The patient was a successful and wealthy entrepreneur aged 35. His working day was lived at a great pitch of tension and every evening he would go out to restaurants and night clubs and get through a lot of alcohol. He would on average drink a couple of bottles of wine and up to a dozen double vodkas before becoming, in his terms, ‘pretty incoherent’. He was beginning to feel ‘dreadful, sick, sweaty’ on most mornings and would often be unable to remember how he had reached his bed. Cocaine then began to be available in his social circle and before long he discovered that this drug appeared to provide an antidote to some of the unwanted effects of alcohol. For instance, if he snorted (sniffed) cocaine a few times during the evening, ‘it lifted me up, I could go on drinking, it stopped me passing-out with the alcohol’. He also found that a snort or two of cocaine helped to alleviate the unpleasant early-morning symptoms caused by the previous night's drinking. Within a few months he progressed from snorting to free-basing (inhaling) cocaine, and his cocaine use rapidly and disastrously went out of control.[…]