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Many people continue to abuse drugs and consume a lot of alcohol even as the campaign against them continues. An approximate of 500,000 people die from drug abuse and alcoholism on a yearly basis. The two are highly addictive and form part of what is affecting the society most. The paper will discuss the effects of drugs and alcohol and examine their negative effects on the individual and society. Drugs and alcohol pose negative effects on people’s health, their interactions with others in the society and inhibits them from leading a successful life.

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Fifty states of the US have set the minimum drinking age to be 21. However, exceptions in 40 states apply. Alabama, Florida, Idaho, Indiana, Kentucky, Missouri, Arkansas, New Hampshire, Pennsylvania and Virginia are the only states that have no exceptions in their drinking laws. In these states, minors (those below 21) are strictly not allowed to drink by the law!

Exceptions- for the minimum drinking age are applicable in the other states, not mentioned above, under the following circumstances:

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My name is John, and I am an alcoholic. This is the declaration made by members of Alcoholics Anonymous. Alcoholics Anonymous also claims to be the only effective means of recovering from alcoholism. Declaring to be the only effective source for recovery from alcoholism is like claiming there is only one drug to treat an illness. Alcoholics Anonymous is not an effective form of treatment for all person’s dependent upon alcohol. Studies, statistics, modern science, and rational thought have proven that Alcoholics is not effective.

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Essays on Alcohol

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Alcohol is a chemical substance derived from the fermentation or distillation of various fruits, grains, or other natural sources. It is commonly consumed in the form of alcoholic beverages and is known for its psychoactive effects. Alcohol, specifically ethanol, acts as a central nervous system depressant, affecting brain function and altering behavior.

The origin and history of alcohol can be traced back to ancient civilizations. The earliest evidence of alcohol production dates back to around 7000 to 6600 BCE in China, where fermented beverages made from rice, honey, and fruit were consumed. Similarly, in the Middle East, evidence of alcoholic beverages made from barley dates back to around 5400 to 5000 BCE. Throughout history, alcohol has played a significant role in various cultures and societies. It was often associated with religious rituals, social gatherings, and medicinal purposes. The Ancient Egyptians, Greeks, and Romans had a wide variety of alcoholic beverages, and the art of brewing and distillation spread through trade routes. During the Middle Ages, monasteries in Europe became centers of brewing and distillation, and the production of alcoholic beverages became more organized. In the 18th and 19th centuries, the Industrial Revolution led to the mass production of alcohol, contributing to social issues related to alcohol abuse.

Alcohol has both short-term and long-term effects on the body and mind. In the short term, alcohol acts as a depressant, slowing down the central nervous system and affecting coordination, judgment, and reaction time. It can cause relaxation, euphoria, and lowered inhibitions. However, excessive consumption can lead to negative effects such as impaired judgment, blurred vision, slurred speech, and increased risk-taking behavior. Long-term alcohol use can have detrimental effects on various organs and systems. Prolonged heavy drinking can damage the liver, leading to conditions such as cirrhosis and alcoholic hepatitis. It can also weaken the immune system, increase the risk of cardiovascular diseases, and contribute to the development of certain types of cancer. Alcohol misuse and addiction can have profound social and psychological consequences. It can strain relationships, lead to financial difficulties, and contribute to mental health disorders such as depression and anxiety. Additionally, excessive alcohol consumption is associated with an increased risk of accidents, injuries, and even fatalities. It is important to note that moderate alcohol consumption can have some potential health benefits, such as a reduced risk of heart disease. However, these potential benefits must be balanced with the risks and individual circumstances, and it is always advisable to consume alcohol responsibly and in moderation.

Public opinion about alcohol varies greatly depending on cultural, social, and individual factors. It is a complex and multifaceted topic that elicits diverse perspectives. Some individuals and societies view alcohol consumption as an acceptable and enjoyable part of social gatherings and celebrations. They may see it as a way to relax, socialize, and enhance the enjoyment of certain experiences. In these contexts, alcohol is often seen as a normal and integral aspect of everyday life. On the other hand, there are those who hold more cautious or negative views towards alcohol. They may emphasize the potential risks and harms associated with its use, such as addiction, health problems, and impaired judgment. Concerns about alcohol-related accidents, violence, and addiction can shape public opinion and lead to stricter regulations and policies. Public opinion on alcohol is also influenced by cultural and religious beliefs, as well as personal experiences and values. Some individuals may have witnessed the negative consequences of alcohol misuse and therefore hold more critical views. Others may have positive associations with alcohol and view it as a benign or enjoyable substance when consumed responsibly.

Alcohol is a frequently depicted substance in various forms of media, including movies, television shows, music, and advertising. Its portrayal in media can range from positive and glamorous to negative and cautionary, reflecting the diverse perspectives and attitudes towards alcohol. In some media representations, alcohol is shown as a symbol of sophistication, celebration, and socializing. It is often associated with luxury and enjoyment, depicted in glamorous settings where characters are seen drinking champagne, cocktails, or wine. This positive representation can be found in movies like "The Great Gatsby" and TV shows like "Mad Men," where characters are shown indulging in alcohol as a part of their lifestyle. However, media also portrays the negative consequences and risks associated with alcohol consumption. Films like "Leaving Las Vegas" and "Flight" depict the destructive effects of alcohol addiction, showcasing the devastating impact it can have on individuals and their relationships. Such portrayals serve as cautionary tales and highlight the potential dangers of excessive alcohol use. Furthermore, there are public service announcements and campaigns that aim to raise awareness about responsible drinking and the harmful effects of alcohol abuse. These messages often depict the negative consequences of alcohol-related accidents, impaired judgment, and addiction.

1. According to the World Health Organization (WHO), alcohol is responsible for more than 3 million deaths worldwide each year. This includes deaths from alcohol-related diseases, accidents, and violence. It is a significant public health concern that requires attention and prevention efforts. 2. A study published in the journal Addiction revealed that alcohol consumption is a leading risk factor for disease burden and premature death globally. It ranked as the seventh leading risk factor for both death and disability-adjusted life years (DALYs) in 2016, highlighting the significant impact of alcohol on population health. 3. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that alcohol-related problems cost the United States economy an estimated $249 billion in 2010. These costs include healthcare expenses, lost productivity, and criminal justice costs associated with alcohol-related incidents. This statistic emphasizes the economic burden of alcohol misuse on society.

Alcohol is an important topic to explore in an essay due to its widespread use and the complex implications it has on individuals, society, and public health. Understanding the various aspects of alcohol, including its history, effects, public opinion, and representation in media, can provide valuable insights into its impact on individuals and communities. By delving into the history of alcohol, one can examine its cultural, social, and economic significance throughout different time periods and regions. Exploring the effects of alcohol on the human body and mind helps shed light on the risks and potential consequences associated with its consumption. Analyzing public opinion allows for an understanding of societal attitudes, perceptions, and debates surrounding alcohol use and abuse. Furthermore, the representation of alcohol in media and popular culture plays a significant role in shaping public perceptions and behaviors. Investigating how alcohol is portrayed in films, advertisements, and literature can reveal underlying messages and narratives about its consumption.

1. Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for use in primary care (2nd ed.). World Health Organization. 2. Dawson, D. A., Goldstein, R. B., Saha, T. D., & Grant, B. F. (2015). Changes in alcohol consumption: United States, 2001–2002 to 2012–2013. Drug and Alcohol Dependence, 148, 56–61. 3. Grant, B. F., & Dawson, D. A. (2017). Alcohol and drug use disorder: Diagnostic criteria for use in general health care settings. National Institute on Alcohol Abuse and Alcoholism. 4. Gual, A., Segura, L., Contel, M., & Heather, N. (2013). AUDIT-3 and AUDIT-4: Effectiveness of two short forms of the Alcohol Use Disorders Identification Test. Alcohol and Alcoholism, 48(5), 565–565. 5. Koob, G. F., & Volkow, N. D. (2010). Neurocircuitry of addiction. Neuropsychopharmacology, 35(1), 217–238. 6. Rehm, J., Mathers, C., Popova, S., Thavorncharoensap, M., Teerawattananon, Y., & Patra, J. (2009). Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. The Lancet, 373(9682), 2223–2233. 7. Roerecke, M., & Rehm, J. (2010). Alcohol consumption, drinking patterns, and ischemic heart disease: A narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers. BMC Medicine, 8(1), 1–23. 8. Room, R., Babor, T., & Rehm, J. (2005). Alcohol and public health. The Lancet, 365(9458), 519–530. 9. Schuckit, M. A. (2014). Alcohol-use disorders. The Lancet, 383(9929), 988–998. 10. World Health Organization. (2018). Global status report on alcohol and health 2018. World Health Organization.

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The beliefs about pros and cons of drinking and intention to change among hazardous and moderate alcohol users: a population-based cross-sectional study

Fredrik g. ansker.

1 Uppsala Universitet, 751 05 Uppsala, Sweden

Asgeir R. Helgason

2 Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden

3 Centre for Epidemiology and Community Medicine, Health Care Services, Stockholm County Council, 171 29 Solna, Sweden

4 Reykjavik University, Iceland

Kozma Ahacic

Background : Fundamental to supporting hazardous alcohol users are the rationales for reducing alcohol intake highlighted by the users themselves. This study analyses the relative importance of beliefs about pros and cons of drinking in relation to having an intention to reduce intake among both hazardous and moderate alcohol users. Methods : Intention to change was assessed in a representative sample of Stockholm’s population ( n = 4278, response rate 56.5%). Alcohol use was assessed using the Alcohol Use Disorders Identification Test measure. A decisional balance inventory was used to examine various beliefs about the pros and cons of drinking, which covered affect changes, social gains and losses, and possible adverse effects. Independent correlations were determined by logistic regression using a backward exclusion procedure ( P > 0.05). Results : Higher ratings of importance were generally related to intent, whether or not the contrast was with having no intent or already having made a reduction. This was especially true for hazardous users. Only two beliefs were independently correlated with change among hazardous users: ‘Drinking could get me addicted’ and ‘Drinking makes me more relaxed/less tense’ (pseudo-R2 < 0.1). Among moderate users, there was no uniform pattern in the relationships. Conclusions : Unexpectedly, hazardous users with an intent to change rated pro arguments as more important than those with no intent to change. Of the investigated pros and cons, only a few were independently related to intention to change drinking behaviour. These arguments provide interesting topics in consultations. Little support was found for any rational decision making behind the intention to reduce alcohol intake.

Introduction

Hazardous alcohol users are often identified in primary care. 1 One approach that has been widely used and thoroughly evaluated in these encounters is Motivational Interviewing (MI). 2–5 Advice and brief interventions have been shown to be effective in reducing drinking among hazardous users. 2 , 3 , 5

In these, and other situations where advice or counselling is involved, the sentiments underlying a problem behaviour, i.e. its pros and cons, usually become explicit. It has been suggested that people drink either to enhance positive affects (enhancement motives) or to reduce negative affects (coping motives). 6 , 7 Drinking to enhance positive affects is a way of augmenting positive aspects and experiences, both socially and emotionally. Drinking to cope with negative affects is a strategy for putting up with or ignoring negative emotions and other negative aspects of life. Drinking based on these decision strategies is associated with higher alcohol consumption than drinking merely from social motives, which has been linked to moderate consumption. 7–9

Decision making has been seen as involving a comparative conflict between potential gains (pros) and losses (cons), where the person balances the two when coming to a decision. A model based on this idea was developed by Janis and Mann in the 1970s. 10 Their concept was further developed into the decisional balance model, 11 and integrated into a model of behaviour change, the Transtheoretical Model (TTM). 12–14 The model identifies five stages of change. At first, one is not at all ready for change (pre-contemplation). Next, one contemplates change, albeit ambivalently, weighing gains against losses (contemplation). Then, one plans for change, getting ready to bring it into effect in the near future (preparation). When the change is made (action), one strives to adapt to the new situation. Then, the new behaviour has to be maintained (maintenance).

The pros and cons attributed to health behaviours have been shown to co-vary with stage of change. 15–18 With a decrease in drinking as the change, the importance of arguments in favour of drinking decreases, while the importance of arguments against increases. When alcohol abusers either have undergone change without formal treatment or have decided to seek treatment, the weighing up of pros and cons has been found to be an important aspect. 19–21 The TTM is also used as a tool to evoke motivation to change among patients with problem behaviours, as part of the MI approach. 22

The TTM has been criticized on a variety of grounds. Important issues are whether transition through the stages of change is unidirectional or whether there are relapses between stages, 13 , 23 and whether readiness to change does actually predict change. 24 , 25 Nevertheless, the model implies a distinction that recognizes one basic everyday aspect, which any meaningful dialogue about change with persons with hazardous use of alcohol has to take into account. That is, talking about pros and cons with persons who intend to change is likely to differ from talking with persons who are trying to maintain change, or who have no intention of changing. Further, it is reasonable to suppose that some specific beliefs about pros and cons stand out, i.e. are more important than others.

The approach has been applied to different treatment populations where excessive use of alcohol has been involved. Therefore, it is unclear whether any of the previously identified arguments are relevant at all to non-problem behaviours, such as when use of alcohol is moderate. It is also unclear whether the relationships of pros and cons to change still prevail if lower cut-offs are set to delimit target groups with less excessive alcohol habits, such as hazardous users in the general population. To the extent that people behave as reasoning actors, the arguments can be expected to have some value in explaining a person’s intention to change, i.e. to reduce intake of alcohol. People who are not addicted may also be assumed to act more rationally, even if the arguments are less important.

This study aims to examine the independent relationships of beliefs about various pros and cons (from the decisional balance model) to the intention to reduce alcohol intake in the general population, among hazardous and moderate alcohol users separately.

A cross-sectional randomly selected postal survey of a representative sample of the adult population aged 18–70 years in Stockholm County, Sweden, was conducted in 2003. The response rate was 56.5% ( n = 4278).

Alcohol use

Alcohol use was assessed using the Swedish self-report version of the Alcohol Use Disorders Identification Test (AUDIT). 26 Recommended cut-offs used in this study to represent hazardous drinking were 8 points for men and 6 points for women. 27 Men with a non-zero but lower AUDIT score than 8, and women with a non-zero but lower score than 6 were considered as moderate drinkers. Missing values ( n = 183) were excluded.

Stages of change

The subjects were asked whether they had consumed a minimum of one standard glass of alcohol in the past 12 months. If ‘no’, they were excluded. If ‘yes’, they were asked to specify which of the following statements was most applicable to their situation: (i) ‘I reduced my alcohol use more than 12 months ago’; (ii) ‘I reduced my alcohol use 6–12 months ago’; (iii) ‘I reduced my alcohol use less than 6 months ago; (iv) ‘I intend to reduce my alcohol use within 30 days’; (v) ‘I intend to reduce my alcohol use within 6 months’; (vi) ‘I do not intend to reduce my alcohol use within 6 months’ . This is a staging method that has been used in earlier studies to assess stage of change and alcohol use. 15 Three groups were created to represent the stages of change to be used in the analysis: ‘No intention to reduce alcohol use’, which was represented by alternative (vi); ‘Intention to reduce alcohol use’, represented by alternatives (iv) and (v); and ‘Already reduced alcohol use’, represented by alternatives i–iii. Subjects who did not complete this part of the survey ( n = 237) were excluded from the analysis.

Pros and cons of drinking

A 16-item decisional balance inventory 28 was translated from English into Swedish. The inventory investigated various pros (eight items) and cons (eight items) of drinking ( table 1 ). The subjects were asked to rate the importance of each item when deciding when/how much they drank on a 0–4 point Likert scale, where 0 = ‘Not at all important’ and 4 = ‘Extremely important’.

The examined pros and cons of drinking

Statistical analyses

The statistical analyses were performed using SPSS v. 20.0. Comparisons of prevalence were made using chi-square tests. All significance levels in the regression models came from Wald’s chi-square tests. T-tests were performed to compare ages in the drinking categories and to compare the means of the pros and cons of drinking in the categories. The correlations between the independent variables (the pros and cons of drinking) and the outcome (intention to change) were computed in a series of logistic regression models. The independent variables were treated as linear functions in the regression models.

Intention to change was modelled to enable two alternative contrasts to be made: ‘Intention to reduce use’ vs. ‘Having already reduced use’, and ‘Intention to reduce use’ vs. ‘No intention to reduce use’ . These models assessed hazardous users and moderate users separately. First, all bivariate associations between the outcomes and the separate pros and cons were modelled one by one. Next, to evaluate the independent relationships, all pros and cons were included in the same model, which was then reduced by stepwise backward exclusion. The exclusion criterion for the stepwise backward model was P > 0.05 and the inclusion criterion was P < 0.10. The same stepwise backward exclusion procedure was adopted with the pros and the cons kept separate, but it yielded the same results as when they were all taken together, and therefore are not presented in this report. The same applied to the three full logistic regression models that were constructed to assess the arguments; that is, the pros and cons were treated both together and separately. Nagelkerke pseudo r-square was estimated for the reduced models. 29

The average age of members of the study sample was 43 years, of which 56% were women . Eighteen percent were hazardous drinkers and 70% moderate drinkers. The hazardous drinkers were younger than the moderate drinkers, with an average age of 36 years in comparison with 44 years ( P < 0.01), and more likely to be men, 54% in comparison with 46% ( P < 0.01).

Among the hazardous drinkers, 17% had an intention to reduce alcohol use ( table 2 ). The corresponding proportion among the moderate drinkers was lower, at just above 2% ( P < 0.01).

The distribution of the stages of change among hazardous and moderate drinkers ( n = 3726)

Significance levels are given for hazardous drinkers in comparison with moderate drinkers on the basis of Wald’s chi-square tests in logistic regression models.

Hazardous use

Table 3 presents the mean scores for all the pros and cons, beginning with the highest scoring item among hazardous drinkers. All 16 arguments had significantly higher average scores, i.e. were rated as more important among hazardous than among moderate users ( table 3 ).

Mean scores for various pros and cons of drinking among hazardous ( n = 772) and moderate ( n = 2954) alcohol users

Intention to change—hazardous users

Among hazardous users, 8 of the 16 beliefs were bivariately related to ‘Intention to reduce use’ when contrasted with ‘No intention to reduce use’ ( table 4 ). When contrasted with ‘Having already reduced use’, three arguments were found to be related to intention to reduce use. Higher ratings of importance were related to intent, regardless of whether the contrast was having no intent or already having made a reduction.

Odds ratios (ORs) for the intention to reduce alcohol use for various pros and cons of drinking among hazardous ( n = 772) and moderate ( n = 2954) users a

*** P < 0.01, ** P < 0.05, * P < 0.1

a: All abstainers ( n = 329) were excluded from the models.

b: The contrast between hazardous users with ‘intention to reduce use’ ( n = 127) and those with ‘no intention to reduce use’ ( n = 353). Hazardous users ‘having already reduced use’ ( n = 266) were excluded. Missing values ranged between 3 and 15.

c: The contrast between hazardous users with ‘intention to reduce use’ ( n = 127) and those ‘having already reduced use’ ( n = 266). Hazardous users with ‘no intention to reduce use’ ( n = 353) were excluded. Missing values ranged between 5 and 15.

d: The contrast between moderate users with ‘intention to reduce use’ ( n = 66) and those with ‘no intention to reduce use’ ( n = 1940). Moderate users ‘having already reduced use’ ( n = 742) were excluded. Missing values ranged between 34 and 123.

e: The contrast between moderate users with ‘intention to reduce use’ ( n = 66) and those ‘having already reduced use’ ( n = 741). Moderate users with ‘no intention to reduce use’ ( n = 1940) were excluded. Missing values ranged between 6 and 27.

f: A reduced model using stepwise backwards elimination ( P > 0.05) of all the pros and cons.

The reduced models in table 4 indicate that only two arguments were independently related to intention to reduce intake: ‘Drinking makes me feel more relaxed and less tense’ and ‘Drinking could get me addicted to alcohol’. Persons who rated these two arguments as more important were more likely to be intent on change than persons who rated them as less important. The results were the same for both the contrasts, i.e. in comparison with those who had no intention to change and with those who had already made a change.

Intention to change—moderate users

Among moderate users, significant bivariate relations with intention to reduce intake were found for 14 of the 16 arguments when the contrast was with ‘No intention to reduce use’ ( table 4 ). Higher ratings of importance were related to intent for these arguments.

When the contrast was ‘Having already reduced use’, 10 of the bivariate correlations were significant. Moreover, one argument was inversely related to intent. That is, people who attached higher importance to ‘Drinking gives me a thrilling feeling’ were less likely to be intent on change and more likely already to have made a change. Otherwise, persons rating the arguments as important were more likely to be intent on change and less likely already to have made a reduction.

Model results—moderate users

The arguments ‘I feel happier when I drink’ and ‘Drinking could get me addicted to alcohol’ were independently correlated with the intention to reduce alcohol use, whether the contrast was with ‘Intention to reduce use’ or ‘No intention to reduce use’. Higher ratings of importance were related to intent for these arguments. In both models, two other arguments were independently, but inversely, correlated with the intention to change. Adjusted for the other significant relationships, moderate users who attached higher importance to ‘Drinking gives me a thrilling feeling’ were less likely to be intent on change and more likely to have no intention to change. They were also more likely already to have made a change.

After adjustment for the other significant relationships in the model, moderate users who rated ‘Drinking could land me in trouble with the law’ as important were less likely to be intent on change and more likely to have no intention to change. Here, the adjustment for the other variables reversed the bivariate relationship. This is an indication of the co-variation of the independent variables in relationship to the outcome.

Moreover, after adjustment for the other significant relationships but not otherwise (i.e. the bivariate relationship was non-significant), moderate users who rated the argument ‘I can hurt people close to me when I drink too much’ as important were less likely to be intent on change and more likely already to have made a change

The arguments in the models explained 6–12% of the variance in intention to reduce intake of alcohol.

Our results show that the hazardous users who intended to change generally stressed pro and con arguments more than others, no matter whether these arguments were pros or cons. The relationship shown by the pros, i.e. a peak in argumentation at the acute stages of change rather than a decrease in importance, was unanticipated. However, a variety of curvilinear dependencies between rating of importance and stages of change have been shown previously. 11 , 15 , 16

For hazardous users, the result can be straightforwardly interpreted; those who were in the midst of a process of change attached greater meaning to it than did others. Such an interpretation points towards the opposite direction of causality, i.e. that thoughts about change precede the stressing of any particular arguments. But thoughts about change and arguments may also be intertwined and concurrent.

‘Drinking could get me addicted to alcohol’ was a belief that was independently associated with the intention to change among hazardous and moderate alcohol users alike.

As well as fear of addiction, the analysis also identified the ‘Drinking makes me feel more relaxed and less tense’ argument as prominent among hazardous users. All the other arguments’ bivariate relationships were explained by their co-variation with these two arguments.

Among moderate users, the ‘I feel happier when I drink’ argument was identified as an accompaniment to fear of addiction. Two further arguments also exhibited independent relationships among the moderate users in a direction opposite to the other arguments. There was no uniform pattern.

The co-variation between arguments and change was more complex for moderate than for hazardous users. This could have been either due to greater statistical power in the sample of moderate users or to its heterogeneity. That is, some of the people who had effected a change had probably previously been hazardous users. Others may have changed their hazardous habits a long time ago and had no intention of changing further.

Both the arguments identified alongside fear of addiction were affect statements, indicating the presence of cognitive processes and self-reflection about behaviours that precede change. They fit into a motivational model of drinking, where the former reflects a coping strategy, the latter an enhancement strategy. 7 In this model, both enhancement and coping are strategies attributable to excessive use of alcohol.

According to our findings, ‘drinking to cope’ is relevant to the intention to reduce alcohol intake among hazardous users, whereas ‘drinking to enhance’ is relevant to those with an intention to reduce intake among moderate users.

The question of whether beliefs about the pros and cons are of any use in enhancing motivation to change in settings of advice or counselling is interesting, but the answer is less clear. The low degree of explained variance and the high number of arguments without an independent explanatory value among hazardous drinkers raise questions about the merit of assuming a rational decisional process behind change. Less than a tenth of the variance in intention to change was explained by the relative importance of the chosen arguments. Thus, there was little evidence of any rational decisional process.

According to an inventory of prevention campaigns in Sweden, 30 fear of addiction has been used to provoke thinking about drinking behaviour. Another focus has been on the acute risks that follow intoxication, something not fully covered in this study.

Otherwise, our primary goal was to identify the beliefs about pros and cons that are of greatest value in talks with hazardous drinkers, e.g. in primary care. It would be of great interest to further assess the arguments we have identified. Fear of addiction may be a hallmark of the specific socio-political environment in Sweden today. Which arguments correlate with change in other countries would be interesting to investigate.

Ultimately, the decisional balance model suggests that, somewhere within the process of change, the cons’ accumulated importance will exceed that of the pros. 11 This aspect was not addressed in the present study, but would be interesting to pursue.

A distinctive trait of our study is that we used a broad population-based sample. The concepts, measures and inventories for stages of change and decisional balance with regard to alcohol, were first developed for high-risk, heavy drinkers, and it was uncertain how they would work among drinkers at lower risk. Although hazardous drinkers tend to stress both pros and cons more than their moderate counterparts, only a few of the arguments examined here seem to be independently related to an intent to reduce alcohol intake, at least among hazardous and moderate users in the general population.

Limitations

The inventory of the pros and cons was developed for heavy episodic drinking among U.S. college students. 28 It may be that other arguments are more relevant for other age groups, drinking cultures, and countries.

Our population of hazardous drinkers included 92 subjects who would qualify as harmful or excessive drinkers, with AUDIT scores of 15 or higher for men, and 13 or higher for women. However, additional calculations excluding these subjects showed similar results.

The non-response rate was rather high (44%), and high consumers are known to be over-represented among non-responders. 31–33 It is unclear whether non-response bias influenced our results.

Conclusions

There was little evidence of any rational decision making behind the intention to reduce the intake of alcohol, at least on the basis of the arguments examined here. In the general population, little of the variation in intention to reduce alcohol intake seems to be explained by the importance attached to these different arguments for and against drinking. A minority of the examined arguments were independently related to change. Fear of addiction was identified as an incentive for change among both hazardous and moderate users of alcohol. Hazardous users who found that drinking made them feel more relaxed and less tense were also more intent on change.

Acknowledgments

The authors express their gratitude to the people at Stockholm County Council who collected the survey data.

F.A. performed the background research and statistical analysis, and drafted the manuscript. K.A. conceived of and designed the study, and provided intellectual support in drafting the manuscript. A.R.H. is an expert in the area of MI-based counselling. All three authors revised the draft critically for important intellectual content, and they have all read and approved the final manuscript.

Conflicts of interest : None declared.

• This is the first report to examine the beliefs about pros and cons of drinking and their supposed relations to stages of change among hazardous and moderate alcohol users in a broad population.
• Of the investigated beliefs about pros and cons of drinking, only a few were independently related to an intention to reduce intake of alcohol, and have only weak explanatory value.
• This report gives new insight into the counselling of hazardous alcohol users in primary care. It highlights the fear of addiction among alcohol users with an intention to change, but gives little support for the idea that there is any rational decision-making process behind the intention to reduce alcohol intake.

The Impact of Alcohol on the Central Nervous System: Understanding its Effects and Consequences

This essay about alcohol’s impact on the central nervous system (CNS) highlights its dual nature. Moderate consumption can relax and reduce stress, but excessive intake leads to adverse effects such as disrupted neurotransmitter signaling, neuroinflammation, and structural brain changes. Chronic alcohol use impairs cognitive and motor functions, contributes to neurodegenerative disorders, and fosters addiction through the brain’s reward pathway. The essay also discusses the broader societal and public health implications, emphasizing the need for education, prevention, and treatment strategies to mitigate these negative effects.

How it works

Alcohol, a pervasive element in human social interactions, has been integrated into cultural traditions for thousands of years. Its presence is nearly ubiquitous during both joyous and sorrowful events. However, behind its façade of promoting social ease lies a complex and often detrimental relationship with the central nervous system (CNS), significantly affecting brain structure and function. Comprehending these effects is vital to fully appreciate the range of consequences linked to alcohol consumption.

To begin with, it is important to recognize the dual nature of alcohol.

In moderate amounts, alcohol can induce a sense of relaxation, reduce stress, and even offer certain health benefits, particularly with beverages like red wine. However, the positive aspects quickly diminish with excessive intake, leading to numerous adverse effects on the CNS.

Alcohol primarily influences the CNS by targeting the neurotransmitter gamma-aminobutyric acid (GABA). GABA is the brain’s main inhibitory neurotransmitter, playing a crucial role in reducing neuronal activity. Alcohol amplifies GABA’s inhibitory effects, resulting in the well-known sedation and relaxation associated with drinking. However, long-term alcohol use can disrupt GABAergic signaling, leading to tolerance, dependence, and withdrawal symptoms when alcohol use is discontinued.

On the other hand, alcohol also inhibits the excitatory neurotransmitter glutamate. By blocking glutamate receptors, alcohol decreases neuronal excitability, further enhancing its sedative effects. This inhibition of glutamatergic signaling can interfere with synaptic plasticity, impairing learning and memory. Chronic alcohol abuse may lead to structural changes in the brain, such as hippocampal shrinkage and cortical thinning, contributing to cognitive deficits observed in those with alcohol dependence.

Additionally, alcohol affects neuroinflammatory pathways. Prolonged alcohol consumption triggers an inflammatory response in the brain, marked by the activation of microglia, the CNS’s resident immune cells. This neuroinflammation contributes to neuronal damage and is implicated in the development of alcohol-related neurodegenerative disorders, including alcoholic dementia and Wernicke-Korsakoff syndrome.

The cerebellum, which is responsible for coordinating motor movements and maintaining balance, is particularly susceptible to alcohol’s effects. Acute intoxication can impair cerebellar function, resulting in slurred speech, unsteady movements, and poor coordination. Chronic alcohol abuse may cause cerebellar degeneration, leading to tremors, ataxia, and other motor impairments.

Furthermore, alcohol impacts the mesolimbic dopamine system, often known as the brain’s reward pathway. Alcohol consumption stimulates dopamine release in the nucleus accumbens, producing euphoria and reinforcing addictive behavior. Over time, repeated activation of this reward circuitry can lead to neuroadaptations, fostering the development of alcohol dependence and addiction.

Beyond its direct effects on brain physiology, alcohol consumption has extensive societal and public health implications. Excessive alcohol use is a leading cause of preventable death and disability globally, contributing to numerous health issues, including liver cirrhosis, cardiovascular disease, and various cancers. Additionally, alcohol-related accidents, violence, and social dysfunction impose significant burdens on individuals, families, and communities.

Addressing the impact of alcohol on the CNS requires a comprehensive approach that includes education, prevention, and treatment strategies. Public health initiatives aimed at increasing awareness of the risks associated with excessive alcohol consumption and promoting responsible drinking behaviors are essential. Policies that regulate alcohol availability, pricing, and marketing can also help mitigate its harmful societal effects.

On an individual level, early intervention and access to evidence-based treatment programs are crucial for those struggling with alcohol use disorders. Behavioral therapies, pharmacological treatments, and support groups can facilitate recovery and reduce alcohol-related morbidity and mortality.

In summary, alcohol’s impact on the CNS is extensive and multifaceted, encompassing neurochemical, structural, and behavioral changes. While moderate alcohol consumption may offer some benefits, excessive or chronic use poses significant risks to brain health and overall well-being. By understanding the intricate relationship between alcohol and the CNS, we can promote healthier attitudes towards alcohol and minimize its negative consequences on individuals and society.

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At 18, Is It Time for a Drink? Argumentative Essay

An American teenager who is eighteen years old is allowed to do several things, such as vote, join the military, and get married; however, drinking is not allowed until he or she is twenty-one years old.

The officially permitted drinking age in the U.S. was raised from eighteen to twenty-one in 1988 due to the National Minimum Age Drinking Act that had been signed into law four years earlier by President Ronald Reagan.

The main reason was maturity; that is, at eighteen one is not mature enough to drink responsibly (Kiesbye, 2). However, I agree with the verdict of the group of university and college presidents that the drinking age should be lowered from twenty-one to eighteen.

Opponents of lowering the legal drinking age usually refer to the dangers of binge drinking. They say that the practice is increasing and that any person who is below eighteen is simply not responsible enough to have an alcoholic beverage.

This type of drinking most of the time occurs in the underground and hidden places where the teenagers cannot be discovered. However, although binge drinking is a problem in America, the root cause is the high drinking age that our lawmakers have instituted ignoring certain realities.

Let us face the reality: if a person wants to drink, he or she will definitely find a way to do that. And since legal adults (those over eighteen) are unable to get hold of alcohol themselves, they will inevitably go to hidden places and drink excessively without any supervision or guidance.

When the drinking age is lowered, teenagers can drink responsibly without having to hide themselves. Therefore, “the current limit ignores the reality of drinking during college years and drives it underground, making binge drinking more dangerous and students less likely to seek help in an emergency” (Gordon and Holland, para. 2).

I think it is of essence to question this law: why is it that the age of twenty-one is the “magical’ age that a person is considered as intelligent and mature enough to drink alcohol? Truly, some adults consume alcohol irresponsibly. On the other hand, some young people are able to drink responsibly.

At eighteen, Americans are regarded as adults. It may seem odd to allow those above eighteen years to marry, drive their own cars, and do other sorts of things, and yet to be prevented by the same law from taking a glass of wine in a café or even a glass of champagne at their own wedding party. I feel that it does not make sense to have a limit that is higher than the legally recognized age of maturity.

Young people look at alcoholic beverages as something exciting (Bishop, 19). They consider it an activity preserved for the adults; however, young people want to be adults As Soon As Possible. Therefore, as is the case in most institutions, they usually carry fake identity cards to drinking dens; thus, leading to more problems, or steal the drinks from their parents’ drink cupboard.

Maintaining the drinking age at twenty-one does not encourage responsible drinking. In addition, when the opportunity to take alcohol arises, “Let us compensate for the lost time” attitude crops in resulting in binge drinking, which leads to results that are even more disastrous.

By reducing the legal drinking age, it would inevitably water down some of the temptation to take alcohol since the young people often say that it is more fun when it is illegal.

And, more so, in most cases, young people tend to engage in illicit activities. Therefore, lowering the age will reduce this tendency. In reality, increasing the drinking age is even worse than not doing anything at all simply because most individuals would want to get drunk as a sign of rebellion to the authority. “Not much can be done to control student drinking.

Americans younger than 21 casually defy the law by secretly drinking. If the law was changed, the practice can take place in the open, where it could be better monitored and moderated” (Snelgrove, para. 22). I think that the obsession of wanting to consume alcohol would lose its appeal if drinking were not regarded as purely an adult thing.

As pointed out by the article, “At 18, is it time for a drink?” teen drinking is longstanding problem, which has affected the American society and the drinking age limit has not done enough to cut short.

The American society does not care to instruct the teenagers’ on limits or responsibilities; however, they apparently assume that the teenagers will know their limits and be responsible consumers of alcoholic beverages upon attaining the lawful “magical age” of twenty-one.

A number of developed countries in Europe, such as France, Belgium, and Italy, have established a legal minimum drinking age at sixteen years. It is interesting to note that in those countries one is allowed to drive at eighteen years of age.

If the American society can focus more on educating the youth on responsible drinking habits rather than restriction, then several problems can be prevented (Gordon and Holland, para.16). The youth in the U.S., unlike their counterparts in Europe, are not able to learn how to consume alcohol and other substances gradually, safely and with caution.

Even though the average daily consumption of alcohol in some European nations such as France and Spain is higher than in the United States, the percentage of alcoholism and irresponsible drinking is much lower due to education on safe drinking habits and enforcement of gradual drinking behavior.

Supporters of the legal drinking age often cite possible increase in car accidents as a reason to maintain the drinking age. However, they fail to realize that individuals of all ages get into car crashes, teenagers and adults, when they abuse alcohol.

Educating the public on the dangers of this vice can be more beneficial than simply giving restrictions. In most countries in Europe, teenagers are permitted to drive at eighteen years of age, and also to drink responsibly at the same age.

Therefore, they are able to learn early about the dangers of drinking alcohol and practice good drinking habits. I think that lowering the drinking age would be able to reduce the number of car crashes that are related to excessive consumption of alcohol.

Restrictions can be put to prevent the teenagers from drinking, but can they really be stopped? No one was there to stop the over ten million American teens aged twelve to twenty who have already drunk an alcoholic beverage at present. Out of this number, it is astonishing that about half of them are engaging in binge drinking.

To put more facts on the table, it is estimated that about eighty percent of students in grade nine through twelve will have tasted at least one drink of an alcoholic beverage in their lifetime and about fifty percent of these students have tasted at least one drink of alcohol in the last one month.

So, tell me, are restrictions stopping them from pursing their illicit courses? Abuse of alcohol among the teens is a real problem that we should not ignore the way we are doing now through unfair restrictions.

Since more and more teens are destroying their lives, I suggest that we try something different, something that can ultimately bear fruits since the high drinking age seems to be taking us nowhere. Therefore, I strongly believe that lowering the drinking age and then educating the teenagers on the dangers of alcohol consumption can reduce this problem.

We should all recognize that America has a huge problem with teen drinking. The only way to find a solution to this problem is by stopping to ignore it. “It’s time we look at the issue afresh and see whether there are better solutions than we currently have in place because, after all, we haven’t solved the problem” (Gordon and Holland, para. 8).

The American teenagers should get more education about the effects of alcohol, rather than giving them punishment. The legal drinking age should be restored to eighteen since the current age at twenty-one lacks any real basis. A lowered drinking age will bring us to reality and institute better ways of curbing the vice. Consequently, fewer problems would arise.

Works Cited

Bishop, Bruce. Effects of lowering the drinking age . Salem, Or. : Legislative Research, 1979. Print.

Gordon, Larry, and Holland, Gale. “ At 18, is it time for a drink? ” Los Angels Times . 2008. Web.

Kiesbye, Stefan. Should the legal drinking age be lowered? Detroit : Greenhaven Press, 2008. Print.

Snelgrove, Erin. “18 or 21? Drinking age debate heats up.” Yakima-herald . 2008. Web.

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IvyPanda. (2018, May 15). At 18, Is It Time for a Drink? https://ivypanda.com/essays/at-18-is-it-time-for-a-drink/

"At 18, Is It Time for a Drink?" IvyPanda , 15 May 2018, ivypanda.com/essays/at-18-is-it-time-for-a-drink/.

IvyPanda . (2018) 'At 18, Is It Time for a Drink'. 15 May.

IvyPanda . 2018. "At 18, Is It Time for a Drink?" May 15, 2018. https://ivypanda.com/essays/at-18-is-it-time-for-a-drink/.

1. IvyPanda . "At 18, Is It Time for a Drink?" May 15, 2018. https://ivypanda.com/essays/at-18-is-it-time-for-a-drink/.

Bibliography

IvyPanda . "At 18, Is It Time for a Drink?" May 15, 2018. https://ivypanda.com/essays/at-18-is-it-time-for-a-drink/.

Jurors hear about Karen Read’s blood alcohol level as murder trial enters fifth week

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A woman accused of leaving her Boston police officer boyfriend for dead in a snowbank after a night of drinking was still legally intoxicated or close to it roughly eight hours later, a former state police toxicologist testified Tuesday.

Prosecutors say Karen Read dropped John O’Keefe off at a house party hosted by a fellow officer in January 2022, struck him with her SUV and then drove away. Read has pleaded not guilty to second-degree murder, and her defense team argues that the homeowner’s relationship with local and state police tainted the investigation. They also say she was framed and that O’Keefe was beaten inside the home and left outside.

As the highly publicized trial entered its fifth week, jurors heard from Nicholas Roberts, who analyzed blood test results from the hospital where Read was evaluated after O’Keefe’s body was discovered. He calculated that her blood alcohol content at 9 a.m., the time of the blood test, was between .078% and .083%, right around the legal limit for intoxication in Massachusetts. Based on a police report that suggested her last drink was at 12:45 a.m., her peak blood alcohol level would have been between .135% and .292%, he said.

Multiple witnesses have described Read frantically asking, “Did I hit him?” before O’Keefe was found or saying afterward, “I hit him.” Others have said the couple had a stormy relationship and O’Keefe was trying to end it.

O’Keefe had been raising his niece and nephew, and they told jurors Tuesday that they heard frequent arguments between him and Read. O’Keefe’s niece described the relationship as “good at the beginning but bad at the end,” according to Fox25 News, though the nephew said they were never physically violent.

The defense, which has been allowed to present what is called third-party culprit evidence, argues that investigators focused on Read because she was a “convenient outsider” who saved them from having to consider other suspects. Those they have implicated include Brian Albert, who owned the home in Canton where O’Keefe died, and Brian Higgins, a federal agent who was there that night.

Higgins, a special agent with the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives, testified last week about exchanging flirtatious texts with Read in the weeks before O’Keefe’s death. On Tuesday he acknowledged extracting only those messages before throwing away his phone during the murder investigation.

Higgins said he replaced the phone because someone he was investigating for his job had gotten his number. He got a new phone and number on Sept. 29, 2022, a day before being served with a court order to preserve his phone, and then threw the old one away a few months later. Questioning Higgins on the stand, Read’s lawyer suggested the timing was suspicious.

“You knew when you were throwing that phone and the destroyed SIM card in the Dumpster, that from that day forward, no one would ever be able to access the content of what you and Brian Albert had discussed by text messages on your old phone,” attorney David Yannetti said.

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