DR Mark Daglish will be online from noon on Wednesday, April 1, to answer readers' questions about amphetamines and other drugs of addiction.
EDIT: Interview text added.
12:57
[Comment From Spectator]
Lots of my mates take eS in the Valley each weekend and they're fine.
12:57
[Comment From Spectator]
this is a beat-up, right?
12:57
Mark Daglish: Hello. My name is Mark Daglish. I am an Addiction Psychiatrist.
I will be happy to answer your questions on the effects of alcohol & other drugs on the brain.
12:59
Mark Daglish: Hi Spectator - thanks for your question.
There is good evidence now that many of the amphetamine type drugs cause longer term structural changes in the brain. The short term effects don't look or feel too dramatic, but we are note sure what the damage may do in the long term.
1:00
Do you ever mix the use of legal, illegal and prescription drugs?
Yes, legal and illegal
( 24% )
Yes, prescription and illegal
( 6% )
Yes, All three
( 10% )
No.
( 61% )
1:01
[Comment From Dad]
i always maintained that cannabis was a better option because it was harder to hide foreign stuff. Is that the case? Or do the new hydroponic super strains bugger that up anyway?
1:04
[Comment From Jake]
Hello Mark, I used to take Ecstasy, speed and crystal but have been clean for 5 years now. Since getting off I am unable to take Cold and Flu tablets as I get very bad side effects. Is this common? Would you expect the side effects to diminish?
1:04
Mark Daglish:
Hi "Dad"
In general it would be harder to hide adulterants in amongst leaf cannabis. It is well known that the resin can be switched for all sorts of things.
That doesn't make cannabis a safe drug however. We known that many people can get away with using small amounts occasionally, but heavy longer term use has effects on drive and memory.
For some cannabis can lead to bad long term mental health problems. This seems to be particularly true for those who start young and use the stronger stuff, like skunk or the hydoponics.
1:06
[Comment From Soldier]
Is there any indication that speed etc and its after affects might have had anything to do with the high rate of military suicides?
1:06
[Comment From Weezel]
How much of addiction is a personality thing (ie: are some people more likely to become addicts?) and how much is a physiological/chemical thing?
1:06
Mark Daglish: Hi Jake,
I presume the tablets that give you problems are the ones that contain pseudephedrine or similar. It may be that you are still getting effects from drugs that feel a bit like the amphetamines.
It is definately true that like smoking you never go back to being a non-smoker, you are always an ex-smoker - same for the other addictive drugs.
1:07
[Comment From Jonny]
Hi Dr Daglish, can you tell me whether smoking weed(say once a month) will have any major long term affects?
1:08
[Comment From ME]
This is all guess work really isn't it? Every person is different and will react differently. So if one person takes a certain amount of the stuff and gets these side effects, another person may take the same amount and get none. Isn't this the same as any prescription drug out there also?
1:08
Mark Daglish: Hi Soldier - unfortunately it is well known that drug & alcohol problems increase the risk of suicide. This is particularly true if you have other mental health problems like PTSD in soldiers.
1:08
[Comment From Phil]
What are the long term side effects of taking 5-MEO-DMT ?
1:08
[Comment From insomnia]
is taking sleeping pills bad for your body and brain if it gives u a good nites rest and that you dont need coffee the next day? is it really that bad then? Would you say your addicted to sleeping pills then?
1:09
[Comment From Edward]
Hi Mark, A friend of mine in his late teens has recently been diagnosed with mental health problems that the doctor said was precipitated by his heavy smoming of marijuana over the past couple of years. Is that possible? He is in rehab and has stopped smoking but they say he will never be over his mental health issues. Can he ever get back to normal?
1:10
Mark Daglish: Hi Weezel - risk of addiction is very much an individual thing. There are gene effects, early exposure effects, childhood effects and personality effects. In general the more risk factors you have the higher your risk of getting hooked and the more you should stay away from the drugs.
The other big risk factor is amount used. The more you use the more likely you are to get addicted.
1:10
[Comment From Concerned]
I've heard that drug-use can cause schizophrenia. Is this true? And does it only happen to heavy drug users?
1:10
[Comment From Ragnar]
Dr D, do you see more alcohol or drug addicted patients?
1:11
[Comment From Cheech]
Mate of mine smoked dope daily for about a decade. Says it slowed his synapses down so his decision-making became slower and his hand-eye coordination was affected. Can this really happen to anybody?
1:12
Mark Daglish: Hi Edward,
Sorry to hear about your friend. This is a very common problem that Mental health services see. I can't stay if your firend will get better, but....
If he can stay away from the drugs he will do MUCH better than if he continues to use. This and taking the prescribed medication are the best things you can do to stay well & out of hospital.
1:13
Mark Daglish: Hi Ragnar,
About 60-80% of the patients I see in for detox are alcohol dependent. This is partly because alcohol is the commonest drug and also because it has the most dangerous withdrawal states. People forget that severe alcohol withdrawal can be fatal
1:14
[Comment From Ragnar]
Dr. D, if that is the case, do what do you attribute the different legislative treatment accorded to alcohol and drgus?
1:14
[Comment From Tedlands]
Dr Daglish, Despite how bad both are for you, is it true that Coke is a cleaner drug then Ecstasy?
1:15
Mark Daglish: Hi insomnia,
Some sleeping pills can become addictive if misused. We see lots of problems with Alprazolam and diazepam.
The best avice for insomnia is not to use the tablets too often. On of our biggest problems is insomnia caused by alcohol and drug problems. It is a common reason for relapse.
1:16
[Comment From Mother]
Can the same sort of side effects occur if prescribed the wrong medication? Or even the right medication?
1:16
Mark Daglish: Hi Cheech & Concerned
You are both right. There are a lot of effects from cannabis use. Heavy users often get problems with memory and drive in the short term. In the longer term it can lead to schizophrenia, particularly with young onset of heavy use in vulnerable people.
1:20
[Comment From Jonny]
What are some of the major affects you see of ecstacy and meth users after only a year or two of use?
1:21
[Comment From Ray]
I am concerned about a friend of mine who began taking e tablets last year. They believe that its all just fun and is now up to taking 3 at one time (up from one a time). Its a couple of nights a week they do it. They seem fine - how long will it take to see any effect it will have on them in the long term?? And will it effect them in the long term definately or is there a chance that it won't even if they keep going??
1:21
Mark Daglish:
Hi "Mother",
There are always potential problems with any medication. In research studies you always see some side-effects in the people who are taking the placebo (dummy) tablets.
The important thing is to discuss the side-effects with the Doctor prescribing the medication. Often people misunderstand the dose instructions or they need adjusted, and many people need to find the right drug for them.
1:22
Mark Daglish: Hi Jonny,
Short term effects of both ecstacy & methamphetamine & amphetamine are drops in the levels of particular chemical messengers in the brain. Depending on which chemical messenger (ecstacty -> serotonin, amphetamines -> dopamine) then you get different effects.
1:25
Mark Daglish: Hi Ray
The biggest problem your friend & researchers in the field have, is knowning what is in the tablets.
It is likely that small amounts of rare use cause minimal harm for most people. As the dose rises and the frequency increases problems become more likely.
Animal studies of ecstacy have shown that as the animals get closer to humans the gap between the damaging dose and the "recreational" dose gets smaller. Rats need about 40 times the dose, pigeons about 7 times the dose and monkeys about 4 times the dose to get brain damage.
1:26
[Comment From Robbo]
quick question for you - obviously these things arent great for you, but what if you space it out a bit? say 1-2 every 2-3 months?
1:28
Mark Daglish: Hi Robbo,
There are many factors that make the drugs more or less risky. In the rat studies with MDMA they found that the damage was more likely if they put lots of rats together, made them do exercise, increased the ambient temperature and added loud noise. In effect the most damaging place to give a rat MDMA is at a rave!
1:29
[Comment From Weezel]
Is choice of music an issue?
1:29
[Comment From matt]
hi mark, i was a heavey speed user in the mid 90's. i used for about 3 years solid until i met my now wife. i havent used any drugs for the past 11 years, is it possible i have any permanent damage?
1:29
Mark Daglish: Hi Weezel - just the volume and how much it makes you jump up & down!
1:31
[Comment From Weezel]
Have you ever done any drug education work, and if so, how do you convince kids that their 'expert' peer advice is wrong and the real expert advice is right?
1:32
Mark Daglish: Hi Matt,
I'm afraid I can't asnwer your question - it is one I am often asked by patients. We know a bit about average changes in a group of ex-users, but finding the answer for an individual is much harder.
We know that some people are more vulnerable to the damage, but not why. We also know that on average the group effects reduce with time away from drug.
The clear advice is always that staying clean is better for you than a relapse.
1:34
[Comment From Mother]
Thanks. I am also concerned about the teaching of primary school students about the effects of these drugs. In your opinion, is it best to teach them of these things while they are still so innocent or start talking about it when they are more grown. What is the highest risk age?
1:34
[Comment From Jonny]
Would you say that taking ten e's in a year is better or wose than taking ten in a month, regarding affects on the brain?
1:34
Mark Daglish: Hi Weezel - this is a big problem. Everyone knows "a mate" who's used lots of everythign for years and is fine.
Personal stories seem to be more powerful as a message than science.
1:35
[Comment From Cruiser]
Hi Dr Mark I work in an area where I am continually dealing with drug effected persons and I have to say that they all have mental health issues.
1:35
[Comment From Tim]
Hi Mark, What are the youngest ages kids are getting into drugs these days and how quickly is the age going down? I have a young son and want to watch out for this before its too late.
1:35
Mark Daglish: Hi Jonny,
Generally more tablets at once is worse than well spread out. Of course, folk who use 10 in a month will be more likely to use more the next month.....
1:37
[Comment From Vincenzo]
Hi Mark - Do 12 step programs work in the treatment for amphetamine addiction.
1:37
[Comment From Jacob09]
I use cocaine once a month, i find it very stimulating. Using it in small amounts cant hurt too much can it?
1:38
Mark Daglish: Hi Mother & Tim,
It is not unusual for us to see people who started their drug / alcohol career at the age of 12. Of course, we see the severe end of the spectrum.
I always believe in informed choices. I don't think "hiding" drugs makes kids safer. The challenge is in making the learnign materials age appropriate.
1:39
Mark Daglish: Hi Cruiser,
We have the same experience. Overlap between drugs, alcohol and mental health is the norm not the exception in services.
1:39
[Comment From Sky]
My wife is costant binger on wine, 2-3 bottles at a time and reacts with massive mood swings, always to the bad side. Currently is seeing a counsellor and has one session of electro therary with hypnosis. Is this a suitable treatment? Are there better alternatives?
1:40
Mark Daglish: Hi Vincenzo,
12 step programmes (like AA & NA) work extremely well for some people and not for others. One experience we do have is that not all the groups are the same and people often have to "shop around" to find the group that suits them.
1:42
Mark Daglish:
Hi Jacob,
Cocaine is an interesting drug. The biggest risks from monthly use would be:
1) increasing use over time
2) short term effects - like doing silly / dangerous things while high
3) Longer term effects on the heart and brain in particular.
Cocaine users do present to emergency departments with heart attacks, strokes and other effects from high blood pressure and racing pulse.
1:44
[Comment From user2009]
Hi Mark, is there any other way to get off morphine rather than going on an opiate program which blacklists you as a drug addict? I want to get off it but dont want to be listed as an addict. Does that make sense?
1:44
Mark Daglish: Hi Sky,
There are lots of different services out there to help with alcohol problems. Mood swings are a common effect.
If you live in Queensland then your GP should be able to put you in touch with the local ATODS (alcohol, tobacco & other drugs service).
There are medications available for alcohol problems as well. These are very effective for some people.
1:44
[Comment From John]
Hi Mark - I've heard that some people are more prone to drug addiction than others, one reason given is that some people have an "addictive personality" and others don't. Is having a so called "addictive personality" a myth or a fact.
1:47
[Comment From Sky-sympathiser]
Hey Sky, what's this electro-shcok therapy? I thought that went out with straw hats
1:47
Mark Daglish: Hi user2009
Opiate withdrawal is rarely dangerous (unlike alcohol) and so stopping is always an option. Of course, that is much easier for me to say than for you to do.
The reason we often try to persuade people on to a programme is that we know the rate of relapse to illicit use is much lower for those on a script than it is for those who detox. It helps to separate the psychological elements of addiction from the pharmacological elements.
There is an old saying that methadone is what gets people to come back to the clinic where the real treatment happens.
1:48
[Comment From Sky]
They put some elctrodes around the head and neck and it pulses the brian apparently to try and reset the paths or something. I am a bit sceptical.
1:49
[Comment From John]
Is "Cognitive Behaviour Therapy" - ie reprogramming of the subconscious part of the brain an effective method - such as the Allen Carr method used to quit smoking /drinking
1:49
Mark Daglish: Hi Sky et al,
Some have advocated electro-acupuncture as a treatment for addictions. The issue is how good the research data is to back it up. The treatments we provide in the clinics all need to have an evidence base to back up their use. In the "alternative" field this is less clear.
1:51
Mark Daglish: Hi John,
Cognitive Behavioural Therapy (CBT) is a well validated treatment for a number of mental health issues, including addiction. Other "talking" treatments that have been shown to work also include Motivational Interviewing and Relapse Prevention. Others are in development as we learn more about the mind processes that underly addictions.
1:52
[Comment From Peter]
I have a severe chronic pain condition which was treated with opiates for a couple of years. Following an assessment with ATODs I was blacklisted from being prescribed S8 medicine. The pain is unbearable and I don't know where to turn. I haven't had any S8 medicines for 18 months so I am not withdrawing.
1:53
[Comment From Sky]
My main concern if for my kids that see this a few times a week. I don;t get home until 6ish so by that time the booze has usually taken effect. She isn;t dangerous to the kids, just very load and short tempered but unloads on me as soon as I walk through the door. Should I watch them carefully and are they possibly more at risk to faling into this bahaviour. I have quietly tried to teach then about drinking. Ages 10 and down
1:56
[Comment From will "Bris city"]
I have never taken drugs but my friends tell me that drugs make sex a lot better, is this true?
1:56
Mark Daglish: Hi Peter,
Sorry to hear about your difficulties. It is impossible for me to comment about your case as obviously I don't know you. I can make some general comments:
We see a lot of people with problematic use of prescribed opiate pain killers. Often the pain problem is compounded by depression and other difficulties.
Often the opioids end up not being that good at controlling the pain and may even end up aggravating the problem.
Usually the best way forward is to tackle the problems on several fronts. Non-drug techniques for pain control and other approaches to maximising what one is able to do despite the pain often give people the best long term outcomes.
It is never easy or quick, but progress can be made.
1:59
Mark Daglish:
Hi Sky,
There is some work from a variety of researchers that suggests a few factors are particularly warning signs for kids risk of developing alcohol problems.
1) Does it run in the family?
2) Do they have an initial high tolerance to alcohol (they just seem to get less drunk from the same dose as their friends)
3) Do they tend to use alcohol as a coping strategy?
Risks 1 & 2 are not something you can change. Risk 3 can be learnt from watching others round about you.
2:01
[Comment From Brett]
Will (Bris City) - In my experience drugs affects a male getting an erection or sustaining it. So if you cant get it up then what good are you . Without drugs you can go all night long so my advice is "no drugs" and she'll definitely have a smile on her face in the morning.
2:03
Mark Daglish: Hi will "bris city"
A number of drugs have developed a reputation for enhancing sex. In some cases this is true (at least in the short term).
The risk is like all the other reasons for use; plus the extra risk of ending up finding that sex is boring without a drug.
Many drugs have longer term effects to reduce libido (sex drive) and also cause problems like impotence.
2:06
Mark Daglish:
Sorry folks - we have run out of time.
Thank you to all for your thought provoking questions.
Thanks also to those of you who answered the poll.
The reason for that question is that mixing drugs &/or alcohol is the commonest cause of fatal overdoses. I was interested to see how widespread this dangerous practice is.