Drug addiction counselling

Who actually comes

Rarely the person the word "addict" conjures. Far more often: someone in their thirties or forties, working, mortgaged, functioning — using cocaine most weekends and increasingly some weekdays, or smoking cannabis every evening to switch off and no longer able to sleep without it, or taking prescription medication in doses that stopped matching the prescription some time ago.

People in this position usually delay getting help for years, because they do not fit the picture and are afraid of being treated as though they do.

What I work with

• Cocaine — including the specific pattern of weekend use that gradually annexes Thursday, then Wednesday, and the brutal comedowns that make the next use more likely.
• Cannabis — particularly daily evening use, tolerance, and the sleep and motivation problems that follow both from the use and from stopping.
• Stimulants and party drugs — MDMA, ketamine, amphetamines.
• Prescription medication — painkillers, benzodiazepines, sleeping tablets, where dependence has developed from legitimate use.
• Poly-drug use, including alongside alcohol, which is the norm rather than the exception.

The comedown problem

With stimulants especially, the drug creates the conditions for its own repeat. Cocaine depletes the systems that let you feel pleasure normally. The following two or three days are flat, anxious and low — often with a specific, crushing self-disgust that people describe as the worst part of the whole cycle.

That state makes the next use dramatically more likely, because you now have a problem to which the drug is the fastest known solution. It is the same loop as alcohol, running faster.

Understanding this matters, because it tells you where the intervention point is — it is not at the moment of use. It is in how you get through Monday and Tuesday.

How we work on it

1. Map the real pattern. Which days, with whom, after what. Most drug use is far more situational than people realise.
2. Deal with the comedown deliberately rather than white-knuckling it, because that is where the next use is decided.
3. Handle the social architecture. Certain people, certain places, certain group chats. This is often the hardest and most avoided part.
4. Build urge tolerance — riding out a craving instead of fighting it.
5. Work on shame, which for professional people with a secret drug habit is usually enormous and usually the thing keeping it hidden.
6. Rebuild round values. What the use is costing, and what you want instead.

Confidentiality, specifically

People ask this about drugs more than anything else, so to be direct: I do not report drug use to the police, your employer, your GP or anyone else. What you tell me stays between us, subject only to the narrow legal exceptions set out on the privacy page — which concern serious risk to life and the safety of children, not possession.