Alcohol Use Abroad

Alcohol (ethanol) is a psychoactive drug that causes depression of the central nervous system (brain and spinal cord). It is a legal drug, readily available, and its use is generally accepted throughout the world. Alcohol, when consumed responsibly (e.g., with meals, moderately at social gatherings, celebrations, and in religious ceremonies), is generally not harmful for healthy people. However, the potential for abuse of alcohol is quite great, and it is extremely difficult to alter a pattern of alcohol abuse once it has been established. While seeming to relieve stress, alcohol has the potential of becoming psychologically and physically addictive. It is important that students realize that they are at risk for alcohol abuse.

Alcohol and Culture

The use of alcohol is encouraged in some societies and prohibited in others. Many cultures teach young people to drink moderately and responsibly in the home, and thus do not experience the reactionary or "rebellious" alcohol abuse that some American students expose themselves to. In most cultures there are also methods for controlling alcohol abuse, but these vary and may not be obvious to a person unfamiliar with a particular culture.

Why Students are at Risk

When American students go abroad there is often more access to alcohol:

• many countries have lower drinking ages than in the U.S.
• many locations serve alcohol more readily than non-alcoholic beverages
• local culture may utilize alcohol more frequently
• the alcohol content is often stronger in other countries

Excessive or inappropriate use of alcohol is often associated with stress. An individual may begin or increase drinking after a loss, disappointment, change in environment, or because of loneliness. These stressors are common among students. Inevitably, transition adjustment in another country, unfamiliarity with local customs, and/or a lower drinking age may lead to irresponsible alcohol use while students are studying abroad. Students are at particular risk for increasing alcohol use or developing an abusive pattern for a variety of reasons. Among them are:

• Stress of adjustment
• Depression
• Desire to please others
• Boredom
• Easy availability and low cost of alcohol in host country
• Peer pressure
• Student may be a "novice drinker"

Effects of Alcohol

Behavioral effects can include:

• Irritability
• Anxieties
• Loss of judgment
• Moodiness
• Violent behavior
• Impulsiveness
• Inability to cope

Physical effects can include:

• Gastrointestinal irritation and ulcers
• Liver damage
• Sexual dysfunction and impotence
• Heart disease
• Cancer of the mouth, esophagus, or stomach
• Malnutrition
• Altered muscle coordination, tremors and convulsive disorders

Symptoms of Alcohol Abuse

The essential feature of alcohol abuse is a maladaptive pattern of use manifested by recurrent and significant adverse consequences related to the repeated use of alcohol. Symptoms of abuse may include:

• Daily use of alcohol (particularly if required to function normally).
• Inability to reduce intake, despite efforts to do so.
• Increasing alcohol consumption.
• Neglectful appearance.
• Blackouts (loss of memory of events which occurred when intoxicated).
• Continued drinking despite having serious physical disorder aggravated by alcohol
• Violence or aggression when intoxicated.
• Unexplained injuries.
• Binge drinking (episodes of remaining intoxicated for days at a time).
• Drinking alone.
• Legal difficulties (e.g., DUI).
• Failure to meet obligations to family, friends, or at work.
• Erratic or compulsive behavior.
• Deterioration of physical or psychological functioning.

Resisting Social Pressures to Drink

Some personal strategies, which may help, include:

• Understanding why you are choosing to use alcohol
• Making rules for oneself to guide drinking
• Setting personal limit for drinking, sticking to it, or drinking less
• Providing more non-alcoholic than alcoholic beverages for oneself, friends and guests
• Maintaining daily physical activity
• Drinking only with meals
• Making oneself aware of the impact one's drinking has on oneself and others

Who Has a Drinking Problem?

Positive responses to any of the following may indicate that a drinking problem exists:

• Can you drink more than other people without showing it?
• Do you have a drink at about the same time every day?
• Have you ever spoiled a party or outing by getting drunk?
• Has your family or friends talked to you about your drinking?
• Have you ever lost time from work because of your drinking?
• Do you need a drink in the morning?
• Do you ever wake up unable to remember what happened that night before?
• Do you take a drink before going to a party where drinks will be served?
• Do you ever drink enough to get high when you are alone?
• Has drinking become the most important and pleasurable of your activities?

Getting Help

A student's use of alcohol can become such a part of daily life, that it may not be recognized as a problem. Denial is a common defense which can also interfere with seeking help. However, few people struggling with alcohol can overcome that problem alone. Administrators should support treatment of alcohol abuse as both a medical and social/personal problem to be addressed. Students should be made aware of whether a discussion will be confidential.

Adapted from "Dealing with Alcohol" module, Pre-Service Health Training for Volunteers Binder, Peace Corps Office of Medical Services.