All substance use can become problematic: alcohol, tobacco, illicit drugs, prescribed medicines, ‘legal highs‘, solvents...
Problematic substance use also comes in many forms:
Self-medication
Using a substance to cope with situations including stress, anxiety, depression, physical pain or sleep difficulties.
Bingeing
Using a substance in excess by consuming a large amount over a relatively short period of time.
Dependency
Using a substance compulsively
to induce a desired experience or remove an undesired experience.
This can develop as either or both of the following types of symptoms:
Psychological
Using a substance compulsively for the need of the psychoactive effect.
Physical
Using a substance compulsively for the body to function properly.
Problems arise due to the three R’s: substance use is experienced as ‘rewarding’, which is reinforced and leads to repetition of behaviour.
The presence of two or more of the following symptoms may be an indication of a substance use disorder:
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Using larger amounts or over longer periods than intended.
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Persistent desire or unsuccessful efforts to reduce use.
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Spending a great deal of time obtaining, using or recovering from a substance.
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Cravings - strong urges to use a substance.
Recurrent use resulting in...
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Failure to fulfil major work, school or home obligations.
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Social or interpersonal problems.
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Giving up important occupational or recreational activities.
Continued use...
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In physically hazardous situations.
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Despite physical or psychological problems caused.
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Tolerance - need for increased amount of the substance to achieve desired effect.
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Withdrawal - development of specific symptoms after reducing use.
This is an important decision that should be considered carefully. It may be unrealistic, or even unsafe, to just stop using suddenly - particularly with alcohol, benzodiazepines and heroin.
Keeping a substance use diary can help with goal setting by recording: What you used? How much? When? Where? Who with? Why?
If your goal is to stop using altogether, choose a target date for this to begin.
If your goal is to reduce using, plan how much and how often you will use over the next few weeks.
Everyone is different
Whatever the decision, it is important your goals are realistic. Unrealistic goal setting is unhelpful and can deter you from stopping or reducing use.
Problematic substance use develops over time, as does addressing such problems.
It is a process with many ups and downs along the way.
Personal factors, which are typically present in childhood and early adulthood, can heighten the risk of developing a substance use disorder.
It is important to be aware of your own susceptibility by considering:
Genetics - family history of blood relatives with a substance use disorder.
Early Trauma - adverse experiences such as abusive family and unstable home situations.
Personality - externalising traits in the form of impulsivity and sensation seeking.
Mental Health - pre-existing disorders including anxiety and depression.
My Susceptibility
Use your device's note-taking app or a piece of paper to identify your susceptibility to substance use disorder. Is there anything that makes you more susceptible?
Some situations can apply pressures that increase the risk of developing a substance use disorder.
Expand the list to see examples of such pressures. It is likely you will have encountered some, or even all of them.
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Being around people who use.
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Places where past use took place.
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Overwhelming stress.
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Negative emotions, such as anger or loneliness.
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Positive emotions, such as joy or excitement.
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Fatigue or exhaustion.
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Long periods of boredom.
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Thinking you can use without problems recurring.
To manage high risk situations and avoid problematic substance use, the following strategies may be helpful:
Relationships - minimise contact with people who trigger pressures-to-use and talk to supportive family, friends, band members, crew or management.
Activities - distract yourself from pressures-to-use by finding alternative means of coping, relaxation or enjoyment.
Feelings - recognise, understand and accept the cause of your emotions that arise with pressures-to-use.
Thoughts - challenge problematic thinking by talking yourself through pressures-to-use and remembering they will pass in time.
Surroundings - limit time spent where there are pressures-to-use and safely dispose of substances and paraphernalia around your home, hotel room or tour bunk.
You can memorise these strategies by using the acronym RAFTS.
Finding alternative means of coping, relaxation and enjoyment can act as a substitute for substance use.
In some instances, this may involve replacing the substance with a healthier option, such as a soft drink or chewing gum.
Activities like physical exercise, reading a book or listening to music can also be effective.
If you are concerned about your substance use:
Contact your GP - they can discuss any concerns, offer treatment or refer you to a local substance use support service. Alternatively, you can contact your local substance use support service directly.
Visit the Adfam website to find support in your area.
Other support options to consider are 12-step programmes (Alcoholics Anonymous / Narcotics Anonymous) or SMART Recovery meetings.
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