Category: Alcohol Abuse

Annotated Bibliography

Dickerson, D. L., Venner, K. L., Duran, B., Annon, J. J., Hale, B., & Funmaker, G. (2014). Drum-Assisted Recovery Therapy for Native Americans (Dartna): Results from a Pretest and Focus Groups. American Indian & Alaska Native Mental Health Research: The Journal of the National Center, 21(1), 35–58. https://doi-org.ezproxy.liberty.edu/10.5820/aian.2101.2014.35

Drum-Assisted Recovery Therapy for Native Americans (DARTNA) is a substance abuse treatment intervention for American Indians and Alaska Natives. This article dives into the study that look into the effectiveness of DARTNA. This study had an initial pretest of DARTNA provided to 10 patients with histories of substance use disorders and also three subsequent focus groups, substance abuse treatment providers, and the DARTNA Community Advisory Board. Initial pretest were analyze the potential benefits of DARTNA and their assessments were collected anonymously on paper. The focus group examine treatment protocol, its cultural appropriateness pertaining to drumming education, activities, culture and community. All focus groups were held at the same treatment program in the Los Angeles with identical procedures and discussion topics. Some questions were added or emphasized based on information from the previous focus groups and moderated by the first author of this article and his assistant. Consent form was reviewed and questions were answered and participate were free to leave the group if they chose at that time. The duration was about 2 hours, and participants received a $40 gift card for participating. Information gathered during this research and participants’ feedback was beneficial in the treatment manual. The overall consensus was that DARTNA was a beneficial culturally based substance abuse treatment intervention.

Fish, J., Osberg, T. M., & Syed, M. (2017). “This is the way we were raised”: Alcohol beliefs and acculturation in relation to alcohol consumption among Native Americans. Journal of Ethnicity in Substance Abuse, 16(2), 219–245. https://doi-org.ezproxy.liberty.edu/10.1080/15332640.2015.1133362

This article looks at a study that examined the beliefs of some Native Americans and how it relates to their alcohol use that focusing on the notion that alcohol is a key component in Native American cultures. This notion was assessed through the Stereotypical Alcohol Beliefs Scale for Native Americans. It measured 20 item which was administered to 144 individuals who identified as Native American along with a measuring perceived norm, alcohol expectancies, and drinking motives. Stereotypical Alcohol Beliefs Scale for Native Americans assessment scores found to be strongly associated with typical weekly drinking, alcohol expectancies, and drinking motives. Also, hierarchical regression analyses revealed that a level of acculturation shows a link between alcohol beliefs and weekly drinking whereas Native Americans who were less perspective to mainstream culture demonstrated a positive association between their cultural alcohol beliefs and their weekly drinking. The findings suggest that alcohol beliefs can an appropriate supplementary target for interventions for individuals who are not oriented to the mainstream culture. **

Fish, J., Livingston, J. A., VanZile-Tamsen, C., & Wolf, D. A. P. S. (2017). Victimization and substance use among native american college students. Journal of College Student Development, 58(3), 413-431. Retrieved from http://ezproxy.liberty.edu/login?url=https://search-proquest-com.ezproxy.liberty.edu/docview/1897781222?accountid=12085

The Tribal Critical Race Theory propose that Native American students have low retention rates cause by the structural barriers and racism present in colleges and universities resulting in placing Native American students at risk for victimization and substance use negatively impacting their academic success. This study purpose is to look at the rates of victimization as often as used among Native American students versus other students and the impact it has on their academic experience. The proposed study looked at substance use, rate and types of victimization of Native American students compared to other students of ethnicity. The study also looked at victimization and substance abuse impacted their academic performance and whether victimization and substance abuse are a predictor of academic success among students. We conducted a secondary analysis of data collected as part of the American College Health Association (ACHA) National College Health Assessment (NCHA) with permission from ACHA. Results revealed that Native Americans students are victimized at a higher rate than other students and slightly lowered than other ethnic group when comparison of substance use. **

Gone, J., & Calf Looking, P. (2015). The Blackfeet Indian culture camp: Auditioning an alternative indigenous treatment for substance use disorders. Psychological Services., 12(2), 83–91. https://doi.org/10.1037/ser0000013

American Indian and Alaska Native (AIAN) communities are experiencing many health disparities to include high rates of substance use disorders. Psychological services for Natives are generally funded by the federal Indian Health Service and typically administered by tribal governments. Those treatment programs involved an inclusion of traditional cultural practices or adaptation of conventional treatment approaches within treat programs. In this article looks at a third possibility with collaborative, community-based development of an alternative indigenous intervention implemented as a form of substance use disorder treatment on its own terms. A trial implementation of a seasonal cultural immersion camp was conducted based on traditional Pikuni Blackfeet Indian cultural practices with 4 male clients from the reservation’s federally funded treatment program. The trial consists of four camps all distinctive, first one was flexible and easygoing, with the second being of leisured paced, the third camp was sensitively guided while the fourth was community base. All camps involved ritual participation, traditional skills, and other cultural activities. At the conclusion of the trial it was noted that although funding affected the scope of the intervention it shows promise for the Native American communities and highlighted the need for trials and information concerning the delivery of community-based psychological services for Natives.**

Greenfield, B. L., Venner, K. L., Tonigan, J. S., Honeyestewa, M., Hubbell, H., & Bluehorse, D. (2018). Low rates of alcohol and tobacco use, strong cultural ties for Native American college students in the Southwest. Addictive Behaviors, 82, 122–128. doi: 10.1016/j.addbeh.2018.02.032

College attendance is associated with an increased risk for substance use, yet we know little about substance use among Native American college students and its regional variation. The following study examined substance, drug use and their connection to gender, institution, age, and cultural involvement related to Native American college students in the Southwest region. Online survey completed by Native American community and university college students in a large Southwest city concerning substance use and involvement in cultural activities. Survey reveals the intent of substance and drug use among Native Americans student and rates of use of student in the Southwest. **

Legha, R., Raleigh-Cohn, A., Fickenscher, A. et al. (2014). Challenges to providing quality substance abuse treatment services for American Indian and Alaska native communities: perspectives of staff from 18 treatment centers. BMC Psychiatry 14, 181 doi:10.1186/1471-244X-14-181

This qualitative study examined the challenges of offering adequate substance abuse treatment services for American Indian and Alaska Native communities. Data was gathered from the Centers for American Indian and Alaska Native Health’s Evidence- Based Practices and Substance Abuse Treatment for Native Americans project. Programs used were of those with innovative clinical services that represented thee geographic, cultural diversity of the Native Americans communities which included at cultural treatment approach, evidence- based treatment and federal funding for services. Among Native Americans, substance abuse is still problematic despite available treatment to Native Americans and Alaska Natives communities. Interviews were conducted along with focus groups at several substance abuse treatment centers with 76 participants. Results pointed to three areas of concern; infrastructure of the treatment settings, associates of service and treatment system and the availability of clinical services. Findings suggest services provided in the Native American communities more individualized, comprehensive, integrated and more longer-term care. **

Meyer, Aleta et al. (2018). Addressing Substance-use Problems in Tribal Home Visiting. Infant mental health journal. 39.3 : 287–294. Web.

This article highlights an alarming fact that among ethnic groups, Native American has the highest consumption rate of alcohol use noted during home‐visiting programs serving tribal communities. A need to address substance‐use problems among the families and the community is crucial. An online means was used in this study consisted of 144 participants from a local Indian reservation and the surrounding area. The questionnaire included the 20-item preliminary version of the Stereotypical Alcohol Beliefs Scale for Native Americans, Daily Drinking Questionnaire, Comprehensive Effects of Alcohol Questionnaire, Drinking Motives Measure, Rutgers Alcohol Problems Index, and the Vancouver Index of Acculturation wish demographics measurements. Nine Tribal home‐visiting programs initiative utilized to complete a survey about their approaches to addressing substance‐use services in their home‐visiting services. The survey was self‐administered online and covered training of home visitors to identify and address substance‐use issues, substance‐use prevention activities and screening procedures within home‐visiting services and referral and treatment outside of home visiting. Results showed a reduction of substance use and more focus should be placed on designing program enhancements, training and staffing, monitoring performance, and evaluating outcomes are needed to best serve families with young children who are struggling with the negative impacts of substance‐use problems in home based programs.**

Patterson—Silver Wolf (Adelv unegv Waya), D.A., Welte, J.W., Barnes, G.M. et al. (2015) J Gambl Stud 31: 1387. https://doi-org.ezproxy.liberty.edu/10.1007/s10899-014-9512-z

This article dives into a study that looked at the increase in gambling trouble and alcohol abuse among Native Americans in the US. Traditional Native American cultural identity which may be an underlining factor for gambling and alcohol abuse among Native Americans. Telephone interviews were utilized to conduct a survey including 415 Native American adults throughout the United States. Gambling issues among Native Americans and non-Native Americans were similar in the past according previous data collected. However, present data collection points out that Native Americans have a higher rate of gambling problem as their counterparts and alcohol consumption was much less in previous years. Analysis hints at a socioeconomic status linkage to increase odds of gambling problems for Native Americans. Those closer deeper cultural self-association had a higher level of gambling problems versus those that distance themselves from their roots. No significant cultural factors predicted alcohol abuse. More investigation is needed into the impact of cultural factors on gambling tendency and problems. **

Skewes, M. C., Hallum‐Montes, R., Gardner, S. A., Blume, A. W., Ricker, A. and FireMoon, P. (2019). Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder. Am J Community Psychol, 64: 72-82. doi:10.1002/ajcp.12354

This article looks at numerous studies on the crisis of alcohol and drug and alcohol‐related morbidity and mortality within the American Indians and Alaska Natives versus compared to other groups in the United States and the scarce availability of evidence‐based treatments that are culturally appropriate and acceptable. The research study program purpose was to promote health equity in rural communities, by developing academic‐community partnership to create a culturally grounded intervention for adults battling substance use disorder living within the reservations. Interview study consisted of in‐depth qualitative interviews with 25 tribal members knowledgeable about substance use and recovery on the reservation. The goal was to understand social norms and cultural conceptualizations of substance use to inform the development of a sustainable, community‐driven intervention. Results of the study suggest a holistic approach to recovery that spiritual and cultural aspects was important to the community and necessary for the intervention to succeed along with multi‐layer intervention for individuals, families, and the overall community. This study offered value information that can be implemented in the future and strengthened relationship within the servicing community. ***

Walsh-Buhi, M. L. (2017). “Please Don’t Just Hang a Feather on a Program or Put a Medicine Wheel on Your Logo and Think ‘Oh Well, This Will Work’”. Family & Community Health, 40(1), 81–87. doi: 10.1097/FCH.0000000000000125.

When looking at the latest theories on substance abuse prevention initiatives, many are based after Western ideology and that lack any indigenous perspective. This article dives into research study that look at the perspective of several theories applied throughout the Native American communities. Interviews are conducted to identify elements of Native Americans perspective or the lack thereof within this SAP programs. interviews were conducted over following now what did you mean recorded with a maximum of 90 minutes. Waivers and written consent were collected, transcripts were created for future references. Findings reveal that consensus is divided on the effectiveness of theories utilize within the Native American community. This divide was clearly seen among the professionals in distinctive academia. **

Alcoholism is a serious issue in today’s society especially with people over the age of eighteen. The annual death rate in 2019, from teens over the age of eighteen was 1.29 percent while the annual death rate in the general population is 0.66 percent. Alcoholism is becoming a very well-known thing especially with the repercussions it causes. The only problem is, if teens and adults know about the cation of it, why is it becoming a problem? The biggest question I want to know is, how can we prevent alcoholism?

What is alcoholism? The definition is “alcoholism is an addiction to the consumption of alcoholic liquor or the mental illness and compulsive behavior resulting from alcohol dependence Alcohol is the most used drug in the United States. Alcoholism refers specifically to alcohol dependence, this is when people who depend on alcohol create a tolerance, have cravings and go through withdrawals. Other individuals who have problems in their life due to alcohol consumption fall under the category of alcohol abuse. It alone affects more than twenty-seven million individuals and the human population is now around 7.7 billion. Alcoholism can happen to anyone at anytime, it is more common than people think. It mostly happens when a person has an addictive gene and they trigger that addiction. If someone has alcoholic parents, grandparents or a family member that is addicted, they are four times more at risk of developing alcoholism than others without an addictive gene. However, many who have alcoholic parents do not become alcoholics because they abstain from it or do not have the triggering environmental factors to do so.

By the National Institute of Health in 2012, 7.2 adults abused alcohol and only 5 percent of those people got help. Alcoholism usually affects men rather than women. In 2019, the rate of men who are now addicted to alcohol is 9.9 percent. There is one theory that makes sense to why the rate of men are going up when it comes to alcohol abuse or alcoholism and that is because men find drinking to be more pleasurable due to higher dopamine that is released in their brain once they drink an alcoholic beverage. This isn’t a scientific fact but it seems that this is the only reason that makes sense in scientists and doctors; Four percent of this data are guys who are sixteen and older. A full third of Americans who are twenty-one and over completely abstain from alcohol use however, 10 percent of individuals that drink heavily consume seventy-four servings per week or over ten drinks a day on average. The Center for Disease Control put the number for heavy drinkers who also depend on alcohol equals to ten percent. “Alcohol is a fourth-leading preventable cause of death in the U.S., with about 88,000 people dying of alcohol-related causes yearly”. https://luxury.rehabs.com/alcohol-rehab/statistics/

Alcohol is also very expensive, it’s like a smoker who smokes two packs of cigarettes every day. An alcoholic goes through $1,560 every three months and that’s just for alcohol alone. This is why most alcoholics become financially unstable and cant even afford to live in their own home. This number can be differed depending on the drinker and depending on their dependency; it starts as alcohol abuse, it will progress over time and then it will become alcohol dependency. “Alcohol abuse cost the US healthcare system more than twenty-five billion annually. Overall costs which include crime, lost work, and healthcare ring out about two hundred twenty-four billion. The majority of this cost is about seventy-two percent is caused but a decrease in the workplace productivity”. https://luxury.rehabs.com/alcohol-rehab/statistics/ If a person has depression or any mental illness, alcohol will never mix well with them. While a lot of people think they “feel better” when they drink, it is scientifically proven that in the long run they will start to feel and get worse.

What people need to know is that alcoholism doesn’t just happen overnight, people don’t have one drink and automatically get addicted. It takes time for the defense of alcohol to fully control a person and take over life with several other health problems. That doesn’t mean drinking the first time won’t kill you, it depends on how much you consume but if a person consumes a lot on his or her first time they can get alcohol poisoning, which can hurt your internal organs or be a cause of death. People who suffer from this addiction and get help will go through withdrawal which can be very troublesome for some people who depended on alcohol for most of their lives. Withdrawal symptoms can kill a person, even though this is uncommon, it does happen. If a person is a long-term chronic drinker or have had a serious issue with alcohol or any drug and they are trying to quit, they will then come face to face with severe mental and physical symptoms such as high fever or tremors. This is because their body is detoxing(letting out) all the toxic chemicals that is destroying their digestive, central nervous, cardiovascular and endocrine system. When addicts go through these withdrawals, they can’t handle the pain and the only way they think these serve pains stop is by going back on the drug. That’s why more than twenty-eight percent of addicts that go into recovery relapse and nine percent of them relapse, then ODE and die.

There are four symptoms of alcoholism. The symptoms are cravings, loss of control, physical dependence and tolerance. These symptoms are what doctors use when someone is being diagnosed with alcoholism or alcohol abuse. Craving is usually the first sign to show up for alcoholism or alcohol abuse. People who crave alcohol have a strong need to drink or compensate. The most common way to trigger the craving is from stress or emotional heavals. Loss of control is the next stage, this is where one is the inability to limit one’s drinking or any given occasion. This is where a person who usually cannot control themselves comes into play. When a person goes out and has an alcoholic beverage, they cannot stop themselves and feel like they need to have more. When the person loses their control they blackout. Blacking out is where a person loses control on what they do and cannot remember what they did the night before. Then, there is physical dependence which goes in with the withdrawal symptoms such as nausea, sweating, shakiness and anxiety. This occurs when alcohol use is stopped after a period of heavy drinking. The last one is tolerance which people get when they have been drinking for a long time. People start to drink in greater amounts of alcohol in order to get high because they want to drink every problem away. https://www.onhealth.com/content/1/alcoholism_facts

Accepting that one has a problem with alcohol may not be the easiest but it is the first way to help and help them get cleaned up. There are myths that alcoholism is a sign of weakness which people today still believe and that’s why they don’t want to admit they have a problem. But alcoholism is a disease, it is not a sign of weakness. Saying alcoholism is a weakness is like saying asthma is also a weakness, you cannot control a disease or the person who has it. Taking steps to identify a possible drinking problem makes a person as brave as the next. “More than 87 percent of people over the age of 18 or older are reported drinking in their early life time”, “More than twenty-four percent of people reported to binge and heavy drinking within the past year”.https://luxury.rehabs.com/alcohol-rehab/statistics/ In America alone, 16.3 million young adults were reported to be having an alcohol use disorder. About 1.5 million adults are struggling with it, less than one out of every ten adults or young adults understand the struggle. “An estimated 696 thousand students are sexually assaulted by another who has been drinking each year. About 25 percent of students who drink, experience academic consequences such as missing class, doing poorly on tests and falling behind overall. About 20 percent of college students meet the criteria for an AUD this year alone”.https://luxury.rehabs.com/alcohol-rehab/statistics/

The estimate of people receiving treatment at a specialized AUD facility is over one point five million. Getting treatment depends on the severity of your alcoholism and how long you have been living with it.

“Although rates of alcohol abuse reportedly have declined from 18.1 million in 2002 to 17.3 million in 2013, it appears there’s still a large treatment gap. An estimated 22 million people need treatment for alcohol and other drug use, but less than 1% of those people receive any form of substance abuse treatment.” “According to the National Institute on Drug Abuse, more than 23 percent of admissions to public rehab programs are due to alcohol abuse or addiction. The same study found that more than 18% of people who enter treatment do so as a result of alcohol abuse.”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866588/ There are many ways to try and prevent alcoholism. To make people understand what alcoholism is and what alcohol abuse is, people put ads on the T.V for people to see for those who do need help can see which rehab they would want to join. Teachers somewhat teach you in school what alcohol can cause or what it affects, groups also have hot lines for anyone who wants to call and prevent them from having a relapse or for people who want to be more informed with alcoholism or abuse. Making people more knowledgeable about alcoholism or alcohol abuse can help and go a long way.

Other ways to prevent alcoholism and alcohol abuse is to not have alcohol in the house. Having alcohol at home makes it easier to drink without accountability especially if a person lives alone or has a tendency to drink privately. By having a nonalcoholic home, it will lower the chances of alcohol abuse, emotionally drinking or drinking out of boredom. When in public, try and limit yourself with people you can trust and would want to be around. Knowing your limits is important, according to the “National Institute on Alcohol Abuse and Alcoholism”, knowing your limit will help you not get addicted or dependent on alcohol. Another way is to not be friends with people who don’t drink heavily. This might be harder than it sounds but it can help. The saying “you are who your friends are” is true, if a person wants to decrease the chances of having alcohol abuse, they shouldn’t surround themselves with people who drink or go over the top with drinking; “If you socialize with people who don’t drink or don’t drink often, you may be less likely to consume alcohol yourself or have less than usual.” If a person is currently abusing or is addicted to alcohol, join groups like (AA) or support groups can help reduce the chances of having alcohol abuse or becoming an alcoholic. These groups are to help people who are already going through these struggles in life and help them get through their inner demons. They also have treatment centers like the IAFF( Center of Excellence Offers of Treatment) which help addicts regain control of their life and help beat their addiction. https://www.iaffrecoverycenter.com/blog/5-ways-prevent-alcohol-abuse/ (No. 2,3,4)

Some people have argued that lowering the age limit will decrease alcoholism and alcohol abuse. In this argument, people have brought up Europe and different countries whose legal age of drinking is eighteen and they have a lower rate of alcoholism in their countries. America is the biggest country that is having an alcohol problem and the most affected by this disease are young adults aging from seventeen to twenty-four. But this has seen to be false because when the laws were changed in 1980 in America, the drinking age was changed to twenty one and data shows that young adults were becoming less of alcoholics. People then wanted to know if people started to become alcoholics from college and one study has shown it varies on the college. “College students are heavy drinkers as a group, but drinking behaviors varies widely by the college. College environments that afford easy access to low cost alcohol have few policies restricting accessibility to alcohol and have lax enforcement of existing policies that create conditions for heavy drinking among college students. The safe and drug free schools and communities act requires college administrators to enforce the minimum legal drinking age of twenty one years, a restriction that targets approximately half of the traditional college student population.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866588/

Drinking, especially binge drinking is a huge problem with college students; it still remains a huge concern for the school campuses and parents alike. Programs that nearly provide information about alcohol and alcohol-related crime have not been effective among college students. Even though most

colleges have programs that are often favored by the institutions because they are inexpensive and easy to implement. One way that has been effective is providing brief motivational interventions, cognitive-behavioral interventions and challenging students expectations about alcohol. This has made students, especially college students more interested and more knowledgeable about the consequences about alcohol and how binge drinking can ruin you life. “This has not just made students knowledgeable about the problems with alcohol and what binge drinking can do to you, it also opened their eyes making themselves question if they have a problem and see how dependant they are from alcohol.” https://pubs.niaaa.nih.gov/publications/aa83/aa83.htm

“However, surveys of college administrators indicate that enforcement of alcohol policies at most colleges is limited and colleges tend to focus their prevention efforts on education programs.” Another study of adults in American found that those who were legal to purchase alcohol before the age of twenty one are more likely to meet the criteria for alcohol abuse and other drug use than others. Other recent research examines the relative contribution of these policies and found out that in addition to the effect the national minimum legal drinking age of twenty one, each restriction is independently associated with lower levels of drinking and alcohol involved deaths with young adults younger than twenty one. Drinking among young adults and college students varies by states alcohol control and their policies. States that have stricter alcohol policies have lower levels of drinking and problems with underage drinking. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866588/ (College students and the minimum legal drinking age).

They’re many different ways on keeping safe and not abusing alcohol. You cannot catch alcoholism like a common cold but you can abuse it when your drinking it more regularly and over doing it. There is a difference between alcoholism and alcohol abuse which people get mixed up, but alcohol abuse is just the first stage, when that you keep abusing alcohol that will turn into addiction and that is where you get alcoholism. In 2019, since it is more common for college kids to come out of college with some type of substance abuse, the FDA and the government make it easier for people to get help or know that there is help around. Alcoholism and alcohol abuse is still around and still happening but people are always going to do things that are bad for them thinking there will be no repercussions. Alcoholism is a serious disease and if not taken care of like any disease, it can and will kill a person. Most people know someone who is affected by this disease and with people knowing more about it. they can prevent addiction from happening. With alcoholism being more common and knowledgeable, knowing the facts and how to prevent it can save young adults and elderly. Alcoholism and alcohol abuse is a serious thing, getting help isn’t a sign of weakness, it’s a sign of bravery.

Introduction

In the case scenario of David, he was diagnosed to have substance use disorder Those substances he used were cannabis, cocaine and alcohol. He expressed that if no stimulation by alcohol, he could easily reject to use the substances. Therefore, alcohol would be the first priority to keep abstinence in order to help him get rid of substances. In this assignment, diagnosis of Alcohol Use Disorder, effect of alcohol, its metabolism and withdrawal syndrome will be investigated. Then, treatment of it will be discussed.

Diagnosis of Alcohol Use Disorder

The diagnosis of alcohol use disorder (AUD) in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) was the integration of alcohol abuse and dependence in its 4th edition, with an additionally grading system to sub-classify AUD into different severity: mild, moderate and severe (National Institute on Alcohol Abuse and Alcoholism, 2016). There are several diagnostic criteria in DSM-5, like unsuccessful effort to cut down, craving, physical hazardous, tolerance, withdrawal etc., and AUD was diagnosed if two or more of them occurred in the past 12 months (American Psychiatric Association, 2013).

Effect of Alcohol consumption

A common effect of alcohol ingestion

Alcohol intoxication is the circumstances of recent alcohol ingestion with an accumulation of alcohol and its metabolites in blood faster than its metabolization by liver (Jung & Namkoong, 2014). Same with benzodiazepine, alcohol act as central nervous system depressant to decrease gamma-aminobutyric acid (GABA) inhibitory function and increase N-methyl D-aspartate (NMDA) type glutaminergic activity (Krystal, Petrakis, Manson, Trevisan & D’Souza, 2003; Krystal et al., 2006). Drinking too much alcohol would bring about many harmful effects to our body. After ingestion, it would be rapidly absorbed into blood vessel and reach a peak after about 30 to 60 minutes. Alcohol can cross the blood-brain barrier and affect the brain cells to cause psychoactive and behavioral effects, like sedation, hallucinations, impaired judgement, slurred speech, loss of coordination, hangover etc. In case of extreme dose, respiratory depression, coma or death may result. If long-term high dose of alcohol intake, adverse consequences would appear, like cognitive impairment or brain damage. Tolerance would be developed for chronic alcohol consumption as neuroadaptation occurs which a higher dose of alcohol is needed to attain desired psychoactive effect (National Collaborating Centre for Mental Health, 2011).

Thiamine deficiency and Wernicke-Korsakoff syndrome

Thiamine deficiency can be resulted from chronic alcohol consumption causing risk of developing fatal condition called Wernicke-Korsakoff syndrome (WKS) (Donnelly, 2017). Chronic alcohol consumption would lead to impair thiamine absorption from GI tract, weaken the processing and storage of thiamine in liver and increase the thiamine demand for high carbohydrate processing from a high-calorie alcoholic beverage. The lack of thiamine would impair the flow of electrolytes in and out of muscle and nerve cells. It also leads to lack of enzymes essential for producing adenosine triphosphate through Krebs cycle and toxic substances accumulate that can damage the brain. Acute Wernicke-encephalopathy is the first phase of WKS characterized by ocular disturbances (nystagmus and paralysis of eye muscle), mental state change (confusion and unable to concentration) and ataxia (damage in cerebellum and vestibular system). It then developed into Korsakoff syndrome that is the acute onset of serious memory impairment like anterograde and retrograde amnesia that can result in loss of important personal function.

Fetal alcohol syndrome

Apart from the alcoholic effect on adult, let’s have some knowledge of fetal alcohol syndrome (FAS), which is the most severe abnormalities of the fetus due to drinking alcohol by mother during gestation. The fetus may have undeveloped liver and not be able to metabolize alcohol from which directly passing through the placenta and umbilical cord. The alcohol is then exposed directly to the developing fetus and cause serious developmental problems. Stewart (2012) summarized the effect of alcohol on fetal development. In cellular level, alcohol can dehydrate a cell and the cell growth will be interrupted, delayed or died. This particularly remarkable in brain development that leads to inborn brain damage and so learning disabilities like limited ability to memorize, control impulse, paying attention or judgement. It also results in congenital physical deformities like small head size, low birth weight or problems with the heart, kidney or bones. Facial characteristics of FAS fetus were identified like smooth philtrum, thin upper lip and short palpebral fissure lengths. Therefore, any alcohol must be strictly prohibited during all stage of pregnancy.

Metabolism of alcohol

There is always question that why do some people are able to drink more or appear to take a greater risk than others for developing adverse health consequences like hangover, hepatic damage or cancers. This can be explained in view of alcohol metabolism in our body. According to the publication of National Institute on Alcohol Abuse and Alcoholism (2007), the common alcohol metabolism pathways involve alcohol dehydrogenase (ADH) in the liver to breakdown most ethanol and transform them into a carcinogenic compound called acetaldehyde, then it is further breakdown into acetate by aldehyde dehydrogenase (ALDH), then breakdown into water and carbon dioxide for elimination. There are also other ways in body to convert alcohol into acetaldehyde like the use of enzyme cytochrome P450 2E1 and catalase. Some alcohol can also interact with fatty acids and forming fatty acid ethyl esters to damage the liver and pancreas. Nevertheless, acetaldehyde should take in focus as it is highly contributed to toxic effect in damaging the liver, pancreas, brain, and gastrointestinal tract, causing the intoxication sign and symptoms as mentioned before. Therefore, the main reason for variation of people in ability of drinking alcohol is the different ability of the enzymes involved. For example, a fast ADH or slow ALDH would cause acetaldehyde to accumulate and exert its toxic effect.

Alcohol withdrawal syndrome

In acute alcohol withdrawal syndrome, several symptoms are identified to have greater risk to develop if alcohol consumption that beyond healthy limit was stopped abruptly or reduced substantially (National Clinical Guideline Centre, 2010). Severity of alcohol withdrawal symptoms depends on the degree of alcoholism and personal differences. When alcohol is absent or inadequate, GABA receptors and NMDA system will take attempt to restore, and other pathophysiological changes occur like increase corticotropin-releasing hormone, decrease activity of dopamine activity or further increase homocysteine level. All these physiological changes contribute to the sign and symptoms of alcohol withdrawal. After 6 to 8 hours of abstinence, there were a series of symptoms that may occur simultaneously, like agitation, tremor, sweating, nausea, vomiting, palpitation, fever etc. These symptoms usually subside by second to third days. Some particular symptoms must be noted that special attention should be provided like seizure, hallucinations and delirium tremens (DTs). DTs is characterized by rapid onset of confusion and coarse tremor, and the symptoms above can be intensified. In severe cases, hyperpyrexia, ketoacidosis and circulatory collapse can occur which are fatal.

Treatment of AUD

Whether acute alcohol withdrawal patients need hospitalization is mainly depend on two considerations (National Clinical Guideline Centre, 2010). First, we need to evaluate the severity of the syndrome by a widely recognized assessment tool called Clinical Institute of Withdrawal Assessment for Alcohol scale, Revised (CIWA-Ar). Severity of repeated withdrawal episode would be higher due to the ‘kindling effect’, this increase the risk of treatment in the community. Second, we should have a comparison on the treatment between hospital and the community to meet the need of patient with alcohol withdrawal in both acute condition and long-term abstinence. If the patient is difficult to access required services or the community availability of the follow-up services is inadequate, the need for admission would increase.

For patient with alcohol intoxication, vital functions should be closely monitored, especially respiratory function as risk of respiratory depression; liquid replenishment should also be provided to prevent dehydration (Caputo et al., 2018). In more severe case, mechanical ventilation, parenteral fluid resuscitation and gastric lavage with activated charcoal should be prepared. In case of concurrent use of other sedatives, respective antidotes should be considered like naltrexone for opioids and flumazenil for benzodiazepines. Moreover, intravenous metadoxine can be considered for subside of symptoms more rapidly due to its effect on reduction of blood alcohol and acetaldehyde (Caputo et al., 2018).

For patient who developed alcohol withdrawal syndrome, vital parameters and withdrawal symptoms should be closely monitored, and continuous reassurance is required. Hydration is also necessary if symptoms of dehydration presents. Vitamin supplements like vitamin B1 (thiamine), B6, B12, C and folates are needed to prevent Wernicke’s encephalopathy. In case of CIWA-Ar score is greater than 8, benzodiazepine, like diazepine or chlordiazepoxide, should be administered to mimic the alcohol properties so as to mediate the withdrawal symptoms (Caputo et al., 2018). Anti-epileptic can be added in association with benzodiazepine for the development of seizure. If DTs developed, high dose of benzodiazepine is used; but if refractory DTs, adding anesthetic drugs, like barbiturates and propofol, may necessary after intubated with mechanical ventilation (Caputo et al., 2018).

Conclusion

Alcohol Use Disorder is a diagnosis in DSM-5 for patients with alcohol abuse. Ingestion of alcohol can cause many effects to our body and severe alcohol intoxication leads to development of fatal symptoms. Chronic alcohol consumption can bring about thiamine deficiency and increase the risk to have WKS. Alcohol must be forbidden to pregnant women as FAS. Alcohol is metabolized by the use of liver enzyme and toxic mid-produce, acetaldehyde, would accumulate if not able to further break down. Different withdrawal symptoms can appear if alcoholism stop alcohol abruptly. Treatment should be considered in community or hospital for different need of patients with AUD. Both alcohol intoxication and withdrawal have their medical management in the pharmacological and non-0pharmalogical way. Nurses should acquire this knowledge to carry out appropriate actions towards AUD patients who need professional assistance.

References

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9. National Institute on Alcohol Abuse and Alcoholism. (2007). Alcohol metabolism: An Update. Alcohol Alert, 72, 1-5. Retrieved from https://pubs.niaaa.nih.gov/publications/aa72/AA72.pdf
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11. Stewart, G. B. (2012). Fetal Alcohol syndrome. Detroit: Lucent Books.

The teen years are a time of rapid growth, exploration, and onset of risk taking. Taking risks with new behaviors gives teens the opportunity to test their skills and abilities and discover who they are. But, some behaviors have risks, such as drug abuse. Abuse is defined as “the use of a drug to experience psychoactive effects instead of for its medical indication.” 23 percent of teenagers have consumed alcohol by 8th grade. Teenagers just do not understand the consequences of drug abuse.

One of the main problems with teenage drug abuse is addiction. Once a person has any addiction of some sort, their addiction becomes one of their main priorities. Depending on how addicted someone is, depends on how much time and money someone is willing to put aside for their drug.

One way to prevent teen drug abuse is to stop it when it first starts. There are many signs teens show when they start to abuse illegal drugs. One of the most obvious signs is the smell of smoke on their breath or on their clothes. This is most prevalent for Marijuana users because the odor is so strong. Another physical trait that you can look out for is bloodshot eyes. Bloodshot eyes are common symptoms of intoxication from several drugs and is caused by blood vessels in the eyes that expand. Some of the drugs that fall into this category are alcohol, cocaine, and marijuana. When a teen randomly starts to have poor hygiene and/or a diminished personal appearance, they might have started to abuse illegal drugs. If that is the case, then that means that their drug addiction has gotten to a point that their physical appearance is not one of their top priorities anymore.

If a teen all of a sudden is having unusual secretive behavior, then they might have started abusing illegal drugs. They might like to keep to themselves and stop hanging out with their normal friend group. When a teen is isolating themselves, and not telling anyone why, that might be another sign. One last sign is unusual tiredness. Substances such as alcohol and marijuana can cause drowsiness. Many other drugs that make people stay awake for long periods of time, such as cocaine or amphetamines, will also likely cause sleepiness after their effects wear off and a person has been deprived of sleep.

Not only can drug abuse in your teen years have negative effects on your body/ physical wellbeing, but put your professional and social future at risk. Getting caught with any type of illegal drug puts you in the risk of going to prison. If you get lucky, you might only get a fine. Another possibility is that you obtain a criminal record. If you have a criminal record, the job opportunities for you are very slim because most companies do not want to put their companies on the line for a drug addict. Another output is a sexually transmitted disease or unwanted pregnancies, which both come from making the wrong decision while under the influence.

The most common drug that is used and abused by teens is alcohol. This is due to the fact that there is not much exposure on the effects of underage drinking. According to the American Medical Association, ‘Tobacco Control’ has been receiving between 400 million and 900 million dollars a year to promote anti-smoking activities but not anti-alcohol commercials? Approximately 20 percent of 12th graders reported binge drinking in 2014. Nearly 40 percent had used alcohol in the last month. Alcohol is a depressant drug that slows down various sections of the brain and the central nervous system. Some of its effects are not being able to control your behaviour and your bodily functions, like thinking, talking, walking and even breathing. Teens are also more likely to binge drink because their impulse control hasn’t fully developed yet. Heavy or regular drinking during the teenage years can lead to lifelong brain damage, impairment to brain function, and it can put teens in danger of alcoholism as an adult.

A close second to the most abused drug by teens is marijuana. Similar to alcohol, teens assume that marijuana usage has no risks; Most high school seniors do not think occasionally smoking marijuana has any form of risks. More than 20 percent of teenagers have reported that they used marijuana in the last month. Teens who smoke marijuana are more likely to drop out of school, then teens who do not abuse drugs. Although 10% of teens that use marijuana get A’s in school, Marijuana usage as a teen also puts you at an increased risk of having mental health issues. It has been observed that there is a link between various mental health problems, such as anxiety and depression, and the usage of marijuana. If a teen is impaired by marijuana (as well as any other illegal substances), they cannot drive. otherwise they are putting themselves, as well as everyone else in the car in great danger. While you are under the influence of marijuana, your reaction time, coordination, and concentration are very strongly affected which makes driving extremely unsafe. 1 in 6 teens who have used marijuana multiple times become addicted. That means that it’s possible that they make multiple unsuccessful attempts to quit but their own body would not let them.

Another commonly abused drug by teenagers is OTC (Over The Counter) drugs and prescription drugs. Over the Counter drugs are so popular for teens because they are less expensive and easily accessible. Nearly 40 percent of teenagers who abused prescription medication got the drugs from their own parent’s medicine cabinets. A person of any age can purchase Over the Counter drugs and there is also no limit on how many you can purchase at a time.

There are seven types of drugs. The first type is stimulants, which mainly impacts the body’s central nervous system. This drug increases the activity of the central nervous system and the body, drugs that are pleasurable and invigorating, or drugs that have sympathomimetic effects. Stimulants increase your heart rate, blood pressure, breathing and blood glucose level, which causes a feeling of “speeding up”. Stimulants can be snorted, consumed as food and drink, or, most common, in the form of a pill. The primary reason that doctors would prescribe stimulants for a person would be if they had ADHD, narcolepsy, or asthma.

The second type of drug is hallucinogens. Hallucinogens are drugs that alter a person’s state of mind. One kind of hallucinogens are Dissociative drugs. Dissociative drugs can cause users to feel out of control or disconnected from their body and environment. The other kind is classic hallucinogens. While you are under the influence of either drug, you will experience intense mood swings, feeling sensations that you think are real but are not, and you might hear sounds that are not actually there.

The third type of drug is depressants. Similar to stimulants, depressants also mainly affect the central nervous system. Depressants on the other hand, slow down the central nervous system and the messages going between the brain and the body. As an addiction to depressants worsens, insomnia, weakness, and nausea are all possible withdrawal symptoms. Confusion, dizziness, fever, and difficulty urinating are all effects depressants have on its users. Some long term side effects of depressants are depression, chronic fatigue, breathing difficulties, sexual problems and sleep problems. Some examples of depressants are alcohol, opiates(Heroin and Morphine), and benzodiazepine.

Another type of drug is inhalants. Inhalants are unlike most other illegal drugs because they can be found inside of your own house. Inhalants starve the body of oxygen and force the heart to beat irregularly and more rapidly. Some examples are cleaning fluids, gasoline, hairspray, glues, etc. Most inhalants affect the central nervous system and slow down brain activity.

Cannabis is the fifth type of drug. It might not be as harmful to your body, but you can still develop an addiction to marijuana. A large majority of marijuana is grown here in the United States which is convenient for most users. Since marijuana is so easily accessible, it is an ideal drug to get addicted to. Those who smoke or ingest marijuana may build up a tolerance to it over time, meaning they need to use more to experience the same effects, which is where the addiction comes in.

The sixth type of drug is opiates. The main usage of opiates is to treat pain. Substances like opiates are highly addictive and and put all of its users at risk of opiate addiction. Some of the most common opioids that are found in prescribed painkillers are dilaudid, oxycodone, hydrocodone and fentanyl, as well as the illicit drug heroin. Common side effects of opioid usage include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression.

The last kind of drug is dissociatives. Dissociatives are drugs that alter the brain’s receptors for the chemical glutamate, which plays a substantial role in cognition, emotionality, and pain perception. Dissociatives tend to make its users feel as if they are watching themselves from outside their own bodies. Side effects of dissociatives are immediate and start to kick after its first use. Some of them are depression/ anxiety, suicidal thoughts, speech difficulties, and many others.

Being a teen is never easy, especially if you are battling a drug addiction. Teen years are a struggle for everybody and it’s when everyone begins to distinguish themselves from others. Although for some reason drugs may be perceived as cool or trendy, it is never okay to abuse drugs. So if you suspect that a teenager may be experimenting with drugs, then the best thing to do is to try to talk to them and find help. Battling an addiction is difficult to do alone, whether you are a teen or not.

It’s not drugs that make a drug addict, but the need to escape reality. I have chosen to explore the them Drug and Alcohol abuse. This theme is evident in books The Dirt: Confessions of the worlds most notorious rock band written by Vince Neil, Nikki Sixx, Mick Mars, Tommy Lee and Neil Strauss, I am Ozzy by Ozzy Osbourne and the films Once were warriors directed by Lee Tamahori and Walk the Line directed by James Mangold.

In this book The Dirt: Confessions of the worlds most notorious rock band, written by Vince Neil, Nikki Sixx, Mick Mars, Tommy Lee and Neil Strauss drug and alcohol abuse is a recurring event. Once such event is when Nikki Sixx lies to a girl about his name. ‘She walked up and said “Hi I’m Lita, Lita Ford with the runaways. What’s your name?”

“Rick” I said.

“Really?” She asked.

“Yeah, I’m Rick.” I was pretty full of myself and assumed that everyone knew my name.

“Sorry,” she said “I thought you were someone else.”

“Well, you thought wrong,” I sneered, with my nose in it’s usual place up in the air.

“That’s to bad Rick,” she said “because I wanted to split a Quaalude with you.”

“You did?” I began to pay attention.

“I thought you were Nikki.”

“I am Nikki! I am Nikki!” I practically wet myself like a dog in pursuit of a treat.

She bit the Quaalude in half and stuck it in my mouth, and that was it.’

This shows that Sixx was already heavily addicted to drugs at the stage in the book. This shows that drugs will twist your sense of reality, and what someone will do to get a hold of a single pill to get a high. Sixx lies to a woman about his name, but when she offers to share the Quaalude with him he instantly begins paying attention practically wetting self like a dog in pursuit of a treat. The treat is this case being the Quaalude or high. Another example of drug and alcohol abuse in the book is when Sixx is at home with his girlfriend Nicole and he would be “shooting up” cocaine and other drugs such as heroin. Sixx “shot up” so much that his veins were collapsing in on themselves and paranoia would set in causing him to imagine that there were intruders everywhere trying to break into his house. “As I shot more and more cocaine, paranoia set in and soon I hardly let anyone in the house. Nicole and I would sit around naked day and night. My veins were collapsing and I would scour my body to find fresh ones: on my legs, my feet, my hands, my neck, and, when the veins everywhere else had dried out, my dick. When I wasn’t shooting up, I’d patrol my house for intruders. I started seeing people in trees, hearing cops on the roof, imagining helicopters outside with S.W.A.T. teams coming to get me. I had a .357 Magnum, and I’d constantly hunt for people in the closets, under the bed, and inside the washing machine, because I was sure someone was hiding in my house.” This shows that Sixx was clearly abusing the cocaine and other drugs that he was taking, especially once his veins started collapsing and he was having to find other places to “shoot up”. When Sixx wasn’t “shooting up” he was in a state of paranoia imagining that the swat was coming for him. He also carried a handgun which means he could’ve shot someone especially one of the West-Tech employees as he pulled a gun on the West-Tech employees multiple times as Sixx answered the door. This theme that is carried through the book of Drug and Alcohol abuse is similar to themes in the book I am Ozzy by Ozzy Osbourne.

Another text that shows the themes of drug and alcohol abuse is I am Ozzy by Ozzy Osbourne as drug and alcohol abuse is a recurring theme. The first major event that shows the true drug and alcohol abuse that Osbourne partakes in is when he is living in Los Angeles recording different albums, abusing cocaine. “Then I’d go to bed, wait for my heart to stop beating at eight times its usual speed, then fall into this fucking horrific withdrawal. The comedowns were so bad that I used to pray. I’d say, ‘God, please let me sleep, and I promise I’ll never do cocaine again, as long as I live.’ Then I’d wake up with my jaw aching from spouting so much bullshit the previous night. And I’d do another line. It was amazing how quickly it took over our lives. It got to the point where we couldn’t do anything without it. Then it got to the point where we couldn’t do anything with it, either. When I finally realised the pot wasn’t enough to calm me down from all the coke, I started getting into Valium. Then eventually I moved on to heroin, but thank God I didn’t like that stuff.” This quote shows that Osbourne done a lot of drugs and suffered the consequences, the consequences being the coming down off the high praying to god that he would never do it again but going back and doing another line of it again in the morning. He also used other drugs like Marijuana to calm, and bring down his heart beat from the amount of cocaine he was snorting, eventually he moved onto drugs such as valium to calm his heart even more. In this period, he also shows he was sensible when it comes to some drugs such as heroin which he tried but never touched again. Another example of the drug and alcohol abuse in this book is when Osbourne is living with married to Sharon Osbourne who was incredibly strict with him and the only one who could control him. “You wouldn’t believe the things I’d do – the time and effort I would dedicate to sneaking a drink behind her back. I’d ‘pop to the supermarket’ next door, then walk straight through to the back of the grocery section, through the door to the store-room, climb out of the window at the back, jump over a wall, crawl through a hedge, and go to the pub on the other side. And then, after necking six pints in a row, I’d do the same in reverse. The most unbelievable thing about my behaviour is that I was convinced it was entirely fucking normal.” This quote shows that Osbourne would go to extreme lengths just to get a drink going behind his wife’s back and sneaking around by going to the supermarket next door, climbing out the back window and then crawl through the hedge to get to the pub, then while at the pub he would quickly down six pints and sneak back the way he had come. This shows that he was truly addicted to alcohol at the time as he would do almost anything just to have a sip of alcohol. The themes in this text are very similar to The Dirt: Confessions of the world’s most notorious rock band.

The film Once were warriors shows the theme of drug and alcohol abuse clearly in several scenes throughout the film. The first scene that shows this is when Jake has been heavily drinking heavily over the course of the evening essentially abusing the alcohol. In this scene due to the alcohol he abuses Beth after she refuses to cook Bully eggs and bacon. “Hey, cook us some eggs, eh, Beth? Ooh, and some bacon. Fuck off! What the fuck’s going on? I asked for some eggs, but… Cook the man some eggs. You want eggs? Well, have the bloody lot of them! It’s OK, man. Cook the man some fucking eggs. Do it yourself, Jake! I’m not the fuckin’ slave around here, Jake!’ As Beth is saying this and Jake is beating her up it is obvious that Jake has been drinking a lot, as he slurs slightly when he is speaking throughout the scene making it really obvious he’s been drinking. Another scene in the movie where you can see Jake has been abusing alcohol is when he is grieving for his lost daughter, and Beth walks in and tells him she is taking her home to her proper home. “I want us to take Grace back home to the Marae. This is her fucking home. No, it’s not. This was never her home… never. And that fucking place is? Fucking Maoris who think they’re better than the rest of us? I hate them. Bastards living in the fucking past. It’s our past, too, Jake. What’s that supposed to mean? I want Grace to be with her people. We should have gone back a long time ago. F*ck off! You’re not taking her anywhere. I’m taking her, Jake, with or without you. I wasn’t there when Grace needed me. This time I’m going to do the right thing by her, and you’re not going to stop me. You fucking do, and I won’t be here when you get back. Well, go on, then. Go! Get the hell out of here! I’m taking her. I’ll kill you first! Well, go on. Do it. You’re still a slave, Jake… to your fists, to the drink, to yourself. Well, go on. Kill the bloody lot of us!”. In this scene Jakes eyes are red and puffy, and he slurs his words a lot he also stumbles as he threatens to kill Beth. She says it best saying that he is a ‘slave to the drink’ this is saying that he is addicted and under its influence with it controlling him and what it does. In the scene as he threatens Beth he nearly breaks down.

The film Walk the Line directed by James Mangold, shows the theme of Drug and Alcohol abuse several times throughout the movie several times. The first prominent time that the drug and alcohol abuse occur is when Cash invites June Carter on stage to sing which she accepts with prompting. On stage during the middle of the song Cash swoops in and kisses Carter on the cheek. This causes her to storm off stage. Soon after this in Cash’s dressing room after being rejected he goes off the rails slightly, he smashes his guitar and rips the sink off the wall. He then reaches into his pocket to grab out a bottle of pills and swallows them with beer. As he does this he is breathing heavily and sweating profusely. This shows that he has been abusing the drugs and had started to withdraw before swallowing his pills and letting them kick in. Another scene in the film that shows the drug abuse that Cash suffers is when he is preforming ‘I got stripes’ and he starts sweating a lot and is acting almost psychotically yelling at his drummer to “play the f**king things” and kicking lights. Cash starts to walk across the stage and collapses on the floor blacking out. This is due to Cash withdrawing from the drugs he has been taking and overexerting himself while on tour and abusing drugs to often. This has similar themes to I am Ozzy by Ozzy Osbourne.

I believe that certain drugs have no place in todays society. The Dirt, I am Ozzy, Once were warriors and Walk the Line all show that drug and alcohol abuse is commonplace everywhere from Rockstar’s to poor family’s.

A research study conducted by a UK charity named Alcohol Research UK, developed a research project with the aim to identify and link what the roles of alcohol was in domestic abuse relationships. The main aims of this project was to identify individuals who had previous or current domestic abuse convictions, individuals seeking guidance and just the general public, to explore whether alcohol played any role in their conflicts with their partners (Gilchrist, Ireland, Forsyth, Laxton & Godwin, 2014). The key findings of this project were that there showed a pattern of cases relating particularly to big events such as football matches. This could be because at events such as this one, there is a high chance that there could be a great deal of alcohol intake that could then progress into feelings of anger or other similar emotions.

Another key finding was that nearly two thirds of cases that were reported and logged to the police, were found to have at least one case where a partner believed to be under the influence of alcohol when the incident occurred. To conclude the article, the charity stated that the research conducted did have its limitations as linking alcohol and domestic abuse together is very complex. The article also provided future suggestions on how to research the issue in more depth, such as collecting a bigger number of participants and data and consider a theoretical approach when addressing the issue. In an article produced by (Foran & O’Leary, 2008), it is written that most violent crime perpetrators have been found under the influence of alcohol. The article also states that alcohol seems to be the common factor when it comes to violent and aggressive behaviors. These key findings of both journals seem to share a common factor of how alcohol can have a negative effect on relationships and certain individuals who consume alcohol may be prone to show aggressive behaviors. This article also approaches the question as to whether alcohol is the main factor and is considered a controversial subject to researchers and victims of domestic abuse. It states that some individuals may feel as though the blame is getting backtracked from the offender and is used as an excuse for their misconduct.

The World Health Organization supports the articles and the evidence shown above as it also highlights that there are strong links to the number of domestic abuse cases which involved the perpetrator to have been under the influence of alcohol. The report also stated key points as to what leads the offenders to commit violent crimes towards their partners, this key point emphasized that heavy drinkers can often make their partnerships stressful and unpleasant due to their state, that could lead to conflicts and in some cases even violence. The report also implements policies and how to deal with the issue as a world health organization. It highlights the importance of how health organizations have a huge role in how they are going to address issues relating to alcohol abuse and domestic violence. The policies need to address prevention strategies that could be used to prevent these cases and that would improve public health (World Health Organization, 2006). Linking to the question, the British Crime Survey also showed that victims who reported cases on domestic violence showed that 32% of those cases, victims believed that their partner was under the influence of alcohol. (Finney, 2004), discusses the links between alcohol and domestic abuse and supports the evidence from (Gilchrist, Ireland, Forsyth, Laxton & Godwin, 2014) and by (Foran & O’Leary, 2008), the report highlighted that heavy drinkers showed a high number of risk of offender behavior. The key points to consider is that the articles and reports shown all have vey similar links between alcohol and domestic abuse.

Even though some researches have admitted to the fact that there is not enough sufficient evidence to base that alcohol is the main factor of domestic abuse, it was clearly highlighted that alcohol use in domestic abuse is very common. A contradicting article published in 2006, states that particularly in the UK there is no in-depth research to link that alcohol is linked to domestic abuse. (Galvani, 2006), also highlights that the research they conducted showed that most female victims do not blame the alcohol use for the male perpetrator’s actions. The key findings of this article showed that agencies who specialize in substance abuse and domestic violence, must also acknowledge other issues relating to why domestic abuse occurs in order to help both the victim and the perpetrator.

Addictions are common among the public. For example, from substances, medications, and liquor to addictions like sex, betting, and eating disorders like anorexia nervosa and bulimia. Somebody in your work or companion circle has battled with fixation. Addiction advising takes learning and tolerance from advisors. I have connected the information from the course of this addiction to ‘28 Days’ featuring Sandra Bullock. In this paper, I will concentrate on Gwen Cummings, the principal character played by Sandra Bullock. She is a city paper editorialist that battles substance misuse, explicitly liquor.

Gwen Cummings is a woman in her thirties living and working in a huge city. At the beginning of the motion picture, we see her drinking intensely with her sweetheart and companions. The following day, she races to her more established sister’s wedding high, where she is a bridesmaid, and remnants of the gathering by moving heedlessly and falling into the wedding cake. She demands that she can supplant the cake, and takes the wedding limousine so as to go to a pastry kitchen. She winds up colliding with a house and going to court. Her sentence is going to prison or heading off to a treatment office. Her treatment is automatic.

Gwen’s substance misuse issues started when she was a youthful youngster. We can see that Gwen’s mom was a heavy drinker from her youth flashbacks. Her mom regularly drank when Gwen and her more established sister, Lily, were near, and she was frequently found gone out on the floor of their home drunk. There were a few things that made Gwen helpless against substances. Her mom’s substance propensities, sentiments of forlornness, and sociocultural variables. For example, age, school, and societal messages are on the whole contributing variables that made it simple for Gwen to fall prey to liquor and the repetitive impacts. Liquor is a narcotic.

Inside the psychological model, there are a few understandings that attempt to clarify the etiology of addictions. These incorporate intellectual conduct and learning approaches just as the psychodynamic and character models. These models share a few things for all intents and purposes, including the convictions that substance misuse can be seen as a side effect of an increasingly essential pathology, trouble or battle with influence guidelines, and additionally fundamental and essential connection issues. To sum things up, these models interface substance use to trouble, implying that the utilization of a substance approaches the decrease of difficult mental states such as nervousness, stress, strain, and further equivalents encouraging feedback for proceeding with use and alleviation of the upsetting manifestation. Inside this model, this educated conduct proceeds until physical reliance created for the side effects of withdrawal becomes an incredible reason and inspiration for proceeding with use.

By applying this model to the character, Gwen Cummings, on the reasons why she consumes alcohol, a treatment plan was constructed so that it would assist her with processing those reasons and stressors. Gwen was assisted and motivated while she attempted new practices and ways of dealing with stress to use when experiencing her stressors. By tending to Gwen’s hidden causes of her fixation, it was done to diminish the probability of relapsing. This is one of the benefits of the psychological model of addiction. Gwen Cummings would grasp a desire for recuperation by using this method to deal with the location of her mental pressure and adapting new adapting aptitudes to counter her dependence.

As indicated by the DSM-V, Gwen meets the criteria for the liquor use issue. She meets four out of the eleven criteria. As stated in the DSM-V, she constantly wants to utilize liquor. Going out to drink with her beau and companions is a normal social movement that she appreciates, and she wouldn’t like to stop. Drinking has prompted her powerlessness to satisfy her work commitments. She keeps on drinking despite the way that it meddles with her relational connections, explicitly with her sister. Whenever Gwen and Lily communicate, there is a constant strain. Lily needs to incorporate Gwen in significant life occasions, for example, her wedding, yet, in addition, feels baffled by her when Gwen appears alcoholic. Gwen likewise gets drunk and drives, as found in the motion picture where she drives the wedding limousine. There isn’t sufficient data from the motion picture to propose that she meets more criteria. I would characterize Gwen’s seriousness as moderate since four manifestations are available.

The behavioral formation would be successful in Gwen’s treatment. The conduct involves positive reinforcement, negative reinforcement, and discipline. Gwen has gotten uplifting feedback for drinking, for example, wonderful emotions, kinships, and a relationship. It is hard to implement negative support since Gwen is a grown-up, yet one can see that discipline is working. Because of her drinking and driving episode, she has compulsory addiction treatment. A token economy could be compelling, so Gwen would see the positives of drinking less. One would foresee more clear basic leadership, effectively taking an interest in the working environment, and participating in exercises and diversions that bring delight.

What I understand from the movie ‘28 Days’ is that individuals with psychological disorders are additionally trashed by the general population around them, bringing about disgrace and humiliation, just as preference and victimization. In this way, the comprehension and treatment of psychological disorders have wide ramifications for the regular daily existence of numerous individuals. Psychological disorders share much for all intents and purposes with other restorative issues. They are out of the patient’s control, they may now and again be treated by medications, and their treatment is frequently secured by restorative protection. Psychological disorders have both biological as well as environmental influences.

The general problem of drinking alcohol can lead to addiction and further negative implications within the body and mind of an individual. This is important because individuals begin to drink just to feel good it will cause a serious social and medical problem as they may not be able to function without it. Therefore, the critical issue at that point is how can one avert and control its addiction and limit the damages that are associated with drinking. Within the article, ‘Increased Addictive Internet and Substance Use Behavior During the COVID‐19 Pandemic in China’ (2020) written by Yan Sun MD, et al, explains the background to question the link if addictive behaviors such as substance abuse and being in quarantine. Research has been directed to single out the expansion of liquor utilization due to being isolated inside the article of the ‘Compromising Increment in Liquor Utilization in Doctors Isolated Due to COVID Episode in Poland: The ALCOVID Review’ (2020) built up by Andrzej Silczuk. It similarly explains the major increase in alcohol consumption between males and females while identifying the importance of the development of drinking and dependence development.

Individuals are drinking a lot more alcohol during the COVID-19 pandemic than before the spread of the coronavirus. Within the article, ‘Increased Addictive Internet and Substance Use Behavior During the COVID‐19 Pandemic in China’ (2020) written by Yan Sun MD et al., studies the level of alcohol consumption before and after COVID-19 restrictions were placed upon us. The study focuses on how the COVID-19 pandemic has stimulated a widespread of different health issues such as anxiety, depression and other psychological reactions. Yan (2020) suggests the link to how addictive behavior, such as substance abuse and behavioral addictions can occur while furthering affecting your immune system responses and decision-making abilities. The current thesis examines the connection between a survey of a self-report questionnaire online on the general population. On the website, joybuy.com and collected responses during 24-31 march 2020. Yan (2020) findings singled out approximately 6416 participants and demonstrate that there was an increased from 31.3% (n = 2006) to 32.7% (n = 2098) for drinking. 18.7% of 331 ex‐drinkers and 25.3% of 190 ex‐smokers had relapsed. However, a limitation of this research is that, with such a small number of participants involved and the unreliability of how truthfully everyone answered it may not be able to explain the effects of alcohol and smoking accurately. Yan (2020) asserts that considering the stress of potential infection or actual infection will further increase an individual’s negative emotions such as anxiety and depression, which is the main cause of relapse. Therefore, by providing further investigation by a more generalized survey for everyone outside of China can help understand the significant increase of the factual data.

Correspondingly, research has been conducted to single out the increase of alcohol consumption due to being quarantined within the article of the ‘Threatening Increase in Alcohol Consumption in Physicians Quarantined Due to Coronavirus Outbreak in Poland: The ALCOVID survey’ (2020) established by Andrzej Silczuk. The studies outlined by Andrzej Silczuk (2020) suggest that the overall potential dangers of the development of alcohol dependency during the COVID-19 pandemic have increased. Andrzej (2020) promotes the idea through an ALCOVID survey study that was planned and routed to doctors, enlisted online utilizing open organizations, who went through isolation during an ongoing pandemic. Andrzej (2020) found that by providing open-ended questions it will further help divide the participants within two subgroups of alcohol that has increased or decreased and those whose alcohol did not change as controls. The first question is about the case of being in isolation how it has influenced the liquor use. The subsequent inquiry focused in on the explanations behind liquor warmth on Q-Is. To understand why the physicians were divided into two subgroups, Andrzej (2020) provided an understanding to those who alcohol use has increased or decreased and those whose alcohol did not change as controls. Over 53% of screened specialists uncovered that the measures of the devoured liquor have raised, practically 20% of subjects drank more than seven standard beverages for one event. Additionally, over 40% used alcohol more than four times per week (Andrzej, 2020). The results suggest that the effect of the virus has impacted the vast majority of alcohol consumption as Andrzej study provides how it is affecting the health practitioners. Although the study described within the study doesn’t provide why individuals increase their alcohol consumption the results consider the trend increase of what is occurring.

Whilst it has been shown within Yan article of ‘Increased Addictive Internet and Substance Use Behavior During the COVID‐19 Pandemic in China’ (2020) the major effects wellbeing of the pandemic that is examined in detail corresponds with Andrzej article ‘Threatening Increase in Alcohol Consumption in Physicians Quarantined Due to Coronavirus Outbreak in Poland: The ALCOVID survey’. Yan (2020) provides that within the study presented in the thesis compares the explanations of a variety of methodologies that can help enhance greater knowledge of the social aspects of alcohol consumption. Consequently, it gives a comprehension of how the COVID-19 pandemic has affected people to begin or keep drinking again as face‐to‐face exercises have been enormously diminished. While the study provides valuable information about the increase of alcohol consumption, Andrzej promotes the difference of what influences people in relapsing from abstinence with the guidance of the difference between females and males. For instance, Andrzej (2020) provides statics of respondents (n = 113), 62 were women (54.9%) and 51 were men (45.1%). These results demonstrate that females drank a lot more alcohol than males. Whereas Yans’ neglected the difference between male and female alcohol consumption differences. Thus, results should deliver great information on the frequency of these relapses to expanded substance maltreatment to direct decision‐making at the general wellbeing and public approach levels a lot more directly.

With the major health challenges due to COVID-19 has caused rising risk factors that individual experiences, such as, substance abuse and suffering from mental illnesses. As it has been criticized through Yan (2020) that alcohol can affect individuals by creating addictive behaviors, and further implications within the future. Similarly explained, Andrzej (2020) outlines the informational influence of the instance that aids in explaining why there is increasing importance on the self-addiction of alcohol during the quarantine.

A spate of recent fatal drunk driver accidents has triggered a series of reactions from many parties who are urging the government to enforce stricter laws and stern punishments to reduce or eliminate the problem. It seems like our laws are weak, with punishments that are too lenient, which causes people to take this issue lightly. But do stricter rules work in combating drunk drivers? The issue of drunk drivers has its causes, effects, and solutions. Here, we will discuss drunk driver issues that not only endanger the perpetrator’s life but also endanger the lives of innocent victims. There are a few major consequences of alcohol consumption that lead to an increasing number of accidents.

In this millennial era, teen drivers are no longer a rare occasion. At the age of 17, a teenager can obtain a driving license and legally drive on the road. Teen drivers are more likely to be influenced by peers and other external factors that lead them to make poor decisions (Walter, 2017). The combination of these factors leads to reckless driving behaviors, such as speeding, illegal racing, and even driving under the influence of drugs and/or alcohol. Focusing on the drunk driver issue, there is no safe amount that you can drink and still drive. Even one drink can influence your driving offenses. “Nowadays, drunk drivers have become driving while intoxicated, driving while impaired, driving while under the influence, operating while under the influence (impaired, intoxicated, or whatever), and in many other injuries or accidents (Taylor and Gammon, 2014).

Another important aspect that contributes to drinking abuse is due to peer influence. Peer influence among adolescents is very impactful on an individual. Peer groups affect an individual’s personality in many ways, especially when there is a lack of support from family. Reasons often used by adolescents to drink alcohol are their curiosity about something new, experimentation, the need to establish a separate or psychological and emotional identity of independence, to eliminate boredom, or as part of ‘feeling good’ syndrome to cope with their daily pressure, and encouragement for self-confidence (Stephen, William, Corbin, and Kim, 2014). Although consumption of alcohol after 18 years old is allowed, a bad circle of people around the individual could influence the person to drive while under the influence of alcohol.

Next is the psychiatric crisis, where a person initially uses alcohol to relieve stress or as a gateway to forget their problems. A psychiatric disorder is a mental illness diagnosed by a mental health professional that greatly disturbs your thinking, moods, and/or behavior and seriously increases your risk of disability, pain, death, or loss of freedom (Salters, 2020). In mental health terms, a crisis does not necessarily refer to an accident, natural disaster, or some traumatic event (Giancola, 2019). A psychiatric crisis usually emerges from the disruptive behavior of a loved one (Sarah, 2014). It can be domestic violence, deliberate self-harm, suicidal intent or attempt, psychotic depression, threatened honor killing, home run away, and outrageous behaviors resulting from alcoholism (Juergens, 2020). In time, alcohol consumption has become more and more uncontrollable because the drinkers have the urge or thought that by only drinking, they may forget their problem. At first, the drinks are considered as a ‘cure’, but in the end, a person eventually gets stuck with a new problem which is alcohol addiction. People with these diagnoses have problems associated with excessive use of alcohol, opioids (for example, oxycodone and morphine), recreational drugs, hallucinogens, and six other types of drugs. This group also includes gambling disorders (Martin, 2016).

Among other things that urge a person to drink alcohol is due to negative feelings. This is majorly due to a lack of parental love or affection. In urban areas, most parents are working, causing their children to be left unattended or receive less affection. Another linked factor is their selfish desire to throw themselves as an adult and declare their independence (adolescence) by drinking alcohol. Besides that, when your body perceives or experiences stress, it responds by secreting hormones into your blood in an attempt to cope with the stressor. This stress response affects the way your body functions and alters your body temperature, appetite, and mood. This is one reason some people turn to alcohol after a stressful event. In many cases, people will turn to alcohol when a stressful situation feels out of their control. Several factors, including genetics, usual drinking behavior, experiences with alcohol or other drugs, and social support, are factors in determining whether a person will drink during a stressful situation (Walter, 2011).

Drunk driving could lead to several negative effects. The danger of drunk driving can cause fatal accidents. Drunk driving could lead to several negative effects. The danger of drunk driving can cause fatal accidents. One of the most devastating aspects of drunk driver accidents is that it is often the passengers of the other vehicle who are seriously injured or killed and not the person who was under the influence of alcohol (Taylor and Sears, 2012). For the family members who are coping with the loss of a loved one or for a victim who has sustained catastrophic injuries and is trying to put the pieces of their life back together, a proper evaluation of the accident scene is the crucial first step to handling when a drunk driver causes an accident (Leonard, 2015). Why Drunk Drivers Are More Likely to Cause Accidents? Anyone with high blood alcohol content has a decreased ability to maintain control of their car and has decreased reaction times and overall judgment behind the wheel (Martin, 2016). The person may assume that they are fine to drive but their faculties have been significantly impaired when affected by alcohol. The word impaired comes up often in descriptions of drunk drivers because when compared with their typical ability to operate a car safely, a person under the influence of drugs or alcohol does not have the same capabilities and protections (Lee, 2019). Drunk drivers are also more likely to engage in other risky behaviors such as speeding or driving on the wrong side of the road. It is not always easy to spot drunk drivers, meaning that passengers in other vehicles or another driver may attempt to respond in mere seconds and be unable to avoid a catastrophic accident.

The effects of drunk driving in society are death and damage costs which are further divided into loss of productivity, legal and court expenses, medical costs, insurance bills, traffic congestion, and property damage. Drunk drivers are especially important to understand when an accident occurs because those who are hurt in an accident may be curious about who will pay their medical bills (Fischer, 2017). Furthermore, authorities dispatched to the scene who believe that alcohol may have been a factor in the accident itself may be interested in gathering evidence that could be used to pursue a criminal case. These situations may call for a civil as well as a criminal claim. These are handled separately in the court system. The criminal allegations involve the assessment of penalties associated with breaking the law directly. Although the illustration of property damage and serious bodily injury can be used to show the severity of the accident and to support the fact that the person who caused it was under the influence of alcohol, the criminal case does not mean that the person who was hurt or who lost a loved one is entitled to damages. The criminal trial for drunk drivers is handled completely separately from any civil trial. A civil trial, however, may be brought by someone who has been seriously injured because of the drunk driver’s behavior or family members who have lost a loved one allegedly because of that drunk driver’s behavior. Although this may be carried out at the same time as a criminal trial and involve many of the same facts, witnesses, and evidence, it is completely distinct from the criminal trial that is seeking to pursue the penalties against the responsible driver (Feldmann, 2013). A person who is injured in a drunk driver accident needs to do more than simply report their suspicion that the driver was under the influence of drugs to the police officers at the scene of the incident. They should also get medical attention to identify a proper diagnosis and consult with a knowledgeable personal injury lawyer immediately regarding whether or not they are currently eligible to pursue a case (Feldmann, 2013).

Next, drunk drivers and the loss of beloved lives. Alcoholism is known to break a family apart as one may lose their breadwinner or their future successor. The effects of drunk driving can be devastating to family members’ mental state and change their lives forever. The dangerous practice of drunk drivers is a major youth killer. Research in 2012 by the Malaysian Institute of Road Safety Research (MIROS) showed that a drunk driver was 13 times more likely to cause an accident compared to a sober person (Bernama, 2020). Recent cases in Kuala Lumpur have shown that the majority of the victims of drunk drivers are youth aged 17 to 30 years old. A case involving a student from UiTM Shah Alam happened early last year. The student who was on the way back to his hostel sadly crashed into a car that was driven in the opposite direction of the highway. The perpetrator was the drunk driver but he survived the crash, however, unfortunately, not the student (Suhaimi, 2018).

There is always a solution to every problem, and it applies to this case. There are a few steps that need to be taken to reduce the number of accidents caused by drunk drivers. First and foremost, stricter laws and better enforcement. In terms of stricter laws to deter drunk drivers, Malaysia already has these in place, and the government is currently in the process of drafting an even stricter law. The current penalties for drunk drivers include financial penalties and jail time for more severe offenses (Effa, 2020). However, just coming up with stricter laws would be pointless if proper enforcement is still lacking. Take the West, for example, law enforcers can do roadblocks or regular check-ups at hotspots or bars, especially during the weekends. This ensures the chance of offenders being caught increases, thus leading drinkers to take this issue seriously. But, if the authorities are either not out enforcing the law or are turning a blind eye when they catch someone, even the fiercest penalties in the world would be meaningless. Many other countries have strict laws and enforcement when it comes to drunk drivers, where it has been implanted into the minds of the citizens that drunk driving is unacceptable. Take Germany, for example, which has one of the highest alcohol consumption per capita in Europe. Enforcement is high in the country, and if you are caught consuming over the limit you will be fined and have your driver’s licence suspended.. This, combined with the fact that it is extremely hard to get your license back once you have lost it to a DUI (driving under the influence) charge, is enough to deter many Germans from drinking and driving (Galbicsek, 2020). Hence, it is a common practice to not drive when they are drinking or to appoint a designated driver if they are going out in a group.

Secondly, educating drunk drivers. There is one crucial factor in Malaysia’s drunk driver issue – the lack of proper education and awareness among Malaysian drivers about the dangers of drunk driving. This must start from the time they learn to drive. Some countries have driving classes and tests that include the dangers of drunk driving. Other countries even make the students watch a video showing real-life victims of drunk driver mishaps (Nelson, 2015). The drinks industry itself also needs to take the initiative to educate its drinkers about the dangers of drunk driving. In the past, some of the bigger players in Malaysia, including the beer breweries and spirits conglomerates, have run anti-drunk driver campaigns. Many major alcohol-related events also have tie-ins with ride-sharing companies to provide codes for their patrons to ride to and from the events.

On top of everything, better cooperation with industry stakeholders is equally important. In the United States and many other countries, bar owners and even individual bartenders can be held liable or even criminally charged if they continue serving an already drunk patron or allow him or her to drive home knowing they are drunk (Monico, 2020). In Malaysia, that does not happen. While it is easy for us to point fingers at bars and bartenders and blame them for letting someone drive home drunk, the fact remains that they have no legal obligation to do so. If there is, say, a law that says bars can be charged if they are guilty of continuing to serve someone who

Promoting Healthy Drinking Behaviors

The chosen population who is at Risk of Alcohol-related Harms: Teenagers.

The teenage population is one of the noticeable developments and advancement that are loaded up with vitality, energy and new encounters. All teenagers exhibit diverse characteristics and experience their high school life more differently in a unique unpredictable way, making guardians or parents occupy a hard time to counter them. Parental and social impacts influence a teenager’s improvement in various ways. In any case, every one of them experiences hormonal changes and temporal changes that add to framing their feeling of freedom and character.

Teenagers mentally develop during youthfulness and can start making life objectives or life goals. The capacity to comprehend unique thinking increments consider and conceptualize potential outcomes to theoretical circumstances.

One of the main issues encountered in teenagers from alcohol-related harms are going by car. As teenagers slowly mature, they gradually learn how to drive which sometimes can’t be properly managed from danger. In a portion of these high-chance driving circumstances, the hazard is raised for drivers all things considered (e.g., late-night driving), in other critical problems for riding, drinking booze and consumption causes such catastrophe on the road, they receive a sizable percentage of the death rate. The prime motivation to not drink and drive is that doing as such altogether secures your danger of being in an accident on the road, consequently placing damage to yourself or someone else like the passengers.

A major and common issue with alcohol that can affect anyone is alcohol poisoning or intoxication. The degree of liquor gets therefore substantial, it can truly influence the pieces of the mind that control equalization and discourse, changing the nerves that control your breathing and heartbeat and lower your body temperature, which can prompt hypothermia. It can likewise drop your muffle reflex, placing you at genuine danger of stifling to death, particularly on the off chance that you upchuck.

Another issue that relates to the Teenage population is sexual activity from alcohol-related effects. It executes an enormous impact of significance in hazardous sexual conduct, including undesirable, unintended, and unprotected sexual activity, and sex with sundry accomplices. Such conduct expands the hazard for impromptu pregnancy and for contracting explicitly transmitted ailments (STDs), incorporating contamination with HIV, the infection that causes AIDS.

The effect of alcohol most frequently involves their school and education life experience. After some time, an excess of liquor harms the brain cells within, conducting issues and enduring harm to memory, thinking, and judgment affecting their education standards. Teenagers who drink will, in general, do ineffectively in school and their practices may force them into difficulty dropping out early. Some of the two potential aspects are influenced by alcohol contributing to the selected population of teenagers being at higher risks.

Drinking and Driving

The following factors that affect the teenager whilst driving with alcohol is personal and environmental factors. Drivers aren’t oftentimes aware of the risk when they are relied upon to operate the vehicle affected by liquor present. Therefore, the driver, as a rule, might suspect there is no danger in alcohol influenced driving, procuring comparable peril since they don’t anticipate the astonishing outcome. This is related to personal factors as these incorporate judgments of in general vulnerability including estimations about such things as separation to drive, time of day, probability of getting captured, climate conditions, and self-adequacy, just as remunerations related with driving and relative expenses or trouble in acquiring substitute transportation.

Other hazard components surveyed in an examination incorporate gender, society or sorority connection, family ancestry of liquor issues, receive frames of mind of various adolescents toward liquor anticipations. A gender contrast among undergrads is less clear for liquor-related and moderately private issues or include mischief to self. At any rate, men are virtually certain than ladies to experience negative drinking results that are open and are destructive to other people whilst driving. Another critical element that still relates to underage drink and drive is the alcohol factors.