The Big Picture
Some people misuse alcohol, medications, or other substances and become unable to stop. These substances can change how a person feels, thinks, and behaves. They can also affect relationships, work, and health.
Alcohol is the most commonly abused substance. People who misuse alcohol may experience physical and emotional changes, and some face serious health problems.
As a Continuing Care Assistant (CCA), you need to recognize possible signs of substance misuse. You also need to know how to report concerns, protect private information, and respond without arguing with the client.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- A substance-related and addictive disorder involves deliberately misusing substances and being unable to stop.
- drug tolerance means needing increasingly larger amounts of a substance to get the same effect.
- drug withdrawal is a physical reaction that happens when someone stops taking a substance they have been abusing.
- Alcohol misuse can affect memory, concentration, behaviour, relationships, and physical health.
- CCAs must report suspected substance abuse to their supervisor immediately and keep the information confidential.
- Never argue with a client about suspected substance abuse or buy alcohol, drugs, or other substances for them.
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Course Notes: Key Ideas You Need to Know
Understanding Substance-Related and Addictive Disorders
A substance-related and addictive disorder involves deliberately misusing substances and being unable to stop abusing them.
A person may misuse one substance or several substances together.
Substances that may be abused include:
- Prescription medications
- OTC medications and substances
- Illegal drugs
- Alcohol
- Marijuana
- Other substances
These disorders commonly create difficulties in relationships and at work.
How Substances Affect the Mind and Behaviour
Abused substances affect the central nervous system.
Different substances can produce different effects.
- Calming or depressing effects: Some substances have a calming or depressing effect on the central nervous system.
- Stimulating effects: Other substances stimulate the mind and affect thinking.
- Mood changes: Some substances make people feel happy, confident, or relaxed.
Other possible effects include:
- hallucination: Seeing, hearing, smelling, tasting, or feeling something that is not real.
- An exaggerated belief in one’s own abilities.
- Emotional or aggressive behaviour.
Key fact: Not every substance produces the same effects. Some are calming, while others are stimulating or change a person’s mood.
Drug Tolerance and Drug Withdrawal
Two important concepts are drug tolerance and drug withdrawal.
They describe different things.
Drug Tolerance
drug tolerance develops when the body becomes accustomed to a substance.
The person needs increasingly larger amounts to experience the same effect.
For example, an amount that once produced a certain effect may no longer produce that same effect. The person needs more of the substance to experience it again.
Drug Withdrawal
drug withdrawal is a physical reaction that occurs when someone stops taking a substance they have been abusing.
Withdrawal can be severe.
Possible signs and symptoms include:
- Depression
- Agitation
- Abdominal cramps
- Nausea
- Diarrhea
- Painful muscle spasms
The difference is important:
| Drug Tolerance | Drug Withdrawal |
|---|---|
| Happens as the body becomes accustomed to a substance. | Happens when a person stops taking an abused substance. |
| The person needs more of the substance for the same effect. | The person experiences a physical reaction to stopping. |
Serious Risks of Substance-Related and Addictive Disorders
Substance misuse can have serious consequences.
Some people with addiction may commit crimes to support their substance use.
Without treatment, these disorders can lead to death.
Common causes of death include:
- Overdose
- Suicide
- Diseases contracted through contaminated needles
These risks show why substance-related and addictive disorders are serious health concerns.
Treatment for Substance-Related and Addictive Disorders
Treatment depends on the substance or substances being abused.
Two important treatment concepts are detoxification and psychotherapy.
Detoxification
detoxification is the process of removing an abused substance from the body.
This can happen in two ways:
- The substance leaves the body naturally.
- The substance is removed medically.
People who have abused drugs, alcohol, or combinations of substances need detoxification as part of treatment.
During detoxification, the person usually experiences drug withdrawal.
Hospital care is usually required.
Psychotherapy
psychotherapy is a form of treatment in which a person works with a mental health specialist to explore their thoughts, feelings, and behaviours.
Almost all treatment programs for substance-related and addictive disorders include psychotherapy.
Mental health professionals help clients work through and manage their problems.
Understanding Alcohol Use Disorder
Alcohol is abused more than any other substance.
Alcohol use disorder can involve different patterns of drinking and different levels of severity.
A person does not have to drink alcohol every day to experience problems related to alcohol misuse.
Signs and Symptoms of Alcohol Abuse
Alcohol abuse can cause noticeable changes in a person’s thinking, behaviour, and physical condition.
Signs and symptoms include:
- Intoxication: Drunkenness
- Memory impairment
- Difficulty concentrating
- Tremors
- Loss of interest in family and friends
A person’s drinking can also affect relationships with other people.
Physical Health Risks of Alcohol Abuse
People who abuse alcohol are at risk for conditions involving the:
- Liver
- Pancreas
- Heart
Many people who abuse alcohol also have poor nutrition.
Many are also addicted to nicotine from cigarettes. This puts them at risk for lung disease and certain cancers.
Pregnancy risk: Women who drink alcohol during pregnancy can give birth to babies with fetal alcohol spectrum disorder.
Levels of Alcohol Use Disorder
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) is a manual published by the American Psychiatric Association. It is used throughout North America to classify mental health disorders.
The DSM-5 divides alcohol use disorder into three levels:
- Mild
- Moderate
- Severe
These levels are based on:
- The extent of the person’s alcohol use
- How strongly the person craves alcohol
- How much alcohol has disrupted the person’s life
Remember that the classification considers more than how often someone drinks.
Drinking Amounts and Health Risks
The amount of alcohol someone drinks affects their health risks.
For most people, drinking more than two drinks per day can cause significant harm.
Important amounts to remember:
| Drinking Amount | Health Risk |
|---|---|
| More than 2 drinks per day | Can cause significant harm for most people |
| Women drinking more than 10 drinks per week | Higher rates of cancer and other health concerns compared with women who drink less |
| Men drinking more than 15 drinks per week | Higher rates of alcohol-related problems |
These numbers describe health risks associated with alcohol consumption.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition gives weekly risk figures of more than 10 drinks for women and more than 15 for men. Nova Scotia Health also shares the newer Canada’s Guidance on Alcohol and Health, released in 2023. It uses the same weekly risk ranges for women and men.
Under this newer guidance, drinking 1 to 2 standard drinks per week is considered low risk, 3 to 6 is moderate risk, and 7 or more is increasingly high risk. Not drinking avoids alcohol-related risks. These ranges describe health risks, not the mild, moderate, and severe categories used to classify alcohol use disorder.
Why this matters in Nova Scotia: Keep Sorrentino’s drinking figures for your textbook study, but recognize the newer guidance when learning about current alcohol-related health risks.
Official source: Canada’s Guidance on Alcohol and Health, Canadian Centre on Substance Use and Addiction
Last checked: October 9, 2026
Different Patterns of Alcohol Use
People do not all misuse alcohol in the same way.
Some drink alcohol every day.
Others go several days or weeks without drinking. They then consume a large amount in a short time.
Both patterns can occur among people who misuse alcohol.
People at Risk for Alcohol Abuse
Certain circumstances may increase the risk of alcohol misuse.
- People with mental health disorders may turn to alcohol when experiencing stress or loneliness.
- Some people use alcohol because they want to feel better.
- Older people who live alone are at risk for alcohol abuse.
These circumstances help explain why people may turn to alcohol.
How Alcohol Misuse Can Affect Families and Others
People who misuse alcohol may be emotional, aggressive, or abusive.
Family members can experience abuse and other difficulties as a result.
Not everyone who misuses alcohol becomes aggressive toward others.
Some people appear cheerful, friendly, or entertaining when drinking. Even when they are not violent, their drinking can still damage their health.
Safety: Drinking and driving puts the person drinking and other people on the road at risk of death.
Treatment for Alcohol Use Disorder
The main treatment for alcohol use disorder is to stop drinking alcohol.
Treatment and support may include:
- Alcoholics Anonymous (AA): A group that helps people stop drinking.
- Individual counselling: Counselling provided to the person experiencing alcohol-related problems.
- Family counselling: Counselling involving the family.
Individual and family counselling are often needed as part of treatment.
Supporting Clients With Substance-Dependence Disorders
CCAs have specific responsibilities when they suspect a client is misusing alcohol, medications, or other substances.
The main rules involve immediate reporting, confidentiality, avoiding confrontation, and refusing requests to purchase substances.
What the CCA Must Do and Avoid
- Report suspicions immediately: Tell your supervisor at once if you suspect substance abuse. Possible signs include smelling alcohol on a client’s breath or noticing that a client’s medication runs out faster than expected.
- Protect confidentiality: Discuss suspected substance abuse only with your supervisor. Do not share the information with anyone else.
- Avoid confrontation: Do not argue with a client about suspected substance abuse. Tell your supervisor immediately.
- Never purchase substances: Do not buy alcohol, drugs, or other substances for clients. Doing so is unethical . Report any such request to your supervisor.
Nova Scotia CCA Note
Sorrentino tells CCAs to report suspected substance misuse to their supervisor immediately and keep the concern confidential. Nova Scotia’s current Continuing Care Assistant Occupational Standards of Practice also explain that CCAs observe changes in a person’s behaviour and condition and report changes that need attention.
In Nova Scotia, CCAs follow the care plan and their employer’s procedures when documenting required information. The standards also distinguish a CCA’s observations from a full nursing assessment, which a CCA is not permitted to perform.
Why this matters in Nova Scotia: Report concerns promptly, protect the client’s private information, and follow your employer’s documentation requirements. Your observations do not give you authority to carry out a nursing assessment.
Official source: Continuing Care Assistant Occupational Standards of Practice, Nova Scotia CCA Program
Last checked: October 9, 2026
Exam Clue Words
Pay close attention to words that make the CCA’s responsibility clear.
- At once / immediately: Report suspected substance abuse to your supervisor without delay.
- Do not: Avoid arguing with a client about suspected substance misuse. Do not discuss the concern with anyone except your supervisor.
- Never: A CCA must not purchase alcohol, drugs, or other substances for clients.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| Drug tolerance and drug withdrawal mean the same thing. | Tolerance means needing more for the same effect. Withdrawal is a physical reaction after stopping. |
| Someone must drink every day to misuse alcohol. | Some people go days or weeks without drinking, then consume a large amount in a short time. |
| A person who seems happy while drinking is not at risk. | Alcohol can still harm their health, even without aggressive behaviour. |
| A CCA should confront a client about suspected substance misuse. | Avoid confrontation and report the concern immediately to the supervisor. |
| A CCA can buy alcohol or drugs for a client if asked. | Purchasing these substances for clients is unethical and must never be done. |
Fast Review
Use these points to review the most important facts before a quiz or exam.
- Substance-related and addictive disorder: Deliberate substance misuse combined with an inability to stop abusing the substance.
- Effects on the central nervous system: Abused substances may be calming, stimulating, mood-altering, or cause hallucinations and changes in behaviour.
- Drug tolerance: The body becomes accustomed to a substance, and larger amounts are needed to produce the same effect.
- Drug withdrawal: A physical reaction after stopping an abused substance. Symptoms may include depression, agitation, abdominal cramps, nausea, diarrhea, and painful muscle spasms.
- Detoxification: The abused substance leaves the body naturally or is removed medically. Withdrawal usually occurs, and hospital care is usually needed.
- Alcohol abuse signs: Intoxication, memory problems, poor concentration, tremors, and reduced interest in family and friends.
- Alcohol health risks: Conditions affecting the liver, pancreas, and heart, along with poor nutrition.
- DSM-5 classifications: Alcohol use disorder can be mild, moderate, or severe, depending on alcohol use, cravings, and disruption to daily life.
- Drinking amounts: More than two drinks a day can significantly harm most people. Women who drink more than 10 drinks a week have higher rates of cancer and other health concerns. Men who drink more than 15 drinks a week have higher rates of alcohol-related problems.
- Treatment: Avoiding alcohol is the main treatment for alcohol use disorder. AA and individual or family counselling can provide support.
- CCA reporting and confidentiality: Report suspected substance abuse immediately. Discuss concerns only with your supervisor.
- CCA restrictions: Do not confront or argue with clients about suspected substance abuse. Never purchase alcohol, drugs, or other substances for clients, and report such requests to your supervisor.
Final Pep Talk
There are several similar terms in this topic, especially drug tolerance, drug withdrawal, and detoxification. Give yourself time to separate their meanings, then review the CCA rules until you can recognize what to report, what to avoid, and what you must never do.