Why it’s important to be honest about drug usage

Why is it important to assess the risk with regards to drugs?

We need to assess the risk of someone having a critical illness, dying or being off work. When want to know if someone is taking a certain type of drug because they could then be putting themselves at higher risk of other conditions. Someone who takes cocaine, for example, would be at higher risk of having a heart attack or a stroke, even for young people, because of the effect it has on their blood pressure. It can also affect heart wall thickness, stiffen the arteries and induce dangerous heart rhythms. One of our company doctors has said that if they see a young male in hospital having suffered a heart attack, one of the first things they do is check for cocaine in the bloodstream. Cannabis is one of the worst for mental health issues especially in teenagers. Someone who starts taking it while their brain is developing can significantly increase their risk of developing a bipolar disorder or schizophrenia.

What questions do you ask about drugs?

We ask about current and previous drug use. If someone has used drugs in the past, it will be a few years before we can offer standard terms or cover at all. The effect on their body, both physically and psychologically, especially if they have used drugs for many years, remains quite high. There is also the potential of them going back to using that drug, given the addictive nature of many drugs. Someone who takes drugs are more likely to engage in risky behaviours. Therefore, we would want to see a doctor’s report to determine whether they use any other drugs, have any alcohol issues and to check that they have been honest about their smoking habits (use of cigarettes).

Do you view all drugs the same?

We’re more lenient with cannabis use compared to some other drugs. We wouldn’t be able to offer any cover to someone who uses heroin or cocaine or has done so in recent years. We can consider people who use cannabis, however, depending on how much they use, how often and whether it impacts on their life – are they still working and do they have any physical or mental health issues? For minimal use, one or two times a week, we may be able to offer cover at standard terms or a small increase. We apply smoker rates if they mix it with tobacco. For higher use – several times a week or daily – we could probably still offer cover but may increase their premiums.

Are there any ‘new’ drugs on your radar?

We are starting to see disclosure of nitrous oxide use. If this is current or within the last few years, we would be unable to offer cover. It tends to attract younger users. It’s a drug that you inhale and you sometimes see empty canisters of it dumped in streets and parks. The side effects can be permanent. It can lead to a vitamin B12 deficiency, the longer-term risks of which are things like nerve damage and even paralysis. Nitrous oxide is in gas and air used on labour wards. The NHS is now looking at offering birthing mothers other forms of pain relief because of it leaking into the atmosphere and potentially affecting staff on those wards.

What about prescription medication or shop-bought products?

Occasionally we see people who use cannabis for a medical condition such as multiple sclerosis. There aren’t many conditions in the UK that cannabis is signed off as a treatment so it might be that people are self-treating. We would look at it on a case-by-case basis. Supermarkets and pharmacies now stock a range of CBD products, but we view those as safe for use because the potency is very low. The THC (tetrahydrocannabinol) part of cannabis – the psychoactive part, which can cause hallucinations and paranoia – has been removed. With illegal cannabis, the strength of it is going up, especially the THC part. In 2005, about 50% of seizures by police were of high strength cannabis; now that figure stands at 94%. For people who use prescription painkillers it will depend on their medical history and to what extent there is a dependency.

How do you view drugs in relation to alcohol?

We typically view drug use as higher risk than alcohol consumption, even relatively high alcohol consumption. Many drugs have a very rapid effect on the body; someone could potentially take too much and end up in hospital. In addition, alcohol is regulated; people know what they are consuming as bottles of wine, beer or spirits will state the number of units or the alcohol strength and there are clear NHS guidelines on ‘safe’ levels of alcohol consumption. With drugs, people don’t know what the drug is mixed with, or the strength or potency of the drug, so they don’t really know what they are taking or what effect it will have on their body; there are all manner of unknown risks. Often people may take several drugs at the same time or drink while taking drugs. Alcohol and cocaine when combined create a toxic chemical in the body, which can have a greater impact on the heart and liver. The combination is even worse than taking one or the other.

What is the key takeaway for advisers whose clients use drugs?

A lot of people may not want to tell their adviser about current use or a history of drug use and some advisers may not know how seriously we view drug-taking. It’s important for advisers to think about the impact of drugs and the importance of full disclosure. After a few years, a client may be able to get cover or better terms. For cannabis, we would consider someone a non-user after two years or for someone who had been a low-to-moderate user or four to five years for heavy use. For heroin, we would be looking for someone to be off it for at least five years or sometimes seven years before we would offer terms because the rates of reoccurrence are high. For someone who had come off heroin by using methadone we would be looking for them to have finished that treatment for three or four years, or longer if they had a history of relapse.