13. Alcohol and Drugs

Alcohol is the most widely used and abused drug among Irish men and is a major risk factor for ill-health and premature death. Alcohol-related problems are epidemic in Irish society, as a weekend visit to an accident and emergency department in any Irish hospital will testify. Problems associated with drinking alcohol include increased numbers of accidents and injuries; increased violence; increased absenteeism from work; a risk of suffocation through choking on one’s own vomit; alcohol poisoning, which is potentially fatal; and an association with many physical and mental health disorders, including depression and suicide.

There is no doubt that some men drink more when they are under stress. However, using alcohol as a means to de-stress may only give temporary relief of symptoms, followed the next day by a worsening of the stress feelings – one step forwards and two steps back! Using alcohol as a stress buster can make you more likely to become dependent on alcohol.

There can undoubtedly be significant health and social benefits to low-dose alcohol, if drunk by the right person at the right time in the right amount. But it is very much a case of ‘less is more’.

The system of ‘units’ of alcohol in drink was thought up years ago as a means of estimating the amount of alcohol in different drinks so as to work out how much alcohol someone is consuming. The strength of drink is measured as ‘ABV’, which means alcohol by volume.

The most accurate way to calculate the number of units in an alcoholic drink is to look at the percentage of alcohol by volume (% ABV) of a drink. This equals the number of units of alcohol in 1 litre of that drink. For example, wine with 12 per cent ABV has 12 units of alcohol in a litre of wine, so if you drink half a litre of wine (500 mls), which is four small glasses, then you have had 6 units of alcohol.

Ordinary strength beer, at 4 per cent ABV, has 4 units of alcohol in a litre, so if you drink half a litre, which is just under a pint, then you will have had 2 units of alcohol. Strong beer, at 6 per cent ABV, has 6 units in a litre, so a half litre of this equates to 3 units. So you can see that the number of units of alcohol can vary widely from beer to beer, depending on the ABV.

Calculating the number of units of alcohol in a drink isn’t rocket science and certainly doesn’t require a degree in maths.

Multiply the amount of drink in millilitres by the percentage ABV and then divide the answer by 1,000. This gives the number of units in that drink. For example:

It’s no longer accurate to simply say a glass of wine is 1 unit of alcohol because it depends on the size of the glass as well as the strength (ABV) of the wine. Drinkers beware!

The World Health Organization has recommended upper limits of alcohol intake for men at 21 units spread over the entire week. What they are saying is that consuming up to 21 units of alcohol over the full week is unlikely to harm your health. However, if you binge drink all these units in one or two days, then certainly you will harm your health. Just as you would not take a week’s supply of pain killers in one day so you should not take all your weekly quota of units of alcohol in one go. In general, the more you drink above the recommended limit the more harmful alcohol is likely to be. Not only is the number of units consumed important but their timing as well. One small drink can impair your reflexes and judgement. Even a small amount of alcohol can have negative effects on some men’s well-being. So it is important to look at the broader effects alcohol has on you and not just focus on the amount. Many men may feel they are ‘grand’ because they don’t drink as much as their friends do. But if they look at the effects alcohol is having on them in terms of psychological or physical health, or effects on work, sport or relationships, then it may be a different story. Some men can experience negative effects from small amounts of alcohol, such as anxiety, feelings of panic and palpitations. If this is the case then clearly you shouldn’t drink at all. It is important to be aware of the health issues associated with alcohol so you can make an informed decision for yourself.

There is a saying, ‘less is more’, and this is very true when it comes to alcohol. While a little alcohol can be good for your health, more is definitely not better. Excess alcohol can damage nearly every organ in the body and has been implicated in about sixty different diseases. This risk of damage increases when you either binge drink or consume more than 21 units per week.

Heavy drinking increases the risk of high blood pressure and its complications of heart attack and stroke. Alcohol can cause irregularity of the heartbeat, known as atrial fibrillation, which in itself can increase the risk of clotting and stroke. Alcohol can directly damage the heart muscle itself causing a condition called cardiomyopathy, whereby the heart loses its ability to pump blood strongly; this can result in heart failure.

Alcohol can increase the risk of many cancers, including cancer of the mouth and throat, and cancer of the oesophagus (food pipe), stomach, liver and pancreas gland. Excess alcohol may also have a role in increasing your risk of bowel or colon cancer as well as prostate cancer.

The liver is the main organ responsible for filtering and removing alcohol from the body. The liver can metabolise and break down approximately 1 unit of alcohol per hour. However, if you drink alcohol faster than your liver can break it down then the amount of alcohol in your bloodstream rises.

Alcohol can affect the liver in three ways. Firstly, many people who drink excess alcohol develop what is known as a fatty liver. This is where you get a build-up of fat within the liver cells. Fatty liver is often reversible if you reduce your alcohol intake to within safe limits. However, sometimes people with fatty liver can go on to develop inflammation of the liver, known as alcoholic hepatitis.

Alcoholic hepatitis, secondly, is where the liver becomes swollen and inflamed. In mild cases this may not cause any symptoms and can simply be detected with a blood test, which may show an elevation of some of the liver enzymes. In more severe cases, though, you can feel unwell and develop nausea, yellow jaundice and sometimes pain over the liver area. If alcoholic hepatitis is severe, then the liver can shut down and go into liver failure, which can cause retention of fluid, life-threatening bleeding, confusion, coma and often death.

Finally, heavy drinking over a long period of time can lead to the development of alcoholic cirrhosis. Cirrhosis is a condition in which the normal soft, smooth tissue of the liver becomes replaced with hard, fibrous scar tissue. Some people who never drink alcohol can get cirrhosis, for example, as a result of viruses or other disorders of the immune system. However, it is felt that about one in ten heavy drinkers over a long period of time will get cirrhosis. Unfortunately, the scarring that occurs in the liver is irreversible. In severe cases, when the liver scarring is extensive, the only treatment option may be a liver transplant.

Excess drinking can damage the muscles of the body, causing muscle wasting and reduced power. It can also cause a deficiency of calcium and thinning of the bones, which is known as osteoporosis.

Alcohol can affect one’s metabolism. It has the potential to be quite fattening. One gram of alcohol has 9 calories, which is the same amount of calories as 1 gram of fat. As well as that, alcohol has ‘empty calories’. In other words, it has no nutritional value. This can lead to malnourishment through deficiency of valuable vitamins and minerals.

Alcohol stimulates the appetite, often causing men to consume more calories, for example, the trip to the chipper or a Chinese takeaway, which becomes more desirable after a few pints. Alcohol can trigger food cravings and compulsive eating patterns. This can clearly contribute to a bulging waistline and eventual obesity. It can also lead to a raised blood fat level (triglycerides), which can increase the risk of heart disease.

Alcohol can cause inflammation of the food pipe, causing heartburn or reflux of acid. It can damage the lining of the stomach, eroding it and sometimes aggravating stomach ulcers. This toxic effect on the gut wall can also lead to poor absorption of nutrients, which can contribute to malnutrition. Alcohol is one of the leading causes of pancreatitis, a painful condition caused by inflammation of the pancreas gland.

Alcohol can affect the immune system and increase your risk of many immune-related disorders. A weakened immune system combined with malnutrition is one of the reasons why heavy drinking is associated with an increased risk of tuberculosis (TB). Alcohol can increase the risk of many infections, including pneumonia.

Alcohol affects the blood and can cause anaemia (low iron) and a low white cell count (the army that fights infection) as well as affecting the blood platelets and other blood-clotting factors, making bleeding more likely.

Excess alcohol can cause erectile dysfunction. As a depressive drug it will reduce libido. Alcohol can also lower the sperm count, contributing to male infertility.

Alcohol can damage the nerves and nervous system. It can damage nerves in the skin and legs, which can affect your ability to sense and touch objects. This is known as neuropathy. Alcohol can also damage the brain cells, leading to memory loss and confusion. Adolescents are thought to be particularly vulnerable to the effects of alcohol on the brain because their brains are still developing.

Chronic alcohol abuse can be associated with a form of dementia known as Korsakoff’s syndrome, where the affected person has no short-term memory. There is a tendency to invent stories (known as confabulation) and in conversation a tendency to repeat the same stories over and over again. Long-term memory for distant events tends to remain good.

Alcohol can be associated with seizures, which are sometimes known as ‘rum fits’. These seizures can occur a day or so after binge drinking as a response to withdrawal of the alcohol from the brain.

Alcohol can be associated with a long list of psychological health issues because it is a depressant. It can lower mood, leading to anxiety, panic and symptoms of depression. There is no doubt that many men who feel low turn to alcohol and drink more than they should. However this can make the depressive symptoms worse, which can cause a vicious cycle. As alcohol is a depressive drug it can lower your self esteem and diminish your get-up-and-go and zest for life. It can affect your sleep, particularly the quality of your sleep, so that the next day you feel tired.

Alcohol is a depressive drug and even one drink can impair judgment and reflexes. Alcohol has the potential to interact with a wide variety of other prescription medication. Some of these interactions can be potentially dangerous. For example, a well-known antibiotic called Flagyl (metronidazole) can cause you to become very unwell if you drink alcohol while on it. It is best to check with your doctor or pharmacist about any medication you have been prescribed, so you are aware of all the risks and can make an informed decision.

Alcohol is a major risk factor for accidents, including falls, fires and workplace accidents as well as road traffic accidents and death. This is because it affects reaction times, thought processing and coordination.

Drinking excessive amounts of alcohol can lead to unplanned sexual encounters, which can result in sexually transmitted infections and unplanned pregnancy, as well as regret and embarrassment. Alcohol can also encourage uninhibited behaviour patterns, resulting in overly emotional responses to certain situations. This can lead to aggression and potential violence.

Alcohol abuse is very much a family illness as all other family members can suffer as well. Alcohol can impair your performance as both a parent and a partner. Time spent drinking outside the home can compete with family time and the cost of alcohol can impact on needed resources for other family members. Alcohol abuse is also very much a part of the domestic violence story.

Alcohol is a major factor in work absenteeism, reduced productivity and poor job performance.

For best health you should not drink more than 3 to 4 units on any one day. Binge drinking is dangerous and bad for your health. Social drinking is defined as using and enjoying alcohol in the context of a social occasion in the company of others, when alcohol is sipped and enjoyed slowly and you are aiming for no more than two to three drinks on that occasion. It is also suggested that a person should be free from or have a break from alcohol use for up to two to three days between social occasions.

There is a complex relationship between alcohol intake and heart disease. Compared to non-drinkers of alcohol, light to moderate drinkers, i.e. those who have one to two drinks per day, have a reduced risk of heart disease, heart attack and cardiac death. However, men who consume more than three drinks per day have an increased risk of heart disease and cardiac death.

It has been shown that alcohol increases the levels of HDL cholesterol, a protective type of cholesterol (see Chapter 6). One or two drinks per day can elevate your HDL cholesterol level by 5–10 per cent.

As well as that, some types of alcohol, particularly red wine, contains antioxidants such as flavinoids, which are thought to help prevent hardening of the arteries. Alcohol also has a beneficial effect on blood clotting by inhibiting the activity of platelets, which are part of the natural blood clotting process in the blood.

Light to moderate drinking reduces the risk of angina, heart attack, ischemic stroke and sudden cardiac death. Overall, death rates seem to fall with light drinking but rise sharply as alcohol consumption increases. So, compared to non-drinkers, light drinkers live longer. However, as you drink more your risk of death increases rapidly, way above that of non-drinkers.

Low-dose alcohol can help reduce the risk of developing diabetes and stroke. Low-dose alcohol may be pleasurable and relaxing, which may have important psychological and social benefits, and it may reduce your risk of developing erectile dysfunction.

A hangover is the physical after-effects of drinking excess alcohol. It is caused by toxins from alcohol and dehydration. The kidneys have to work much harder to clear alcohol from the body and as a result a lot of fluid is also lost, causing dehydration. Alcohol also reduces the supply of blood sugar from the liver, which results in lower blood sugar levels. The effects of this include feeling weak, fatigued and lightheaded. Cogeners can also contribute to a hangover. These are toxic chemicals produced as by-products during the fermentation of alcohol. Coloured drinks such as brandy, bourbon, red wine and champagne tend to have more congeners than clear drinks such as vodka or gin. Alcohol also can cause a deficiency of vitamins such as thiamine (Vitamin B₁).

Symptoms of a hangover may include a pounding headache, nausea, dizziness and sensitivity to light and noise, all of which are self-inflicted. The best cure for a hangover is time, and the effects should go within 24 hours or so. However, the following will help:

The CAGE questionnaire is a simple but quite accurate questionnaire that can detect your likelihood of alcohol dependency. It was developed by Dr John Ewing, founding director of the Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill. The four questions are:

Answering yes to one or more of these questions suggests that you may well be at risk of alcohol-related problems and that you may be better off avoiding alcohol.

The AUDIT questionnaire, also known as the Alcohol Use Disorders Identification Test, is another useful screening test to see if you are at risk of alcohol dependent problems. It was devised by and is copyright of the World Health Organization.

A score of 8 or higher on this questionnaire is considered positive and indicates that you are at risk of alcohol-related health difficulties.

The use of illegal drugs has become widespread in the Western world in recent years and Ireland is no exception. The use and abuse of these substances is part of life in every corner of Ireland and not just in the bright lights of Dublin or Cork. Drugs can get into any household, irrespective of address, upbringing or bank balance. Educating yourself and your family about the real dangers of these substances is very important to dispel the myths that they are safe. Of course nothing could be further from the truth, as you will read below.

Cocaine is a white flaky powder made from the leaves of the coca plant, which grows in South America and South East Asia. ‘Coke’, ‘white lady’, ‘snow’ and ‘gold dust’ are just some of the street names for cocaine. In Ireland cocaine comes in two forms: cocaine powder and crack cocaine. Cocaine powder is usually used by snorting it through the nose. It is sometimes injected and can also be eaten. Crack cocaine is a more addictive form of cocaine and is usually smoked.

Cocaine used to be seen as an upper-class drug. However, since the Celtic Tiger years it has become much more widely available and for many people has become the illegal drug of choice. Regular and even daily use of cocaine is increasing. It is thought that about 7 per cent of Irish men have taken coke. In many ways the increase in cocaine usage has been a good analogy for the excesses of the Celtic Tiger and the ‘I want it all and I’ll have it all now’ mentality. Attitudes to cocaine have accordingly changed with increased prosperity and the desire for instant gratification. Unfortunately, cocaine can have devastating effects on both physical and mental health and leave a trail of destruction in its wake.

Cocaine is a powerful stimulant drug and is highly addictive. The initial effects can include increased energy, confidence and alertness, and an increase in sex drive. The user may also feel less hungry, more aggressive, more excited and more prone to taking risks. Cocaine can also give you headaches, nausea and stomach or chest pains. Some users feel paranoid or suffer from hallucinations. As cocaine is used more often, tolerance develops, which means larger amounts of the drug are needed to achieve the same ‘high’ and the good feelings experienced tend to lessen. This can lead to serious adverse health effects. Cocaine is highly addictive and dependence (both physical and psychological) can develop rapidly, with strong cravings for cocaine.

Withdrawal effects can include sleep disturbance, exhaustion, irritability, restlessness and feelings of depression. Some people can experience severe seizures. ‘Snow bugs’ is an unpleasant crawling sensation that can be felt under the skin during cocaine withdrawal.

Cocaine is usually snorted into the nostrils. This causes the blood vessels in the nose to narrow, damaging the lining (septum) between both sides of the nose. Eventually a hole can appear in the septum. A tell-tale sign of regular cocaine use is a red, runny stuffed-up nose. Cocaine can also cause loss of smell, hoarseness and nosebleeds.

In the body cocaine causes the release of large amounts of the stress hormone noradrenaline, which causes the blood vessels in the body to narrow and your blood pressure to go up. As a result, some of the most frequent complications are effects on the heart. Cocaine can increase the heart rate, breathing and blood pressure. It can disrupt the electrical messages to the heart and bring on serious irregularities of the heart beat, called ventricular fibrillation. It can cause heart attacks and stroke.

The main blood vessel in the body, known as the aorta, can be damaged by cocaine use. This can lead to a tearing of the lining of the aorta, known as an aortic dissection. This tends to cause a crushing pain in the upper back or chest.

Cocaine can affect the lungs, causing chest pains, and sometimes the lungs may stop working. It can affect the brain, resulting in fever and headaches as well as strokes and seizures, and it can affect the stomach, causing abdominal pain and nausea. Chronic cocaine users can lose their appetites and become run-down, with accompanying weight loss. Eating cocaine can damage the blood supply to the bowel, resulting in gangrene.

Mental health effects are many and varied. Cocaine commonly causes anxiety, restlessness, panic attacks, depression and feelings of paranoia. This can lead to a paranoid psychosis where the person loses touch with reality and experiences auditory hallucinations (a sensation of hearing voices).

Regular users of cocaine can become impulsive and aggressive in their behaviour and lose their sense of perspective. This can lead to more violence and risk-taking, for example when driving.

There is a potentially dangerous interaction between cocaine and alcohol. Taken in combination, the two drugs are converted by the body to cocaethylene. Alcohol makes cocaine last longer because of the way the drugs interact in the liver. Mixing cocaine and alcohol significantly increases the risk of heart attack.

The cannabis plant contains many different chemicals and can come in many different strengths, with variable effects. The plant is used as either the resin (a brownish/black lump) or as herbal cannabis, which is made from the dried leaves and flowering tops. Other names for cannabis include ‘marijuana’, ‘weed’, ‘puff’, ‘hash’ and ‘wacky backy’. Cannabis is usually taken by mixing it with tobacco. It is then inhaled deeply into the lungs for a number of seconds. Cannabis can also be smoked in a pipe and can be brewed as tea or even cooked as ‘hash cakes’.

Cannabis affects special areas of the brain called cannabinoid receptors, which are mainly found in areas of the brain that influence pleasure, thoughts, and sensory and time perception.

Cannabis gets into the bloodstream quickly after being taken and tends to build up in fatty tissues throughout the body. It is stored there and it can take several weeks for the body to eliminate it. This is why cannabis can sometimes be detected in urine up to 56 days after it has last been used.

Short-term use of cannabis can affect people in different ways. These can include a temporary ‘high’, a sense of relaxation or contentment (of being ‘stoned’), becoming more talkative and sometimes having a sense of time slowing down. Changes in awareness can make colours seem more intense and music sound better. Cravings for food (having the ‘munchies’) and hallucinations (when you see or hear something that isn’t there) may occur. Short-term memory, concentration and learning can be affected. Cannabis can also cause feelings of nausea, fatigue and loss of energy and can affect your coordination. The feelings are usually only temporary, although the drug can stay in the system for some weeks.

Long-term cannabis use can have a depressant effect, reducing motivation and leading to apathy. Short-term memory, concentration and learning can be affected. This can lead to poor performance at work or school.

Smoking cannabis damages your throat and lungs just like cigarettes do. It can cause hoarseness, a chronic cough and bronchitis as well as lung damage, including lung cancer. Indeed, smoking cannabis is thought to be even worse for your lungs than cigarettes. Cannabis can affect male fertility by leading to a decreased sperm count and reduced sperm mobility.

Mental health problems can include confusion, anxiety, panic, depression, paranoia and schizophrenia. Regular use of the drug increases the risk of developing a psychotic episode or long-term schizophrenia.

Speed (amphetamine) is a man-made stimulant that is usually swallowed in pill form. It can also be a powder that is dissolved in liquid for injection or drinking. Amphetamine is a stimulant, which quickens the heartbeat and can increase energy levels, making the user feel more confident. It can also cause anxiety, panic and paranoia, as well as impaired memory and concentration. The ‘come down’ period, when the effects wear off, can last for days, with users feeling very tired and depressed and having symptoms of anxiety and panic. Sleep disturbance is very common and can keep users awake for days afterwards.

Speed can increase your blood pressure, which can cause a stroke. Regular users can become very run-down with a weakened immune system, which makes them more prone to all types of infections. Mental health can be severely affected by regular use, leading to severe depression and paranoia, with an increased risk of psychosis.

Ecstasy is made up of a mixture of substances, including a synthetic drug called MDMA, and is classed as a hallucinogenic amphetamine. It comes in tablet form and is swallowed. Other names for ecstasy include ‘E’, ‘doves’, ‘XTC’ and ‘disco biscuits’. Taking ecstasy can cause relaxation, disinhibition and feelings of warmth. It is sometimes known as the ‘love drug’. Initial effects can last for several hours and include feeling more alert; colours, sound and emotions can also seem more intense. Feelings of confusion, anxiety and paranoia may occur. The ‘come down’ phase can cause profound fatigue, inability to sleep and feelings of depression.

Health risks include blurred vision, liver and kidney problems and a danger of overheating and getting dehydrated if you are out dancing in a club. This is known as ‘heat stroke’ due to a combination of a raised body temperature from the ecstasy and dehydration from dancing and the rise in temperature. It can lead to convulsions, coma or even heart attack and stroke. Heart palpitations can occur with an increase in blood pressure and skin temperature. Mental health problems include long-term damage to serotonin receptors in the brain with an increased risk of depression.

Heroin is made from the pain-killing drug morphine and comes from the opium plant. It is a highly addictive drug with tolerance developing rapidly so that users need to take more and more heroin to get the same ‘high’. Heroin can be smoked, sniffed or injected. When you take heroin there is an intense rush of excitement followed by a dream-like state of relaxation. These effects can last several hours and are much more intense if the heroin is injected. First time use, especially if injected, often causes nausea, vomiting and severe headaches. Sharing needles when injecting heroin increases the risk of blood-acquired infections such as blood poisoning or HIV, and Hepatitis B and C. Withdrawal symptoms can occur within 24 hours of the last ‘fix’ and include a multitude of symptoms known collectively as ‘cold turkey’. These can include sweats, chills, anxiety, irritability, cramps and muscle spasms.

The use of heroin can lead to significant health problems. These include a weakened immune system from poor nutrition, collapsed veins, skin abscesses, an increased risk of pneumonia and other chest problems, and chronic constipation. Using heroin can affect your fertility and cause erectile dysfunction. The drug can consume a user’s life, leading to the breakdown of relationships, career and home life. Many addicts get involved in crime to feed their habit. Heroin can lead to mental health problems, including depression and suicide.

LSD is a hallucinogenic drug that comes either in pill form or embedded in a small piece of paper. It changes the way in which the mind perceives colour, sound, events and time, and this experience is called a ‘trip’. This can be a pleasant experience (good trip) or it can be very frightening, with feelings of panic and paranoia (bad trip). It can lead to long-term mental health problems. Flashbacks can occur in some people up to months after taking acid, whereby the experiences of the ‘trip’ return temporarily.

Sedatives are drugs that are used medically to help induce sleep or as a short-term option to treat severe stress or anxiety. However, they can also be misused and abused due to their widespread ‘recreational’ or non-medical use. People who have difficulty dealing with stress, anxiety or sleeplessness may overuse or become dependent on sedatives. Sedatives are also widely abused by other drug takers. For example, heroin users may take them either as a substitute or to supplement their heroin use. Stimulant users may take sedatives to calm feelings of edginess. Others take sedatives to relax and forget their worries. These drugs include diazepam (Valium), nitrazepam (Mogadon) and temazepam (Normison).

Accidental overdose with sedatives can occur when someone who is drowsy or confused repeats the dose. Mixing sedatives with alcohol is dangerous as the two drugs can combine to slow brain function and breathing, leading to loss of consciousness and even death. Sometimes sedative use can bring on symptoms of depression, aggressive behaviour, phobias and other mental health problems. Sedatives can sometimes cause long-term or short-term memory problems.

Magic mushrooms are mushrooms that grow wild, usually in October and November. They are hallucinogenic and can be eaten raw, cooked or made into a tea. Their effects are similar to a mild LSD trip. They can cause symptoms of relaxation and excitement as well as hallucinations and paranoia. Magic mushrooms increase blood pressure and heart rate and after eating them you can get dizzy and nauseous. Flashbacks can occur and taking them can lead to mental health problems.

Solvent abuse is not only glue sniffing but the sniffing of any substance that contains butane or propane gas – aerosols, gas refills and paint thinners are a few examples. The result is a ‘high’ similar to that produced by alcohol. Like alcohol you get a hangover afterwards. The inhalation has potentially serious side-effects, including sudden death due to effects on the heart, lungs or brain. Death can occur on the very first occasion of use. Accidents can occur when using solvents, including suffocation and inhalation of vomit.

If you think alcohol or drugs may be having a negative effect on your life, you are not alone. Addiction is all too common among Irish men. The first step to recovery is admitting to yourself that you may have a problem and accepting the need to make changes. Talk to your family doctor, who can support you and give you help and advice. Your doctor may refer you for counselling. AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) can provide group support through regular meetings. Specialised addiction centres like Aiseiri can provide great residential recovery programmes with an aftercare follow-up plan. Unfortunately, many Irish men remain in denial.

Alcohol is a potentially serious health hazard for many Irish men.
Abuse of alcohol often results in mental health issues, including anxiety and depression. Physically, almost every part of your body can be affected by alcohol, including your sexual health.
Irish men often drink more than is good for their health.
Alcohol is measured in units and there is a tendency to underestimate the number of units consumed.
Keeping a diary of your drinking habits for a week or two (including weekends or nights out) can help give you an accurate picture of your level of consumption.
Self-assessment questionnaires can help you decide if you are drinking too much for your health. If you don’t ask an honest question you won’t get an honest answer.
Making a decision to reduce your alcohol intake can be very positive for your health, as well as your wallet and waistline.
The taking of illegal drugs such as cannabis and cocaine is now widespread among Irish men. These substances can have serious ill effects on your physical and mental health.
Recreational illegal drugs, by their nature, mess with your mind – that’s partly the idea. They can also have serious effects on your long-term physical and mental health. Be warned!
There is a lot of help out there if you feel alcohol or drugs are having negative effects on your health. Talk to your family doctor, who will help and advise you.