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A 'drug' is "any substance, with the exception of food and water, which, when taken into the body, alters its function physically and/or psychologically".¹
Drugs are also called substances.
Psychoactive drugs are the ones people are generally concerned about. These work on the central nervous system and influence people's emotions, thinking and behaviour.
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Psychoactive drugs influence people's emotions, thinking and behaviour. They may be legal (e.g. alcohol) or illegal (e.g. heroin). |
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Drug dependence can be physical, psychological or both. |
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Sudden withdrawal from a drug can be dangerous. Before stopping use, a person should consult a doctor. |
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When a young person has used drugs in order to cope with problems and difficulties, it is hard to give this up and try new ways of handling things. |
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The use of two or more drugs at one time increases the risk of overdose. |
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The harm minimisation approach supports the provision of full information about the effects of drugs and ways to reduce harm from drug use. |
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There are legal and illegal (or illicit) psychoactive drugs.
Legal drugs include alcohol and cigarettes, and prescribed medications such as the tranquilliser Benzodiazapine (e.g. valium, serepax, rohypnol).
Illegal drugs include marijuana, amphetamines (speed), heroin, cocaine and ecstasy.
Interestingly, it is the legal and socially acceptable drugs of tobacco and alcohol that account for most deaths and health problems in Australia. They also account for many social problems, such as violence and car accidents. Any drug can be harmful if not taken according to medical advice or at a safe level.
The illegal status of certain drugs mean they may cost more and therefore tend to be associated with criminal behaviour, in particular heroin use. The ingredients may be less certain and therefore the strength and safety of the drug unknown. It also means there is a greater risk of legal consequences if someone is found using or selling the drug.
Drugs are further classified according to the effect they have on a person.
Stimulants speed up the central nervous system and result in an increased heart rate and alertness. These include coffee, amphetamines (speed), cigarettes (which also have muscle relaxant in them) and cocaine.
Depressants slow down the central nervous system and reduce heart rate and increase relaxation. These include alcohol, heroin (H, smack, dope), inhalants (chroming, glue or paint sniffing) and marijuana (cannabis, dope, weed). Marijuana also has hallucinogen qualities.
Hallucinogens distort one's sense of reality, for example, they may lead you to see, feel or hear things which are not there. Hallucinogens include LSD, acid trips, magic mushrooms and ecstasy. Ecstasy also has some stimulant or speed in it.
It is worth noting that in most categories, there are legal and illegal drugs
For information about specific substances, go to the Australian Drug Foundation website.
If a person has been using a drug for a period of time, has developed an increased tolerance of the drug and needs the drug in order to function, then they are said to have developed a physical dependence. It's impossible to say how much one person needs to use to develop dependence.
Physical dependence, or addiction, means the person's body has adapted to having the drug in their system.
If a person reduces or stops using a drug, they are likely to go into 'withdrawal' or to experience withdrawal symptoms. Withdrawal is the body getting used to functioning without the drug in its system. When a person has completely withdrawn or stopped using drugs and there are no drugs left in their system, they are said to have 'detoxed'. This process of withdrawal or detoxification can take up to three weeks and sometimes longer depending on the type of drug that was being used and the quantity. Levels of drugs present in a body are shown through urine and blood tests.
Withdrawal, or 'detox', symptoms vary in their nature and intensity, depending on the amount and type of drug taken, and on the characteristics of the person. Withdrawal symptoms may include: irritability, nausea, shakiness, cramps, depression or sleeplessness.
It is normal for people to want to avoid going through withdrawal and the discomfort and pain this may involve. Out of a desire to avoid withdrawal, people can feel a desperate need, and go to desperate measures, to get more of the drug they were using.
If a person has a physical dependence and then suddenly stops using, they will most likely go into withdrawal. Going from using a lot to not using at all is also called going cold turkey. This can be dangerous particularly if a person has been using benzodiazepines. It is very important that people planning to withdraw from drugs get some medical supervision or advice.
People often have a preferred or primary drug that they use. If they go into withdrawal, they might use another drug to try to self-medicate their withdrawal symptoms or until they relapse and take more of their preferred drug again. For example, some people use marijuana or valium to cope with heroin withdrawals until they are able to get more heroin.
Withdrawal or 'Detox' Programs provide the following services under professional supervision:
- suitable medication to relieve withdrawal symptoms
- emotional support and strategies
- information for suitable support beyond the detox
- some provide alternative therapies (such as massage, naturopathy and acupuncture to assist with withdrawal symptoms).
These services may be Residential (live-in for a week or two), Outpatient (person goes to appointments at a clinic during the withdrawal period) or Home-Based (worker visits the persons home to provide support during the withdrawal period).
Stopping heavy substance use suddenly (for example, alcohol or Benzodiazepines) can be dangerous.
Prior to reducing or stopping use of these substances, a person needs to consult a doctor and consider engaging with a Withdrawal Service. They can then undertake changes in a planned, professionally supervised and supported way.
A person may be psychologically dependent or addicted to a substance even though they may not be physically dependent anymore. For example, they may 'detox' or withdraw from the substance (and have none of the drug present in their body), yet still have cravings or a strong desire or yearning to use the drug, which can seem hard to resist. This is a sign of psychological dependence. Physical withdrawal can also trigger, or lead to, cravings.
In order to make changes to their drug use, people need to be able to handle urges or cravings to use. There are strategies that can be used to deal with cravings (See: Alcohol and Other Drug Services for Families).
In order to address their psychological dependence, people may have to make other substantial changes in their lives, for example changes to:
- the purpose or meaning they have in their lives
- what they see as most important in their lives
- how they spend their time and who they mix with
- their thinking patterns
- the way they handle emotions and stress
- the way they handle relationships
When drug use has been used as a method of coping, it is hard to give this up and try new ways of handling things. Various treatments aim to address both the physical and the psychological aspects of drug use (See: Alcohol and Other Drug Services for Families).
Tolerance is when the body adapts to having a drug in the body, and the person gradually needs more of the drug to get the same feeling they were after.
If a person who has been using drugs regularly reduces or stops using, and goes through withdrawal, their tolerance drops. If they use again, they are likely to be more sensitive to the effects of the drug. They will require less of the drug to get the same effect that they are after; for example, they may feel more stoned on marijuana or heroin, or more drunk on alcohol.
When people suddenly increase their drug or alcohol use again after a period of reduction or abstinence, there is a much higher likelihood of intoxication (being highly substance affected) or overdoses (where a person may become unconscious or die). If a person has been imprisoned or in a drug withdrawal unit they will usually come out with a reduced tolerance of drugs. They are at risk of overdosing if they use the same quantity of drugs that they were using prior to entering prison or a withdrawal program.
People leaving withdrawal services or prison should be made aware of the risk of overdose.
Overdose is a particular concern for heroin users for the following reasons:
- The purity or amount of heroin in the substance injected is unknown, therefore, it is not possible to predict how much will result in overdose. (Some users may think they know the purity level as they are using the same dealer or source etc).
- Heroin is usually injected, so the drug hits the system quickly.
- Heroin is a depressant or sedative drug which means that it slows the heart rate and breathing. High doses may cause breathing to stop altogether.
- If other depressants or sedatives such as benzodiazepines (e.g. valium), alcohol or methadone are used with heroin there is a cumulative (or added) effect which is hard to predict.
- Everyone is different, and the same amount of a certain drug will affect people differently at different times.
You should always call '000' if you are concerned about someone's physical state, for example if they are having trouble breathing, or collapse or are unconscious. You should consider learning first aid for dealing with overdoses if you are very concerned about your young person.
Harm minimisation is the approach that the Australian government has adopted to deal with drug problems in our community.
Harm minimisation acknowledges that drug use has always occurred in societies, and is likely to always occur and that some people will choose to use drugs. It attempts to:
- Prevent people from starting to use drugs.
- Reduce the quantity of illegal drugs available to people through police and law enforcement.
- Reduce and minimise the harm associated with drug use by promoting strategies for safe drug use.
- Provide support to assist people to control, reduce and stop using drugs via Alcohol and Other Drug Treatment Services.
Harm minimisation focuses on people's right to make choices in their lives and moves away from blaming and judgement of people who use drugs. Blame and judgement is seen as generally unhelpful to people trying to make positive changes in their lives.
Importantly, this approach maximises the safety and wellbeing of people who do use drugs. For example, the free needle and syringe program provided for people in Australia has kept the number of drug users with HIV and AIDS down to low numbers compared to other countries.
The harm minimisation approach supports the provision of full information about the effects of drugs and ways to reduce harms related to using drugs.
Giving information on safer or less harmful ways to use a drug to someone who is continuing to use drugs and is not interested, ready or able to stop their use achieves many things:
- It increases the likelihood the person will survive.
- It may avoid preventable long-term side effects.
- It communicates concern while leaving the decision to stop with the person.
There are different strategies and information for different drugs. For example, heroin and injecting drug use, marijuana, and party drugs. Literature on harm minimisation strategies for heroin users emphasises the importance of not sharing needles and provides information to users on how to clean syringes properly. Harm reduction strategies for marijuana use include such things as using a glass rather then a plastic bottle for a 'bong' when smoking marijuana so less fumes are inhaled.
Education about how to inject drugs in the safest way possible helps to prevent the spread of blood-borne viruses, such as Hepatitis C. This disease is very prevalent within the injecting-drug using community, currently occurring at rates of approximately 80% of injecting drug users.
For more information on Harm Reduction strategies, see Alcohol and other Drug Services for Families.
Substitution therapies, or pharmacotherapies, are a medical treatment for drug dependence. They aim to deal with both the physical and psychological aspects of drug dependence. They are intended to reduce the cravings for the drug while also minimising the harmful effects of drug dependence on a person's life.
Examples of pharmacotherapies are Methadone, Buprenorphine, Naltrexone and Campral.
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