Alcohol and Drug Use, Abuse and Dependence

Alcohol containing beverages are frequently considered one of life’s pleasures, and there are now some studies which support that small doses of alcohol can have health benefits. In a similar vein, drugs delivered in the context of medical need, taken as prescribed, contribute to the common good.  

 

In contrast, the use of alcohol and/or drugs can have very negative consequences as well.  We do not yet understand a great deal about what causes someone to go from acceptable and appropriate use to abuse and or dependence.  However, abuse and dependence are fairly common among both Americans and Canadians.  

 

For example, both the United States and Canada have research organizations funded by the government to study the problems of abuse and dependence.  These agencies have developed estimates of the rate of drinking and drug use in the US and Canada.  

 

For instance:

■ 54.9% of US adults report at least one alcoholic beverage per month.

■ 1 in 3 adult drinkers report past-month binge drinking, where a binge is defined as 5 or more drinks in one drinking occasion.

■ Binge drinkers are 14 times more likely to drink and drive than non-binge drinkers.

■ Heavy drinking (daily drinking of more than one drink per day for women and two drinks per day for men) is reported for approximately 6% of US citizens. Prevalence is higher for men (7.1%) than women (4.5%).

■ About 4% of the US population meets criteria for alcohol dependence in the last year. In Canada, about 4% of men and 2% of women meet alcohol or drug dependence criteria (CCHS, 2003).

When we look specifically at alcohol use among firefighters, we see that:

■ Studies of firefighters demonstrate that 29% of active duty fire fighters have possible or probable problems with alcohol use (Boxer and Wild, 1993).

■ 50% of the firefighters surveyed in Oklahoma City had a prior history of alcohol problems (North, 2002).

 

Defining the problem:

Alcohol and drug users frequently have a difficult time knowing if their use has crossed over the line into a health risk behavior.  Therefore, the following definitions may be useful:

Heavy drinking is defined as daily drinking of more than one alcohol containing beverage for women and more than two alcohol beverages for men.

 

Alcohol Abuse is defined as an unhealthy pattern of use with one or more of the following occurring within a 12-month period:

 

Alcohol dependence requires having three or more of the following symptoms in the past year (DSM-IV, 1994):

 

Definitions for problematic drug use include:

 

Drug dependence - defined as having three or more of the following symptoms in the past year (DSM-IV, 1994):

 

 

The consequences of alcohol and drug misuse can be extremely costly and painful.   The following statistics illustrate these costs.

 

 

As the list of consequences show, alcohol and drug abuse are not problems that are confined to the user; in fact, the people most effected by alcohol and drug problems may be those close to, or dependent on, the user (e.g., family, friends and coworkers).  Thus, people who have crossed over into health risk from their alcohol and or drug misuse should know that lots of help is available, and the variety of effective help is increasing every year.

Firefighters who want to learn more about the types of help available can find excellent web resources at the National Institute of Health (www.nih.gov; www.nida.nih.gov; www.niaaa.nih.gov)

 

Recovering from alcohol and drug abuse problems can be done in many ways and in many venues.  Research shows that most of the community-based self-help programs such as Alcoholics Anonymous or Narcotics Anonymous are helpful for a substantial group of people.  Some people trying to change their alcohol or drug problems may require medical supervision for detoxification. Others can recover through setting a good behavioral plan with a mental health provider.  Still others benefit from inpatient treatment.  A growing number of medications seem to aid people in staying abstinent and/or controlling urges to use.   For some, a comprehensive plan is necessary in which all or some of the preceding interventions are employed.

 

When alcohol and drugs impair a firefighter or someone he cares about, the ripple effects can be far-reaching. The IAFF stands firmly behind those in recovery from this problem, and encourages the use of local EAP representatives to facilitate treatment.

 

In summary, firefighters who have alcohol and/or drug problems or who may have friends or family with alcohol and drug problems can access the following services:

 

Web based information for AA or EAP.

 

Full resumption of family, work and social life is the reward that awaits those who successfully resolve alcohol and or drug problems.