The Pharmaceutical Journal
Vol 270 No 7251 p764-765
31 May 2003

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Help is available for those with alcohol or drug addiction problems

Pharmacists, who are also patients, describe in their own words what it is like to have to take a medicine for life

Help is available for those with alcohol or drug addiction problems

Let us be clear about this: people initially do get a buzz from drugs. They do not do it repeatedly because it is unpleasant. They get something out of the drug, something desirable enough to throw caution to the wind. There is, however, a down side.

I considered myself a social drinker during my teenage years, drinking modest amounts of beer after a game of rugby or football, or a couple of pints with a good vindaloo. My twenties and thirties continued in similar vein with nothing to indicate what lay ahead. There were bottles of wine under the stairs brought out for guests or the main meal on Sunday and occasionally I used to make wine using blackcurrants or brambles when in season. My intake of alcohol remained fairly constant for 20 years or so at a level not dissimilar to the Government guidelines for drinking within a safe limit. I achieved a good degree at university and was making good progress in my chosen career but it was clear to me that something was not quite right within me. I have heard it variously described as being "not comfortable in my own skin" or "square peg in a round hole" or any number of similar phrases used to describe what it felt like to be generally unhappy with myself and my life.

To my spectacularly average childhood were added life events beyond the range of normal human experience, and these, along with a genetic predisposition to chemical use, made my descent into dangerous chronic drug use and a life of total chaos rapid and complete, but this was some years ahead.

Most days I would have a few glasses of wine in the evening sufficient to help me relax, relieve a bit of boredom, sleep a little better, mix with friends more easily or as a reward at the end of a long day.

However, for reasons that elude me, one afternoon, I ignored all my personal and professional morals and self-administered one tablet of propranolol 10mg to smooth the edges off a fraught day. I had stepped over the line between legal and illegal drug use. I justified this to myself on the grounds that if I had gone to my GP he would have given it to me anyway.

Five years later I was consuming opiates, hypnotics, anxiolytics and antidepressants in daily quantities measured in grams not milligrams. It felt like my cerebrospinal fluid had been replaced with vegetable soup. Small problems became insurmountable while large ones were ignored. As I continued to use drugs on a daily basis, tolerance developed and the doses crept upwards, but I still thought I did not have a problem. "I can control it. I'll stop tomorrow."

Health deteriorated

My physical health deteriorated markedly, with constipation being a particular problem. I was underweight, unable to shrug off minor infections, had unbearably itchy skin as well as insomnia, depression and anxiety. I also had the moral characteristics of an alley cat. Impatience, rudeness, intolerance of others, anger most of the time, ferocious ambition at all costs, superiority and arrogance were the norm. None of these unpleasant characteristics was the real me. It felt as if the drink and drugs took away all the pleasant attractive parts of me leaving just the unpleasant parts that were so visible to others.

Worst of all, drugs took away the very essence of my personality, my soul, and without that I felt incomplete. Suicide seemed preferable to the treadmill of obtaining drugs without being found out but stopping was just not possible on my own because the withdrawal syndrome is just so awful. Abdominal pain, joint pain, bone pain (a humdinger), sweating, rhinorrhoea, eyes running, sneezing, coughing, diarrhoea 24 hours a day, severe hyper-reflexes, muscle cramps, total sleeplessness for a week at a time while still trying to appear normal at work and home, is not much fun. The dilemma was that just a few tablets, given up so sincerely the day before, would relieve all the symptoms within 20 minutes.

I certainly did not think of myself as a junkie because I was not using street drugs intravenously, bought from some scruffy pusher driving a flash car, but rather pharmacopoeial quality substances, orally, purchased from a reputable wholesaler. I still did not believe I had a serious problem and firmly believed that no one else was aware of it either. Their inaction enabled me to continue taking drugs for years to come.

I smashed cars, had numerous shunt accidents when momentary losses of consciousness occurred, had a grand mal seizure and was so out of control that death by accident or suicide was a real possibility. I was a health professional, a husband, father to wonderful children, had a house and cars, no bad debts — yet I wanted my life to end.

Every morning I would swear off drugs forever (sometimes I could manage an hour) and every night I would lie awake in bed thinking up painlessly theatrical ways of committing suicide. The light at the end of the tunnel had been extinguished.

It was about this time, when I had truly reached my rock bottom and was incapable of helping myself, that a telephone call was made on my behalf to the Pharmacists Health Support Scheme (see Panel). Within a few days I found myself admitted to a treatment unit dedicated to the care of health professionals with drink or drug issues and from that day to this, some seven years later, I have not wanted or needed a drink or drug. This is truly remarkable.

What struck me immediately at the clinic was that I was not the only health professional with drug issues, when I really believed the converse. I was treated with dignity and respect, and a lot of good humour (I had forgotten how to laugh) when I was fully expecting to be put through the mill as a morally weak drug user who deserved all that he got.

For some time issues of confidentiality were uppermost in my mind but I was worrying needlessly. Confidentiality and anonymity are essential parts of the treatment programme and are fully respected and guaranteed. I have met dozens of fellow patients over the years and I know the surname of only a few. I may choose to break my own anonymity but no one else does so on my behalf. We all honour the principles of confidentiality and anonymity but nevertheless the self-help bonds between us are enormously strong and remarkably effective.

Because drugs impair one's judgement and perception of life, I had made many decisions that at the time seemed to me to be correct but turned out not to be so. I have learnt a few simple skills that have enabled me to rebuild my life and to deal with any problems that come along.

I had, as a consequence of my drug use, a number of legal and professional issues to deal with and while I had to accept the responsibility for my actions the staff at the treatment centre and the health support scheme helped me through them all. Without their help and support I know that the shame would have been so crushing as to push me over the edge. They are gifted dedicated professionals and it has been a real privilege of my recovery to have met them and to include them in my life, each in their own way.

What I was not expecting was the quality of life I now enjoy. It was only by getting well that I realised how ill I had been. Not only have all my psychological issues been dealt with, my personal and professional lives have changed beyond recognition. An unexpected benefit has been that the turnover of my pharmacy has doubled in five years due in no small measure to my new approach to patient care. Relationships with family, friends and colleagues are based on total honesty whereas before there was suspicion and deceit.