Substance Use Disorders
What is it?
Well, a substance can be anything that is consumed in order to achieve a high, alter your senses, or change your mood/consciousness/perception. Young people might use substances for a variety of reasons. However, it’s when the usage is prolonged, heavy, or causing social or personal problems that it might become diagnosed as a substance use disorder: substance dependence or substance abuse[1].
In your life, are you experiencing?
- Behavioural changes
- Personality changes
- Work and school responsibilities are getting out of control
- Losing social relationships
- Experiencing an increase in personal or social problems
Could I be suffering from a substance abuse disorder?
Substance abuse as a diagnosis comes after seeing how you have been using substances, in particular, if you are experiencing a significant impairment in functioning[2]:
- Unable to fulfil responsibilities at home, at work, or study.
- Continuing to use substances when it is physically dangerous, e.g. when driving a vehicle.
- Your usage runs you into legal trouble, due to changes in your cognitive ability, or because of your desire to obtain more of the substance.
- Recurring social or personal issues.
- When you no longer have access to the substance, you show symptoms of withdrawal
- Your tolerance to the substance increases, and you need more every time.
People turn to substances for a variety of reasons.
Why might someone turn to substances[3]?
- The individual:
- May be genetically predisposed to do so
- Personality (e.g. character that has difficulty following rules and authority)
- Poor coping ability
- Educational issues
- Age of first use was early
- Strong personal reason to use
- Traumatic experiences (e.g. experienced abuse when a child)
- From a low socioeconomic background
- Poor levels of peer or community support
- Adverse peer influence.
- The influence of the family:
- Patterns of destructive methods of communication
- Lack of family cohesion
- Inadequate parental monitoring, discipline, or family management techniques
- Poor relationships between family members
- Parent’s role as a model (e.g. exposure to parental drug use)
- The community and society’s influence:
- Traumatic community environment
- Legislation and law enforcement
- The availability of the substances
- Society’s acceptance of substance use
A close relationship between substance use disorders and other mental disorders exists. Furthermore, use of some substances can increase the risk of developing certain disorders, though it is uncertain which causes which. What is clear however, is that young people with substance use issues often have one or more concurrent mental health disorders, like anxiety, depression and schizophrenia[4].
Signs and Symptoms
Have you noticed in yourself or a friend[11]…
- Use substances to cope emotionally, socially or physically, on a regular basis.
- Neglecting important or once enjoyable responsibilities and activities
- Participation in dangerous/risky behaviour due to the substance use (e.g. drink driving, using dirty needles, unprotected sex)
- Flare up of relationship problems (e.g. fights with partner, friends, or losing friends)
- Physical tolerance build up – having to use more of the substance to feel the same effects
- Withdrawal – physical and mental withdrawal symptoms when you are not using the substance or needing the substance to feel “normal”
- Loss of control of the substance use – being dependent on it, or unable to stop even if you want/try to
- It feels like the substance use is taking over your life (e.g. spending a lot of time using, finding, or getting the substance, and also time spent recovering from the effects)
FAQs
Q: Sure, my friends and I like to drink sometimes. But is ‘substance abuse’ really an issue for people?
It is estimated that in Australia, 12.7% of people between 16-24 years have a substance abuse disorder, with more men than women affected (16% of males and 10% of females).[5] The usage of alcohol at harmful levels is the most common reported substance abuse disorder (around 9%).[6]
Q: I’m only going to partake in drugs and alcohol while I’m young, because I want to enjoy my life. When I’m older and have to get more serious, then I’ll quit and sober up.
Substance abuse disorders can cause substantially grave ill effects both in the short and long terms. The consequences depend on the type of substance and the way it is used: Respiratory problems result from smoking, whereas the spread of infections such as Hepatitis come from injecting. There are also the immediate effects of intoxication such as overdose, road accidents, falls, risky sexual behaviour, violent and aggressive behaviour. Longer term physical effects of the substance can be brain damage, liver disease, and cancer. There is also the significant mental distress that stems from drug dependence.[7]
Q: My friend says that all her problems at home and from school go away when she abuses substances. What can I say to her about it?
The Australian Government Department of Health and Ageing recommends that you could take this opportunity to have a chat to your friend[8]. Start by talking about the other issues she is experiencing, and if you can, try expressing your concern about her using substances as a means to cope.
Let her know that if there are problems, you would be happy to talk about them, and have a look at what could be done to make things better. Prompt your friend to consider if her problems return after the effects of the substance wear off, and point out (gently!) that using only makes the problems disappear for a little while. Express to them your feelings about the dangers of using substances to deal with problem, and make it clear that you want to work together with them to find a better way of solving their problems. Remember to show empathy, and to speak gently, without judgement.
Q: What can be done about substance abuse?
It is difficult to accept and acknowledge that you have a problem, and to take the further step of asking for help. Remember to be honest with yourself, and your family and friends, and get the help and support that you need.[9] Lifeline recommends the following steps:
- Recognise when your substance use has become a problem – realising and accepting that you are abusing or addicted to substances is the first step to finding help.
- Get support – getting through this on your own can be difficult. Talk to friends, family, your doctor, other health professionals or a telephone helpline about your substance use.
- Investigate options for help – manage and treat substance misuse and addiction through counselling, medication, rehabilitation centres, self-help programs or support networks. You might need to try a number of options before you find what works for you – it’s important to keep trying.
- Find alternative coping strategies – if you are using substances to cope with life or escape personal problems, find other ways to manage the situation and deal with life’s stress and pressures. By dealing with other problems in your life you can make it easier to recover and not relapse.
- Deal with setbacks and keep going – Recovery can be a long and difficult road. Expect some setbacks and don’t focus on failures, focus on your plan and understand your triggers and how to best respond to them in future.
Q: I think I might be in trouble with my addictions, but I’m scared. How would someone be treated for substance abuse disorder?
There is a way out! Treatment options that have been shown by research to be effective include:
- cognitive behaviour therapy,
- multidimensional family therapy,
- functional family therapy, and group CBT
- contingency management and brief interventions like motivational interviewing
- However, little is known about the effectiveness of medication to treat substance abuse disorders in young people.[10]
Even if an individual didn’t meet the full criteria for a substance abuse diagnosis, they could still benefit from support to reduce the amount of their substance abuse.
Seeking help?
Services particularly supporting parents, families and friends of abusers:
Family Drug Support: Consisting of volunteers who have experienced the trauma of having family members with drug problems first-hand, Family Drug Support is an organisation for those who need help with someone they love.
Ted Noffs Foundation: Providing vital services for youth and their families, who are going through drug and alcohol problems and related trauma.
Alcohol and Drug Information Service (ADIS): Under the Australian Government Department of Health and Ageing, The Alcohol and Drug Information Centres are state and territory-based services that offer info, advice, referrals, intakes, assessment, and support 24 hours a day. Offered are services for individuals, family, friends, GPs, other health professionals, businesses, and community organisations. The Western Australia branch can be contacted via:
Alcohol and Drug Information Service
(08) 9442 5000
1800 198 024 (rural WA only)
Parent Drug Information Service
(08) 9442 5050
1800 653 203 (rural WA only)
Organisations helping those with substance abuse disorders
Somazone: An Australian website created by young people for young people. Somazone provides fast, anonymous, and free access to quality health information. Somazone is a part of the Australian Drug Foundation (ADF), and strives to empower young people through addressing their physical, emotional, and social health needs in a non-judgemental, relevant way.
Turning Point: Aims to promote and make the most of the health and wellbeing of individuals and communities that are affected by and living with alcohol and other drug-related problems.
The Youth Substance Abuse Service: (YSAS) is a community service delivering a range of services for young people between 12 and 21 years old, who are experiencing difficulties related to alcohol and other drugs.
Cannibas Information and Helpline: A confidential line providing cannabis users and friends and family with information and support, regarding cannabis use.
Sane: Mental health information and help via telephone (Monday to Friday, 9am–5pm) or online.
References
[1] http://www.headspace.org.au/what-works/research-information/substance-use
[2] https://www.lifeline.org.au/Get-Help/Facts—Information/Substance-Abuse—Addiction/Substance-Abuse-and-Addiction
[3] http://www.headspace.org.au/what-works/research-information/substance-use
[4] Armstrong, TD, Costello, EJ. Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity. J Consult Clin Psychol. 2002 Dec;70(6):1224-39.
[5] ABS. Australian Bureau of Statistics. 2007 National Survey of Mental Health and Wellbeing: Summary of Results. (Document 4326.0). 2008.
[6] Reavley, NJ, Cvetkovski, S, et al. Help-seeking for substance use, anxiety and affective disorders among young people: results from the 2007 Australian National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry. 2010 Aug;44(8):729-35.
[7] http://www.headspace.org.au/what-works/research-information/substance-use
[8] https://www.drugs.health.gov.au/internet/drugs/publishing.nsf/content/79142A3B967BB04FCA2577EC007DEADC/$File/Ideas%20for%20supporting%20friends.pdf http://www.drugs.health.gov.au/internet/drugs/publishing.nsf/content/campaign/$file/Reasons%20teens%20use.pdf
[9] https://www.lifeline.org.au/Get-Help/Facts—Information/Substance-Abuse—Addiction/Substance-Abuse-and-Addiction
[10] http://www.headspace.org.au/what-works/research-information/substance-use
[11] https://www.lifeline.org.au/Get-Help/Facts—Information/Substance-Abuse—Addiction/Substance-Abuse-and-Addiction
Generation Wired 