Ok, so I have Crohn's disease, have lived through a few addictive phases and have done a whole slew of drugs. I am also a health care professional who works with people with various illness, ages, and conditions. Here is a little review based on drug and my experience and how my disease has reacted depending on the drug. Also included are some stories of people whose files I have been implicated in. I feel it important to give this information as many opinions on this forum have been moralistic and do not include the fact that a person who will experiment could either fall into addiction or learn how to use recreationally in response to body signs.
I am in relatively good health, have had symptoms since age 8, misdiagnosed with stomach problems related to depression at 15 and at 17 I finally received a diagnosis of Crohn's. At that time, I had one hospitalisation for about a week and I have had various up and down periods. I am currently 24 years old.
I have psychological history of depression, anxiety, and a social history of prolonged and moderate adolescent sexual exploitation. Family history of poly-addictions, depression, anxiety, eating disorders.
Disease portrait:
I started with pentasa @ 1500mg/day (I tend to take 750mg/day to save money given its likelihood to just be a placebo with minimal clinical effect) and entokort for about a year. After that point, I started taking imuran and I got to a point where I was healthy enough to go with just pentasa, a good diet and supplements for about four years until I decompensated and am now back on entokort since about a month ago and after a month I will start imuran again. I have no surgeries, abscesses, but I have a lot of scar tissue in the secum as that is my primary area of inflammation.
Substance use portrait:
At 18, I started smoking cigarettes and marijuana at the same time. At 19 (legal drinking age in my home province), I started drinking HEAVILY (10-12 drinks 2-3 nights per week) while managing the stress of full time school school, a part time job (full time when no school), and various volunteer work places. At about 20, I started consuming ecstasy between 2-7 tablets per night twice a week (mostly on weekends). Over the period of the ecstasy abuse, I consumed cocaine between 1-3 times per month (generally 0.5g each time), LSD every few months, shrooms on a rare basis and ketamine whenever it was around, typically 0.3-0.4g of ketamine per consumption, sometimes up to 1g per evening of consumption. I have had combinations of all of these at the same time and pretty much every imaginable combination in between.
Currently, I use cocaine on special occasions (2-3 times per year, about 0.5g per use), as well as ecstasy/MDMA (typically 1-3 "dose quantities" per use, on a 2-3 times per year basis). I no longer use ketamine due to a lack of available. Shrooms I stopped due to gastro discomfort and LSD is more a spiritual thing that comes into my life when the time is right (it has been over a year since I last used LSD). I have used speed once, but it is pretty much the same as a dirty ecstasy pill.
I have never used heroin, methamphetamine (on purpose), anything injected, PCP. I did crack once but given its addictability and how useless it was as a drug, I decided it best never to try it again. Crack is dirty.
I will now provide an overview, followed by a synthesis of information, opinion and recommandations. I will also include drug combination perspectives.
Drug overview:
Alcohol: Ever have the shits after a night of drinking? I generally can get drunk two nights a week, but if I do the third night, I get diarrhea, cramps, sometimes bleeding and increased inflammation. Alcohol for sure aggravates symptoms. In order for me to maintain a good health, I can, at this young age and good health point, get pretty drunk one night, and not go over 3 standard drinks any other night during the week. I sometimes have a drink every evening and haven't found that causes problems, but everything in moderation!
Cigarettes: I have researched this and the information is not clear. Cigarettes are clearly related to various health problems and are known to interfere with medication, therefore the risks with cigarettes are numerous. I find cigarettes relieve my short term symptoms, but I have equally found that once I started smoking, replacing cigarettes with NRT (nicotine replacement therapies such as patches, gum, lozenges, etc) are adequate to prevent the withdrawal constipation. Cold turkey makes me almost need hospitalisation. Much literature says that smoking, long term, increases the need for surgery in Crohn's patients, so I am slowly trying to stop smoking. It is an ongoing battle and generally, someone who doesn't smoke should not start for symptom relief (as I did). It is better to get an Rx of prednisone over a 5 day period at 40mg/day if you are in the same health portrait as me and are desperate for quick resolution.
Marijuana/other THC products: THC is basically my replacement for peptol bismol -- it solves all of my gastro symptoms. However, I have had patients who have Crohn's and their consumption of marijuana has given them fierce acid reflux. Marijuana is a drug that very much varies depending on your body chemistry (you know how there are some people who say they get super paranoid and hallucinate on marijuana? It does not agree with everyone). Basically, if it works for you, keep going, but watch it closely. Watch out for the munchies!! Often I have munched out and ended up becoming completely bloated and fatigued and constipated for days because I munched on a shitload of garbage in my furor. A marijuana-smoking crohn's patient should ALWAYS have crohn's friendly snacks on hand, or otherwise have good impulse control so as to not eat too much. This is a drug that can be your best friend, or worst enemy. Pay attention to how your reaction with the drug evolves. Family history of schizophrenia? Be fucking careful. Avoid if possible.
Ecstasy: This is a tricky one. Consuming ecstasy will generally diminish appetite, therefore causing less gastro traffic. For people with PTSD, ecstasy has been therapeutic in helping people establish health attachment to people. However, as is well know, ecstasy can be more than just MDMA and caution should be used. You should never take a pill that you haven't heard anything about (your drug dealer being high on it does count) as often, the only way to know what's in a pill (outside of pill testing kits) is based on subjectiveexperience. Regular ecstasy users can generally tell what's in a pill. If you are healthy but still very stressed, using E in a controlled manner could help you break through and learn things about yourself. On the other hand, this was my drug of addiction. Extreme caution to be used with it.
Cocaine: The problem with cocaine is not necessarily cocaine (although, quickly consuming a shit ton of it can cause cardiac arrest), but its ability to allow you to drink more booze. However, alcohol aside, I generally find cocaine makes me need to crap more and the day after I find my inflammation area more "hard" when I palpate the area. Cocaine consumption over two-three days has been pretty scary for me. Cocaine has high addictive potential because it doesn't really feel like a whole lot (but it does feel good.. directly stimulates reward centers!!), so an addiction happens slowly. However, doing a line every now and then only kills some people. To note: if you have a family history of schizophrenia or heart disease, stay the fuck away from this shit. Cocaine is known to trigger schizophrenia in those with a predisposition to it. This drug generally is known to destroy lives for those who let it go from once every now and then to a regular thing. It's also more expensive. So destructive.
Ketamine: Haven't found any Crohn's related problems with it. However, it is the only addictive psychedelic. Can cause nosebleeds as it is generally snorted. Also the people you have to meet to get it regularly can be a bit questionable. DO NOT MIX WITH ALCOHOL EVER. You could get dateraped. OK to mix with uppers, but of course, don't test this out with large quantities. Always do a little bit of this drug if you're going to do it because it will just make your legs give out and you'll be useless.
Shrooms: May make you vomit. As it is ingesting plants, you may be allergic to it. My ex was. Not so fun. Shrooms have low addictive potential, but do have psychological addiction potential. It is possible to overdose on higher recreational doses. Again, family history of schizophrenia -- avoid and/or use EXTREME caution, given it is a hallucinogen.
LSD: I have found LSD makes some weird gastro symptoms that I have to treat with marijuana. My non-Crohn's friends have found this too. Not addictive (impossible to develop a tolerance), however if you have done other drugs, LSD will potentially make you want to take them. Caution to be exercised.
As with all drug use, make sure to consume lots of water and to allow yourself a full day following a trip to recuperate, relax and not have anything to do. It is extremely important to get your sleep, and often when partying with friends, they would stay up until Sunday at 7pm doing drugs, when I would have left around 7-8am, knowing that I needed to get sleep so my body could recover.
If you're going to drugs and you have Crohn's, you have to know your limits and be comfortable saying no, even if someone is giving you all the free drugs. Telling someone to just not do drugs is not very helpful, although "safe" advice.
Ultimately, learn about each drug you are considering doing before trying them. (addictive potential, what addiction patterns look like, what "tolerance" means, what withdrawal looks like, which drug combinations are safe and which are unsafe, etc).
I can understand your hesitance to tell your doctor about your drug use, but the only way you can do that safely, is to not do them regularly. If ever you go to a hospital in emergency and have consumed drugs, you absolutely have to tell the triage person so that in case you are at risk of dying, they can adjust for the presence of drugs in your system.
If you feel you have a problem with drug use, get help before the addiction gets you. Because as you have Crohn's, a drug addiction could destroy you. Playing with drugs is like playing with fire with our condition, but those who don't have the desire to do drugs or who have gotten over it don't remember what it's like to be in that mindset.
Generally though, my biggest warnings have to be:
-stay the fuck away from unprescribed prescription drugs, heroine, and methamphetamine
-speed is a dirty dirty dirty drug. should be avoided, has high addictive potential and has a two-four day crash. this is extremely long and could easily hurt your life. it just gives you energy, and can cause psychoses. i, as a rule, stay away from it
-study erowid.org and read stories. many stories are about people's addictions and lives. good experiences and bad experiences alike can be found there.
-become an expert on drugs before you do any of them. become someone who can help friends recognize problems so that you ca recognize these problems in yourself
-if you have a flareup, stop doing any drugs except marijuana (only if you find it helps with symptom relief). when i say drugs, i include alcohol in this.
-don't pretend your invincible. your curiosity is natural and your disease shouldn't limit your life journey -- however try to avoid letting your life journey aggravate your disease.
all of the perspectives i have just provided are in the goal of helping you make safe decisions. do not follow my advice to the letter, but if you're experimenting, this should be a starting point at which you can start to consider things. if you are not thinking in-depth about what i am saying, it is best to stay away from drugs until you understand the importance of the things i have brought up here.
addiction isn't easy, and looking back, i could have experimented without going overboard as i did. so i share this information in hopes it will help you make some informed decisions.
treat drugs with respect, and treat yourself with respect, and understand that your body, mind and disease are unique to you, so you need to be able to look at yourself closely to avoid being a tragic drug addict that everyone pities and talks awkwardly about.
good luck!