find good ways to minimize their effects. The best stress-reducers over time become good habits that will increase our wellness and help us succeed in college and careers;
N.B.: The Student Success Library item was customized for Santa Monica College (SMC) in Santa Monica, CA. You may come across SMC-specific resources, links, or activities that do not apply to you. Search for your own school’s resources or google for similar tools that can help you where you live, study and work.
This work, Substance Abuse, Use and Dependence, is part of the Student Success Library, which is a derivative of Student Success, originally modified by Vanessa Bonilla, Dr. Tyffany Dowd, Jackeline Felix, Dyana Valentine, Olivia Vallejo and Daniella Washington from the original Student Success by Graciela Martinez, Anh Nguyen, and Liz Shaker under CC BY-SA 4.0. Student Success Library is licensed under CC BY-SA 4.0 by Dyana Valentine. Last edit date: July 2022.