Alcohol, smoking, and illegal drugs

Some of the people we talked to discussed drinking alcohol, smoking and taking illegal drugs. Here they share their experiences of the impact that taking these substances had on arthritis or their treatment.
People who drink, smoke or take illegal drugs should speak to their doctors about how such things impact on their health.
Drinking alcohol 
Some medications are known to interact with alcohol and can cause problems. For example, drinking excessive alcohol whilst on methotrexate can cause liver damage. You should always seek advice from your doctor about drinking alcohol whilst on any medication.
The age that people started drinking varied from person to person. Some said they were too young to drink and had never tasted a drop, whilst others started drinking as young teenagers. Sometimes people started drinking when they were 18 years or older. A few said that they drunk less as they got older. Some drank the odd glass of wine or bottle of beer on special occasions but others drank without watching their limits.
People who chose to limit the amount of alcohol they drunk did so for various reasons. Some said it was a personal choice – they simply didn’t like the taste, felt no need to drink lots or found it harder to deal with hangovers as they got older. Others limited their intake for medical reasons. Doctors and nurses advised people not to drink whilst taking certain medications, such as methotrexate. People also talked about the negative effects of drinking alcohol the next day. They said the fatigue would be more severe, the pain worse, and mobility (such as walking) reduced. Some said they would suffer for a week if they drank too much. They also said that they worried about “losing control”, hurting themselves or getting into danger.
People who drank more than the odd glass sometime said that they wanted to go out, relax and have a good time. Some felt that having fun on a night out was worth the pain the next day.
Sometimes people’s symptoms appeared to improve after a few drinks. Some said they temporarily felt less pain and would become more mobile. After drinking Michelle felt like she could “walk for a mile” and “jump up and down”. She would overdo it physically and be in “agony” the next day. If Rebecca was having difficulties with pain and mobility her friends would pick her up in the car and take her to the pub to take her mind off things.
People on medication planned their drinking so it interacted less with whatever medication they were on. Deni said she was able to drink because she was not on any medication.
People sometimes felt pressured by peers to drink alcohol. For example, David Z had a drink on people’s birthdays so he didn’t “stick out like a sore thumb”. He said the amount of drinking that went on at his university went down in years 2 and 3 because people had more work to concentrate on. Lu was told she was “boring” by a stranger in a club because she didn’t order an alcoholic drink. Some didn’t want to reveal that they had arthritis so made up excuses about why they couldn’t drink.
Some of the people we spoke to enjoyed going to pubs and clubs even though they only drank soft drinks. They saved money that would have been spent on alcohol and were able to drive home after a night out. People who avoided alcohol even joined in drinking games - instead of drinking alcohol they drank soft drinks or ate chocolate. Some found activities that they could enjoy with friends that didn’t revolve around alcohol, such as eating in restaurants or gaming. Others hung around more with friends who didn’t drink.
There are decreasing numbers of young people smoking these days. Smoking is known to cause serious conditions like heart disease and lung cancer. People with arthritis may have additional problems related to smoking. For example, people with ankylosing spondylitis sometimes have reduced ribcage movement when they breathe which can then in turn make smoking related problems such as cough and recurrent chest infections more troublesome. To prevent lung damage the best thing people can do is stop smoking altogether but this can be difficult if you have been smoking for some time. Speak to your doctor about quitting smoking.
Some of the people we spoke to didn’t smoke for health reasons. David Z had asthma and said smoking would make it worse. Kyrun knew that smoking could cause damage to his lungs, or even give him lung cancer. He said it was his problem to worry about. He felt that smoking hadn’t affected him yet. Dean felt that smoking “takes the edge off” stress. Several people smoked to be social on a night out, but didn’t smoke regularly.
Illegal drugs
Some of the people we spoke to talked about illegal drugs. Some felt indifferent to illegal drugs but others were against them for health reasons, particularly if they were taking prescribed medications. A few people told us they had used marijuana (cannabis) for pain relief. One person smoked a lot of marijuana over a long period of time and said it was the best pain relief she had tried. She would like to see more medical research into its benefits and believes the law should be changed. There is no medical evidence to date that supports the use of marijuana for pain relief in arthritis. However, there’s increasing concern around the use of cannabis during the adolescent years when the brain is still developing, so excessive use in all young people remains concerning for health reasons. Visit our 'Drugs & Alcohol' section for more information about young people's experiences of alcohol and illegal drugs.

Last reviewed November 2018.
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