This is a story about fit for purpose...

Here are a range of prescription medications. Three of them are illegal to possess without a prescription under the Misuse of Drugs Act, because they are scheduled as "class B" and "class C", respectively carrying a 5 year prison sentence, a 2 year prison sentence and an unlimited fine.

So, 3/5ths of the medicines pictured here could see me locked up for somewhere between 2 and 5 years, if I didn't have a prescription.

The medication at the top of the picture is lamotrigine, which treats bipolar depression, as well as epilepsy. It has no abuse potential, but it does carry a high risk of causing a fatal skin rash.

The medication in the middle of the picture is bupropion, which treats addiction to nicotine. It has no abuse potential, but it also carries a high risk of causing seizures, which might be fatal.

The medication in the bottom-left of the picture is pregabalin, which treats neuropathic pain. It is addictive and can be abused. Pregabalin is a "class C" controlled substance, and anybody caught in possession without a prescription, will receive 2 years imprisonment and an unlimited fine.

The medication in the top-right of the picture is methlyphenidate, more commonly known as Ritalin®, which treats Attention-Deficit-Hyperactivity Disorder (ADHD) and Attention-Deficit Disorder (ADD). It is addictive and can be abused. Methlyphenidate is a "class B" controlled substance, and anybody caught in possession without a prescription will be imprisoned for 5 years and receive an unlimited fine.

The medication in the bottom-right of the picture is zopiclone, which treats insomnia and other sleep disorders. It is addictive and can be abused. Zopiclone is a "class C" controlled substance, and anybody caught in possession without a prescription, will receive 2 years imprisonment and an unlimited fine.

So, if I didn't have a prescription for all the medications on this table, I could be facing 9 years in prison and an unlimited fine, should the judge decide that my sentences should run consecutively, not concurrently, due to the gravity of my crime.

Yet, millions of UK citizens receive the medicinal benefits of pregabalin, methylphenidate and zopiclone, and the quality of their lives is greatly improved. These tablets were developed as medicines by pharmaceutical companies, to treat medical problems. Substantial empirical evidence was gathered in many controlled trials, to prove that these medicines were safe and effective at treating the medical problems they have been licensed for.

Indeed, these medicines have unexpected benefits beyond the purpose they were licensed for. Lamotrigine improves sleep quality. Bupropion is a fast-acting non-drowsy antidepressant, which also increase libido and enjoyment of sex. Pregabalin reduces anxiety and aids sleep. Methylphenidate improves concentration, allowing students to study harder and for longer periods. Zopiclone can prophylactically prevent psychosis and mania, by preventing sleep deprivation.

It is very hard to argue that the Misuse of Drugs Act and the Psychoactive Substances Act are successful laws, because the evidence shows that the use of mind-altering substances remains entirely unaltered by legislation which seeks to discourage that behaviour, and harshly penalises those who break the law.

If I approached my GP and asked for zopiclone to help me sleep, methylphenidate to help me concentrate at work, pregabalin (or any benzodiazepine) to treat my anxiety and zopiclone to treat my depression, they would flatly refuse all my requests.

My GP would tell me that zopiclone is too addictive, despite my insomnia ruining my life. My GP would tell me that methyphenidate is too addictive, despite my inability to concentrate impairing my ability to be productive at work. My GP would tell me that pregabalin is not licensed to treat anxiety, and it's too addictive, despite my poor quality of life due to anxiety. My GP would tell me that benzodiazepines are too addictive, despite my life-ruining anxiety. My GP would tell me that bupropion is not licensed to treat depression.

Instead, I would be offered sertraline, which would allegedly treat my depression and reduce my anxiety. Sertraline is very slow to take effect and it has an emotionally-blunting effect, as well as affecting sex drive and ability to orgasm. Sertraline is not an effective treatment for anxiety. Sertraline is not an effective sleep aid. Anybody who has ever tried to quit sertraline will tell you that it is very addictive and the withdrawal side effects are intolerable.

In short, doctors would offer me nothing.

In short, doctors would tell me to go away, even though their medicine cabinets are stuffed full of medicines which have been extensively proven to treat the ailments which ruin my quality of life. The medications exist, but I would be denied a prescription to access those medications.

This much like a man who is dying from a bacterial infection being told that he's not allowed any penicillin, because a small number of people have a penicillin allergy.

Then, there are medications such as diacetylmorphine and ketamine, which are considered essential medicines. Diacetylmorphine, more commonly known as heroin, is scheduled as "class A" which carries a 7 year prison term and an unlimited fine, if possessed without a prescription.

How can we have a Misuse of Drugs Act which puts diacetylmorphine - a medicine routinely prescribed - into the same category as crack cocaine. Crack cocaine is fiendishly addictive and has zero medicinal use. Crack cocaine is so addictive, that it might even be considered to be "instantly addictive" and the vast majority of its users commit acquisitive crimes - muggings, thefts, burglaries - to raise money to pay for their drug addiction. Addiction is a medical condition, not a crime.

How can we have a Misuse of Drugs Act which puts mushrooms into the same category as crack cocaine? In fact the law states that it's magic mushrooms which are a "class A" controlled substance, which implies that the government believes in magic. Is that not utterly terrifying? Is it not utterly terrifying that our lawmakers are so mentally impaired that they would make specific reference in law to a certain type of mushroom which is "magic". Like, are you for real? We actually have laws criminalising magic, in the 21st century.

What would be a fitting punishment for anybody possessing a "magic" mushroom? Perhaps they should be made to climb a beanstalk grown from "magic" beans. Perhaps they should be lashed to a dunking seat and immersed underwater until they drown. Perhaps they should be burnt at the stake. These are the punishments that are most ususal for involvement in "magic".

We also know that behaviours such as sex and gambling can be addictive, but nobody imagines that gambling addicts inject decks of playing cards into their veins. In fact, gambling is widely permitted, advertised and promoted throughout society, despite its addiction potential. We are allowed to have sex, even though there is a risk of contracting sexually-transmitted diseases, and there is addiction potential.

Terrifyingly, the government has now passed an Act of Parliament which criminalises:

Things that cause hallucinations, drowsiness or changes in alertness, perception of time and space, mood or empathy with others

Obviously, eating a big meal might cause you to feel drowsy. Being tired will make you drowsy and less alert. Being tired will affect your mood and make you more 'snappy' with others. It seems pretty obvious that children are a thing that causes drowsiness, changes in alertness, mood and empathy with others. Many mothers get post-natal depression (mood change) and many parents feel a great deal of empathy towards their children. Is the production of children going to carry the 7 year prison sentence, as the law states?

The law helpfully tells us that:

Food [doesn't] count as psychoactive substances.

But, hang on a second... aren't mushrooms food? If I'm a mushroom producer or supplier, am I exempt from the 7 year jail sentence?

Let us imagine that I cross-breed a "magic" mushroom with a regular mushroom, not thought of as "magic" by government lawmakers, I must surely be able to produce a non-magic mushroom, which I can supply as food, even though it might cause hallucinations, changes in perception of time and space and mood. Clearly if I used gene editing, I could produce a mushroom that was not "magic" at all - no witchcraft or wizardry necessary - and this could be bought and sold in the supermarkets as food.

Fundamentally, the Misuse of Drugs Act and the Psychoactive Substances Act are flawed pieces of legislation, which are not protecting citizens of the United Kingdom, reducing crime, reducing antisocial behaviour, saving lives or reducing the burden on public services. In fact, it is categorically clear that the UK's approach to mind-altering substances is a gigantic waste of money, which is also ruining countless lives, by criminalising people with medical conditions.

The fact that we have the word "magic" in our statute books, criminalising mushrooms that are alleged to have "magical" properties, in the 21st century, is quite absurdly ridiculous. The fact that we have put "magic" mushrooms, diacetylmorpine and crack cocaine into the same "class A" schedule, carrying the harshest punishments. Diacetylmorhine is an essential medicine, administed every day by up to 130,000 doctors and countless nurses. Picking "magic" mushrooms to share with my friends is punishable by life imprisonment.

I can understand that crack cocaine is an instantly addictive drug that drives most of its users to commit a very great deal of crime, because they are suffering from an illness. Therefore those who supply crack cocaine are committing a terrible crime, because crack cocaine exists for no other purpose than its abuse, and it's abuse is so devastating that it ruins the life of the sick person and creates very many victims of crime. I can understand why supply of crack cocaine is punishable by life imprisonment.

I cannot understand that "magic" mushrooms, which are not addictive, and its users commit no antisocial nuisance nor cause any burden on the state, and are an incredibly safe thing to eat with no fatalities attributed to their consumption, are seen as the same as crack cocaine in the eyes of the law. Those who supply magic mushrooms are no more guilty than a person who obtains a crate of beer, with which to share with their friends. 

The antisocial behaviour of people intoxicated by alcohol, the addictiveness of alcohol and its adverse health effects, makes suppliers and producers of alcohol culpable for a very serious crime, which deserves harsh punishment, if we follow the logic applied to other mind-altering substances.

To sell packs of cigarettes is possession with intent to supply an addictive harmful substance. The health damage caused by cigarette smoking and the antisocial nature of it, because of the harm caused to passive smokers by second-hand smoke, as well as the unpleasant smell of cigarette smoke, which also harms items of clothing and other property. Cigarette smoking places considerable burden on the state, who must invest significant sums of money into smoking cessation treatments, smoking prevention programs and treat the many smoking-related diseases. Smoking-related diseases shorten lives, cause early death and reduce the productive capacity of those who suffer from cigarette addiction. Cigarettes have a high economic cost to society. Suppliers and producers of cigarettes, cigars and loose tobacco are culpable for a very serious crime, which deserves harsh punishment.

When the esteemed neuropsychopharmacologist Professor David Nutt was adviser to the government on its drug policy, he suggested - based on overwhelming empirical evidence - reclassifying all drugs based upon the health risks they posed, the harms they cause to society, and the economic cost of their use and abuse. He was forced to resign. Drugs are a politcal pawn and the government has no interest in the wellbeing of its citizens, with respect to drug use.

We only need to look at Portugal, which took a scientific data-driven approach to its drug policy and has achieved:

• 60% increase in uptake of addiction treatment programs
• 90% drop in the rate of drug-injection related HIV infection
• 45% decrease in the murder rate
• Drug-related deaths dropped to 3 per million (in comparison to the EU average of 17.3 per million)

The most [un]surprising thing of all is that drug use remained the same. People like to take drugs. LOTS of people like to take drugs. Alterations to the law do not affect people's desire to take drugs. Drug laws are not a disincentive to drug taking, because drug taking has been a feature of human life since pre-historic times. People want to take drugs, hence why alcohol, cigarette and coffee consumption is ubiquitous and legal.

2.5 million Xanax tablets were purchased on the black market in the UK. At least half a million people in the UK are using MDMA (ecstasy) on regularly, and on a single weekend, a million tablets could be consumed. Almost one million UK citizens are using powder cocaine, and most of them are affluent professionals.

What we can learn from Portugal is that punitive drug laws have no affect on citizen's behaviour. The criminalisation and harsh punishments are not a disincentive to illicit drug purchase and consumption.

Legislation to criminalise the sale of alcohol - prohibition - was tried in the USA from 1920 to 1933, and it was an abysmal failure. Industrial alcohol was deliberately made extremely poisonous in 1927, causing innumerable deaths and making people blind. But people drank it anyway, getting literally "blind drunk". Moonshine was responsible for vast numbers of speakeasy customers being poisoned: 33 people in Manhattan, NY died in just three days, for example.

We can see from all historical evidence, worldwide, that every culture has used mind-altering substances extensively. Coca leaf chewing is common in South America. Tobacco smoking and chewing originated in North America. Betel nuts and areca leaves are chewed all over Asia. Khat leaves are chewed in Africa. Tea leaves a brewed in hot water in China and India. Coffee beans are roasted, ground and brewed in South America. Cannabis has been drunk as Bhang in India for more than 3,000 years, and the Egyptians were smoking cannabis 3,600 years ago. Opium was being consumed 5,400 years ago, by the Mesopotamians. Alcohol wins the top prize though, because it's been brewed for at least 13,000 years - since the goddam stone age.

The invention of distillation apparatus is a relatively recent phenomenon, but we should accept that human desire for intoxicating alcoholic beverages has been unwavering since the discovery of the fermentation process, and the invention of brewing methods. The body of archeological evidence overwhelmingly proves that beer and wine were present in human lives, continuously. Mass production of cheap distilled spirits pose new challenges, but we must remember that society does not adapt to scientific and technological advances with sufficient speed to avoid difficult periods of re-adjustment.

The isolation of psychoactive molecules responsible for psychoactive effects, and the laboratory synthesis of those naturally occurring compounds, has resulted in highly refined and pure chemicals. The investment in high-volume chemical production for industrial and agricultural uses, makes the precursor ingredients for synthesised compounds extremely cheap, and therefore, drug supply can inexpensively meet drug demand, through mass-production. The very poorest people in the world are often able to afford to buy very potent and pure drugs.

In 1804 Friedrich Sertürner isolated the morphine molecule from opium. In 1804 the world's population was 1 billion and the average global income was $3 a day (adjusted for inflation). Today, 3.4 billion people live on approximately $3 a day, which means that there are 340% more people living in poverty on an increasingly overcrowded planet.

We know from animal studies that stress and overcrowding affects behaviour adversely - "the behavioural sink" - and experiments have produced compelling evidence. Animals whose living conditions are intolerable, will prefer water laced with alcohol, cocaine, heroin and other addictive drugs. When the experiment is repeated with better living conditions, such as having other animals to socialise and have sex with, more comfortable bedding, exercise wheels and toys to interact with, then the rats prefer to drink the water without any mind-altering substances.

Findings from experiments with overcrowding in rat colonies found the following disturbing results:

Many female rats were unable to carry pregnancy to full term or to survive delivery of their litters if they did. An even greater number, after successfully giving birth, fell short in their maternal functions. Among the males the behavior disturbances ranged from sexual deviation to cannibalism and from frenetic overactivity to a pathological withdrawal from which individuals would emerge to eat, drink and move about only when other members of the community were asleep.

The animals would crowd together in greatest number in one of the four interconnecting pens in which the colony was maintained. As many as 60 of the 80 rats in each experimental population would assemble in one pen during periods of feeding. Individual rats would rarely eat except in the company of other rats. As a result extreme population densities developed in the pen adopted for eating, leaving the others with sparse populations.

Infant mortality ran as high as 96 percent among the most disoriented groups in the population.

Translated into human terms, we see that the majority of the world's population live in overcrowded cities. We see neglected and abused children taken into foster care. We see high infant mortality rates in the developing world. We see sexual deviancy. We see widespread manic-depressive symptoms and other psychiatric illnesses. We see men living lives of quiet, desperate isolation, withdrawn from the world and spending most of their time in their bedrooms, emerging only to grab a microwave pizza or use the toilet.

One must remember that in the rat overcrowding experiments, there were no drugs or alcohol. The behaviour of the rats was a spontaneous response to their living conditions.

Thus, we must conclude that the problems we see in society are not caused by drugs and alcohol, but the abuse of drugs and alcohol is caused by intolerable living conditions.

In the west, the social problems we have are due to industrialisation and mass-production, which required high-density housing in close proximity to the factories, mills, textile manufacturers and steel works. The social problems were compounded by the service industries building tall office blocks in the business districts of major metropolitan areas. Property developers built high-rise housing blocks in cities which were already densely populated.

Manhatten had a population of 60,000 people in 1800. Today it has a population of 1.7 million people who each earn $378,000 per annum, on average.

Hong Kong Island had a population of about 3,000 people in 1842. Today it has 1.3 million people and a 2-bedroom city centre apartment would cost about $2 million to buy.

Those are the affluent places.

In the developing world, the social problems are due to the purchasing power of "soft" currencies. Only the US dollar, Japanese yen, European euro, Swiss franc, Canadian dollar, Australian dollar, New Zealand dollar and British pound, are considered to be "hard" currencies.

Developing world nations need to build factories, mills, mines, railways, ports, power stations, which can only be paid for in hard currency, along with hospital and a university, fully equipped, staffed. The university needs a library full of books. Almost everthing has to be imported, and the suppliers want to be paid in hard currency.

The developing world nations take out loans from the World Bank, issued in hard currency to buy what they need. The crop harvest, manufactured products and natural resources are exported to buyers who pay with soft currency. Labour is also sold using soft currency .

$1 can purchase 8.3 minutes of labour in the USA. $1 can purchase 36 hours of labour in Ethiopia. The poorest and hungriest Ethiopians get paid 10 Ethiopian birr for 12 hours labour. A day's wage is the same as the cost of the day's food.

$1 is exchanged for 30 Ethiopian birr. The dollar seller can pay 3 Ethiopians their daily wage, after they complete 12 hours labour. The Ethiopian birr seller can purchase $1 of specialist goods, specialist services, or hire a highly-qualified and experienced expert, from the richest nations. $1 could purchase 1 minute of time from a prospecting geologist to survey Ethiopia's stone, ores, minerals, metals and gemstones. When the data is gathered, Ethiopia can then calculate the capital expenditure to purchase land, build processing facilities, buy equipment, and build supply infrastructure. Then they consider the cost the cost of paying for supply chain services. They calculate how soon they can be ready to start exporting. They calculate a sustainable export capacity and work out the anticipated lead time from initial purchase order, legally binding supply contract, agreed.  The operating costs are deducted from the expected income from the exports. It's pretty easy maths:

(Capital expenditure + operational costs + transport costs) - (average raw material market price x quantity of raw material available)

This equation gives three numbers,

1. How much money do we need spend before we see a single dollar

2. How much money will be earned until all the natural resource is gone

3. Proft (if any)

Wheat to make flour with is $0.46 in the US commodities exchange. Coffee beans are $0.94/kg. Orange juice is $1.17/litre. Cotton is $0.71/kg. Raw sugar from sugar cane has by far the lowest market price, of $0.13/kg.

Processing makes little difference: Alcohol made from cane sugar trades at $1.34/litre and refined white sugar trades at $348.

So we can forget growing crops. The US and EU subsidise their farmers by purchasing their harvest, then dumping it in huge silos, or otherwise paying farmers a subsidy for not growing their crop, which is greater than the amount the farmer could expect to earn by selling the harvest. That's economic warfare by the wealthy west on the impoverished developing world nations. The game is rigged.

Then stone, ores, metal, precious metal and gemstones are worth considering.

Iron ore trades at $89/kg. If you invested in heavy machinery and a processing plant: Copper trades at £3/lb, Aluminium at $1/lb. Nickel at $6/lb and Zinc is at $1/kg.

This is because $1 can purchase at least 1kg of flour, which will feed a mother and child for a day. The hungriest poorest people will exchange 12 hours labour . Therefore $1 buys 87 times more labour in the poorest parts of the developing world, than it does in the USA. So $1 is offered in exchange for enough local currency to buy 1kg of flour. It costs 30 Ethiopian birr to buy 1kg of flour,

The densest population on the planet is Tondo - a district in Manila - where you are never more than 2 metres away from another person. I'm 1.83 metres tall, so if I lay down to sleep, I would have 17 centimetres between me and the nearest person That's disturbing.

The developing world population has increased dramatically in the last 200 years, which is a lot of hungry mouths to feed, in countries which might not have clean drinking water, medicine, sanitation systems, and people live with a lot of hunger. See below:

Can you see the trend? Poor nations are getting more populated, which drives down the value of their labour drives down the value of the crops they produce, and drives down the price of the the other commodities they can produce. In a system of global free-market capitalism: A hungry person will work harder for longer, than a well-fed one. A person who lives in a country with high infant mortality rates will have more children that a person with great well-equipped hospitals and doctors, in every city.

It's ludicrous to be criminalising things which would never exist if we paid more for our edible crops. For example, 1kg of opium resin is worth $2,506 if you buy it wholesale directly from the farmers in Afghanistan. That heroin has a market value of $6,600 in the USA.

The drug problem is the inevitable conclusion of exploiting the developing world's labour, crops and raw materials.

I should really have written this as a series of blog posts, but I might is this in a non-fiction book I plan to write if I can convince somebody I like to co-author it with me. Or at least get a literary agent to find me a publisher and give me an editor.

Side note: I started writing this on Saturday and it's now Monday (well, Tuesday, technically) and I've hardly slept. I must publish this now, and proof-read and edit tomorrow.

I hope you find these 4,000 words entertaining.

Tags: #economics #politics #drugs #addiction  #politics #law #criminal

This is a story about tailored medicine...

It's a subject I've written about at length before, but I was writing about my experiences with different mood stabilisers earlier today and I thought I would re-purpose that content for my blog, because I'm tired and I'm stressed, and it seems like a logical thing to do: To take something I wrote earlier and re-use it.

What I've written is in the style of advice given to somebody who's perhaps newly diagnosed as bipolar, or perhaps suspects that they have bipolar disorder. What I've written is from my own personal experiences. What I've written is not meant to be completely authoritative and factually correct, but I'm aware that it's my general writing style to present my opinions in a persuasive manner.

So, without further ado, let's get onto the list of bipolar mood stabilising medications I have known and loved (or hated, more like).

Quetiapine (Seroquel)

Horrible side effects, including weight gain, daytime sleepiness, dry mouth and constipation. When it takes effect, it's so strong that it's very hard to get to bed, or use the toilet in the middle of the night. Cannot be mixed with alcohol - the alcohol makes you feel very unwell.

Overall, this medication feels like being "heavily sedated" and it would be very difficult to carry on a normal life at dosages above 200mg. At dosages of 300mg or more, you'll be sleepy and dopey all the time. At dosages over 400mg, you'll be a shuffling zombie, good for nothing except dribbling in front of daytime TV.

Not compatible with having a job.

Aripiprazole (Abilify)

This medication had a strange side effect, where I lost fine motor control of my lips and seemed to produce excessive amounts of saliva. It was impossible to have a conversation with somebody without spraying them with spit, which was a horribly degrading experience for me.

Aripiprazole is very long-lived in the body, so it can take a week or more to wear off and get back to normal, even after taking this medication for only a couple of days (i.e. if you try it and you get bad side effects immediately, you'll have those side effects for a whole week at least).

Because of its very long half-life, I would have serious reservations about trying this one, except as a last resort.

Lamotrigine (Lamactil)

No side effects at first, but the dosage has to be increased very slowly with this one. Migrane headaches are a very common side effect, which I got, so I decided to stop taking it. The headaches are tolerable, I guess, because this is the medication with the fewest side effects.

Some psychiatrists might not consider lamotrigine to be a mood stabiliser, but in fact more of an antidepressant which is safe for bipolar people to take. It improves sleep quality so I think it's a good choice from amongst the fairly bleak options.

Also a good choice if you plan on attempting to have a normal job and work.

Olanzapine (Zyprexa)

Side effects include weight gain, daytime sleepiness and a general feeling of being drugged, but nowhere near as bad as quetiapine.

Very good at quickly stopping a manic episode, so it could arguably be used only when entering a manic phase, and then stopped a short while later, but this would require discipline.

Not recommended to take on a long-term basis.

Not compatible with having a normal job.

Sodium valproate (Depakote)

Dreadful side effects. Will turn you into a total shuffling, dribbling zombie and eventually you will get an irreversible kind of brain damage, which will cause you to make involuntary facial movements (a bit like a tic).

This is an awful drug, given to paranoid schizophrenics who are very severely sick (paranoia, hearing voices, hallucinations etc).

If you're on this, it's probably forcibly injected into you in a psychiatric institution. The injections last for 3 months. Don't ever let yourself get so unwell that this becomes necessary. Exhaust all the other options first.

Lithium

Very hard to get the dose right, and requires regular blood testing, which is annoying and inconvenient. Very effective and side effects are tolerable if you can get the dose perfect but it might take many years to find exactly the right dose, and it will be very destabilising if you start going too low with your dose - i.e. you might end up triggering manic episodes when you're simply trying to avoid side effects.

Lithium causes irreversible health damage when used long term, and is therefore "life limiting" in a way - it might reduce your lifespan by 5 years or more, which is obviously a high price to pay.

General Comments

Psychiatrists will tell you that you need to commit to a medication for at least 3 months, in order to feel the therapeutic effects and for the side effects to wear off. I have tried all the medications listed above for 3 months or more, and the side effects never wore off. The side effects were intolerable for all the medications, except lamotrigine.

If you take these medications for longer than a few weeks (with the exception of lamotrigine) then you cannot stop taking them abruptly. If you suddenly stop taking these medications, you will have horrible rebound mania and possibly psychosis too (hearing voices etc). However, I have successfully 'weaned' (i.e. tapered) myself off all these medications, without too many problems.

The worst manic episodes I've had have been when stopping quetiapine and olanzapine abruptly. When I've tapered off the medications slowly, my mood has been fine and I've not had any problems. In fact, every time I've stopped taking a medication, I've felt much better, because the side effects are so awful.

I would advise you to consider olanzapine as a treatment for acute episodes of mania... i.e. you should have some ready to take, and when you start to go manic then start taking it to make sure your mania doesn't spiral out of control.

I would also advise you to consider lamotrigine as first or second choice. I believe many busy working professionals with bipolar disorder find lamotrigine to be a good medication, because it has few side effects.

Psychiatrists will probably pressure you to be on a stronger medication, which is likely to be an atypical antipsychotic (quetiapine, aripiprazole, olanzapine, sodium valproate, risperidone, clozapine) but all of these will have very profound side effects, most notably making you feel tired and sleepy, lethargic, foggy-headed, confused, increasing your appetite and reducing your sex drive. It's personal choice, but I find those side effects unacceptable.

Alternatives to Medication

Alternatively, you can use good lifestyle choices to manage bipolar: no alcohol, no caffeine, strict bedtimes, strict work:life balance, exercise, good diet. You will probably need some trusted people around you who can let you know when your speech is becoming more pressured, you're getting irritable, perhaps you're getting a little obsessive about projects, becoming more impulsive and taking more risks... essentially, when you're heading into a manic episode, which could escalate. I find that getting 8 to 10 hours sleep each night, no more and no less, helps me to keep my mood stable. I also find that my manic episodes are much less of a problem since I quit caffeine. Recreational drugs are a terrible terrible idea, and completely incompatible with bipolar, unfortunately, especially the stimulants: legal high powders, speed, coke, crystal meth, meow meow, M-CAT, mephedrone, monkey dust etc. etc.

Stressful life events can be very triggering for mania, as well as the temptation to work hard because of a job change, promotion or exciting project. It takes a lot of careful planning to ensure that stress is kept to a minimum and work:life balance is preserved. If you want to get obsessed with anything, make it exercise and the great outdoors.

In Conclusion

I'm living a functional and complete life, with a full-time job, managing to have good relationships, managing my money, not engaging in risky behaviours or otherwise suffering many problems with my bipolar disorder. I have depressions, which are sometimes bad enough to cause me to take some time off work, but only a few days here and there. I have hypomanic episodes, where I can spend a lot of money and make impulsive decisions. However, considering that I don't take any mood stabilising medications for my bipolar disorder, my mood is remarkably stable and almost everybody would consider me to be successfully managing my condition, without having any particularly adverse effects on my quality of life.

I can highly recommend trying to go medication free, or spending a lot of time trying different medications and tweaking the dosage, because life is so much better when you're not drugged up to the eyeballs with powerful psychiatric chemicals, which radically alter you and your personality, with horrible side effects.

I'm not antipsychiatry per se, but I would advise people to make very well informed decisions and remind your clinicians that it's your body, so it's your rules, and like with every profession, there are people who are brilliant at their jobs and there are people who are not so great. You need to educate yourself so that you know whether you're getting good advice or not. You can't just trust everybody who calls themselves a doctor.

Mental health is complex. Bipolar disorder is complex. People are complex. We are all individuals and we have individual needs and individual unique circumstances. Tailor your solution to meet your needs.

Tags: #bipolar #medication #mentalhealth

This is a story about re-relapse...

The title of this blog post, the hyphenated nonsensical word "re-relapse" and the image of an oral syringe which I happened to spot lying on the floor of a hospital, are all intended to set the tone of this piece: Everything you think you know about drug addicts is probably wrong, especially when referring to "drug addicts" as a collective group of mostly identical people.

I could easily wander into the territory of blathering on about "we're not all the same, you know" and other such clichés, but instead I thought I'd simply tell you the story of my re-relapse.

I guess how I became a drug addict again is far less interesting and important than why, so I'm actually going to explain some of the who and the what which means my story makes sense, I hope.

Back in November 2018 - less than 3 months ago - I was a drug addict. I also booked some flights to Mexico for my girlfriend and I, so that we could spend Christmas and New Year on the beach. This presented a problem: How does a drug addict go on holiday?

When I went on holiday to Turkey for a week in October 2018, I literally went cold turkey, which I thought was really funny because I had travelled to Turkey for a hot holiday during the cold UK autumn. The irony of it had a kind of poetic deliciousness, which I couldn't resist. Besides, I wasn't that much of a drug addict at the time.

During that week in Turkey, I struggled to sleep at first, without the drugs which I had become addicted to. Then I became incredibly tired and lethargic due to lack of sleep, and I didn't leave my hotel room for 3 days. However, by the end of the holiday I was able to enjoy some sunshine and I was also 'clean' - I was no longer a drug addict.

Now we must ask: If I had managed to get 'clean' and beat my drug addiction, why would I relapse? The answer is quite simple and straightforward really: Because I am using drugs as a coping mechanism for my ordinary day-to-day circumstances.

What about Mexico?

I had planned a 2-week holiday with my girlfriend, to Mexico, which would have been far more enjoyable than the holiday to Turkey, except for the fact that my drug addiction had escalated. I'm not sure what was so particularly awful about November, except that the UK weather was getting even colder and more miserable, but I found it necessary to augment my existing drug addiction with additional substances.

I did not want to travel through two international airports carrying controlled substances, for which I did not have a prescription. In the UK, it's a criminal offence to be in possession of certain medicines, unless you have a prescription. I did not have a prescription. One of the medicines which I needed to transport with me to Mexico via transatlantic flight, in order to maintain my drug addiction, was unfortunately illegal to possess in the UK without a prescription.

What was I going to do?

I procrastinated for a long while, and then with 3 weeks until the scheduled departure of our flight to Mexico, I decided to start reducing my dose a little bit every day. I tapered myself off one of the medications I was addicted to - Xanax - until I was no longer addicted to it, so I was then able to travel without being at risk of prosecution for trafficking narcotics across international borders.

Essentially, I got 'clean' again. Yet again. I've gotten 'clean' so many times.

Oh, did I mention that I also quit drinking?

Yeah. Don't try to quit Xanax in the space of 3 weeks if you're addicted to it. If you're addicted to Xanax, you need to taper down your dose really slowly or else you'll have problems.

I had problems.

I drank 9 pints (5 litres) of very strong beer and I don't remember many of the details, except that I went bat shit crazy and smashed some stuff up. I was pretty much blackout drunk, so my memory is very patchy. I was out of control. I was a mess. The worrying thing is how little of it I remember.

So, I quit drinking soon after I started trying to quit Xanax. Mixing alcohol and Xanax is a bad idea, but drinking alcohol while quitting Xanax is a disastrous idea.

However, quitting alcohol and Xanax, when you're addicted to both... that's hell.

I had 3 weeks where I felt like the world was about to end and life was not worth living. I had 3 weeks where I was absolutely convinced that every conceivable disaster was lurking just around the corner. I had 3 weeks of the most unbearably awful anxiety.

Then I went to Mexico.

Turns out you can just buy Xanax over-the-counter in a pharmacy in Mexico if you smile nicely and pay in cash. Obviously, I was well aware that it's illegal to sell Xanax in Mexico, but I was also well aware that it wasn't illegal for me to buy it or possess it. So, I bought a bottle of Xanax from a Mexican pharmacy, and I resumed my drug addiction. Xanax is branded Tafil in Mexico by the way... if you ever need to get some.

Then, at the end of my holiday in Mexico, which was awesome by the way, I threw the leftover tablets in the bottle into the trash, at the airport.

Since my holiday, my life has continued pretty much as normal. I don't drink - I've managed to remain almost completely sober since I quit alcohol back in December. My life is also normal, insofar as I'm a drug addict.

Every night I take a sleeping pill and a tranquilliser, and I do so because I need sleep and I need to be tranquil. My life circumstances dictate my need for the substances I use.

I imagine that I will become completely 'clean' and 'sober' again one day, but for the time being, I need to endure some pretty horrible life circumstances, and I find that the drugs I'm addicted to are helping me to cope, even though it's commonly thought that all drug addiction is automatically a bad thing.

What I wish for is not to be 'clean' and 'sober' but for the circumstances of my life to be more pleasant and favourable to a life without the 'crutches' of drugs, but what I wish for seems mostly impossible, at the moment. I can't achieve the impossible. I have to work within the limits which I'm constrained by. I have no control over most things in my life, which cause me a great deal of discomfort and unhappiness, but I've found my coping mechanisms which work.

The end.

Tags: #addiction #medication

This is a story about life at the limits...

I suppose that it's a regular complaint of mine that I'm feeling overwhelmed, and it's a regular boast that I've been through some substantial periods of adversity. I'm also aware that the picture I've selected to accompany today's blog post is not exactly very stormy, but it's the best I could come up with in the circumstances.

I stopped writing for a while, which was because my friend killed himself, and also an enormous project kicked off at work, and also I had plans to get myself across the Atlantic Ocean and back again in one piece... plus all the many other important things to numerous to list. In short, I didn't make the time to write and there were a number of very good reasons why I took a break from writing every day.

Now, my friend's funeral is done, my transatlantic jaunt is done and the enormous project at work isn't going to be finished any time soon, so I must resume my daily writing duties, even on days when I don't feel like writing.

This morning I woke up and I felt terrible. I considered not going to work. I got to the office and several of my colleagues told me that I looked awful and said that I should go home. There was snow forecast and local schools were closing. My colleagues weren't doing anything except staring out of the window and/or talking about stockpiling food. I came home early and worked from my bed.

Unfortunately, I have my 'day job' plus my company to run, plus this website, which I have started to attempt to migrate from one place to another, although all these things are behind the scenes. I also treat my writing a bit like a job, in that I sometimes force myself to write even when I'd much rather be doing something else, or I've got a lot on my plate.

The things that get neglected are my sister and my niece, my friends, all the phone-calls I never answer, all the messages and emails I never reply to, and all the tasks which can be deferred for as long as possible. I need a haircut. My car needs servicing. Today is the final day that personal taxes are due to be paid in the UK, and I was close to the deadline as usual. I need to find a new place to live. I need to renew my car insurance. I need to see if my former friend's mum still has my stuff - the majority of my stuff - still stored in her garage, or whether she's disposed of it, since the fallout with the friend.

I quit drinking back in early December, although I did have a couple of drinks on Christmas Day and New Year's Eve. Quitting drinking helps, actually. I feel fitter, healthier and I've lost some weight. I find my life to be much improved versus the recent period when I was drinking heavily every single day.

Something's gotta give though.

Today it was my health. Sunday, Monday and Tuesday, it was also my health. Every day I take too many sleeping pills and too many tranquillisers.

Eventually, the weather will improve, my finances will improve, my routine will stabilise, I will get the housing security I need, I will have the regular social contact I need, I will get the exercise I need, I will replace my run-down old car with a newer nicer one, I will replace my worn-out clothes, I will pay off my debts and I will get a haircut.

Not today though.

Tags: #work #sick #alcohol #medication

This is a story about radio silence...

On June 20 of this year I attempted to write my life story from 2011 onwards, covering the happiest, most successful period of my life and the pinnacle of my career - doing a tech startup accelerator program in Cambridge with a cohort of incredible people - and the subsequent reasons why I stepped down as CEO, separated from my wife, sold my house and settled my acrimonious divorce.

I wrote 10,000 words in a non-stop brain dump. Once I started I couldn't hold back - the words flooded out onto the page.

It was supposed to be succinct. It was supposed to be a simple set of bullet points.

It turned out to be a lot harder than I thought, to write down even the first part.

Part two has a lot to cover:

• Homelessness
• Hospitals
• Police
• Drug addiction
• Psych wards
• Suicide attempts
• More banking jobs
• More IT projects
• Moving to Manchester
• Moving to Wales
• Several relationships and breakups; love and loss
• Psychosis
• Self medication
• Alcohol
• Depression
• Anxiety
• Boredom
• Financial problems
• Near-bankruptcy
• Salvation

I'm not going to write part two in the same way that I wrote part one.

That was 6 months ago. This is now.

A lot can happen in 6 months.

As a quick recap, here are the problems I've been trying to tackle this year:

• £54,000 of debt
• Homeless
• No job
• No car
• Single
• Addicted to prescription drugs: sleeping pills, tranquillisers and painkillers
• Alcohol abuse
• Depression, anxiety and bipolar disorder

As if those problems weren't enough, in June I had relapsed onto supercrack. I'd been working but I'd lost my job - through no fault of my own - and I was in no hurry to get another one, because my addiction had returned with a vengeance. I was in a place with no family and only a handful of friends, none of whom were equipped to deal with my clusterfuck of issues. I was more-or-less alone, except for the people who I try to connect with on a daily basis through my blog, Twitter, Facebook and other digital means.

I came up with the title "No News is Bad News" because it's usually true. I came up with that title, because a period of silence on my blog is usually cause for concern. It's usually time to start phoning round the hospitals to see if I've been admitted. It's usually time to start worrying if I'm dead or dying.

Back in June - 6 months ago - the title was very apt, because I hadn't been online for a while. Losing my job had completely destroyed my hopes of dealing with the mountain of issues I was facing. Losing my job had wrecked my plans for recovery.

Today, my world looks very different.

I can't tell you too much - because it's private - but I'm writing from the comfort of my girlfriend's bed. Her bedroom is very pink and girly. She just brought me a plate with a generously buttered thick slice of toast and a glass of orange juice, which I am eating in bed. I'm getting crumbs in the bed and greasy finger-marks on my laptop.

I'm no longer living out of a suitcase in a hotel and eating in the same gastropub every night, sat at a table for one. I'm unofficially co-habiting. We only met a few weeks ago. The relationship is going fast. Too fast some might say.

I kiss my sweetheart good morning and wish her a good day as I depart for work. My journey takes no more than 15 minutes when the traffic is kind to me. I'm finding it easy to get up in the morning. I don't dread lonely evenings in a bland hotel room. I don't dread the unsustainable interminable monotony of miserable days in the office, and miserable evenings spent alone.

I'm going too fast though.

I'm working too hard.

It takes vast quantities of alcohol, sleeping pills and tranquillisers to prevent me from working 12 to 14 hour days. It requires a huge amount of effort to stop myself from working at the weekend. I'm desperate to achieve results as quickly as possible, because the finishing line is within sight.

It could be months before I'm well-and-truly out of the danger zone and enjoying some long-overdue financial security. It's definitely going to be a long time before I get truly settled at home and at work. I need to decide where I'm going to live and what I'm going to do for a job, on a more long-term basis. At some point, my good luck is going to run out and I'll be forced back into living out of a suitcase, maintaining a long-distance relationship, and having to face the anxiety and stress of proving myself in a new organisation, with a new set of work colleagues.

Mania has arrived. There's no doubt about that.

My manic energy has been ploughed into my day job, instead of my new novel. I worry that my work colleagues have noticed that I've completely obsessed by my project. I worry that the undesirable accompanying behaviours - irritability, rapid and pressured speech, arrogance and delusions of grandeur - will become so hard to hide in the office that I might be forced to disclose my bipolar disorder to my colleagues, in the hope that they'll be sympathetic.

My blog has been neglected, along with my friends.

I work too hard. I'm moving 'too fast' in my new relationship - the "L" word has been used and she has given me a key to her place. We're going on holiday together. All my original problems are still there, to some extent. I need to decide where to live, pay off my outstanding debts, drink less, quit the sleeping pills and tranquillisers, get my mania under control.

What else can I tell you?

I can't try to tell you too much all at once, even though I desperately want to. I want to sit down and write 10,000 words without taking a single break. I want to pour my heart out onto the page and tell you everything, but I'm trying to pump the brakes a little bit. I'm trying to be a little bit sensible, even though I'm clearly going too fast.

It feels like the week-long hiatus from blogging was not bad news. Perhaps it's good news? No. It's not good news. I'm not looking after myself. I'm not managing my bipolar very well. I'm allowing myself to become manic, for the purposes of achieving 'great' things at work. It's exciting to be manic after so many months of depression and misery.

It would be a good idea for me to resolve to resume my daily writing, but I'm wary of making unrealistic promises. Today, I'm coming to terms with the fact that my 3rd novel remains unfinished, when I had hoped to have completed it yesterday.

That, ladies and gentlemen, is my present situation in a nutshell.

Tags: #bipolar #relationships #debt #homeless #addiction #medication #alcohol #writing

This is a story about drug dependency...

This is how I function. This is how I normalise myself. This is how I comply with society's demands. This is how I cope with social jet-lag. In our fit-in-or-fuck-off culture, this is how I conform. These are my crutches. I might appear functional and unimpaired. It might be somewhat insulting or offensive to describe myself as struggling in any way - perhaps I should instead talk about my wealth and privilege and acknowledge that since being born with a silver spoon in my mouth, my life has been uninterrupted gilded luxury; I've never known pain; I've never known suffering.

Think about the starving African children.

I comparison with the 8 or 9 bottles of red wine I was consuming every week - drinking alone - my use of a few sleeping pills and tranquillisers seems relatively safe and healthy.

This is all I have left.

I've had to eke out my dwindling supplies for far longer than I'd expected to. My opportunities to "re-up" have been constricted and constrained. I've been forced into drug withdrawal, which mercifully has been bearable because of my successful rationing strategies.

Insomnia has been the price I've paid for economising; suddenly cutting back on the medications I've become dependent on. Hypomania has been a very real and tangible consequence of the brain chemical destabilisation.

Perhaps I shouldn't meddle with my mind? Perhaps I should put my faith in the medical community? Perhaps there are people who know what's best for me?

Ironically, I'm using these medications - obtained on the black market - to plaster over the cracks and blend in with the very people who are specifically tasked with deciding what's best for you. I'm a member of the paternalistic elite. One should always remember that the people dishing out the advice and prescriptions are just as fucked up as everybody else.

My hypomania constantly threatens to boil over and create a disaster. My hypomania is a constant threat to all the health and wealth I've managed to accumulate this year. My hypomania is almost impossible to conceal, constantly attempting to sneak out from under the cover and camouflage I've carelessly draped over it, in the hopes of it being ignored and not talked about by my discreet, polite and extremely civilised colleagues.

Unable to sufficiently bludgeon my brain into submission to society's demands, using powerful psychiatric medications, my mask slips.

Exhaustion from the toll of 11.5 consecutive months desperately attempting to re-enter civilised society has reduced me to surviving on my instincts. I speak without thinking. It is only my well-practiced and well-rehearsed routines which allow me to continue to appear functional, when my mind has crumbled and descended into outright insanity internally. If I could only sit mute in my office chair at my desk, I would be fine, but unfortunately stuff pops into my head and pours out of my mouth before I have a chance to hold my tongue.

My medication dependency is a cruel mistress. My anxiety skyrockets in the late afternoon and evenings as my short-acting tranquilliser wears off. My insomnia robs me of refreshing and energy-replenishing sleep, leaving me almost paralysed by panic attacks about the simple task of getting out of bed, having a shower, getting dressed and going to work. Unless I take the right amount of pills at the right time, my mask of sanity quickly slips. The illusion of a functional productive member of society quickly evaporates, the moment that I skip a dose or start reducing my medication.

Of course, I'm hopelessly dependent. I admit it. So what?

My life revolves around my regular medication doses. So what?

Doesn't anybody's life revolve around cyclical things? Life and death, sunrise and sunset, summer and winter, weekdays and weekends, work and leisure, awake and asleep, hungry and satiated, horny and spent, love and loss. Some of the cycles are societally and culturally enforced to remain the same year-round, when it's clear that it's unnatural. Why the hell don't we sleep more in winter, when the days are shorter? Why the hell don't we sleep more when we're tired? Who the hell invented the fucking alarm clock and the 9 to 5 office job anyway?

I am quite literally tyrannised and oppressed - abusively coerced - into compliance with health-damaging social rituals, lest I be excluded from society; marginalised. It's in my rational economic self-interest to comply, but it's in the interests of my mental health to refuse to comply. Non-compliance will be met with harsh and intolerable economic sanctions.

Of course I seek out and consume the pharmaceuticals which 'normalise' me and allow me to cope; to function.

You might be surprised that I'm a junkie who needs his fix so that he can work a boring office job. You might think that junkies take drugs to feel pleasure and otherwise get high, but my drug dependency is mandated by the otherwise unbearable awfulness of the 9 to 5 grind.

You might think that people get rich off drugs by selling them. You might think that drugs will ruin your life, my drug dependency has been a mandatory part of repairing my life. Do you really think that it's humanly possible to achieve the kind of comeback - the recovery - which I've managed to complete during the past 11.5 months of turning up at the office and acting normal, without access to the full range of pharmaceutical options?

I've done the impossible: gotten off the streets, where I was sleeping rough, gotten out of the hostels, gotten off the terrible drugs, gotten out of the psych wards, repaid unimaginably huge debts, got myself a place to live of my own, got myself a respectable good job, held down that job, impressed my colleagues, delivered high quality work on time and on budget.

You think that was possible without performance enhancing drugs? Are there laws that say I can't use the very best of medical technology to allow me to function at my very best in a workplace environment? I'm not an athlete. I can use whatever the fuck I want and I have done.

It might seem logical to presume that I must now have a massive drug habit, because I've leaned so heavily on unhealthy coping mechanisms to get me to the point I'm at today.

I use the word "dependency" very carefully.

It's true that technically I am dependent on medications. It's true that abrupt cessation of the 2 or 3 medications I use on a regular basis would be catastrophic for my career, my reputation, my finances, my stability and all the other things in the house-of-cards which constitutes my life.

However, the doses I take are laughably negligible.

Instead of being in a horrible mess, the dose which maintains me in a functional and stable state is totally reasonable and acceptable. The problems I've stored up for the future - by becoming dependent on medications for normal day-to-day functioning - are pathetically tiny insignificant problems compared with the goddam mountainous obstacles I've had to tackle to get this far.

It concerns me that my stash is now critically low, because my whole happy healthy wealthy future hinges upon the continuation of the well-established routine for another 6 to 12 months, at the very least. If I can carry on with my dirty junkie medication dependency for another 18 months I will be rich as fuck compared to the struggling masses, which would be an unexpected result for anybody who's been brainwashed to believe that junkies like me are no-hope losers.

I don't go to the doctor. I don't have a psychiatrist. I don't have a psychologist. I don't have a community mental health team (CMHT) or a crisis team. I do what the fuck I want.

My experiments with being completely medication-free earlier in the year were a total disaster. I do hope that one day I'll be able to quit the pills, but I don't see how I'll ever be able to do when my health needs directly contradict capitalism's need to exploit me as an expendable commodity. There is a fundamental incompatibility between human needs and corporations' needs. There is a systemic inability to cope with anybody who deviates from the top of the bell curve.

I'm different, and I no longer expect society to accomodate me. I accept that I must alter myself - with pharmaceuticals - so that I can accomodate society's inflexible demands for homogeny and conformity.

I swallow a sleeping pill so that my social jet-lag is medically corrected. I swallow a short-acting tranquilliser so that the existential dread of working a pointless bullshit meaningless office job is bearable. I'm not overjoyed or happy to be doing it. In fact, I'm not happy at all about any of the situation. It would be fucking weird if I was artificially happy all the fucking time, because there's not a lot to be happy about during the death-throes of late capitalism.

You know what makes me happy? Spooning. Kittens. Holidays. Sex. Dreaming about going to live in a cabin in the woods. Delicious food. Binging on mindless entertainment. Extreme sports. Writing.

Should I be attempting to live the dream? Should I be trying to have it all? Should I mix work and pleasure?

Yes, I'm going to do all those things but you have to pay to play and it costs a fuckload of cash to make dreams come true.

I'll leave you with this quote:

"The power of inclosing land and owning propriety, was brought into the creation by your ancestors by the sword; which first did murther their fellow creatures, men, and after plunder or steal away their land, and left this land successively to you, their children. And therefore, though you did not kill or theeve, yet you hold that cursed thing in your hand, by the power of the sword; and so you justifie the wicked deeds of your fathers" -- A Declaration from the Poor Oppressed People of England, Gerrard Winstanley

It's up to the reader to decide whether I'm a Lord of the Manor, born into wealth and enjoying inheritance from my ancestors who plundered and stole. The fact that you've persevered reading this text in English using a computer or smartphone puts you into a certain socioeconomic set and suggests a level of academic achievement, which might suggest you might have benefitted equally from "the power of the sword" although you did not "kill or theeve" yourself.

All I can say of myself is that I'm trying to play by the rules in a rigged game. Nobody said I wasn't allowed to use performance enhancing drugs. This isn't sport, it's survival.

Tags: #medication #bipolar #mentalhealth #sleep #insomnia #career #addiction

This is a story about drug smuggling...

I never intended on becoming a narcotics trafficker. It happened by accident. To say that I'm a helpless puppet with my strings being pulled by the unseen hand of addiction, is not the whole truth. My executive brain functions and rational mind are still present, but there's quite a battle that rages within me. I'm mostly unaware of powerful subconscious thoughts which are often driving my behaviour, with my superego unable to perceive that I'm being steered towards addiction-sustaining acts, or indeed omissions.

Travelling from a rich country to a poorer one, customs might not expect illegal narcotics to flow in that direction, and as such might be caught off-guard by anything smuggled across the border by a wealthy Brit. My rational conscious brain says it's not worth taking the chance. Each country has their own drug laws and their own attitude towards those who flout them, with some countries being very punitive indeed, in an attempt to make an example of those who are part of the narcotics trade.

I've carried controlled substances across international borders a few times, quite by accident. Obviously I'm not talking about kilos of cocaine. I'm talking about the occasional tablet which escaped my notice when I was packing my bags.

I tried to buy some zopiclone - sleeping tablets - on the day I arrived here in Turkey. I hadn't planned to, but I saw a sign for a pharmacy and I thought I would enquire if it could be bought over the counter. It turns out you can't buy it without a prescription from a Turkish doctor.

Then, predictably, I had a sleepless night.

The last few weeks at work have been quite bearable, but perhaps only because I've been drinking heavily, taking sleeping tablets and also taking tranquillisers. I knew I was creating a problem for myself with the impending holiday, but I also needed to get through the seemingly unending and almost intolerable working weeks, without having a nervous breakdown.

After hardly sleeping all night, I then had very vivid nightmares. A lot of my nightmares revolved around drug addiction.

Feelings of overwhelming depression and anxiety have kept me in bed all day.

I expected this.

I'm paying the price for having made my working day more bearable using addictive sleeping pills and tranquillisers, because now I'm going cold turkey in Turkey. Lolz.

I knew this would happen. I was prepared to accept some panic attacks and sleepless nights; some horrible anxiety and gnawing dread; feeling like the world's about to end. This the deal with the devil that I struck: to be able to keep working my full-time job and able to cope, but to pay the price later.

I could have sworn I searched my bag thoroughly, to ensure I wasn't carrying anything through the airports that I shouldn't have been. In fact I did search my bag thoroughly, but my subconscious prompted me to be not quite thorough enough. I genuinely believed that I was travelling with not even a single solitary tablet to salve my anxiety and insomnia, my my subconscious was much more alert - as anxiety reached its peak, it told me to search more thoroughly and it knew I would find something. One lonely blue tablet, nestled in the stitching of the fabric, which could only be located with an obsessive search.

Of course, one blue tablet does not an addiction make.

Lots and lots of 'accidents' do however add up to an addiction.

It's unavoidable that I'm going to have to suffer some cold turkey withdrawal from sleeping pills and tranquillisers this week. It's unavoidable that I'll return to the UK far less addicted - dependent - on medications than when I left. That's one of the reasons why I chose to spend my holiday in a foreign country, where I'd be less likely to be tempted to fall back into old habits, although of course addictions follow you everywhere.

I would argue forcefully that the worst of my addiction is dealt with, and I'm using medications to help me keep working and earning money, in order to pay off mountainous crippling debts. I would argue that I'm using medications reasonably responsibly, and not in an abusive or recreational manner. I would argue that I'm hyper-aware of the risks of becoming physically dependent on benzodiazepines, and would not risk that happening again now I've managed to escape the clutches of that dreadful class of drugs.

It does however somewhat surprise me that I've managed to do it again - to smuggle drugs by accident - although mercifully this one tablet has therapeutic, not abusive potential. It's a bona fide medicine. It's not the dreaded slippery slope; the thin end of the wedge.

I need to be aware of the risk that I could back-slide gradually into an increasingly abusive and regular pattern of drug abuse. I need to be careful. I'm well aware that the worst of my addiction was prolonged for a very long time, because I thought I was able to get away with casual, occasional or so-called recreational use, which lulled me into a false sense of security; I was deluding myself.

Not the happiest story ever told, having spent the day in bed with the curtains drawn, but I often have days like this on holiday, where the accumulated stress and anxiety of the preceding months suddenly swamps me. I've hardly taken a day off sick, so it should be expected that I'd get sick as soon as I relaxed.

It'll soon be Monday morning, but at least I don't have to go to work this week.

Tags: #drugs #addiction #medication #holiday

This is a story about misanthropy...

On this day 5 years ago, I tried to help a homeless alcoholic called Frank. I made a lot of notes. As my divorce disrputed my attempt to get my life back on track in London, dragging me back to Bournemouth to empty and sell my house, it destroyed my fragile new life and plunged me into the very world of homeless hell, which I had usefully compiled notes on. I did manage to help Frank, but ironically crosssed paths with him later on - as I was descending into hell, he was well on his way to recovery.

On this day 4 years ago, I got myself off the streets, out of the 14-bed hostel dorm, and back into banking. I went to Barclays, which quickly dug me out of debt and restored some long overdue health, wealth and prosperity to my life.

On this day 3 years ago, I went to HSBC and repeated the same magic trick of managing to get myself back off the streets, out of the hostel, into a lovely Thameside apartment, and out of debt. Feeling like my life was going well, I went to a hackathon to create technology solutions to the refugee crisis.

On this day 2 years ago, I was lying to my girlfriend and my guardian angel, because the project I'd been working on had ended prematurely and I hadn't bothered to get another contract. Instead, I had tried to treat my own depression with medication prescribed by an online pharmacy, destabilising my mental health - inducing hypomania - and causing a subsequent relapse.

On this day last year, I woke up as a resident of Wales for the first time since being born here. The day before, I had been discharged from a psych ward in Manchester, England, following a suicide attempt which was very nearly successful.

I'm pretty upset that divorce was such a destabilising distraction at a time when I desperately needed a clean break, and I'm struggling to forgive and forget my ex-wife and parents sabotaging all my hard work; destroying my chance to follow through with well thought out plans which were subsequenty proven to be correct and successful.

I can blame the Barclays thing not working out on a couple of idiots who got fired for trying to screw me over, but in all truth, I wasn't very stable. I was too outspoken. I didn't keep my mouth shut. I made mistakes in my personal life. I had lapses.

I can blame the HSBC thing not working out on the sheer pressure and workload of working on their number one project, while also dealing with homelessness and cripling debt. I can blame a friend who asked me to help him get a job. I can blame a few loafers who benefitted from my hard work. But, again, I was too outspoken. I wasn't at all stable. I was so exhausted and stressed that I was very strung out and very manic.

I can blame not wanting to immediately get another contract 2 years ago on the fact that the project had been so mind-numbingly spirit-crushingly boring, and I'd been so de-skilled, that I'd lost all self-confidence. I really couldn't face any more of the same awfulness without taking a break. However, it was still my so-called 'choice' to relapse and I knew the consequences were likely to be dire, although I kinda "got away with it" that one time.

I can blame attempting suicide and nearly dying on the fact that I knew instinctively that I was in deep trouble. The contract in Manchester didn't pay enough to get me out of debt. I knew I was going to get shafted by a very unpleasant and immoral wannabe Labour MP, who embodies none of the values of socialism. I was working too hard for too little reward, but I also made bad so-called 'choices' such as getting mixed up with a social group who mostly bonded over recreational drug abuse. There was no way I was going to be able to quit physically addictive sleeping pills, tranqulisers and neuropathic painkillers, as well as working a very demanding job which didn't even pay enough to make any kind of dent in my debts. Suicide was my choice, in the face of overwhelming odds stacked against me.

So, here I am in Wales.

What's going to be different this year?

I'm in approximately the same financial position that I've been in all those previous years. My mental health seems to be the same, swinging between suicidal depression and mania.

Just gotta keep my mouth shut.

Gotta make sure I don't go on any crusades, trying to save anybody.

Put on my own oxygen mask before helping others.

This year is different because I've been working for 10 consecutive months without a major fuck-up. Of course, there have been fuck-ups, but they haven't caused me to lose my contract or otherwise let my client down. I've delivered a couple of projects quite successfully, to the great satisfaction of my clients.

This year is different because I've had an affordable place to live of my own since March, and I don't have anybody mooching off me or otherwise trying to ride my coat tails. I don't have anybody pressurising me to subsidise their laziness and inability to make good on their financial commitments. I don't have anybody using my gas, electric, water, sewerage, council tax and broadband, and running up thousands of pounds worth of rent arrears.

This year is different because I've had contract extensions and managed to have consecutive contracts, such that I've hardly stopped working at all.

This year is different because I've been working on my skills and making myself more confident and employable. I've felt increasingly capable and good at my job, without getting too deep into the territory of delusions of grandeur.

This year is different because the pressure is markedly reduced and the stress levels are more manageable, despite crushing mountainous debts. There have been really awful times - such as renting a place to live - but I seem to be well established in a good routine now, such that I just need to keep turning the pedals.

I drink too much. I'm unfit.

However, in the space of 11 months I'll have managed to buy a car, rent an apartment, pay off £21,000 of debt, and save up enough money to pay a hefty tax bill. I don't enjoy living out of a suitcase, but I'm not slumming it anymore. I've been able to take a weekend break to see old friends in Prague and I have a week-long holiday to Turkey booked, which will be my first proper holiday for over 2 years. I stay in a nice hotel midweek and I eat in a gastropub. This is the self-care aspect, which didn't really get taken care of in previous years. There's no point working as hard as I do unless it's delivering some quality of life; I might as well just kill myself if life's going to be an unrewarding slog.

I sometimes can't believe what comes out of my mouth, in terms of the fucking rage which is somewhat pent-up inside me. This is a summary of the many false starts I've had, and nearly-but-not-quite moments, where it looked like I was going to make a breakthrough and get properly back on my feet. It's incredibly frustrating to repeatedly do the impossible - quitting addictive drugs, getting off the streets, out of the hostels and back into mainstream civilised society, while also dealing with a major mental health problem - and to see that there's nothing wrong with my approach per se. On paper, everything should go perfectly and quickly restore me to health, wealth and prosperity, but it does require a run of good luck, and that luck is very much dependent on the co-operation of other people.

Who do I want to blame? Capitalism? Banking? Bad bosses? Wimmin? Parents? Even friends?

I spend a lot of time writing very aggressive angry stuff.

I can't believe what I write.

Maybe this year won't be any different, because I'm a spoiled overprivileged vile bitter old man, who doesn't take any personal responsibility; I'm too quick to blame others.

We shall see. The story continues.

Tags: #frank #homeless #hostel #friends #banking #london #wales #capitalism #debt #career #addiction #alcohol #recovery

This is a story about self-experimentation...

It's very difficult to conduct a scientific study involving human beings. Our innate ability and inclination to adapt to our ever-changing environment means that we can't control the variables as we would be able to in vitro.

Sample sizes are always tiny - statistically impossible to gain any insight from - because of the difficulty of recruiting so-called ideal study candidates and being able to follow them for long enough to gather any meaningful data. Each individual will have wildly varying personal circumstances, which render any studies of hundreds or thousands of participants, complete and utter pseudoscience hogwash; nonsense; garbage.

Aggregating data from all the antidepressant controlled trials, as well as thousands of other studies into the efficacy of those medications, concludes to a high degree of statistical significance, that in more than 80% of cases the person's depression would have 'cured' itself on its own - medication makes no difference at all.

Clearly, psychoactive medications do have perceptible effects, just as you're able to tell if you've drunk 4 pints of beer or 4 pints of water. Thus, a double-blind placebo trial is not a placebo trial at all, because those who are in the placebo group know that they're unmedicated.

The question then arises: can we prove that some medications have positive effects?

Problematically, we are as superstitious as an animal with a bird-brain, quite literally. If a food pellet is randomly released to feed a pigeon kept in a cage, the pigeon begins to believe that whatever it was doing when the food pellet was released caused the food pellet to be released. If the pigeon was - for example - turning 360 degrees clockwise when the pellet was randomly released, it will continue to spin in circles, believing that its actions are causing the food pellets to be released. This is called magical thinking and humans are just as prone to it as a bird-brained pigeon.

Extrapolating, if we take up yoga, start eating kale, listen to whale music, start believing in imaginary sky monsters, wear lucky underwear, read self-help books, use homeopathic remedies or start doing any one of the many billions of similarly stupid and futile superstitious rituals, these are at least 80% likely to co-incide with a natural improvement in our mood which would have happened anyway. However, we will falsely attribute our better mood and more hopeful future, to something which actually had absolutely no effect whatsoever so far as good empirical evidence-based repeatable science is concerned.

To control the variables is extremely hard, in complex modern life.

I had a very good night's sleep last night, woke up early, ate a healthy breakfast, got to work early, had a productive day, and I felt like I had the energy and enthusiasm to do some exercise. My quality of life was manyfold better today than it has been for a very long time. My hope and optimism were sky high today.

Let us deconstruct the reason for my good day.

Last night I swallowed two 7.5mg zopiclone tablets, which are a sleeping pill. Perhaps it's high quality sleep, delivered with some help from medicine, that's the reason I had such a good day - I was well rested and refreshed.

No.

Earlier in the year - and in fact quite recently - I had completely quit all sleep aids and I was sleeping very well without them. I have no problems initiating sleep and remaining asleep. This variable is eliminated.

Last night I swallowed one 2mg Xanax tablet, which is a short-acting benzodiazepine hypnotic-sedative muscle relaxant, generically known as alprazolam. Perhaps it's relief from anxiety delivered with the help of medicine that is the reason why I had such a good day - my anxiety was subdued.

No.

Earlier in the year - and in fact quite recently - I had completely quit all sedatives, tranquillisers and tranquillising painkillers and I was coping very well with my anxiety without those medications. I am fully functional despite my very high-stress and demanding life. This variable is eliminated.

Last night was my 5th consecutive night without alcohol. Perhaps it's the healthy decision to quit booze and become teetotal which is the reason why I slept better, woke up refreshed, had improved concentration and felt more full of energy and enthusiasm for other healthy activities than I have done for a long time. I thought about catching up with a friend. I thought about doing some exercise.

Ah. We have a problem.

On the face of it, we have 3 significant changes, and those changes all concern mind-altering substances.

I can be fairly certain that I'm able to sleep and I'm able to cope with my anxiety without medication, but I combined two medications which should have helped with both, which is already complicating the clinical picture, but then I also quit heavy drinking quite abruptly and managed to get through 5 consecutive sober days. 3 changes is far too many changes to attribute my improved mood to any one of them, or even all 3 in combination.

But.

Oh no.

There are other changes too.

I got paid on Monday. Getting paid is always a good day. Sure, Monday I was off work sick, but it wasn't until yesterday that I started doing some sums and I realised that I can pay off half my debts at the end of the month. It's something worth considering.

I went back to work on Tuesday. Not losing my job is always a big relief when I get sick. Sure, it'd be pretty bad luck to lose my job after just one day off sick, but it's always a relief somehow to go back to work and find everything's fine and people are cool with me. It's something worth considering.

I have 8 working days - less than two weeks - until I go away on holiday. I haven't had a week-long holiday since July 2016, over two years ago, so that's a massive relief to know that I'm going to get a relaxing break soon. It's something worth considering.

I spent the weekend in the company of old friends. I took a flight to Prague. Socialising and travel are exciting and stimulating. I played with my friends' children. We did activities, like sightseeing and mushroom picking in the woods. All of those things are very nice and normal and pleasant. Sure, it was exhausting, but now that I've gotten over the travel I have some really nice memories of that trip. It's something worth considering.

At work I'm starting to feel like I'm really making a difference and I'm a valued member of the team. My colleagues were glad to have me back and people are keen to work with me. I feel cherished and a little bit more secure every day. I feel increasingly confident in my own skills, knowledge and experience. It's something worth considering.

My sister picked up my mountain bike from my parents, so that I can collect it from her. I'm looking forward to seeing her and maybe my niece too. I'm looking forward to having my bike back. I'm looking forward to getting my bike repaired, upgraded, and being able to use it to get a bit more fit and active. It's something worth considering.

Lives are complicated.

Life is complicated.

It's impossible to control the variables.

If you were looking for the perfect test subject - a guinea pig - you would fail to find a better one than me, because so many things in my life are constant. I stay in the same hotel, I eat in the same gastropub, I do the same job I've done for 21+ years. I'm a creature of habit and I'm not destabilised by anybody else, such as family, a partner or children. I've cut every variable out of my life that's possible to do, short of locking myself in a laboratory cage. I'm the perfect test specimen.

I can't tell you why I had a good day today, but I have very good reason to believe that it was a combination of a multitude of factors, including the sleeping tablets to help me get back into a good sleep pattern, the anxiety tablets to help me cope with intolerable stress levels, the sobriety, the travel, the socialising, the money, the job satisfaction and a million and one other little things, all of which are very positive. For example, my Apple Macbook was repaired under warranty, saving me the cost of a £1,500 replacement or a hefty repair bill, which is a big relief. Who could have predicted any of this and why would we attribute my life improvements to any one particular thing, such as the favourable mood of an imaginary sky monster? Stuff was just going to get better on its own.

As you can tell, I'm not the superstitious type.

I will, however, be taking a zopiclone and a Xanax again tonight.

Tags: #medication #depression #anxiety

This is a story about when the alarm clock goes off...

I'm routinely late for work but I think I've figured out why. I was very tired when my alarm went off this morning, but I think I could've gotten out of bed and gone to work. I was tired but I felt OK. I needed more sleep but I'd have been alright if I immediately got out of bed.

Unfortunately I let the dread set in.

My thoughts and feelings changed from "I need more sleep" to "I'm going to be late" to "I don't want to go to work at all". From initially planning to get up, iron a shirt, iron a jumper, take a shower, get dressed and drive to work, I then started planning how best to tell my team that I wasn't going to make it to our morning meeting. As lunchtime approached I dreaded having to finally get up and the ridiculousness of "I'm going to be late" meaning not turning up until the afternoon.

I did not get up.

As the afternoon wore on I was dreading having to tell my team that I was actually going to be a no-show. I dreaded the loss of earnings. I dreaded the damaging impression that I'm unreliable. I dread the day that I'm finally unable to keep going any longer, and I stop turning up for work altogether. I dread the day that I hit the wall.

I did not tell my team that I was going to take the day off sick.

It might seem like I'm my own worst enemy. It might seem like I'm making things harder for myself. It might seem like there's a long string of decisions here, and I'm making bad choices, but it doesn't feel like it at all. The whole process is quite agonising.

A couple of times in the past fortnight I've woken up at around the time when my alarm goes off. I've gotten up, dressed, had breakfast, driven to work and arrived on time or even early. "This must be what life's like for a normal person" I've thought to myself. It's been blissful on those days. Life has felt sustainable and pleasant and I've even envisaged being able to keep working for the foreseeable future, on those good days.

Most days are not good days.

I've only found a few solutions for the dread.

Short-acting hypnotic-sedatives work very well in the short term. Xanax and zopiclone last just long enough to get a good night's sleep a bit more tranquillising effect in the morning, when the dread would normally set in. Without a sleep aid, the dread sets in the night before: "I'm never going to get enough sleep and I'll be exhausted in the morning" I think as I lie awake until the wee hours of the morning.

Alcohol works a little bit as a sleep initiator but the liver metabolises alcohol so efficiently that it's mostly eliminated from your bloodstream after 4 or 5 hours. Alcohol-induced sleep is not high quality and it's followed by dehydration and a full bladder, which I usually try to ignore because I'm warm and comfortable in bed. By the time the alarm goes off alcohol withdrawal and bad sleep combine to make the dread doubly bad.

Getting absolutely smashed drunk works surprisingly well as a mechanism for getting me to the office more-or-less on time. Waking up half-pissed from the night before does offer an intoxicated tranquillisation which allows me to overcome the dread.

Driving to work drunk and/or tranquillised and being in the office while reeking of alcohol and/or slurring due to tablets, is a pretty undesirable state of affairs. Public transport, heavy lunchtime and after-work drinking were the norm in the City, so my heavy alcohol dependency was not conspicuous until I was banished to the provinces.

Everything's catching up with me now.

The heavy boozing has led to sudden weight gain this year, which depresses me. Drinking heavily no longer seems like a sustainable strategy to get through the working weeks.

The solution is a total detox, exercise, sensible bedtime, healthy breakfast and good sleep hygiene; routine. The solution is to live the most boring life imaginable, dedicating myself purely to the pursuit of being able to get up in the morning. The solution is to completely change the way I live - the way I act - in order to fit in with early-bird culture.

In many ways I am still going through an extended benzodiazepine withdrawal, neuropathic painkiller withdrawal and sleeping tablet withdrawal. My alcohol use has prolonged and worsened the excruciating withdrawal from the physically addictive medications. My body and brain's instinctive reaction to drink more and eat more to compensate, has been a very poor coping mechanism and has instead lengthened and exacerbated the negative symptoms, instead of providing the mild relief I so desperately crave.

Having used Xanax a couple of times in the last fortnight, it was remarkable how my brain responded: "THIS is the stuff which I've been screaming for" it seemed to say, as I gained some long-overdue respite from round-the-clock anxiety and the dread.

Obviously it's not desirable to use pills or booze long-term. Obviously, it'd be good to suffer the short-term pain and get healthy, before things get any worse. I've done a substantial part of the hard work, in breaking my physical dependence to a multitude of addictive medications.

I desperately craved alcohol all weekend but remained sober because my friends who I was visiting are not big drinkers. I was really craving alcohol tonight, but I managed to resist, although I'm comfort-eating to compensate for the craving.

I hate the situation, where I'm not where I want to be with anything. I'm not teetotal. I'm not medication-free. I'm not doing the healthy stuff. I'm gaining weight not losing it.

To eat less, eat healthy, go to the gym, be teetotal, stop taking sleeping pills and stop taking the occasional tranquilliser, but yet maintain my miserable single hotel-dwelling living-out-of-a-suitcase life, seems completely ridiculous. However, using my misery as a justification for drinking as much as I want, whenever I want, is also ridiculous and has led to appearance change and health degradation, which I don't find acceptable.

Tonight I've comfort-eaten and not done any exercise. Tonight I will take one or maybe even two sleeping pills. However, I won't have any alcohol or tranquillisers. I'll try to go to sleep at a sensible time. I'll try to get up early, have a healthy breakfast and get to work on time. If I can do all that, it's still a reasonable achievement considering the circumstances.

I'm not reliable. I am struggling. Hopefully nobody will hold it against me though.

Tags: #career #depression #sleep #medication