Alcohol, Drugs, Date Rape and Unwanted Pregnancy

“The contribution of alcohol and other drugs to sexual assault has been increasingly recognized during the last 15–20 years,” says an article in the Canadian Medical Association Journal (CMAJ March, 2009). The authors report that 20.9 per cent of victims of sexual assault met the criteria for drug-facilitated sexual assault, also known as date rape.

As we know, rape occurs when sexual intercourse is non-consensual. A person forces another person to have sex against his or her will. It is not uncommon to find that drugs and alcohol are involved in the rape. Rape includes intercourse in the vagina, anus, or mouth. Rape is among the most serious crimes a person can commit. Men as well as women and children can be raped.

The person who commits rape uses violence and fear to force the person to have sex. Victims of rape are physically and emotionally traumatized. Unwanted pregnancy and infection may be some of the unfortunate outcomes.

Date rape occurs when a substance is administered to a person which lowers his or her sexual inhibition and increases the occurrence of unwanted sexual intercourse. Usually, the victim and the person who commits the crime are known to each other and have been together socially in the past.

Rape is common with an estimated lifetime risk of up to one in four for women. About 25 per cent of the 1400 women who contact the Canadian Sexual Assault Centre each year report that drugs were a factor in a rape.

The drugs used in date rape usually have no colour, smell or taste and can easily be mixed with different kinds of drinks without the victim’s knowledge.

Drugs most commonly used in date rape are alcohol, marijuana, benzodiazepines, cocaine, heroin, amphetamines, GHB (gamma hydroxybutyric acid), Rohypnol (flunitrazepam), and Ketamine (ketamine hydrochloride). This list is extensive. Most of these drugs are often metabolized and excreted before the victim even perceives that a sexual assault may have occurred. Unfortunately, this contributes to the underreporting of drug-related sexual assault.

Alcohol is involved in most of the cases of date rape. Urine samples submitted by rape victims to treatment centers across the United States within 72 hours of a suspected drug-facilitated rape, alcohol was detected in 69 per cent of the samples, marijuana in 18 per cent and cocaine in 5 per cent.

The patient requires immediate attention regarding safety, management of injuries, forensic examination, emergency contraception, prophylaxis for sexually transmitted infections and psychosocial support.

Prevention is better than cure. If you are out drinking then vigilance is the key word. Drink your beverage slowly, keep an eye on your drink when mixed and obtain a fresh one after leaving the drink unattended. Do not accept drinks from strangers.

If you think that you have been drugged and raped then go to the police station or hospital right away. Get a urine test as soon as possible. Do not douche, bathe, or change clothes before getting help. You will destroy the evidence you need to find and convict the offender.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Alcohol

“The premier now knows, or has been reminded, that misery is real and can and does happen to anyone. No matter how hard you work, how smart you are, how right you think, bad things happen”, writes Paul Sullivan, a columnist with the Globe and Mail and a reformed alcoholic for 21 years.

By the time this column appears, Gordon Campbell may still be premier of British Columbia. But almost every Canadian now knows who he is and what he did.

Was it a momentary lapse of judgment while under the influence of alcohol? Or an act of irresponsibility (while under the influence of alcohol) which could have endangered his and other people’s lives?

Let us briefly remind ourselves of the good, the bad and the ugly side of alcohol.

What is good about alcohol?

-Alcohol reduces sickness and death from coronary artery disease
-Makes the blood thinner
-Reduces the incidence of Alzheimer’s disease and dementia

What is bad about alcohol?

-Alcohol causes fetal alcohol syndrome in the new born
-Causes cirrhosis of liver, liver failure and pancreatitis
-Causes gastritis and bleeding
-Causes cancer of the esophagus, breast and other cancers
-And is very heavy in useless calories

What is ugly about alcohol?

-Alcoholism is considered a disease
-It is a compulsive addictive behavior
-It is a drug with complex behavioral effects
-It causes traffic or work related accidents
-It is a major cause of death and disability
-It destroys a person’s personal life, family life and capacity to earn a decent living

The good side of alcohol is sometimes abused by individuals who get addicted to it. Therefore physicians are reluctant to encourage or promote alcohol as a panacea for major health problems.

Critics of alcohol use say that much of the protective effect gained from alcohol use in coronary artery disease can be achieved by other means – exercise, diet, avoiding smoking, and control of cholesterol level.

What is moderate drinking? Is it one, two, or three drinks a day? It depends on how much you are used to drinking. Moderation for a non-drinker is different than for a habitual drinker.

What is alcoholism?

The term alcoholism first appeared in 1849 in an assay written by a Swedish physician, Magnus Huss, titled “Alcoholism Chronicus”.

Alcoholism means excessive and repeated use of alcoholic beverages. Ten percent of the population is dependent on alcohol.

“Alcohol is like love: the first kiss is magic, the second is intimate, the third is routine. After that you just take the girl’s clothes off” – Raymond Chandler (1888-1959).

So, let us be smart and say, “No driving after more than two drinks of alcohol!”

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Alcohol Use

Dear Dr. B: Some time ago, there was a discussion in this newspaper about the health benefits of alcohol. The letters to the editor has left me confused. Can you help? What does the medical literature say? Yours: A Heart Patient

Dear Heart Patient: Mankind has known the use and abuse of alcohol for many centuries. In fact, the term alcoholism first appeared in 1849 in an assay written by a Swedish physician, Magnus Huss, titled “Alcoholism Chronicus”.

Alcoholism is considered a disease. It is a compulsive addictive behaviour. Alcoholism means excessive and repeated use of alcoholic beverages. Ten percent of the population is dependent on alcohol. It costs the health care system millions of dollars.

Raymond Chandler (1888-1959) said, “Alcohol is like love: the first kiss is magic, the second is intimate, the third is routine. After that you just take the girl’s clothes off.” Where does the benefit stop and the harm start?

For many years, there has been scientific evidence to suggest that moderate amount of alcohol is good for our health. But physicians have been reluctant to publicize or promote this advantage. They are worried that some people will use this as an excuse to justify excessive drinking. The alcohol industry will use this to promote their products. And the promotion of the benefits will raise moral, religious and ethical issues and confuse and divide the people who otherwise would benefit the most.

But Dr. B, what are the benefits?

-There is overwhelming evidence that moderate alcohol drinking reduces sickness and death from coronary artery disease.
-Alcohol also favourably changes the blood lipid levels and makes the blood thinner.
-There is 24 to 53 percent decline in the risk of duodenal ulcer.
-It reduces death from stroke, reduces the incidence of blood vessel disease in the legs and arms, and reduces adult onset diabetes.
-Up to three drinks a day, alcohol reduces blood pressure in females but heavy drinking will have the reverse effect.
-Moderate drinking of wine, beer, and spirits can reduce the incidence of Alzheimer’s disease, and dementia.
-Alcohol alleviates the effects of stress.

Dr. B, what are the dangers of abusing alcohol?

-Alcohol is addictive – it’s a drug with complex behavioural effects that can be pleasurable or unpleasant, stimulating or depressing.
-Drinking during pregnancy causes fetal alcohol syndrome in the new born – a very serious condition.
-It can cause cirrhosis of liver, liver failure and pancreatitis.
-It can cause gastritis and bleeding .
-It can cause traffic or work related accidents – resulting in disability or death.
-Alcohol is implicated in more than 20 causes of death.
-It can cause cancer of the oesophagus, breast and other cancers.
-Alcohol abuse can destroy a person’s personal life, family life and capacity to earn a decent living.
-What is moderate drinking? Is it one, two, three drinks a day? Moderation for a non-drinker is different than for a habitual drinker.

Critics of alcohol use say that much of the protective effect gained from alcohol use in coronary artery disease can be achieved by other means – exercise, diet, avoiding smoking, and control of cholesterol level.

The question remains: Should the Canadian medical organizations and physicians publicize the benefits and the risks of moderate alcohol consumption to the Canadian public?

The best thing for you, as a heart patient, is to discuss your individual case with your family doctor or your specialist. I hope the information provided here will be of help.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Substance Abuse

“Substance abuse is an enormous problem in Canada,” says Dr. John S. Millar, MD, in an editorial in the Canadian Medical Association Journal. Dr. Millar is Provincial Health Officer for British Columbia.

The exact cost –monetary and nonmonetary- of disease, disability and death due to substance abuse is difficult to estimate. But it is thought to be in billions of dollars.

Three commonly abused substances are tobacco, alcohol, and drugs.

Tobacco use continues to be the leading lifestyle-related cause of death in Canada – 45,000 each year. About 30 percent of adult Canadians over 15 smoke regularly. Teenage girls are more likely to smoke (39 percent) than teenage boys (22 percent).

Alcohol use takes its toll. About 10 percent of adult Canadians have a drinking problem. Impaired driving is a major cause of death. About 45 percent of the dead drivers have some alcohol in their blood and 38 percent are over the legal limit of .08 percent blood alcohol concentration.

Use of drugs like cannabis, cocaine and heroin amongst Canadians has been increasing. In 1994, the daily use of cannabis in Canada was estimated at 7.4 percent of the population, cocaine at 0.7 percent, and LSD, speed or heroin at 1.1 percent.

In Alberta, the most popular illicit drug is cannabis (marijuana and hashish).

In 1994, 32.8 percent of Albertans (aged 15+) reported using cannabis at some time in their lives, while 8.4 percent said they had used this drug in the 12 months preceding the survey.

What about Medicine Hat? I asked Paul Jerry, a Chartered Psychologist and Instructor at Medicine Hat College in the Addictions Counseling Program.

“Compared to other places in Alberta, Medicine Hat is doing well,” says Jerry. Out of 26 AADAC service areas, Medicine Hat ranks 14th for rate of cannabis and other drug possession charges; 24th for sexual and physical assault charges; and 19th for total rate of alcohol-related primary and secondary diagnosis admission to hospital.
According to AADAC’s breakdown of client demographics, 60 percent of these clients are adult males, 23 percent adult females, 10 percent collaterals and 6 percent teens, says Jerry.

Why are some people prone to substance abuse?

According to Dr. Millar, there is a biological or genetic propensity for substance abuse. This is similar to chronic diseases such as diabetes, hypertension and asthma.

It has also been shown that people who have been abused or neglected in childhood or children from low socio-economic background (poverty, homelessness) have high incidence of substance abuse.

It is also common among people with mental illness.

Dr. Millar says that it is important to understand the underlying cause for substance abuse for any intervention program to succeed. We should stop treating addicts and substance abusers as criminals and begin treating them as patients who deserve respectful, effective care.

I asked Paul Jerry, who has 10 years’ experience in the field of mental health and addictions, about the Addictions Counseling Program at Medicine Hat College.

“Our program is unique in that we hold the view (different from AADAC) that eating disorders and sexual compulsivity can be framed in an addictions perspective. So we apply the addiction model to alcohol, drugs, gambling, food and sex. We train counselors to intervene with these issues in individuals, couples, families, groups, and communities.”

Finally, Carl Jung (1875-1961) has the last word: Every form of addiction is bad, no matter whether the narcotic be alcohol or morphine or idealism.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!