Alcohol and Drug Use

Overview

Some people who drink alcohol, use cannabis or other drugs, or misuse prescription or over-the-counter medicines may develop substance use disorder. This means that a person uses these substances even though it causes harm to themself or others.

A person who has substance use disorder will have two or more of these symptoms:

• Using more of the substance or using it for a longer time than they ever meant to.
• Not being able to cut down or control their use.
• Spending a lot of time getting or using the substance or recovering from the effects.
• Having a strong need, or craving, for the substance.
• Not being able to do their main jobs at work, at school, or at home.
• Continuing to use, even though the substance use hurts their relationships.
• Not doing important activities because of their substance use.
• Using substances in situations where doing so is dangerous, such as driving.
• Using the substance even though they know it's causing health problems.
• Needing more of the substance to get the same effect or getting less effect from the same amount over time (tolerance).
• Having uncomfortable symptoms when they stop using the substance or use less (withdrawal).

Substance use disorder can range from mild to severe. The more symptoms of this disorder you have, the more severe it may be.

A person might not realize that their substance use is a problem. They might not use alcohol or drugs in large amounts at one time. Or they might go for days or weeks between drinking episodes or using drugs. But even if they don't drink or use drugs very often, their substance use could still be harmful and put them at risk.

Alcohol and drug use may be a person's way of trying to self-treat another condition, such as depression.

Using alcohol or drugs can put others at risk. For example:

• Using alcohol while pregnant puts the baby at risk for problems from fetal alcohol syndrome. Alcohol may affect the baby's growth and development, behaviour, and ability to learn.
• Children who are exposed to alcohol or drug use in the home may develop mental health conditions, such as depression and anxiety. They may have behavioural problems and trouble with learning and do poorly in school. And they may be more likely to develop substance use disorder.
• Alcohol and drugs can affect a teen's brain development. They can also affect emotional and social development. Alcohol use can cause changes in a teen's alertness, perception, movement, judgment, and attention. This can make it harder for teens to think, learn, reason, and make good choices.

People who use alcohol or drugs may be more likely to engage in risky behaviours. For example, they may not use condoms during sex. Or they may have more than one sex partner. This increases the risk of unintended pregnancy and sexually transmitted infections (STIs). They may drive when "high" or when they've had too much to drink. This may increase the risk of injury or car crashes.

If you think you might have a problem with alcohol or other substances, talk to your doctor.

Alcohol

Alcohol is part of many people's lives. It may have a place in cultural and family traditions. So it may be hard to know when someone is drinking too much and when it's a sign of alcohol use disorder. If you choose to drink alcohol, try to drink less. It's important to remember that drinking alcohol is not risk-free. Your risk of harm from alcohol is:

• Low if you have 2 standard drinks or less per week.
• Moderate if you have between 3 and 6 drinks per week.
• High if you have 7 or more drinks per week.

People who drink too much alcohol are more likely to have poor grades or job performance. They're more likely to use tobacco products and to experiment with cannabis or other drugs. And their drinking may increase their risk of getting hurt or being in a car crash.

Over time, drinking too much alcohol may cause health problems, like high blood pressure, problems with digestion, and liver, heart, brain, and nervous system problems. It may also cause sexual problems, osteoporosis, and cancer.

The use of alcohol with medicines, cannabis, or other drugs may increase the effects of each. Using alcohol along with opioids increases the risk of opioid overdose.

Recreational drugs

People who use drugs such as cannabis, cocaine, heroin, or meth, may develop substance use disorder. People use many drugs for recreational purposes, including some that are also used as medicines. Examples include opioids, ketamine, and LSD. People may use drugs to get a "high" or to relieve stress and emotional problems.

Drugs come in different forms and can be used in different ways. They may be smoked, snorted, inhaled, or taken as pills. They may be put in liquids or food. They may be put in the rectum or vagina or be injected with a needle.

Teens and young adults may be at higher risk of being victims of sexual assault or violent behaviour in situations where drugs are used.

Prescription and over-the-counter medicines

Some people misuse prescription medicines, like opioids (such as Oxyneo and Dilaudid), benzodiazepines (such as Valium and Xanax), and stimulants (such as Adderall). Misusing prescription medicines can cause serious harm and, in some cases, even death.

Some over-the-counter medicines, such as cold medicines that have dextromethorphan in them, are being misused by teens and young adults as a way to get "high."

Inhalants

Glue, shoe polish, cleaning fluids, and aerosols are common products with ingredients that can also be used to get a "high."

Health and safety risks of alcohol and drug use

When you use alcohol or drugs, you may be putting your health and safety at risk.

Alcohol or drug use can:

• Make car crashes more likely. If you drink and drive, or if you drive while you are high, you can easily hurt yourself or others.
• Lead to unprotected sex and/or sexual assault. This can lead to pregnancy and sexually transmitted infections (STIs), including HIV.
• Increase the risk of overdose, injury, and death.
• Cause you to do things you wouldn't usually do. You may say things that hurt your friends. Or you may do something illegal that could result in paying a large fine or going to jail, like being arrested for driving while intoxicated.
• Affect your work or schoolwork. It can cause you to lose your job or drop out of school.
• Change how you feel about your life. It can lead to depression and suicide.
• Cause mood swings and affect your sleep and your ability to think, learn, reason, remember, and solve problems.
• Harm many organs and systems in the body, such as the liver, pancreas, heart, brain, and nervous system.
• Contribute to the development of some cancers, such as cancers of the mouth, throat, esophagus, liver, colon, and breast.
• Cause high blood pressure, stomach problems, or sexual problems.
• Cause harm to a developing baby (fetus) if alcohol or drugs are used during pregnancy.

Self-Care

If you are concerned about your own or another person's alcohol or drug use, learn what steps to take to help yourself or someone else.

Ways to reduce harm from substance use

Although there is no amount of alcohol or drug use that is safe, there are some things you can do to reduce your risk of serious health problems and injuries caused by alcohol or drug use.

• Avoid risky situations and activities. Don't drink or get high and drive, and don't get in a car with a driver who has been drinking or using drugs.
• Make a plan to get home safely. For example, choose a designated driver, have money to pay for a taxi or bus fare, or call a loved one for a safe ride home.
• Don't take over-the-counter or prescription medicines that interact with alcohol. And don't take these medicines with drugs or other harmful substances.
• Don't use alcohol or drugs if you're pregnant or trying to get pregnant. These substances can increase your baby's chance of being born with a birth defect or fetal alcohol syndrome.
• Don't mix alcohol with drugs or other harmful substances.
• Don't use alcohol or drugs to try to make yourself feel better. Using alcohol or drugs may make your problems worse and may cause you to do things that you normally wouldn't do, like hurt yourself or others.
• Be aware at all times of your surroundings and the people around you.
• Limit how much you use alcohol or other substances. The more you use, the greater the risk of getting sick, hurt, or in trouble.

Reducing harm from alcohol

• Have a meal or a snack with a drink. Don't drink on an empty stomach.
• Drink slowly. Don't have more than 2 standard drinks in any one sitting.
• Have a glass of water or other non-alcoholic, caffeine-free beverage (such as a soft drink or fruit juice) between drinks.

Reducing harm from drugs

• Ask your pharmacist or doctor whether any of your current medicines can cause dependence.
  • Be especially aware of pain medicines (such as opioids), tranquilizers, sedatives, and sleeping pills. Follow the instructions carefully, and do not take more than the recommended dose.
  • Make sure that your doctors are aware of medicines prescribed by another doctor. Use only one pharmacy when getting your prescriptions filled.
• Don't share needles, syringes, and other equipment (such as cookers, cotton, cocaine spoons, or eyedroppers) with others if you use drugs. Be aware of who you get your supplies from. Be sure the supplies haven't been used before. If you use dirty needles or equipment, you can get hepatitis, HIV, or other serious infections.
• Talk to your doctor or pharmacist about a take-home naloxone kit. Naloxone helps reverse the effect of opioids. A kit can help, and can even save your life, if you have taken too much opioids. You can get a naloxone kit without a prescription at most drugstores or through a community Take Home Naloxone program.
• Be aware of who you get your drugs from. Drugs can vary greatly in strength depending on who you get them from.
• Be aware of how a drug might affect you, especially if you stopped using the drug and then started using again. You may not be able to handle the same amount of the drug as you could before.
• Don't leave your beverage unattended or accept a drink from an open container.
• If you use drugs, go to a supervised consumption site. This is a place where you can safely use drugs in the presence of trained medical staff. Go to https://www.canada.ca/en/health-canada/services/substance-use/supervised-consumption-sites/status-application.html to find a site near you.

Ways to help yourself or someone else

• Do not ignore the problem.
• Know the signs of substance use. These include being unable to cut down or control use, continuing to use even though it hurts a person's relationships, and having problems at work, school, or home.
• Make an appointment with a doctor or another health professional, such as a counsellor, to discuss steps for getting treatment.
• Find out when support groups, such as Alcoholics Anonymous (AA), LifeRing, Narcotics Anonymous (NA), or SMART Recovery, meet. These self-help groups help members get sober and stay that way. There are also support groups for family members and friends.
• Ask the other person if they would accept help. Don't give up after the first "no." Keep asking. If the person agrees, arrange for help that same day.
• Provide support for the other person during detox or other treatment.
• Help set up community services in the home, if needed. Older adults may benefit from services like home care, nutritional programs, transportation programs, and other services.
• Help with decision-making. Some people who misuse substances can't process information or communicate their decisions well.
• Check out what services are available in your area.
  • If you work, talk to your human resources department about getting a referral to your employee assistance program, if your employer offers it.
  • Visit Wellness Together Canada online at www.wellnesstogether.ca to learn about treatment programs in your area. Talking to someone about your feelings about substance use can help.

When to call for help during self-care

Call 911 if the following occurs during self-care at home:

• You feel you cannot stop from hurting yourself or someone else.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away.

• Call or text Canada's suicide and crisis hotline at 988.
• Call Talk Suicide Canada: 1-833-456-4566 or text 45645 (4 p.m. to midnight ET).
• Kids or teens can call Kids Help Phone: 1-800-668-6868 or text CONNECT to 686868.
• Go to the Talk Suicide Canada website at https://talksuicide.ca or the Kids Help Phone website at https://kidshelpphone.ca for more information.

Consider saving these numbers in your phone.

Call a doctor if any of the following occur during self-care at home:

• Symptoms occur more often or are more severe.

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