by Dr Ann Horgan:
member of the Royal College of Psychiatrists

We are living in a country awash with alcohol and drugs. The old constraints of lack of money and the power of religion are much weaker. Every day we hear of violence, suicide, marriage breakdown, and unplanned pregnancy and so on that are associated with the unwise use of these substances. What information do we need to avoid the dangers?

Alcohol:
Alcohol is used to mark every stage of our life. A pint is bought for our father in the pub when we are born and a whiskey is drunk to our memory when we die. We drink to celebrate or forget the results of the junior certificate, the leaving certificate, our college exams, our driving test, our latest romance, our football team.
There are many casualties of this love affair with drink. Alcohol is a major factor in many suicides, one third of marriage break-up; a high percentage of attendances in Accident and Emergency departments and health problems leading to hospital stays. We are unique in Europe in the last decade in the startling increase in our alcohol consumption (and this in a country where we have always been famous for our drinking).
It’s not very complicated to drink safely-

Legal Age:
The legal age for purchasing drink in this country is eighteen. It is wise to wait until at least this age before starting to drink as before this a person has not matured physically and mentally. Some would argue that we should raise the legal age to 21as a similar increase in the legal age in the USA was associated with a significant fall in youth suicide. Doctors today in Ireland are regularly seeing people who have begun drinking in their teens and are fully- fledged alcoholics before the age of twenty- five.

The safe limits:
Doctors say " 21 units a week for a man, 14 units a week for a woman". A unit is a half-pint (glass) of beer or stout or a glass of wine or a small (English) measure of spirits. So a weekly limit for a man is 10.5 pints and a woman 7 pints of beer or stout.
It is unwise to drink more than 3-5 units at one sitting. The safe limits are lower for people who are unwell physically or mentally. Many people on medication are advised not to drink at all. If you are troubled by suicidal thoughts avoid alcohol as it increases the likelihood of acting on these suicidal thoughts.If you have a family history of alcohol problems be very careful as you may be at a higher risk of developing problems.

Recognising a problem:
there is a significant risk that you may have a problem with alcohol if you regularly drink above the safe limit. Other warning signs are
(a) Problems with your physical health such as regular stomach upset or ulcers, regular morning after symptoms like sweating shakes and nausea.
(b) psychological symptoms like depression, memory problems or irritability
(c) Social problems such as marital problems, financial problems, complaints about the quality of your work or legal problems such as drunk driving charges.
If family or friends suggest that you have a problem with alcohol you should take this very seriously, as they are almost invariably right.

Seeking help:
If you wish to discuss your drinking with a professional advisor the simplest thing to do is go and talk to your family doctor. If there is a problem this can generally be managed by cutting down to safe limits. In a small number of cases it is needed for the person to stop drinking completely and your doctor will advise about this and further treatment as needed
Some other tips for drinking safely:

1. Never drink and drive.

2. Drink with friends.

3. Do not engage in unplanned sex. If you do have sex use contraception unless you are actually trying to conceive a baby. (an old college joke is that "Arthur Guinness is the father of the nation")

4. Don’t drink if you are feeling very sad, worried or irritable, as alcohol will intensify the feelings and may lead you to a course of action you will regret.

5.One drink an hour alternating with soft drinks or water as the night goes by. Don’t allow yourself to get drunk: remember the 3-5 unit limit -falling down and vomiting is not charming!

6. Don’t let drinking be your only social activity-eat out, go to the cinema, take up a hobby. Go out with your friends and don’t drink alcohol just for a change.

7. Allow other people not to drink-There is a huge social pressure to drink in Ireland. Remember drinking alcohol is optional and not everyone wishes to-respect their choice.

8. Reconsider your relationship with alcohol if you are frequently drinking over the limits.

Street Drugs
From a mental and physical health standpoint there is no such thing as the safe use of street drugs. Firstly as they are produced illegally there is no such thing as (for example) a standard ecstasy tablet or cannabis joint. Secondly all are associated with potentially serious mental and physical health problems: for example
Cannabis-Linked with increased incidence of schizophrenia and lung cancer.

Ecstasy- Rebound depression, dehydration and sudden death.
Amphetamines-Psychosis and rebound depression, cardiovascular collapse.
Heroin- personality deterioration Aids and hepatitis C.
Glue- hallucinations and brain damage.
LSD -hallucinations and schizophrenia.

So the simple advice is don’t use drugs. If you choose to ignore this advice then at the very least don’t use drugs on your own. Use with a sober friend because at least then you will have someone to bring you to hospital if it all goes horribly wrong.

Advice for parents
Ultimately as a parent you have to accept that your son or daughter will make up their own mind about alcohol and drugs. There are some things that will give them a good chance of making wise choices but unfortunately there are no guarantees.
1. Use alcohol wisely yourself and don’t take drugs.

2. Give consistent clear messages about what is acceptable behaviour
If they are earning money encourage them to spend on other things besides going out drinking.

3. Get to know their friends.

4. In younger ages get to know the parents of their friends. This can help with the negotiations about "my friend is allowed why am I not?" Parents can decide what they will allow and stick to it.

5. From an early age encourage them to have a wide range of interests
Keep the lines of communication open at all times.

6. Become informed about alcohol and drugs and give this information to your children. It is better to say "don’t …because" rather than "don’t because I say so"
In summary have fun but stay safe- Remember "Slainte" translates as "Good Health."

Abuse of medication
Some people develop a problem with medicines that can be easily bought in
any chemist. The most commonly misused are cough bottles and pain- killers.
If you regularly exceed the daily maximum dose or find that you are taking a
medicine because it gives you a ?good feeling? you may have a problem. Again
talk to your family doctor who will definitely have met this problem before.
Medicine that your doctor prescribes can also be misused so always follow
instructions carefully.

Summary
A simple ABCD to stay safe
A is for Alcohol
Ten pints weekly for a man, seven for a girl
Wait until eighteen to give it a whirl
Never, ever drink if you are feeling blue
And when drinking don?t do things you wouldn?t normally do

BC and D stand for drugs of all kinds
B is for bought ones in the chemist or shop
Follow the label and know when to stop
C is for the criminal who sells on the street
Don?t use his idea of a lovely treat

And remember if you are developing a problem go and speak to your family
doctor who will know how to help.