When discussing addiction in relation to mood altering substances, I think it is important to get a handle on some definitions first… So, we have substance use, substance abuse and addiction.
Substance Use refers to any use of a substance. This could be having sugar in your tea, drinking coffee, having a single glass of wine with dinner or a piece of chocolate for desert.
Substance Abuse is different to Substance Use in that it is a more harmful and binge like use. This could be; getting drunk at a dinner party, having a few lines of coke out at the club, overeating, or this could be a weekly or monthly pattern of use where, say, every Thursday and Friday night we go out and get wasted. The “abuse” of the substance has negatively impacted on your ability to function and has increased the risks to your health, wellbeing and safety.
Addiction is identified when the pattern of use is negatively impacting on our relationships, working capacity, health, safety and engaging in everyday activities. When we feel we need more of the substance to get the same buzz, that’s known as tolerance. If we notice that a significant amount of time is spent thinking about, planning to use, seeking out or actually using the substance and we have had unsuccessful attempts to either cut down or stop using the substance, then it is likely that addiction is in our life.
So now that we have a handle on the definitions of substance use, substance abuseand addiction…what can we do about it? I guess that all depends on where you feel you fall on the scale and what you would like to do about it.
If you have identified as someone that uses substances and you haven’t noticed any real negative impacts, then I would encourage you to check in with your GP to get a second opinion from someone who has your best interest at heart. That way you can be sure that what you are doing isn’t potentially causing harm to your health in a way that you haven’t noticed yet.
For those of you who identify with more the Substance Abuse definition, then it would be a good idea to start making notes in a journal or on your phone of what you’re using, how much you’re using and when. It’s also helpful to rate your mood and note down anything you feel might be helpful for you to make your next decision, such as any embarrassing things that happened, how bad the hangover was, any disagreements that came up with your partner, friends or family as a result of the use or related activities… and then see what it actually looks like over a month. When you look at the numbers and have a chance to reflect on your actions clearly, you may find that you would like something to change. That’s great! That is the first step to making change… seeing that there is something worth changing.
Once you’ve realised that you would like something to change, there are a few options available to you. Firstly, speaking to your GP can help find clarity around what is actually going on and gives them an opportunity to check your out your physical health to see if any management plans need to be put in place.
Secondly you could speak to someone, whether that’s your friend, family member or a professional. Simply talking to someone about the fact that you’re thinking about making change helps to build a support network around you so that you don’t have to go it alone! There are great phone lines in each state and territory that provide counselling, information and referral options for people looking for change in their substance use called the Alcohol & Drug Information Service (ADIS). Here are the numbers for your state:
NSW - 1800 422 599
WA - 1800 198 024
SA - 1300 131 340
QLD - 1800 177 833
VIC - 1800 888 236
NT - 1800 250 015
ACT - (02) 6207 997
TAS - 1800 811 994
If, after reading this you feel that addiction may be in your life, then you are not alone. Addiction doesn’t discriminate between ages, genders, socioeconomic status or religion! It also doesn’t have anything to do with willpower alone so feeling weak or silly for struggling with an addiction is common, though really unhelpful.
Remember – Shame breeds addiction and compassion helps it to move along, trust me!
There are a number of options you can look into when you feel addiction is in your life, and as I work from a Harm Minimisation approach, I will be discussing things in order from high risk to low risk. I’m going to start off with what to do when using drugs through injection and then move on to excessive alcohol use. From there I will discuss detox and rehab briefly and finally, I will discuss community-based groups that you can attend for free to increase your support network. These groups are great for people who fall into the Substance Abuse category too.
When discussing injecting drug use, the most important thing to focus on is that we are using safe injection practices and safe disposal practices. The Needle and Syringe Program (NSP) is nation-wide and provides free or low-cost fit packs, which are boxes that syringes and injection paraphernalia come in. This is also a great place to speak with professionals about how to reduce the risk of your using or reduce the use all together. If you do a quick google search of the Needle and Syringe Program in your state it will show a list of sites where you can go and collect or drop off your fit packs.
It is really important that we use a new needle every time and dispose of the needle safely to avoid anyone in the community or yourself from getting a needle stick injury. Remember, simply putting them in the bin isn’t safe disposal because garbage collectors are put at risk.The bonus of having a fit pack is there is a safe disposal unit within each fit pack where you can insert the used syringe and safely dispose of it. I will do another podcast or article on safe injection practices for anyone who is interested to learn more.
Excessive alcohol use is a very high risk due to the potential to have seizures. Usually the level of alcohol use would be daily and often will start consuming alcohol in the morning or when they wake up. Some signs of excessive alcohol use is noticing your hands tremble when you haven’t had a drink in a while, headache and irritability. If this is the case then it is extremely important to work with a medical professional on a plan of reducing or stopping alcohol use. This may involve medication or simply observation to ensure you are safe and minimise the likelihood of having a seizure.
When discussing detox and rehab there are two main pathways. The private or public system.
Private rehabilitation is usually within a private psychiatric hospital and the program is covered in part or full by your private health fund, depending on your level of cover. These programs are usually for 21 days and include group and individual psychological treatment, 24-hour medical support and the introduction of helpful daily routines such as improved sleep hygiene, exercise and other fun activities. There is usually no need to attend a detox unit prior to admission because the medical staff are available to assist with your detox during your stay.
The public rehabilitation program is then separated into two, detox and rehab. You can request to go into your local public hospital detox unit and usually this is a 7 day stay. The main focus here is on medically supervising your detox from the substance however rarely provides psychological treatment. When you are discharged it is really important to have a follow up plan with other supports to assist with the mental side of addiction. Public rehab can be from 3 months to 12 months in length and are mostly inpatient stays. That means you stay at the facility for that time and attend group and individual therapy whilst building those helpful routines back into your life. Usually this is subsidised by Centrelink or potentially requires an amount each week to be paid, like rent. If you are in community housing and want to attend rehab, you can speak with your case worker about having your accommodation held for you upon completion of the program.
There are a number of great community-based group programs that are there to provide support and information for free. In a future article and podcast I will discuss the difference between them however for now let’s just know they exist!
So, you may have heard of Alcoholics Anonymous or AA. This is part of the 12-Step program and includes a number of specific groups that work to create a community around each substance or addiction. So, there is a Narcotics Anonymous or NA, one for gambling, sex, methamphetamine and so on. Then you have SMART Recovery which stands for Self Management And Recovery Training. These groups are run by trained facilitators and are open to anyone wanting to look at changing an unhelpful behaviour, whatever that may be. A quick google search of the 12-Step program or SMART Recovery will bring up a list of groups you can attend in your area.
So, there we are! A brief overview of the difference between substance use, substance abuseand addictionand a few options of the next step to take. I am sure this was a lot to take in and as I go through this I realise there will need to be specific episodes and future articles on a number of things discussed here. If you have any questions or comments, I would love to hear from you and if anything in this article or podcast has brought up some triggers I would encourage you to call ADIS or speak with your GP.