DRUGS OF MANY KINDS CAN DAMAGE YOUR MENTAL HEALTH

MENTAL health is just as important as physical health - as we should
be equally conscious of looking after it.

That is one of the main messages of Mental Health Awareness Week,
which was launched on Monday by Health Minister Patrice Minors.

One way in which many of us adversely affect our mental as well as
physical health is by taking drugs - legal or illegal. The most
widespread examples are alcohol and nicotine.

Dr. Edirimuni Rodrigo, a consultant psychiatrist at St. Brendan's
Hospital, who completed his training in Sri Lanka and England, takes a
closer look at this phenomenon in this week's Insight.

HUMAN beings have used brain and mental state altering substances from
the beginning of civilization. Alcohol was probably the earliest drug
used, from accidentally consuming fermenting fruit and grain.

There is archaeological evidence to indicate the early use of
substances like cannabis, opiates and cocaine too. The consequences
and costs of alcohol must have become apparent very early, as there is
evidence of severe strictures against the use of such drugs in early
human societies.

The popular belief continues to hold that these substances provide joy
and enhance one's brain and mental functions, but scientific evidence
has yet to indicate any substance which enhances our thinking,
emotion, memory, perception, consciousness or behaviour. All these
substances alter our mental functions, but there is little evidence to
suggest that they enhance such functions.

The most dangerous drug people use is tobacco. An estimated 1.1
billion out of six billion people in the world use tobacco, causing
over 4.2 million deaths an year.

Approximately 11,000 die every day from disorders related to tobacco
use. We have heard about the HIV/AIDS epidemic, the SARS epidemic but
not about the tobacco epidemic.

The World Health Organisation estimates that every year tobacco use
kills more than AIDS, tuberculosis, maternal deaths, accidents,
homicides and suicides put together. It is the most dangerous consumer
product ever produced.

Alcohol, the second most commonly used and abused drug, is freely
available in almost all countries. A third of the entire world health
care cost is spent to treat disorders arising from alcohol and tobacco
use.

However, unlike tobacco (even one cigarette is harmful), there is no
evidence to suggest that drinking within sensible and safe limits
poses a health threat.

The World Health Organisation and the Royal College of Psychiatrists
(UK) suggest that a person should drink no more than one or two drinks
(a glass of wine, a measure of spirits, half a pint of beer) in any
day and to include a few days of abstinence each week.

Pregnant women should not drink at all as there is considerable
evidence that drinking alcohol during pregnancy harms the foetus.
Caffeine, the mild stimulant in tea, coffee and other cola drinks, is
perhaps the only drug we consume with little or no adverse health and
social consequences.

However, if the consumption is high enough a person could become
addicted to caffeine and often anxiety symptoms stem from excessive
caffeine. Cannabis (marijuana) is the most commonly used illegal drug
and world wide there are about 140 million users of this drug.

The use of heroin is estimated to have doubled or tripled since 1985.
The risk of death, particularly among users who inject the drug, is
about 20 to 30 times higher than non-drug users in the same age group.

COCAINE and its derivative "crack" cocaine has seen a global increase.
Traditionally, people in Andean countries in South America chewed the
coca leaves for thousands of years. It was relatively recently in 1860
when the main chemical, cocaine was isolated and became more widely
available.

In earlier times it was used mainly as a painkiller, but in the 1970s
and 1980s it became very popular with young people in western European
and North American countries.

It is perhaps more relevant and useful to look at these drugs through
their action on the brain and the nervous system rather than in terms
of legal or illegality of use.

The objective evidence is that all these drugs tend to affect the
brain and consequent behaviour in an adverse manner.

The responsibility of parents and educational institutions in
particular, and society in general, is to give the skill to its young
people to decide on the most healthy course of action in regard to use
of substances of dependence.

People need accurate, objective information about drugs and society
has a responsibility to protect children from exposure to drugs before
they gain the skill and knowledge to make an informed choice.

Research has revealed that educational programmes focusing on learning
how to manage emotions do better in persuading young people from using
drugs, rather than direct programmes focussing exclusively on drugs.

Promotion of healthy lifestyles should be given priority both for
young and adult populations. These will include eating balanced meals,
regular exercise, regular sleep, being engaged in a range of
recreational and relaxation activities, being part of a supportive and
affectionate social network, gaining abilities to solve routine life
problems and to plan one's life goals.

Every government has a responsibility to formulate and implement a
national alcohol and drug policy to ensure a reduction in both supply
and demand of drugs in a given country.

Policies must work towards reducing availability of drugs, both legal
and illegal, while health and educational policies must promote a
reduction in demand for drugs. Research has again shown such
preventive measures tend to give better value for money than money
spent on treatment.

This is so, because treatment of the drug- and alcohol-dependent
person is very challenging and the results are often disappointing. In
Bermuda a range of treatment services are available for persons having
drug use related problems through a service known as Turning Point
based at St Brendan's Hospital.

These include both in-and outpatient services provided by a multi
disciplinary team of therapists.

Outpatient services are available on all weekdays during working
hours. In-patient treatment is provided by a detoxification unit,
which helps patients withdraw from a drug under safe conditions.

A team of therapists provides both psychological and pharmacological
interventions and assists clients with their social problems.

Turning Point encourages and welcomes the involvement of family and
friends in the recovery programs of its clients. In addition to the
services provided by St Brendan's Hospital, some non-governmental
organisations also provide residential care.

Alcoholics Anonymous and Narcotics Anonymous are the other therapeutic
agencies, which help people with drug dependencies.

The availability of a range of therapies for alcohol, tobacco and
other drug use related disorders needs to be emphasised and with good
engagement in a therapy programme, many can look forward to a
drug-free life.

Whether your addiction is tobacco, alcohol, heroin, cocaine or
cannabis (marijuana) one can quit using one's drug of dependence. A
person may need to attempt several times before succeeding quitting
and hence the phrase "DO NOT QUIT QUITTING".