Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
MHBiz 23 March 2016 Working with people experiencing substance use disorders Dr. Leanne Craze, Sydney, Australia What we will cover today 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: short-term and 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? 5.1% aged 16 years and over (previous 12 months) Alcohol use disorder 4.3% Other drug use disorder 1.4% Males 7% & Women 3.3% Tends to commence in teens – median 18 years Often occur with depressive, anxiety and psychotic disorders 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? Use and amount is increasing Unable to have a good time or get through a day without it Using more often to get away from something Unable to stop thinking about using Change in energy levels Changes in mood and other psychological effects as well as health problems Relationship conflict Blackouts Risks 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: Depressant Stimulant Hallucinogen 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 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 Take it easier Do it more safely Don’t mix drugs Don’t use alone Set some limits and enlist friend power Understand interactions with prescribed medications Tips for supporting – change Check out online information 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 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? Not worried – pre-contemplation Thinking about it – contemplation Trying – preparation Doing – Action Sticking to it – maintenance Readiness for change? Oopsie moments and relapse commonly occur along the way Successful self-changers might go through the stages three or four times Many will return to contemplation change Some resources that might help customers with maintaining change Common reactions to trauma https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesS.pdf Common reactions to grief and loss – https://ndarc.med.unsw.edu.au/resource/comorbidity-guidelines-appendix-t-common-reactions-grief-and-loss 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 Structured problem solving worksheet – https://ndarc.med.unsw.edu.au/resource/comorbidity-guidelines-appendix-z-structured-problem-solving-worksheet Goal setting worksheet – https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesAA.pdf Pleasure and mastery worksheet https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesBB.pdf Visualisation and imagery https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesEE.pdf Overview of drug and alcohol treatments Counselling & pPsychological therapies Detoxification Pharmacotherapy Rehabilitation Complimentary therapies e.g. mediation, massage Social supports and health care e.g. GP, housing, financial, legal Peer support Family support Information about treatments Alcohol and drug treatment guide https://issuu.com/australiandrugfoundation/docs/yourguide_alcohol_aod Treatment guidelines for comorbidity ie both mental illness and substance use disorder https://ndarc.med.unsw.edu.au/resourcetype/comorbidity Anxiety management techniques - https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesR.pdf Motivational interviewing - https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesD.pdf The importance of harm reduction 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? 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 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 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/ 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