Alcohol and other drugs

• The use of legal substances (such as caffeine, alcohol and tobacco) is the most common type of substance use. Alcohol and other drug use in Australia is decreasing, despite public perceptions to the contrary.
• A person’s age, sex, cultural background and social environment can influence their substance use. People use alcohol and other drugs for a range of reasons and consumptions patterns can vary drug to drug.
• Alcohol and other drugs can affect the physical, psychological, mental, social, financial and legal wellbeing of the user, their family and friends, work colleagues, and the wider community.
• A common misconception is that the ‘addictive’ nature of certain substances causes them to be harmful.
• The use of any substance which affects the mind has the potential to cause harm, and the likelihood of harm occurring increases with greater amounts used.
• There are many theories about harmful substance use, none of which fully capture its complex nature. Effective prevention needs to address a range of social and individual factors.

People tend to choose substances that help them in some way, such as increasing pleasure, or decreasing emotional or physical pain. Alcohol and other drugs act directly on the brain and can seem to be predictable and effective ways to change how a person feels, at least in the short-term.

Alcohol and other drugs are often associated with important social rituals such as celebration, socialising, relaxation, healing, spirituality and commiseration. In some groups, clubs or communities, alcohol or other drug use can be seen as part of belonging to the group.

The choice of substance is influenced by the particular needs the person is trying to meet. The same drug may be experienced by different people in different ways, which may impact their particular pattern of use.

Some people find their alcohol or other drug use becomes problematic, because the harm associated with it outweighs the apparent benefits.

Substance use may be a problem when someone:

• has difficulty meeting responsibilities at home, work or school
• has tried unsuccessfully to cut down or quit.
• uses more than they intended despite wanting to stop
• has recurring problems with health, safety, relationships, finances or the law through their substance use
• needs the substance to cope with everyday life or particular experiences
• organises other events or needs around their substance use
• needs increasing amounts of the substance to have the same effect
• feels sick or moody without the substance, but feel normal when they use again
• find themselves using as a way to maintain friendships or relationships.

The harm associated with drug use can occur in many ways, depending on:

• how you get hold of the substance, such as finding the money or risks in buying the substance
• how you put the substance into your body, such as drinking, eating, inhaling, smoking, snorting or injecting
• the effect of the drug on your body, through increased heart rate, unconsciousness or long-term liver damage
• what you do while under the influence of the drug , through increased risk taking or neglect of other responsibilities
• what happens after you use, which may include depression when ‘coming down’ or withdrawal symptoms.

A number of psychological treatments can help people who experience problems with alcohol or other drug use.

Motivational interviewing

Most people have mixed feelings about their alcohol and other drug use. Motivational interviewing is a technique that psychologists use to help people explore their doubts and indecision about making changes to their drug use.

Brief interventions

Psychologists can often provide helpful assistance in one or two sessions. This may involve providing information about harm minimisation techniques, such as staying as safe and healthy as possible if you choose to use alcohol and other drugs.

Cognitive behaviour therapy (CBT)

CBT helps you change unhelpful thoughts and behaviours that can contribute to alcohol and other drug use, and aims to build skills to manage cravings for alcohol and other drugs when they arise.

Mindfulness strategies

Mindfulness is a state of being open to your experiences in the present moment. Mindfulness strategies can help you respond to feelings and sensations associated with alcohol and other drugs by paying attention to them, rather than avoiding them. Psychologists can help you learn to be more accepting of your thoughts and sensations, less overwhelmed and distressed by them, and better able to cope.

Community reinforcement

Some people decide to stop drinking or using drugs altogether. Psychologists can use a community reinforcement approach to help you organise your life so that the benefits of not using alcohol or other drugs outweigh the benefits of continuing.

Couples and family therapy

Psychologists can help couples or families where one or more of the members is drinking or using other drugs. You may also find couples or family therapy helpful if you have noticed your own alcohol and other drug use affecting your relationship with others.

Pharmacotherapy

Some medications can help you to reduce your use or alcohol or other drugs, or help you to continue not to use once you have stopped. Talk to your GP about the options.

Many people recover from harmful substance use on their own, but if alcohol and other drugs are affecting your day-to-day life or the life of someone you know, a psychologist may be able to help.

Psychologists are highly trained and qualified professionals, skilled in diagnosing and treating a range of mental health concerns, including substance use problems.

A psychologist can help you to identify and manage the factors that contribute to your substance use. If you are using substances to cope with other difficulties, psychologists can also help you to find other ways to deal with these problems. These problems might include grief and loss, abuse, trauma, relationship break ups, low self-esteem, or overwhelming emotions such as anger, anxiety or depression.

Psychologists usually see clients individually, but can also include family members to support treatment where appropriate. Psychologists sometimes offer group therapy, involving a small number of people with similar issues.

If you are referred to a psychologist by your GP, you might be eligible for a Medicare rebate. Ask your psychologist or GP for details.

There are number of ways to access a psychologist. You can:

• use the Australia-wide Find A Psychologist service directory or call 1800 333 497
• ask your GP or another health professional to refer you.

1. AIHW. (2017). National Drug Strategy Household Survey (NDSHS) 2016 – key findings. Retrieved from www.aihw.gov.au.