Whelehans Health News

Therapeutic Treats is Mullingar’s only training centre entirely dedicated to holistic therapy training courses, are having an information  day on Saturday 25th February from 12pm to 3pm at Phoenix Yoga Studio, Market Point. Therapeutic Treats offer professional training in Holistic Therapies to certificate and diploma (ITEC) level. With over 15 years’ experience as a therapist,  Fiona Conlon Nally (college director) ensures the training courses are unique and personal, allowing students offer a healing and deeply relaxing experience to their future clients. Our Anatomy & Physiology tutor, Vonnie Nally, has a Master’s Degree in Science. Vonnie will be at our open...

The World Health Organisation recommends that every adult accumulates a minimum of 30 minutes’ exercise every day. Sadly, less than a third of us meet this recommendation.   The strain on our health service that this inactivity is causing is tremendous. Our ever-expanding waistlines have led to an alarming surge in diabetes, cancer, heart disease and depression. Inactivity is a major public health issue.   The good news is that we can do something about it! In order to be considered "physical exercise"; the activity must place an extra demand on the cardiovascular system. Usually this means elevating the heart...

Other complications of Addiction

Coma, unconsciousness or death – People with drug addiction problems often take a mix of many drugs which increases risk of overdose.

Some diseases - injecting drugs especially if sharing needles increases risk of hepatitis and HIV/AIDS (though there is more public awareness of the risks of needle sharing and more needle exchange regimes nowadays). Alcohol abuse and smoking can lead to well publicised health problems. Drugs or alcohol can lead to risky sexual behaviour (unprotected sex), increasing the risk of developing sexually transmitted diseases.

Accidental injuries/death – drug and alcohol addiction problems increase the risk of accidents and injuries and even death due to falls, propensity for violence, driving under the influence to name a few.

Suicide – Substance abuse (but not nicotine addiction) increases suicide risk

Relationship problems – addiction leads to social, family, marital and relationship issues leading to family breakups, etc.

Child neglect/abuse - the high proportion of neglected and abused children have one or both parents with drug or alcohol addictions.

Unemployment, poverty and homelessness – It is more difficult to hold down a job when suffering from drug/alcohol addiction so unemployment, poverty and homelessness are more common.

How is Addiction diagnosed?

It is often family members or friend who raises concern about the person’s behaviour (rather than the person himself/herself doing so). Your GP is a good first point of contact. They'll be able to provide you with help and advice and recommend specialist addiction services.

The doctor will ask several questions, including how often the substance is consumed, whether the substance use has been criticised by other people, and whether the patient feels he/she may have a problem.

If the doctor suspects an addiction problem, the patient may be referred to a specialised addiction counsellor, psychologist or psychiatrist. A blood test may be required to determine whether the substance is still in the blood (whether the substance has been taken recently).

Here are some of the criteria that are looked at to help make a diagnosis:

• Tolerance - after some time (even only a few weeks) the substance has less effect on the person because their body has developed tolerance; this is a sign of addiction.
• There are physical/psychological withdrawal symptoms if the person stops using meaning the person uses the substance to avoid experiencing withdrawal or uses a similar or alternative substance to avoid experiencing withdrawal (eg) a heroin user using a benzodiazepine or cannabis to ease withdrawal symptoms.
• The person often takes higher-than-intended doses of the substance (eg) causing unintended overdoses
• The patient is continually tries to quit or cut down.
• More and more time is spent getting hold of the substance, using it, or recovering from its effects.
• The person’s substance abuse causes him/her to give up social, occupational or recreational activities.
• The person has occasional or frequent blackouts or memory lapses due to overuse of the substance
• The person’s behaviour and personality changes completely while using the substance (eg) a tendency for violence in an otherwise non-violent person
• Despite being aware the substance is causing psychological/physical problems, they continue using it.

Treatment options for Addiction?

The first step to treatment is for the person to acknowledge and realise they have an addiction. There is little (or no) chance of a person giving up unless they want to give up. Treatment can include community and hospital based options including counseling (psychotherapy), self-help groups, and medication. The HSE Community Alcohol and Drug Service (CADS) offers help and have centres in all parts of the country (see below)

Cognitive behavioural therapy (CBT) and motivational enhancement therapy (MET) have been shown to be very effective in treating addiction problems. In Ireland, these services are not as readily accessible as in the UK. MET is a counselling technique that can help tackle ambivalence (mixed feelings) a person may have about giving up the substance and about taking part in a treatment programme.

Treatment options consist of withdrawal from the substance and then continued support to help stay off the substance. Treatment varies depending on the substance the person is addicted to:

Addiction to depressants – depressants includes barbiturates or benzodiazepines (eg) diazepam (Valium^®). Withdrawal symptoms include insomnia, anxiety, restlessness and sweating. Less common withdrawal symptoms include hallucinations, tremors, seizures, fast heart rate, high blood pressure and fever. In rare cases there can be delirium (severe confused state), which can be life-threatening. Benzodiazepines are only meant for short term treatment of anxiety like disorders in severe cases only. However they are often abused by people suffering from substance abuse problems (eg) to prevent the comedown from drugs like heroin.

Addiction to stimulants (eg) cocaine, amphetamines (“speed” being a street name). Withdrawal symptoms include tiredness, moodiness and depression, anxiety, low enthusiasm, sleep disturbance, and poor concentration. Treatment includes counselling and if the depression is severe, then anti-depressive medication may be prescribed.

Addiction to opioids – Opioids are a drug class that are often prescribed as painkillers. Examples include morphine, codeine, methadone and oxycodone. Heroin (medically called diamorphone) is also an opioid and is the most addictive of all opioids. Withdrawal symptoms can be severe and can include sweating, anxiety, insomnia, stuffy nose, high blood pressure and diarrhoea. For milder opioid addictions, the person may be able to go through withdrawal by “cold turkey” without the need for prescription medication once they get sufficient support (eg. counselling, CBT, family support, etc). For more severe opioid addiction the person may need to be prescribed methadone, or buprenorphine to ease cravings.

Community Alcohol and Drug Service (CADS)

The HSE Community Alcohol and Drug Service offer counselling and treatment services for adults suffering from addiction to alcohol, drugs and gambling. CADS have centres in Mullingar, Athlone and Longford. CADS provides counselling and treatment to help people get over their addiction. You can contact them at 04493 41630.

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591.

Other complications of Addiction

Coma, unconsciousness or death – People with drug addiction problems often take a mix of many drugs which increases risk of overdose.

Some diseases - injecting drugs especially if sharing needles increases risk of hepatitis and HIV/AIDS (though there is more public awareness of the risks of needle sharing and more needle exchange regimes nowadays). Alcohol abuse and smoking can lead to well publicised health problems. Drugs or alcohol can lead to risky sexual behaviour (unprotected sex), increasing the risk of developing sexually transmitted diseases.

Accidental injuries/death – drug and alcohol addiction problems increase the risk of accidents and injuries and even death due to falls, propensity for violence, driving under the influence to name a few.

Suicide – Substance abuse (but not nicotine addiction) increases suicide risk

Relationship problems – addiction leads to social, family, marital and relationship issues leading to family breakups, etc.

Child neglect/abuse - the high proportion of neglected and abused children have one or both parents with drug or alcohol addictions.

Unemployment, poverty and homelessness – It is more difficult to hold down a job when suffering from drug/alcohol addiction so unemployment, poverty and homelessness are more common.

How is Addiction diagnosed?

It is often family members or friend who raises concern about the person’s behaviour (rather than the person himself/herself doing so). Your GP is a good first point of contact. They'll be able to provide you with help and advice and recommend specialist addiction services.

The doctor will ask several questions, including how often the substance is consumed, whether the substance use has been criticised by other people, and whether the patient feels he/she may have a problem.

If the doctor suspects an addiction problem, the patient may be referred to a specialised addiction counsellor, psychologist or psychiatrist. A blood test may be required to determine whether the substance is still in the blood (whether the substance has been taken recently).

Here are some of the criteria that are looked at to help make a diagnosis:

• Tolerance - after some time (even only a few weeks) the substance has less effect on the person because their body has developed tolerance; this is a sign of addiction.
• There are physical/psychological withdrawal symptoms if the person stops using meaning the person uses the substance to avoid experiencing withdrawal or uses a similar or alternative substance to avoid experiencing withdrawal (eg) a heroin user using a benzodiazepine or cannabis to ease withdrawal symptoms.
• The person often takes higher-than-intended doses of the substance (eg) causing unintended overdoses
• The patient is continually tries to quit or cut down.
• More and more time is spent getting hold of the substance, using it, or recovering from its effects.
• The person’s substance abuse causes him/her to give up social, occupational or recreational activities.
• The person has occasional or frequent blackouts or memory lapses due to overuse of the substance
• The person’s behaviour and personality changes completely while using the substance (eg) a tendency for violence in an otherwise non-violent person
• Despite being aware the substance is causing psychological/physical problems, they continue using it.

Treatment options for Addiction?

The first step to treatment is for the person to acknowledge and realise they have an addiction. There is little (or no) chance of a person giving up unless they want to give up. Treatment can include community and hospital based options including counseling (psychotherapy), self-help groups, and medication. The HSE Community Alcohol and Drug Service (CADS) offers help and have centres in all parts of the country (see below)

Cognitive behavioural therapy (CBT) and motivational enhancement therapy (MET) have been shown to be very effective in treating addiction problems. In Ireland, these services are not as readily accessible as in the UK. MET is a counselling technique that can help tackle ambivalence (mixed feelings) a person may have about giving up the substance and about taking part in a treatment programme.

Treatment options consist of withdrawal from the substance and then continued support to help stay off the substance. Treatment varies depending on the substance the person is addicted to:

Addiction to depressants – depressants includes barbiturates or benzodiazepines (eg) diazepam (Valium^®). Withdrawal symptoms include insomnia, anxiety, restlessness and sweating. Less common withdrawal symptoms include hallucinations, tremors, seizures, fast heart rate, high blood pressure and fever. In rare cases there can be delirium (severe confused state), which can be life-threatening. Benzodiazepines are only meant for short term treatment of anxiety like disorders in severe cases only. However they are often abused by people suffering from substance abuse problems (eg) to prevent the comedown from drugs like heroin.

Addiction to stimulants (eg) cocaine, amphetamines (“speed” being a street name). Withdrawal symptoms include tiredness, moodiness and depression, anxiety, low enthusiasm, sleep disturbance, and poor concentration. Treatment includes counselling and if the depression is severe, then anti-depressive medication may be prescribed.

Addiction to opioids – Opioids are a drug class that are often prescribed as painkillers. Examples include morphine, codeine, methadone and oxycodone. Heroin (medically called diamorphone) is also an opioid and is the most addictive of all opioids. Withdrawal symptoms can be severe and can include sweating, anxiety, insomnia, stuffy nose, high blood pressure and diarrhoea. For milder opioid addictions, the person may be able to go through withdrawal by “cold turkey” without the need for prescription medication once they get sufficient support (eg. counselling, CBT, family support, etc). For more severe opioid addiction the person may need to be prescribed methadone, or buprenorphine to ease cravings.

Community Alcohol and Drug Service (CADS)

The HSE Community Alcohol and Drug Service offer counselling and treatment services for adults suffering from addiction to alcohol, drugs and gambling. CADS have centres in Mullingar, Athlone and Longford. CADS provides counselling and treatment to help people get over their addiction. You can contact them at 04493 41630.

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591.

Signs and symptoms of Addiction

Substance dependence

Substance dependence is addiction to a substance, such as a drug, alcohol or nicotine. The person can no longer control use of the substance due to intense cravings. With addictions, most often the he person takes the substance over and over and cannot stop. Often at least one serious attempt was made to give up but the person relapsed.

Signs and symptoms include:

Withdrawal symptoms occur when the drug goes out of the system and the person will experience unpleasant physical and emotional symptoms. They include cravings, moodiness, ill-tempered behaviour, poor focus, depression, sense of emptiness, frustration, anger, bitterness and resentment.

Physical symptoms can include an increased appetite, especially an urge for sugary and fatty foods (occurs with the likes of cannabis use or heroin use) or an inability to eat due to nausea and vomiting in the case of withdrawal from the likes of opiates (eg) heroin. Insomnia is a common symptom of withdrawal especially with withdrawal from illegal drugs. Constipation or diarrhoea are common both during use of many drugs and withdrawal. With some substances, withdrawal can trigger violence, trembling, seizures, hallucinations, and sweats.

Addiction continues despite health problems – due to the addictive nature of the substance the person continues taking the substance regularly despite developing illnesses due to its use. (eg) some smokers continue smoking despite developing smoking related diseases such as lung cancer or heart problems and alcoholics often continue smoking despite developing liver disease

Social and/or recreational sacrifices - some activities are given up because of an addiction to something. An alcoholic may miss out on family or work engagements as they would prefer to get drunk or are too hung-over or a smoker may avoid situations or people where smoking is not possible. Also, the financial difficulties caused funding an expensive addiction may reduce ability to ability to take part activities you once were able to afford (eg) going on a holiday, going for a meal

Maintaining a good supply - addicts will always make sure they maintain a good supply, even if they do not have much money. Sacrifices may be made in other areas (eg. food, clothes) to make sure they have sufficient supply.

Taking risks – risk taking occurs to enable getting his/her substance of choice including stealing, violence, trading sex for money/drugs etc. Being under the influence of substances like alcohol or drugs can lead to a person engaging in risky activities which they wouldn’t dream of when sober (eg) drink driving, violence

Obsession – the addiction causes the person to spend more and more time and energy trying to get hold of the addictive substance and causing damage to other areas of life (family, work, finances, etc)

Secrecy and solitude - in many cases the addict may take their substance alone and in secret (often due to shame)

Denial – many addicts are not aware, are in denial or refuse to admit that they suffer from an addiction.

Excess consumption - for addictions such as alcohol, drugs and even nicotine, excessive use pretty much goes hand in hand with the problem. This leads to blackouts due to alcohol or drug binges and both physical and mental health problems

Dropping hobbies and activities - as the addiction progresses the person often stops doing things he/she used to enjoy (eg. sports, clubs etc. This may because they are physically not able to take part in the activity (due to the damage drugs, alcohol or smoking does to the health), they can no longer afford to take part (addiction eats up all available funds) or the addiction takes up to much time (ie) Trying to get the substance or using the substance such as drinking means time for other activities is limited

Having stashes - the addicted person may have small stocks of their substance hidden away in different places (eg. house, car, work) and often in unlikely places. This is to help ensure they never run out.

Consuming an initial large dose - this is often seen with alcoholism. The person may gulp the first drink down to get that feeling of “relief” and to get drunk and feel good quickly (and take away the emotional and physical pain of withdrawal quickly)

Problems with the law is common as drug, alcohol and gambling addictions can be expensive so the person may need to steal or deceive to fund an expensive habit. Substance abuse can impair judgment and leads to the person taking risks and engage in illegal behaviour that is out of character and wouldn’t engage in when sober. For example the likes of assaults and drunk and disorderly offences can occur even in those who would never dream of breaking the law when sober.

Financial difficulties – the addicted individual may sacrifice a lot to make sure its supply is secured. Even cigarettes, which are currently over €11.50 for a packet of twenty (2016 budget) meaning a 40-a-day smoker will spend €700 per month or nearly €8,395 per year on smoking (which equates to over €11,000 pre-tax income).

Behavioural addiction

Behavioural addiction is addiction to a behaviour such as gambling or video gaming.  The physical signs of drug addiction do not occur in behavioural addiction. Behaviorally addicted individuals have certain symptoms and will undergo many of the same consequences brought about by addiction to alcohol and drugs as well as other obsessive behaviours (eg) money problems, relationship breakdowns, guilt, etc

Community Alcohol and Drug Service (CADS)

The HSE Community Alcohol and Drug Service offer counselling and treatment services for adults suffering from addiction to alcohol, drugs and gambling. CADS have centres in Mullingar, Athlone and Longford. CADS provides counselling and treatment to help people get over their addiction. You can contact them at 04493 41630.

To be continued….next week

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591.