Question and answer: Sessions about drug abuse

This week, I will be responding to several questions sent by readers which all revolve around substance use. While I have tried to address them individually, I also thought it may be useful to others who may also have some concerns but had not expressed them. So here goes.

Please, I have an uncle who takes alcohol almost daily, but he is never drunk and he is functioning well at work (he is a banker). But his wife does not like it (she thinks he is increasingly drinking too much) and the rest of the family is also worried. He insists that he does not have any problem and that he is just enjoying his life. Should we be worried or not?

Thank you, but before I can confidently say whether you should be worried or not, it would be nice to have an idea of the quantity of alcohol he consumes daily/weekly. Professionally speaking, mere drinking of alcohol is not a sign or symptom of a mental health problem. If your uncle takes one bottle or half a bottle daily and he is not having any problems at work, home or with respect to his physical health, then he may just be fine. However, I suspect that with the wife’s description of an increasing pattern of drinking over time, and the family concerns, there may actually be a need for an evaluation with a mental health professional. Please, look for a nice way of convincing him to see someone for a chat about his alcohol consumption.

Why did you mention alcohol in your article about drug abuse? Most people like me only take alcohol to have fun and relax. We don’t have a mental health problem please.

Thank you, but see my response above. I was also very clear in my article that it is only where a pattern of alcohol consumption is beginning to cause problems, such as drinking in risky circumstances, for example as a driver (hazardous use); or a pattern of drinking that is causing damage to the body (harmful use); or when it gets to the level that the individual can no longer do without alcohol (dependence) – it is at these levels that it becomes a problem for us to medically worry about.

Having explained as above, I should quickly add that alcohol is potentially a very dangerous drug; even though it is socially acceptable and legally available to all adults. It can potentially cause physical damage to the liver, contributes to high rates of road traffic accidents and is a source of social and economic difficulties for many individuals. It is best to take it in moderation and responsibly. Or better still, avoid it if you can.

I have a room-mate in the female hostel (name of school withheld) who has a habit of drinking several bottles of cough syrup with codeine. She usually pours them into her flask with chilled coke and constantly sips from the flask all day long. She says it makes her feel cool and happy. She and her friends all enjoy drinking it and they have invited me a few times to join them but I am hesitant. But on the other hand, I keep wondering though, that it looks harmless, since it is not like taking hard drugs such as cannabis or alcohol, right? Is it safe to take cough syrups?

Congratulations for being hesitant and for not joining your friends just yet. It is certainly not a safe habit. The cough syrups contain codeine, which is an opiate….the same chemical class as heroin. If you start taking it, your body will gradually adjust and you will no longer feel as cool as when you first started taking it. You may then ‘graduate’ to taking stronger variants – until you lose control. Don’t do it.

I read on the internet that in some places in the US, cannabis is now being used for medical purposes. It is also legal in The Netherlands. So, does that mean I can continue smoking cannabis, since it is good for my health?

Cannabis has some useful and beneficial effects but the side effects outweigh the benefits. There are very strong links between cannabis use and psychosis, for example. Whereas, those who use it for medicinal purposes resort to it only where nothing else works. Not that it is a recommendation for us all to start smoking cannabis. Would you like to test whether or not you will experience a psychotic episode following cannabis use?

Conclusion: Prevention of drug use and abuse is ALWAYS better than seeking a cure. Do not indulge, but rather seek for other ways of feeling good with yourself – such as engaging in sports.