Tuesday, February 20, 2007

Prevention Better than Cure?

With drugs hitting the UK headlines, it seems only fitting to write a short note about alcohol, drugs and mental illness. In clinical practice people commonly tell me that they are unaware about the mental health risks of illicit drug taking, and I am always keen to highlight mental health promotion.
It is known that drugs such as cannabis, cocaine, amphetamines, ecstasy, LSD and heroin in some people can precipitate an acute mental illness, as well as dependency. Of course, some people who develop a psychotic illness following drug abuse had precursor symptoms of a psychotic illness, and were trying to self-medicate with drugs, which led to an exacerbation of the illness, and sometimes schizophrenia.
Whilst talking of mental health preservation it is also worth briefly discussing alcohol. With alcohol consumption increasing in some age groups and pubs being open longer hours it is important to be constantly vigilant to vulnerablities of alcohol dependence. One way of preventing this is to try and ansure at least two or three days a week are completely alcohol free. Another useful alcohol indicator is to ask the CAGE questionnaire:

Have you ever tried to Cut down on your drinking?
Have you ever got Annoyed because someone mentioned your drinking?
Have you ever felt Guilty about the amount you are drinking?
Have you ever started to drink Early in the morning?

Mental Health Promotion is not about waiting until the sickness has set in, but trying to increase education to help people make informed choices.


Maalie said...

> Have you ever tried to cut down on your drinking?

Oh yes, some years ago when I went through a "bad patch". Thankfully I recognised the danger well before it was too late. Those days are well behind me now.

A very interesting post.

simon said...

I agree jim...

Anonymous said...

I wish my friend Sue had had the same strength as Maalie.

Dr Michelle Tempest said...

I was sorry to hear the news about your friend Ellee, sending you good wishes. All the very best

Ian Lidster said...

Oh, the old chicken and egg thing. When I was working in addictions there were two mutually antagonistic schools of thought. At my end, with addictions, we held the assumption that clients should get free from substance before looking at mental health issues. At the mental health it it was assumed that the psychological distress should be considered first, and that the substance abuse could come later. I have no answer to this connundrum, but I do appreciate your well-considered thoughts on substance abuse and mental illness.
And thank you, Michelle, for your comments on alcohol, which remains our biggest killer drug in every sense of the word, and is so often disregarded when other drugs cause people to fret.

Bob - BlogMYruns.com said...

Have you ever started to drink Early in the morning?

ONE time and that was when I got more control over the beers,(about 12 years now)

that day is still very VIVID for me:It really made me sick after I woke up and started to drink a few...I got pissed at myself and that was it. I was saved from having a few morning beers, that was my "Ah Ha" moment, enough already!! Thank you Jesus, AMEN.

I come from a long family history of drunks and it is a very sensitive issue for me... makes me sad on how alcoholism is hidden yet if that same person had cancer ...it would not even be an issue to GET HELP NOW!!!

Good post and I am glad I beat that DEVIL thing called Alcohol and pray daily for the ones I love to do the same :-)


Dr Michelle Tempest said...

Thanks Bob for making that post so personal - your thoughts shared here are very much appreciated.

Ian, thanks for your comments. I agree with you that dual diagnosis (drugs plus mental health issues) is a very diffiucult area to work in. It is usual practice that to treat a mental health illness it is best illicit drug free. However, often the most difficult part can be to engage the patients initially. Your comments as always are thoughtful and appreciated. All the very best. Michelle

Clare said...

Most of the girls in my department at work are really into drinking alot. One of them was only saying today they between her, her boyfriend, her sister and her brother they had seven bottles of wine between them on Saturday evening!!!

We did actually have a discussion at work the other day because I don't tend to drink that much and the outcome was that most of the other girls couldn't imagine going out and not drinking. They said although they would have a good time it wouldn't be as good as if they had alcohol. I found that quite sad.

lorenzothellama said...

Very interesting post. I find that if I have one drink then I am away. It is the old principal that if one is good, then three is going to be much better. I know this weekness in me, so either I don't drink at all, or I decide on a 'cut off' point and then try to stick to it. The trouble is that most alcohol tastes so very lovely and it is not the effect that is important but the taste! Mmmm ... gin and martini!

Michelle said...

Michelle, thanks for this post. Many a time i have argued with clients over the effects of smoking cannabis and its relationship to mental illness, mainly schizophrenia. I wish people would stop calling it a "recreational drug", it down plays its absolute effect.

Anonymous said...

I do wonder how many people end up self-medicating with various drugs because they can't get help with symptoms that disturb them or distort their lives. I've met a number of young men with a history of alcohol, cannabis and cocaine use who are wondering if they are undiagnosed ADD or ADHD, based on their history as children.

heiresschild said...

good post. i was married eons ago for 11 months. that's all i could take. he was an alcoholic. drank until he literally passed out. would just keep drinking until he couldn't. his father was an alcoholic and introduced him to it in his teens. he died about 3-4 yrs ago, but it was the only life he knew. never could admit he had that problem. real sad.

have a cousin now addicted to sleeping pills. rehab is just for about 2 wks, which hasn't made a difference. i don't think it's long enough. she's been several times to rehab. lost her job, can't get a new one. kind of like her life is out of control, and no one knows what to do.

Anonymous said...

My friend Sue (I still call her that) her best friend has just been done for drink driving - she was 4 times over the limit - and in the morning. She goes to court on Friday. Her face has alcoholism etched all over it, I've offered to take her to a clinic, we'll have to see what the courts decide.

Dr Michelle Tempest said...

Thanks to you all so much for so kindly taking the time to comment on this blog. It is very much appreciated. This is an emotive and personal issue for so many people. Michelle

jmb said...

You are so smooth with you comments on comments. I think you must be a very good psychiatrist. Do you consult by email if I ever need psychiatric treatment? It's a bit far to come! Just kidding. I enjoy your blog.

Dr Michelle Tempest said...

Glad you like the blog. Thanks jmb! Michelle