SMOKING:
WHERE AM I AT?
My habits?
- How old was I when I started?
- Do I relieve anxiety through smoking?
- Do I inhale?
Harm?
- Am I often out of breath?
- A flower's fragrance, a tomato's flavour: still appreciated?
- Does smoking no longer give me pleasure?
- Am I always worried about running out of cigarettes?
- My skin, my voice?
- Tobacco + pill = risk of embolism.
- Impaired fecundity?
- If pregnant, increased risks of premature birth; then, sudden death,
asthma, bronchitis for the baby.
- Early menopause. Osteoporosis.
- Chronic bronchitis: breathlessness, cough, expectoration,
pneumonia, suffocation.
- Cancers: lung, oesophagus (swallowing), throat, tongue,
bladder are to be watched.
- Hypertension, palpitations, myocardial infarction
- Arteries of legs and fingers.
- Relapses of duodenal ulcer?
HARD TO GIVE UP?
Degree of dependence?
- How early do I smoke my first cigarette?
- How many cigarettes a day?
Previous experience of giving
up or cutting down: what worked best?
My motivation for giving up?
- My freedom, passive smoking by my
children and spouse, my sport, a pregnancy, pollution?
In reality, pollution is the cause of most diseases and deaths,
but which? People cry out about pollution from others. In
fact, nearly all hazardous pollution is self-inflicted:
too much in my ashtray, perhaps my glass, my plate,
my carburettor and my medicine cabinet.
- Belief that I will succeed?
- Belief that I will keep up more than six months?
- Is my motivation enormous? Then I will not even finish an
opened pack: to the bin!
DRINKING?
These questions concern
nobody else.
They start with the worse.
They end in what everybody asks for.
I,
DO I SUFFER DAY AFTER DAY?
- Quality of sleep? Nightmares?
- Depression? If not, anxiety?
- Early morning anguish?
- Do a few drinks relieve it?
Seek one or several other morning
symptoms of withdrawal:
- tremor, sweat, nausea, vomiting?
Are these disorders relieved by alcohol?
- A history of delirium, hallucinations, seizure?
If no withdrawal symptoms:
- Need to increase my intake to get
the effect?
- Do I find it difficult to stop
after two or three drinks?
If yes, this is the first stage of dependence.
- Have I ever tried to cut down?
What was the result?
- Do I feel trapped by alcohol? Hooked?
What about my freedom?
II, IF
ALCOHOL DEPENDENT
The need for alcohol, besides
withdrawal:
- Failed attempts to cut down?
- Obsessed by alcohol supply?
- Craving?
- Persisting drinking in spite of harm and expense?
- Giving up other priorities?
- Who is winning, the person or the bottle?
Disorders not explained by the
need:
- Loss of pleasure:
only drinking in order to feel less bad?
- Denial: to myself and others, hiding bottles?
- Hostility towards myself and others?
- Loss of positive emotions?
- Loss of communication with my close relatives?
- Loss of tolerance: at a late stage: are three drinks enough
to fall over?
Emotional condition
- Broken relationships?
- Feeling enslaved?
- Quality of life? Any suicide attempts?
Retrospect:
- How old was I when I started drinking to excess?
- How many years were there between social drinking and the
appearance of withdrawal?
- Did I abuse tranquilizers, dissolving my energies?
- Once hooked, which succeeded:
stopping or cutting down?
- How long did I succeed?
- Did I attend self-help groups, in order to give up?
- Alcohol-related hospital stays?
- If I relapsed into dependence, how many days elapsed between the first
drink and the recurrence of withdrawal symptoms?
A noxious environment?
- Domestic violence? Loneliness?
- Disappointments, separations, mourning?
- Conflicts, worries, unemployment, retirement?
- Distressing home environment, lost home?
- Family drinking habits or being led astray?
- Disinformation. Early initiation to alcohol?
A personal propensity?
- Often drunk as a teenager? Other addictions?
- If depression, did it occur before, during or after dependence?
If anxiety, the same.
Circumstances of craving?
- Festivities: being unable to say no
to the first excess drink?
- Vexations? Being criticized or threatened by my employer
or spouse?
- Bodily pains?
- Did I notice these circumstances?
- Did I devise coping strategies?
Harm, other than broken relationships
and suicide attempts?
- Inability to hold down a job, invalidity?
- Traumas, sex at risk?
- Pathological drunkenness ?
- Heart (infarction n° 1 of death causes): palpitations, hypertension,
breathlessness?
- General and digestive condition: loss of appetite (prelude
to cirrhosis), weight loss, jaundice,
pancreatic pain?
- Neuro-psychic impairment: muscular pain or weakness, impaired
sight of colours, memory disturbances?
- Congenital defects affecting my child (fetal alcoholism)?
- Accidents
Fires
Police
Incarceration?
After all, am I sick owing to
alcohol?
Am I 90% convinced that I need to change my
drinking habits?
Projects shared with my physician?
If dependent,
then choosing to quit:
My motives:
- Stop suffering and being hooked?
- My own experiences
of failed attempts to cut down.
- Having met a recovered alcohol dependent?
Agreeing to be helped: I am
the only one to decide, but I won't succeed alone!
- Armistice with my relatives!
- Agreeing to meet a recovered alcohol dependent?
- Weaning at home is often possible.
- After weaning, close support, e.g.telephone calls.
- Recovering only succeeds in groups:
either institutional or self-help groups.
- Supervision at appointed times, regular attendance to group meetings
and consulting-room are essential.
After weaning, alcohol will
remain on my mind
for at least two months.
- If dependent, I can never hope to drink in
moderation again
or to recover the lost pleasure.
Succeeding through abstinence?
12 to 15 months after
weaning,
focus on freedom and quality of life.
Freedom?
- Do I feel completely free from alcohol?
- If yes, what words can describe this freedom?
Well within myself?
- Depression, suicidal ideas, sleep, self-esteem ?
- Able to cope with vexations?
- Having realistic purposes?
- General health perception?
Well with my relatives?
- Communication, social life, loneliness?
III,
IF NOT DEPENDENT,
CHOOSING BETWEEN
MODERATION
OR ABSTINENCE
- Relying on my own experience
and medical advice.
Mandatory conditions
for controlled drinking after heavy drinking without dependence:
- two weeks without alcohol;
- then abstention three days a week;
- then no more than sixteen drinks a week
(twelve for females).
- Within this framework, no more than fours units/day and
three units/hour.
Learn to smile and
politely say no
to the first excess drink.
- Never drink alone, nor to drown my sorrows,
nor as a medicine
- Then I reduce my risks of accidents, hospital days and dependence.
IV,
IF I AM A MODERATE DRINKER,
OR AN ABSTAINER
"Moderate" means
being usually free to stop after the second or third drink.
How much may I drink before driving?
- All alcoholic drinks, i.e.
beer, wine, port, whisky
contain the same amount of alcohol,
that is around 11 grams = one unit.
- Counting the drinks (units) provides a safe guide.
- Three units (two for a woman) can be enough to test positive
when breathalised at .5 gram of alcohol per litre of
blood. This is enough for the driver to become dangerous,
without noticing it.
- I may get into trouble for breaking the law.
- It would take at least six hours just to reduce blood alcohol
concentration by one gram per litre:
one drink over the limit means waiting for one additional
hour.
- A successful party, how many drinks?
- And then, driving? Pregnancy? Contamination?
How much without risking my health?
- There is not one answer for everybody.
In many cases one cannot drink any alcohol:
some sports; in combination with medication; when depressed;
a history of dependence on alcohol, medicines or drugs; hepatitis;
pregnancy.
- Therefore, the proper answer cannot be expected from television,
but from my personal physician.
Is little wine good for my health?
- Not if I am a woman or a young man or if I smoke.
- It is now deemed that if other categories of abstainers have a
shorter life expectancy, it is due to factors other than their abstinence.
- Anyway, physicians no longer recommend alcohol to abstainers, for want
of being able to predict how far it will go.
It is up to me to make my own mind!
from: https://parlersante.medicalistes.fr
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