Health Consequences of Alcohol and Other Drug Use

for Students, Faculty, and Staff at California State University, Chico

Although the behavioral, interpersonal, and social consequences of the use of alcohol or other drugs can be quite similar, the physiological and psychological responses differ according to the classification of the chemical ingested. Adverse health reactions can result from both abusive and moderate use of any classification. While chronic health problems are often associated with long-term misuse and abuse, acute and traumatic instances can occur from one-time and moderate use. Such negative results are as dependent upon the circumstances of the use as they are upon whether the user is addicted or alcoholic.

As a summary of the health implications of alcohol or other drug use, this document will look at five classifications. Alcohol, as society’s most abused drug, is the first classification, followed by other depressant drugs, stimulants, marijuana, and hallucinogens. This document is descriptive in nature and should not be used to diagnose either individuals or the results of alcohol or other drug use. A variety of resources were used to compile this information, most significantly the third edition of Drug and Alcohol Abuse by Marc A. Schuckit, M.D.

Alcohol

An estimated 18 million adults in the United States have significant alcohol-related problems. Ten percent of adults, twenty percent of men and ten percent of women, can be classified as heavy drinkers. That is, they consume an average of two or more drinks per day. Combined with the more moderate drinking of another 60 percent of the population, the consumption of alcohol in this country contributes to some astounding statistics: The U.S. Surgeon General estimates that alcohol is involved in 200,000 deaths in this country per year, ten percent of the U.S. annual mortality. The National Institute on Drug Abuse estimates that 100,000 deaths per year can be attributed directly to alcohol. There are more than one million annual alcohol-related hospital discharges in this country. Half of all traffic crash deaths are alcohol related.

Adults, of course, are not the only ones who suffer from the effects of alcohol consumption. Driving under the influence is the number one killer of American teenagers. Maternal consumption results in a variety of alcohol-related birth defects in 4,000 California newborns each year, in 36,000 children nationwide.

Virtually all body systems are affected by the long-term abuse of alcohol. Such consumption results in ulcer disease, gastritis, pancreatitis, fatty liver, alcoholic hepatitis, chronic active hepatitis, and cirrhosis. Cancers of the digestive tract (particularly the esophagus and stomach), head, neck, and lungs are common in heavy users. However, intake of as little as one or two drinks per day has been associated with an increased risk of breast cancer. Chronic heavy consumption can lead to organic brain syndrome and permanent incoordination as well as elevated risk for hemorrhagic stroke. Heavy use is correlated with inflammation and abnormalities of the heart, hypertension, and elevations of blood fats, including cholesterol. Even low doses of alcohol can decrease the ability of an already diseased heart to contract and expel blood, and can diminish warning signs of pain. Heavy consumption decreases production of all types of blood cells, resulting in anemia, lowered resistance to infections, poor clotting and increased bruising, and gastrointestinal bleeding. Many conditions resulting from immune system deficiencies are related to alcohol consumption. Sexual dysfunctions, including decreased sperm production and motility, decreased testosterone production, impotence, and menstrual irregularities, are alcohol related. Binge drinking can result in muscle inflammation and chronic drinking in muscle attrition in the shoulders and hips. Heavy drinking is also associated with alcoholic ketosis brought on through vomiting and dehydration, osteoporosis, resulting in broken bones, and renal dysfunction. Emotional responses in addition to interpersonal difficulties include intense sadness, auditory hallucinations, paranoia, and anxiety. Alcohol fragments sleep and can lead to insomnia. And, of course, heavy consumption results in hangovers. In summary, “alcohol abusers have lower life
expectancies and higher mortality rates at younger ages than non-alcoholics.”

Serious health consequences can also result from non-alcoholic, episodic drinking. Because of the narrow range between the anesthetic and the lethal dose of alcohol, toxic reactions leading to death can occur when large amounts are consumed at one time. The potential effect of alcohol on other depressant drugs can also be fatal when the two are used in combination. The most common negative health consequences from occasional drinking are trauma related, however, and involve both the drinker and non-drinking bystanders and victims.

Other Depressants

Although users of alcohol tend to feel “up” with low-level consumption, alcohol is actually a depressant drug. The “high” results from a depressing of the user’s usual inhibitions. Psychological and physical “lows” follow with continued consumption. Other depressants include opiates, sedative-hypnotics, and anti-anxiety medications. Suffice it to say that such industrial products as solvents and aerosols, when inhaled for their mind-altering properties, also create depressant-like effects.

Opiates and Narcotics

Possibly the first drugs to be abused were opiates. Naturally occurring opiates include opium, heroin, morphine, and codeine. In recent years, synthetic opiates have been developed as medical analgesics and antagonists. Examples include such trademarked compounds as Darvon, Percodan, Demerol, Lomotil, and Talwin. All are central nervous system depressants that slow down both physical and psychological responses. The most serious medical consequence of opiate abuse is toxic reaction, more commonly known as overdose. Generally incurred accidentally, overdose leads to death when the respiratory and circulatory systems slow down to the point of ceasing to function.
More common health consequences of opiate abuse occur not from the chemicals themselves, but from the lifestyles that frequently accompany their use. Whether street junkies or party chippers, opiate abusers are prone to AIDS contracted from dirty needles, abscesses and other infections, tetanus and malaria, hepatitis and other liver abnormalities, gastric ulcers, heart arrhythmias, endocarditis, anemias, electrolyte abnormalities, bone and joint infections, eye abnormalities, kidney failure, muscle destruction, pneumonia, lung abscesses, tuberculosis, bronchospasm and wheezing, depression, and sexual dysfunctions, as well as social, interpersonal, and legal problems.

Hypnotics and Anti-anxiety Drugs

Such prescription medications as Nembutal, Seconal, Quaalude, Miltown, and Equanil can be abused and do have serious negative health consequences. The most common is toxic overdose, which results in depressed central nervous system, cardiac, and respiratory functioning. Temporary psychosis involving auditory hallucinations and paranoid delusions can also occur. Use of these drugs can interfere with short-term memory and recall as well as impair judgment and motor performance. Decreased inhibitions can result in an increase of angry outbursts and potential for traumatic consequences. Permanent neurological damage is possible. When ingestion is through the use of a syringe and needle, the usual results of contaminated paraphernalia can result: hepatitis, tetanus, abscesses, and AIDS. The inadvertent injection of any depressant into an artery can result in muscle and nervous tissue death, necessitating limb amputation. Unsupervised withdrawal from these drugs can involve dangerous convulsions and serious depression.

Stimulants

All drugs in this classification regardless of their relative current “popularity” among drug abusers share the essential ability to stimulate the central nervous system. Amphetamines, caffeine, methamphetamine, dextroamphetamine, and, of course, cocaine, are among the drugs in this category. The stimulating effects of these drugs are also obvious on the peripheral nervous system and the cardiovascular system. The stimulation results in decreased fatigue, increased feelings of sexuality, interference with sleep patterns, and decreased appetite.
Abusers of stimulant drugs are more likely to experience drug-induced psychiatric disturbances than are other abusers. Though transitory, these disturbances can be quite frightening as they mimic manic stages, serious psychoses resembling schizophrenia, major depression, and panic attacks. Differences in health-related responses to stimulant drugs are dependent upon the mode of ingestion. Nasal and intravenous use create more acute responses than does oral use. The purity of the chemical also plays a significant role in the intensity of response. In addition to its phenomenally addictive qualities, the great danger with cocaine and its derivatives lies in the rapid onset of increased heart rate that can actually lead to cardiac fibrillation, heart attack, respiratory arrest, and death. Other negative health consequences associated with stimulant use include strokes, destruction of nasal tissue, bronchitis, tooth grinding, and skin ulcers. Maternal use can cause similar difficulties for a fetus as well as contribute to spontaneous abortions, premature labor, and detached placentas.

Hallucinogens

Given the cyclical nature of the kinds of drugs users choose to abuse, relatively little is currently heard about such hallucinogens as psilocybin, mescaline, or the alphabet soup/designer drugs like LSD, PCP, MDMA, STP, etc. They are, however, among the oldest of recognized mind-altering substances. The most common health-related responses to hallucinogen use include panic reactions, flashbacks, and toxic reactions with ingestion of high levels of some of the compounds. The psychological states in these circumstances can include high anxiety, loss of contact with reality, depersonalization, paranoia, confusion, drug-induced psychosis, and, of course, hallucinations. PCP users often become violent and appear to acquire super strength due to the pain-numbing qualities of the drug. This lack of pain combined with violent reactions often leads to serious physical injuries.

Marijuana

Until the relatively recent crisis with crack cocaine, marijuana was probably the drug that created the most concern for Americans. Although marijuana is sometimes called a hallucinogen, its use more often results in changing level of consciousness than in actual hallucinations.The drug has the peculiar ability to simultaneously create physical symptoms akin to both depressants (relaxation, sleepiness) and stimulants (increased respiratory and heart rates). Chronic long-term use affects most body systems, resulting in bronchitis and other respiratory difficulties, decreased strength of heart contractions, possible negative consequences on the immune system, lower sperm count, increased rate of chromosomal breakage, decreased size of prostate and testes, blocked ovulation, acute memory impairment, and possible reduction in growth-hormone production. Maternal use reduces oxygenation to the fetus and can result in behavior and learning difficulties for the child. Marijuana use by those with diabetes can create life-threatening ketoacidosis.

Episodic use of marijuana can result in panic reactions, including feelings of anxiety, fears of losing control or going crazy, or fears of physical illness. Flashbacks can occur, as can temporary psychotic states. Marijuana is also likely to worsen prior psychotic states. Toxic reactions are possible with high-level use of high-potency marijuana. As with alcohol, some of the most serious health consequences of marijuana use result when decreased judgment, impaired ability to estimate time and distance, and impaired motor function and ability to carry out multi-step tasks contribute to injury-causing accidents. A recent study indicated that seventeen percent of drivers in fatal automobile crashes tested positive for marijuana use.

For more comprehensive information on the health consequences of alcohol or other drug use, consult your county alcohol and drug administration, a local alcohol or drug program, or visit the
Campus Alcohol And Drug Education Center, CADEC.

Legal Implications of Alcohol and Other Drug Use by Students, Faculty, and Staff at California State University, Chico

A variety of implications surround the use of alcohol and other drugs. This summary is designed to alert you to some of the legal risks you assume when you use alcohol or other drugs. Where the sanctions are clear, the penalties for illegal use will also be described. However, this summary is only a descriptive document. It should not be interpreted as legal advice or counsel. The regulations summarized here are those most likely to affect students, faculty, or staff at institutions of higher education in California.

Although the physical, psychological, and social effects of the abuse of alcohol or prescription drugs and use of illegal drugs are often similar, the laws regulating that use often differ. Serious federal penalties exist in relation to controlled substances (illicit drugs and a variety of prescription medications). However, with the exception of a recent mandate that states adopt a legal drinking age of 21 to receive federal transportation funds, there has been no national policy related to the consumption of alcohol since Prohibition. The repeal of Prohibition granted control of alcohol use and availability to individual states. Through its Constitution, the State of California maintains virtually all such control at the state level. Generally speaking, localities can only affect alcohol use and availability through land use and zoning ordinances. On the other hand, many of California’s mandates relative to alcohol are written to apply to other intoxicating substances as well.

Thus, regulations on the use of illicit and illegal drugs exist at both the state and national levels. They are not always consistent with each other. Indeed, the National Drug Control Strategy recommends that state and local governments should adopt federal principles of accountability as models in developing their anti-drug strategies. If you are a trafficker in illegal drugs, you probably know the laws you are violating better than most attorneys. This document will focus primarily on the legal impact of what people often consider minor use until they get embroiled in those implications.Local governments, cities, and counties may also have laws regulating the use of alcohol or other drugs. However, given the multiplicity of residences of students and staff at this institution, no attempt will be made through this summary to address local restrictions. Offices of city and county counsel can provide that information. The student and employee handbooks speak to regulations specific to this campus.

Finally, this document will address the illegal use of prescription medications only as such drugs are classified as controlled substances. Penalties for such illegal use are similar to those for illicit drugs. Remember that even though prescription and over-the-counter drugs are legal in many circumstances, their misuse and abuse can create the same kind of negative health consequences as alcohol or other drugs.

Possession and Use

Anyone under 21 years of age who buys alcohol is committing a misdemeanor. Attempting to buy by a minor is also an infraction of the law. Public intoxication which interferes with the personal safety or use of public ways is disorderly conduct, a misdemeanor crime.It is unlawful to drive a motor vehicle or ride a bicycle on a highway when you have a blood alcohol content (BAC) level of .08% or above. Punishment is greater if a child under 14 years of age is in the vehicle at the time.It is unlawful for a person under the age of 18 who has a BAC of .05% or more to drive a vehicle.The act of driving implies consent to be tested for BAC. It is unlawful to operate a water vessel, water ski, or use an aquaplane, etc., with a BAC of .08%, .05% if the operator is under 18 years of age.
It is unlawful to operate an aircraft in the air or on the ground or engage in sport parachuting with a BAC of more than .04%. Except for specific educational purposes, alcoholic beverages are not allowed on public school campuses in California, including community colleges.

Marriage licenses will not be issued to applicants under the influence of alcohol or other drugs.It is unlawful to manufacture controlled substances in the home or in any other unregulated facility.Growing or processing peyote is punishable by imprisonment in the county jail for not more than one year.It is a felony to use alcohol or drugs to aid the commission of a felony, including rape and other sex offenses.Applicants for professional licenses must not be addicted to alcohol or other drugs at the time of application.

Distribution

It is a misdemeanor crime to sell, give, or furnish alcohol to anyone under 21 years of age. It is a misdemeanor crime to sell or furnish alcohol to a common drunkard or incompetent.Only eating establishments and holders of retail liquor licenses may sell or expose for sale alcoholic beverages within one mile of a university or state college.
It is unlawful for sellers of alcoholic beverages by the drink to employ a person for the purpose of encouraging the sale of such beverages.

Manufacture, distribution, receipt, etc., of “imitation controlled substances” or any drug that is falsely advertised, adulterated, or misbranded is unlawful.Providing a minor with paraphernalia for the ingestion of tobacco or any controlled substance is unlawful.Providing intoxicants to prisoners or wards is a felony punishable by up to three years of state imprisonment.It is illegal to use the postal service or other interstate conveyance to offer to sell or transport, import, or export paraphernalia.It is unlawful to import controlled substances except for medical or scientific purposes.It is unlawful to export to any country that has a treaty with the United States prohibiting such export. Penalties vary depending upon the country involved.

Consequences

Carriers of motor vehicle insurance can increase premiums, cancel, or deny renewal as a result of driving under the influence convictions. Employers’ motor vehicle coverage can also be cancelled or renewal denied if employees have been convicted of certain driving under the influence offenses.The Department of Motor Vehicles may refuse or revoke driver’s licenses of practicing alcoholics or addicts or those convicted of alcohol- or drug-related offenses.Refusal to submit to a blood alcohol content test will result in a six-month suspension of driving privileges, two-year suspension if there has been a prior such offense within seven years, and three-year suspension for two or more offenses within seven years.Employers may refuse to hire or may fire an employee who cannot perform job duties or endangers his/her or others’ health or safety due to current use of alcohol or other drugs. (However, employers of 25 or more employees must reasonably accommodate any employees who wish to voluntarily enter treatment programs, providing no undue hardship is created for the employer.)
State disability retirement allowances are paid unless the disability is due to the intemperate use of alcohol or other drugs.

No addict or person in danger of becoming an addict may be employed as a peace officer.Drunkenness on duty, intemperance, or addiction are causes for discipline for any state employee. Examinations for certifications can be refused and certifications withdrawn by the State Personnel Board for anyone who is addicted to alcohol or other drugs.

Discharge from employment “as a result of an irresistible compulsion to use or consume intoxicants” disqualifies claimants from receiving unemployment benefits, as does any institutionalization as a drug addict.

Disability insurance benefits may be denied “for any loss sustained or contracted in consequence of the insured’s being intoxicated or under the influence of any controlled substances unless administered on the advice of a physician.” Permanent or probationary employees of the California State University may be dismissed, demoted, or suspended for addiction to controlled substances or drunkenness on duty.

Community colleges may deny credentials to addicts/alcoholics and those convicted of narcotics offenses. No one convicted of any controlled substance offense is to be employed by a community college unless that person has been rehabilitated for at least five years. Law enforcement must notify relevant community college officials of the arrest of any teacher or instructor for a controlled substance offense. Immediate suspension or compulsory leave may result from such arrest. Conviction will result in the suspension/revocation of credential or certificate.

Community college students may be suspended or expelled for use, sale, possession on campus of, or presence on campus under the influence of any controlled substance.Penalties for the manufacture, distribution, or dispensing or possession with intent to manufacture, distribute, or dispense illegal drugs vary significantly depending upon the substance and amount in question. Both fines and incarceration are imposed, and civil penalties can also be applied. In all cases, however, penalties are at least doubled for such offenses committed by convicted felons and for anyone who distributes to anyone in prison or jail, within 1000 feet of a school or university or 100 feet of a recreational facility, to anyone under 18 by anyone over 18 years of age, or to a pregnant woman.

Drug traffickers lose federal benefits for five to ten years to life after conviction.Drug possessors lose federal benefits for up to one year and can be required to enter treatment, undergo testing, and/or perform community service.