Lifestyle choices and juvenile idiopathic arthritis (JIA)

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It's your choice to drink, use drugs or not. In this section, learn about the effects drugs, drinking alcohol and smoking can have on JIA management.


The term “drug” can refer to a medication that is prescribed by a doctor or purchased without a prescription at a pharmacy. Prescription drugs can be abused if they are taken for the wrong reasons, at the wrong dosage or by someone that was not prescribed them. The term can also be used for recreational drugs purchased illegally.

There are many different types of recreational drugs, such as:

  • nicotine (cigarettes)
  • marijuana (pot, weed, joint, THC)
  • cocaine (coke, snow, flake, blow)
  • amphetamines (ecstasy, X, E, uppers, XTC, dexies, speed, meth, ice, crank, cat)
  • heroin (H, horse, junk, smack)
  • anabolic steroids.

Recreational drugs can be harmful in many ways:

  • They can interact with JIA medications and possibly cause damage to organs like your liver, kidneys or lungs.
  • They may cause other physical problems like vomiting or poor balance, which can lead to falls causing injury.
  • They may cause mental problems like confusion, anxiety, learning problems or memory loss.
  • They can lead to risky behaviour like riding in a car with a drunk driver.
  • They can make you addicted. Addiction means that you use the drug for a psychological high and your body becomes used to the effects of the drug so you need more and more to get the same feeling. It can be very hard to stop using them.
  • Some drugs may be mixed with other dangerous chemicals. It is difficult to know what is in them and what effect they can have on you.
  • Many drugs are illegal and can lead to trouble with the law.
  • A drug overdose can cause serious mental or physical damage or even death.

Some young people believe drugs will help them think better, be more popular, become more active or become better athletes. Some people are simply curious and figure one try won't hurt. Others want to fit in. Many young people use drugs because they are depressed or think drugs will help them escape their problems. Actually, drugs don't solve problems. Drugs can hide feelings and problems. When a drug wears off, the feelings and problems remain - or become worse. Drugs can ruin every aspect of a person's life.

Cigarette smoking

There are many different reasons for why people start smoking. What’s important to know is that cigarette smoking is bad news for your health. Nicotine, the addicting ingredient in tobacco, causes the body and mind to become so used to it that you feel that you need to have it to feel normal. Cigarette smoking causes cancer, a lung disease called emphysema, and heart disease.

Cigarette smoking is also expensive. Once it becomes a habit, smoking can cost you thousands of dollars a year.

Smoking can make your JIA worse:

  • Smokers lose bone density, which increases their risk of osteoporosis. If you remember back to Session 1, osteoporosis is a complication of JIA in young people. Osteoporosis can cause the bones to become thin and weak, and more likely to fracture. If you smoke, your chances of developing osteoporosis become greater.
  • Smoking can tighten blood vessels in your body. This can prevent oxygen and nutrients from getting to your skin. It can make you look pale and unhealthy, and can make you prone to wrinkly skin at an early age. Some research studies have also linked smoking to an increased risk of developing psoriasis.
  • People who smoke often find it difficult to participate in physical activities and exercise. Smoking can cause a faster heartbeat, poor blood circulation, and shortness of breath, making it hard to be active. For young people with JIA, this could be a problem since exercise is key to improving joint stiffness and preventing joint damage.

Other consequences of smoking include:

  • Wrinkles.
  • Yellow teeth.
  • Bad breath.
  • Bad-smelling clothes and hair. It’s often hard to get the smell of smoke out as it lingers for awhile.
  • Greater risk of injury and slower healing time. Smoking can affect your body’s ability to produce collagen, which is the protein that connects your bones, tendons, cartilage and muscles. This means that damage to tendons and ligaments will heal more slowly in smokers.
  • Increased risk of illness. Smokers tend to have more colds, flu, bronchitis and pneumonia than nonsmokers. Also, young people who diet by smoking instead of eating lack the nutrients to grow, develop and fight off illness properly.

Staying smoke-free

The best way to avoid the problems caused by cigarette smoking is to not start smoking in the first place. It may be difficult to do this if others around you smoke and you are offered cigarettes. If you find yourself in this situation, have your reason for not smoking ready, such as “I just don’t like it,” or “I want to stay in shape for swimming,” or “No thanks, not right now.”

If you do smoke and would like to quit, there is a lot of support available. Information is available on the Internet, through your local hospital, and organizations like the Canadian Cancer Society​. You can also speak to your doctor. These resources can help you with whichever approach to quitting you prefer. Some people decide to give up smoking all at once and others find that a gradual approach is better. Others may even prefer a support group for young people who would like to quit.

Quitting smoking can be difficult at first, but don’t give up! Staying smoke-free can help bring back more energy, better looks and give you more life to live!

What is alcohol

Alcohol can come in many different forms. Some people drink it for the taste or the effect it can produce such as helping you to feel relaxed. Some forms can also be used as a cleaner or antiseptic. When people drink alcohol, the alcohol is absorbed into the bloodstream. The bloodstream then carries the alcohol throughout the body. The alcohol affects the brain and spinal cord, which are important in controlling almost all bodily functions.

How alcohol affects you

Alcohol is a depressant. This means it slows down the functioning of your central nervous system - your brain and spinal cord. Alcohol can slow down the messages trying to get to your brain. In some cases, it can block the messages altogether. This causes changes in your perceptions, emotions, movement, vision and hearing.

If you have had a lot of alcohol to drink, you can become drunk. You may start to stagger, lose coordination, slur your speech and be confused and disoriented. You might become very friendly and talkative or you could become angry and aggressive. Alcohol will also slow down your reaction time. It takes longer to respond to a person running out in front of the car you are driving. This is why drinking and driving is so dangerous.

Drinking large amounts of alcohol in a short time period can lead to alcohol poisoning. This is exactly what it sounds like. The body becomes poisoned by a large amount of alcohol. Vomiting is usually the first symptom. Extreme sleepiness, unconsciousness, difficulty breathing, low blood sugar levels, seizures and even death may result. If you suspect someone may have alcohol poisoning, get them medical help as soon as possible.

Alcohol can affect you in other ways as well:

  • Alcohol can interact with some JIA medications, like methotrexate. This can lead to serious health problems like liver damage.
  • Drinking under age can lead to trouble with the law. The legal age to drink in most provinces in Canada is 19 years. Young people who drink are also more likely to get into fights and commit crimes than those who do not.
  • Drinking regularly can lead to problems at school. It can reduce your ability to study well and concentrate.
  • The changes that come with drinking can lead to doing embarrassing things like throwing up and can leave you with a bad hangover.
  • Alcohol can put your health at risk in other ways as well. Risky behaviour may cause injury when intoxicated.

It’s your choice to drink, use drugs, or NOT!

Even if you don’t really want to smoke, drink or use recreational drugs, it can be hard to avoid it, especially when your friends are doing it. You might not want to feel left out. There are, however, different strategies you can try. Some people find it helps to just say “no” without giving any explanation. Others like to give a reason. You could say, “I’m not into drinking/smoking,” “I have a game tomorrow,” “My parents are coming to pick me up soon,” “I already got in trouble for drinking once, I can’t do it again,” “I don’t like the taste; it makes me feel sick,” or “I can’t smoke this with my JIA medications.”

If you are going to a party where you know alcohol or other drugs will be available, make a plan in advance. You and a friend can make up a signal for when it’s time to leave. Other strategies include pretending that you are drinking when you are not. For example, drink a Coke and pretend it’s a rum and Coke or carry a beer bottle around the entire night while dumping it out in the bathroom.

Getting help

If you think you need some help or just someone to talk to, you can speak to your doctor, school counsellor, or even a trusted adult relative.

Last updated: January 31st 2017