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In this lesson plan, students are encouraged to investigate patterns of alcohol use and abuse and to recognize the early and late stages of alcoholism. Students categorize drinking behaviors (Alcoholic, Problem Drinker, Social Drinker) by placing a drinking behavior or condition under the correct category. This teaching technique is appropriate for high school and college students.

Learning outcomes

The learner will:

  • categorize drinking behaviors into three groups (Alcoholic, Problem Drinker, Social Drinker) and explain why they placed a selected behavior/statement under that category.
  • explore alcohol misuse and risk-taking behaviors.
  • recognize the early and late stages of alcoholism.

Teacher planning

Time required

90 to 120 minutes

Materials needed

Technology resources

  • Compact disc or MP3 player
  • Compact disc or MP3 version of “All Things Being the Same.” Paul, Ellis, All Things Being the Same, from Stories. Black Wolf Records. 1994, compact disc.

Pre-activities

Teacher preparation

Write out each drinking behavior/statement listed below on a separate card (5” x 7”) and shuffle the cards:

  • Drinks slowly (”nurses” drink during a party)
  • Carefully measures amount of alcohol for mixed drinks
  • Always serves food when serving drinks (avoids serving salty foods)
  • Provides non-alcoholic alternatives at party
  • Doesn’t push drinks on guests
  • Stops serving alcohol one hour before end of party
  • Knows when to stop drinking
  • Surrounding themselves socially with heavy drinkers
  • Only drinks occasionally
  • Drinks to get good and ‘buzzed’
  • Binge drinking
  • Takes a drink before a class presentation, date, or driving
  • Drinking to increase sexual performance
  • Becomes aggressive after drinking
  • Cuts classes or misses work frequently due to hangovers
  • Gets poor grades and chronically turns papers in late due to drinking
  • Does or says things they regret while drinking
  • Needs to drink alcohol in order to have a good time
  • Blackouts
  • Recovering from hangovers regularly
  • Drinking more or over a longer period of time than intended
  • Persistent desire or one or more unsuccessful attempts to control drinking
  • Can no longer get high on one six pack of beer
  • Drinking in hazardous situations
  • Frequent intoxication or withdrawal along with unfulfilled obligations
  • Drinking daily
  • Drinking to escape or to deal with problems

Reading

Prior to the lesson, ask students to read any Internet article of their choice on alcohol use and abuse and its association with serious medical illnesses such as cancer, cardiovascular problems, liver cirrhosis, stroke, hypertension, and brain damage.

Activities

Focus activity

  1. Have all students write a brief definition for each of the following drinking categories: Social Drinker, Problem Drinker, and Alcoholic in their own words. Ask one student to share their definition of a Social Drinker, and another student to share their definition of a Problem Drinker, and one student to share their definition of an Alcoholic. Answers will vary but do not provide definitions at this point. Explain to students that we will determine the differences between the three types of alcohol consumption, social drinking, problem drinking, and alcoholism in today’s lesson.
  2. Play a recording of All Things Being the Same by Ellis Paul and provide students with a copy of the lyrics. This song is a narrative account of a woman who frequents a local bar and consumes an abundance of alcohol. Listening to the lyrics and performance of this song may increase the likelihood of students’ appreciation of using music to convey stories about problem drinking and alcoholism.
  3. After playing the song All Things Being the Same ask students to respond to three questions:
    1. Is there any social message in the song regarding the use of alcohol? Answer: Yes, Ellis Paul wrote All Things Being the Same as a social commentary on the negative aspects of excessive alcohol consumption. Paul wrote the song following a weekend concert in Atlanta at Eddie’s Attic, a premier nightclub for performing songwriters. The main character in the song was based on an actual customer who Paul saw drinking alone every night (e.g., “She’s got her name on a stool down at Eddie Owens place.”)
    2. Based on the lyrics of the song do you think that the main character portrayed in All Things Being the Same is a Social Drinker, Problem Drinker, or Alcoholic? Ask students to explain why they choose one of the three drinking categories above and be prepared to share their answer with the class. Answer: In this song, the main character is portrayed as a problem drinker or perhaps an alcoholic, but certainly not a social drinker.
    3. Does the song promote a better understanding of problem drinking? Answer: Yes. In this song, the main character is portrayed as a problem drinker or an alcoholic. For example, portions of the lyrics state, “She is searching for some form of salvation. In the corner of a bar down the street. But the gin controls whole conversations. And plays magic tricks with her feet…” In addition, the main character in the song is devoid of authentic friendships, “All her friends are nothing more than strangers. Whose names are just words on a face. If they bumped into her out on a sidewalk on some Sunday, they wouldn’t recognize her outside of the place.”

Teacher input

After students answer the three questions relating to the song All Things Being the Same, introduce the next activity by saying, “Today we will not define each category of drinking (Social, Problem, and Alcoholic) in a traditional manner. Instead, you are going to participate in an activity to determine the categories (Alcoholic, Problem Drinker, Social Drinker) that best relates to drinking behaviors by placing a drinking behavior or condition under the correct category.”

Guided practice

Social, Problem, and Alcoholic Drinking activity

  1. Students can either work in pairs or by themselves for this activity.
  2. On the board or wall, post three separate large headings:
    SOCIAL DRINKER PROBLEM DRINKER ALCOHOLIC
  3. Give each student (or pair of students) one card with a single drinking behavior or statement.
  4. Ask one student (or pair) at a time to tape their card under the category (Alcoholic, Problem Drinker, Social Drinker) that best applies and to explain why they placed the behavior/statement under that category.
  5. If students are unsure what category to affix the card under, allow them to ask the class for assistance. Guide students to affix cards under the correct heading. Be sensitive to the fact that students may be uncomfortable rendering an opinion in front of their classmates.
  6. When the activity is completed, the lists should appear as follows:
    SOCIAL DRINKER
    1. Drinks slowly (‘nurses’ drink during a party)
    2. Carefully measures amount of alcohol for mixed drinks
    3. Always serves food when serving drinks (avoids serving salty foods)
    4. Provides non-alcoholic alternatives at party
    5. Doesn’t push drinks on guests
    6. Stops serving alcohol one hour before end of party
    7. Knows when to stop drinking
    8. Surrounding themselves socially with heavy drinkers
    9. Only drinks occasionally
    PROBLEM DRINKER
    1. Drinks to get good and ‘buzzed’
    2. Binge drinking
    3. Takes a drink before a class presentation, date, or driving
    4. Drinking to increase sexual performance
    5. Becomes aggressive after drinking
    6. Cuts classes or misses work frequently due to hangovers
    7. Gets poor grades and chronically turns papers in late due to drinking
    8. Does or says things they regret while drinking
    9. Needs to drink alcohol in order to have a good time
    ALCOHOLIC
    1. Blackouts
    2. Recovering from hangovers regularly
    3. Drinking more or over a longer period of time than intended
    4. Persistent desire or one or more unsuccessful attempts to control drinking
    5. Can no longer get high on one six pack of beer
    6. Drinking in hazardous situations
    7. Frequent intoxication or withdrawal along with unfulfilled obligations
    8. Drinking daily
    9. Drinking to escape or to deal with problems

Assessment

  • Ask students, “What one thing did you learn today that could help you recognize the early and late stages of alcoholism?” Have students discuss the variety of concerns that people have associated with problem drinking and alcoholism. Following the discussion, inform students that numerous concerns are natural and that it is important for them to talk about these feelings and share them with someone they can trust. Answer any questions students may have.
  • Measure the three learning outcomes to assess successful completion of the lesson. First, assess whether students are able to categorize drinking behaviors into three groups (Alcoholic, Problem Drinker, Social Drinker) and explain why they placed a selected behavior/statement under that category. Second, assess whether students can identify and express opinions while exploring alcohol misuse and risk-taking behaviors. Finally, assess whether students are able to list and explain the early and late stages of alcoholism.

Supplemental information

Social drinkers are those individuals who drink in low-risk patterns. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “low-risk” drinking for females consists of no more than 7 drinks per week and no more than 3 drinks per sitting. For males, it consists of no more than 14 drinks per week and no more than 4 drinks per day. This means one 12-ounce beer, or one 5-ounce glass of wine, or a 1.5-ounce shot of liquor (vodka, whiskey, rum).

Another way to define social drinking would be to consider the safe limits of alcohol use. The recommendation is that men between the ages of 21 and 65 should not consume more than 2 drinks a day. Women and everyone who is over the age of 65 should not consume more than one drink per day. Those who drink regularly above the safe limits are at increased risk of:

  • Certain cancers
  • Cardiovascular accidents
  • High blood pressure
  • Accidents while under the influence
  • Progression to alcohol abuse and addiction

Problem drinkers display clear differences between their drinking habits and those of alcoholics. In fact, according to the NIAAA, 72% of people have a single period of heavy drinking that lasts 3-4 years and peaks at ages 18-24 (typically occurs during the college years) that they phase out of. When problem drinkers are given sufficient reason to cut back on their drinking (i.e., have a negative drinking consequence, debilitating hangover, becoming a parent) they are able to self-correct and return to drinking in a low-risk manner.

While there is currently no world-wide consensus on how many drinks constitute problem drinking the term is often taken to mean consuming five or more standard drinks (male), or four or more drinks (female), on one occasion.

The CAGE questionnaire is a good indicator that someone is moving from social drinking to problem drinking. The questions on this test are:

  1. Have you ever felt the need to Cut down on your drinking?
  2. Have people ever Annoyed you by criticism of your drinking?
  3. Have you ever felt Guilty about your drinking?
  4. Have you ever taken a morning Eye-opener drink to steady your nerves or to get rid of a hangover?

Alcoholics may be given countless reasons to cut back on their drinking but they are unable to permanently cut back on their drinking. Alcoholics may have occasions where they drank in a low-risk manner, but they inevitably return to their alcoholic drinking patterns. High-functioning alcoholics (HFAs) in particular tend to minimize their drinking by falsely labeling it as a “problem” or as “heavy” drinking because they often do not believe that they fit the stereotype of an alcoholic. However, what defines an alcoholic is a person’s relationship to alcohol and not how they appear to the outside world in terms of their personal, professional or academic life.

Most American adults drink alcohol, yet fewer than ten percent ever develop drinking problems. Although moderate drinkers tend to live longer and healthier lives than both alcoholics and those who abstain from alcohol, moderate drinking is difficult to define and is often confused with social drinking.

Many high school and college students drink to excess and engage in risky drinking behaviors such as binge drinking and drinking and driving. Recent studies suggest that nearly half of all college students are binge drinkers consuming five or more drinks in short succession (Weschler, et al., 2008). The Harvard School of Public Health reported that students who engaged in binge drinking in high school usually continue this behavior in college and relatively few high school binge drinkers stop binge drinking in college. In addition, many students who did not binge drink in high school begin binge drinking in college (Harvard School of Public Health, 2012).

Forty percent of children who start drinking before the age of 15 will become alcoholics at some point in their lives, compared with 25% for those who begin drinking at age 17, and about 10% for those who begin drinking at ages 21 and 22 (Facts About Alcohol).

References

Alcohol Rehabilitation Center. “Facts About Alcohol.” Accessed July 1, 2012. http://www.alcoholrehabcenter.com/content/5126/facts-about-alcohol-from-social-drinking.php.
Harvard School of Public Health. “College Alcohol Study.” Accessed July 1, 2012. http://www.hsph.harvard.edu/cas/FAQ/index.html.
Wechsler, Henry, Meichun Kuo, Hang Lee, and George W. Dowdall. “Environmental Correlates of Underage Alcohol Use and Related Problems of College Students.” American Journal of Preventive Medicine 19 (2000): 24-29.
Weschler, Henry and Toben F. Nelson “What We Have Learned from the Harvard School of Public Health College Alcohol Study: Focusing Attention on College Student Alcohol Consumption and the Environmental Conditions That Promote It.” Journal of Studies on Alcohol and Drugs 69 (2008): 481-490.

  • North Carolina Essential Standards
    • Healthful Living (2010)
      • Grades 9 - 12

        • 9.ATOD.1 Understand the health risks associated with alcohol, tobacco, and other drug use. 9.ATOD.1.1 Explain the short-term and long-term effects of performance-enhancing drugs on health and eligibility to participate in sports. 9.ATOD.1.2 Analyze the role...
        • 9.ATOD.2 Apply risk reduction behaviors to protect self and others from alcohol, tobacco, and other drug use. 9.ATOD.2.1 Identify ways to avoid riding in a car or engaging in other risky behaviors with someone who is under the influence of alcohol or other...

North Carolina curriculum alignment

Healthful Living Education (2006)

Grade 9–12

  • Goal 5: The learner will choose not to participate in substance abuse.
    • Objective 5.05: Predict potential effects of an individual’s substance abuse on others.