A Partner and Family Guide to Dealing with OCD

DO's 

DO: Be Supportive. Talk about the Obsessive Compulsive Disorder. Listen to the loved one. Try to be understanding during stressful time's and praise any improvements made during treatment. Try and improve the sufferers self-esteem, confidence, and boost their self-image. Encourage the individual by letting them know that they are NOT alone and that treatment for OCD is available. Work with the Professionals and the individual in setting workable guidelines to follow at home. Encourage the OCDer that there are OCD medications and behavior therapy programs for Obsessive Compulsive Disorder to help them and assure them them their symptoms can be reduced significantly. Suggest that they join a Support Group with you or by themselves.

DO: Be Consistent. Set rules for behavior and stick to them. As much as possible it is important to keep a normal family routine. All communication about rules and guidelines must be consistent, clear and simple.

DO:Be Positive. Remember OCD is no one's fault. The OCD is an ILLNESS, not part of someone's PERSONALITY.

DO: Be Informed. Get as much information as possible on the illness, booklets, pamphlets, video's etc, and educate both yourself, the family, and the sufferer on all aspects of the illness.

DO: Remember. You deserve support too. You can feel overlooked if you are the partner or parent of an OCD'er, but OCD is a very stressful illness. you may benefit by talking to others who share this issue. Join a Support Group and any other helpful resources available.

DONT's

DON'T: Get involved with the person's Obsessions and Rituals. This only makes them worse by acknowledging them. This then gives the Compulsions some kind of credibility and worth, which they DO NOT deserve. Don't be persuaded to participate in the obsessive-compulsive behavior, but detach yourself from them with LOVE, don't refuse in an angry or aggressive way.

DON'T:Be tempted or persuaded by tears or emotional blackmail. The sufferer is just that - suffering, but giving into their Compulsions will only make their symptoms worse, making the illness harder to get rid of.

DON'T:Be afraid to take definitive action. If the loved one refuses to acknowledge that anything is wrong and resists seeking help, make them aware that whilst you still offer support in helping them find the professional help they need you will no longer continue to make special accommodations for their OCD behavior.

DON'T: Forget you play an important role in the recovery of the OCDer. They will need your help and support if they are to benefit from any treatment. Don't forget each Partner, parent, family member or friend can help the individual with OCD by reinforcing GOOD behaviors and helping them resist inappropriate one's.

DON'T:Be embarrassed by the nature of the illness. Millions of people suffer silently because of this. It is healthy to be open and confident when describing to others the symptoms of the illness, especially in front of the sufferer. Let them see there is nothing to be embarrassed about.

DON'T: Give up on the sufferer. OCD is a very difficult illness for anyone to understand, and it can be hard for a partner or family member to know how best to behave with the individual. Educate yourself so that you are better equipped with that knowledge.

DON'T:Forget yourself! Take time out to look after yourself too. Develop interests and hobbies for your own relaxation periods. Be aware that OCD is stressful for you and family members as well as the sufferer.

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A Crisis Plan For People Who Experience Psychiatric Symptoms

I feel very strongly that anyone who has ever experienced psychiatric symptoms needs to develop for themselves, while they are well, a crisis plan such as the one that follows. This plan allows those of us who experience psychiatric symptoms to maintain some degree of control over our lives , even when it feels like everything is out of control.

Developing such a plan takes time-don't expect to do it in one sitting. Work on it with family members or friends, your counselor, case manager or psychiatrist-whoever feels comfortable to you.

The hardest part for me was uncovering those symptoms that indicate I need others to take over for me. It brought up memories of very hard times in the past. I did it very slowly with lots of support.

Once you have completed the plan, keep a copy for yourself, and give copies to all your supporters.

Update it whenever you need to.

CRISIS PLAN

When I am feeling well, I am (describe yourself when you are feeling well):

The following symptoms indicate that I am no longer able to make decisions for myself, that I am no longer able to be responsible for myself or to make appropriate decisions.

When I clearly have some of the above symptoms, I want the following people to make decisions for me, see that I get appropriate treatment and to give me care and support:

I do not want the following people involved in any way in my care or treatment. List names and (optionally) why you do not want them involved:

Preferred medications and why:

Acceptable medications and why:

Unacceptable medications and why:

Acceptable treatments and why:

Unacceptable treatments and why:

Preferred treatment facilities and why:

Unacceptable treatment facilities and why:

What I want from my supporters when I am experiencing these symptoms:

What I don't want from my supporters when I experiencing these symptoms:

Things I need others to do for me and who I want to do it:

How I want disagreements between my supporters settled:

Things I can do for myself:

I (give, do not give) permission for my supporters to talk with each other about my symptoms and to make plans on how to assist me.

Indicators that supporters no longer need to use this plan:

I developed this document myself with the help and support of:

Signed: ___________________________ Date: _______________

Attorney: _________________________ Date: _______________

Witness: __________________________ Date: _______________

Witness: __________________________ Date: _______________

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Learn about alcohol and drug addiction treatment approaches that have been proven effective through scientific study.

This section presents several examples of addiction treatment approaches and components that have been developed and tested for efficacy through research supported by the National Institute on Drug Abuse (NIDA). Each approach is designed to address certain aspects of drug addiction and its consequences for the individual, family, and society. The approaches are to be used to supplement or enhance, not replace, existing drug addiction treatment programs.

This section is not a complete list of efficacious, scientifically based addiction treatment approaches. Additional approaches are under development as part of NIDA's continuing support of treatment research.

Source: National Institute of Drug Abuse, "Principles of Drug Addiction Treatment: A Research Based Guide."

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Quest for Freedom!

~ An insight into OCD ~ Obsessive Compulsive Disorder

Dear Diary,

What do I say about this month, I wonder? What words could possibly sum it all up? - Heartbroken, hurt, excited, proud, angered or just Stunned!!!

These are all emotions that I've had during this past month, and the best way to describe where I'm going in my life is to say I'm going with the flow, wherever that's taking me!

One door, the one that led to my ALMOST 11 year marriage seems to be closing shut in my face. I have no control over that, no choice and I can't keep it open no matter how I try. I am saddened, hurt and numbed by that; so numb, that I retreat into myself sometime's and just stare off into space...so my Mum tells me!

Yet the OCD now has two doors, one saying Negative, the other saying Positive. The negative door is closing more and more, whilst the positive is gradually opening. I am doing more to confront my OCD fears all the time and along with that I am getting some really positive encouragement back from all the Positive OCD stuff I'm doing.

A couple of weeks ago, I was asked to do a National Radio interview with BBC Radio Scotland, although I felt nervous of course, it was just a normal amount of nerves rather than the disabling amount of fear and worry that would have taken over me before and probably prevented me from doing it. I really enjoyed it and would love to do something like that again, but a year ago I never would have believed I could have done that.

There are some really special people out there in Cyberland who have become very good friends thanks to the Web Site, and they help and support me as much as I do them. In fact, to be really honest, I think I would have given up altogether without their kind shoulders to lean on! I hope they know who they are. Thank you. :o)

Out of it all, some good has happened; freedom, loving friendships and more fulfillment in my life. Of course, there are plenty of times when it also feels like there's a huge loss and a part of me will always be missing, but for now though, I'm just plodding on and going along with the flow, trying to be supportive to any one who needs it and as a byproduct getting some support and happiness back. I'm not looking ahead too far or planning my future. I'm just taking some of my own advise and taking each day as it comes.

Because I am living out of the 3 mile catchment area of my Dr's. surgery, I have had to register with a new one closer. I remember how terrified I was with the last one! These people just don't understand, it took me 10 years to get enough courage to go to the other one! I was dreading it, but I knew it had to be done and so I gritted my teeth and did it. Of course, I came out feeling relieved!

Thanks for being there guys, and thanks to everyone who's signed my OCD bulletin board. The kind words and uplifting messages really, really help me, especially right now when so much in my life is unknown and uncertain. I guess you all give me reasons to carry on.

Well! that's all I can think of to say at the moment. Don't lose faith in your abilities everyone! I'm trying very hard not to lose faith in mine!

Love ~Sani~

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May 7, 2001 (but it's not officially May's entry)

Dear Diary,

I've been feeling quite down the last couple of days, and a bit numb. I thought I was handling my marriage crisis quite well.

I've been getting on with stuff and trying really hard to keep it from dominating my thoughts. Trouble is, something else upset me and that made it flood into my mind. I know that I had to do what I did. I know I wasn't getting well where I was, and I know I wanted to go home long ago, but it's so sad that my husband couldn't or wouldn't see it like that.

I've been working on getting control of the OCD for the both of us, and instead there's just me. I'm used to being 2 not 1; it's lonely sometime's. I miss us, especially now that I can do so much. Memories of us, before the OCD got such a strong hold on me, come into my head all the time, and make me sad, because they're gone and we might not make any more memories together.

The illness made me isolated from all my friends. They've now moved on with their lives, and it takes time to make new ones.

I'm not sure if I've fully accepted that my marriage could be over...... first time I've written that.:( Since I saw Phil last I haven't heard from him at all. That really hurts. It feels like I've been pushed out of his life completely, like "we" never existed and I don't really understand why.

The thing is, I can't and won't let the OCD take over again though. I mustn't, else that would mean it was all for nothing. Sometime's, it's like I have to be SO strong and keep in control and together, but inside my heart is broken into pieces. My confidence has taken a battering, and it hurts to look forward, because I just see me....that's all, just me. :(

Off to bed now...... think I need some sleep, take care folks, love ~Sani~ xx

If I could tell the world just One thing
it would be that we're all okay,
And not to worry cause worry is wasteful
and useless in times like these.

I won't be made useless,
Won't be idle with despair.
I'll gather myself around my faith,
It lights the darkness most feared.

"Hands" ~ Jewel
"In the end, only kindness matters."

Love ~Sani~

next: My Obsessively Clean Diary: July 2001
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Quest for Freedom!

~ An insight into OCD ~ Obsessive Compulsive Disorder

Dear Diary,

Here come's the rain again!" Today is a total wash out! It's been raining all day. So much for Summer!

I'm not feeling quite as spaced out as I did yesterday, thank goodness! I felt really numb all day and had for a couple of days. It was like I was invisible and silent and watching life around me but not really able to take part in it. A very weird feeling.

I stayed at my Mum's last week and continued to make small progress with the OCD. I normally wouldn't dare go into certain shops in the town there (too much contamination!) and wouldn't go into the town on Saturdays, but I managed to do both and had a really nice visit with my Mum.

It was Dad's Birthday at the weekend, so we took presents and cards to him in the Nursing home which was great. There have been too many birthdays where I haven't been able to see family. My Dad doesn't have as good an understanding of OCD as my Mum, but he does know I'm doing well and encourages me.

Whilst at Mum's, I spoke on the phone to Phil, then wished I hadn't! as he admitted to being "in love," with the woman he's having the affair with. That began my feeling of numbness, I think. It seems I finally have to accept my relationship with him is over. If only he'd given us a chance. All those years taken up by OCD, denying us a "normal," marrige and now just when we could be enjoying our lives together he has to go and find a "replacement," someone who he has no foundation with or memories to share.

Phil and I met when we were both 19 and married when we were 26. So we were together for 17 years! That's a long time, especially if you become virtually isolated with that person, almost as if you're on a deserted island, just the two of you. I feel such a huge loss in my life that I am really finding it hard to come to terms with. Imagine if you and the person closest to you were the only two people on earth and they disappeared. That lonliness and isolation is what I'm feeling all the time and sometimes I just can't bear it. When that happens, I always seem to get really tired and need to sleep, as if my mind can't cope anymore and needs to switch off for a while.

The down side to doing so much more in my life and allowing myself to keep getting "contaminated," is that I feel the need to wash my hands more. Although only once at a time and not as I used to have to do ~ a case of my having to stand at the sink washing my hands over and over again until they were red and sore!

I will sign off for now, hope everyone reading this is okay and staying determined.

Love ~Sani~

next: My Obsessively Clean Diary: October 2001
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Tools for helping your child develop positive self-talk and constructive ways to deal with everyday problems.

Parents of children with Attention-Deficit/Hyperactivity Disorder (AD/HD) and/or learning disabilities (LD) daily contend with some very challenging parenting tasks. Whether you're facilitating home-school communication, providing support with schoolwork, or responding to your child's social and emotional issues, parent advocacy is critical to your child's happiness and success. Yet, you may spend so much energy trying to help make the outside world more manageable for your child that you find yourself on "low fuel light" when behavior problems arise at home. I've developed a parent coaching system that involves proactive intervention, with parents acting as guides for their children's behaviour both at home and in the "real world."

The Self-Control and Social Skills Challenge

If your child has AD/HD and/or LD, you're probably well aware of any problems she has with self-control and social skills. Typical problems include:

• Low tolerance for frustration and disappointment
• Difficulty making sound decisions
• A limited repertoire of social skills

These problems may cause frequent conflict between you and your child at home. In an effort to curtail problems, many parents turn to the traditional behavior management technique of reward and punishment. While that approach has certain benefits, it doesn't promote self-control and good decision-making in children. The reward-and-punishment approach may also place the parent in an adversarial role with the child.

As a child psychologist who specializes in the treatment of ADHD and LD, I devote much of my time to training parents and children to use a coaching program that promotes self-control and social skills. The parent coaching approach stresses the importance of viewing a child's behaviour as a "window" through which to assess her skills. Coaching teams up parent and child to practice strategies for coping with the hurdles of AD/HD and LD.

A Child's "Thinking Side" vs. "Reacting Side"

Coaching is ideally suited to the needs of children with AD/HD and LD. Problems with impulsivity, persistence, and judgment are addressed by the parent coaching principles of preparation, practice, and review. You approach your coaching role with a practical framework for helping your child understand what goes wrong. Underlying this framework are the concepts of your child's "thinking side" and her "reacting side."

The thinking side is the part of your child's mind that makes good decisions and watches over her behaviour.

The reacting side is the part of your child's mind that reacts emotionally, and without thinking, to certain events in her life. This common sense framework paves the way for you to introduce your child to related concepts, such as triggers, helpful self-talk, power talk, and figuring out the clues and self-instructions in life.

The Verbal Playbook

I recommend that as a parent coach, you establish and maintain a safe and trusting dialogue with your child. The goal is to help your child with AD/HD or LD break new ground by understanding her own struggles. Ideally, you will possess a calm voice, nurturing demeanour, and open mind. It's also helpful to acknowledge your own triggers. Perhaps most important is a readiness to listen to your child's point of view, paying careful attention to the words that reflect her perceptions and beliefs. This provides a glimpse into the self-talk landscape that fuels your child's reacting side behaviours and makes it so difficult for her to learn from her mistakes. As the parent-child dialogue proceeds, you'll want to refer back to your child's words to illustrate how negative self-talk impedes positive change. You can bolster your child's willingness to discuss her troubles by your choice of words. Saying, "Now that I've heard your side, maybe there's a lesson for both of us to learn," can help soothe her raw emotions. Rather than sounding like a judging adversary, you are perceived as an ally.

Touching on Triggers

Triggers are situations, or "hot buttons," that tend to set us off. You might start by telling your child about your own triggers (which she may already be well aware of!). You might say something like this: "We all have triggers that set off our reacting side, like when I get really angry with myself for misplacing things." Next explain that if we are willing to calmly discuss what has taken place, not only can we learn to watch out for triggers but we can use strategies to keep our thinking side in charge. This gesture opens up a pathway for you to offer knowledge and tools to reveal your child's triggers and develop a game plan for correction.

Typical triggers that heat up the reacting side in children with AD/HD and LD fall into three broad categories:

• Self esteem (or "pride injuries")
• Frustration of desires (or "not getting what I want")
• Social encounters (or "dealing with people")

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Provide details of what you observe and how your child's reacting side gets her into trouble. For example, you might tell your child, "When your brother calls you a name (social encounter), your reacting side is quickly triggered and you throw a tantrum." Don't Take the Bait!

Next, present a proactive solution to your child. "We can prepare your thinking side to stay in control by planning what you'll say to yourself (helpful self-talk) and what you'll say to your brother (power talk). That way you don't take his bait." Explain that being "baited" by people, or even situations, is both common and controllable.

You can reinforce the self-control goal of "not taking the bait" by explaining the importance of helpful self-talk and power talk when facing triggers. "If you are prepared for baiting, and you tell yourself, 'I'm not going to take his bait,' and simply say to him, 'I see what you're doing, and I'm not going there,' you'll keep your cool." Such a dialogue epitomizes the kid-friendly "verbal playbook" that parents and kids build as they review triggers. During role-play, you might play the role of the "baiter," while your child rehearses her self-talk and power talk strategies.

Coaching to Win

Parent coaching is a way to help your child develop the self-control and social skills required in today's complicated, fast-paced world. It also provides you with a pathway to make the most of "teachable moments" when gaps appear between your child's skills and outside expectations. When engaged in the safety of a coaching dialogue, your child will welcome these concepts with interest and openness, realizing in the long run she will reap the benefits of empowerment.

The Parent Coach: A New Approach to Parenting in Today's Society

19.95 from http://www.parentcoachcards.com/

This resource is built around the accompanying Parent Coaching Cards, tools already proven effective in teaching children the social and emotional skills important to their everyday lives. Step-by-step instructions for using the cards make it easy for parents, teachers, and mental health professionals to "partner" with children to achieve targeted goals. This innovative product, praised for its commonsense approach, is simple to use, portable, and effective. You can expect reduced parent-child conflict, better communication among family members, and improved academic and social success. With a chapter devoted to each of the 20 eye-catching cards, users will have all the guidance they need to create positive relationships with children and happier homes.

About the author: Dr. Richfield is a child psychologist who has produced The Parent Coaching Cards and the book: The Parent Coach: A New Approach to Parenting in Today's Society. He has written many articles on ADHD, which I am sure will be of real help to many parents. http://www.parentcoachcards.com/

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6. Is the use of medications like methadone simply replacing one drug addiction with another?

No. As used in maintenance drug addiction treatment, methadone and LAAM are not heroin substitutes. They are safe and effective medications for opiate addiction that are administered by mouth in regular, fixed doses. Their pharmacological effects are markedly different from those of heroin.

As used in maintenance treatment, methadone and LAAM are not heroin substitutes.

Injected, snorted, or smoked heroin causes an almost immediate "rush" or brief period of euphoria that wears off very quickly, terminating in a "crash." The individual then experiences an intense craving to use more heroin to stop the crash and reinstate the euphoria. The cycle of euphoria, crash, and craving - repeated several times a day - leads to a cycle of addiction and behavioral disruption. These characteristics of heroin use result from the drug's rapid onset of action and its short duration of action in the brain. An individual who uses heroin multiple times per day subjects his or her brain and body to marked, rapid fluctuations as the opiate effects come and go. These fluctuations can disrupt a number of important bodily functions. Because heroin is illegal, addicted persons often become part of a volatile drug-using street culture characterized by hustling and crimes for profit.

Methadone and LAAM have far more gradual onsets of action than heroin, and as a result, patients stabilized on these addiction medications do not experience any rush. In addition, both medications wear off much more slowly than heroin, so there is no sudden crash, and the brain and body are not exposed to the marked fluctuations seen with heroin use. Maintenance treatment with methadone or LAAM markedly reduces the desire for heroin. If an individual maintained on adequate, regular doses of methadone (once a day) or LAAM (several times per week) tries to take heroin, the euphoric effects of heroin will be significantly blocked. According to research, patients undergoing maintenance treatment do not suffer the medical abnormalities and behavioral destabilization that rapid fluctuations in drug levels cause in heroin addicts.

Source: National Institute of Drug Abuse, "Principles of Drug Addiction Treatment: A Research Based Guide

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Summary of laws concerning taking supplies of ADHD medication in or out of the UK.

We get a number of people contacting us about the issue of taking supplies of ADHD medication out of the UK when they go on holiday. We also get people contacting us from outside the UK who are coming to the UK on holiday or for longer periods of time.

We have contacted the Home Office who have sent us copies of the regulations, which we have copied later in this Information Sheet.

However we have summarised this initially but would recommend that if anyone is thinking of travelling they should read the information from the Home Office in this sheet or to contact the Home Office direct on 0207 0350472 and ask for the Drug Information Department who will be able to advise you further.

Summery of Information from the Home Office

Taking any controlled medication out of or bringing to the UK is subject to import or export conditions and need to be declared at the customs at any port of exit or entrance.

Methylphenidate - Ritalin, Equasym, Concerta

Dexamphetamine Sulphate

ADDerall

All come into this category.

As the regulations stand at the moment it is OK to travel with Controlled Drugs into or out of the UK provided the amount is no more than 3 months supply and does not exceed 900mgs - an update here as at May 2007 the Home Office only now issue a license if you are going to be out of the UK for a month or more - so basically if you are just going on a two week holiday, you are no longer required to have the license. However, it is advisable, even if you are travelling with less than this amount, that you get a letter from your doctor giving:

• The name of the medication both generic and brand name
• saying that you are prescribed the medication
• what it is prescribed for
• the accurate dosage per day
• strength of medication
• total quantity to be taken out of / into the country
• the patient's name, address, date of birth
• the country of destination and departure,
• return date to the UK or the country you are visiting the UK from

However there are still some countries which have different regulations, so you can check the information from the Home Office below for more details of these countries and the particular regulations and relevant contact details below.

It is also a good idea to check out the details for the ID Card produced by the Milton Keynes Support Group as this is another good way of proving who you are and that you have been prescribed the medication.

If you are going out of / or visiting the UK for longer than 3 months, you would need to follow the Home Office Regulations below. It is also worth remembering that a doctor will normally only give supply for one month in advance anyway.

You should also contact the Embassy for any Country you are visiting before you intend to travel to confirm any particular regulations they have and how you can sort out the prescribing of medication in the Country you are travelling to and to ask for details of a doctor you can register with on a temporary basis to enable you to continue with your medication whilst away.

The Embassy should be able to put you in touch with someone before you travel to arrange treatment whilst away. You need to remember that there are some places where the condition of ADD/ADHD is not so well recognised, so make sure you find out all information well in advance of any travel. It would also be worth speaking to your prescribing doctor for details of your medication including dosage and any reports which you can take with you to confirm your diagnosis to any temporary doctor you have to see whilst away.

 

Copy of Information from the Home Office including relevant medication details:

Personal import/export licences are issued to travellers who are carrying controlled drugs abroad (or in the case of an import licence, into the UK) for short periods for their own personal use. They are issued in circumstances where the total amount being carried exceeds the maximum amounts shown on the Open General Licence List (See 1.5) and where the period of travel does not exceed 3 months.

 

Where the total quantity of the drug being carried does not exceed the aximum amount shown on the Open General Licence List, patients can be advised that they do not need a licence - a covering letter from their prescribing doctor will suffice.

Licences are issued to expire one week after the expected return date to the UK (or one week after the expected date of departure from the UK in the case of an import licence).

A personal licence has no standing outside the UK and is merely a document which allows travellers to pass through UK Customs unhindered. Travellers should, therefore, be advised to contact the Embassy or Consulate of their country of destination (or any country through which they may be travelling) to check that there are no regulations or problems concerning that particular drug before embarking upon their journey.

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Information required

In order to issue a Personal Licence, we will require a letter from the patient's prescribing doctor advising:-

1) Patient's name, address and date of birth
2) Country of destination
3) Dates of departure and return to the UK
4) Details of the drug - name, form (eg tablets), strength and total quantity to be taken out of the country.

A minimum of 14 days notice is required to ensure licences are issued in good time (although we can issue at shorter notice if expedient)

Licences are normally sent direct to the patient - if for example, the clinic want the licence sent to them, they should be advised to make this clear on their letter of application.

Where a particularly large amount of a controlled drug is to be carried (particularly Methadone), the request must be referred to the Inspectors before the licence is issued.

There is a specific form which the GP has to fill in on your behalf giving all the information needed by the Home Office and this can be downloaded here and more information can be found at the Home Office Site for Drugs Information Click Here. There is a copy of the form again along with Guidelines for Drug limits for travellers - however although we have added the link to the page you need to go to for this I have not been able to access the page they link to to actually download these guidelines at the moment - I am investigating this and will update as soon as possible! Click Here

There is also a complete guide to the drugs that are clasified as needing license for travelling abroad - this does not only include Methylphenidate but a number of other medications which perhaps were not considered normally so this is certainly worth a look if you are travelling Click Here.

1.1 Sweden, Greece, Netherlands, Thailand, Tunisia and Turkey- Special Requirements

Sweden Travellers to Sweden carrying more than 5 days supply of controlled drugs will require permission from the Swedish authorities. The licence must not be issued until permission has been granted and a minimum of 14 days notice is required.
Contact: Patrik Moberg, Medical Products Agency, Box 26, S-751 03 Uppsala, Sweden Tel: 46 18 54 85 66 Fax: 46 18 17 46 00

Greece
Travellers must ensure that they carry with them, in addition to the licence, a doctor's prescription and report relating to the drug(s) they are carrying. They should also ensure that they have a sufficient supply for the duration of their stay in Greece. Period of travel should not exceed 1 month.

Netherlands
Import of controlled drugs for personal use is not permitted. Travellers can obtain controlled drugs once in Holland and should be advised to carry a letter from their doctor confirming the drug, dosage etc so that they can apply to a doctor once there.

Thailand
No more than 1 month's supply of Morphine Sulphate to be imported for personal use. Also travellers should be advised to contact the Thai Embassy well in advance of travelling to check that there are no problems with bringing in controlled drugs.

(Above information for these countries accurate as at May 2000 but may well have changed so travellers should still be recommended to contact the appropriate Embassy to check whether these requirements still apply.)

Tunisia (Current information as at 11/12/01)
Travellers going to Tunisia should contact the Tunisian Embassy in London, as a licence allowing controlled drugs to be taken into Tunisia will need to be issued by the Tunisian Ministry of Health.

Turkey (Current information as at 27/9/01)
Turkish Authorities require that licences are legalised by the Foreign Office. Travellers should be advised to contact the Turkish Consulate for advice and guidance on how to do this. The FCO's Legalisation Department also provides an automated phone service, which provides information on how to get documents legalised. The telephone number is 020 7008 1111.

1.2 Travellers to Spain (as from 25/5/01)

Travellers to Spain (including Canary Islands and Balearic Islands) will also require an import licence issued by the Spanish Consulate. When issuing the licence we should enclose a notification letter (see 'F' drive - Spain letter) advising the patient to contact their nearest Spanish Consulate (see Appendix II for phone & fax numbers) with:

1) Flight details - airports and flight numbers
2) The address where they will be staying in Spain

This information is required by the Spanish authorities to enable them to issue an import licence.

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1.3 Periods of travel exceeding 3 months duration

Licences can only be issued for a maximum period of 3 months. Travellers who will be abroad for longer periods should be advised to register with a doctor in the country of their destination to obtain further supplies of prescribed controlled drugs.

In the case of visitors to the UK, they should be advised to register with a doctor in the UK - the Dept. of Health will advise them on how to go about this.

Phone numbers:-

Tel: 0113 254 6315 (Prescribers) / 020 7972 4174 (Drug Misusers)

1.4 Open General Licence List

(List of controlled drugs and permitted quantities)

There is a longer list than this one but we have only used information for the main medication for ADD/ADHD

Ritalin/Methylphenidate Hydrochloride 900mgs
Dexamphetamine Sulphate 900mgs
Dexamphetamine 300mgs
ADDerall is a single entity amphetamine product combining the neutral sulfate salts of dextroamphetamine and amphetamine, with the dextro isomer of amphetamine saccharate and d, l-amphetamine aspartate. Therefore it is likely to be classed in the same way.

EMBASSIES AND CONSULATES
Country Representative Telephone Number

(we at adders.org have only included a few off of the Home Office List here - the ones mentioned above along with USA, Australia, South Africa and New Zealand for contact information for other Countries you would need to contact the Home Office direct)

America Embassy 020 7499 9000 (Ext. 2772)

Australia High Commission 020 7379 4334

Greece Consulate-General 020 7221 6467, 020 7229 3850

Netherlands Embassy 020 7590 3200

New Zealand High Commission 020 7930 8422

Spain

Spanish Consulate (London) Tel: 020 7594 0120 or 0121
Fax: 020 7581 7888

Spanish Consulate (Manchester) Tel: 0161 236 1262 or 1233
Fax: 0161 228 7467

Spanish Consulate (Edinburgh) Tel: 0131 220 1843 (Adela Pilar)
Fax: 0131 226 4568

South Africa Embassy 020 7930 4488
High Commission 020 7451 7299

Thailand Embassy 020 7589 2944 (Ext. 118)

Tunisia Embassy 020 7584 8117

Turkey Consulate 020 73930202 Ext: 231
020 7245 6318 (Customs Dept)

We have recently been asked about taking medication into Japan and as it was so far not on the above list I did a bit of digging around and actually spoke to someone at th Japanese Embassy who told me that Methylphenidate is allowed to be taken into Japan but only 1 month supply - 30 days.

It would also be helpful to have an official doctor or specialists letter to accompany you for this as we set out above as she did also say that some official documentation would be helpful too.

You can contact the Japanese Embassy on: Tel: 0207 465 6500

If you are visiting the UK then you would need to contact the British Embassy in your own Country before travelling.

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Journal Articles and Book Chapters

• Peele, S. (1981), Reductionism in the psychology of the eighties: Can biochemistry eliminate addiction, mental illness, and pain?American Psychologist, 36, 807-818.
• Peele, S. (1997), Utilizing culture and behavior in epidemiological models of alcohol consumption and consequences for Western nations, Alcohol & Alcoholism, 32, 51-64.
• Peele, S. & DeGrandpre, R.J. (1998), Cocaine and the concept of addiction: Environmental factors in drug compulsions.Addiction Research, 6, 235-263.
• Peele, S. (1998, Spring), Ten radical things NIAAA research shows about alcoholism. The Addictions Newsletter (The American Psychological Association, Division 50), 5(2), pp. 6; 17-19.
• Peele, S. (1998), The results for drug reform goals of shifting from interdiction/punishment to treatment. International Journal of Drug Policy,9, 43-56.
• Peele, S. (1999), The fix is in. A Commentary on "The Fix" (Massing, 1998) and "An Informed Approach to Substance Abuse" (Kleiman, 1998)International Journal of Drug Policy, 10, 9-16.
• Peele, S. (1999), Promoting positive drinking: Alcohol, necessary evil or positive good? In: S. Peele & M. Grant (Eds.), Alcohol and pleasure: A health perspective, Philadelphia: Brunner/Mazel, pp. 375-389.

Pamphlets

• Peele, S. (1980), The addiction experience. Center City, MN: Hazelden. Modified from two-part article that appeared in Addictions (Ontario Addiction Research Foundation), Summer, 1977, pp. 21-41; Fall, 1977, 36-57.

Magazine Articles

• Peele, S., & Brodsky, A. (1974, August), Love can be an addiction.Psychology Today, pp. 22- 26.
• Peele, S. (1978, September), Addiction: The analgesic experience.Human Nature, pp. 61-67.
• Peele, S. (1996, March/April), Telling children all drinking is bad is simply not true. Healthy Drinking.
• Peele, S. (1998, March/April), All wet. The gospel of abstinence and twelve-step, studies show, is leading American alcoholics astray. The Sciences, pp. 17-21.
• Peele, S. (2001, Summer), Change is natural. This is why therapists and helpers must embrace natural processes.SMART Recovery News & Views, pp. 7-8.
• Peele, S. (2002, May), Hungry for the next fix. Behind the relentless, misguided search for a medical cure for addiction. Reason, pp. 32-36.
• Peele, S. (2002, August), Harm Reduction in Clinical Practice.Counselor: The Magazine for Addiction Professionals, pp. 28-32.
• Peele, S. (2004, July), Is AA's loss psychology's gain?Monitor on Psychology, Volume 35, No. 7 July/August 2004, p. 86.
• Peele, S. (2004, May-June), The surprising truth about addiction. Psychology Today, pp. 43-46.

Newspaper Articles

• McCarley, A., & S. Peele (2006, February 2), Author's true milestone lost in controversy. The Atlanta Journal-Constitution.
• Peele, S. (2006, October 18), Hail the revelation. A spell in 'rehab' is all the rage among public figures. But what's behind their sudden urge to get clean, and does it send out the wrong messages?The Guardian.

Internet Publications

• Peele, S. (2004), The crack baby myth can itself be damaging.The Stanton Peele Addiction Website.
• Peele, S. (2005, October), Combating the Addictogenic Culture. The Stanton Peele Addiction Website.
• Peele, S. (2006), Marijuana Is Addictive - So What?The Stanton Peele Addiction Website. Also available in Hungarian.
• Peele, S., & A. McCarley (2006, February), James Frey Told One Essential Truth. The Stanton Peele Addiction Website.
• Peele, S., & A. McCarley (2006, February), James Frey's One True Thing. The Stanton Peele Addiction Website.

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Rosemary is an herbal remedy used to improve memory, relieve muscle pain and spasm, relieve menstrual cramps, and stimulate hair growth. Learn about the usage, dosage, side-effects of Rosemary.

Botanical Name:Rosmarinus officinalis 

• Overview
• Plant Description
• Parts Used
• Medicinal Uses and Indications
• Available Forms
• How to Take It
• Precautions
• Possible Interactions
• Supporting Research

Overview

Rosemary (Rosmarinus officinalis) is widely used as a culinary herb, especially in Mediterranean dishes, and is also used as a fragrant additive in soaps and other cosmetics. Traditionally, rosemary has been used by herbalists to improve memory, relieve muscle pain and spasm, stimulate hair growth, and support the circulatory and nervous systems. It is also believed to affect the menstrual cycle, act as an abortifacient (inducing miscarriage), relieve menstrual cramps, increase urine flow, and reduce kidney pain (for example, from kidney stones). Recently, rosemary has been the object of laboratory and animal studies investigating its potential in the prevention of cancer and its antibacterial properties.

Plant Description

Native to the Mediterranean area, rosemary is now cultivated widely in other parts of the world, although it thrives in a warm and relatively dry climate. The plant takes its name from rosmarinus, a Latin term meaning "sea dew." It is an erect evergreen shrub that can grow to a height of six and a half feet. The woody rootstock bears rigid branches with fissured bark. The long, linear, needle-like leaves are dark green above and white beneath. Both the fresh and dried leaves are pungent. The small flowers are pale blue. The leaves and parts of the flowers contain volatile oil.

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Parts Used

The leaves and twigs of the rosemary plant are used for culinary and medicinal purposes.

Medicinal Uses and Indications of Rosemary

Food Preservation

Most evidence for rosemary's medicinal uses comes from clinical experience rather than from scientific studies. However, recent laboratory studies have shown that rosemary slows the growth of a number of bacteria such as E. coli and S. aureus that are involved in food spoilage, and may actually perform better than some commercially used food preservatives.

Alopecia

As stated above, one traditional use of rosemary has been to try to stimulate hair growth. In one study of 86 people with alopecia areata (a disease of unknown cause characterized by significant hair loss, generally in patches), those who massaged their scalps with rosemary and other essential oils (including lavender, thyme, and cedarwood) every day for 7 months experienced significant hair re-growth compared to those who massaged their scalps without the essential oils. It is not entirely clear from this study whether rosemary (or a combination of rosemary and the other essential oils) was responsible for the beneficial effects.

Cancer

Both laboratory and animal studies suggest that rosemary's antioxidant properties may have activity against colon, breast, stomach, lung, and skin cancer cells. Much more research in this area, including trials involving people, must be conducted before conclusions can be drawn about the value of rosemary for cancer.

Available Forms

• Dried whole herb
• Dried, powdered extract (in capsules)
• Preparations derived from fresh or dried leaves, such as tinctures, infusions, liquid extract, and rosemary wine
• Volatile oil (to be used externally, not to be ingested)

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How to Take It

Pediatric

There are no known scientific reports on the medicinal use of rosemary in children. Therefore, it is not currently recommended for this age group.

Adult

Listed below are the recommended adult doses for rosemary. (Total daily intake should not exceed 4 to 6 grams of the dried herb.):

• Tea: 3 cups daily. Prepare using the infusion method of pouring boiling water over the herb and then steeping for 3 to 5 minutes. Use 6 g powdered herb to 2 cups water. Divide into three small cups and drink over the course of the day.
• Tincture (1:5): 2 to 4 mL three times per day
• Fluid extract (1:1 in 45% alcohol): 1 to 2 mL three times per day
• Rosemary wine: add 20 g herb to 1 liter of wine and allow to stand for five days, shaking occasionally

Externally, rosemary may be used as follows:

• Essential oil (6 to 10%): 2 drops semisolid or liquid in 1 tablespoon base oil
• Decoction (for bath): Place 50 g herb in 1 liter water, boil, then let stand for 30 minutes. Add to bath water.

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Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.

Rosemary is generally considered safe when taken in recommended doses. However, there have been occasional reports of allergic reactions. Large quantities of rosemary leaves, because of their volatile oil content, can cause serious side effects, including vomiting, spasms, coma and, in some cases, pulmonary edema (fluid in the lungs).

Those who are pregnant or breastfeeding should not use rosemary in quantities larger than those normally used in cooking. An overdose of rosemary may induce a miscarriage or cause damage to the fetus.

Rosemary oil, taken orally, can trigger convulsions and should not be used internally. Topical preparations containing rosemary oil are potentially harmful to hypersensitive people who may be allergic to camphor.

Possible Interactions

Doxorubicin

In a laboratory study, rosemary extract increased the effectiveness of doxorubicin in treating human breast cancer cells. Human studies will be necessary to determine whether this is true in people. Meanwhile, those taking doxorubicin should consult with a healthcare practitioner before taking rosemary.

Supporting Research

al-Sereiti MR, Abu-Amer KM, Sen P. Pharmacology of rosemary (Rosmarinus officinalis Linn.) and its therapeutic potentials. Indian J Exp Biol. 1999;37(2):124-130.

Aruoma OI, Spencer JP, Rossi R, et al. An evaluation of the antioxidant and antiviral action of extracts of rosemary and Provencal herbs. Food Chem Toxicol. 1996;34(5):449-456.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:326-329.

Brinker F. Herb Contraindications and Drug Interactions. Sandy, Ore: Eclectic Medical Publications;1998:117.

Chan MM, Ho CT, Huang HI. Effects of three dietary phytochemicals from tea, rosemary and turmeric on inflammation-induced nitrite production. Cancer Lett. 1995;96(1):23-29.

Chao SC, Young DG, Oberg J. Effect of a diffused essential oil blend on bacterial bioaerosols. Journal of Essential Oil Research. 1998;10:517-523.

Debersac P, Heydel JM, Amiot MJ, et al. Induction of cytochrome P450 and/or detoxication enzymes by various extracts of rosemary: description of specific patterns. Food Chem Toxicol. 2001;39(9):907-918.

Elgayyar M, Draughon FA, Golden DA, Mount JR. Antimicrobial activity of essential oils from plants against selected pathogenic and saprophytic microorganisms. J Food Prot. 2001;64(7):1019-24.

Foster S, Tyler V. The Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 4th ed. New York: The Haworth Herbal Press; 1999:321-322.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical Economics Company; 2000:645-646.

Hay IC, Jamieson M, Ormerod AD. Randomized trial of aromatherapy. Successful treatment for alopecia areata. Arch Dermatol. 1998;134(11):1349-1352.

Ho CT, Wang M, Wei GJ, Huang TC, Huang MT. Chemistry and antioxidative factors in rosemary and sage. Biofactors, 2000;13(1-4):161-166.

Huang MT, Ho CT, Wang ZY, et al. Inhibition of skin tumorigenesis by rosemary and its constituents carnosol and ursolic acid. Cancer Res. 1994;54(ISS 3):701-708.

Lemonica IP, Damasceno DC, di-Stasi LC. Study of the embryotoxic effects of an extract of rosemary (Rosmarinus officinalis L.) Braz Med Biol Res. 1996;19(2):223-227.

Martinez-Tome M, Jimenez AM, Ruggieri S, Frega N, Strabbioli R, Murcia MA. Antioxidant properties of Mediterranean spices compared with common food additives. J Food Prot. 2001;64(9):1412-1419.

Newall C, Anderson L, Phillipson J. Herbal Medicines: A Guide for Health-care Professionals. London, England: Pharmaceutical Press; 1996: 229-230.

Offord EA, Macé K, Ruffieux C, Malne A, Pfeifer AM. Rosemary components inhibit benzo[a]pyrene-induced genotoxicity in human bronchial cells. Carcinogenesis. 1995;16(ISS 9):2057-2062.

Plouzek CA, Ciolino HP, Clarke R, Yeh GC. Inhibition of P-glycoprotein activity and reversal of multidrug resistance in vitro by rosemary extract. Eur J Cancer. 1999;35(10):1541-1545.

Schulz V, Hansel R, Tyler V. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer; 1998:105.

Singletary KW, Rokusek JT. Tissue-specific enhancement of xenobiotic detoxification enzymes inmice by dietary rosemary extract. Plant Foods Hum Nutr. 1997;50(1):47-53.

Slamenova D, Kuboskova K, Horvathova E, Robichova S. Rosemary-stimulated reduction of DNA strand breaks and FPG-sensitive sites in mammalian cells treated with H2O2 or visible light-excited Methylene Blue. Cancer Lett. 2002;177(2):145-153.

Wargovich MJ, Woods C, Hollis DM, Zander ME. Herbals, cancer prevention and health. J Nutr. 2001;131(11 Suppl):3034S-3036S.