Hi Chris, I too am an adult with CAH. As far as the drinking/smoking thing goes, if you don't smoke, don't start. I personally don't drink because everytime I had more than one drink I got a terrible headache. For me, headaches are closely linked to low cortisol. If I get a headache I know I need to take more dexamethasone. Drinking/smoking just aren't worth it to me. Keep as healthy as you can (and try to eat low carb too, that seems to help with stamina) Susan A.