Download When is substance use a problem?

MHBiz
23 March 2016
Working with people experiencing substance
use disorders
Dr. Leanne Craze,
Sydney, Australia
What we will cover today
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What are substance use disorders
How many Australians?
Why substance use?
When is it a problem?
Risks
Types of drugs and their shorter term effects
Longer terms effects
Tips for supporting
Overview of treatments
Resources
What are substance use disorders
Occur when alcohol or other drugs are used at
levels where there are adverse:
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short-term and
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long-term harm
What are substance use disorders
Adverse effect on a person’s life in two or more:
Taking
Finds
larger amounts for longer periods
it difficult to cut down despite wanting to
Focussed
Craving
on obtaining and recovering from the drug
to use
Repeated
use interferes with daily living
Tolerance
Withdrawal
Repeated
use despite hazards and health effects
How many Australians?
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5.1% aged 16 years and over (previous 12 months)
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Alcohol use disorder 4.3%
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Other drug use disorder 1.4%
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Males 7% & Women 3.3%
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Tends to commence in teens – median 18 years
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Often occur with depressive, anxiety and
psychotic disorders
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People with psychosis – alcohol disorder 2x
more likely; drug use disorder 6x more likely
Why substance use?
People use drugs:
 To relax
 Out of curiosity
 To perform
 For enjoyment
 Be social
 Avoid physical or emotional pain
 To feel different or better
Types of substance use?
People often move between categories:
Experimental use
Recreational use
Situational use – to cope or manage
Intensive use
Dependent use
Group Exercise – reasons and
motivations for substance use
Film: Back to reality
Listen to what each of the young people say
about why and when they began using.
What were some of their reasons and
motivations?
What effects both positive and adverse did
they discuss?
When is substance use a problem?
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Use and amount is increasing
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Unable to have a good time or get through a day
without it
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Using more often to get away from something
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Unable to stop thinking about using
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Change in energy levels
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Changes in mood and other psychological effects as well
as health problems
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Relationship conflict
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Blackouts
Risks
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Availability
Social tolerance and acceptance
Use in families and close relationships
Social and cultural reasons
Genetic predisposition
Experience of trauma and loss and gried
Reduced sensitivity to effects especially alcohol
Enjoyment becomes habit
Self-medication
Types of drugs and their shorter term
effects
Drugs classified according to effects on a person’s
Central
nervous system and brain’s functioning
Thinking
Feeling
Perception.
Types of drugs and their shorter term
effects
Three major classifications
Depressants
Stimulants
Hallucinogens
People frequently use one or more different types
of drugs
For detailed info:
http://www.druginfo.adf.org.au/attachments/354_drugeffects_english.pdf
Types of drugs and their shorter term
effects
For detailed info:
Drugs
ICE:
& their effects: http://www.druginfo.adf.org.au/attachments/354_drugeffects_english.pdf
https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/ICE%20FACT%20SHEET%202.pdf
Emerging
psychoactive agents:
https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/NDARC%20Fact%20Sheet%20-%20EPS.pdf
Group exercise – the emogi of drug
use
Your table will be assigned a type of drug:
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Depressant
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Stimulant
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Hallucinogen
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Polydrugs
Your mission is to find the emogis that best
reflect the type of drug and their major effects.
Longer term effects of substance use
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Alcohol use disorder
Other substance use disorder
Depression and anxiety
Drug-induced psychosis that persists
Social problems e.g. dropping out of education
or work, legal problems
Relationship problem
Physical health problems
Tips for supporting – minimising risks
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Take it easier
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Do it more safely
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Don’t mix drugs
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Don’t use alone
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Set some limits and enlist friend power
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Understand interactions with prescribed
medications
Tips for supporting – change
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Check out online information
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Try a specialised telephone or web-based helpline
Build in some drug/alcohol free times
 Enlist some friends
 Be choosier or wiser in your substance use
 Get active to take focus away from drugs
 Learn some strategies for managing stress and anxiety
 Ask a GP or counsellor to help
 Look after your physical health
 Be patient, don’t give up and keep trying
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Tips for supporting – change
Encourage a person to talk about it with a GP, AOD
counsellor or other counsellor
How
to set realistic goals
Exploring
ways to cope with the urge
Strategies
for anxiety, stress and grief and loss
Ways
for strengthening health and wellbeing
How
to keep safe
Working
on relationships – interpersonal skills
Professional
Support
treatment and support options
groups and how they might help
Readiness for change – some stages
Readiness for change?
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Not worried – pre-contemplation
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Thinking about it – contemplation
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Trying – preparation
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Doing – Action
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Sticking to it – maintenance
Readiness for change?
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Oopsie moments and relapse commonly occur
along the way
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Successful self-changers might go through the
stages three or four times
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Many will return to contemplation change
Some resources that might help customers with
maintaining change
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Common reactions to trauma https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesS.pdf
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Common reactions to grief and loss –
https://ndarc.med.unsw.edu.au/resource/comorbidity-guidelines-appendix-t-common-reactions-grief-and-loss
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Good things and not so good worksheet - https://ndarc.med.unsw.edu.au/resource/comorbidity-guidelines-appendix-vgood-things-not-so-good-things-worksheet
Identifying negative thoughts –
https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesX.pdf
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Structured problem solving worksheet –
https://ndarc.med.unsw.edu.au/resource/comorbidity-guidelines-appendix-z-structured-problem-solving-worksheet
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Goal setting worksheet –
https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesAA.pdf
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Pleasure and mastery worksheet https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesBB.pdf
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Visualisation and imagery https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesEE.pdf
Overview of drug and alcohol treatments
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Counselling & pPsychological therapies
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Detoxification
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Pharmacotherapy
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Rehabilitation
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Complimentary therapies e.g. mediation, massage
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Social supports and health care e.g. GP, housing, financial,
legal
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Peer support
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Family support
Information about treatments
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Alcohol and drug treatment guide https://issuu.com/australiandrugfoundation/docs/yourguide_alcohol_aod
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Treatment guidelines for comorbidity ie both mental
illness and substance use disorder https://ndarc.med.unsw.edu.au/resourcetype/comorbidity
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Anxiety management techniques - https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesR.pdf
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Motivational interviewing - https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesD.pdf
The importance of harm reduction
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Focuses on the problems associated with
substance use rather than the use itself
People who don’t want to stop, offered
support to reduce the harm and effects
Support to QUIT is also available
When is treatment more likely to be
effective?
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Designed to meet person’s needs and situation
Focussed on the goals defined by the person
Strengths-based & trauma informed
Identifies related issues and offers help or
referral
No-judgmental
Confidential
Evidence-based
Delivered by properly trained and accredited
Self care
Supporting someone with substance use
problems is often difficult
 Family and friends need support for themselves
Family Drug Support 1300 368 186
GP for referral to a counsellor
 Workers are encouraged to seek professional
supervision and mentoring
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Helpful resources
Australian Drug Foundation www.adf.org.au
 Aust Govt Alcohol Information www.alcohol.gov.au
 Counselling online – www.counsellingonline.com.au
 National Drug and Alcohol Research Centre
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www.ndarc.med.unsw.edu.au
AA and NA support groups www.aa.org.au & www.na.org.au
 Quitting cannabis app and resources 
https://ncpic.org.au/cannabis-you/tools-for-quitting/quit-kit/
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Also DrugsMeter app & Alcohol Tracker app
Helpful phonelines
Alcohol and Drug Information Service (ADIS):
(02) 9361 8000 or 1 800 422 599 (toll free)
 NSW Users and AIDS Association (NUAA): (02)
8354 7300 or 1 800 644 413 (toll free)
 Family Drug Support (02) 4782 9222 or 1300
368 186
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