1. Working with people experiencing substance use disorders
MHBiz
23 March 2016
Working with people experiencing substance use disorders
Dr. Leanne Craze,
Sydney, Australia

2. What we will cover today
What are substance use disorders
How many Australians?
Why substance use?
When is it a problem?
Risks
Types of drugs and their shorter term effects
Longer terms effects
Tips for supporting
Overview of treatments
Resources

3. What are substance use disorders
Occur when alcohol or other drugs are used at levels where there are adverse:
short-term and
long-term harm

4. What are substance use disorders
Adverse effect on a person’s life in two or more:
Taking larger amounts for longer periods
Finds it difficult to cut down despite wanting to
Focussed on obtaining and recovering from the drug
Craving to use
Repeated use interferes with daily living
Tolerance
Withdrawal
Repeated use despite hazards and health effects

5. How many Australians? 5.1% aged 16 years and over (previous 12 months)
Alcohol use disorder 4.3%
Other drug use disorder 1.4%
Males 7% & Women 3.3%
Tends to commence in teens – median 18 years
Often occur with depressive, anxiety and psychotic disorders
People with psychosis – alcohol disorder 2x more likely; drug use disorder 6x more likely

6. Why substance use? People use drugs: To relax Out of curiosity
To perform
For enjoyment
Be social
Avoid physical or emotional pain
To feel different or better

7. Types of substance use? People often move between categories:
Experimental use
Recreational use
Situational use – to cope or manage
Intensive use
Dependent use

8. Group Exercise – reasons and motivations for substance use
Film: Back to reality Listen to what each of the young people say about why and when they began using. What were some of their reasons and motivations? What effects both positive and adverse did they discuss?

9. When is substance use a problem?
Use and amount is increasing
Unable to have a good time or get through a day without it
Using more often to get away from something
Unable to stop thinking about using
Change in energy levels
Changes in mood and other psychological effects as well as health problems
Relationship conflict
Blackouts

10. Risks Availability Social tolerance and acceptance
Use in families and close relationships
Social and cultural reasons
Genetic predisposition
Experience of trauma and loss and gried
Reduced sensitivity to effects especially alcohol
Enjoyment becomes habit
Self-medication

11. Types of drugs and their shorter term effects
Drugs classified according to effects on a person’s
Central nervous system and brain’s functioning
Thinking
Feeling
Perception.

12. Types of drugs and their shorter term effects
Three major classifications
Depressants
Stimulants
Hallucinogens
People frequently use one or more different types of drugs
For detailed info:

13. Types of drugs and their shorter term effects
For detailed info:
Drugs & their effects:
ICE:
Emerging psychoactive agents:

14. Group exercise – the emogi of drug use
Your table will be assigned a type of drug:
Depressant
Stimulant
Hallucinogen
Polydrugs
Your mission is to find the emogis that best reflect the type of drug and their major effects.

15. Longer term effects of substance use
Alcohol use disorder
Other substance use disorder
Depression and anxiety
Drug-induced psychosis that persists
Social problems e.g. dropping out of education or work, legal problems
Relationship problem
Physical health problems

16. Tips for supporting – minimising risks
Take it easier
Do it more safely
Don’t mix drugs
Don’t use alone
Set some limits and enlist friend power
Understand interactions with prescribed medications

17. Tips for supporting – change
Check out online information
Try a specialised telephone or web-based helpline
Build in some drug/alcohol free times
Enlist some friends
Be choosier or wiser in your substance use
Get active to take focus away from drugs
Learn some strategies for managing stress and anxiety
Ask a GP or counsellor to help
Look after your physical health
Be patient, don’t give up and keep trying

18. Tips for supporting – change
Encourage a person to talk about it with a GP, AOD counsellor or other counsellor
How to set realistic goals
Exploring ways to cope with the urge
Strategies for anxiety, stress and grief and loss
Ways for strengthening health and wellbeing
How to keep safe
Working on relationships – interpersonal skills
Professional treatment and support options
Support groups and how they might help

19. Readiness for change – some stages

20. Readiness for change? Not worried – pre-contemplation
Thinking about it – contemplation
Trying – preparation
Doing – Action
Sticking to it – maintenance

21. Readiness for change?
Oopsie moments and relapse commonly occur along the way
Successful self-changers might go through the stages three or four times
Many will return to contemplation change

22. Some resources that might help customers with maintaining change
Common reactions to trauma -
Common reactions to grief and loss –
Good things and not so good worksheet - good-things-not-so-good-things-worksheet
Identifying negative thoughts –
Structured problem solving worksheet –
Goal setting worksheet –
Pleasure and mastery worksheet -
Visualisation and imagery -

23. Overview of drug and alcohol treatments
Counselling & pPsychological therapies
Detoxification
Pharmacotherapy
Rehabilitation
Complimentary therapies e.g. mediation, massage
Social supports and health care e.g. GP, housing, financial, legal
Peer support
Family support

24. Information about treatments
Alcohol and drug treatment guide -
Treatment guidelines for comorbidity ie both mental illness and substance use disorder type/comorbidity
Anxiety management techniques -
Motivational interviewing -

25. The importance of harm reduction
Focuses on the problems associated with substance use rather than the use itself
People who don’t want to stop, offered support to reduce the harm and effects
Support to QUIT is also available

26. When is treatment more likely to be effective?
Designed to meet person’s needs and situation
Focussed on the goals defined by the person
Strengths-based & trauma informed
Identifies related issues and offers help or referral
No-judgmental
Confidential
Evidence-based
Delivered by properly trained and accredited

27. Self care
Supporting someone with substance use problems is often difficult
Family and friends need support for themselves
Family Drug Support
GP for referral to a counsellor
Workers are encouraged to seek professional supervision and mentoring

28. Helpful resources Australian Drug Foundation www.adf.org.au
Aust Govt Alcohol Information
Counselling online –
National Drug and Alcohol Research Centre
AA and NA support groups &
Quitting cannabis app and resources -
Also DrugsMeter app & Alcohol Tracker app

29. Helpful phonelines
Alcohol and Drug Information Service (ADIS): (02) or (toll free)
NSW Users and AIDS Association (NUAA): (02) or (toll free)
Family Drug Support (02) or