Alcohol and Other Drugs

Alcohol

Alcohol is the most widely used drug in Australia today and drinking in moderation is acceptable to many people. However, alcohol can be harmful to both mental and physical health and the risks increase with the amount of alcohol consumed.

Tips for tackling the festive season

How much is safe to drink?

The following guidelines have been developed by the National Health and Medical Research Council: to help people make informed choices about their levels of drinking.

Drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol related disease or injury.

Drinking no more than four standard drinks on a single occasion (e.g. going from venue to venue on a night out) reduces the risk of alcohol related injury arising from that occasion.

For women who are pregnant, planning a pregnancy or breastfeeding, not drinking is the safest option.

Not drinking is recommended for children under 15 years of age as they are at the greatest risk of harm.

For young people between the ages of 15-17 the safest option is to delay their initiation to alcohol.

There is no amount of alcohol that is safe for every individual. This is because there is huge variability in our biological responses to alcohol. Factors such as gender, body size, experience of drinking, genetics, individual metabolism and nutrition all play a part. Social factors such as smoking, binge-drinking and drink driving also contribute to the ultimate effects of alcohol consumption. Medications including prescription, herbal, over the counter and illicit drugs all interact with alcohol in different ways. Those prone to mental health problems may also have worse symptoms after a drink.

When was the last time you woke up and wished you’d had just one more drink the night before?

I have never regretted not drinking. Say this to yourself, and you’ll get through anything.

Meredith Bell

How much is a standard drink?

One standard drink equals 10 grams of alcohol

Can/stubbie low-strength beer	= 0.8 standard drink
Can/stubbie mid-strength beer	= 1 standard drink
Can/stubbie full-strength beer	= 1.4 standard drinks
100 ml wine (13.5% alcohol)	= 1 standard drink
30ml nip spirits	= 1 standard drink
Can spirits (approx 5% alcohol)	= 1.2 to 1.7 standard drinks
Can spirits (approx 7% alcohol)	= 1.6 to 2.4 standard drinks

When does alcohol become a problem?

The risk of harm relating to alcohol increases with the amount of alcohol consumed. If you drink more than the recommended limit on a regular basis, this can have a harmful effect on many of the body’s systems and organs, including the brain. Many illnesses such as heart disease, certain cancers, kidney and liver disease are related to high level of alcohol use, misuse and dependence.

People may use alcohol as an escape from difficult situations or feelings and eventually lose their ability to cope with day to day life without the use of alcohol. Personal relationships, family responsibilities, work, accommodation and education may become neglected as the person’s use of alcohol becomes more and more important to them.

Although most people drink to relax, have fun, or fit in with a group, some people find it difficult to control their use of alcohol and find themselves drinking more than they intended. Alcohol use, particularly excessive alcohol use is correlated with incidents of assault, homicide, accidents and incidents of domestic violence and it is estimated that over 3,000 Australians die each year as a result of harmful drinking.

Anxiety and depression are also strongly linked to alcohol, with around 40% of those seeking treatment for alcohol dependence also having experienced symptoms consistent with depression. Numerous studies have shown that when people with significant alcohol dependence stop drinking entirely their mood usually worsens the first few days, but after three weeks is greatly improved.

What are the signs of problem drinking?

Alcohol is considered to be a ‘depressant’ substance, meaning that it slows down the nervous system. Depressants tend to make a person’s thinking slower and can make them drowsy and uncoordinated. Emotions tend to be intensified, so if a person feels angry for example, they may get angrier than usual.

Signs that you might have a problematic relationship with alcohol include:

drinking heavily when you are disappointed, under pressure or have had a quarrel with someone
being able to handle more alcohol now than when you first started to drink – building up a physical tolerance
feeling uncomfortable if alcohol is not available
a family member or close friend expressing concern or complaining about your drinking
wanting to continue drinking after your friends say they’ve had enough
drinking alone or ‘sneaking in’ extra drinks so that other people don’t notice how much you are drinking
feeling depressed or anxious before, during or after heavy drinking
eating very little or irregularly during drinking bouts
avoiding family or close friends while you are drinking
forgetting what happened when you were drinking
drinking earlier in the day, or first thing in the morning
having memory ‘blackouts’
when you’re sober, regretting things you did or said while drinking
trying to stop drinking without success
driving under the influence or assaulting someone whilst drunk
having more financial, work, school and/or family problems as a result of your drinking
having the ‘shakes’ in the morning and finding that it helps to have a another drink, tranquilliser or other medication
staying drunk for several days at a time
seeing or hearing things that aren’t there after periods of heavy drinking.

Alcohol dependence

Physical dependence occurs over a period of prolonged heavy alcohol use when your tolerance to alcohol increases and you become so used to alcohol that you have to drink more and more to get the same effect and . when there is no alcohol in your body you are likely to experience some of the following symptoms of withdrawal:

nausea, vomiting and headaches
trembling or shaking
sweating profusely
craving more alcohol
flu-like symptoms.

What causes alcohol problems?

These problems are usually due to a combination of biological, social, and psychological factors unique to each person but may include:

the social acceptability of alcohol along with its availability and price of alcohol affects how much it is used
Genes – there is evidence that people who have a genetic vulnerability to alcohol dependence are at an increased risk of developing these problems
Family history – alcoholism tends to ‘run in families’ although it is unclear whether this is due to genetic factors or social and psychological factors (learned behaviours that are passed down through generations/trauma), but is probably best explained by a combination of these.
Stressful or traumatic life experiences can be the catalyst for a person drinking alcohol to excess

What help is available?

There are a range of services and treatment options to assist someone with a drinking problem. Each may be appropriate at different times.

Detox

If you are physically dependent on alcohol, you may need to get rid of the alcohol in your system. This is known as detoxifying or ‘detox’. The physical symptoms and the length of the withdrawal process vary according to the individual. There are various ways to detox:

at home with assistance from your doctor
in a medical facility such as a hospital or specialised detox service.
Medications may be given to help ease the withdrawal symptoms.

NOTE: If you experience delirium tremens (the DTs, or the ‘shakes’) seek immediate medical help. In extreme cases this can be fatal.

Rehabilitation

Following detox it is important to make life changes that will help you avoid further problematic drinking. Rehabilitation involves counselling, education, living skills and other supports.

Group treatment options

Alcoholics Anonymous (AA) is an international fellowship of men and women who have had a drinking problem. It is non-professional, self-supporting, non-denominational and available almost everywhere. Meetings are attended on a regular basis and members go through their own journey of the ’12 Step’ program. Many people all over the world have found AA to be helpful and effective but it is not for everyone. The best thing to do is to learn about it and decide whether the program sounds right for you.

Smart Recovery (Self-Management and Recovery Training) is a voluntary peer-managed, self-help program based on Cognitive Behavioural Therapy (CBT) tools. Groups are open so people can attend as many meetings as they like. Participants are given the opportunity to discuss difficulties, challenges, accomplishments and successes while focusing on setting goals. The focus is on the here and now and encouraging people to abstain and achieve a healthy lifestyle balance.

The program assists participants to manage the beliefs and emotions that lead or encourage them to drink or use drugs so that they are empowered to quit. It is based on 4 key components:

enhancing and maintaining motivation
coping with cravings
problem solving
lifestyle balance.

For information about meetings across NSW go to www.smartrecoveryaustralia.com.au

What can I do to help myself?

Talk to someone about your drinking and think about why you want to stop or cut down. It helps to be clear about your motivation.

Decide on your goal – do you want to stop completely, or simply reduce the amount you drink?
Think about why you drink and what benefits you get. Can you think of other ways of getting those benefits?
Monitor your alcohol intake in units and try to stay below the maximum recommended amounts.
Take one day at a time and don’t give up if you relapse. Most people find that it takes several attempts to stop drinking so don’t be disheartened – just resolve to try a bit harder tomorrow.

How can family and friends help?

It can be frustrating when someone you love is drinking too much, particularly as it is impossible to force someone to stop drinking or to receive treatment. However, there are some things you can do that may help.

Don’t try to protect the person from the results of their drinking. By making excuses for the person, you are ‘enabling’ them to continue drinking without experiencing the natural consequences. For example, someone might ask you to call in sick to their workplace when they have a hangover. If you agree, they do not have to accept the consequences of their drinking and may see no reason to stop.
Find out about local treatment options and pass this information on.
Accompany the person to a treatment program and encourage them to persevere.
When talking to someone about the problem, use specific, recent examples of their problem drinking to support what you are saying. The best time to approach the person may be soon after an alcohol-related incident has occurred.
Be clear about what you will and will not tolerate. Explain what you will need to do if they don’t get help. This should not be done in a ‘threatening’ way, but in a way that tells the person that you have limits and that there are consequences of their drinking.
Consider contacting Al-Anon for support. This is a program adapted from Alcoholics Anonymous and helps family members to cope with the impact of a person’s drinking.

Other Psycho-active drugs

Psycho-active drugs are substances that affect the brain and cause an altered mental or emotional state. They include legally prescribed drugs such as antidepressants and sleeping tablets, as well as illegal drugs such as heroin, cocaine, marijuana, ecstasy or amphetamines.

Legal problems aside, some people use illicit drugs without coming to any physical or mental harm. However, many find that their drug use causes problems with their physical and/or mental health.

Physical and mental health issues with drug using

If a person has no physical tolerance to the drug, they may take more than their body can handle and overdose.
A person and/or their friends may not know how to cope if someone has a bad reaction, e.g. severe intoxication or overdose
A person may experience a drug induced psychosis that can in some cases lead to a long term psychotic illness such as schizophrenia.
Illicit drugs are not subject to any kind of price or quality control and users can never be sure about the strength, safety or purity of the drug they are taking. Some drugs are mixed with other substances before being sold to bulk them out and increase the dealer’s profits. These added substances may be as harmless as sugar or as harmful as pesticides.
A person may continue to use and become physiologically or psychologically addicted.
Health problems such as emphysema, cancer, HIV and hepatitis can occur either directly as a result of the substance use or as a consequence of lifestyle factors associated with illicit drug use.
Financial problems are common as illicit drugs are usually expensive, leaving less money for things such as rent, bills, food or clothing.
When does drug use become a problem?
A person’s drug use becomes problematic when they:
develop a tolerance to the drug and need to take larger amounts to get the desired effect
experience withdrawal symptoms when not using the drug
feel unable to reduce or stop using
spend large amounts of time and energy obtaining, using and recovering from drugs
know that the drug is causing ongoing physical or mental health problems but keep using despite this.

What are the different types of drugs?

Stimulants – include amphetamines, cocaine, and party drugs such as ecstasy and ice. These speed up the functions of the nervous system so that the person using them often appears wide awake, full of energy and more talkative than usual. Emotions tend to be intensified, so if the person is feeling happy and having fun, that experience is enhanced.

Hallucinogens – include LSD (‘acid’), magic mushrooms, and ketamine. These affect the person’s perception, so that they see, hear and feel things that do not really exist. The person’s behaviour may appear confused or bizarre and their thoughts and conversation may be difficult to follow.

Depressants – include alcohol, cannabis, opioids such as heroin, and solvents and inhalants such as petrol or glue. These slow down the nervous system. Depressants tend to make the person’s thinking slower and may make them drowsy. Emotions that the person is feeling tend to be intensified.

What causes drug problems?

It is likely that a combination of bio- psycho-social factors affect whether an individual will have problems with drugs.

It is thought that people who have other experiences of psycho-social distress, particularly those with experiences of mental distress and or illness have an increased likelihood of using psycho-active drugs, the occurrence of these two types of problems are often termed as having a ‘dual diagnosis’ .

There are a range of theories that attempt to explain this association and all provide so me rational for the relationship between substance use and mental illness, but no one perspective offers an absolute explanation.

The actions of psycho-active drugs are largely attributable to interactions with the central nervous system, resulting in changes to physical and mental functioning. Depending on the type of substance and its primary action, substances might mask, mimic, precipitate or exacerbate experiences of mental distress and or illness.

It is not uncommon for people to believe that the use of psycho-active drugs improves or alleviates their experiences of distress. Whilst these desirable changes may occur, they are not long lasting and are often associated with higher levels of distress and greater negative experiences in the medium to long term.

What h

What help is available?

Detoxification, rehabilitation, medication and ongoing counselling and support are all parts of treatment for drug addiction. Treatment will depend on the severity of the addiction and the substance involved.

What can I do to help myself?

Educate yourself about drugs and addiction through reading books and reputable websites such as those listed below.
Take one day at a time – it may be too overwhelming to think of staying away from drugs forever. Make a promise to yourself not to use drugs today and worry about tomorrow, tomorrow. It takes the majority of people more than one attempt to stop using drugs, so don’t label yourself a failure if you lapse.
Try Narcotics Anonymous – a 12-Step program developed along the lines of Alcoholics Anonymous.
Allow drug treatments, such as rehabilitation, time to work. Staying in treatment for longer periods helps avoid relapse.
There is a strong social stigma around people who are addicted to drugs. Try to remember that you are more than just your addiction. You are also a son or daughter, parent, friend, and someone with a unique set of hopes, fears, dreams, strengths and weaknesses. Getting to know and accept yourself as you are will help you to stop using drugs.

How can family and friends help?

It can be frustrating when someone you love is using drugs, particularly as it is impossible to force someone to stop using or to receive treatment. There are some things you can do that may help:

Don’t try to protect the person from the results of their drug use. By making excuses for the person, you are ‘enabling’ them to continue using without experiencing the consequences. For example, someone might ask you to call in sick when they are suffering a drug ‘come-down’. If you agree, they do not have to accept the consequences of their drug use and may see no reason to stop.
Find out about local treatment options and pass this information on.
Accompany them to a treatment service if they agree to go.
When talking to someone about the problem use specific, recent examples of their drug use to support what you are saying. The best time to approach the person may be soon after a drug-related incident has occurred.
Be clear about what you will and will not tolerate. Explain what you will need to do if they don’t get help. This should not be done in a ‘threatening’ way, but in a way that tells the person that you have limits and that there are consequences of their drug use.
Find support for yourself from a support group such as Family Drug Support.

Talk To Someone

Remember that many people experience problems with alcohol and drugs. It can be very helpful to talk to a friend, relative, counsellor or psychologist to better understand what part these substances are playing in your life and to seek specialist help if your use is a significant problem in your life. Don’t let misconceptions about addictions stop you from seeking help.

Contact the Mental Health Information Service on 1300 794 991 for information about services in your area
Contact the Alcohol and Drug Information Service on (02) 9361 8000 or 1800 422 599 for information about treatment options
See your family doctor (GP)
Contact the Australian Psychological Society (APS) on 1800 333 497 for referral to a psychologist in your area.