When feeling stressed, anxious or depressed, it is not unusal to escape from these feelings by using alcohol, drugs, smoking  and this might seem like a quick way to feel better. Whilst short term they may provide some relief from everyday stressors, long term it can lead to significant problems with your health, social and occupational functioning and your emotional wellbeing.

If you are concerned that you or someone you care about has a problem with alcohol or substance use there is a lot of help available. Get in touch keepingwell.nwl@nhs.net

Using drugs or alcohol to help manage stress, anxiety and depression is a very common problem. Whilst short term they may provide some relief from everyday stressors, long term it can lead to significant problems with your health, social and occupational functioning and your emotional wellbeing.

For your local drug and alcohol services, click here and enter your post code

Action on Addiction

Range of abstinence-based treatment services for people with severe dependency on alcohol and drugs. Telephone: 0300 330 0659. 

Alcoholics Anonymous

Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. 

Build on Belief

Offer a peer support service for people struggling with substance issues. 

Club Soda

Club Soda helps you live well by being more mindful about drinking. Whether you want to cut down, take a break from alcohol or stop drinking, you’re welcome to join us. 

Families Anonymous

Telephone and other support services for families and friends of drug users. Telephone: 020 7498 4680.

Talk to Frank

Helpline for anyone concerned about drug or solvent misuse. Advice and information for drug misusers, their families, friends, carers. Telephone: 0300 123 6600. 

London Friend

Run LGBT drug and alcohol service. Telephone: 020 7833 1674.

Phoenix Futures

Charity and housing association which has been helping people overcome drug and alcohol problems for more than 40 years. Telephone: 020 7234 9740. 

UK Narcotics Anonymous

Helpline and regular self help meetings for addicts who have a desire to stop using and who wish to support each other in remaining drug free. Telephone: 0300 999 1212. 

Recovery Focus

A national group of charities, who are all highly experienced in providing specialist support services to individuals and families living with the affects of mental ill health, drug and alcohol use, gambling and domestic violence across the country. Telephone: 020 7697 3300.

Release

Helpline and support for drug users, families, friends. Advice on drug related subjects including health, welfare and legal issues. Telephone: 020 7324 2989. 

Salvation Army

Runs homes for the treatment of alcoholics and drug addict. Telephone: 020 7367 4500. 

Substance use

Everyone is entitled to treatment for substance use (drug addiction) if you need it. With the right help and support, it's possible for you to get drug free and stay that way. Your treatment will depend on your personal circumstances and what you're addicted to. 

A GP is a good place to start. They can discuss your problems with you and get you into treatment. They may offer you treatment at the practice or refer you to your local drug service.

If you're not comfortable talking to a GP, you can approach your local drug treatment service yourself. 

Visit the Frank website to find local drug treatment services.

If you're having trouble finding the right sort of help, call the Frank drugs helpline on 0300 123 6600. They can talk you through all your options.

What treatment involves

Your treatment will depend on your personal circumstances and what you're addicted to and may include a number of different treatments and strategies such as:

  • Talking therapies: such as CBT, help you to see how your thoughts and feelings affect your behaviour.
  • Treatment with medicines: you may be offered a substitute drug. This means you can get on with your treatment without having to worry about withdrawing or buying street drugs.
  • Detoxification (detox): this is for people who want to stop taking opioids completely. It helps you to cope with the withdrawal symptoms.
  • Self-help: some people find support groups like Narcotics Anonymous helpful. Your keyworker can tell you where your nearest group is.
  • Reducing harm: Staff at your local drug service will help reduce the risks associated with your drug-taking. 

It can be helpful to talk to other people who know what you're going through. It is useful to check with your GP to give you details of local support groups for people affected by someone else's drug use.

There are also organisations that run helplines and local support groups for people living with a person who uses drugs.

FRANK

FRANK is a support service that provides information about drugs, plus advice for people who use drugs, and their parents or carers. Find a Frank support near you

Call the Frank helpline: 0300 123 66 00

Adfam

Adfam has local support groups and helpful information online for families affected by drugs and alcohol.

Find an Adfam support group near you

DrugFAM

DrugFAM offers phone and email support to people affected by other people's drug or alcohol misuse.

Email: office@drugfam.co.uk or call the helpline: 0300 888 3853.

Families Anonymous

Families Anonymous is based on the same principles as Alcoholics Anonymous. It runs local support groups for the family and friends of people with a drug problem.

Email: office@famanon.org.uk or call the helpline: 0207 4984 680.

Release

Release offers free, confidential advice on drugs law for people who use drugs, and their families.

Email: ask@release.org.uk or call the helpline: 020 7324 2989.

If you're a manager or employee working in the NHS and find one of your staff members or colleagues using alcohol or drugs at work - what do you do?

We've put together a short presentation that provides guidance on how to have an open conversation about substance use at work.

Alcohol support

Realising you have a problem with alcohol is the first big step to getting help. You may need help if:

  • you often feel the need to have a drink
  • you get into trouble because of your drinking
  • other people warn you about how much you're drinking
  • you think your drinking is causing you problems

Try to be accurate and honest about how much you drink and any problems it may be causing you. If you have become dependent on alcohol, you will have found it difficult to fully control your drinking in some way.

If you are unsure if your substance misuse has become problematic, please take this self-screening test which will give you an indication of whether you benefit from further support.

  • After just one medium glass of wine (just after 2 units), you will start to feel relaxed, you feel more confident and you become more talkative. At this point, your driving ability is already impaired, which is why it’s best to drink no alcohol if you’re driving.
  • After your second glass of wine (just over 4 units), your blood flow increases, you start dehydrating and your attention span is shorter.
  • After your third glass of wine (just over 6 units), your reaction time is slower, your liver is pushing harder and your sex drive may increase, whilst your judgement may decrease.
  • And after four glasses of wine (just over 9 units), you’re noticeably emotional and may become easily confused.

Now think about a time you have been out with work colleagues or friends and had some alcohol, how much of your time out can you actually remember?

Am I a binge drinker?

This part of the article is available in audio recording - listen here. Even if you don’t drink alcohol every day, you could be a binge drinker if you:

  • Regularly drink more than the low risk drinking guidelines in a single session
  • Tend to drink quickly
  • Sometimes drink to get drunk

If you find it hard to stop drinking once you have started, you could also have a problem with binge drinking and possibly alcohol dependence. As everybody is different, it is not easy to say exactly how many units in one session count as binge drinking, but in the UK, it is considered you are binge drinking if you consume more than:

  • 8 units of alcohol in a single session for men (e.g. 2 pints of 5% beer)
  • 6 units of alcohol in a single session for women (e.g. 5 small (125ml) glasses of 13% wine)

The impact of the binge drinking on your physical and mental health will depend on your tolerance to alcohol and the speed you consume it at.

Binge drinking can lead to:

  • Accidents resulting in injury, which means you may have to take time off work.
  • Misjudging risky situations – again, thinking about safety of yourselves and the people around you.
  • Losing self-control and taking part in risky behaviours like having unprotected sex.

How can I reduce my risk from binge drinking?
Next time you’re drinking, remember the following key points:

  • Limit how much you drink on any single occasion
  • Try to eat when you are drinking
  • Alternate your alcoholic drinks with non-alcoholic drinks such as water or juice
  • Make sure you have planned ahead and are not working or driving soon after a heavy drinking session

You can be at risk from others and can easily lose control of what you do or say and may make risky decisions. Keeping track of your drinking, especially when in unfamiliar circumstances is so important.

If you are unsure if you drinking alcohol has become problematic, please take this self-screening test which will give you an indication of whether you benefit from further support.

So you have a hangover, now what?

This part of the article is available on audio recording - listen here

Splitting headaches, sickness, dizziness, dehydration: anyone who's ever drunk too much knows the consequences. Alcohol makes you pee more, which can lead to dehydration. Dehydration is what causes many of the symptoms of a hangover.

Hangover cures are generally a myth. There are no cures for a hangover, but there are things you can do to avoid one and, if you do have one, ease the discomfort.

Tips to avoid a hangover

  • Do not drink more than you know your body can cope with. If you're not sure how much that is, be careful.
  • Do not drink on an empty stomach. Before you start drinking, have a meal that includes carbohydrates (such as pasta or rice) or fats. The food will help to slow down your body's absorption of alcohol.
  • Do not drink dark coloured drinks if you've found you're sensitive to them. They contain natural chemicals called congeners, which irritate blood vessels and tissue in the brain and can make a hangover worse.
  • Drink water or non-fizzy soft drinks in between each alcoholic drink. Fizzy drinks speed up the absorption of alcohol into your body.
  • Drink a pint or so of water before you go to sleep. Keep a glass of water by your bed to sip if you wake up during the night.


Things to avoid

  • Drinking more alcohol, or "hair of the dog", does not help. Drinking in the morning is a risky habit, and you may simply be delaying the appearance of symptoms until the extra alcohol wears off.
  • If you've been drinking heavily, doctors advise that you wait at least 48 hours before drinking any more alcohol (even if you don't have a hangover), to give your body time to recover.

 

This part of the article is available in audio recording - listen here

Big pint of Big Mac?

Drinking four bottles of wine a month adds up to approx. 27,000 calories which is equivalent to eating 48 Big Macs per year. Drinking 5 pints of lager each week adds up to 44,200 calories which is equivalent to 221 Krispy Kreme chocolate coated doughnuts each year, so if you’re trying to lose weight, it’s not only about what you eat but also about what you drink!

How does alcohol cause weight gain?
Alcohol contains a lot of calories, 7 calories per gram. Carbohydrates and proteins have 4 calories per gram and fats have 9 calories per gram, making alcohol almost as many calories as a gram of fat. Plus, don’t forget about the calories in your mixers such as tonic, juices and fizzy drinks such as Cola.

Majority of alcoholic drinks are made from natural starch and sugar, hence having hardly any nutritional value yet still so high in calories.

A couple of drinks on occasions may not be noticeable on your waistline but regularly drinking more than the NHS recommends can have a noticeable impact on your waistline and cause less obvious, but more serious health problems.

Tips to avoid weight gain

  • Do not drink on an empty stomach and if you do decide to snack whilst drinking, choose healthier options.
  • Drink at your own pace, buying rounds for one another can mean you end up drinking more than you may have initially intended.
  • Alternate an alcoholic drink with a glass of water as this will help prevent you from becoming dehydrated.
  • Stick to the recommended guidelines and do not drink more than 14 units in a week.
  • If you are planning to cut down, do it with a friend or partner as you’ll be more likely to stick to it with an accountability partner.
  • Eat a healthy meal before you start drinking so you’re less likely to be tempted to go for a less healthy option following a few drinks such as fast food or crisps.
  • If you’re drinking white wine, try adding a splash of soda water to help the same number of units last longer

Dry January is the UK's one-month alcohol-free challenge. It isn’t about giving anything up. It’s about getting something back. Get your fun back. Get your energy back. Get your calm back.

Our Keeping Well tips for a successful Dry January

Find a substitute non-alcoholic drink
Especially when in social situations or when you are craving that glass of red wine after a busy shift at work. Instead of your usual, try alcohol-free beverages such as sparkling water, soda, or non-alcoholic versions of alcoholic drinks like a virgin mojito. Non-alcoholic beer or wine is also another option, but some brands still have 0.5% of alcohol by volume, so be sure to check the label. Another thing to be mindful of is that sugar is often added to these beverages to make them taste better, so try to chose ones which have lower sugar contents.

Avoid temptations – out of sight means out of mind
Try to keep alcohol out of your house, and when going to visit a friend or family, bring your non-alcoholic drinks with you and tell them all about the amazing challenge that you are doing.

Create a support group
Accountability is a great thing – the more family and friends you tell, the more encouragement you’ll get to keep going. If you can, do the challenge with a friend and go dry together!

Use the Try Dry app
This free app is great!! It helps you track your drinking, set goals and offers motivational information like calories and money saved from not drinking. It is aimed at cutting back or cutting out alcohol all together, depending on your choices.

Don’t give up!
If you slip up, don’t feel guilty – just begin again the next day

Watch this short video from Stefani, our dedicated Drug and Alcohol Practitioner with a special Dry January message:

Get help to quit smoking

Smoking is one of the biggest causes of death and illness in the UK contributing to 78,000 deaths and causing 70% of lung cancers. Despite the frightening ways that smoking impacts on health, it can be difficult to break a long-term habit, especially if it has become a coping mechanism or provides comfort.

But quitting smoking is the single most important way to improve your health and wellbeing, as well as saves you a huge amount of money (on average £2,200 per year).

This article is also available in audio recording - listen here.

First of all, congratulations! Whether this is your first, or fiftieth time – you have taken the first step to becoming smoke free! You will begin to notice an improvement in your quality of life, mood, stress levels and physical health. However, change can be difficult, and a big decision like this is bound to have some impact on your life. Let us look at these in a bit more detail:

What will happen when I stop smoking?

The instant you stop smoking, your body will start to recover. You may experience some nicotine withdrawal and recovery symptoms in the first few weeks. You may still have the urge to smoke or feel a bit restless, irritable, frustrated or tired. Some people find it difficult to sleep or concentrate. Remember the symptoms will pass and there are lots of things you can do to manage them in the meantime.

Helping your body and brain learn how to quit nicotine is challenging. Withdrawal from nicotine is a short phase overall, but it can be intense. Deal with nicotine withdrawal with mental strategies you can use as you go through the early days of smoking cessation. Empowering yourself with knowledge about what to expect can make this process more manageable.

We can support you at this stage of your smoke-free journey, simply self-refer using our online referral form, the live chat or give us a call.

Will I gain weight?

After you quit smoking, your body burns calories more slowly. Even if you eat no more than when you smoked, you may put on some weight.
But being more active can help. Regular exercise may prevent about half the weight gain expected after a year of quitting smoking. It burns off calories and reduces cravings for cigarettes.

  • Build up to at least 150 minutes (2.5 hours) of moderate-intensity aerobic exercise, such as fast walking, swimming or cycling, every week.
  • Moderate-intensity activity means working hard enough to make you breathe more heavily than normal and feel slightly warmer than usual.
  • The more exercise you do, the more calories you'll burn.

The important thing about stopping smoking is that you see it through. If you're concerned about weight gain but think stopping smoking and dieting at the same time will be too much, stop smoking first and deal with any weight gain afterwards.

Smoking helps me relax and de-stress, how is stopping going to impact my mental health?

We all know that quitting smoking improves physical health. But it's also proven to boost your mental health and wellbeing: it can improve mood and help relieve stress, anxiety and depression.

Smoking, anxiety and mood
Most smokers say they want to stop, but some continue because smoking seems to relieve stress and anxiety. It's a common belief that smoking helps you relax. But smoking actually increases anxiety and tension. Smokers are also more likely than non-smokers to develop depression over time.

Why it feels like smoking helps us relax
Smoking cigarettes interferes with certain chemicals in the brain. When smokers haven't had a cigarette for a while, the craving for another one makes them feel irritable and anxious. These feelings can be temporarily relieved when they light up a cigarette. So smokers associate the improved mood with smoking. In fact, it's the effects of smoking itself that's likely to have caused the anxiety in the first place. Cutting out smoking does improve mood and reduces anxiety.

The mental health benefits of quitting smoking

  • anxiety, depression and stress levels are lower
  • quality of life and positive mood improve
  • the dosage of some medicines used to treat mental health problems can be reduced
  • stopping smoking can be as effective as antidepressants.
How do I cope with cravings?

If you can control your cravings for a cigarette, you'll significantly boost your chances of quitting. The most effective way to tackle cravings is a combination of stop smoking medicines and behavioural changes.

Going cold turkey may be appealing and works for some, but research suggests that willpower alone isn't the best method to stop smoking. In fact, only 3 in every 100 smokers manage to stop permanently this way.

There are three tried and tested ways to tame cravings:

  • nicotine replacement therapy
  • prescription stop smoking medicines
  • behaviour changes

Nicotine replacement therapy
Nicotine replacement therapy (NRT) gives your body the nicotine it craves without the toxic chemicals that you get in cigarettes, so it doesn't cause cancer. It helps you stop smoking without having unpleasant withdrawal symptoms. NRT won't give you the same "hit" or pleasure you would expect from a cigarette, but it does help reduce cravings. NRT is available as gum, patches, lozenges, microtabs, inhalator, nasal spray, mouth spray and oral strips.

Stop smoking medicines
Prescription tablets are an alternative to NRT in helping you stop smoking. They don't contain nicotine, but work on your brain to dampen cravings. As they take a few days to work fully, you need to start these medicines for a week or two before you stop smoking.

Change your behaviour
NRT and stop smoking medicines can help curb cravings, but they can't completely eradicate them. There are some additional things that can help:

  • avoid triggers
  • stay strong
  • exercise
  • be prepared
  • delay
I have relapsed! What do I do now?

Many people who quit smoking relapse at some point. Don't be put off trying again. The key is to learn from what went wrong so you're more likely to succeed next time.

If you do relapse, don't worry. It can take a few tries to quit smoking for good. It can be helpful to commit yourself to the "not a single drag" rule. Promise to yourself and others that you'll not even have a single drag on a cigarette, by sticking to this simple rule you can guarantee that you won't start smoking again.

If you have had a cigarette or two:

  • Don't give up – you can still avoid a full relapse. Commit to the "not a single drag" rule and get back on with it.
  • Remind yourself why you want to quit. Then take control again.
  • Get support – call the free NHS Smokefree helpline on 0300 123 1014 to speak to a trained adviser. Lines are open Monday to Friday, 9am to 8pm and Saturday and Sunday, 11am to 5pm.
  • Make it hard to smoke – avoid places where you can easily ask someone for a cigarette. And don't buy a packet.
  • Stay strong – if you're tempted to smoke again, force yourself to wait 2 hours. Then decide if you really need the cigarette.
  • Keep taking any prescribed stop smoking medicine or using nicotine replacement therapy, unless you go back to regular smoking. It can help you get back on track.

If you have relapsed and are back to regular smoking:

  • Don't become despondent – set a new quit date, maybe in a week or so.
  • Learn from your mistakes – what caused you to slip up? Think of ways you could have avoided smoking. Work on your coping skills so you're prepared next time you're in the same situation.
  • Talk to your GP or a friend - if you need more help to cope with cravings in your next quit attempt.
  • Stay positive – making mistakes or slipping up can be a useful experience if you're prepared to learn from it. Remember, you'll be stronger next time because you'll know what to look out for.

Talk to us at Keeping Well

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