Alcohol and other drugs

Why do people use alcohol and other drugs?

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

Substance use is 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. Because different people may experience the same drug in different ways, it is hard to know why an individual has their particular pattern of substance use without getting to know more about what it means for them. The availability and cultural norms associated with different substances can also influence individual preferences.

When might alcohol or other drug use become a problem?

With time, some people can find their alcohol or other drug use becomes problematic, because the harm or risk of harm associated with the substance use outweighs the benefits. Substance use may be a problem when you:

• Have difficulty meeting responsibilities at home, work or school
• Use more than you intended despite wanting to cut down or quit
• Have recurring problems with health, safety, relationships, finances or the law through the substance use
• Need the substance to cope with everyday life or particular experiences
• Organise other events or needs around your substance use
• Need increasing amounts of the substance to have the same effect
• Feel sick or moody without the substance, but feel normal upon resuming use
• Have tried unsuccessfully to reduce or cease use.
• Find yourself using as a way to maintain your friendships.

What kinds of problems can alcohol or other drug use cause?

We often tend to think of the immediate harm associated with what drug is being used, how much and how often. But substance-related risks or harm can occur at any stage of drug use, including:

• How you get hold of the substance (e.g. raising the money or risks in buying the substance)
• How you put the substance into your body (e.g. drink, eat, inhale, smoke, snort, or inject)
• The effect of the drug on your body (e.g. increased heart rate, unconsciousness or long-term liver damage)
• What you do while under the influence of the drug (e.g. increased risk taking or neglect of other responsibilities)
• What happens when you cease to use (e.g. depression when "coming down" or withdrawal symptoms).

What can you do if you think you have a problem?

It can sometimes be hard to admit that your alcohol or other drug use has become a problem, especially if you still enjoy aspects of the drug use. Think about whether you would like to change your use in some way, such as:

• What you use
• How much you use
• When or how often you use
• Method of use
• Where you use
• Who you use with
• What you do to get hold of or afford the drug
• What you do while under the influence of the drug.

It can be useful to ask yourself what are the helpful and not so helpful consequences of using the substance, and what are the advantages and disadvantages of cutting down or quitting. These questions are particularly useful in identifying what goals you would like to set for yourself in changing your substance use, and the challenges that you might experience in working toward achieving those goals.

Replacing the substance use

It helps to identify what needs the substance use is meeting, and find alternative ways of meeting those needs.

• Experience pleasure or relaxation
• Feel more confident or assertive
• Socialise or feel a sense of belonging
• Have a break from problems
• Cope with painful feelings or memories
• Pass the time
• Complete other goals or tasks
• Delay or avoid doing unpleasant tasks
• Prevent the onset of withdrawal symptoms
• Do what you would 'normally do' - it's a habit.

While substance use may help to meet these needs in the short term, prolonged use of substances over time may be less effective in meeting these needs, as well as creating additional problems such as those noted previously. Just as it takes time to develop substance use habits, it sometimes takes a while before the alternative solutions feel natural and effective. Finding other ways to meet your needs can involve trial and error. Instead of looking for one solution that will replace the substance, it usually helps to replace the use with a variety of alternatives.

Dealing with cravings

People often experience strong urges to use the substance when they first try to cut down or stop their use. The following suggestions have been found to be useful by some people to cope with cravings:

• Work out when you are most likely to experience cravings and plan how you intend to cope with them before they happen
• Identify when the craving starts - it is easier to deal with cravings before they become more powerful
• Remind yourself that cravings are a normal part of cutting down and that they will pass with time – the less you give into cravings the weaker they become
• Try to find something to distract yourself with – even if you only delay using the substance
• Talk to someone supportive
• Try to work out when you are more likely to crave the substance – e.g. in certain situations, with particular people, or when you feel a certain way – and plan ahead how you will deal with each situation when it comes up.

It is a good idea to plan alternative activities for the times you would normally use alcohol or other drugs, but you may also need to look at broader changes to your lifestyle or coping strategies.

Strategies to cut down

Some people choose to cut down their use rather than stop immediately, either to regain control over their use or as a step toward stopping completely. It is advisable to seek medical advice prior to cutting down or ceasing use, as some people experience severe withdrawal symptoms. Seek medical assistance if you become unwell during a reduction in substance use.

The following strategies have been found to be useful in cutting down:

• Plan your use - set limits on the day, time and amount being used
• Try to have at least two substance free-days a week
• Fit your substance use around other priorities
• Plan ahead how you will deal with times you might find difficult - you may need to avoid some situations at first
• Delay the first use and each use after that
• Don't try to keep up with others - go at your own pace
• Ask a friend to support you
• Find something else to do to take your mind off wanting to use for example it can help to take up a new hobby
• Identify friends who support your efforts to change and who you feel comfortable with - you may initially decide to spend less time with friends who use the substance you are trying to reduce
• Decide how you intend to respond to friends who might offer you the substance before you see them – such as "Not tonight", "No, but you go ahead", "No, doctor’s orders" or simply "No, thanks"
• Remind yourself of the good things about cutting down
• Seek some counselling
• Talk to a GP about pharmacological treatments
• Join a support group
• Identify other things you have in common with friends apart from substance use.

Rewarding effort

Reward your efforts to change, even if you don’t always meet your goals. Changing habits can be difficult, and being hard on yourself just tends to make it worse. Try not to rely on will-power alone - it's a hard way for anyone to change their habits. Try a range of strategies to cut down or quit. Each time you try to make changes, ask yourself what you could do differently next time and what you would still do the same. You may choose to get some help along the way. But the most important thing is to keep trying. It's worth it.

Where to get help

If you have tried making some of the changes suggested in this brochure and found it difficult, it could be time to speak with a psychologist who specialises in alcohol and other drug use issues. They can help you to work out where you are getting stuck in making changes and help you to develop strategies that are relevant to you.

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.

It can also be valuable to seek help when someone you care about has a problem with alcohol or other drug use, as it can be an emotionally difficult and draining experience. Psychologists can assist you to find ways to deal with challenging situations and look after yourself.