This is not a formal questionnaire and there are therefore no scores. However, its questions describe the progressive illness of chemical dependence.
Did any of the questions relate to you? Because if any of them did, you are dependent on drugs or alcohol. The more questions that apply to you, the worse the progression of your addiction or alcoholism.
Remember – an addict is somebody who goes on using drugs even though they are causing problems. An alcoholic continues to drink despite the problems drinking causes.
The questionnaire can also be used by the family and friends who suspect someone they love may have a problem with drugs or alcohol.
If you decide you have become dependent on a drug or on drink, do not be disheartened. Facing the reality of chemical dependence is the first step towards getting well.
Read on to discover how you can recover from this illness.

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Try to answer these questions honestly. Those who are drinking should substitute the word ‘alcohol’ for ‘drugs’.
1.   Do you need more drugs than you used to to get the same effect, or do you use drugs more often than you used to?
In the first stages of their illness, addicts find that their use of a drug increases as their tolerance for that drug grows. They need more drugs to get high, or they need them more often. In the same way alcoholics may have a very hard head for alcohol, priding themselves on out-drinking their companions. This is because their tolerance for alcohol is growing.
2.   Do you experience temporary memory lapses or difficulties in keeping track of time?
Addicts find that they lose track of time, either because the drug is speeding them up, or because it is slowing them down so that they nod off. Alcoholics have memory lapses, when they cannot remember what they did or where they were. These are called ‘blackouts’. As the illness gets worse, time difficulties and blackouts increase in number and their onset becomes more unpredictable.
3.   Have you ever sneaked extra supplies of the drug?
Addicts often find they are sneaking off to their own room or to the lavatory in someone else’s house to take more drugs while nobody notices. Or they may steal their friends’ drugs. They may start searching other people’s medicine cabinets, or smoking the cannabis plant being grown by someone else.
If they use alcohol, they will start trying to get extra drinks at a party or to sneak in an extra round.
4.   Are you preoccupied with drug-using?
The mental obsession with drugs grows as the illness progresses. The addict begins to withdraw from those who do not use drugs, and to avoid their company. Most talk with fellow-users is about drugs, doing drugs, dealers and prices. Alcoholics talk about what they drank, pubs and drinking occasions. Other hobbies and interests fade away.
5.   Do you use drugs in a hurry?
More and more the addict uses drugs for the effect, and wants that effect quickly. To that end, using becomes more urgent. In the haste, needles are not sterilised. Standards deteriorate. There is a compulsive need for instant gratification, and to get drugs as quickly as possible the addict will do all kinds of things he or she would not normally have done. Addicts or alcoholics have no idea of putting off pleasure. Just as a baby howls and screams when his rattle falls out of the pram, so an addict will lose emotional control if anything comes between him and his drugs.
6.   Are you reluctant to talk to non-users about your use of drugs? Addicts soon begin to avoid all references to their drug habit. They are reluctant to talk about it to non-users, and may be angry if the subject is raised. They feel that other people should mind their own business about their drug-use, and will make them feel guilty about raising the subject. Alcoholics get angry if people suggest they drink too much.
7.   Do you sometimes lose control after the first drug or drink has been taken?
Addicts begin to feel they need more as soon as they have taken the first drink or drug. Their control over how much they take begins to vanish. They may be compelled to finish whatever drug supplies are available – even when they know they will have run out of the drug in the morning. Alcoholics may have to finish the bottle, cannot leave the bar till it closes, are always the last at a party. This loss of control may not occur every single time – but the results of taking the first drug or drink become increasingly unpredictable.
8.   Do you find yourself inventing alibis, excuses, inventions or downright lies to explain your drug-using?
Addicts soon begin to find alibis for their drug habit. They will rationalise their behaviour with a variety of excuses, reasons and explanations. These are invented to persuade themselves and others that they do not have a drug problem. Alcoholics behave in the same way.
9.   Have your family, or people you like, begun to say anything about your drug-using?
As the illness progresses, family and friends begin to notice. Their concern may take the form of anxious suggestions of medical treatment, nagging, rows, coaxing, extorting promises, threats or entreaties.
10.  Have you begun to spend too much money, run up debts, started handing out advice to others or spending time on fantasies and schemes which never get accomplished?
A sort of grandiosity sometimes begins to creep into the addict’s lifestyle. Feelings of being superior to colleagues or family begin to grow. Addicts and alcoholics may spend money recklessly, buying extravagant cars or presents for others, entertaining beyond their means, or leading a lifestyle which is out of their financial reach.
11.  Do you experience feelings of growing anger, or increasing fits of frustration?
A kind of inner anger or resentment begins to grow in the addict. Impatience and intolerance of others increases. The addict or alcoholic is increasingly touchy, over-sensitive or unable to take the slightest criticism.
12.  Do you have moments of remorse and guilt about your drug-using or your behaviour while using drugs?
In the beginning feelings of remorse and guilt grow in addicts and alcoholics. These vary from the remorse which follows bad behaviour, to feelings of guilt and unease which may occur at any time, even if there seems to be no apparent reason. Under the influence of this remorse, resolutions to give up or promises of better behaviour are made – only to be broken. In the end, some addicts feel nothing and show no moral sense at all. In their drug-using they are looking for relief from pain rather than for pleasure.
13.  Do you have spells when you abstain from drugs?
Addicts may change the pattern of their drug-using from daily using to spells of abstinence followed by using again. These days or weeks of abstinence may be part of a resolution to stop using-but there is always an excuse to start again. This can be a way of deluding themselves that they are not dependent. For there is a myth that if you can stop using drugs you are not an addict. But it is a myth, since all addicts can stop for a time. It is the way they start again, and again, and again that shows they are dependent. Alcoholics go on the wagon for a time in much the same way. Sometimes periods of abstinence – at home, in health farms or even in clinics and hospitals – are a way of trying to control the drug. After drying out and getting better physically, the addict feels able to start using again.
14.  Have you changed your pattern of using drugs?
In the battle to control their using, many addicts start changing their pattern of using. They may switch from one drug to another, claiming it was the previous drug that caused problems. They may change from snorting to injecting in order to maintain or increase the high. Or they may start taking prescription drugs, including methadone, claiming that these cannot harm them. Alcoholics may start switching drinks, claiming that drinking beer or wine only is the way to control their drinking.
15.  Have you lost friends you had before using drugs? Childhood friends, or work friends made before using drugs, begin to drop away as the addict’s life centres more and more around drugs. Friends are now chosen because of their mutual interest in drugs or drink.
16.  Have drugs affected your work?
Trouble at work begins to show in the addict’s life. Days lost through drug-use or drinking, warnings about irresponsible behaviour, or loss of promotion are the first signs. Later, jobs are lost, or sometimes the addict or the alcoholic resigns from a job before being fired. Those who are self-employed start losing work or clients. As the illness progresses, addicts have to use drugs to function. Then they cannot function properly because they have used drugs. This is the illness – first addicts start using drugs and then drugs start using them. Or, as the old proverb has it – man takes a drink: drink takes the man.
17.  Has the attitude of your family and friends towards you worsened? Family and friends who were once anxious and concerned about the addict’s drug-using or the alcoholic’s drinking now begin to lose patience. Addicts and alcoholics may find they are now thrown out of the family home.
18.  Have you had medical treatment, hospital treatment or residential treatment of any kind for your drug-use?
Addicts and alcoholics begin a round of medical establishments for their problem. Sometimes they are treated for drug dependence or alcoholism. At other times, doctors or clinics may diagnose them as suffering from depression or some other mental illness. These are often mistaken diagnoses and are convenient because they allow addicts to continue to deny their addiction.
19.  Do you feel growing resentments?
The inner anger of the addict and alcoholic grows. He or she blames others for everything. Even small setbacks produce inappropriate fury and resentment.
20.  Have you tried changing jobs, changing friends, changing homes or changing countries to escape your problem?
In an attempt to escape the growing pain of the problem, addicts and alcoholics start changing their outward circumstances. They may change jobs to avoid the stress that they themselves have created. They may change partners. They may try living in a new area in order to get away from dealers, drug-using friends, or drinking pals. They often start a new life abroad, in the hope that this will do the trick. Recovering addicts call this escape behaviour ‘doing a geographical’. They do not realise that through all these changes they take themselves and their drug or drink problem with them.
21.  Do you protect your supply of drugs?
Here are some of the things that addicts do to protect their supply: they have more than one hiding place for drugs or for bottles; they hide drugs even when they are living alone; they try to save part of the drug or drink for the next morning; they con the doctor into giving them more than one prescription; they have more than one doctor in order to get more than one prescription; they keep a spare prescription in case they run out; they collect drug paraphernalia; they purchase more drugs or drink before their supplies run low.
22.  Do you use drugs to get you started in the morning?
Some alcoholics start drinking in the morning just to get themselves together. In the same way, eventually addicts have to use drugs shortly after waking in the morning just to face the day.
23.  Do you do things under the influence of drugs that you would not have done before you started using drugs?
The addict’s behaviour begins to show signs of ethical deterioration. Drug-using affects behaviour. The addict may come to accept lower standards of behaviour. Often this behaviour is the direct result of being high; sometimes it will occur when the addict is in a period of temporary abstinence. Here are some of the things addicts and alcoholics have done while they were using or drinking: lied to loved ones; fiddled expenses; fiddled the housekeeping money; run up debts knowing they could not pay; stolen money from family; shoplifted; mugged people; had sex with people they did not like; had sex for money; stolen a friend’s drugs. By the end, most addicts and alcoholics show total and utter disregard for themselves and others.
24.  Are you using drugs more or less continuously now?
At the late stages of the illness, the addict may need to take drugs more or less continuously. Drugs are needed last thing at night, during the night, and first thing in the morning before getting out of bed. Addicts start keeping their supply by the bed. Alcoholics have a bottle within reach of the bed.
25.  Do you have indefinable fears?
Addicts and alcoholics suffer from fear which has no reason to it. They may also have inexplicable anxiety and panic attacks. An appalling sense of impending doom afflicts them.

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Case No.l : Jaswinder had almost ruined himself by drinking. When his family doctor was summoned for his check up, he told him that his kidneys had been damaged, and any intake of wine- even one drop of it – might act as a deadly poison.
Jaswinder said, he could not leave wine which was already a part of his life blood. “I can never get to sleep in the night without my “night peg”.
With great difficulty he was made to take the following combination of Floral remedies.
1. CHERRY PLUM : to upgrade his control of mind.
2. MIMULUS: to overcome his fear of sleeplessness in the absence of his “night peg”.
3. WALNUT to break his age-long link with drinking. The above combination given T.D.S for 3 months steered the patient clear of his age-old vice.
Case No.2 : Mrs. K. Kaur, a school teacher in G.T.B. Public school, came to the dispensary and spoke thus “Uncle, it is 9 A.M.now. I have been to the bath room 5 times between 8-9 a.m. Hardly do I reach my desk to teach the class, I feel the urge to urinate and go to the bath room”. With the 1st dose of Cherry Plum she felt substantial relief. One more dose taken after 1 hour relieved her completely.
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This is the 2nd method of preparing mother tinctures which is used for the flowers and twigs of the trees, bushes and plants, most of which bloom early in the year before there is much Sunshine.
Care should be taken to get the wild flowers or their bushes and plants from their natural habitat in jungles or mountains. Cultivated varieties of the Remedy Flowers such as Clematis, Cherry Plum, Gentain, Honey Suckle, Mimules, Rock Rose, Star of Bethlehem are not Suitable for Flower Remedies.
There are also several varieties of the following :
Centaury, Elm, Gentain, Heather. Honey Suckle, Mustard. Oak. Pine. Rock Rose, Scleranthus, Star of Bethlehem and Willow.
It would be well worth one’s while to check the plant or tree with the illustration and the botanical description before preparing any tincture.
The flowers and twigs are gathered at about 9 A.M on a fine sunny morning from many trees and plants of the Same Kind, in a stainless Steel saucepan about 6 pint capacity. Three quarters of the saucepan is filled with the dowering sprays, leaves and twigs (about four ounces) and covered with its lid.
It is carried back home as quickly as possible and the flowers and twigs are covered with two pints of spring water or bottled mineral water, and the sauce pan with cover removed, is placed over the heat till the water boils. During this operation, the flowers and twigs are pressed below the water by a twig of the same tree from time to time.
Take 2 small glass Jugs and one one-ounce glass bottle, sterilize them in boiling bottled mineral water (or spring water) and dry them and wrap The jugs in a clean cloth. When cold, the one-ounce bottle is half filled with brandy, properly corked and labelled with the name of the tincture of the Remedy lying in the sauce pan.
After the liquid in the Saucepan has cooled, the leaves and twigs are gently removed with a twig of the same tree, and the liquid allowed to stand for some time to enable the sediment to settle as much as possible.
The decantered liquid is poured gently in one of the small glass jugs. Again the liquid in this Jug is allowed to stand for sometime to allow further settlement of Sediment. Cover the 2nd Jug with two or three layers of blotting paper, and gently transfer the liquid from the first Jug without disturbing the Sediment underneath to the second Jug where it is filtered.
Fill the remaining half of the one-ounce bottle (half-filled with brandy) with this filtered essence.
The mother tincture is ready, from which Stock Bottles are prepared.
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The reader will be aware by now, if you are suffering from second stage stress breakdown symptoms, that you got this way by using your will-power to ignore the anxiety signals of nervous system overload.
However, if you are experiencing stage one symptoms only, and if you followed all my suggestions so far, you should not develop stage two symptoms. But if you do, you will not be afraid of them, because you know that the second stage symptoms of losing control of your emotions and being unable to ‘psych’ yourself or motivate yourself into doing something you don’t want to do, are just a sign that you must now rest, get help to relieve the stress, and that you must now get some more sleep.
Second stage symptoms are your marching orders, your instructions that this is the end of your ability to stay in the stressful situation without behaving abnormally.
In stage three breakdown you will not be aware, usually, that your abnormal behaviour is due to stress and you will not be able to do anything meaningful to help yourself. When you develop stage three stress symptoms, you will need a ‘rescuer’ to take over and help you.
Therefore, you should regard the symptoms of stage two breakdown, the loss of emotional control and the inability to motivate yourself as easily as before, as a potentially serious threshold not to step over.
If, however, you either choose or are forced to ignore these symptoms and try to continue on under the stress as before, then you will experience serious stress breakdown. If you are to be helped out of your stage three breakdown, the person helping you will have to take into consideration those factors which caused you to ignore the stage two stress breakdown symptoms. You may, in fact, be too strong to stop yourself from breaking down further. You may not be weak enough to prevent breaking down. I know these statements seem paradoxical, but they indicate a basic truth about stress breakdown – strong people are more likely to break down than weaker people.

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Let us assume you discovered that in fact your anxiety was due to your trying to push your nervous system beyond its capacity. If you just stop doing that, your anxiety will subside. No harm done. The alarm mechanism has done its job.
However, like many other people, you may not think it is possible for you to reduce the load on your nervous system. You may have convinced yourself that there is no alternative to pushing yourself beyond the comfortable limits of your nervous system’s processing capacity. I have to ask you then some more questions.
1. Are you sure you can’t get any help, or is it your pride that makes you determined to do this work or face this problem without help?
2. Are you doubling your problem by setting time limits on work when you have no way of guaranteeing the performance of others who are also involved?
3. Are you fruitlessly trying to work out by yourself, in advance, how to deal with problems that may arise, when in reality the solution to those problems will require the cooperation of others?
Perhaps you might find after answering all these questions that you are in fact a person who has no alternative except to continue putting up with the anxiety because nobody else can really help. You may in fact be the only person who can stay up all night with a sick child or a dying relative, or you may have to see a task or problem through because you may be the only person qualified or able to do the job.
In this case, you might still be able to avoid further stress breakdown if you realize that immediately after the urgency has passed, you must pay back the psychic energy you borrowed in order to keep going under the stress. And remember, you are like Cinderella: your magic will definitely run out. However, Cinderalla had the advantage of knowing it would run out at the stroke of midnight; you aren’t sure how long you can keep going under stress, ignoring the warning signals.
If you decide you cannot slow down or avoid the stress, you must make sure that you get as much sleep as possible, snatching forty winks here and there as you can. You must eat regularly and you must not try to drive yourself to keep going by using stimulants. You should not take alcohol or sedative drugs. When the worst of the stress is over, you should rest and be looked after for a few days.
Above all, you must not make wrong assumptions about the anxiety symptoms you experience. Anxiety is not a sign of weakness, it is a sign of a normally functioning nervous system.

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Epidemiology
Roughly 4 million Americans currently have Alzheimer’s disease, and this number is projected to increase to 16-19 million by 2050 (National Institute on Aging and U.S. Census Bureau).
In a large-scale, prospective cohort study by Laurin et al, high levels of physical activity in > 65-year-old women were associated with reduced risks of 42%, 50%, and 37% for cognitive impairment, Alzheimer’s disease, and dementia of any type, respectively. A significant dose-response relationship showed decreasing risk with increasing levels of physical activity. Men did not show this effect in the same study, and the investigators speculated that the number of male subjects could have been too small. Laurin et al hypothesized that the neuroprotection might have been attained by sustaining cerebral blood flow; by limiting increases in resting blood pressures, lowering lipid levels, inhibiting platelet agreeability, and enhancing cerebral metabolic demands; by improving cerebral nutrient supply and angiogenesis; or by a combination of the above. These hypotheses have yet to be proven.
Sedentary lifestyle may be a risk factor in neurodegenerative diseases because it is associated with higher risk of stroke and is more pronounced in the elderly. Studies have found that physical activity either delays loss of, or has no effect on, cognitive function in elderly subjects. However, no studies have reported an accelerated loss of cognitive function with physical activity.
Lindsay et al2 have suggested that regular physical activity could represent a novel and safe preventive strategy against Alzheimer’s disease and many other conditions, and it should be examined further. Interestingly, among patients with COPD, acute exercise was associated with improved performance on the verbal fluency test, a measure of verbal processing.

Intermediate Mechanisms
Several animal studies indicate a beneficial effect of exercise on the central nervous system (CNS), and are described briefly here.
- Aged sedentary rats had 11% fewer Purkinje cells and 9% smaller Purkinje cell soma volumes than aged rats who exercised. Indeed, aged rats that exercised had the same number of Purkinje cells as young rats, thereby suggesting that the degree of age-associated degenerative changes in parts of the CNS are dependent on earlier lifestyle and health habits, and may be prevented or delayed by physical exercise.
- Physical activity in rats produced 2- to 12-fold enhancements in spatial learning performance on both the Morris and place learning-set probe trials, respectively.
- Physical activity also attenuated motor deficits and impeded age-related neuronal loss.
- Physical activity increased the discharge frequency of pyramidal cells and interneurons as long as the animal ran continuously on the wheel. Furthermore, the discharge frequency of pyramidal cells and interneurons increased with increasing running velocity, even though the frequency of hippocampal theta waves remained constant.
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Until recently, most people thought of Parkinson’s disease as something that afflicted only older people. Many were surprised when one of the younger generation, Michael J. Fox, announced that he had to drop out of the popular television series Spin City due to persistent Parkinson’s symptoms. Former U.S. attorney general Janet Reno further alerted the U.S. populace that Parkinson’s could no longer be ignored when her tremors became so persistent that she could no longer keep them a secret. Although these two examples have high visibility, these individuals are not alone. Last year, over 1.5 million Americans were believed to have Parkinson’s disease, a chronic, slowly progressive neurological condition that typically affects those over the age of 50. Rates of Parkinson’s have quadrupled in the past 30 years and may increase even more dramatically as growing numbers of baby boomers reach and pass age 60. The hallmark of Parkinson’s disease, and the symptom most commonly associated with it, is a tremor, or form of “shaking palsy.” These tremors can become so severe that the simplest task, such as eating with a fork or brushing one’s teeth, can become difficult. These additional symptoms may also occur:
• Tremor of the hand when in a relaxed position or when under stress
• Rigidity or stiffness in the muscles
• Slowness in movement and a delay in initiating movements
• Poor balance
• Difficulty in walking, shuffling steps, and inability to take next steps
• Slurred speech, slowness in thought, and small, cramped handwriting
Although there are many theories that exist concerning the causes of this disease, the most common appear to be these:
• Familial predisposition (about 15-20 percent of those who have Parkinson’s have a close relative with it)
• Accelerated aging
• Exposure to environmental toxins such as pesticides
Parkinson’s is progressive and incurable; however, new drug therapies, including levodopa, dopamine antagonists, and MAO inhibitors, work to keep the symptoms under control, in most cases for months and years. Surgical options have also provided promising results, such as brain tissue transplants and the use of fetal tissue or genetically engineered cell transplant. Both of these alternatives offer hope for the future.
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