A substance use disorder involves using too much alcohol, tobacco or other drugs. It can also be called substance abuse, substance dependence or addiction.
Around 1 in 20 Australians has an addiction or substance abuse problem. It can result in changes and long-term damage to the brain and other organs. Substance abuse is a major cause of mental illness.
The most commonly abused substances in Australia are tobacco and alcohol. Smoking is the single most preventable cause of sickness and death. Around 13% of Australians aged 14 and over smoke every day, and smoking causes almost 8% of the burden of disease in Australia.
Just under 1 in 6 Australians drink at risky levels. Alcohol can lead to the short-term risk of accidents, injuries or violent behaviour as well as long-term medical complications such as liver disease and mental disorders.
Drug use disorders include the misuse of illegal drugs (such as cannabis and amphetamines) as well as the use of prescription medicines, like painkillers or sedatives, for non-medical reasons. People who use illegal drugs have much higher rates of mental illness than the rest of the population. The most commonly used illegal drugs in Australia are cannabis, ecstasy, cocaine and meth/amphetamines.
Signs of substance abuse
Most people enjoy a drink now and again. But when someone loses control of their alcohol or drugs, when the substance starts causing harm like injuries or medical problems, damaging relationships or causing problems at work, then it can be a sign that the habit is becoming a problem.
People who abuse substances may become dependent. It means they don't feel the effects of the substance any more, and experience cravings or withdrawal symptoms when stopping.
Other signs your or someone you know might be abusing a substance include:
- regularly using more of the substance than intended
- regularly trying to cut down or stop using, but never succeeding
- spending too much time getting, using, or recovering from the substance
- cravings, or a strong desire to use the substance
- often failing to meet responsibilities at work, home or school because of substance use
- continuing to use a substance when it has caused relationship problems
- giving up social, work or leisure activities because of substance use
- using substances again and again, even when you're aware of the potential damage or danger
- continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance
- tolerance: the substance does not have much effect on you, or you need more of the substance to get the effect you want
- 'withdrawal' symptoms: feelings of physical illness when not using the substance that are only relieved by taking more of it
Substance abuse and mental health
Alcohol is the most widely used social drug in Australia. It increases the risk of depression and anxiety and other mental illnesses in some people. Likewise, people with mental health issues are more likely to abuse alcohol than others. Alcohol can make medicine like antidepressants less effective. In the short term, alcohol is a major cause of violence and suicidal behaviour.
Having a mental illness can make someone more likely to abuse drugs to lessen their symptoms and make them feel better in the short term. In other people, drug problems may trigger the first symptoms of mental illness. People with a mental illness experience drug problems at a far higher rate than the general community.
Treatment for substance abuse
Many treatment options are available for addictions and substance abuse, ranging from counselling through to hospital treatment depending on which substance is involved and how serious the dependence is.
Mild substance abuse can be treated with simple counselling and lifestyle changes. Severe dependence on substances like alcohol or heroin may require treatment in a hospital.
Detoxification means stopping intake of the substance and having medical treatment until the substance has cleared from the bloodstream.
Rehabilitation (going to ‘rehab’) refers to longer term treatment, which may occur in a residential clinic or at home. This often involves psychological treatments to address any underlying issues that may have caused the initial substance abuse, such as childhood trauma, anxiety or depression.
For people who have a substance use disorder and a mental illness, treatment needs to address both conditions at the same time to be effective.
Where to get help
If you are concerned that you or someone you care about may have a problem with their substance use, see your doctor. You could also try healthdirect's Symptom Checker and get advice on when to seek professional help.
12-step programs such as Alcoholics Anonymous (AA) 1300 222 222 and Narcotics Anonymous (NA) 1300 652 820 are available in many locations throughout Australian cities and regional areas. They provide a support group for people who have recovered from addiction and can support and mentor others with alcohol or addiction problems.
Specialised information for young people is available at ReachOut.com and headspace. Free online counselling programs for people who are concerned about their drug or alcohol use are available at Counselling Online and the Australian Centre for Addiction Research.
If you or someone you know is having a personal crisis, call Lifeline on 13 11 14 or chat online.
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Last reviewed: November 2018