Alcohol and Cocaine

Meg Wright

PREVALENCE IN SCOTLAND

• Alcohol - 50 % of men 30% of women consume more than recommended limit.

• Scotland has the 8th highest alcohol consumption rate in the world

• Many social, health and economic problems as a result

PREVALENCE IN SCOTLAND

• Cocaine use in Scotland is the 3rd highest in Europe

• 75% of cocaine users use alcohol - independently and also while using cocaine

• Harm from using both is greater than using either separately

EFFECTS of MIX

Physical• Liver produces COCAETHYLENE• 30% increase in blood levels of cocaine if

alcohol taken at same time or just before• Increase in heart rate and blood pressure• Increase load on the heart can lead to

sudden cardiac death

EFFECTS of Mix

Psychological• Alcohol is a depressant, cocaine a

stimulant – people feel they can drink more

• More euphoric and rewarding leading to increased high

• Feelings of wellbeing• Co-dependency

EFFECTS of Mix

Behavioural

• Increase in physical violence • Increase in risk taking behaviours • Increase in impulsive decision making• Reduced memory and ability to learn

Typical alcohol and cocaine user

• Recreational – not seen as a problem, not taboo

• Seen as a glamorous sociable activity• Educated/Aspirational/Affluent/Employed • Addiction related to lifestyle, culture,

availability, pressures of work and status

Outcome for users

• Spiral into unemployment, debt, poverty • Breakdown of relationships• Child protection issues • Collapse of self-esteem• Criminal record • Poor health • Paranoia/anxiety/mental health issues

Case Study

• 37 year old male, employed• Consumes 32-35 units in one session• Started taking cocaine to “last the pace and

keep awake”• Cocaine stopped him feeling depressed and

worrying about money problems • Got arrested: “best thing ever happened to him”• Rude awakening; abstinent from alcohol and

cocaine for last five months

Case Study

• 32 year old male, employed, homeowner • Strongly into image, appearance, suntan lounge• Spends £300-£600 a w/end on cocaine and alcohol • Takes116 units of alcohol and 2-3 grams of cocaine

a weekend • “Don’t think you’re drunk, think you’re cool”• Involved in fighting - broken teeth, black eyes• Problems with work: Tired, depressed and paranoid • In alcohol counselling allied to motivational

interviewing, stress management and anger management

Case Study

• 20 year old male from deprived area, unemployed• Drank heavily along with frequent use of cocaine• Motivating factor - boredom; the combination gave

him a greater “buzz”• Made him feel happy and upbeat about his life• Began having seizures, which stopped immediately

he ceased using cocaine• Still drinking, but not as heavily• Receiving counselling

Conclusions

• Potentially lethal combination within a relatively short period of time

• Use of these two substances would appear to be increasing

• Often used as part of a lifestyle and not as a response to deep underlying causes

• Other problems e.g. criminal record, abuse, unemployment, tend to follow on from the use of the substances and not the other way around

Conclusions

• Important for assessment and screening to picks up dependency on both

• Staff have to be empowered and trained to deal with both substances

• More research has to be carried out into the combined effects of both and to treat them as their joint use increases