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Alcohol abuse: think before you drink.

A message From The Deputy Chief Of Staff, G1

ALCOHOL and other drug abuse among Soldiers seriously impacts mission readiness. Soldiers who abuse alcohol or other drugs are more likely to have financial, marital, legal and social problems. More than 50 percent of the Soldiers discharged for misconduct for other than drugs or alcohol also had a drug or alcohol incident within the year prior to discharge.

When one Soldier has an alcohol or other drug incident, it impacts the whole unit; the Soldier's squad leader, platoon sergeant, first sergeant and commander are all involved and are taken away from other duties. Soldiers with substance-abuse problems are less productive at work, miss work more often due to health, personal or legal problems, and thus force their peers to work harder to complete the mission.

Every Soldier should be educated on the impact that the abuse of alcohol and drugs has on health, family, job performance and unit readiness. Soldiers must be able to recognize the early signs of abuse in themselves, peers and subordinates, and not be afraid to seek help from their chain of command or local Army Substance Abuse Program (ASAP).

Commanders, leaders and Soldiers are all responsible for ensuring compliance with the drug and alcohol polices established by the Department of Defense, Department of the Army and the unit's higher commands. Soldier support of these policies will help to maintain unit readiness and reduce the loss of the Army's most valuable resource, Soldiers!

F.L. HAGENBECK

Lieutenant General, GS

Deputy Chief of Staff, G1

High-risk drinking

A Challenge to Mission Readiness

THE results of the 2002 Department of Defense Worldwide Health Survey revealed increased alcohol consumption and heavy drinking (or the consumption of five or more drinks per typical drinking occasion, at least once a week) among Soldiers during the four-year period of the surveys.

This signals a greater risk of alcohol dependence, serious personal consequences and productivity loss. The Army is committed to educating Soldiers, their families and DA civilians about how to reduce the risks associated with alcohol consumption by addressing the dangers of alcohol abuse and its associated high-risk behaviors.

This issue of Hot Topics outlines the scope of the problem, from signs and symptoms to impaired driving to the deglamorization of alcohol use.

What is Alcohol?

ALCOHOL is a central nervous system depressant that is found in beverages such as wine, beer and liquors. Many people do not consider alcohol a drug, but it is; it changes the way the entire body functions. It can make one relax and feel more comfortable or can make one more aggressive and out of control.

While alcohol is a legal drug, its misuse and abuse pose a serious threat to mission readiness throughout the Army due to its association with a number of high-risk behaviors such as: suicide, spousal abuse, assault, sexual assault, motor vehicle accidents and work-related injuries.

What is High-Risk Drinking?

HIGH-risk drinking, also known as episodic drinking, is defined as "the consumption of five or more drinks in a row on one occasion". High-risk drinkers are not necessarily alcoholics, but they do have a greater chance of being involved in other high-risk behaviors. According to a recent Harvard School of Public Health alcohol study, drinkers who frequently participate in high-risk drinking are 21 times more likely to:

* Fall behind at work,

* Damage property,

* Be hurt or injured,

* Engage in unplanned or unprotected sexual activity,

* Drive while intoxicated.

Impaired Driving

IMPAIRED driving, or driving while under the influence (DUI) of alcohol or another drug such as marijuana or cocaine, is an enormous problem throughout the Army and the United States as a whole. A National Highway Traffic Safety Administration study states that every 30 minutes someone is killed in an alcohol-related crash and that every two minutes someone will be non-fatally injured. In 2002 alone, 17,149 people died as a direct result of impaired driving. This represents 41 percent of all of the traffic-related deaths that year.

While traffic accidents cannot always be prevented, alcohol-related crashes CAN BE. Before celebrating or going out, plan ahead, choose one person who will not drink to be your designated driver, or use public transportation. Many areas around the country also offer Safe-Ride Programs or free cab rides during holiday weekends such as: Independence Day, Christmas and New Years. Check with your local Army Substance Abuse Program (ASAP) to find out if these programs are offered in your area.

BAC and the Human

Blood Alcohol Concentration is the amount of alcohol in the bloodstream, measured as a percentage. This chart is a general guide to the effects of BAC on the human body. The BAC level's actual effect on performance and judgment is different for every person.
BAC Effect on Body
.02 No loss of coordination, slight euphoria and loss of shyness.
.05 This is the legal limit for military personnel on duty.
.06 Lowered inhibition, feeling of relaxation and euphoria, minor
 impairment of reasoning and memory.
.08 Judgment, self-control, caution, and reason are impaired.
 .08 is the legal limit in most states
.15 Impaired balance, movement, and coordination. Difficulty
 standing, walking and talking.
.20 Decreased pain and sensation. Erratic emotions.
.30 Diminished reflexes. Semi-consciousness.
.40 Loss of consciousness, very limited reflexes, anesthetic effects.
.50 DEATH


Tips

Tips for Responsible Drinking

WHILE the misuse and abuse of alcohol can lead to dangerous and high-risk behaviors, it is possible to drink responsibly. The following are some easy tips to assist in making the responsible decision if you decide to drink:

* Eat before and during drinking--While a full stomach cannot prevent alcohol from affecting you, eating starchy and high-protein foods will slow it down.

* Don't gulp or chug your drinks; drink slowly and make the drinks last--Try to drink no more than one alcoholic drink per hour.

* Alternate between alcohol and non alcohol drinks--This will give your body extra time to eliminate some of the alcohol.

* Remember the word HALT: NEVER DRINK if you're Hungry, Angry, Lonely, or Tired.

* Before you celebrate, designate--Identify a responsible driver who will not drink, or plan ahead to use public transportation.

Tips to Avoid Drinking

IT is always OK not to drink. Whether you always abstain from drinking, you simply aren't in the mood, or because you're Hungry, Angry, Lonely or Tired, it is always your choice to make. In instances where you feel pressured to drink alcohol, there are countless ways of saying no:

* "No, thank you"--It's your choice not to drink, you don't need to explain yourself.

* "Alcohol's not my thing."

* "I'm the designated driver."

* "No thanks, I already have a drink."

* "I'm on medication."

* Simply walk away.

Another way to avoid drinking alcohol is to enjoy mocktails. Mocktails contain the same ingredients as many popular alcoholic drinks with one exception, they don't contain alcohol. Refreshing and fun, they can be consumed without having to worry about any of the consequences of alcoholic drinks.

WARRIOR

Personal Courage not to use/abuse drugs and alcohol and to notify the chain of command of Soldiers who do.

Respect your Army, unit, fellow Soldiers and yourself by staying drug free and drinking responsibly.

Integrity--Stay true to the Army Values and Warrior Ethos by supporting the Army's drug and alcohol policies.

Duty--Do your duty as a Soldier and stay mentally and physically tough by not abusing drugs or alcohol.

Excellence by exhibiting honorable behavior on and off duty. Don't be a substance abuser!

THE Army Center for Substance Abuse Programs (ACSAP) is proud to introduce its new alcohol-and-other-drug abuse prevention campaign, Warrior Pride. Warrior Pride is an Army-wide substance-abuse prevention campaign to reduce alcohol and drug abuse among Soldiers. It emphasizes that the Warrior Ethos and Army Values are incompatible with alcohol abuse and drug use. Warrior Pride will include posters, brochures and electronic training media that will be distributed through your local Army Substance Abuse Program.

Leader's Role in Warrior Pride:

* Understand alcohol abuse and its effect on personal and mission readiness.

* Know your local resources and when to ask for help.

* Take action and intervene BEFORE a problem develops.

* Emphasize off-duty alternatives to drinking.

Consequences Of Alcohol Abuse

ALCOHOL abuse, or a pattern of heavy drinking that results in high-risk behavior, can have serious effects on the human body. While many of the short-term effects may seem minor, they can all lead to more serious, sometimes life threatening, issues. Many of the short term effects can also lead to serious interpersonal and behavior problems at home and at work.

Physical Effects: Short-Term:

* Distorted vision

* Black-outs--Not being able to remember what the user did while drinking

* Loss of coordination

* Altered perceptions and emotions

* Impaired judgment

* Bad breath

* Hangovers

* Increased heat loss from the body

* Increase in digestive secretions causing stomach irritation

* Increased urination

Long-Term:

* Loss of appetite; weight loss

* Vitamin deficiencies

* Gastritis; ulcer

* Cancer (liver, esophagus, throat)

* Cirrhosis or fatty liver disease

* Heart or Central Nervous System Damage

* Hepatitis

* Sexual impotence

* Permanent memory loss

* Personality changes--edgy, irritable, oversensitive or withdrawn

Behavior Changes

The more one drinks, the greater the chance problems at home, at work, with friends and low ones, and with other people. The problems include but are not limited to:

* Changes in peer group

-Association with known abusers -Separation from friends and family

* Arguments with spouse, family or friends

* Unusual borrowing of money

* Stealing

* Secretive behavior (drinking in secret)

* Avoiding communication

* Neglect of personal appearance

* Trouble with the police (DUI, domestic disputes, etc.)

* Life revolving around alcohol events

Changes in Work Habits

* Decreased Productivity

* Chronic lateness or absenteeism

* Personal problems or illness

* Strained relationships with coworkers and supervisors

* Procrastination of work assignments

* Changes in attitude

Signs and Symptoms of Alcohol Abuse and Alcohol Dependence

ALCOHOL abuse does not necessarily mean the user is physically addicted to alcohol. But alcohol abusers can develop problems as a result of their alcohol consumption and poor judgment, failure to understand the risks, or lack of concern about damage to themselves or others. Because they are not addicted, alcohol abusers remain in control of their behavior and can change their drinking patterns in response to explanations and warnings. But many people who abuse alcohol eventually become alcohol dependent.

These are some of the indicators that alcohol may be a problem:

* Users who cannot cut down on their alcohol use.

* Users who cannot stop drinking once they start or cannot remember how much they drank.

* Users who commonly drink alone; this is an indicator that there is the potential for future alcohol dependence.

* Users who begin drinking prior to social events or drink to excess at events.

* Users who consistently pass out after drinking.

* Users who brag about their ability to hold their liquor or joke about incidents that have occurred while they were drinking.

* Users who drink to cope with difficult situations.

* There is a negative change in the user's attitude or work habits: arriving late, frequent absences, smelling like alcohol.

When Dependence Sets In

ALCOHOLISM is a term commonly used to describe the medical disorder of alcohol dependence. Many health professionals prefer more precise language that distinguishes between alcohol dependence and alcohol abuse.

Alcohol Dependence is an illness with four main features:

* Physiological Tolerance--When the user's brain and body begin to get used to drinking. This causes the user to have to drink more and more just to get the same "buzz."

* Physical Dependence--When the user needs to drink just to feel OK.

* Addiction--When the user cannot stop drinking; his or her entire style of living is characterized by compulsive use and overwhelming involvement with alcohol.

* Withdrawal--When the effects of alcohol wear-off, this may cause physical pain in the user and he or she may begin suffering from depression, hallucinations or delusions.

The AUDIT (Alcohol Use Disorders Identification Test)

THE AUDIT is a tool that was created by the World Health Organization to help identify people whose drinking behaviors have become hazardous or harmful. The minimum score (for non-drinkers) is zero. The maximum score is forty; a score of eight or more indicates a likelihood of high-risk or harmful drinking behaviors. Contact your local Army Substance Abuse Program for additional information on alcohol use/abuse.

Circle the number in parentheses associated with the answer that is correct for you:

1. How often do you have a drink containing alcohol?

Never (0) Monthly or Less (1) 2-4 times a month (2) 2-3 times a week (3) 4 or more times a week (4)

2. How many drinks containing alcohol do you have on a typical day when you are drinking?

1-2 (0) 3-4(1) 5-6 (2) 7-9 (3) 10 or more (4)

3. How often do you have six or more drinks on one occasion?

Never (0) Less than monthly (1) Monthly (2) 2-3 times a week (3) 4 or more times a week (4)

4. How often during the last year have you found that you were not able to stop drinking once you had started?

Never (0) Less than monthly (1) Monthly (2) 2-3 times a week (3) 4 or more times a week (4)

5. How often during the last year have you failed to do what was normally expected from you because of drinking?

Never (0) Less than monthly (1) Monthly (2) 2-3 times a week (3) 4 or more times a week (4)

6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?

Never (0) Less than monthly (1) Monthly (2) 2-3 times a week (3) 4 or more times a week (4)

7. How often during the last year have you had a feeling of guilt or remorse after drinking?

Never (0) Less than monthly (1) Monthly (2) 2-3 times a week (3) 4 or more times a week (4)

8. How often during the last year have you been unable to remember what happened the night before because you had been drinking?

Never (0) Less than monthly (1) Monthly (2) 2-3 times a week (3) 4 or more times a week (4)

9. Have you or someone else been injured as a result of your drinking?

No (0) Yes, but not in the last year (2) Yes, during the last year (4)

10. Has a relative or friend, or a doctor or other health worker been concerned about your drinking or suggested you cut down?

No (0) Yes, but not in the last year (2) Yes, during the last year (4)

Procedure for Scoring AUDIT: Your score can be determined by totaling the number of points circled in questions 1-10. After totaling your score, compare it to the numbers listed below.
SCORE EXPLANATION

1-7 You are probably a social and/or responsible drinker.

8-40 You are experiencing some high-risk drinking behaviors
 and may want to take a closer look at your drinking
 patterns and any effects your drinking may be having
 on your relationships, work or finances. You may also
 want to contact your local Army Substance Abuse Program
 for additional information.


Substance Abuse and the Risk Reduction Program

THE Army recognizes that there is a relationship between alcohol and drug use and other high-risk behaviors such as spouse abuse, financial problems, accidents and injuries. The Army Center for Substance Abuse Programs developed the Risk Reduction Program (RRP) to assist commanders in identifying, preventing and reducing these high-risk behaviors and increasing unit and Soldier readiness.

The Risk Reduction Program gives a quarterly Shot Group report of high-risk incidents (see below) that helps leaders quickly identify potential problems in their units and then use installation agencies such as ACS, Safety and the ASAP to provide help to their Soldiers.

In addition to the regular Shot Group reports, the RRP provides commanders two Unit Risk Inventory surveys. The URI and the Reintegration URI (R-URI) are command climate surveys that help commanders identify high-risk behaviors and attitudes as reported by Soldiers. Soldiers returning from deployments should be administered the R-URI between 90-120 days after they return, to identify high-risk behaviors and attitudes such as post traumatic stress disorder, financial and other problems that developed during and since returning from a deployment. When the RRP is used, the well-being of Soldiers and the entire Army improves. Additional information on the Risk Reduction Program can be found at www.acsap.army.mil.

ACSAP Director's Message

DRINKING alcohol is a privilege that carries a great responsibility. If you drink, make sure that you remember the acronym HALT (Don't drink if you are Hungry, Angry, Lonely, or Tired.), and that you have a buddy you can trust and have planned a safe, sober ride home.

I would emphasize that, if you believe that you or someone you know has a problem with alcohol, it is your duty to recognize the symptoms of alcohol abuse and to reach out for help. Soldiers should always take care of and look out for one another. Many resources--including your local Army Substance Abuse Program (ASAP), chaplain and your chain of command are available to you for additional help.

We at the Army Center for Substance Abuse Programs (ACSAP) strive to provide the Army community with all of the information needed to make responsible decisions regarding alcohol use. If, after reviewing this issue of Hot Topics, you would like additional information on alcohol or any other drugs of abuse, please visit the ACSAP Web site at www.acsap.army.mil. Our site offers a variety of training materials, presentations, brochures, information on Warrior Pride, programs on prevention and posters.

We hope that this issue has provided information to assist you in malting responsible alcohol-related decisions and that it has a deterrent effect on alcohol-related incidents throughout the Army.

-Dr. George P. Chagalis, Director, Army Center for Substance Abuse Programs.

Resources

THE Army Center for Substance Abuse Programs has developed and distributed several products to assist in preventing alcohol abuse. The products below can be acquired by visiting your local installation Army Substance Abuse Program or by visiting www.acsap.army.mil.

* "Think Before You Drink" Poster. This poster assists Soldiers in making smart decisions when drinking alcohol and offers suggestions that help make drinking alcohol safer.

* "It's Only Beer" Poster. This poster informs Soldiers of several myths about beer consumption. "Absolute Restraint ... A Leader's Guide to Alcohol Abuse" Brochure. A reference for leaders that provides information about alcohol use and abuse.

* PowerPoint presentations and information papers. Information on all aspects of alcohol, to include the effects of alcohol and impaired driving.

Web Resources:

* Alcoholics Anonymous. People share their experience, strength and hope with each other as they work to solve their common problem and help others to recover from alcoholism. www.aa.org

* Mothers Against Drunk Driving. MADD is a nonprofit organization whose mission is to stop drunk driving, support victims of this violent crime, and prevent underage drinking. www.madd.org

* National Clearinghouse for Alcohol and Drug Information. Offers information and free publications on alcohol and other drugs of abuse. www.health.org

* Al-Anon/Alateen. A1-Anon offers hope and recovery to people affected by the alcoholism of a loved one or friend. www.al-anon.alateen.org

* Facing Alcohol Concerns Through Education. A national non-profit organization that focuses specifically on alcohol issues. www.faceproject.org

* Intervention Resource Center. The IRC provides information and referrals for alcoholics and other drug-addicted persons, their families and employers. www.interventioninfo.org

REMEMBER, it is always OK to choose not to drink; however if you do decide to drink, then it's important that you remember the following:

Party Responsibly. Have a good time and blow off steam, but don't make drinking your priority. Eat, dance, talk and play games. You should be there to have a good time; you shouldn't be there just to get drunk.

Plan Ahead. Make sure you've arranged for a sober ride home BEFORE going out. Remember: if you don't have a designated driver, call a friend or take a cab.

Pace Yourself. Limit yourself to one drink per hour or alternate between alcoholic and non-alcoholic drinks. Know your limits and stay in control of your mind and body; maintain your Warrior Pride.
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Publication:Soldiers Magazine
Geographic Code:1USA
Date:Feb 1, 2005
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