Category: Alcohol

Drug Test

A drug test is a scientific examination of a biological sample like urine, hair, blood, sweat, or oral fluid/saliva to establish the existence or absence of particular parent drugs or their metabolites. Deborah et al, (1998)stated that “one of the significance of drug test is testing for the presence of substance and detecting that encourages steroids in sports or drugs prohibited by laws, like heroin, cocaine and cannabis”(p. 32).

Urine Drug Screen

When an employer demands for a drug test from a worker the employee is characteristically informed to go to a gathering site. The employee’s urine is taken at an isolated position in a particularly designed protected cup, conserved with a tamper opposed to tape, and sent by means of express liberation service to a laboratory that is used in testing to monitored drugs.

The first stage at the testing site is to divide the urine into two separate aliquots. The first is used to test for drugs with the use of an analyzer that performs immunoassay for preliminary screening.

If the urine screen indicate positive, then a different portion of the sample is used to verify the presence of drugs using gas chromatography-mass spectrometry (GC-MS) methodology (Lennart, 1991). All the test results are transferred to an MRO for extra and appropriate medical reviews on the collected results. If the result of the screen indicates negative, the MRO reveals that the worker has no plain drug to detect the presence of urine.

Thomas and Ulrike (2008) also explained that “the test result of the immunoassay and GC-MS are non-negative and confirm a concentration level of parent drug or metabolite above the well-known boundary, the MRO contacts the worker and to decide if there is any genuine reason for medical treatment or recommendation” (p. 6).

On-site direct drug testing is getting more extensively used in states permitting it as a more cost-efficient technique of efficiently identifying drug abuse that exist among employees, as well as in treatment programs to scrutinize patient evolution. Deborah and Joseph (1998) explained that these instantaneous tests can be used for both urine and saliva testing (p. 19).

Though the exactness of such tests depends on the manufacturer, some kits possess enormously high rates of correctness, associating directly with laboratory test results. Jim (2006) explained “about 5% of all the pre-employment urine samples tested positive for drugs”(p. 14). The effects are much higher for post-accident and logical suspicion test.

Hair Testing

Analysis of hair samples has numerous rewards as an introductory screening method to test for the existence of drugs. The significance of hair testing include the non-invasiveness, reduced cost as well as ability to resolve a great number of possibly interrelated, toxic and physically essential elements. Particularly in the United States hair testing is becoming more and more useful for employers to test employees for possible prohibited drug use (Cathryn and John, 1989, p. 49).

Testing for the presence of both FAEE and ETG levels have been used in UK courts and hair testing for alcohol makers is now conventional in both the UK and US legal systems. There are strategies for hair testing that have been made available by the Society of Hair Testing that identifies the markers to be tested for and the cut-off concentrations that require testing.

Alcohol

Effective differentiating between other drugs consumed and alcohol, alcohol is not set down directly in the hair. The method used in this test ensures that the test procedure directs and generates products of ethanol metabolism. The most important part of alcohol is oxidized in the human body and it is given out as water and carbon dioxide, and this reacts with fatty acids to generate esters. Mireille (2003) explained that the amounts of the reflection of four of these fatty acid ethyl esters are useful in the indication of the alcohol use (p. 19).

Hatala (2003) stated that “the quantity found in hair is calculated and measured in nanograms though with the advantage of modern technology, it is likely to detect even very small amounts” (p. 43). In the testing of Ethyl Glucuronide, or EtG, testing can detect amounts in picograms.

Conversely, a significant difference exists between most drugs and alcohol metabolites as explained by Jim (2006) “in the way that they go through the hair, also, other drugs like FAEEs go straight into the hair through the keratinocytes, and this is the cell that is responsible for hair growth”(p. 43).

Mireille (2003) also explained that, “these cells structure the hair in the root and then grow through the skin exterior taking any essential materials along with them” (p. 22). As a result, the sebaceous glands secrete a substance in the scalp and then flow together with the sebum along the hair shaft (Jim, 2006, p. 14).

Drug Testing Methodologies

Various kinds of drug tests come in different ways. Before a sample is tested, the tamper-evident seal is tested for consistency. If it emerges to have been interfered with or was injured during transportation, the laboratory will reject the sample and will not test it. Johnathan (2008) explained that, “one of the first steps for all drug testing is to make the sample to attain a testable state” (p. 45). Urine and oral liquid can be used for some tests, but other tests necessitate the drugs to be removed from urine earlier.

Threads of hair, scraps as well as blood must be organized before testing. Jim (2006) said that “the purpose of washing hair and keeping it clean is to get rid of second-hand sources of drugs on the external surface of the hair, after which the keratin is broken down with the use of enzymes”(p. 3). Sweat scraps are opened up and the sweat compilation element is drenched in a flush to break up any drugs available.

Laboratory-based drug testing is performed in such a way that it makes use of two different types of testing methods. The first is identified as the screening test, and this is functional to all illustration that passes through the laboratory.

The second is known as the confirmation test, which is only useful to samples that test positive throughout the screening test. Johnathan (2008) asserts that “screening tests are naturally executed by immunoassay (EMIT, ELISA, and RIA are the most common)” (p. 16). A measuring stick drug testing method that could at some prospective point provide screening test potential to field investigators has been developed.

After testing the positive sample, the sample is made standard and tested again by the confirmation test. Negative samples are screened, thrown away and described as negative.

The confirmation test in most laboratories is conducted via a mass spectrometry, and is enormously accurate but also moderately costly to run (Mireille, 2003, p. 35). False positive samples gotten from the screening test will be harmful on the verification test. Samples testing positive throughout both screening and confirmation tests are described as positive to the body that regimented the test.

A lot of laboratories save positive samples for some period of months or years in the occurrence of a doubtful result or court proceedings. During testing in a work environment, a positive result is usually not recognized without a reassessing the product by a Medical Review Officer that will question the subject of the drug test.

Drug Testing Methods

Urine Drug Testing

Urine drug test kits are accessible as on-sight tests, or laboratory analysis. Mireille (2003) asserts that “urinalysis is the most common test type and it is used by federally authorized drug testing programs that are considered as gold standard of drug testing” (p. 43).

Urine based tests have been maintained in most courts for over 30 years, though, urinalysis conducted by the department of defence has been questioned for consistency of testing the metabolic nature of cocaine. However, Johnathan (2008) explains that “there exist two connected metabolites of cocaine, benzoylecgonine (BZ) and ecgonine methyl ester (EME), the first (BZ) is produced by the existence of cocaine in an aqeous solution with a pH greater than 7.0, while the second (EME) is generated the actual human metabolic process” (p. 47).

The existence of EME verifies genuine intake of cocaine by a human being, while the existence of BZ is suggestive only. Oral fluid is not measured as a bio-hazard except there is observable blood, though; it should be handled with extreme care (Thomas and Ulrike, 2008, p. 46).

Spray (Sweat) Drug Testing

Spray (sweat) drug test outfits are non-insidious. It is very simple to collect the specimen that no bathroom will be required for collecting the specimen. The detection window is extended and can typically detect drug use up for a number of late. These drug tests are comparatively tamper proof since they are very difficult to influence and it usually does not require a laboratory for analysis.

Mireille (2003) stated that huge differences of sweat assembly rates of potential donors make some results questionable. There is not much assortment in the drug tests since they are not as well-liked as urine or saliva drug testing kits (p. 42). Their prices are normally higher for every test performed. One major drawback of this testing method is the inadequate amount of drugs that can be distinguished, and the capability to create instant results.

Hair Drug Testing

Hair drug testing is capable of detecting drug use over a very long period of time and it is often used for highly safety significant positions where there is zero acceptance of drug usage. Standard hair follicle screen extends to a period of 30-90 days. The growth of hair is typically at the rate of 0.5 inches per month. If the hair on the head is not available, body hair can be used as a suitable alternative (Miller et al., 2009, p. 34).

Even if the person being tested has a bald head, hair can also be collected from roughly any other part of the body like facial hair, the underarms, arms, and legs. However, it is always claimed that hair test cannot be interfered with, it has been made known that this is basically incorrect. For instance, THC does not voluntarily put down inside epithelial cells so it is likely for superficial and other forms of defilement to lessen the amount of testable cannabinoids that exists in a hair sample.

Legal, Ethics and politics of Mandatory Drug Testing

Drug testing is likely to detect cannabis users, since THC metabolites are fat dissolvers and have the ability to stay longer in the body than those other drugs that are broadly measured as very dangerous like cocaine and heroin. Thomas and Ulrike (2008) explained that this can help direct possible cannabis users to switch to drugs that are less harder, most of which normally have considerably shorter detection period or are less expected to be tested for (p. 24).

It has also been observed that regular medical tests are prone to errors of the same type that intimidate the correctness of drug tests, but medical tests are neither accidental nor obligatory, and are typically performed in test boards that provide the physician with a number of results to infer together, with abnormal combinations normally resulting in retesting and a hunt for other supporting verification. Also, drug tests are not parts of such panes, and other verification is often not obtainable.

Conclusion

Drugs and alcohol testing are forms of medical testing that can be used to detect the presence of drugs or alcohol in one form or the other in the body. Therefore, it is very important that that drug testing is carefully performed so as to arrive at the exact or correct test.

References

Cathryn, J. & John, S. G. (1989), The Constitutionality of Drug Testing at the Bail Stage, 80, The Journal of Criminal Law and Criminology (1973-), pp. 114–176.

Deborah, F. C. & Joseph, G. R. (1988), A Critical Review of the Assumptions Underlying Drug Testing, 3, Journal of Business and Psychology, pp. 22–41.

Lennart, E. H. (1991). The Unconvincing Case for Drug Testing, 17, Canadian Public Policy / Analyse de Politiques, pp. 183–196.

Hatala, J. W. (2003). The Feasibility of Testing Hair for Illicit Drug Use in the United States Marine Corps. Monterey, California: Naval Postgraduate School. pp. 2. Web.

Jim, B. ( 2006). “A Little Dab Will Do It”. LASNews (University of Illinois). Web.

Johnathan, C. J. (2008). Legal Q&A: Alcohol and Drug Testing. Web.

Mireille, J. (2003). Drug Testing in the Trucking Industry: The Effect on Highway Safety, 46, Journal of Law and Economics, pp. 131–156.

Miller, N. S., Giannini, A. J., Gold, M. S. & Philomena, J. A. (2009).Drug testing: Medical, legal and ethical issues. Journal of Substance Abuse Treatment.7 (4):239-244.

Thomas, R. S. & Ulrike, Z. (2008). On the Wisdom of Mandatory Drug Testing, 7. Journal of Policy Analysis and Management, pp. 542–547.

Introduction

Alcohol and substance abuse during pregnancy are famous for the adverse effects they have on the fetal development during gestation. A lot of research has been conducted on this relationship and none so far has come up with any positive effects of alcohol on the growth or development of an unborn child of an alcoholic or substance abusing pregnant woman.

Many people abuse various drugs throughout their lives including cocaine, methamphetamine, tobacco, prescription opiate, marijuana, and alcohol among others. However, most researchers seem more inclined to conduct studies on the effects of alcohol abuse than of any other drug, with tobacco being second in popularity.

The reasons for this trend in research could be that alcohol’s effects are easily identifiable, especially since they are embodied in a condition known as Fetal Alcohol Spectrum Disorder, (FASD), which outlines a range of varying health disorders in newborn babies because of prenatal exposure to alcohol.

Among these are; Fetal Alcohol Syndrome (FAS), which affects children whose mothers consumed alcohol throughout most of the pregnancy, and Fetal Alcohol Effects (FAE), which are individual or separate symptoms of FAS, but are manifested in children whose mothers either drank less amounts or during specific semesters.

Consequently, such children will exhibit a range of deficits in growth and development, but not to the full-blown level or combinations as FAS symptoms. The mothers may have consumed a lot of alcohol during the first semester only, which results in distorted facial features and retarded brain development.

This paper will conduct a literature review of most of the studies that have been conducted in this field and further summarizing from them the adverse effects of exposing unborn babies to alcohol and drug abuse. It is important to note that such effects carry on into adulthood, although the physical manifestations are somewhat ameliorated during puberty spurts. However, mental deficits remain painfully obvious throughout the person’s life.

Objectives

This paper intends to bring to the awareness of pregnant women and their families the dangers associated with exposing themselves and their unborn children to both alcohol and substance abuse. Most of the research conducted in this field of study has been fragmented and disconnected from related research.

Therefore, it is the intention of the paper to link all these studies in a bid to generate a comprehensive display of both substance abuse and alcoholism during pregnancy and the effects attached to this form of deviance. In addition to pointing out the morphological and Central Nervous System’s (CNS) shortcomings in such a child, the paper also intends to touch on the psychological harm that comes with such a condition, and its strain on the mother-child relationship.

Aim

The aim of such a display of adverse effects is to provide the public with comprehensive insight into what happens when one abuses any drug during pregnancy. Most FAS conditions have been diagnosed in children of young teenage mothers (16-22). The presumption behind these diagnoses is that these youth are not prepared to handle the responsibilities of child-care, right from the carrying of pregnancies to term.

Consequently, they engage in binge drinking and substance abuse either to rebel or to cope with the stigma and rejection that is associated with pregnancy at this age. Mothers do not know the damage they are doing to the children in their womb, and this paper aims at creating this much-needed awareness.

With knowledge comes empowerment, if they knowingly abuse drugs after glimpsing at the probable effect, it will not be in ignorance. Secondly, this study hopes to put together the propositions of previous research on how to counter the problem of fetal exposure to drugs. It will compile the proposals of past researchers and consequently have reformists adopt some of them during policy making to alleviate this problem from the society.

Methodology

I will compile the findings of related research while including the disclaimers given by such researchers over the accuracy of their findings. This includes indicating whether any steps were taken to eliminate other confounding variables such as post-natal exposures to socioeconomic difficulties and family problems, as well as mothers’ age and quality of antenatal care allocated to the unborn infant.

Next, I will categorize the effects of substance abuse based on the drug in question across the board, i.e., I will combine all research that has been conducted on effects of tobacco for instance, then move on to those of cocaine, and so on.

In other words, this paper will pick on the strengths of every study and avoid overlapping shortcomings, making it very reliable. For those studies with similar findings, they shall not all be included. The vein of the findings shall be adopted, and the different sources shall serve as additional evidence. Others with similar ideas but different characteristics shall be used to build on the already developing train of thought.

Literature Review

This paper derives its authority from several sources that have been cited as authority in the matter of fetal exposure to alcohol, and/ or substance abuse.

These are reports on the findings of various researches including the methodology applied, the theoretical frameworks, the strengths and weaknesses of each procedure, and recommendations for future researchers as well as for donors in terms of progressing corrective measures. Having already named them and given the topics here, in the next section of this paper where the paper discusses the findings, the write will just name the first two researchers and the title of their work then go ahead to report their findings.

It is also important to note that within the above studies, are inclusions of other studies that the researchers compare or contrast their findings and methodologies. I shall include such in-text researchers where a relevant point is projected, but just to the extent which is mentioned under the current research.

Findings

Alcohol

Alcohol is a teratogen. In other words, it is a substance that is harmful to the development of the body, both physically and mentally (Larkby, & Day, 1997, p. 192). When a pregnant woman consumes alcohol, it is absorbed into her mainstream and absorbed alongside food and oxygen by the fetus’s system.

Consequently, the fetus becomes inebriated, and unfortunately, its “clean-up” mechanism that is responsible of ridding the body of toxic substance is not nearly as efficient as that of its mother. The alcohol is thus retained for long periods within the fetus resulting in the adverse effects of alcohol on fetal growth and development. A child may be born with withdrawal symptoms such as restlessness, muscle tremors, irritability, and eating and sleeping disorders (Nulman, Rovet, & Stewart, 1997, p. 259).

During the first trimester, particularly the first until the fourth week, the heart, the Central Nervous System (week 3 marks the beginning of brain development) eyes, legs, arms, ears, lungs, kidneys and genitals are the organs that are in development. Consequently, exposing the fetus to alcohol then can result into morphological deficits such as alterations in facial features as well as small eye openings (short palpebral fissures).

It can further result into the development of epicanthic folds on eyelids, short upturned nose, flattened philtrum, (middle ridge linking nose and lip) thin upper lip, flattened midface, underdevelopment of upper and / or lower jaw, and abnormal skull structure (Clarren, Olson, Clarren & Astley, 2002, p. 315).

They also include mental development inhibition, which results in mental retardation and behavioral problems. In particular, such an individual’s brain parts are underdeveloped. These include the hippocampus, frontal lobes, corpus collosum, and basal ganglia.

Consequently, they suffer delayed motor and speech development, hearing impairments, abnormalities in sleep patterns, and difficulty in adapting and responding to stimuli. One of the most effective tools used in diagnosing these deficits is the Brazelton Neonatal Behavioral Assessment Scale (Loebstein, & Koren, 1997, p. 195).

Alcohol abuse during the third trimester causes growth retardation. Consequently, infants are born with a low birth weight and height and they remain thin and short through the rest of their lives. Some researchers carried forward their studies to investigate the continuance of these effects in the adulthood of the patient.

Morphological features such as facial distortions are ameliorated during adolescence by puberty spurts as well as normal muscle development (Clarren, Olson, Clarren, & Astley, 2002, p. 320). However, mental retardation remains.

One study indicated that such individuals IQ ranges from a low 29 (completely retarded) to 105 (high average). Consequently, most of them have learning disabilities due to inherent mental incapacitation. Neuropsychological measures have yielded results that indicate that these individuals, (5-15) have difficulties in; processing and storing information, visual and spatial skills, problem solving-they cannot make complex decisions, and poor sequential processing.

Behavioral problems that have been observed include hyperactivity, irritation during infancy, inattention, lack of concentration, lack of independent living skills, stubbornness, social withdrawal, and social problems such as depression and anxiety. Conduct problems include lying, cheating, stealing, poor communication, antisocial inclinations, and problems with substance and drug abuse.

Research has proved that the relationship between amount and duration of exposure can either be linear i.e. it is directly proportional and the more an expectant woman drinks, the more the damage caused on the infant. It can also be a threshold relationship (Nulman, Rovet, & Stewart, 1997, p. 263). This came up with the few exceptional cases where alcohol did not adversely affect the fetus; therefore, there was a quest to establish the threshold amount of alcohol that can be consumed without affecting the unborn baby.

Unfortunately, for drinkers, no such amount has been established this far because different people react differently to different amounts of alcohol consumed. Most researchers noted age of the mother, socioeconomic status after birth, maternal rejection of the infant and maternal co morbidity with medical or psychiatric disorders as the confounding variables of their research but that once controlled, however, these factors have negligent effects on the findings.

Tobacco

Research has proved the directly proportional relationship (linear) between maternal smoking during pregnancy and criminal inclination and substance abuse by the adult who suffered this exposure as a fetus (Brennan, Grekin, & Mortensen, 2002, p. 50).

The most common crimes such individuals engage in include; murder, attempted murder, robbery, rape, assault (including domestic assault), illegal possession of a weapon, theft, breaking and entering, fraud, forgery, blackmail, embezzlement, vandalism, prostitution, pimping, and narcotics offenses.

It is important to note that there was no special relationship between the inclination to commit narcotic offences and fetal exposure to tobacco. This research also proved that, male offspring of such history is given to more aggression and violence than their female counterparts are. An interesting relationship was addressed between female offspring inclination to become dependent on substance abuse and exposure to tobacco in the womb (Brennan, Grekin, & Mortensen, 2002, p. 52).

It was proved that this relationship is linear, and that the aggression portrayed by these females is largely in the process of acquiring illicit substances. Therefore, future researchers seeking to address the issue of violence in female offspring exposed to tobacco in the uterus are advised to focus on disturbance reports and statements instead of charge records.

Cocaine

In addition to some defects associated with alcohol use such as reduced circumference of skull and growth defects, addicted cocaine users who continue to use it during pregnancy have various ill effects.

These range from spontaneous abortions, abruption of placenta (these two are more common when cocaine is taken intravenously, they cause fetal hypoxemia), premature labor, precipitous deliveries, stillbirths, and me conium staining (Loebstein, & Koren, 1997, p. 195). A cocaine-specific effect is prenatal cerebral infraction, which results from the constriction of the veins circulating blood in the cerebrum. Such a child will have difficulty with comprehension and expression.

Recommendations

Most researchers recommended that the therapists to be used in counseling addicted expectant women be friendlier and give the mothers hope in recovery. This can be made possible if we use therapists who are themselves recovering from dependence (Nulman, Rovet, & Stewart, 1997, p. 262).

Many proposed the inclusion of the more complex psychomotor development assessment to phase out physical assessment. Finally, some proposed the incorporation of prevention and intervention strategy development by future researchers (Larkby, & Day, 1997, p. 197).

Critical Analysis of a Key Concept

I choose to analyze alcohol consumption by expectant women. Alcohol has been a social beverage since time immemorial and most people accept it, as it is not regarding the repercussions they subject themselves into when they consume it. However, some people consume it to ‘forget’ their problems or as a way of coping with their stress issues.

This study has proved that alcohol consumption is detrimental to fetal health. Every drink an expectant woman consumes is taken by her unborn baby as well. The effects of this are inhuman, as the baby will be damaged for life. They can be born already addicted to alcohol and suffering withdrawal symptoms, or with physical, mental and neurological deformations, which will affect them for life.

Extreme cases of deformation are difficult on the mother as well. It is interesting to note that, there is no threshold amount of alcohol that a person can consume without risking his/her baby’s health. Most women in my community consume wine almost every night after dinner ‘for digestive purposes’.

There is also the misled belief that wine is not too strong a drink. A simple sip at the wrong time of fetal development can wreak havoc on the baby’s IQ. It is also important to note that such a child will always blame the mother for his condition, meaning that there will be a strained relationship at best with the child, in addition to the burden of raising a deformed child.

Finally, statistics show that drinking is more common among Caucasian females that African Americans or Hispanics, and that it increase with the level of education. It is therefore important that we pay attention to these statistics and findings to protect our children from deformities at birth and in life.

Conclusion

This paper has looked into the effects of alcohol and substance during pregnancy on the newborn and on the mother-child relationship. It has surveyed the findings of authoritative researchers and compiled them to draw its conclusions on this phenomenon.

It has also indicated the aims of the study as intending to create awareness among the youth, and policy makers on the adverse effects of drug use during pregnancy. It included recommendations for future researchers as well as for policy makers seeking to alleviate this growing problem, and finally, it critically analyses alcoholism in among women. I would advice all affected parties to pay attention to its findings to stay off trouble with drugs.

References

Brennan, A., Grekin R., Mortensen, E. (2002). Relationship of Maternal Smoking During

Pregnancy With Criminal Arrest and Hospitalization for Substance Abuse in Male and Female Adult Offspring. American Journal of Psychiatry , 3 (2), pp. 48-54.

Clarren, K., Olson, C., Clarren, S., & Astley S. (2002). A Child with Fetal Alcohol Syndrome. In G. M. (ed.), Interdisciplinary Clinical Assessment of Young Children with Developmental Disabilities. Baltimore, Maryland: Paul H. Brookes Publishing Co.

Larkby, C. & Day, N. (1997). The Effects of Prenatal Alcohol Exposure. Alcohol Health & Research World , 4 (1), pp.192-197.

Loebstein, R., & Koren, G. (1997). Pregnancy Outcome and Neurodevelopment of Children Exposed In Utero to Psychoactive Drugs: The Motherisk Experience. Journal ofPsychiatry & Neuroscience ,2(1), pp. 192-196.

Nulman, I., Rovet, J., & Stewart, D. (1997). Neurodevelopment Of Children Exposed In Utero To Antidepressant Drugs. The New England Journal of Medicine , 1 (1), pp. 258-262.

Introduction

Teenage binge drinking (TBD) seems to have become a major concern for the American society. According to the statistical data, 16% of the U.S. teenagers have tried binge drinking, and 12% still do it on a regular basis (Mares, van der Vorst, Engels & Lichtwarck-Aschoff, 2011). A range of dangerous myths and stereotypes concerning the safety of TBD is quite popular among teenagers; as a result, TBD not only persists, but also gains increasingly more popularity among its audience.

Definition

One of the most notable things about the phenomenon concerns the fact that there is no single definition for the phenomenon. Most sources claim that binge drinking occurs among teenagers and that the term cannot be attributed to people over nineteen (Mares, van der Vorst, Engels & Lichtwarck-Aschoff, 2011). However, when it comes to specifying what binge drinking actually involves, a range of contradictory facts emerge. For example, certain sources define binge drinking as a consumption of a specific amount of liquor in one session (e.g., more than four, five or six drinks) (Main, 2009). Other sources declare that binge drinking is a phenomenon during which the process of drinking becomes unintentional and, therefore, impossible to control (Main, 2009).

Thesis

Despite the fact that teenage binge drinking leads to a range of serious consequences and is bound to trigger major health issues for drinking teenagers, the issue is often overlooked compared to other problems concerning teenage drinking; as a result, TBD is never addressed properly and has drastic consequences on young adults. In order to solve the problem, the attitude towards TBD must be overlooked and a comprehensive health education strategy based on raising awareness, intensifying family support and developing proper stress coping mechanisms must be provided.

Factors: What Induced TBD

The major problem with TBD is that there seems to be an entire mythology grown around it; some of the suppositions are admittedly true, yet most of the myths surrounding the subject are completely false, hindering people from developing an efficient strategy to fight the disease. For a health educator, it is crucial to realize that teenagers are prone to developing impressive resistance when it comes to addressing their binge drinking issue.

It is a common idea that the lack of awareness concerning the effects of binge drinking is what makes teenagers grow addicted to liquor. Such an assumption, however, is far from being true. Instead, teenagers do not seem to realize the seriousness of the consequences. Hence, the awareness strategy must be aimed at proving the point instead of repeating the ideas that the patients have heard a million times before.

Perhaps, one of the most dangerous myths about TBD concerns the easiness, with which people supposedly get rid of it. According to the latest questionnaires and opinion polls, a number of young people, who indulge in binge drinking, assume that they will be able to quit whenever they want (Main, 2009). However, as further researches display, very few of such young people actually want to cease drinking; more to the point, most of them are doomed to increasing the daily amount of consumed alcohol to the point where they become addicted to it (Main, 2009). In addition, a range of adults assume that teenagers will inevitably start drinking because of the “growing pains” and their rebelliousness (Main, 2009).

While the common myths created by the adults, which allows the latter to shut eyes to the fact that TBD exists, the myths spawned and supported by teenagers are much more dangerous, since these myths are especially hard to prove wrong – not because of their fallacies, but because of the unwillingness of young people to accept the truth. One of such myths is that TBD is not the “actual” drinking and that a teenager, who drinks only occasionally, though in quite heavy doses, is not subjected to developing a binge drinking issue (Main, 2009).

Apart from the misconceptions regarding the understanding of teenagers’ motivations for drinking and, therefore, underestimating the problem, people often fail to recognize alcohol dependency as a medical issue, because alcohol itself is rarely viewed as a drug. Indeed, as the recent research results show, 32% of adults consider alcohol consumption as something entirely out of the ordinary and do not see its regular use as a reason for concern (Mares, van der Vorst, Engels & Lichtwarck-Aschoff, 2011).

Alcohol, especially light liquor, is often viewed as an element of recreation; using alcohol drinks in order to experience relaxation, adults do not prevent teenagers from doing the same thing. Teenagers, in their turn, interpret such a response as an approval for continuing alcohol consumption and, in their turn, increase the amount of beverages consumed or the amount of times that they drink alcohol per day.

Unlike the previous issues, however, this one is by far the most dangerous myth affecting teenage binge drinking. In contrast to the previous ones, it affects the way in which a teenager will shape their attitude towards drinking in the future. As a result, the idea of using alcoholic beverages as a tool for relaxation is most likely to result in developing a serious drinking issue in adulthood (Mares, van der Vorst, Engels & Lichtwarck-Aschoff, 2011).

Consequences of TBD: Evaluating the Threat

As it has been stressed above, a range of people assume that TBD does not have any tangible effects on one’s adult life. Unfortunately, researches have shown that this is far from being true. Apart from the obvious dependency on liquor as the key method of recreation, people, who used to indulge in TBD, are most likely to develop a range of disorders at a relatively young age. Among the most common ones, kidney failure (Steele, Belostotsky & Lau, 2012), alcohol induced liver disease (Herring, Berridge & Thom, 2008) and even mental health disorders (Squeglia et al., 2012) are listed.

It should be noted that most of these issues remain dormant up until the age of thirty, when the effects of TBD finally take their toll and trigger malfunction of a range of organs of human body. Indeed, according to the results of the study carried out by Squeglia et al. (2012), TBD does affect people’s capacity to carry out the basic logical tasks as they grow up, even though there are considerable differences in the results for male and female TBD: as the researchers state, “females who develop heavy drinking patterns are more likely to have neural abnormalities that predate substance involvement” (Squeglia et al., 2012, p. 536), whereas male teenage binge drinkers are more apt to developing substantial attention issues, which are especially noticeable in the male teenage binge drinkers, who have thicker cortices (Squeglia et al., 2012, p. 536).

Therefore, TBD is harmful in not only that it contributes to developing liver and kidney issues in young adults, but also in that TBD suppresses the brain functions of the human body, leading to major cognitive and memory issues in early adulthood.

Solutions: Designing the Appropriate Strategy for Health Education

In order to address the issue efficiently, busting the myths will not be enough; while being an admittedly important step to take, this can be counted only as the first part of a major process for the TBD threat prevention. Apart from disclosing the truth to teenagers and their parents, it will be required to provide both with the information on binge drinking and its prevention: “A multifaceted approach, including a full range of prevention and intervention components, is required to safeguard the health of students from the effects of alcohol, tobacco, and other drugs” (Curriculum Development and Supplemental Materials Commission, 2009, p. 59). The key to efficient intervention is not to use a big scare tactics, but to report the key facts honestly, at the same time providing parents and their children with efficient strategies for binge drinking prevention, including the means to get rid of such factors as peer pressure, emotional distress, etc.

Health education as the key: strategies

When it comes to defining the means to enhance TBD awareness among both parents and their children, the issue of health education should be brought up. It must be kept in mind that, for young people in 9^th–12^th grades, the message must not be too on-the-nose; otherwise, it will not perform its key purpose. Hence, the following steps must be considered as the possible program for a course in health education on the TBD issue among nine-and twelve-graders:

Step one: Awareness campaigns.

As it has been stressed above, a range of myths concerning TBD is cycling among teenagers, thus, making the latter assume that TBD should not be a major concern. As it has been proven, this assumption is not only wrong, but also very dangerous, since it encourages teenagers to indulge in binge drinking and, therefore, leads to the development of early symptoms of alcoholic dependency in young adults.

Once the mechanism is launched, alcoholic dependency starts developing. Since a range of specialists claim that alcoholic dependency cannot be cured and can only go into the remission stage, the issue of TBD can be considered a major threat to both the health and the social life of young adults (California Department of Education, 2009).

Therefore, massive awareness campaigns regarding the threats of TBD must be launched, and discussions of the issue of TBD must be included into the curriculum of public schools. Teenagers have the right to know what is going to happen to them once they engage in TBD, and the school must provide this information to them.

Step two: Family support

No matter how hard teenagers might try to make their peers consider them fully independent, they, in fact, are linked to their family members very closely in terms of emotions and communication. Therefore, it is imperative that teenagers’ family members should provide sufficient support for their children and engage into the process of raising teenagers’ awareness.

It is crucial, though, that the family members should not be overbearing or overprotective; according to the DSM-V, overbearing is fraught with a range of serious consequences, starting from young people getting out of control and up to teenagers developing neuroses and other related disorders. In fact, the DSM-V manual suggests a very adequate method for parents to address or prevent the situation of teenage binge drinking:

Adaptive functioning is assessed using both clinical evaluation and individualized, culturally appropriate, psychometrically sound measures. Standardized measures are used with knowledgeable informants (e.g., parent or other family member; teacher; counselor; care provider) and the individual to the extent possible. (American Psychiatric Association, 2010, p. 37)

Apart from designing an efficient method of addressing the problem, the family members must also reconsider their own attitude towards alcohol consumption. Even though teenage binge drinking is often associated with college life when most students remain away from their parents, the latter may expand their influence to reach their child even if a teenager lives away. The parents, who have drinking issues themselves, on the other hand, have very little effect on their children; more importantly, with an example of drinking parents, a teenager is highly unlikely to quit binge drinking, as the American Psychiatric Association (2010) claims.

Therefore, it would be an appropriate step to start with defining the possible issues with alcohol consumption among the family members. It is imperative that a teenager should have a positive role model to relate to. It is only with the help of supportive parents, who either do not have or have got rid of alcoholic dependency that a positive environment for a teenager to quit binge drinking can be created.

Step three: Self-actualization

The third step can be interpreted as the reinforcement of the stages that have been listed above. It should be kept in mind that the complete remission and the following transfer from one lifestyle to another will require that a teenager should cope with a lot of stress. It is obvious that a person, who used to indulge in binge drinking, is going to experience much stress when abandoning the habit, which used to bring so much delight into their life. As a result, an efficient stress coping mechanism will have to be developed so that the patient should not experience chronic stress (Hahn, Payne & Lucas, 2010, p. 81).

Among the key suggestions for developing the proper coping mechanisms, the enhancement of self-actualization (Hahn, Payne & Lucas, 2010, p. 32) must be mentioned. The patient must reconsider their values and get their priorities straight, therefore, realizing that binge drinking only prevents them from reaching their goals; more to the point, TBD erases the progress made and deprives one of personality completely.

As soon as the process of self-actualization starts, the communication process with the family members must be enhanced; thus, the patient will be able to retain their psychological health. It is especially important that the emphasis should be made on the nonverbal elements of communication (Hahn, Payne & Lucas, 2010, p. 33)

Conclusion

Teenage binge drinking is a major problem for not only the United States, but also for a range of states all over the world. Because of a range of myths surrounding TBD, not only teenagers, but also a range of adults tend to treat the issue rather lightly. However, TBD poses a serious threat to young people, leading to major issues in the adult life; as a result, a comprehensive health education strategy must be provided to raise awareness among both teenagers and adults.

In order to prevent and address the issue, such a stress-coping mechanism as self-actualization of the patient can be suggested. As long as the patient has the support of the family and is provided with the information regarding the TBD, they are most likely to be safe from TBD and its consequences.

Reference List

American Psychiatric Association. (2010). DSM-V. New York, NY: American Psychiatric Association. Curriculum Development and Supplemental Materials Commission.

California Department of Education. (2009). Health framework for California public schools. Sacramento, CA: California Department of Education.

Hahn, D. B., Payne, W. A. & Lucas, E. B. (2010). Understanding your health. 11th ed. New York City, NY: McGraw Hill.

Herring, R., Berridge, V. & Thom, B. (2008). Binge drinking: an exploration of a confused concept. Journal of Epidemiology and Community Health, 62(6), 476-479. Retrieved from JSTOR.

Main, C. T. (2009). Underage drinking and the drinking age. Policy Review, 155(1), p. 33. Retrieved from ProQuest.

Mares, S. H. W., van der Vorst, H., Engels, R. C. M. E. & Lichtwarck-Aschoff, A. (2011). Parental alcohol use, alcohol-related problems, and alcohol-specific attitudes, alcohol-specific communication, and adolescent excessive alcohol use and alcohol-related problems: An indirect path model. Addictive Behaviors, 36(3), 209–216. Retrieved from ScienceDirect.

Squeglia, L. M., Sorg, S. F., Schweinsburg, A. D., Wetherill, R. R., Pulido, C. & Tapert, S. F. (2012). Binge drinking differentially affects adolescent male and female brain morphometry. Psychopharmacology, 220(3), 529–539. Retrieved from ResearchGate.

Steele, M. R., Belostotsky, B. & Lau, K. K. (2012). The dangers of substance abuse in adolescents with chronic kidney disease: A review of the literature. CANNT Journal, 22(1), 15–24. Retrieved from ProQuest.

The Purpose of Assessment Tools

A variety of assessment tools exists that help case management professionals gather the most accurate data about their clients. One such tool is A Pocket Guide for Alcohol Screening and Brief Intervention for Youth. The purpose of this tool is to help gather information about the alcohol use of school students and provide intervention resources. This tool includes a two-step flow-chart for screening school students of different age groups for alcohol use. It recommends specific activities for different risk groups. This tool is a good choice for a professional as it is an all-in-one solution for both screening and interventions.

Another useful tool is Guideline for Alcohol and Substance Use Screening, Brief Intervention, Referral to Treatment. It is a two-page guide that provides questions for a brief alcohol and substance use screening. Also, it includes the exact advice for the health care professional to follow depending on the screening results. The intervention statements included in this tool vary according to the client’s reaction. This guide is compact but very informative and can be used even with clients who are not willing to work on a change, which makes it an excellent resource for a case management professional.

Case Study

The client is an eighteen-years-old male, a high-school student, unemployed, and living with his parents. The client was referred by his parents who report that the client has substance use problems. The client’s parents are worried that the client might face legal charges. The client believes that drugs help him concentrate and uses substances to reduce anxiety.

Guideline for Alcohol and Substance Use Screening, Brief Intervention, Referral to Treatment was used to gather information, and the client falls into the Harmful Use category. The other tool was not applicable because the client has both drug and alcohol use problems. The client reports using different substances to control restlessness and anxiety, which are typical symptoms of ADHD (Wolraich, 2006, p. 87). The goal of the treatment is to eliminate ADHD symptoms and stabilize the substance abuse disorder.

Developing Goals

The client reports symptoms associated with Acute Stress Disorder (ASD), including anxiety, insomnia, and having difficulty concentrating (Kivi, 2015). The client reports recurring thoughts about her son, who is in the military, and fears that he is under threat of serious injury. The client is under stress at work and worried about her daughter’s poor academic performance. The client uses alcohol to calm herself down and believes that she would not be able to fall asleep without it.

The client reports having stomach cramping and pain, which is likely a result of stomach inflammation due to repeated or excessive drinking (Stomach Pain after Drinking Alcohol, 2016, para. 6). The client is likely to suffer from Substance Use Disorder (SUD), and ASD is likely a primary contributor to her alcohol reliance. The treatment should cater to the client’s immediate needs. Short-term goals of the treatment are:

• providing pain relief medication for stomach aches;
• prescribing soporific drugs to improve sleeping behaviors;
• educating the client about alcohol abuse and providing counseling to help the client cope with her current situation.

Mid-term goals are to provide psychotherapy and prescribing medication to reduce the symptoms of ASD and as a result, stabilize SUD. Values that caused the client to seek help, such as the well-being and academic performance of her daughter, can be used to motivate her to overcome ASD and SUD (Summers, 2009, p. 9).

The major barrier to recovery is the fact that the client cannot control what happens to her son. However, in the long-term, the client’s adaptive coping mechanisms can and should be increased. Other long-term goals include managing gastrointestinal problems and coordinating care including working with clinicians. The agencies that provide the necessary services in my area are Samaritan Counseling Center Inc and Alcohol Treatment Centers Montgomery.

References

Kivi, R. (2015). Acute Stress Disorder. Web.

Stomach Pain after Drinking Alcohol. (2016). Web.

Summers, N. (2009). Fundamentals of Case Management Practice, Skills for the Human Services, Fourth edition. Belmont, CA: Brooks/Cole.

Wolraich, M. (2006). Attention-Deficit/Hyperactivity Disorder. Infants & Young Children, 19(2), 86-93. Web.

In any population survey or epidemiological study, the complex nature of drinking behavior also gives rise to problems of measurement. Respondents differ in the types of beverage they drink, the amounts of each beverage they drink on occasions of drinking, and their frequency of drinking. Within individual considerations raise further complications. The same person drinking the same beverage on different occasions may drink different amounts, while in consecutive weeks an individual may undertake different numbers of drinking occasions which may involve the use of different beverages. When assessing the various methods in use to measure alcohol consumption, it is important to bear in mind that in epidemiological research the most important aspect is the classification of respondents by individual levels of consumption (Wilke, 1994). This is necessary to examine the relationship between individual experience of disease and consumption, and, in the population, is essential to the calculation of attributable risk. About 85% of all US residents have had an alcohol-containing drink at least once in their lives and about 51% of US adults are current users of alcohol (Death Statistics for Types of Alcohol Abuse 2005).

A subcategory of cardiovascular mortality which has been linked with alcohol consumption is a hypertensive disease. A recent review of population studies ( MacMahon, 1987) considered 30 cross-sectional studies and noted that the majority of these reported small but significant elevation of blood pressure in consumers of around 35 units per week or more. In 40% of studies, non-drinkers had higher blood pressures than moderate consumers (Death Statistics for Types of Alcohol Abuse 2005). The author concluded that the long-term effects of restriction of alcohol intake as a public health measure to reduce levels of hypertension required further investigation using long-term controlled trials, particularly among moderate consumers. It is clear from experimental work that there is a causal effect of alcohol on blood pressure among subjects with normal blood pressure and that on the restriction of alcohol intake blood pressure rapidly returns to normal (Ammerman, 1999).

Although the relation between alcohol and cerebrovascular disease has been moderately frequently researched, few studies have given adequate attention to quantifying alcohol consumption and estimating the risk at different levels. There seems to be a consensus medical opinion that alcohol is implicated in both ischaemic and hemorrhagic stroke, but the mechanisms may be different in the two cases (Chafetz and Demone 1962). The statistical evidence is only persuasive in the case of hemorrhagic stroke for men at high levels of consumption (Ammerman 1999). For women, few of whom have very high consumption, there is little statistical evidence. At low levels of consumption, there is some evidence that alcohol is associated with a lower risk of stroke as compared with zero consumption. The studies prove an effect of heavy alcohol on cerebral blood flow and indicate that even low alcohol concentrations can produce spasms in isolated arteries, while high concentrations will cause ruptures of blood vessels Alcohol has been shown to affect blood platelet metabolism and function and hence coagulability (Ammerman, 1999). “The effect of alcohol is also likely to be mediated by blood levels of HDL and LDL cholesterol which respectively rise and fall with increasing intake. This may account for the apparent protective effect of low alcohol consumption on non-haemorrhagic strokes” (Chafetz and Demone 1962, p. 65). Reduced coagulability is potentially harmful in hemorrhagic stroke, although it could be of benefit in coronary heart disease.

The most important risk factor for stroke is hypertension and, as seen in the previous section, heavy drinking is known to be a risk factor for hypertension. Even when hypertension is controlled for statistically, heavy drinking remains significantly associated with an increased risk of hemorrhagic stroke; hence other mechanisms are likely to exist. It is noted that strokes among alcoholics seem to be precipitated during the intoxication itself rather than in the withdrawal syndrome (Death Statistics for Types of Alcohol Abuse 2005). Biochemical markers of alcohol intake have been studied has been reported as showing a very high association with stroke. There is also an association between acute alcohol intake and atrial fibrillation which is an established precursor of thromboembolic stroke Altogether, despite quite a large number of studies, the possible mechanisms linking acute alcohol intake with stroke are not well understood, and this is acknowledged in the literature (Chafetz and Demone 1962).

In any attempt to answer the question of how much risk of stroke is alcohol-related, the role of confounding variables must be considered. For example, smoking is generally thought to be a risk factor for stroke, but, as it is highly associated with drinking, estimates of the risk attributable to drinking will vary depending on whether smoking, is or is not adjusted for (Jackson et al 1991). If one adjusts for smoking, the alcohol-relative risk will attempt to estimate the increased risk for a person consuming at a given level compared with a person consuming no alcohol, assuming both smoke the same amount (Death Statistics for Types of Alcohol Abuse 2005). At extreme smoking levels, such a comparison could be rather hypothetical, as it is rare for zero alcohol consumption to be combined with high smoking, or high alcohol with non-smoking. It is also quite likely that for individuals a change in drinking behavior would be accompanied by a change in smoking behavior so that any increased or decreased risk could not be assigned uniquely to one or another factor. In the absence of an understanding of causal mechanisms, there is no unique statistical estimate of the risk attributable to alcohol. If smoking is adjusted for, there is likely to be an underestimation of the true alcohol effect; if it is not adjusted for, overestimation is likely to result (Goodlett et al 1999).

The reason alcohol is filling is that it shares another characteristic of food: Like meat, fruit, or milk, it must go through the process of digestion, or oxidation. The process begins in the stomach, where the stomach muscles start a churning movement not only helps get the digestive fluids secreted by the stomach lining to the food but also gets some of the oxygen in the body to the food. The oxygen combines with the food, burns off its chemical ingredients, and turns it into carbon dioxide and water (Death Statistics for Types of Alcohol Abuse 2005). Most foods are oxidized slowly and in successive stages, first in the stomach and small intestine, allowing the various nutrients in the food to be absorbed slowly into the bloodstream for distribution to the parts of the body where they are needed (Jackson et al 1991). Because of the small size of the ethyl alcohol molecule, alcohol begins to oxidize immediately. It is absorbed into the lining of the stomach and small intestine virtually unchanged in form. Instead of being acted upon by the stomach, it acts on the stomach walls. Large amounts of alcohol over years damage the stomach lining and cause the stomach muscles to lose tone. The liver accepts some more alcohol for oxidation and sends the rest on to the heart again. This process continues until the alcohol is completely oxidized. Meanwhile, alcohol, like actual foods, has reached every part of the body. The difference is that while real foods travel throughout the body in oxidized or digested form, alcohol passes through the various organs in unoxidized form (Kelly and Edwards 1998). While the stomach and liver suffer most from excessive amounts of alcohol, no part of the body is unaffected. One of the first effects a drinker notice is a warm, flushed feeling. This is because the blood vessels in the skin enlarge. Small doses of alcohol cause an increase in blood pressure and an increased heart rate. But this condition does not last long. Alcohol slows down the heart rate, causing less blood to be pumped throughout the system. Thus, alcohol is not beneficial to a very cold person. It is bad for the person because it slows the circulation rather than increases it and lowers the body temperature. In extreme cases, the cardiac nerves are paralyzed, causing instant death. Alcohol abuse contributes to a variety of heart diseases, the primary cause of death nationally. Chronic heavy drinking causes the walls of the blood vessels to thicken, which accounts for the swollen, red appearance of the noses and faces of many alcoholics. This slows down the passage of blood through the vessels and thus hinders the carrying of nutritional materials to the body cells (Wilke, 1994).

In sum, alcohol heavy use can lead to cardiovascular diseases and mortality. Researchers explain the extremely strong inverse relationship with a slight upturn in risk for the heaviest drinkers among the other, initially ill, respondents in terms of self-selection. Those who are most ill and therefore most at risk drink the least — because they are ill. The upturn in risk among the heaviest drinkers in this group is explained as an effect of their consumption. While the data for the initially ill group are also consistent with a protective effect of drinking among men with cardiovascular diagnoses, they maintain that such an interpretation does not accord with information concerning changes in drinking habits.

References

Ammerman, R.T. (1999). Prevention and Societal Impact of Drug and Alcohol Abuse. Mahwah, New Jersey London.

Chafetz, M. E., Demone J. W. Jr. (1962). Alcoholism and Society, Harold W. Oxford University Press.

Death Statistics for Types of Alcohol Abuse. (2005). Web.

Goodlett, Ch. R., Hannigan, J. H., Spear, L. P. (1999). Alcohol and Alcoholism: Effects on Brain and Development, Lawrence Erlbaum Associates.

Jackson R., Scragg R. and Beaglehole R. (1991) “Alcohol consumption and risk of coronary heart disease”, British Medical Journal 303: 211-16.

Kelly, K. J. Edwards, R.W. (1998). Image Advertisements for Alcohol Products: Is Their Appeal Associated with Adolescents’ Intention to Consume Alcohol? Adolescence, 33 (1), p.47-51.

Wilke, D. (1994). Women and Alcoholism: How a Male-as-Norm Bias Affects Research, Assessment, and Treatment. Health and Social Work, 19, p. 29.

Introduction

In many countries of the world alcohol and dug abuse during pregnancy has been one of the major threats to child health and welfare. Although this fact is well known across many social divides, many expectant mothers across the globe still indulge in excessive drinking of alcohol during pregnancy. These women do this without knowledge that their unsuspecting unborn babies can develop a disorder known as fetal alcohol syndrome after birth (Hans-Ludwig, p. 13).

Fetal alcohol syndrome is a disorder which causes lasting birth defects in a newborn baby. It is associated with expectant mothers who overdrink alcohol during pregnancy. Scientists have not yet found out, if the volume of alcohol taken, the frequency of taking, or the time the alcohol is taken during pregnancy, is connected to a variation in the degree of injury done to the unborn baby. Hence it is advised that expectant mothers should completely abstain from the habit of drinking (Elizabeth, p. 8).

Causes of fetal alcohol syndrome

The main cause of fetal alcohol syndrome is the abuse of alcohol during pregnancy by pregnant mothers. When an expectant woman drinks alcohol it easily penetrates the placenta into the fetus body. Any amount of alcohol she drinks potentially exposes the unborn baby to definite risk of contracting fetal alcohol syndrome. Heavy drinking of alcohol can predispose the fetus to the disorder more than small doses of alcohol. The timing of alcohol consumption is also a very vital aspect in preventing the possibilities of an infant developing the disorder, since alcohol consumption in the first three month of pregnancy offers more risk to the infant than the following period of pregnancy. Although drinking alcohol at any other time can still predispose fetal alcohol syndrome. The primary disabilities an infant suffers from after birth as a result of fetal alcohol syndrome is usually caused by the central system damage damages before birth which had resulted from prenatal alcohol exposure. Most commonly the resultant primary disabilities in the newborn babies are usually confused with a child having behavioral problems although the central nervous distortion is the underlying cause of this problem. The functional disabilities which are the main feature in fetal alcoholism syndrome are caused by the central nervous system damages which occur in more than one way. The damage to the CNS by alcohol is still under research to establish the mechanism in which this phenomenon occurs (Hans-Ludwig, p. 3).

Effects of Fetus Alcohol Syndrome on the Born Child

The effects of ethanol on the fetus might be determined by the amount consumed by the pregnant mother and the time during pregnancy the alcohol was consumed. As mentioned earlier the first three month of pregnancy is more crucial as far as this disorder is concerned. The effect of Fetal alcohol syndrome varies from one child to the next, depending on a variety of factors such as, the amount of alcohol consumed by the mother during pregnancy and the physiological condition of the mother and the fetus before birth. One of the effects of Fetal alcohol syndrome includes development of a characteristic facial appearance, which always consists of small upturned nose, sagging eyelids, emaciated upper lip, inflamed forehead and thin chin. The children having this syndrome are usually characteristically thin and short in stature.

Babies suffering from fetal alcohol syndrome normally develop physical difficulties and deformities such as hearing difficulties, dental disfiguration, coronary problems, kidney problems, muscles and joint problems. There is also a manifestation of central nervous system problems such as affecting the cognitive and adaptive function ability of a child.

Conclusion

Fetal alcohol syndrome is one of the major causes of psychological retardation in children in the modern world. Hence sensitization and education of pregnant women about the cause, effects and prevention of fetal alcohol syndrome is imperative.

Work Cited

1. Hans-Ludwig Spohr, Hans-Christoph, Alcohol: Pregnancy and the Developing Child, Cambridge University Press, 1996.
2. Elizabeth M. A., Pregnancy Risk: Fetal Alcohol Syndrome and the Diagnosis of Moral Disorder, JHU Press, 2003.

Cohen, K., Weizman, A., & Weinstein, A. (2019). Modulatory effects of cannabinoids on brain neurotransmission. European Journal of Neuroscience, 50(3), 2322-2345.

The authors have presented a comprehensive review of the effects of cannabis on the human brain. Specifically, Cohen et al. (2019) present current literature on the impacts of cannabinoids the neurotransmission on the brain. Evidence from human studies and pre-clinical studies have dominated their discussion. The basic idea presented is that cannabis psychoactive composites, which is also the case with marijuana-like drugs with synthetic cannabinoids. Clinical and pre-clinical data from the studies explored have focused majorly on cannabinoid type-1 and type receptors, which have been denoted as CB₁ and BC₂ respectively. Cohen et al. (2019) express that pre-clinical studies exploring the effects of cannabinoids on dopamine neurotransmission find that acute stimulation of CB₁ tends to indirectly induce the mesolimbic dopaminergic activity. Additionally, there is an increased release of dopamine in the striatal regions. Human studies on the same subject reveal that Delta-9-tetrahydrocannabinol (Δ9-THC), which is the main substance in cannabis, tends to cause higher risks of psychotic disorders. Another aspect of mental health is receptor availability where the authors reveal that heavy use of the drug causes a decrease in the striatal dopamine receptor occupancy.

It can be seen that this review approaches the link between drug use and mental health from a physiological perspective where the physical and chemical properties of the drug users’ brains are explored. In addition to the neurotransmission and receptor availability, Cohen et al. (2019) discuss the availability of dopamine transporter (DAT) and serotonin neurotransmissions. However, the authors find that only a limited number of studies focus on the DAT, which means that the validity of the findings cannot be established. Regarding the serotonergic system, the authors find that serotonin (5-HT) plays a major role in mental functions, especially in regulating and controlling cognition, perception, anxiety, and mood. Therefore, evidence from pre-clinical studies indicates that the activation of CB₁ receptors causes a decrease in the release of 5-HT. In human studies, the effects of cannabinoids on the 5-HT system have also been documented where such psychopathologies as anxiety, depression, Alzheimer’s disease, and schizophrenia have been linked with the consumption of cannabis. Similar effects are also observed in other brain functions, including glutamate neurotransmission, Gamma-Aminobutyric Acid (GABA), and the cholinergic system where both pre-clinical and human are explored. Overall, there are multiple themes explored in this review of how cannabinoids affect the human brain. The authors have been comprehensive, which means that the conclusion that cannabis consumption causes mental health issues is well-evidenced and justified. Additionally, they offer clinical implications for the data examined, including the fact that cannabinoids cause mental health issues. However, the authors also notice that most of the scholarly work referenced comprises of pre-clinical studies, either in vitro or in vivo. The main issue with such studies is that they tend to use multiple methods and tools, which means that they have high variability and inconsistencies in the results.

Lowe, D., Sasiadek, J., Coles, A., & George, T. (2019). Cannabis and mental illness: A review. European Archives of Psychiatry and Clinical Neuroscience, 269(1), 107-120.

The authors also present a review on the subject of cannabis use and its effect on mental illness. Lowe et al. (2019) express that the main concern is the fact that many western countries are on the course to legalize marijuana, which will adversely affect vulnerable populations. There is a need to understand the key consequences of the use of this drug before the masses can be allowed to use it. Some key statistics have been used to support the concerns regarding the legalization. For example, Lowe et al. (2019) establish that the consumption rates in Canada in 2017 had reached 43% for people between 16 and 24 years. Additionally, the rates for individuals above 25 years were estimated at 18%, which indicates a trend of rising cannabis use among young people. The major observation made by Lowe et al. (2019) is that such mental illnesses as moods, schizophrenia, and anxiety disorders are common among cannabis users. The review of the impacts of cannabis has been presented in terms of mental illnesses addressed as separate themes, and additional sections regarding the conceptualization of key constructs. First, the authors have explored the link between cannabis and schizophrenia where they find that the drug is a major cause of psychotic illness. Estimates indicate that one in four persons diagnosed with cannabis use disorder (CUD) will develop a psychotic illness. The key substance in cannabis associated with this mental issue is Tetrahydrocannabinol (THC), where half of the heavy cannabis users are likely to develop psychosis.

Second, major depressive disorder and bipolar disorder (MDD and BD respectively) are also shown to be key outcomes for marijuana consumption. The main source of evidence used by Lowe et al. (2019) is a 40-year research comprising a cohort of 400 people across diverse points in time. The key results indicated that the use of cannabis was correlated with high risks of MDD and BD. Other mental illnesses explored are anxiety disorders and posttraumatic stress disorders (PTSD), all of which have been positively associated with the consumption of cannabis. In addition to the mental illnesses, Lowe et al. (2019) also offered a critique of the methodologies used in the current literature on the subject. The first issue is that cannabis tends to cause more physical harms and long-term illnesses that should not be overlooked. Even though the focus was on mental illness, the scholars examine the contradictory constructs of the self-medication hypothesis and addiction vulnerability. The argument is that people use cannabis for self-medication, especially to cope with mental illnesses, despite research showing that CUD causes mental illnesses. Lastly, societal implications of the legalization of marijuana have been highlighted, especially THC’s impacts. Most importantly, issues of policymaking and public education were discussed. Essentially, these issues are the result of misperceptions of cannabis as ‘only good’ or ‘only bad’ where people fail to acknowledge both sides of the impacts. Additionally, the fact that cannabis is perceived as an alternative medicine is a major concern, which dictates that the public should be well-educated on the matters of using marijuana.

Wlodarczyk, O., Schwarze, M., Rumpf, H.-J., Metzner, F., & Pawils, S. (2017). Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review. PLoS One, 12(6), 1-15.

The scholars have presented a systematic review of mental health factors affecting children whose parents have drug and alcohol use disorders. A deviation from the above two articles has been made in the sense that the focus is not on the users themselves, but on the children. This deviation can be seen as an opportunity to explore the indirect links between drug use and mental health. Wlodarczyk et al. (2017) explain that drug-using parents expose their children to environments of severe stress, which potentially increases the risks of psychological and social problems. However, the scholars have indicated that there lacks epidemiological data in this regard, which means that only estimations are possible. As a systematic review, the scholars describe the materials and methods, including a search strategy in the form of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The selected studies had to pass a quality evaluation using a mixed-methods Appraisal Tool (MMAT) checklist. Cross-sectional studies had to pass additional tests that classified them as low, medium, and high quality. Lastly, a narrative analysis was used as the method for the synthesis of the results.

The systematic review yielded 3,402 articles where 11 of them published between 2003 and 2013 met the criteria. From these articles, a total population of children affected by drug-using parents was 1,376 whose ages ranged between 1 and 20 years. Wlodarczyk et al. (2017) noticed a consistency in the findings establishing that mental health of children was affected by the parent-child attachment where the parents abused drugs. The results discussed included the outcomes of the selection of the materials and the major observation However, the main focus should be on the links between drug use and mental health for children with drug-abusing parents. In this regard, Wlodarczyk et al. (2017) confirmed their hypothesis that the home environment in which children are brought up affects their mental wellbeing. The key construct in this discussion is the parent-child attachment and how it is affected by drug use. In many cases, children have been found to develop coping mechanisms to deal with any implications. Even with drug-abusing parents, the parent-child attachment was observed to be persistent unless the children displayed such behavioral characteristics as highly impulsive personality.

Evaluation of the Need for Additional Research

The article by McCarty, Roman, Sorensen, and Weisner (2009) focuses on the issues related to health services research in the context of alcohol and drug abuse. According to the authors, health services research is a multidisciplinary field, which includes problems of organizing, managing, financing, and delivering high-quality care (McCarty et al., 2009). It is stated that patient information systems supported the research of treatment processes and outcomes performed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Institute of Drug Abuse (NIDA) (McCarty et al., 2009). The history of the development of these institutions is discussed in the article; however, the primary scope of the paper is the observation of future perspectives in the sphere of health services research. Therefore, it is essential to overview the author’s perspectives on this issue in order to evaluate the significance of addiction research in the area of substance abuse prevention.

McCarty et al. (2009) identify the following areas of concern: “research on the quality of care, adoption, and use of evidence-based practices (including medication), financing reforms, and integration of substance abuse treatment with primary care and mental health services” (p. 197). However, it is of high importance to mention that there is a considerable need for addiction research in the area of prevention of substance abuse. It is appropriate to mention that among six categories, which are identified in order to regulate the investigation in health services research, there are three categories that concur with the purpose of addiction research: (1) effectiveness and outcomes, (2) organization and management, and (3) methodology (McCarty et al., 2009). Thus, the need for efficient addiction research is evaluated as highly significant.

Critical Analysis of the Research Methodology

Further, it is essential to critically analyze the research methodology of the article by McCarty et al. (2009). It should be stated that the piece of writing under discussion does not represent the work of the highest academic quality. As the authors point out, the primary purpose of their article is to give a historical overview of the development of health services research in the context of substance abuse treatment. The authors did not use any solid research methodology since their work is vastly based on a descriptive literature review. Also, a considerable part of the article is dedicated to the author’s personal reflections on their experience in the area of concern. Accordingly, no research questions or hypotheses are proposed to guide the development of the authors’ work. However, it should be noted that the author’s conclusions based on their experience are still valuable as the opinions of professional healthcare system researchers.

Comparing the article under discussion with the research by Thomas, Allen, Phillips, and Karantzas (2011), it is not difficult to identify strengths and weaknesses of the work by McCarty et al. (2009). The article by Thomas et al. (2011) is organized according to high scientifical standards: it is based on solid quantitative methods, the results are reliable, and the authors profoundly elaborate on the topic of gaming addiction and its prevention. Another example of well-written research on the topic of substance abuse and its prevention is the article by Volkow, Koob, and McLellan (2016). Therefore, it is appropriate to notice that the study by McCarty et al. (2009) has numerous significant weaknesses, which were mentioned in the previous paragraph. Among the study’s strengths, it could be suggested that the authors provided an elaborated historical overview of the question as well as their experience in the area of concern.

References

McCarty, D., Roman, P. M., Sorensen, J. L., & Weisner, C. (2009). Health services research for drug and alcohol treatment and prevention. Journal of drug issues, 39(1), 197-208.

Thomas, A. C., Allen, F. L., Phillips, J., & Karantzas, G. (2011). Gaming machine addiction: The role of avoidance, accessibility and social support. Psychology of Addictive Behaviors, 25(4), 738-744.

Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363-371.

Fetal alcohol syndrome (FAS) is a condition affecting newborns whose mothers consumed alcohol during pregnancy. Studies have shown that the issue may affect both psychical appearance and mental health. The problem impairs which biological functions, as Williams, Smith, and Committee on Substance Abuse (2015) describe it, “exposure to alcohol can damage the developing fetus” (p. 1395).

Neurodevelopmental disabilities are often linked to FAS, with scientists developing diagnostics criteria and prevention programs to counteract the issue. However, according to Williams et al. (2015), the problems connected to mental health caused by FAS remain in place throughout the life of a patient. Early diagnostics and therapy can help improve some of the common symptoms, and thus better quality of life for an individual.

Additionally, the studies on FAS revealed that no amount of alcohol during pregnancy could be justified. Williams et al. (2015) state that “no amount of alcohol intake should be considered safe” (p. 1396). Additionally, the researchers identified that there is no period during pregnancy, in which exposure to alcohol would not affect a fetus. Nor is there a particular type of alcohol that can be considered safe in regards to FAS.

Moreover, FAS is only one issue that can be caused by alcohol consumption during pregnancy. Other problems include partial fetal alcohol syndrome, alcohol-related congenital disabilities, and neurological effects. Popova et al. (2016) state that many comorbidities are associated with FAS; thus Ms. D. should be further examined to determine the scope of issues. The author’s study revealed that psychological consequences include dependence syndrome and psychoactive substance abuse. Thus, it is evident that substance consumption in any period of pregnancy impairs the biological development of a fetus. This aspect affects the mental and psychical health of an individual.

As was previously mentioned, FAS affects an individual throughout a lifetime and can not be adequately treated. However, therapy can help improve some of the coping skills and mechanisms that would help Ms. D take care of herself and her newborn son. Williams et al. (2015) state that “psychological and vocational outcomes through longitudinal intervention and treatment that maximize protective factors and build capacity in identified strengths” (p. 1399).

Social support and education are among the crucial aspects of such interventions. Neuroleptic medication can help improve a patient’s symptoms as well. According to the case assessment, Ms. D. has excellent social support, which should be used as part of the treatment strategy.

Further mental health assessment is required to identify other possible mental health issues that Ms. D may have. For instance, Murawski, Moore, Thomas, and Riley (2015) state that other problems such as attention deficit disorder (ADHD) co-occur in 50% of FAS cases. The authors suggest treating comorbid conditions using conventional approaches to an illness intervention, which may include medication and therapy. However, Williams et al. (2015) state that in some cases, stimulants can worsen the symptoms of patients; thus, the prescription should be closely monitored to reduce adverse effects.

A focus on educational strategies should help Ms. D. adjust her daily life activities. Pruett, Wateman, and Caughey (2013) substantiate the approach of Murawski et al. (2015) by suggesting diagnosing other conditions and approaching treatment through pharmacology and cognitive behavioral therapy. Additionally, they state that education regarding parenting and substance abuse dangers can be beneficial for FAS patients as those would improve their understanding of the existing problems.

References

Murawski, N. J., Moore, E. M., Thomas, J. D., & Riley, E. D. (2015). Advances in diagnosis and treatment of fetal alcohol spectrum disorders: From animal models to human studies. Alcohol Research, 37(1), 97-108. Web.

Popova, S., Lange, S., Shield, K., Mihic, A., Chudley, A. E., Mukherjee, R. A., … Rehm, J. (2016). Comorbidity of fetal alcohol spectrum disorder: A systematic review and meta-analysis. The Lancet, 387(10022), 978-987. Web.

Pruett, D., Wateman, E. H, & Caughey, A. B. (2013). Fetal alcohol exposure: Consequences, diagnosis, and treatment. Obstetrical & Gynecological Survey, 68(1), 62-69. Web.

Williams, J. F., Smith, V. C., Committee on Substance Abuse. (2015). Fetal alcohol spectrum disorders. Pediatrics, 136(5), 1395-1406. Web.

Introduction

Alcohol consumption among pregnant women of Canada is a rather common situation that causes plenty of problems as both maternal and infant health outcomes to depend on a woman. The issue remains controversial and legal due to its connection to women’s rights that are to be respected by law. Nonetheless, consumption of alcohol in the mentioned period of life may lead to severe birth defects and deviation in an infant’s development, including physical and psychological impacts. In this regard, maternal alcohol consumption is to be recognized as illegal as it violates the rights of an infant by hurting his or her health.

The rationale for Support of Unlawful Alcohol Consumption During Pregnancy

At present, essential clinical and experimental material was accumulated on the effect of alcohol on pregnant women and their fetuses. It was revealed that consumption of alcohol by a woman before and during pregnancy leads to pregnancy toxicosis, miscarriages, premature birth, intrauterine malformations, and fetal weight deficit. In their article, Liu et al. argue that ethanol causes a dehydrated depletion in a fetus, impeding embryonic development due to the affection of chemical substances, which significantly increase the severity of the inhibited anomalies and pathology (382). Focusing on longitudinal latent class analysis, the authors revealed that mothers aged 26 are more susceptible to binge drinking compared to those who are younger.

Even irregular and seemingly moderate consumption of alcoholic beverages by a pregnant woman can contribute to the development of long-term changes in the brain of a fetus, the damage from which may not be immediately noticeable. Getting into the blood, alcohol, first of all, affects the cardiovascular system and liver, disrupting the development of brain formations that determine mental activity (Mateja et al. 32). Most importantly, binge drinking considerably increases congenital cardiac defect risks.

The study by Singal et al. presents a population-based cohort study of Manitoba mothers and issues regarding fetal alcohol spectrum disorder (FASD) (2). In particular, the article uncovers the consequences of FASD as well as the health and social service received by mothers whose children were diagnosed with this disease. The findings illustrate potential strategies to treat FASD the most valuable of which is prevention through the increased awareness of women.

Supporting the assumption to make maternal alcohol consumption illegal in Canada, it is appropriate to review corresponding articles that are associated with health and women’s rights. For instance, Gordon reckons that in some cases, involuntary treatment along with detention of enceinte women can be beneficial to protect a fetus from potential harm (184). Elaborating on the theme in the context of the utilitarian critical framework, the scholar assumes that the mentioned interventions should be accepted by law, thus making consumption of alcohol illegal for pregnant women.

In their turn, Uberoi and de Bruyn also consider the theme of women’s rights associated with compulsory treatment or other means of control (169). However, it is emphasized that a sensitive and individual approach is to be utilized to ensure fundamental human rights. For instance, Uberoi and de Bruyn pinpoint the case of the woman who “confided to a nurse her doubts about carrying the pregnancy to term but said she had ultimately decided to keep the baby” (166). From the above example, it becomes evident that confidentially terms were deliberately violated.

Conclusion

To conclude, it is essential to emphasize that the researchers provide critical information regarding the specified theme. They illustrate that alcohol can make significant physical and mental harm to both fetus and a woman. With this in mind, maternal consumption of alcohol during pregnancy should be unlawful in Canada.

Works Cited

Gordon, E. “State Intervention in Pregnancy: Should the Law Respond Thus to the Problem of Fetal Alcohol Spectrum Disorder?” The Journal of Law, Medicine & Ethics, vol. 23, no. 1, 2015, pp. 156–188.

Liu, Weiwei, et al. “Maternal Alcohol Consumption During the Perinatal and Early Parenting Period: A Longitudinal Analysis.” Maternal and Child Health Journal, vol. 20, no. 2, 2015, pp. 376–385.

Mateja, Walter A., et al. “The Association Between Maternal Alcohol Use and Smoking in Early Pregnancy and Congenital Cardiac Defects.” Journal of Women’s Health, vol. 21, no. 1, 2012, pp. 26–34.

Singal, Deepa, et al. “Manitoba Mothers and Fetal Alcohol Spectrum Disorders Study (Mbmomsfasd): Protocol For a Population-Based Cohort Study Using Linked Administrative Data.” BMJ Open, vol. 6, no. 9, 2016, pp. 1–20.

Uberoi, Diya, and Maria de Bruyn. “Human Rights Versus Legal Control Over Women’s Reproductive Self-Determination.” Health and Human Rights, vol. 15, no. 1, 2013, pp. 161–174.