What is drug or alcohol misuse?

Drug and alcohol misuse is when drug and alcohol use becomes a problem. Misuse can involve:

• intoxication
• regular unsafe use
• dependence

Drug or alcohol use can become a problem when it starts to affect a person's:

• judgement
• relationships
• general health and wellbeing
• responsibilities, such as school or work

Drug and alcohol misuse is common. Around 1 in 3 adults in Australia drink alcohol at risky levels and roughly 2 in 5 people in Australia have used an illegal drug at some point in their lives.

Illegal drugs

Drugs are substances that affect how the body or brain functions. Illegal drugs such as cocaine and heroin can be harmful.

Unlike prescription medicines, there is no government organisation that regulates the strength or amount of active ingredients in illegal drugs. This means that someone using an illegal drug can't know how strong the drug is or what is actually in it.

Alcohol

Alcohol is a legal drug that can be harmful if taken in large amounts or for a long time. It affects people in different ways depending on how much they drink and what medications they are on.

Prescribed medicines

Medicines that have been prescribed by a doctor can also be harmful if they aren't taken as directed or are taken for non-medical reasons.

How do I know if someone needs help for their drug or alcohol use?

It can be difficult to tell if a person is misusing drugs or alcohol, especially if they're trying to hide their drug or alcohol use.

Some drugs can cause noticeable physical symptoms such as:

• changes in mood or behaviour
• changes in energy levels or sex drive
• pupils that are larger or smaller than normal
• frequent nosebleeds
• sudden weight loss or weight gain

A person may be misusing drugs or alcohol if their use leads to:

• difficulty keeping up at school or work
• relationship or family problems
• financial difficulties
• Injuries, such as accidents or violence after using drugs or alcohol

Drugs or alcohol use may be a problem if someone:

• finds it difficult to cut down or stop using
• spends a lot of their time trying to find or use drugs or alcohol
• uses larger amounts over time to have the same effect
• uses drugs or alcohol frequently to cope with everyday life
• experiences withdrawal (feels sick or moody when stopping or cutting down on drugs or alcohol)

These signs aren't always related to drug use. This is especially true if for young people who may be coping with the challenges of adolescence.

If you aren't sure whether a person is misusing drugs or alcohol, or needs help for another problem, start a conversation to see if they're OK.

How do I start a conversation about someone's drug or alcohol use?

Here are some tips to start a conversation with someone about their drug and alcohol use.

Prepare for the chat:

• Preparation is key — it s normal to be anxious. Speak with a professional about how to talk to someone about drug use.
• Maintain the person's trust — don't go through their personal belongings or access private information on their social media. They may feel mistrusted and suspicious.
• Pick a place — pick somewhere you won't be interrupted and will have some privacy. Some people find it less confronting to talk while walking together instead of sitting face-to-face.
• Pick the right time — only start the conversation when the person is not currently affected by drugs or alcohol.

Having the conversation:

• It's OK to ask someone directly about drug use. Don't make assumptions that the person is using drugs, or about how much or how often they use drugs.
• Use 'I' statements to express your concerns about the person, for example, 'I'm a bit worried because...'.
• Give the person a chance to respond and express their views.
• Try to listen to the person without being judgemental.
• Talk about the support available that can help the person reduce or stop their alcohol or drug use.
• Make it clear that you are happy to talk again and provide support. You might ask them if they want to chat again in a week or so.

The person may not agree that their alcohol or drug use is a problem and might become defensive or angry. If this happens, it doesn't mean that you have failed — the person may just need more time to think about what you discussed.

What should I not say to someone about their drug or alcohol use?

When speaking with someone about their drug or alcohol use try to avoid:

• being judgmental
• telling them what they should do
• being confrontational
• making them feel guilty
• using bribes or threats
• using negative labels such as 'addict'

When speaking to someone about their drug use, listen respectfully to their views and respond calmly. The tone and the type of language you use is important and can influence how the person responds to your concerns.

How do I support someone who has a drug or alcohol problem?

There are many services available to help people who are struggling with drug or alcohol misuse. If the person is interested in professional help, you can help them find a local drug and alcohol treatment service.

Here are some tips to help support someone with a drug or alcohol problem:

• Help them with practical support, such as delivering meals and checking in regularly.
• Celebrate small successes and try to keep supporting them if they relapse.
• Set boundaries with the person.
• Be realistic about any emotional, practical or financial support you can provide.
• Help the person access self-help recovery programs such as Narcotics Anonymous and SMART Recovery.
• If the person doesn't like the idea of a support group, suggest a private telephone service.

Drug and alcohol treatment and recovery will take time. Many people don't succeed the first time they try to quit.

If you're concerned that the person may overdose on an opioid, consider naloxone (a medicine that can temporarily reverse the effects of an opioid overdose). You can access naloxone for free and without a prescription through the Australian Government's Take Home Naloxone program.

What if the person doesn't want help for drugs or alcohol?

Ultimately, it's the person's decision whether to seek professional help. It's common that people go through cycles of stopping and restarting use of drugs and alcohol.

Here are some tips if the person doesn't want help to reduce their drug or alcohol use right now:

• Be careful not to nag or guilt trip the person. This isn't helpful and could upset them or push them away.
• Set clear boundaries about what you expect or won't tolerate. For example, you might not accept drug use in your home or be willing to have the person in your home if they are affected by drugs.
• Encourage the person to learn how to minimise the risk of harming themselves — for example, through needle and syringe programs (NSPs) or opioid replacement therapy.

Find a needle and syringe program in your state or territory.

How can I look after myself while supporting someone?

Supporting a friend or family member with a drug or alcohol misuse problem can be difficult.

Here are some tips to help you look after yourself:

• Look after your physical and mental health by eating well and keeping active.
• Get support from your own friends and family.
• Go to events or support groups in your community.
• Let the person know if you need to take a break and when you'll be available again.
• Reach out to services such as Family Drug Help, that provide support for family members and friends affected by someone with an addiction.

When should I see a doctor?

If someone has taken drugs or alcohol and may cause harm to themselves or others, or is very unwell, call triple zero (000) and ask for an ambulance.

You should see a doctor if you feel that you have a problem with drugs or alcohol. Getting help is an important first step to making a change.

Get urgent medical help for someone who seems dangerously affected by drugs or alcohol. Signs that someone may be dangerously affected by drugs or alcohol include:

• difficulty breathing or chest pain
• severe drowsiness or unresponsiveness
• seizures or collapsing
• choking or gurgling sounds
• expressing paranoid ideas, hallucinating or becoming agitated
• vomiting
• sweating

You might also notice that the person has:

• a slow heartbeat or pulse
• pinpoint pupils
• cool, pale or clammy skin

It's important to seek immediate medical attention even if you're worried the person might get into trouble for taking illegal drugs.

Paramedics will notify police if there is a risk to their own safety, the person's own safety or the safety of others. Paramedics will also notify a person's parent or guardian if they are under 18 years of age and are taken to hospital.

If a person becomes aggressive or violent after consuming drugs or alcohol, and your own safety is at risk, don't stay with them. You can still help the person by calling triple zero (000) once you're in a safe place.

Resources and support

The Australian Government offers:

• a Drug Help page which provides resources around seeking help for drug use
• Positive Choices which provides information, resources and drug education
• Cracks in the Ice which has information on crystal methamphetamine ('ice') use

Al-Anon Family Groups Australia offers support to the family and friends of someone struggling with alcohol.

Self-Help Addiction Resource Centre (SHARC) provides professional help and practical support to people who are looking after a family member living with addiction.

Counselling Online is a free, text-based counselling service for people seeking help for their own or a family member s drug use.

Drug Info provides information about alcohol and other drugs.

Family Drug Support offers information and support to the families of people struggling with drugs and alcohol — for a 24-hour support hotline call 1300 368 186.

ReachOut provides information, support and advice to young people.

Lifeline provides 24-hour phone and online counselling and support. Call them on 13 11 14.

Languages other than English

Positive Choices has information and resources for people from culturally and linguistically diverse backgrounds.

The Your Room page has information about treatment for drug use in multiple languages.

Information for Aboriginal and/or Torres Strait Islander people

Positive Choices has information and resources for Aboriginal and Torres Strait Islander people and communities.

The Alcohol and Drug Foundation has resources and drug facts for Aboriginal and Torres Strait Islander people.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.