Educating Yourself About Alcohol and Drugs: A People’s Primer

432 Pages·1995·5.6 MB·English

by  Marc Alan Schuckit M. D. (auth.)

Educating Yourself
About Alcohol
and Drugs
A PEOPLE'S PRIMER
Educating Yourself
About Alcohol
and Drugs
A PEOPLE'S PRIMER
Marc Alan Schuckit, M. D.
Illustrations by
Dena Leigh Schuckit
Springer Science+Business Media, LLC
Library of Congress Cataloging-in-Publication Data
Schuckit. Marc Alan. 1944-
Educating yourself about alcohol and drugs: a people's primer I
Marc Alan Schuck it.
p. cm.
Includes bibliographical references and index.
1. Drug abuse. 2. Alcoholism. 3. Narcotic addicts-
-Rehabilitation. 4. Alcoholics--Rehabilitation. I. Title.
HV5801.S363 1995
613.8--dc20 95-5890
CIP
ISBN 978-0-306-44948-2 ISBN 978-1-4899-6547-9 (eBook)
DOI 10.1007/978-1-4899-6547-9
© 1995 Marc A. Schuckit
Originally published by Plenum Press in 1995.
Softcover reprint of the hardcover 1st edition 1995
10987654321
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Preface to the Entire Text
Some General Thoughts
This book was written to help people. My goal is to give the best
possible information about drug and alcohol problems in the most
straightforward manner possible. I hope this text will be used by
people who are trying to decide whether or not they, or a loved
one, have a problem with alcohol or drugs and to consider what
might be done about it when a problem is present.
The thoughts offered here grew out of my work as both a
researcher and the director of two alcohol and drug treatment
programs. For thirty years I have worked with patients, friends,
and colleagues who face possible drug problems. The questions
asked by these important people in my life and by those around
them made me realize there was no standard book based on solid
data (not just opinions) for them to turn to. This problem is even
more troubling in recent years because, as financial support for
those problems has become scarce, it has become more and more
difficult to enter treatment. I hope to fill some of that void.
I believe that, given enough information, people generally
make rational decisions. When a person is trying to assess whether
a drug or alcohol problem exists, and what to do to get help if
one does, the best road to take might not always be obvious at
first reading or thinking. However, with time the thoughts perco
late and eventually a plan of action is likely to appear.
v
vi Preface to the Entire Text
The Book Has Two Major Parts
Thinking and planning clearly can be difficult at a time of
crisis. When the world seems to be falling in around you, and
when your emotions are careening off in first one direction and
then another, it is hard to stop, take stock, and begin to take steps
toward changing patterns of behavior that are causing problems.
However, difficult does not mean impossible. To me, the two key
ingredients for a successful recovery are, first, understanding as
much as possible about one's situation, and, second, identifying
the choice of actions one can take to move toward recovery.
As a result of those considerations, this text is divided into
two parts. The first offers information about what substances are,
some thought about what they do to you, and a discussion of
some of the risks you face when you take them. Reading and
understanding this first major section gives you the type of infor
mation you need to decide whether the risks involved with alcohol
and drugs are worthwhile.
The second major section, or Part II, takes off from there.
Once you understand enough about drugs, you are in a better
position to make an informed decision about whether you or
someone around you really has a problem. Thus, this section
offers detailed information about how steps to recovery can begin,
what is likely to happen during treatment, and the importance of
continuing care after the initial more intense efforts have occurred.
Several Types of Readers
The fact that you have picked up this book and are skimming
the preface means that you have some potential need. Some read
ers are concerned about your own alcohol or drug use and need
to make some important decisions. For others, someone you care
about is having severe problems and you want to help. For yet
others, nothing personal is involved, and you are "studying" to
Preface to the Entire ,Text vii
advance your career or because this is an interesting and poten
tially important topic for society in general.
Even though this span of motivations is large, people who
go beyond these initial pages all share a desire for practical infor
mation about alcohol and drugs. I attempt to meet your needs in
two major ways. The first is to offer useful information that is a
melding of data and clinical experience. This means that even
though I don't offer a large number of references from the scien
tific literature, in preparing this work I reviewed over a thousand
articles and books. Thus, the advice I offer is based on the best
scientific studies available. At the same time, I use my thirty years
of work in the field to translate these scientific studies into a
human perspective, considering what the results are likely to
mean to you.
This information is given in a straightforward way that is as
free of jargon and technical words as I can get. I have been careful
to distinguish my own ideas and philosophies from knowledge
that results from careful studies. In addition, every chapter will
end with a few additional readings that more thoroughly docu
ment some of the thoughts already presented.
The second major goal is to offer information that is as practi
cal as possible. Therefore, each chapter begins with a brief state
ment of what it is trying to accomplish and ends with a brief
summary about what was said. What lies between is the informa
tion offered in more detail, often with a presentation of both pros
and cons. Whenever possible, I share with you what it is I hope
I would do if I faced similar circumstances myself.
The chapters of the text try to weave these different ap
proaches together in a meaningful way. Those who are pragma
tists with limited time who "need an answer yesterday" can use
the index to locate a type of problem and then focus on the
relevant chapters, paying special attention to the summaries or
recap statements at the end. Those who desire more detail can
turn to the articles in the Appendix, the reference lists at the end
of some chapters, and the suggested readings. There is also a
viii Preface to the Entire Text
data-driven companion medical text that I have written that paral
lels much of the information offered here. This is Drug and Alcohol
Abuse: A Clinical Guide to Diagnosis and Treatment, Fourth Edition,
New York, Plenum Medical Book Company, 1995. The philoso
phers and students can take more time, read and think about
examples that are offered, try to understand the emotions as
well as the practical problems presented, and make an effort to
incorporate human feelings into the entire picture. Emotional
texture, in addition to the words, is offered through original illus
trations that were developed specifically for this book. Sometimes,
spending a bit of time reflecting over these prints can bring home
points that the words alone can't adequately describe.
In any event, I hope that by this point you have decided that
the text has something to offer you. This is as good a time as any
to begin the process.
Contents
Preface to Entire Text. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Preface to Part I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1. Chemicals Help Make Us What We Are
Goals.................................................... 5
What Drugs Are and How They Are Taken.............. 6
How Drugs Change the Brain . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Drugs Change How We Feel, with Predictable Results... 15
A Recap................................................. 19
Some Suggested Readings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Appendix .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
2. We All Want to Be or Feel Something Different
Goals.................................................... 25
The Stimulants: Drugs That (at First) Make You Feel Happy
(Powerful, Alert, and Stimulated). . . . . . . . . . . . . . . . . . . . . . 31
The Depressants: Drugs That (at First) Make You "High"
(Sedated and Tired) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
The Opiates: Drugs That Make You Feel No Pain (and Nod
Off or Float). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
ix
x Contents
Forms of Marijuana: Drugs That Make You Feel
Mellow................................................ 41
Hallucinogens: Drugs That Intensify Perceived Senses . . . 43
The Solvents or Inhalants: Drugs That Make You Feel as
if You Are Floating and That Cause Confusion . . . . . . . . 45
Drugs That Make You Feel-Well, Almost Anything..... 46
A Recap................................................. 49
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Additional Readings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
3. There's No Free Lunch
Goals.................................................... 53
What Types of Problems Can Develop? . . . . . . . . . . . . . . . . . . 54
Which· Drugs Have Which Types of Problems? .......... 62
A Note to Family and Friends........................... 78
A Recap................................................. 79
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Additional Readings..................................... 81
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Preface to Part II ......................................... 83
4. Is There Really a Problem?
Goals.................................................... 89
You Can't Ask the Right Questions Unless You Get Rid of
Inappropriate Stereotypes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Making a Good Decision Requires Knowing as Much
as Possible about What Substance Use Problems
Are Like.............................................. 93
If You're Trying to See if There Is a Problem, There Is No
Room for Blame. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
A Note to Family and Friends.. .. .. .. .. .. .. .. .. .. .. .. .. . 101
A Recap................................................. 102
References............................................... 103