40 Chapter 2 The patients who have used drugs state that they often forget things and do not feel like doing anything. All patients state in common that dental care is not prioritized (N=30). “When I was 17 years old, I was really lazy, and especially when I smoked marijuana, I did not think about oral health or brushing my teeth.” [part. 1] “My thoughts were completely somewhere else. I lived in my own world. My thoughts were not about taking care of my teeth and such things.” [part. 25] All patients portrayed cognitive difficulties such as a lack of fluency, working memory and flexibility. In addition, there was no motivation for the patients to take care of themselves. Most patients frequently reported a lack of structure and a lack of planning in daily life as a result of abusing drugs and alcohol, and the patients did not link this aspect directly to FEP. After quitting drugs, the patients became more aware of their health problems. More than half of the patients’ smoke, but they did not link smoking to their oral health. Nutrition was indicated as a risk factor by the patients. It was connected to not only a period of drug abuse but also the side effects of medication. The patients stated that dental problems also affect the intake of nutrition. Binge-eating and an unhealthy food pattern were common for half of the patients. All patients linked drinking sugary beverages (e.g., redbull or cola) to a dry mouth as a side effect of medication; some patients also linked it to a period of drug abuse. “In a period of drug use, I hardly ate. If I was hungry, I got a bag of crisps; I did not care.” [part. 1] “Because of the medication I used for my psychosis, I feel hungry, and I eat a lot. I have gained many pounds since then. In the last half year, I became ten kilograms heavier after starting medication.” [part. 6]. All patients mentioned the side effects of medication as part of reduced oral health. Xerostomia, somnolence, reduced responsiveness, pain, concentration problems and weight gain were the most reported experiences as a consequence of the side effects of medication. All patients felt that their teeth became worse as a result of the use of medication, and the patients were not aware of other factors that influence oral health.
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