Addiction counselling back in person as well as online

I am happy to inform you that starting on 10th May addiction counselling in person will be again possible. Addiction counselling will take place in our offices in Kandertova street. Online addiction counselling continues to be available, either via skype or via other videoconferencing platforms as agreed individually. You can schedule your appointment bye-mail adiporadna@gmail.com or by phone: +420 739 008 972 (WhatsApp is also available). The fees remain the same and can be found in the Price list.

Considering the current epidemiological situation, all services continue to be provided bearing in mind the necessary hygienic precautions to lower the possibility of transmission of infections. The precautions include keeping at least 2 meter distance between persons, mouth and nose covered with an FFP2 or higher level respirator for the whole duration of the meeting, no hand shake, payment preferrably by card or in advance directly to an account and use of hand disinfectant (available in our offices)

I am looking forward to meeting you in person or online,

MUDr. Bc. Jana Malinovská (addiction specialist)

Does your doctor talk with you about your use of addiction substances?

Talk with your doctor about your drinking, smoking or drug use

How often does your doctor ask you how often and how much of alcohol do you drink, whether you use any drugs or whether you smoke and how many cigarretes a day? And if he asks you, does the discussion on this topic end with your answer or does the doctor provide you with feedback on your addictive substance use?

Whilst most doctors ask their patients on smoking and drinking, they often do not ask about use of other addictive substances. Sadly, a significant part of doctors do not realise that question on addictive substance use should never stand alone; the answer from a patient should be followed by brief feedback, either positive or negative. That means that the feedback can be in a form of approval that the patient does not smoke, does not use drugs and drinks only alcohol within low-risk range (followed by a reminder what are the low-risk amounts of alcohol). In case the patient indicates using addictive substances to the extend that is risk to the patient, then the doctor should provide the patient with professional feedback, advice and information so that the patient receives all the essential information to make an informed decision.

It is important to emphasise that a doctor is not someone who will judge you. On the contrary – a doctor should be a person who you trust and are not afraid to tell the truth to. We are only people and we are not always able to objectively assess our situation. With regards to the addictive substance use, we can think that we know what we are doing, and that we have everything under control. If we think we see our situation clearly, we should not be shy to discuss this with our doctor. Our doctor can confirm that this is right and we indeed have the situation under control. If we do not see our situation realistically, that the doctor can provide us with his professional opinion of an unbiased observer. This feedback can help us realise some things that we might not see ourselves otherwise.

A doctor is also someone who is aware of any treatment advances and developments and is able to advice on what to do next. In case of smoking cessation, a doctor can provide you with the lastest information on the addiction treatment options, including the pharmacological supportive therapy that can help you overcome the difficult period of withdrawal when you stop smoking.

Don’t be afraid to talk to your doctor freely about your use of addictive substances. Use the time with your doctor to find out about relevant information related to addictive substance use and addiction. Be informed about treatment options and ways how to reduce addictive substance use, either self-help or with help from a professional.

The final decision whether you will change your lifestyle or not is always up to you. To make the informed decision, it is best to have all the available information. Those can be easily obtained from your doctor.

As we found out there is only limited awareness about this among medical community, we decided to talk about this issue in a series of articles for a Czech medical journal “Vnitřní lékařství” that is aimed at general practitioners and internists. Our goal was to educate doctors not to forget to ask about addictive substance use. The articles can be found here (Czech article on how to ask patients about their drinking) and here (Czech article on how to ask patients on their illicit drug use).

On-line Counselling

We would like to inform you that we continue to be available for online addiction counselling. Due to the ongoing unfavourable epidemiological situation, the addiction counselling takes place on-line only, either via Skype videocall or via other online videocall platforms as agreed individually. The fee for one counselling session remains the same and can be found in the current Price list.

Dry February – “Suchej únor”

You have probably heard of “Dry January”, a public health campaign that encourages people to abstain from alcohol for one month – the whole January. This campaign is known especially from countries like the United Kingdom and France. There is a similar campaign run in the Czech Republic – however, the month the campaign is concerned with is February. The campaign is called “Suchej únor” (= Dry February) and its aim is to encourage Czech people to find out how they feel without alcohol. It motivates people to stay sober the whole February and focus on physical and mental health instead. This year is the 9th year this campaign is running.

Why is this campaign more important than ever?

The current Covid-19 epidemic has had a substantial impact on our lives and has brought an increased level of stress in our population for many reasons, including existential problems, mental health issues and ongoing uncertainty of what will happen next. It has been shown that the current situation worsened problems of people who are addicted to alcohol and/or who engage in harmful alcohol drinking (drinking alcohol that causes harm to the body and mind) and/or risk  alcohol drinking (frequent drinking even of small amounts of alcohol or binge-drinking). Significant proportion of people addicted to alcohol experienced worsening of their addiction, decompensation of their state and related problems.

Trying to stay sober for one month can help in assessing how much under control you have your drinking. And also, one month without alcohol will help you in many areas of life: your concentration and thinking will improve, your liver will have a rest, you will feel more relaxed and you will have more energy. Your sleep will improve, as well as your mood and sex. Your complexion will get better, you might lose some weight and you will feel healthier and refreshed. And of course, you will save much more money each month when not spending for alcohol.

If you have no problem in staying without alcohol for one month, congratulations! Maybe you will abstain from alcohol for the next month as well or you are more comfortable when drinking alcohol less than before.

If you feel you might not have drinking under your control or you struggle with alcohol addiction, know that you are not alone and that there are many people, specialists and ex-addicts who are here to help you.

If you want to talk about your problems with a specialist, feel free to contact us – we are here to help you.

Diabetes and illicit drug use

How does illicit drug use affect diabetics?

About one third of the Czech adult and teenage population has tried an illicit drug. Most people have an experience with experimental or recreational use of illicit drugs such as marijuana (cannabis), ecstasis, club drugs and cocaine. These drugs are typically used as a one time thing “to try it out” or at parties, clubs or with friends as a type of a social activity.

Every tenth person has diabetes – a disease when blood glucose level is increased in consequence of lack of insulin. Diabetes can occur already in young age (especially type 1 diabetes, when the affected person is dependant on regular insulin application). As diabetics reach teenage years and early twenties, it can be expected that some of them try an illicit drug with their peers and a part of them use illicit drugs recreationally or regularly.

It is essential for diabetics to control their blood glucose level as the control of blood glucose level is impaired in this disease. Drugs can case fluctuations in blood glucose. Therefore, risks of illicit drug use in diabetics are also too low or too high blood glucose, apart from typical risks associated with drug use. These blood glucose fluctuations cause other health complications.

Illicit drug use is also connected with specific lifestyle that can lead to decreased caution in blood glucose control. An example is marijuana that increases appetite and is typically associated with worsened self-control of blood glucose level by measuring devices, irregular insulin application and irregular food intake. This can lead to fluctuations in blood glucose in diabetics and to life-threatening complications.

Increased blood glucose level and associated ketoacidosis (a life-threatening and dreaded complication of diabetes that occurs with lack of insulin in the body and high blood glucose levels) can be caused by cocaine or MDMA (ecstasis). Increased blood glucose is seen as feelings of thirst and dry mouth and frequent urination. Symptoms of ketoacidosis are also vomitting, stomach ache, nausea, dizziness, fatigue, confusion and difficulty breathing.

As ecstasis is often used in clubs, it can cause together with increased physical activity from dancing low blood glucose level (hypoglycemia). Low blood glucose level can be recognized as a state similar to being drunk – the person wobbles, is confused, unable to think straight, sweats a lot and can even loose consciousness. The first aid in cases when the person is still conscious is to give the person pure sugar (e.g. sweet juice, tea with sugar, a cube of sugar). If the person is losing conscioussness, it is necessary to call an ambulance.

Considering potential and even life-threatening risks in case of illicit drug use in people with diabetes, it is important to discuss this topic and be aware of effects of drugs on diabetics. Diabetics should be sufficiently informed about possible risks and precautions to avoid complications as part of diabetics will try illicit drugs at some point in their lives.

As this is an issue that is not properly discussed in journals and it is still a taboo for some doctors, we were very happy that the Czech journal “Vnitřní lékařství” (a journal for doctors, mainly internists and general practitioners) published our article on this topic.

The article in Czech (only abstract in English) can be found on the website of the journal.

Individual counselling back in our office

We are pleased to inform you that individual counselling will be taking place again in our office in Kandertova street – our office will be open starting this Monday, 11th May. Skype counselling is still available. Counselling is provided in concordance with recommended anti-coronavirus measures – keeping distance at least 2 metres, nose and mouth covered with a face mask or a scarf during counselling sessions, not shaking hands, payment by card or by a bank transfer in advance and hand disinfection available in our office.

Jana Malinovská