Question: If a friend only uses cocaine every once in a while I shouldn’t be too worried about them right? I am talking about maybe once a month. How often would he need to start using before I should get worried that he is going to get addicted to it?

Jill Edwards Says...:

You are right, in this day and age most people don't worry if someone uses cocaine once a month. But they do sort of keep an eye on it, particularly if they are involved with this friend personally, so there is something about how this use might affect you which goes into the mix as it is well known that cocaine is an addictive drug. so we are looking at the amounts used, so if someone used large amounts, we would be more concerned. If a person moved from using it on a social occasion to using it privately, then we would certainly be getting the wind up. There is no easy number of occasions to give you. It is likely that if they are using dangerously they will hide it. Where they start changing the way they live, where there is lying to themselves or others. Where chaos creeps in.

I would be looking to see whether this person was reasonably satisfied with life. There is more risk if someone is unhappy, depressed or dealing with difficult personal circumstances. Are they self confident.

The other thing is to look at the use of other substances, particularly alcohol The use of alcohol eases the path to cocaine and there are similarlties in the drugs involved. It also enables a person to drink more alcohol without passing out.

If you do have any concerns, it is worth while voicing them and giving the reasons why you are concerned. Make sure you have the numbers of helpful agencies to hand.

It will also be useful for you to know the risks of blood borne viruses from sharing "notes", and to look up the risks of cocaine, in terms of losing money, jobs, houses, relationships etc. There is a lot of money lost through this drug.

I like your concern. Take care! Jill Edwards

Question: I was an alcoholic and I had acute pancreatitis 3 times. The pain was really bad. It even made me quit drinking and that was something I did not think I could ever do. Now I have had another attack even though I have not drank in 8 months and the doctors say I probably have pancreatitis for the rest of my life and it might even kill me unless I really take care of my body. I am not drinking at all anymore but I am abusing percocets and vicodins and nortabs and sometimes even heroin. I am addicted to opiates. I am only 42 and I am not ready to die. I want to quit drugs forever. I want to take Suboxone. But what I want to know is what will happen to me if I go on Suboxone and I get a sudden attack? Will I be able to take morphine on the IV like usual?

Jill Edwards Says...:

No first of all congratulations on stopping drinking. As you say, in a way your had little choice with the pain and illness of pancreatitis. Many people have told me how debilitating the pain of pancreatitis is and I am sorry that you have had a return of it. Clearly now you are realising that you are going to have a look at your health in general, and you are seeing that the major obstacle is the addiction to opiates. I notice that the tablets you take have a variety of substances in them, not just opiates, so this detox could be complicated in its effects. It looks to me as though you would need to follow a reducing programme, so your overall health is not too affected by the changes you are making.

My first and important advice is that you contact your doctor, then you get the support of a drugs agency who are familiar with detoxing from prescription medicines. There is something known as the Thomas method for detoxing. Though you may not follow it without your doctor's permission, it does indicate various practices which help with the side effects of detoxing. Slower is better in this process as going too fast can have effects on your mental health.

Also make sure you have friends, or preferably membership of AA or NA, so there are people around who can be supportive on the low days.

You can consult your doctor about taking Suboxone, but it seems to me that a simple but slow detox from the medication you have would be more straightforwards. As the levels of pain medication reduce, you may then have to deal with the pain itself. I think you could have support from a pain relief clinic, who can give some alternative support.

Finally, you will probably have to make changes to your diet, to give you as much help as you can get with the pancreatitis. I think that food which promotes a healthier liver will also help you. See if you can speak to a nutritionist.

Most people recommend that you have some regular exercise, which helps to reduce depression during or after detox, and would also help with the circulation and health in general.

Briefly then, don't rush into this, do your research and preparation, take an overall approach with a long term view, get support and information from the doctors and professional drugs advisors, your circumstances are complicated and safety first is paramount. My warm wishes go to your success

Question: Can you get physically addicted to marijuana or is it only a psychological addiction like a bad habit.

Jill Edwards Says...:

It is clear from many reports that there are withdrawal symptoms when people who use marijuana regularly stop using it. It would seem likely that people would over a long period of use, start using weed that gives them a higher kick. And I think that the stronger kick you get the greater the withdrawal. Even just looking at the pleasurability of taking the drug, it is a pleasure you have lost and it is often taken in conjunction with other pleasures, like music or sex. So there is a feeling of loss. More than that, this drug like many others is often taken in order to avoid painful feelings concerning a persons past history, or even just evidence that their life is currently rather boring. As the drug often reduces the desire to make choices and get on with living, this boring feeling is frequently how people feel when they stop taking any drug. Marijuana withdrawal, is usually associated with anxiety, depression, loss of appetite and irritability. These symptoms are compounded by any other mental health symptoms which may have been around before the person started taking the drug. So really what I am saying that marijuana as a drug with psychologically pleasurable effects, has real psychological effects when you stop taking it. Any experience which is pleasurable, causes a high, is likely to fall off from the high over time and repeated experience, it is this falling away from the high, tolerance, which makes us increase the usage or strength. So psychological and addiction are really two different windows into the same experience. If you have to look at stopping smoking marijuana, you should not feel bad if you need some support in coming off. Get some help from friends, parents, anyone you know who can support you. Try on-line too. If you wondering about using, it may be a good time to focus on living/enjoying life instead. It is easy to get in and hard to get out.

Question: I am a recovering alcoholic and drug addict. I have 3 years 7 months clean from all drugs and 2 years 4 months clean and sober. I am invited to a friend’s bachelor party in Vegas. He is a very good friend to me and I would like to attend. I am actually not very worried that I will be overly tempted to drink or use drugs but I have a question about gambling. My friends are not big drinkers but they like to play blackjack. I’ve never really played at all. Do you think that since I have a pretty addictive personality I need to stay away from gambling just like I need to stay away from substances? I feel like I should but I also feel like I am overreacting/being fearful of life. I don’t want live my recovery in a cave but I also don’t want to be dumb.

Jill Edwards Says...:

Your absolutely safest position is not to be involved in a practice that is known to be addictive, particularly where it affects how accepted you are in a group that you do not know well.

Gambling in the circumstance you describe is particularly associated with group pressure and you may find yourself under sufficient pressure as things stand. On the other hand, you also could consider how important the money is to you. How much could you afford to lose. If you have a partner, what are they prepared for you to lose.

The people around you may be able to give you good advice, particularly the sober ones. You could find out what kind of stakes they play for. If you decided you wanted to try this you would have to have set limits on what you were prepared to spend and be prepared to lose what you are putting down.

Gambling is a losers game. No-one really wins against the reality of the odds involved. You might also want to talk the issues over with your friend and make sure there are people you trust around you. Think also about what else you could do with the money, what is most important to you. This is a good opportunity to consider your values and spend your money in a way that you choose. 

In the end it is your choice. 

Best wishes

Question: I use heroin on the weekends, usually on Saturday and on Sunday. I started using heroin 3 years ago but it’s only been a regular every week thing for the past year. I know this is a dangerous thing to do but I swear I never have any cravings or withdrawal symptoms come Monday and I am never tempted to use during the week – strictly a weekend party pleasure kind of thing. Are some people more immune to opiate addiction than others? From what I hear from other people I have used with my ability to take it or leave it is abnormal, to say the least.

Jill Edwards Says...:

Habit is an interesting thing, it can both encourage you to use and keep your use within limits which you set. So your habit has settled in to being a regular thing and this supports your continuing to use. If you found yourself breaking your habit, then you might think that you had to stop, which is why keeping your habit helps you to continue to use. There will not be a problem until your level of tolerance begins to rise and you no longer get the results you were getting from a regular amount of substance. It would also be useful to look at what other substances you are using. What is the alcohol mix, alcohol might mask the need for further amounts.

You will have seen that it took a time to progress from irregular to regular use, in the same way it is possible that it will progress slowly to daily use. You do not tell me whether you inject or smoke heroin. Many people smoke then progress to injecting.

No-one is totally immune from the gradual physical addiction, but certain things will help to keep it stable. Having a regular pattern of life and of when and how you use. Having supportive friends and family and not suffering any traumatic events in your relationships/employment will all help. Using heavy amounts of alcohol with it is dangerous in itself, as well as impinging on your control.

I would not be telling you what to do, but I would be wondering why you have to knock yourself out of the picture for much of the weekend by using heroin. I suspect it would be useful to see whether there are aspects of your life which are needing attention but are not getting it because of your using. Look to see what is not happening in your life, and progress that and then you will see the real reasons why this is dangerous and why it is getting on time you chould be thinking about cutting down and moving into a more productive phase of life.

Question: I was taking Adderall for about 6 months (I am not supposed to) and I quit about 3 weeks ago. It was difficult but I have not taken a single pill since the day I quit. I am still feeling tired and depressed, not like my old self. How long will it take for me to get back to normal?

Jill Edwards Says...:

I was taking Adderall for about 6 months (I am not supposed to) and I quit about 3 weeks ago. It was difficult but I have not taken a single pill since the day I quit. I am still feeling tired and depressed, not like my old self. How long will it take for me to get back to normal?

First, congratulations. It is not easy to come off amphetamine based medication. The side effects can be quite uncomfortable and you have got past the worst of these now. The longer term is what you are addressing now. The process of recovery is first of all about the medication and then it becomes a matter of looking at what you want from life and moving towards that.

You no doubt had your reasons for starting to take Adderall and once you have let go of the drugs, the sense of the old problems may return, but you may find that at present you do not have the courage or energy to face them. The sense you have when you have amphetamine in you is that you are on a bit of a high and you can get used to it, so the normal level of energy can feel like “tired and depressed”. There is a process of getting used to normal levels of up and down.

Exercise can be of great help and you should see that you at minimum walk for half an hour and if you can you should join a gym and go there three times a week if possible. This will help to balance your mood.

I do not know if while you have been coming through the withdrawals, you have been isolating a little bit. It is important now to have regular contacts with friends and if you have any interests that you want to follow up, now is the time to do it. Even the smallest steps in the direction you want to go can be like magic in keeping you going.

Reading is useful, you may have access to self help books which will help to guide you in a positive direction, so taking on any kind of self-help programme will give you a sense of structure to your life.

Take care of your eating patterns, simply seeing that you have an eating pattern which includes moderate amounts of proteins (meat, fish and eggs), carbohydrates (whole grains, pasta,wholemeal bread) and fruit and vegetables, will be both a useful activity and contribute more than you might expect to feeling more lively.

You have a chance to investigate any possible plans you have for yourself. While you are taking care of the basics, and when you have established a routine, then talk over with some person who you trust, what steps you could take towards doing what you want to do.

I cannot be sure how long it will take for your mood to right itself, but I am sure that if you take these steps it will be a lot quicker. Best wishes.

Question: I feel like I have to get high every day. I know this is not the PC thing to say but I am in my fourth decade now and I know what I can and cannot do and what I need pretty well. I can’t keep on with the drinking and harder drugs though. I know another serious round with a few of those dangerous suspects could be my last at my age. I am wondering if there is some sort of antidepressant or something like that that I could take - Or maybe even Suboxone…although I am not on opiates right now? Even though I am not depressed. That would get me as high as I need to be every day (which is not even that high really) but that is not too bad for my body and mind for use on a long term basis. I realize this request probably goes against some sort of therapeutic principles but for me, at this point in my life, it is really all about harm reduction and accepting my limitations.

Jill Edwards Says...:

Hullo, thank you for your message. I understand that you are feeling actually quite stuck. I know you tell me that you have to get high and when you say that I hear that you are often feeling quite low and need some relief from that. I hope you are aware that while alcohol often appears to be a high because people can behave very loudly etc, it is a depressant which wipes out the frontal lobe, the sensible part of us, which allows us to do things we would not do in our “right minds”.

You clearly have considerable experience of using hard drugs of different kinds and are used to winding yourself up, but you know that it will not be good to carry on as there is some damage taking place. So you are trying to find a middle road, of harm reduction. I do not know at this point what drugs you are using currently as a maintenance for yourself. It seems you have accepted that you cannot live without drugs, nor can you get a high without drugs.

I would suggest that it might be worth while consulting with your doctor first and then some local help and beginning a very slow reduction in drug use, together with some support in improving your life circumstances, raising the level of personal activity and reducing the isolation that comes with long term drug use.

Exercise will provide some endorphins, which are a small high. Setting short term goals and achieving them will help with the intereaction with life in general. Speak to the doctor to see whether you need a short anti-depressant, that would only be if you are not functioning in an ordinary way, if you were not getting dressed and out the house.

The highs that you get from doing things for yourself, are not as acute as those from drugs but they will not damage you and they will over time build a platform from which you can see life from a more positive place. You may find being with people who are also recovering from drug use/alcohol quite helpful.

My advice is don’t give up on yourself and on life. 40 Plus is a good time to turn things round. It will take time, like growing a garden takes time, but it gives a much better quality of life, something you deserve to have after all you have been through.

Question: I was drinking about 8 to 10 beers most days of the week. Now I am trying to drink 2 or 3 beers every day but I bought a bunch of weed also and I have a bowl or two after the beers and that helps me coast off to sleep without needing such a beer buzz. My wife thinks I am being irresponsible and she is worried that I am going to get caught by our teenage daughter but I think that even though it is not perfect it's a lot better for my body and it is a good step forward in the right direction. She wants me to stop. I want to hear an expert's opinion on this so I can show her that I am not crazy...or maybe so I will know that I really am crazy...

Jill Edwards Says...:

When you are moving away from drinking 8-10 beers a day, it is inevitable that sleeping will be a problem. The difficulties usually last about 21 days, provided there are no additional emotional distressors that are making their presence felt as a person sobers up. I understand you want to reduce the unpleasantness of this process, but avoiding it through taking weed is very common, but has some major disadvantages. REducing the drinking helps you to live a more sober life in which you can begin to put things in order,repair any damage that your drinking has done and re-orientate yourself towards a happier and more productive life.

Taking weed continues the inebriation, just using a different substance. It also leads to various levels of paranoia and disorientation. Your family has had to bear with the drinking over a long period and it is not surprising that they are troubled by the entrance of a different drug. Your teenage daughter must surely be aware of the smell from the smoking. One of the side effects of drinking, is that you will have learnt to give people the kind of truth which suits, so now continuing with a habit which you have to hide, is not effective in supporting a happier life.

I am delighted to hear that you are working so hard to reduce your drinking, it is unfortunately true that someone who has been drinking heavily is also likely to use other substances in a similar fashion. I hope you will find the courage to reduce your weed use so that you do not develop a second habit. To stabilise your sleeping, you will need to go to sleep at a regular time and to get up every morning regularly, even if you have not slept well. The regular hours will support regular sleeping. Eating well and having daily exercise also help the recovery process. Persist with this pattern for 3 weeks and you should see real improvement. Are you also increasing your use of Vitamin B tablets to help the nerve damage from the alcohol?

You will have gathered from me that there is more to this process than reducing your drinking. A sober life can be far more enjoyable than one where your frontal lobe and common sense are separated off from your living, but it takes a time to adjust and build in activities and life styles that suit. Be patient with your self, dont rush into weed as the solution, there are better ones than that.

You can get a lot of support from Alcoholics Anonymous or any of the self help groups. You can see for yourself whether you would be better off being completely sober in the end. That is a personal choice, but talking to people who live this way can be informative. They will be very sympathetic around your difficulties with sleeping. Best of luck. Jill Edwards. If you would like any further service, you can look at my website, www.invitationtotalk.co.uk and contact me from there.

Question: I used to smoke marijuana quite a lot when I was younger. Now my son is using. He is 17. I am not that worried about it since I don't think it is a very harmful drug, actually I would rather he smoke a joint than get drunk. My wife says that marijuana today is a lot stronger and it is dangerous now and that it is addictive now and not like it used to be. She never used drugs of any kind so I am not sure if she isn't just freaked by the idea of ANY drug use by our son and maybe she is not acting totally rationally. Is the marijuana floating around today really more dangerous? I understand that it is stronger but doesn't that just mean you need to smoke less to get high... I seem to remember getting pretty high even on the low potency weed of 20 years ago…

Jill Edwards Says...:

You and your wife can both make a contribution to the process of getting information around these decisions. Your wife is quite right that there are stronger forms of marijuana available now and different parts of the plant like buds can provide a much stronger high. We are beings able to enjoy pleasure and if people find smoking marijuana enjoyable, then we are likely to do more of it. It is a drug that takes a long time to leave the body and people have reported a great difficulty and some real agitation and irritability in stopping using it. What is going on around this life is crucial. As you will remember, in the early days this drug denoted a life style, that was chilled out, laid back etc. This drug has a tendency to increase withdrawal from life rather than getting involved, this can mean that in a 7 year drug period, which is not uncommon, people can go in at 17 and come out at 24 and wonder what happened at a time that is crucial to education, training and just getting on. As you will know it also reduces libido at a time when most people are finding partners and enjoying the sexual side of life. So the effects of marijuana are long term and difficult to see, but no less serious for that. If a young person has some other issues, like sociophobia, or mental health issues of other kinds, or have been bullied or mistreated in other areas, then mis-use can be more serious because they become more dependant and they can be more fearful and less rational in dealing with life and in some cases psychotic. Drugs are available, but it is worth knowing that someone who is getting supplies in will be in closer contact with harder drugs through their dealer and through the friends they make when smoking. Your son is fortunate that he can hear different views from both of you, but I suggest that you all have a good look at the information available to you, the advantages and disadvantages. But more importantly that you all stress the enjoyment to be found from being more involved in life and activity rather than the need to get away from it all. Just make enjoyable living more important, and keep communicating. Taking marijuana does not stop people from drinking.

You and your son can assess together the frequency with which he uses marijuana. Most things can become addictive. If it becomes the main focus of the day, if there is agitation around getting supplies, if a person does things they would not otherwise do to get supplies, if there is lying around using, these are all signs of addiction and you can teach you son to know that any forms of addiction need help and support, and that at that point he would have to get out of that habit.

Question: I am a long time user of over the counter codeine/paracetemol. I take about 10 to 15 per day but the recommended daily maximum is only 8 so I know I am playing with fire and risking my liver every day. I am trying to cut down but it is very hard. I have been using these pills every day for more than 5 years. There are a lot of unpleasant withdrawal symptoms I get when I try to cut down but the worst is the restless legs I get. My legs feel all jumpy and jittery as soon as I try to relax and go to sleep and it is impossible to fall asleep with this feeling. It is really really unpleasant and frustrating. Do you have any advice on anything I can do to relieve the restless legs problem? I try exercising to tire myself out but it doesn’t seem to really help.

Jill Edwards Says...:

Restless leg syndrome can have various causes. The codeine can both be used to treat it as well as cause it as a side effect. I had a look around at various advices and I liked this web-site because it had various suggestions without telling you what you had to do. (http://www.helpguide.org/life/restless_leg_syndrome_rls.htmI) I think it is one of those things that takes a number of different approaches acting together to get a relief, so for example I thought that stretching rather than heavy exercise would be helpful.  Thinking about yoga or Tai Chi as good balancing exercise practices.

When I myself have had it, it has seemed to be associated with digestive disturbances and so it may be associated with the effects of codeine on your digestion. Have you thought about acupuncture. Acupuncture is also used to help people who are suffering withdrawal symptoms and ear acupuncture is usually available from agencies helping people in withdrawal from drugs.

I am wondering what kind of support you are getting with dealing with the codeine/paracetemol problem. As you say it is necessary to cut down slowly. There are agencies for long term prescription use, but these have mostly been dealing with benzodiazepines. It may be useful to look out such an agency, if they will work with you, you will have support to cut down slowly. You may feel a little negative about approaching a drugs agency, but the fact of the matter is that you are taking a morphine based medication and you would benefit from the advice of someone who can treat that condition. They can advise on safe levels of cutting down and as I mentioned some can supply ear acupuncture.

I don’t know if you are able to talk to your doctor, but that would be a good place to start. I don’t know from your question where you are in life as it were, what support you have around you and crucially how much you are able to function, what you are interested in as well as this problem. In my view it is useful to build a supportive life, one with interests and activities and to use this supportive structure to help you move on from the prescription drugs. This is a process and it does not happen overnight. But just working entirely on ones own, is not usually effective.

So exploring what would you be doing if I were not using prescription drugs, how would your life be different. What do you want more out of life? These are all just a part of the answer. I think you are beginning a journey to make changes in your life. You may want to meet some support on your journey. I hope that you will be successful over time. Take care.