3.3 Substance Use and Abuse

Learning Objectives

  1. Define the terms “substance,” “abuse,” and “addictive.”
  2. Describe physical and mental effects associated with smoking and frequent or heavy drinking.
  3. List the risks of using illicit drugs.
  4. Know how to get help if you have a substance use habit to break.

“Substance” is the word health professionals use for most things you might take into your body besides food. When people talk about substances, they often mean drugs—but alcohol and nicotine are also drugs and are considered substances.

Substances—any kind of drug—have effects on the body and mind. People use these substances for their effects. But many substances have negative effects, including being physically or psychologically addictive. Be aware of any substance’s effects on your health and on your life as a student, and make smart choices.

Smoking and Tobacco

Why Start, and Why Is It So Hard to Stop?

Everyone knows smoking is harmful to one’s health, and that smoking causes cancer and lung and heart disease. Most adult smokers continue smoking not because they really think it won’t harm them but because it’s very difficult to stop.

Many young smokers think there is plenty of time to quit later. Social smokers, who may have a cigarette only occasionally with a friend, usually think they won’t develop a habit. But nicotine is a very addictive drug.

Here is some good news: stopping smoking brings immediate health benefits, and the benefits get better over time. Just twenty minutes after quitting, your heart rate drops. After two weeks to three months, your heart attack risk begins to drop and your lung function begins to improve. After one year, your added risk of coronary heart disease is half that of a smoker’s. And every year your health continues to improve[1].

Tips for Stopping Smoking

Stopping isn’t easy. Many ex-smokers say it was the hardest thing they ever did.

However, you know it’s worth the effort. And it’s easier if you think it through and make a good plan. There’s lots of help available. Before you quit, the National Cancer Institute suggests you START with these five important steps[2]:

  1. S = Set a quit date.
  2. T = Tell family, friends, and coworkers that you plan to quit.
  3. A = Anticipate and plan for the challenges you’ll face while quitting.
  4. R = Remove cigarettes and other tobacco products from your home, car, and work.
  5. T = Talk to your doctor about getting help to quit.

To get ready, download this booklet to help you quit smoking; “On the road to Quitting‘, published by Health Canada.

A lot of people are not able to stop smoking by themselves, so don’t feel bad if you aren’t successful the first try. Ask your doctor about other ways to stop. Maybe nicotine-replacement therapy is what you need. Maybe you need prescription medication. Stop by the Student Health Services at the University of Saskatchewan and learn about smoking cessation programs. Your doctor and other health professionals at your school have a lot of experience helping people—they can help you find what works for you.

What’s the Big Deal about Alcohol?

Figure 3-4: Source: https://www.flickr.com/photos/51845556@N00/2528634692/ Permission: CC BY-ND 2.0

Drinking, and binge drinking, have been normalized as part of university life. But don’t assume that everyone in university is drinking and partying like they do in the movies!  Most university students report drinking at least some alcohol at some point in time—and even those who do not drink are often affected by others who do. A report university students in Canada, with data from collected from 32 universities every two years between 2008 and 2016, shows an interesting contrast in the perception of how much their peers are drinking versus how much they were actually drinking: students assumed that only 3.5 percent of students had never used alcohol, but the true number was close to 16 percent; they also assumed that 43 percent of students had used alcohol within the last 10-29 days, but only 13 percent had (American College Health Association National College Health Assessment II, Canadian Reference Group).

Like everything else that affects your health and happiness—eating, exercise, use of other substances—drinking is a matter of personal choice. Like most decisions we all face, there are trade-offs. The most that anyone can reasonably ask of you is to be smart in your decisions. That means understanding the effects of alcohol and deciding to take control.

Students at the University of Saskatchewan have put themselves on the map when it comes to alcohol awareness.  What’s Your Cap? is a student-made web resource that seeks to “raise awareness and knowledge of the risks involved with the over consumption of alcohol and promote a culture of moderation on the University of Saskatchewan campus.”

The goal of this resource is not to preach against drinking. You’ll be able to learn more about the effects of alcohol on the body and mind. You’ll learn about responsible drinking versus high-risk drinking. You’ll be able to access resources that will help you think about your own attitudes and learn coping strategies to help prevent or manage a problem.

What's Your Cap? – Know when to put a lid on drinking.
Figure 3-5: The What’s Your Cap? website includes survey results from U of S students, sharing how much they actually drink. Source: http://www.whatsurcap.ca/about-us/our-supporters/ Permission: University of Saskatchewan.

How Much Alcohol Is Too Much?

There’s no magic number for how many drinks a person can have and how often. If you’re of legal drinking age, you may not experience any problems if you have one or two drinks from time to time. According to Health Canada, ‘heavy drinking’ occurs when a man consumes 5 or more drinks, or a woman consumes 4 or more drinks, per occasion, at least once a month during the past year[3].

As with most factors affecting your health and your well-being as a student, what’s important is being honest with yourself. You’re likely drinking too much or too often if

  • you have missed classes or work because you were hung over or overslept after drinking;
  • your friends or family members have hinted that you drink too much, or you’ve hidden your drinking from others;
  • your drinking is causing trouble in a relationship;
  • you can’t remember what you did or said while drinking;
  • you need to drink to have a good time at a party or with friends;
  • you’ve driven a car when you know you shouldn’t have after drinking;
  • you binge drink (consume five or more drinks at a time).

Visit Student Health Services or talk with your university counselor if you need help. They understand how you feel and have a lot of experience with students feeling the same way.

Safer Drinking

If you think you may be drinking too much, then you probably are. Can you stop—or drink moderately if you are of age—and still have fun with your friends? Of course. Here are some tips for enjoying yourself in social situations when others are drinking:

  • Have a buddy with whom you agree to watch an encourage one another.
  • Drink only moderately (if above legal age) and slowly. Your body processes alcohol at a rate of about one drink an hour—drinking faster than that leads to problems. Sip slowly. Set yourself a limit and stick to it.
  • Avoid drinking games.
  • Drink a mixer without the alcohol. It tastes just as good or better.
  • Alternate alcoholic drinks with nonalcoholic ones to slow down the pace.
  • Rather than just standing around with others who are drinking, stay active: move about and mingle with different people, dance, and so on.

Because drinking is a serious issue in many places, it’s a good idea to know what to do if you find yourself with a friend who has had too much to drink:

  • If they pass out after drinking a great deal of alcohol fast and cannot be awakened, get urgent medical help.
  • Stay with the person if there is any risk that they can hurt themselves (driving, biking) or pass out. Take away their keys if necessary.
  • An intoxicated person who falls asleep or passes out on their back is at risk of choking on vomit—roll them on their side or face down.
  • Do not try to give him food or other substances in an effort to sober him up.
  • Don’t put them in a cold shower, which could cause unconsciousness.

A Note on Marijuana

Times have changed since the 1980’s War on Drugs and the ensuing extreme levels of incarceration, which particularly affected specific racial and socio-economic groups. While it’s considered one of the least dangerous illicit drugs, marijuana is a particularly risky for young people, up to age 24, as their brains are still rapidly developing. Chronic use is also associated with cognitive problems (thinking, remembering, and paying attention), and “might also increase the risk of psychosis, depression and anxiety” (Canadian Centre on Substance Abuse and Addiction). Canadian university students assume that only 8 percent of all students have never used marijuana, but close to 60 percent of all students had never used it (American College Health Association National College Health Assessment II, Canadian Reference Group).

Prescription and Illegal Drugs

While alcohol is a legal drug for those above the drinking age, most other drugs—including the use of many prescription drugs not prescribed for the person taking them—are illegal. They usually involve more serious legal consequences if the user is caught. Some people may feel there’s safety in numbers: if a lot of people are using a drug, or drinking, then how can it be too bad? But other drugs carry the same risks as alcohol for health problems, a risk of death or injury, and a serious impact on your ability to do well as a student.

While society may seem to condone drinking, and the laws regarding underage drinking or being drunk in public may not seem too harsh, the legal reality of being caught with an illegal drug can impact the rest of your life. Arrest and conviction may result in being expelled from university—even with a first offense. A conviction is a permanent legal record that can keep you from getting the career you wanted.

Although the effects of different drugs vary widely, a single use of a drug can have serious effects and consequences. Even if you’re told that a pill is a prescription medication whose effects are mild or safe, can you really be sure of the exact ingredients and strength of that pill? Do you fully understand how it can affect you with repeated use? Can it be addictive? Could it show up on an unexpected random drug test at work?

Any street drug can be laced and cut with other substances, and this has been particularly worrying in the last few years with deaths from fentanyl overdoses. A 2016 Health Canada data shows that fentanyl was found in thousands of street drug samples, reportedly a huge increase from the year before.

If you need help with drug abuse, don’t hesitate to get help:

Table 3.1 “Common Prescription and Illegal Drugs on Campuses” lists some of the possible effects of drugs used by university students. Good decisions also involve being honest with oneself. Why do I use (or am thinking about using) this drug? Am I trying to escape some aspect of my life (stress, a bad job, a boring class)? Could the effects of using this drug be worse than what I’m trying to escape?

Table 3.1 Common Prescription and Illegal Drugs on Campuses[4]

Drug and Common Names Intended Effects Adverse Effects Common Overdose Effects
Anabolic Steroids Muscle development Liver cancer, sterility, masculine traits in women and feminine traits in men, aggression, depression, mood swings —
Barbiturates Reduced anxiety, feelings of well-being, lowered inhibitions Addiction; slowed pulse and breathing; lowered blood pressure; poor concentration; fatigue; confusion; impaired coordination, memory, and judgment Coma, respiratory arrest, death
Prescription Opioids: OxyContin, Vicodin, Demerol Pain relief, euphoria Addiction, nausea, constipation, confusion, sedation, respiratory depression Respiratory arrest, unconsciousness, coma, death
Heroin Pain relief, anxiety reduction Addiction, slurred speech, impaired vision, respiratory depression Respiratory failure, coma, death
Morphine Pain relief, euphoria Addiction, drowsiness, nausea, constipation, confusion, sedation, respiratory depression Respiratory arrest, unconsciousness, coma, death
Abuse of Ritalin Stimulant: mood elevation, increased feelings of energy Fever, severe headaches, paranoia, excessive repetition of movements and meaningless tasks, tremors, muscle twitching Confusion, seizures, aggressiveness, hallucinations
Amphetamines: Dexedrine, Benzedrine, methamphetamine Stimulant: mood elevation, increased feelings of energy Addiction, irritability, anxiety, increased blood pressure, paranoia, psychosis, depression, aggression, convulsions, dizziness, sleeplessness Convulsions, death
Cocaine, Crack Stimulant: mood elevation, increased feelings of energy Addiction, paranoia, hallucinations, aggression, insomnia, and depression, elevated blood pressure and heart rate, increased respiratory rate, insomnia, anxiety, restlessness, irritability Seizures, heart attack, death
Ecstasy Stimulant: mood elevation Panic, anxiety, depression, paranoia, nausea, blurred vision, increased heart rate, hallucinations, fainting, chills, sleep problems Seizures, vomiting, heart attack, death
Marijuana, Hash Euphoria Impaired or reduced comprehension, altered sense of time; reduced ability to perform tasks requiring concentration and coordination; paranoia; intense anxiety attacks; impairments in learning, memory, perception, and judgment; difficulty speaking, listening effectively, thinking, retaining knowledge, problem solving __
LSD Hallucinogen: altered states of perception and feeling Elevated blood pressure, sleeplessness, tremors, chronic recurring hallucinations (flashbacks) __
  1. Health Canada. (2012). On the road to Quitting - Guide to becoming a non-smoker. Retrieved from: http://healthycanadians.gc.ca/publications/healthy-living-vie-saine/non-smoker-adult-non-fumeur-adulte/index-eng.php ↵
  2. National Cancer Institute. (2008). Clearing the Air: Quit Smoking Today. Retrieved from: https://smokefree.gov/sites/default/files/pdf/clearing-the-air-accessible.pdf ↵
  3. Statistics Canada. (2015). Heavy Drinking, 2013. Retrieved from: http://www.statcan.gc.ca/pub/82-625-x/2014001/article/14019-eng.htm#n1 ↵
  4. Centers for Disease Control and Prevention. (2016). Common Prescription and Illegal Drugs on Campuses. Retrieved from: http://www.cdc.gov/DataStatistics/ ↵

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