“Inside the ear is a tiny organ called the vestibular labyrinth. It includes three loop-shaped structures called semicircular canals. They have fluid and fine, hairlike sensors that detect the head’s movement.

Other structures in the ear, called otolith organs, detect the head’s movements up and down, right and left, back and forth. The otolith organs hold crystals that respond to gravity.

For many reasons, these crystals can move out of place. When the crystals move, they can go into one of the semicircular canals. Certain head movements can cause the crystals to move.

When the crystals move, they cause the semicircular canal to become sensitive to certain head position changes. This is what causes the dizziness.”

MAYO CLINIC ( Benign paroxysmal positional vertigo (BPPV) – Symptoms and causes – Mayo Clinic )

Know The ear’s role with BPPV

Inside your ear is a tiny organ called the vestibular labyrinth. It includes three loop-shaped structures (semicircular canals) that contain fluid and fine, hair-like sensors that monitor the rotation of your head.

Other structures (otolith organs) in your ear monitor movements of your head — up and down, right and left, back and forth — and your head’s position related to gravity. These otolith organs — the utricle and saccule — contain crystals that make you sensitive to gravity.

For a variety of reasons, these crystals can become dislodged. When they become dislodged, they can move into one of the semicircular canals — especially while you’re lying down. This causes the semicircular canal to become sensitive to head position changes it would normally not respond to. As a result, you feel dizzy. Depending what section of the semicircular canal the problem is in will be a factor with the actual result on the crystals or rocks flowing freely or become stuck together causing a blockage in one of the canals. The other factor that determines this is the etiology for it occuring (ex. Dehydration or blow to the head).

Causes of BPPV;

Timothy C. Hain MD of dizziness and balance.com states The most common cause of BPPV in people under age 50 is head injury . The head injury need not be that direct – -even whiplash injuries have a substantial incidence of BPPV (Dispenza et al, 2011). There is also a strong association with migraine (Ishiyama et al, 2000). BPPV becomes much more common with advancing age (Froeling et al, 1991) and in older people, the most common cause is degeneration of the vestibular system of the inner ear. Viruses affecting the ear such as those causing vestibular neuritis and Meniere’s disease are significant causes(Batatsouras et al, 2012).

Occasionally BPPV follows surgery, including dental work, where the cause is felt to be a combination of a prolonged period of supine positioning, or ear trauma when the surgery is to the inner ear (Atacan et al 2001). While gentamicin toxicity is rarely encountered, BPPV is common in persons who have been treated with ototoxic medications such as gentamicin (Black et al, 2004). In half of all cases, BPPV is called “idiopathic,” which means it occurs for no known reason. Other causes of positional symptoms are discussed here.

Web MD points out tiny calcium “stones” inside your inner ear canals help you keep your balance. Normally when you move a certain way, such as when you stand up or turn your head, these stones move around. But things like infection or inflammation can stop the stones from moving as they should. This unfortunately sends a false message to your brain and causes the vertigo. About half the time, doctors can’t find a specific cause for BPPV.

When a cause can be determined, BPPV is often associated with a minor to severe blow to your head. Less common causes of BPPV include disorders that damage your inner ear or, rarely, damage that occurs during ear surgery or during prolonged positioning on your back. BPPV also has been associated with migraines. In many cases the doctors can’t figure out the cause.

Complications of BPPV:

Benign paroxysmal positional vertigo occurs most often in people age 60 and older, but can occur at any age. Aside from aging, there are no definite factors that may increase your risk of benign paroxysmal positional vertigo. However, a head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

Although benign paroxysmal positional vertigo (BPPV) is uncomfortable, it rarely causes complications. In rare cases, if severe, persistent BPPV causes you to vomit frequently, you may be at risk of dehydration. The dizziness of BPPV can put you at greater risk of falling. It is more of a headache in going through the time to resolve the vertigo possibly affecting people in doing their regular activities of living for a week to several weeks. For some it never comes back but for many it does after several months depending on what the cause is.

TREATMENT

In all cases the doctor first has the patient (pt.) in their office and either through them or through physical therapy ordered by the M.D. after evaluating the pt with diagnosing the pt. with BPPV in treating the pt. using exercises which help in high percentages resolving the vertigo but continuing them when the vertigo is gone will do very little help unfortunately including it commonly comes back several weeks to months later and the exercises help more than. These exercises used are:

OFFICE TREATMENT OF BPPV are :

The Epley and Semont Maneuvers

There are two treatments of BPPV that are usually performed in the doctor’s office. Both treatments are very effective, with roughly an 80% cure rate, ( Herdman et al, 1993; Helminski et al, 2010). If your doctor is unfamiliar with these treatments, you can find a list of clinicians who have indicated that they are familiar with the maneuver from the Vestibular Disorders Association (VEDA) .

The maneuvers, named after their inventors, are both intended to move debris or “ear rocks” out of the sensitive part of the ear (posterior canal) to a less sensitive location. Each maneuver takes about 15 minutes to complete. The Semont maneuver (also called the “liberatory” maneuver) involves a procedure whereby the patient is rapidly moved from lying on one side to lying on the other (Levrat et al, 2003). It is a brisk maneuver that is not currently favored in the United States, but it is 90% effective after 4 treatment sessions. In our opinion, it is equivalent to the Epley maneuver as the head orientation with respect to gravity is very similar, omitting only ‘C’ from the figure to the right.

The Epley maneuver is also called the particle repositioning or canalith repositioning procedure. It was invented by Dr. John Epley, and is illustrated in figure 2. Click here for a low bandwidth animation. It involves sequential movement of the head into four positions, staying in each position for roughly 30 seconds. The recurrence rate for BPPV after these maneuvers is about 30 percent at one year, and in some instances a second treatment may be necessary.

When performing the Epley maneuver, caution is advised should neurological symptoms (for example, weakness, numbness, visual changes other than vertigo) occur. Occasionally such symptoms are caused by compression of the vertebral arteries (Sakaguchi et al, 2003), and if one persists for a long time, a stroke could occur. If the exercises are being performed without medical supervision, we advise stopping the exercises and consulting a physician. If the exercises are being supervised, given that the diagnosis of BPPV is well established, in most cases we modify the maneuver so that the positions are attained with body movements rather than head movements.

After either of these maneuvers, you should be prepared to follow the instructions of your doctor or physical therapist who should give you written instructions on them to take home with you, which are aimed at reducing the chance that debris might fall back into the sensitive back part of the ear. Not always the case.

What to expect from your doctor on your visit with vertigo:

A doctor who sees you for symptoms common to BPPV may ask a number of questions, such as:

• What are your symptoms, and when did you first notice them?
• Do your symptoms come and go? How often?
• How long do your symptoms last?
• Is one or both of your ears affected?
• Does anything in particular seem to trigger your symptoms, such as certain types of movement or activity?
• Do your symptoms include vision problems?
• Do your symptoms include nausea or vomiting?
• Do your symptoms include headache?
• Have you lost any hearing?
• Have you had any weakness, numbness or tingling in your arms or your legs?
• Have you had any difficulty talking or walking?
• Have you had chest pain?
• Are you being treated for any other medical conditions?
• What medications are you currently taking, including over-the-counter and prescription drugs as well as vitamins and supplements?

“Benign paroxysmal positional vertigo (BPPV) is the most frequent type of peripheral vestibular vertigo.1 BPPV is the main reason for vertigo cases presenting to balance clinics, with a prevalence of 2.4%2 and an incidence of 0.6% per year.3 BPPV is defined by periods of highly debilitating vertigo spells with nausea and nystagmus stimulated by changes in head positions4, 5. Females are more affected compared to males with a male-to-female ratio of 1:1.5-2. The peak age of BPPV occurrence is 60-70 years despite the probability of occurrence at any age.”

The American Institute of Balance (Seasonal incidence of benign paroxysmal positional vertigo – The American Institute of Balance ®)

If one day you start the day going to work than come home feeling like a sinus infection that appears to be spreading to the ears and after going to bed several hours upon wakening I sat up on my bed finding yourself pulling to one side that you think the cause is an ear infection but it could be something else.  When I was getting up and feeling dizzy but made it downstairs to eat a meal but due to the dizziness I vomited causing dizziness to increase terribly (like if sea sick or even like too much alcohol followed with vomiting and now everything’s spinning to the point you can’t get up from the ground) and got my self safely to the ground and couldn’t get up.   This all happened to me one year and when going to the MD that night I was sent to the ER for being ruled out initially of a stroke or transient ischemic attack.  I was aggravated and went.  I than was finding out in the ERmit wasn’t a stroke or TIA, which is what I thought would be the result, but their still was a reason for it.  What might this be?  I was diagnosed with BPPV for severe dehydration and it took me a week through exercises and taking meclizine, also known as antivert, that took my dizziness away.

This could be an ear infection with BPPV or just BPPV itself; this abbreviation stands for BPPV-Benign Paroxsymal Posterior Vertigo (highly probable if its feeling clogged, no draining from the ear canal, no wax build up after checked with an otoscope by an ENT or Neurologist and the symptoms listed above present that I mentioned= Vertigo, Nausea; Possibly vision disturbance with lethargy) including a nystagmus (described below). This is how you feel after a concussion (with or without a nystagmus) in varying intensities depending on the impact after a blow to the head. How do these symptoms arise with no infection in the ear?

This involves the inner ear causing the brain to pick up miscommunication signals in detecting or reading what is happening going on giving the ending result of vertigo =dizziness, causing your balance to be off, which again I reenforce is due to the condition that is going on in the middle ear. It is the sensitivity detection by ear sensitivity hairs picking up what shouldn’t be there, which in turn is causing the symptoms. This can be due to inner ear particles clumped together in the ear or particles in the inner ear floating freely depending where the are located in the inner ear. We will discuss this more in detail shortly, just know these particles are called “rocks”.

If your having these symptoms this should be checked for BPPV and (I do recommend you go to MD to be evaluated first):

Benign paroxysmal positional vertigo (BPPV) is probably the most common cause of vertigo in the United States. It has been estimated that at least 20% of patients who present to the physician with vertigo have BPPV. However, because BPPV is frequently misdiagnosed, this figure may not be completely accurate and is probably an underestimation. Since BPPV can occur concomitantly with other inner ear diseases (for example, one patient may have both Ménière disease and BPPV at once), statistical analysis may be skewed toward lower numbers.

BPPV was first described by Barany in 1921. The characteristic nystagmus and vertigo associated with positioning changes were attributed at that time to the otolithic organs. In 1952, Dix and Hallpike performed the provocative positional testing named in their honor, shown below. They further defined classic nystagmus and went on to localize the pathology to the proper ear during provocation.

It deals with the inner ear.

The patient is placed in a sitting position with the head turned 45° towards the affected side and then reclined past the supine position.

BPPV is defined as an abnormal sensation of motion that is elicited by certain critical provocative positions. The provocative positions usually trigger specific eye movements (ie, nystagmus). The character and direction of the nystagmus are specific to the part of the inner ear affected and the pathophysiology.

BPPV is a complex disorder to define; because an evolution has occurred in the understanding of its pathophysiology, an evolution has also occurred in its definition. As more interest is focused on BPPV, new variations of positional vertigo have been discovered. What was previously grouped as BPPV is now subclassified by the offending semicircular canal (SCC; ie, posterior superior SCC vs lateral SCC) and, although controversial, further divided into canalithiasis and cupulolithiasis (depending on its pathophysiology).

Although some controversy exists regarding the 2 pathophysiologic mechanisms, canalithiasis and cupulolithiasis, agreement is growing that the entities actually coexist and account for different subspecies of BPPV. Canalithiasis (literally, “canal rocks”) is defined as the condition of particles residing in the canal portion of the SCCs (in contradistinction to the ampullary portion). These densities are considered to be free floating and mobile, causing vertigo by exerting a force. Conversely, cupulolithiasis (literally, “cupula rocks”) refers to densities adhered to the cupula of the crista ampullaris. Cupulolith particles reside in the ampulla of the SCCs and are not free floating.

Classic BPPV is the most common variety of BPPV. It involves the posterior SCC and is characterized by the following symptoms:

• Geotropic nystagmus with the problem ear down
• Predominantly rotatory fast phase toward undermost ear
• Latency (a few seconds)
• Limited duration (< 20 s)
• Reversal upon return to upright position
• Response decline upon repetitive provocation. The purpose for this appears to be the brain acquires a response in getting used to this vertigo as normal by picking up wrong messages from that affected ear due to improper messaging by the pick up of how the rocks in the inner ear canal are situated (free floating or residing in a canal portion with how the ear hairs are picking up by sensitivity their presence giving wrong messages to the brain causing vertigo, nystagmus, with or without vomiting.
• Because the type of BPPV is defined by the distinguishing type of nystagmus, defining and explaining the characterizing nystagmus are also important.
• Nystagmus is defined as involuntary eye movements usually triggered by inner ear stimulation. It usually begins as a slow pursuit movement followed by a fast, rapid resetting phase. Nystagmus is named by the direction of the fast phase. Thus, nystagmus may be termed right beating, left beating, up-beating (collectively horizontal), down-beating (vertical), or direction changing.
• If the movements are not purely horizontal or vertical, the nystagmus may be deemed rotational. In rotational nystagmus, the terminology becomes a bit more loose or unconventional. Terms such as clockwise and counterclockwise seem useful until discrepancies regarding point of view arise: clockwise to the patient is counterclockwise to the observer. Right versus left terminology is poorly descriptive because as the top half of the eye rotates right, the bottom half moves left.
• Rotational nystagmus also can be described as geotropic and ageotropic. Geotropic means “toward earth” and refers to the upper half of the eye. Ageotropic refers to the opposite movement. If the head is turned to the right, and the eye rotation is clockwise from the patient’s point of view (top half turns to the right and toward the ground), then the nystagmus is geotropic. If the head is turned toward the left, then geotropic nystagmus is a counterclockwise rotation. This term is particularly useful in describing BPPV nystagmus because the word geotropic remains appropriate whether the right or the left side is involved.
• These 2 terms are useful only when the head is turned. If the patient is supine and looking straight up, these terms cannot be used. Fortunately, the nystagmus associated with BPPV usually is provoked with the head turned to one side. The most accurate way to define nystagmus is by terming it clockwise or counterclockwise from the patient’s point of view.

The tympanic membrane where no doctor can open that and further the problem is in your semi-circular canal and if not resolving the problem it will damage the ear.

June is National Migraine & Headache Awareness Month (MHAM), an opportunity to raise awareness about migraine and other headache diseases. Migraine impacts forty million people in the United States, one billion people across the globe, and is recognized as the #2 cause of disability worldwide. Currently, about 16 million people with migraines in the U.S. are undiagnosed. Approximately 400,000 Americans experience cluster headaches, recognized as one of the most painful diseases a person can have.

The word “headache” is a broad term used to describe pain in the scalp, head and neck. There are many different types of headaches. They may be primary conditions such as tension headaches, migraines and cluster headaches, or they may occur due to underlying health conditions.

Headaches are very common, most people experience them to some degree during their life.

“Headache disorders are amongst the world’s most debilitating conditions globally,” says Susan Broner, M.D., medical director of the Weill Cornell Medicine Headache Program. “In fact, migraine itself is the second most disabling condition in the world in terms of years lost to disability. And if you look at populations of people under 50, it’s the first most disabling condition yet many people go undiagnosed and untreated.”

Severe or recurring headaches of any type can significantly impact daily life. Learning about them can help you communicate your concerns more clearly to your primary care provider.

Tension Headaches:

Tension headaches are the most common type of headache. People often experience occasional tension headaches and don’t seek medical care. However, if you have tension headaches 15 days per month or more, you should consult with your primary care provider.

Causes of Tension Headaches

These headaches are caused by tense muscles around the head and neck, often due to stress, anxiety or depression. Tension headaches may also be triggered by:

• Alcohol
• Caffeine or caffeine withdrawal
• Dental problems such as frequently grinding your teeth or clenching your jaw
• Eyestrain
• Keeping your head in one position for a long time
• Not getting enough sleep

Treating and Preventing Tension Headaches

Occasional tension headaches can often be prevented by:

• Exercising regularly
• Getting enough sleep
• Maintaining good posture while seated and taking breaks from sitting
• Managing daily stress

Chronic tension-type headaches are typically treated with stress reduction techniques such as meditation or cognitive behavioral therapy and biofeedback.

Over-the-counter pain medications (e.g., ibuprofen or acetaminophen) may be used to decrease pain. Muscle relaxers or prescription antidepressants may also be recommended in some cases.

Migraine Headaches:

Migraines are a severe, recurring type of headache that is often debilitating. About 12% of people in the United States have migraines and they are more common in women.

Causes of Migraines

The exact cause of migraines is unknown. But researchers believe that genetics plays a part. Having certain medical conditions may increase your risk of developing migraines, including:

• Anxiety
• Bipolar disorder
• Depression
• Epilepsy
• Sleep disorders

Migraines can be triggered by several factors. Caffeine is one of the more common triggers people encounter.  Caffeine is always a mystery to people because many people find that it helps a headache,

There is currently no cure for migraine, but we are in a renaissance of new treatments, therapies, and approaches to managing the disease.  If you have been struggling in silence, now is the time to speak up, educate yourself, and seek care. You might just change your life for the better.

During the Covid pandemic, there was a significant rise in telemedicine. According to a survey by the Headache and Migraine Policy Forum and MigraineAgain, 78% of migraine and headache patients used telemedicine after the start of the pandemic, in comparison to just 22% before the pandemic. This trend was ushering in a new era of care, where patients could interact with health professionals from the convenience and comfort of their homes. The survey also revealed that there had been a nearly 70% rise in the number of migraine attacks during the pandemic and 84% of people had more stress managing their disease.

On the treatment front, there are new options for patients to explore. “Migraine and headache patients now have more options due to a wave of innovation in acute and preventive care,” noted Dr. William Young, Professor of Neurology, Thomas Jefferson University and Medical Advisor for the Coalition for Headache and Migraine Patients. “These include CGRP monoclonal antibodies, gepants, lasmiditan, and several neuromodulation devices.”

It is so much easier to for many humans to feel since they don’t see anything a migraine or general headache is not so bad but when you experience you may feel different when seeing those people with that symptom.  Headache specialists play a vital role in migraine advocacy and awareness efforts. The symptoms of migraine often cause patients living with the disease to withdraw from their daily lives.. Others may refrain from identifying themselves as a migraine patient, due to stigma surrounding the disease and a lack of compassion surrounding its symptoms. For these patients and so many more, we as healthcare professionals must continue to advocate on their behalf.

A disease awareness month plays a vital role to raise public knowledge, address stigma and build a stronger community of patient advocates.

“Causes of Addiction

• Genetics, including the impact of one’s environment on gene expression, account for about 40% to 60% of a person’s risk of addiction.2
• Environmental factors that may increase a person’s risk of addiction include a chaotic home environment and use, parental drug use and attitude toward ’ drugs, peer influences, community attitudes toward drugs, and poor academic achievement.2
• Teenagers and people with mental health disorders are more at risk for drug use and addiction than other populations.2

Drug and alcohol use can be scary. What’s more frightening is when you’re the one battling a substance use disorder (SUD) or an alcohol use disorder (AUD), and you don’t have a solution to the problem.

American Addiction Centers (AAC) provides 24-hour medical detox, premium rehabilitation treatment, and ongoing care. If you’re struggling with an AUD or SUD and are looking for a solution, reach out to one of our admissions navigators.”

American Addiction Centers (Alcohol and Drug Abuse Statistics (Facts About Addiction)

Harvard Health Publishing states the following:

“If you’d like to cut down your alcohol consumption or start the new year with a clean slate, join in the Dry January challenge by choosing not to drink beer, wine, or spirits for one month. Dry January began in 2012 as a public health initiative from Alcohol Change UK, a British charity. Now millions take part in this health challenge every year.

While past observational studies suggested a link between drinking a moderate amount of alcohol and health benefits for some people, more recent research has questioned whether any amount of alcohol improves health outcomes. And heavier drinking or long-term drinking can increase physical and mental problems, especially among older adults. Heart and liver damage, a higher cancer risk, a weakened immune system, memory issues, and mood disorders are common issues.

Yet, cutting out alcohol for even a month can make a noticeable difference in your health. Regular drinkers who abstained from alcohol for 30 days slept better, had more energy, and lost weight, according to a study in BMJ Open. They also lowered their blood pressure and cholesterol levels and reduced cancer-related proteins in their blood.

Tips for a successful Dry January

A month may seem like a long time, but most people can be successful. Still, you may need assistance to stay dry in January. Here are some tips:

• Find a substitute non-alcoholic drink. For social situations, or when you crave a cocktail after a long day, reach for alcohol-free beverages like sparkling water, soda, or mocktails (non-alcoholic cocktails.)
  Non-alcoholic beer or wine also is an option, but some brands still contain up to 0.5% alcohol by volume, so check the label. “Sugar is often added to these beverages to improve the taste, so try to choose ones that are low in sugar,” says Dawn Sugarman, a research psychologist at Harvard-affiliated McLean Hospital in the division of alcohol, drugs, and addiction.
• Avoid temptations. Keep alcohol out of your house. When you are invited to someone’s home, bring your non-alcoholic drinks with you.
• Create a support group. Let friends and family know about your intentions and encourage them to keep you accountable. Better yet, enlist someone to do the challenge with you.
• Use the Try Dry app. This free app from the UK helps you track your drinking, set personal goals, and offers motivational information like calories and money saved from not drinking. It’s aimed at cutting back on or cutting out alcohol, depending on your choices.
• Don’t give up. If you slip up, don’t feel guilty. Just begin again the next day.

Check your feelings

Sugarman recommends people also use Dry January to reflect on their drinking habits. It’s common for people to lose their alcohol cravings and realize drinking need not occupy such an ample space in their lives. If this is you, consider continuing for another 30 days, or just embrace your new attitude toward drinking where it’s an occasional indulgence.

If you struggle during the month, or give up after a week or so, you may need extra help cutting back. Talk to your doctor about getting the help you need.

The Rethinking Drinking site created by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is also an excellent resource. For the record, NIAAA recommends limiting alcohol to two daily drinks or less for men and no more than one drink a day for women.

Be aware of problems that might crop up

Dry January can reveal signs of potential alcohol problems, including symptoms of alcohol withdrawal ranging from mild to serious, depending on how much you usually drink.

• Mild symptoms include anxiety, shaky hands, headache, nausea, vomiting, sweating, and insomnia.
• Severe symptoms often kick in within two or three days after you stop drinking. They can include hallucinations, delirium, racing heart rate, and fever.

“If you suffer alcohol withdrawal symptoms at any time, you should seek immediate medical help,” says Sugarman.”

“Addiction is a crisis that affects millions, but breaking it down into numbers reveals just how widespread substance use really is:

• According to the 2023 National Survey on Drug Use and Health (NSDUH), 16.9 million young adults (ages 18-25)—nearly half of this age group—reported drinking alcohol in the last month.*
• Of these, 8.3 million were men (48.4%) and 8.6 million were women (50.8%).
• Each year, excessive alcohol consumption leads to more than 178,000 deaths in the U.S., making it one of the leading preventable causes of death.*
• Opioid misuse, another major concern, claimed the lives of over 106,000 individuals in 2021—a number that continues to grow.*

These statistics are more than just numbers—they reflect real people, families, and communities affected by substance use and its consequences. But here’s the good news: understanding the science and realities of addiction is the first step toward creating a healthier path forward.”

Gibson Center for Behavioral Change – Hope, Strength and Evolve (https://gibson-center.com/fact-over-fiction-national-drug-and-alcohol-facts)

Know the signs of addiction:

Drug addiction symptoms or behaviors include, among others:

• Feeling that you have to use the drug regularly — daily or even several times a day
• Having intense urges for the drug that block out any other thoughts
• Over time, needing more of the drug to get the same effect
• Taking larger amounts of the drug over a longer period of time than you intended
• Making certain that you maintain a supply of the drug
• Spending money on the drug, even though you can’t afford it
• Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use
• Continuing to use the drug, even though you know it’s causing problems in your life or causing you physical or psychological harm
• Doing things to get the drug that you normally wouldn’t do, such as stealing
• Driving or doing other risky activities when you’re under the influence of the drug
• Spending a good deal of time getting the drug, using the drug or recovering from the effects of the drug
• Failing in your attempts to stop using the drug
• Experiencing withdrawal symptoms when you attempt to stop taking the drug

Recognizing unhealthy drug use in family members

Sometimes it’s difficult to distinguish normal teenage moodiness or anxiety from signs of drug use. Possible signs that your teenager or other family member is using drugs include:

• Problems at school or work — frequently missing school or work, a sudden disinterest in school activities or work, or a drop in grades or work performance
• Physical health issues — lack of energy and motivation, weight loss or gain, or red eyes
• Neglected appearance — lack of interest in clothing, grooming or looks
• Changes in behavior — major efforts to bar family members from entering the teenager’s room or being secretive about going out with friends; or drastic changes in behavior and in relationships with family and friends
• Money issues — sudden requests for money without a reasonable explanation; or your discovery that money is missing or has been stolen or that items have disappeared from your home, indicating maybe they’re being sold to support drug use.

Alcohol Addiction:

People who drink are affected even before they show signs of being drunk, especially when it comes to decision-making abilities.

At first, alcohol causes people to feel upbeat and excited. But this is temporary and they shouldn’t be fooled.

If drinking continues, the effects on the body—and the potential risks—multiply. Here’s what can happen:

• Inhibitions and memory: People may say and do things that they will regret later, or possibly not remember at all. Inhibitions are lost – leading to poor decision making.
• Decision-making skills: When they drink, individuals are more likely to be impulsive. They may be at greater risk for having an alcohol-related traffic crash, getting into fights, or making unwise decisions about sex.
• Coordination and physical control: When drinking leads to loss of balance, slurred speech, and blurred vision, even normal activities can become more dangerous.
• Death: Drinking too much alcohol can also lead to death. If people drink too much, they will eventually get sleepy and pass out. Reflexes like gagging and breathing can be suppressed. That means they could vomit and choke, or stop breathing completely.

And finally, it’s easy to misjudge how long alcohol’s effects last. Alcohol continues to affect the brain and body long after the last drink has been finished. Even after someone stops drinking, alcohol in the stomach and intestine continues to enter the bloodstream, impairing judgment and coordination for hours.

An alcohol blackout is a gap in a person’s memory for events that took place while he or she was drinking. When a blackout happens, a person’s brain does not create memories for these events as they are happening. For people who have had a blackout, it can be frightening to wake up the next day and not remember what they did the night before.

Teens drink for a variety of reasons. Some teens want to experience new things. Others feel pressured into drinking by peers. And some are looking for a way to cope with stress or other problems. Unfortunately, drinking will only make any problems a person has already worse, not better.

Symptoms

Alcohol is a drug!  Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include:

• Being unable to limit the amount of alcohol you drink
• Wanting to cut down on how much you drink or making unsuccessful attempts to do so
• Spending a lot of time drinking, getting alcohol or recovering from alcohol use
• Feeling a strong craving or urge to drink alcohol
• Failing to fulfill major obligations at work, school or home due to repeated alcohol use
• Continuing to drink alcohol even though you know it’s causing physical, social, work or relationship problems
• Giving up or reducing social and work activities and hobbies to use alcohol
• Using alcohol in situations where it’s not safe, such as when driving or swimming
• Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
• Experiencing withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink, or drinking to avoid these symptoms

Clinical Symptoms of alcohol poisoning include:

• Confusion
• Difficulty remaining conscious
• Vomiting
• Seizures
• Trouble with breathing
• Slow heart rate
• Clammy skin
• Dulled responses, such as no gag reflex (which prevents choking)
• Extremely low body temperature
• Death.

Alcohol use disorder can include periods of being drunk (alcohol intoxication) and symptoms of withdrawal.

• Alcohol intoxication results as the amount of alcohol in your bloodstream increases. The higher the blood alcohol concentration is, the more likely you are to have bad effects. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, poor judgment, slurred speech, problems with attention or memory, and poor coordination. You can also have periods called “blackouts,” where you don’t remember events. Very high blood alcohol levels can lead to coma, permanent brain damage or even death.
• Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to 4 to 5 days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.

When to see a doctor:

If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or if your family is concerned about your drinking, talk with your health care provider. Other ways to get help include talking with a mental health professional or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group.

Because denial is common, you may feel like you don’t have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem with drinking but has stopped.

Causes:

Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder.

Over time, drinking too much alcohol may change the normal function of the areas of your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in craving alcohol to try to restore good feelings or reduce negative ones.

Risk factors:

Alcohol use may begin in the teens, but alcohol use disorder occurs more frequently in the 20s and 30s, though it can start at any age.

Risk factors for alcohol use disorder include:

• Steady drinking over time. Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can lead to alcohol-related problems or alcohol use disorder.
• Starting at an early age. People who begin drinking — especially binge drinking — at an early age are at a higher risk of alcohol use disorder.
• Family history. The risk of alcohol use disorder is higher for people who have a parent or other close relative who has problems with alcohol. This may be influenced by genetic factors.
• Depression and other mental health problems. It’s common for people with a mental health disorder such as anxiety, depression, schizophrenia or bipolar disorder to have problems with alcohol or other substances.
• History of trauma. People with a history of emotional trauma or other trauma are at increased risk of alcohol use disorder.
• Having bariatric surgery. Some research studies indicate that having bariatric surgery may increase the risk of developing alcohol use disorder or of relapsing after recovering from alcohol use disorder.
• Social and cultural factors. Having friends or a close partner who drinks regularly could increase your risk of alcohol use disorder. The glamorous way that drinking is sometimes portrayed in the media also may send the message that it’s OK to drink too much. For young people, the influence of parents, peers and other role models can impact risk.

Complications:

Alcohol depresses your central nervous system. In some people, the initial reaction may feel like an increase in energy. But as you continue to drink, you become drowsy and have less control over your actions.

Too much alcohol affects your speech, muscle coordination and vital centers of your brain. A heavy drinking binge may even cause a life-threatening coma or death. This is of particular concern when you’re taking certain medications that also depress the brain’s function.

Excessive drinking can reduce your judgment skills and lower inhibitions, leading to poor choices and dangerous situations or behaviors.

Health Problems That can Arise:

• Liver disease. Heavy drinking can cause increased fat in the liver (hepatic steatosis) and inflammation of the liver (alcoholic hepatitis). Over time, heavy drinking can cause irreversible destruction and scarring of liver tissue (cirrhosis).
• Digestive problems. Heavy drinking can result in inflammation of the stomach lining (gastritis), as well as stomach and esophageal ulcers. It can also interfere with your body’s ability to get enough B vitamins and other nutrients. Heavy drinking can damage your pancreas or lead to inflammation of the pancreas (pancreatitis).
• Heart problems. Excessive drinking can lead to high blood pressure and increases your risk of an enlarged heart, heart failure or stroke. Even a single binge can cause serious irregular heartbeats (arrhythmia) called atrial fibrillation.
• Diabetes complications. Alcohol interferes with the release of glucose from your liver and can increase the risk of low blood sugar (hypoglycemia). This is dangerous if you have diabetes and are already taking insulin or some other diabetes medications to lower your blood sugar level.
• Issues with sexual function and periods. Heavy drinking can cause men to have difficulty maintaining an erection (erectile dysfunction). In women, heavy drinking can interrupt menstrual periods.
• Eye problems. Over time, heavy drinking can cause involuntary rapid eye movement (nystagmus) as well as weakness and paralysis of your eye muscles due to a deficiency of vitamin B-1 (thiamin). A thiamin deficiency can result in other brain changes, such as irreversible dementia, if not promptly treated.
• Birth defects. Alcohol use during pregnancy may cause miscarriage. It may also cause fetal alcohol spectrum disorders (FASDs). FASDs can cause a child to be born with physical and developmental problems that last a lifetime.
• Bone damage. Alcohol may interfere with making new bone. Bone loss can lead to thinning bones (osteoporosis) and an increased risk of fractures. Alcohol can also damage bone marrow, which makes blood cells. This can cause a low platelet count, which may result in bruising and bleeding.
• Neurological complications. Excessive drinking can affect your nervous system, causing numbness and pain in your hands and feet, disordered thinking, dementia, and short-term memory loss.
• Weakened immune system. Excessive alcohol use can make it harder for your body to resist disease, increasing your risk of various illnesses, especially pneumonia.
• Increased risk of cancer. Long-term, excessive alcohol use has been linked to a higher risk of many cancers, including mouth, throat, liver, esophagus, colon and breast cancers. Even moderate drinking can increase the risk of breast cancer.
• Medication and alcohol interactions. Some medications interact with alcohol, increasing its toxic effects. Drinking while taking these medications can either increase or decrease their effectiveness, or make them dangerous.

Marijuana, hashish & other cannabis-containing substances:

People use cannabis by smoking, eating or inhaling a vaporized form of the drug. Cannabis often precedes or is used along with other substances, such as alcohol or illegal drugs, and is often the first drug tried.

Signs and symptoms of recent use can include:

• A sense of euphoria or feeling “high”
• A heightened sense of visual, auditory and taste perception
• Increased blood pressure and heart rate
• Red eyes
• Dry mouth
• Decreased coordination
• Difficulty concentrating or remembering
• Slowed reaction time
• Anxiety or paranoid thinking
• Cannabis odor on clothes or yellow fingertips
• Major cravings for certain foods at unusual times

Long-term use is often associated with:

• Decreased mental sharpness
• Poor performance at school or at work
• Ongoing cough and frequent lung infections

Barbiturates, benzodiazepines and hypnotics:

Barbiturates, benzodiazepines and hypnotics are prescription central nervous system depressants. They’re often used and misused in search for a sense of relaxation or a desire to “switch off” or forget stress-related thoughts or feelings.

• Barbiturates. An example is phenobarbital.
• Benzodiazepines. Examples include sedatives, such as diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin) and chlordiazepoxide (Librium).
• Hypnotics. Examples include prescription sleeping medicines such as zolpidem (Ambien) and zaleplon (Sonata).

Signs and symptoms of recent use can include:

• Drowsiness
• Slurred speech
• Lack of coordination
• Irritability or changes in mood
• Problems concentrating or thinking clearly
• Memory problems
• Involuntary eye movements
• Lack of inhibition
• Slowed breathing and reduced blood pressure
• Falls or accidents
• Dizziness

Complications to the body with these legal and illegal medications:

• Taking part in risky behaviors such as drink driving or unprotected sex
• Changes in behavior such as mood swings or increased aggression toward others
• Impacts on sleep or experiencing insomnia
• Cognitive/memory problems
• Reduced appetite or not eating a balanced diet
• Regular colds and flu
• Long term health impacts such as liver, kidney and heart problems or cancer (depending on the type of drug used and how frequently it was used)