When a loved one has a drug problem

If you suspect that a friend or family member has a drug problem, here are a few things you can do:

• Speak up. Talk to the person about your concerns, and offer your help and support, without being judgmental. The earlier addiction is treated, the better. Don’t wait for your loved one to hit bottom! Be prepared for excuses and denial by listing specific examples of your loved one’s behavior that has you worried.
• Take care of yourself. Don’t get so caught up in someone else’s drug problem that you neglect your own needs. Make sure you have people you can talk to and lean on for support. And stay safe. Don’t put yourself in dangerous situations.
• Avoid self-blame. You can support a person with a substance abuse problem and encourage treatment, but you can’t force an addict to change. You can’t control your loved one’s decisions. Let the person accept responsibility for his or her actions, an essential step along the way to recovery for drug addiction. 

Discovering your child uses drugs can generate fear, confusion, and anger in parents.
Five steps parents can take:

• Lay down rules and consequences. Your teen should understand that using drugs comes with specific consequences. But don’t make hollow threats or set rules that you cannot enforce. Make sure your spouse agrees with the rules and is prepared to enforce them.
• Monitor your teen’s activity. Know where your teen goes and who he or she hangs out with. It’s also important to routinely check potential hiding places for drugs—in backpacks, between books on a shelf, in DVD cases or make-up cases, for example. Explain to your teen that this lack of privacy is a consequence of him or her having been caught using drugs.
• Encourage other interests and social activities. Expose your teen to healthy hobbies and activities, such as team sports and afterschool clubs.
• Talk to your child about underlying issues. Drug use can be the result of other problems. Is your child having trouble fitting in? Has there been a recent major change, like a move or divorce, which is causing stress?
• Get help. Teenagers often rebel against their parents but if they hear the same information from a different authority figure, they may be more inclined to listen. Try a sports coach, family doctor, therapist, or drug counselor.

Scorpion and Turtle Story

A Scorpion, being a very poor swimmer, asked a Turtle to carry Him on his back across a river.
"Are you crazy?" exclaimed the Turtle.
"You'll sting me while I'm swimming and I'll drown."
"My dear Turtle," laughed the Scorpion, "if I were to sting you, you would drown and I would go down with you. Now where is the logic in that?"
"You're right!" cried the Turtle. "Hop on!"
The Scorpion climbed aboard and halfway across the river gave the Turtle a mighty sting. As they both sank to the bottom, the Turtle resignedly said:
"Do you mind if I ask you something? You said there'd be no logic in your stinging me. Then why did you do it?"
"It has nothing to do with logic," the drowning Scorpion sadly replied. "It's just my character."

Moral of the Story: Children, be careful of whom you associate with.

Boat Orchids

Here in Southern California, one orchid that grows extremely well is the boat orchid, Cymbidium. These types of orchids have been grown and depicted in drawings and poetry for more than two thousand years since the time of Confucius. They are still popular plants today because of the big, showy and long-lasting flowers. The pink, yellow, green, red, brown, peach or combination colored flowers also last superbly as cut flowers—if you change water daily and cut back the bottom of the spike, they can look pristine for a month or two in the vase.

Understanding drug use, drug abuse, and addiction

People experiment with drugs for many different reasons. Many first try drugs out of curiosity, to have a good time, because friends are doing it, or in an effort to improve athletic performance or ease another problem, such as stress, anxiety, or depression. Use doesn’t automatically lead to abuse, and there is no specific level at which drug use moves from casual to problematic. It varies by individual. Drug abuse and addiction is less about the amount of substance consumed or the frequency, and more to do with the consequences of drug use. No matter how often or how little you’re consuming, if your drug use is causing problems in your life—at work, school, home, or in your relationships—you likely have a drug abuse or addiction problem.


As with many other conditions and diseases, vulnerability to addiction differs from person to person. Your genes, mental health, family and social environment all play a role in addiction. Risk factors that increase your vulnerability include:

• Family history of addiction
• Abuse, neglect, or other traumatic experiences in childhood
• Mental disorders such as depression and anxiety
• Early use of drugs
• Method of administration—smoking or injecting a drug may increase its addictive potential 

People who experiment with drugs continue to use them because the substance either makes them feel good, or stops them from feeling bad. In many cases, however, there is a fine line between regular use and drug abuse and addiction. Very few addicts are able to recognize when they have crossed that line. While frequency or the amount of drugs consumed don’t in themselves constitute drug abuse or addiction, they can often be indicators of drug-related problems.

• Problems can sometimes sneak up on you, as your drug use gradually increases over time. Smoking a joint with friends at the weekend, or taking ecstasy at a rave, or cocaine at an occasional party, for example, can change to using drugs a couple of days a week, then every day. Gradually, getting and using the drug becomes more and more important to you.
• If the drug fulfills a valuable need, you may find yourself increasingly relying on it. For example, you may take drugs to calm you if you feel anxious or stressed, energize you if you feel depressed, or make you more confident in social situations if you normally feel shy. Or you may have started using prescription drugs to cope with panic attacks or relieve chronic pain, for example. Until you find alternative, healthier methods for overcoming these problems, your drug use will likely continue.
• Similarly, if you use drugs to fill a void in your life, you’re more at risk of crossing the line from casual use to drug abuse and addiction. To maintain healthy balance in your life, you need to have other positive experiences, to feel good in your life aside from any drug use.
• As drug abuse takes hold, you may miss or frequently be late for work or school, your job performance may progressively deteriorate, and you start to neglect social or family obligations. Your ability to stop using is eventually compromised. What began as a voluntary choice has turned into a physical and psychological need.

Drug abusers often try to conceal their symptoms and downplay their problem. If you’re worried that a friend or family member might be abusing drugs, look for the following warning signs:

Physical warning signs of drug abuse

• Bloodshot eyes, pupils larger or smaller than usual
• Changes in appetite or sleep patterns. Sudden weight loss or weight gain
• Deterioration of physical appearance, personal grooming habits
• Unusual smells on breath, body, or clothing
• Tremors, slurred speech, or impaired coordination

Behavioral signs of drug abuse

• Drop in attendance and performance at work or school
• Unexplained need for money or financial problems. May borrow or steal to get it.
• Engaging in secretive or suspicious behaviors
• Sudden change in friends, favorite hangouts, and hobbies
• Frequently getting into trouble (fights, accidents, illegal activities)

Psychological warning signs of drug abuse

• Unexplained change in personality or attitude
• Sudden mood swings, irritability, or angry outbursts
• Periods of unusual hyperactivity, agitation, or giddiness
• Lack of motivation; appears lethargic or “spaced out”
• Appears fearful, anxious, or paranoid, with no reason

Side-effects of specific drug classes (for elderly)

There are a number of differences between older people and younger people that have an impact on their treatment with medicines. These are particularly apparent in very old patients:

• Older people's bodies take up and eliminate medicines from the body differently than younger patients'.
• Older people are susceptible to a wide range of diseases, including Alzheimer's disease, heart disease, bone diseases and mental illnesses.
• Older people often have more than one disease at a time, making it difficult to treat the separate diseases.
• Older people may be weaker than younger patients, making them vulnerable to disease and the risks associated with medical treatment.

Side-effects of specific drug classes:

NSAIDs

• Gastrointestinal bleeding is more common and has more serious consequences in older patients.
• NSAIDs can worsen heart failure or aggravate impaired renal function. These effects can be worse in elderly patients.
• They are best avoided, if possible, for simple pain relief in osteoarthritis (OA), etc; paracetamol should be tried instead and, if this is insufficient, try a low-dose NSAID in addition, with proton-pump inhibitor (PPI) or misoprostol cover, or substitute a low-dose opioid.
• Consider complementary therapies such as acupuncture to help with pain management.
• The co-prescription of NSAIDs and ACE inhibitors in older patients can be a recipe for disaster; their combined deleterious effect on renal cortical perfusion and function can lead to significant renal impairment in the older patient.

Hypnotics

• Hypnotics with long half-lives are a significant problem and can cause daytime drowsiness, unsteadiness from impaired balance and confusion.
• Short-acting ones may also be a problem and should only be used for short periods if essential.
• In patients prone to falls or dizziness avoid using these agents unless absolutely necessary.
• Where benzodiazepines are used to help patients overcome a crisis or transitional period, great care must be taken that they be given only for short periods, to avoid the danger of dependence and addiction.
• It is much better to take a good history of an older patient's sleep habits and suggest sleep hygiene and non-pharmaceutical measures to overcome insomnia, than to prescribe drugs, which at best will be a temporary solution.

Diuretics

• This class of drugs is often overused in the elderly and should not be used for chronic treatment of gravitational oedema where measures such as leg-raising, increased walking/leg exercises and graduated compression stockings are often sufficient.
• Where diuretics are used to treat hypertension or cardiac failure, they should be reviewed regularly, along with an assessment of the patient's state of hydration and U&Es if necessary.
• Withdrawal of diuretics requires careful monitoring and consideration of potential contra-indications to withdrawal and can be difficult to achieve. For example, patients with well-controlled heart failure can develop troublesome symptoms and blood pressure can rise significantly in hypertensive patients.

Digoxin

In the very elderly, the daily maintenance dose should be 125 micrograms. In the renally impaired, the dose should be 62.5 micrograms. 250 micrograms/day are likely to cause toxicity.

Drugs that cause bone marrow suppression

Drugs such as co-trimoxazole and chloramphenicol should only be used if there is no suitable alternative.

Anticoagulants and antiplatelet drugs

• Beware of gastrointestinal bleeding and contra-indications such as peptic ulceration which may have occurred a long time ago and been forgotten about.
• For warfarin, prescribe only when patients have a full understanding of why the drug is being taken, its dangers, correct daily dosing/timing and the importance of regular INR monitoring.

Antidepressants

• Tricyclic antidepressants commonly cause postural hypotension and confusion in the older patient; they should be used carefully.
• Serotonergic medications used for depression may cause serotonin syndrome and agitation in the older patient; this can be difficult to distinguish from some of the symptoms of depression.

Diabetic medication

• Long-acting oral hypoglycaemics such as chlorpropamide and glibenclamide should be avoided as there is a significant risk of hypoglycaemia when these agents are used in the older patient.
• Tight diabetic control must be balanced against potentially catastrophic events precipitated by hypoglycaemia, particularly in those who live alone, have a poor understanding of diabetes self-management, or who experience few warning symptoms of hypoglycaemia.

The Travelers and the Plane Tree

Two men were walking along one summer day. Soon it became too hot to go any further and, seeing a large plane tree nearby, they threw themselves on the ground to rest in its shade.
Gazing up into the branches one man said to the other: "What a useless tree this is. It does not have fruit or nuts that we can eat and we cannot even use its wood for anything."
"Don't be so ungrateful," rustled the tree in reply. "I am being extremely useful to you at this very moment, shielding you from the hot sun. And you call me a good-for-nothing!"
All of God's creations have a good purpose. Islam teaches us that we should never belittle Allah's blessings.

Slipper Orchids

My favorite type of orchid is the lady slipper orchid because of their strange appearance. They are like no other types of flowers and have pouch-shaped lips. The mostly terrestrial and lithophytic slipper orchids include four genera—Paphiopedilum, Phragmipedium, Cypripedium and Selenipedium. But most Cypripedium and Selenipedium are not plants for the beginner because they can be quite difficult to grow under cultivation unless you live in temperate regions with Cypripedium growing wildly in your back yard!

You can readily buy Paphiopedilum at fancy grocery stores, and if you can’t find them, find a fancier store where women shop with little dogs in their bag! While these types of flowers come in girlie soft pink, eye-catching yellow, innocent white and other soft colors, many of them are dark red, brown and green with hairy and warty petals. The infamous Paphiopedilum sanderianum from Borneo has lateral sepals (the side petals) that can hang down 3 feet (1 meter) long! This highly sought-after plant can cost hundreds of dollars. But there are plenty of wonderful Paphiopedilum plants out there that don’t cost an arm and a leg.