By Sean Mackey-Simpkin and Silvanna Mach
March 18-24 is National Drug and Alcohol Facts Week (NDAFW), and annual observance to improve knowledge, raise awareness, and increase overall dialogue surrounding drug use and addiction.
By having conversations about the facts and myths surrounding alcohol and drug use, we can help promote informed decision making, healthy coping strategies, and work towards the prevention of drug use and addiction, especially among young people.
In this blog post, Youth & Family Counsellor Sean Mackey-Simpkin and Crisis Counsellor Silvanna Mach break down two common myths about drugs and alcohol.
Myth 1: If you’re drinking alcohol, drinking coffee will help sober you up.
Drinking a cup of coffee after consuming alcohol to sober up faster seems like a smart and innovative idea, right? Alcohol is a depressant and coffee is a stimulant, so we may assume coffee can counter the depressant effects (drowsiness, change in hearing and perception, etc) of alcohol because coffee can increase our alertness and attention due to the chemical caffeine.
We see this suggestion a lot in movies and TV shows, or hear it from family members and friends. But like any other medical theory out there, how valid and true is this? I am here to break the news to you, and unfortunately, coffee cannot and will not sober you up, nor will it sober you up faster. Why? I’ll break it down in the simplest way possible:
About 5-10% of alcohol is eliminated in our body through us sweating, breathing, and urinating. The other 85-90% of alcohol metabolizes (a fancy word for “break down”) in the liver by an enzyme called “Alcohol Dehydrogenase” (ADH1 for short) (Jones A., April 2019). To be honest with you, we don’t have a lot of ADH1 to begin with (due to genetic makeup) so when we’re drinking a lot of alcohol, there aren’t a lot of these ADH1 enzymes that can bind to the ethanol (another fancy word for alcohol) content in our body to break it down, which makes the metabolizing rate slow. This means you can’t speed up the process as it is always set due to the number of ADH1 that we have. Because of this, metabolizing alcohol in the body can occur at a pretty constant rate; metabolizing at a 0.015% of alcohol per hour to be exact. You may think that’s all there is to it, but there are other factors (alcohol intolerance, gender, liver problems, etc) that can slow down the alcohol metabolism rate in our body as well. For example, men tend to have more gastric ADH1 enzyme that can break down the alcohol before it enters the bloodstream compared to women (Eaton, S., Jagielo-Miller, J., Prendergast, M., Akins, C., May 2022).
Unfortunately for the caffeine (in coffee) counterpart here, it doesn’t speed the alcohol metabolizing process up because it doesn’t add or introduce any ADH1 enzymes into the body that can break down the alcohol, meaning it does not reduce the alcohol concentration in our blood (BAC) that we have already. All caffeine will do is make us feel more awake or alert, but the impaired judgement, dizziness, and other alcohol effects are still there and not reversed. So, we essentially become more “alert-drunk” instead of just “drunk-drunk.”
Only time will make a difference in the process of sobering up, so, make sure you give yourself enough time to recover. I know I need at least a day or two!
Myth 2: Drugs alone can cause addiction.
Drug use and addiction are topics many people have opinions about, regardless of their knowledge or experience with the subject. These subjective accounts have led to longstanding misconceptions and inaccurate theories about the role of drugs in the development of addiction. In fact, Canada’s drug policy and procedures have historically been informed by these related biases and assumptions, rather than evidence-based research. One “theory” that persists in influencing our drug policy is that drugs alone, through some unknown mystical power, make people addicted (Skewes, & Gonzalez, 2013). This view has led to governments creating strict policies around recreational drug use, under the guise that this legislation will somehow protect citizens from drugs, therefore preventing addiction. The view that drugs alone cause addiction is a fable, helping to create harmful policy that punishes people for substance use, rather than targeting the root causes of addiction.
I am not stating that recreational drugs are not associated with addiction. Drugs are compounds that mimic chemicals responsible for communication in the brain, including within the emotional reward center (Lüscher, 2018). The reward center is part of the limbic system, which activates in response to rewarding activities (i.e., food, socializing, sex). Drugs mimic the chemicals responsible for humans feeling reward in this brain area, creating a powerful emotional connection that contributes to the experience of addiction.
Drugs are powerful enough to increase addiction risk, which should be the end of the story, right? Unfortunately, addiction is much more complex than reward associations. There are many factors outside of drug-brain interactions that also contribute to the addiction phenomenon – specifically biological, psychological, and sociological factors (Skewes, & Gonzalez, 2013). The biopsychosocial model of addiction is a theory that explains these factors and how they contribute to the development and maintenance of addiction. The biopsychosocial model is supported by decades of research and evidence.
Research has shown that biological factors, such as genetics, contribute to addiction. An example of this is studies involving identical twins separated and raised in different environments having significant levels of diagnosable addiction despite being raised separately (Edwards et al., 2009). Genetic evidence has also been found using animal models. Specifically, mice and rats have been given drugs by scientists to test the behavioural changes in the animals and their offspring. Evidence suggests that not only is there significant behavioural effects on animals who are given these drugs, but there are significant changes found in the way their offspring behave and the way their offspring metabolize drugs in an exciting research area known as epigenetic transmission (Vassoler, & Sadri-Vakili, 2014). These drug experiences can cause changes in the offspring even before conception has occurred indicating that the experiences of sexually male individuals also have significant impact on the behavioural profile of their offspring (Harker et al., 2018).
Research has also shown that psychological factors, such as personality traits, are positively associated with addiction development. For example, a meta-analysis found a positive association between substance use disorder development and the “Big Five Personality Traits” of neuroticism and disagreeableness plus the “Big Three Personality Trait” of disinhibition (Kotov et al., 2010). Further, these authors also found significant negative associations between substance use disorder development and having personality traits of agreeableness and openness. We can also see addiction form through classic and operant conditioning models, which explain drug use through initial reward and the avoidance of withdrawal. The avoidance of withdrawal and related negative emotional states is called negative reinforcement and becomes a major driver of addiction maintenance once initial reward experiences have stabilized (May, Aupperle, & Stewert, 2020).
Finally, sociological research has found that social environment plays significant role in the development and maintenance of addiction. An example of this is the observational study of Vietnam veterans, many of whom were addicted to heroin while in active combat (Hall & Weier, 2016). The addiction rate was so high that the United States government was concerned about how to support all the addicted veterans following discharge. Surprisingly, many of the veterans stopped using heroin after returning home. This observational experiment shows the impact of environment on developing and maintaining addiction including presence of boredom, violence, distance from loved ones, and cultural views on opioid use.
Another experiment, this time involving animals, called “Rat Park” is an example of challenging the assumption that drugs cause addiction. The lead researcher, Bruce Alexander, questioned the results of past drug studies that involved locking rats alone in cages and asking them to pick between sugar water and a depressant (typically morphine) (Gage & Sumnall, 2019). Bruce theorized that creating an open social environment with enriching activities would lead the rats to choose water over the depressant (inconsistent with previous results from experiments testing alcohol consumption). Bruce found that rats living in the enriching environment were more likely to choose water over depressant water with isolated female rats having the highest morphine intake. This experiment is an interesting parallel to the human experience because, like rats, we are social creatures that enjoy moving around and having access to interesting creative challenges (i.e., rats make suitable animal models for human addiction behaviour) (Spanagel, 2017). This experiment shows that rats who are denied access to natural enriching environments are more likely to synthetically activate the reward centre of the brain to compensate for the lack of activation while isolated in cages.
Obviously, the examples provided here are not an exhaustive representation of the biopsychosocial model, but they provide enough evidence to support the position that drugs are only part of the addiction story. The biopsychosocial model is currently the most well-supported theory in addiction research. Ultimately, viewing addiction through a biopsychosocial lens allows us to see that addiction is developed and maintained through many factors, rather than drugs alone. The evidence from this model lies in direct confrontation with Canadian drug policy which, attempting to stop drugs from causing addiction, punishes the consumer rather than create policies which address the root causes. This model also provides a starting point to understand how behavioural addictions develop. Adopting a biopsychosocial approach allows us, as youth workers supporting clients with addiction, the chance to step back and ask, “what has happened to you and what do you need?” rather than “what drug did this to you?”.
References
California Department of Alcoholic Beverage Control. (2024). Alcohol facts. Retrieved on March 14, 2024, from https://www.abc.ca.gov/education/licensee-education/alcohol-facts/#:~:text=The%20liver%20metabolizes%20alcohol%20at,to%20circulate%20in%20the%20bloodstream
Eaton, S. E., Jagielo-Miller, J. E., Prendergast, M. A., & Akins, C. K. (2022). Sex differences in alcohol dehydrogenase levels (ADH) and blood ethanol concentration (BEC) in Japanese quail. Poultry Science, 101(5). https://doi.org/10.1016/j.psj.2022.101790
Edwards, A. C., Svikis, D. S., Pickens, R. W., & Dick, D. M. (2009). Genetic influences on addiction. Primary Psychiatry, 16(8), 40-46.
Gage, S. H., & Sumnall, H. R. (2019). Rat park: How a rat paradise changed the narrative of addiction. Addiction, 114(5), 917-922.
Hall, W., & Weier, M. (2016). Lee Robins’ studies of heroin use among US Vietnam veterans. Addiction, 112(1), 176-180. https://doi.org/10.1111/add.13584
Harker, A., Carroll, C., Raza, S., Kolb, B., & Gibb, R. (2018). Preconception paternal stress in rats alters brain and behavior in offspring. Neuroscience, 388, 474-485. https://doi.org/10.1016/j.neuroscience.2018.06.034
Jones, A. W. (2019). Alcohol, its absorption, distribution, metabolism, and excretion in the body and pharmacokinetic calculations. WIREs Forensic Science. https://doi.org/1 0.1002/wfs2.1340
Kotov, R., Gamez, W., Schmidt, F., & Watson, D. (2010). Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychological Bulletin, 136(5), 768-821. https://doi.org/10.1037/a0020327
Lüscher, C. (2018). Drugs of abuse. In B. G. Katzung (Ed.), Basic & Clinical Pharmacology (14th ed., pp. 575-589). McGraw-Hill Education.
May, A. C., Aupperle, R. L., & Stewert, J. L. (2020). Dark times: The role of negative reinforcement in methamphetamine addiction. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00114
Skewes, M. C., & Gonzalez, V. M. (2013). The biopsychosocial model of addiction. Principles of Addiction, 1, 61-70. https://dx.doi.org/10.1016/B978-0-12-398336-7.00006-1
Spanagel, R. (2017). Animal models of addiction. Dialogues in Clinical Neuroscience, 19(3), 247-258. https://doi.org/10.10.31887/DCNS.2017.19.3/rspanagel
Vassoler, F. M., Sadri-Vakili, G. (2014). Mechanisms of transgenerational inheritance of addictive-like behaviors. Neuroscience, 0, 198-206. https://doi.org/10.1016/j.neurosc ience.2013.07.064
If you have questions or need resources and/or addiction support, visit Eastside Community Mental Health Services.
