1. Alcohol and Cocaine Meg Wright

2. 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

3. 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

4. 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

5. 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

6. EFFECTS of Mix Behavioural Increase in physical violence Increase in risk taking behaviours Increase in impulsive decision making Reduced memory and ability to learn

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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