As well as the health impact, using any type of recreational drug – be it nicotine, alcohol or a street drug – will be a problem if it changes the way you act (less motivated, irritable, anxious, aggressive), the way you live your life (not getting on with people, not having enough money, finding it hard to keep living in the same house, getting in trouble with the law) or even the way you look (losing or gaining weight, for example).
It can be hard to tell which problem came first – the drugs or the mental illness.
Having a mental illness can make a person more likely to abuse drugs, to make their symptoms feel better in the short-term. Other people have drug problems that may trigger the first symptoms of mental illness. Some drugs cause a condition called drug-induced Psychosis, which usually passes after a few days. However, if someone has a predisposition to a psychotic illness such as Schizophrenia, these drugs may trigger the first episode in what can be a lifelong mental illness. Using drugs can also make the symptoms of mental illnesses worse and make treatment less effective.
Anyone who has, or is vulnerable to, mental illness is therefore strongly discouraged from using drugs.
People with a mental illness experience drug problems at far higher rates than the general community. Studies suggest that around 50% also have a drug or alcohol problem. It is important, then, that both conditions are correctly diagnosed and receive the appropriate treatment.
There are a number of ways that you can go about getting help for your drug problem.
Research shows that people who have some kind of supportive relationship generally find it easier to tackle their drug problem. Having someone around to encourage you is important because there is someone to talk to if times get tough, and to help you learn new ways of dealing with old problems, see ‘Guide to Drugs’ for further information.
Understanding what causes you to take drugs, as well as the effect they will have on your mind and body, can help you decide what to do about your drug use.
Some people find drug-taking hard to understand. It shouldn’t be. After all, most of us drink alcohol at times and one in four of us still smoke tobacco. We do it because it makes us feel better, in the short term at any rate.
Apart from drinking or smoking, people affected by mental illness, especially, may also use street drugs. Some common reasons are given below, look at these and think about which ones cause you to take drugs:
We all know that taking drugs can make a big difference to the way we feel and act in the period after they’ve been taken. What many people don’t understand is the effect of drugs on our minds and bodies in the long run.
The way drugs can make you feel and act in the long term varies depending on the amount of drugs taken, what type you take and whether they are mixed with any others.
Any use of tobacco is harmful, of course, as we all know (remember that smoking cannabis also usually means inhaling tobacco smoke). Alcohol can be harmful when taken in excess too (more than a couple of drinks a day, five days a week).
There are some common effects of many drugs though, including tobacco and alcohol as well as street drugs.
Some of the physical health problems include:
Mental health problems:
Knowing whether your drug use is becoming a problem is hard for anyone. It can be even more difficult if you have a mental illness because it is harder to know whether what you are feeling is a result of your mental illness or drug taking.
Here are some ways of helping you work out whether your drug use may be becoming a problem.
Look at these and think about which ones are true of you:
If some of these statements are true of you, talk to someone about getting support – see the next section, ‘Getting help’.
Family and friends can play an important role in supporting someone they care about to deal with their drug problems.
Unfortunately, friends and family don’t always find out about drug use until the problem gets out of hand. This can happen for a number of reasons. Drug problems can remain hidden because the person concerned may not yet see it as a problem, or they know they have a problem but feel bad about it or are scared of what people’s reactions might be.
Here are some possible signs of street drug use that family and friends may notice.
Look at these and think about which ones are true of you or someone you care about:
If some of these statements are true of you or someone you care about, talk to someone about getting support – see the next section, ‘Getting help’.
Use of street drugs, as well as tobacco and alcohol, is common in people affected by mental illness. There are a lot of different views on the relationship between the two.
In the past, drugs were thought bring on symptoms associated with mental illness, like psychosis and depression, but only in people who were otherwise likely to become mentally ill at some stage.
These days more and more research suggests that drugs can not only bring on symptoms of mental illness but may actually contribute to causing them in some people.
While drugs can trigger symptoms and even contribute to causing a mental illness, your illness can also make it more likely for you to develop a drug problem.
Studies have found that people who have a mental illness may be more likely to get into the cycle of using drugs because it helps them deal with some of the symptoms of their illness. Many of the major symptoms of mental illnesses – such as feeling anxious, depressed and disoriented – are temporarily relieved by using some types of drugs.
Unfortunately, using drugs and alcohol can make symptoms worse in the long term, so it becomes tempting to take more drugs just to keep getting the short term benefits however, eventually even these short-term benefits wear off.
Drug use among people with mental illnesses is also thought to relate to the difficult time some people have accepting that they have a mental illness. Having a mental illness can make a lot of things hard like getting on with people, getting a job and having a stable place to live in. It can be tempting to turn to drugs as an escape from reality.
While there are a few different views on the relationship between drug problems and mental illness, what we do know is that the combination is a risky and potentially dangerous one, which is better avoided.
There are lots of different ways you can go about changing your drug use.
There are a number of ways to change drug use.
Sharing experiences and providing support for each other is a good way of finding out what has helped others. This is where self-help treatments can be useful.
The main type of self-help treatments are mental illness support groups run through community support agencies and Narcotics Anonymous or Alcoholics Anonymous.
Ask your case manager, local council or Drug and Alcohol Treatment Service for the details of an appropriate group to join.
This type of approach can help you use drugs in a safer way. For example, using less often or only at times when other people are there to keep an eye on you can help you to use drugs more safely, see ‘How can drugs be used in a safer way?’ for details.
GPs, case managers and community support workers can help in working out ways you can use more safely.
This method of treatment is useful for people who want to stop using drugs that their body may crave just after they stop taking them. It ‘s usually done as part of a detoxification program which also offers ongoing counselling, accommodation and day programs.
There are two main types of detoxification programs:
Contact the mental health branch in your state or territory to find out what services they offer in your local area.
Certain medication can help ease the cravings that can make it hard to stop using some drugs. Your GP or psychiatrist can help you to decide on whether this is the right method for you.
If you don’t feel able to stop using drugs straight away, there are ways of using them in a safer way.
While you never know exactly what you are getting, some suppliers are less likely than others to sell ‘clean’ drugs.
The effect that some drugs have (particularly Ecstasy, LSD and cannabis) can depend on what environment you use the drug in.
Taking drugs in places that are unfamiliar, such as being around people you are not comfortable with, can cause a bad reaction in many people, such as feeling panicky or having delusions and hallucinations. This can be especially difficult for people whose mental illness is associated with a chemical imbalance in the brain.
Make sure there is someone not too far away who can get help if you need it.
When using drugs you may be more likely to act out of control and do illegal things (such as driving fast). This puts you at even more risk. With a bit of preparation, there are steps you can take to make it less likely you will run into problems. For example, if you know you are going to take drugs make sure that you are not driving home.
If you have any questions on how to use more safely contact your local drug and alcohol helpline, see ‘Who should I contact?’ for more information.
Drug paraphernalia can carry germs that can make you sick. Keeping your gear clean can reduce the risk of spreading infection. For example, clean your bong after every session and make sure that you don’t share needles.
Combining drugs can make the effects of either or both drugs more powerful or than they may have been if taken separately. You may also want to ask your doctor about the effects of mixing street drugs with your medication.
Much of the harm caused by taking drugs is a result of dehydration. Making sure you have had at least 10 glasses of water in the previous 24 hours makes it less likely that you will experience any extra difficulties that come up because of dehydration.
Using less concentrated versions of drugs (for example, light beer instead of spirits, leaf instead of heads) can reduce the risk of the having too much in one sitting.
Spreading out your drug use over time can allow your body to process the drug out of your system. For example – use less drugs at one time (take fewer puffs, sips or hits, glasses or cones) or by having at least three drug free days per week to allow your body to recover. This will also save you money.
Decide how much you want to use each day and stick to it.
When you take drugs it can be easy to skip meals or opt for food that are the easiest to get. Making sure that you have foods on hand that are nutritious and easy to prepare can make you more likely to eat properly, see ‘Healthy living’ for more ideas.
People who have been using drugs may experience some withdrawal symptoms when they stop. These symptoms can differ depending on what drug you use, however the main symptoms of withdrawal are:
Having withdrawal symptoms may seem difficult, but they can be signs that your body is recovering and re-adapting to being drug-free. They tend to be short-term, only lasting about 7-10 days.
The withdrawal process can be trickier for people with a mental illness however, because of greater sensitivity to changing chemicals in the brain. This is why you should only withdraw from drugs in consultation with a doctor.
Managing your mental illness well can also help you get a handle of your drug use. That is why it is important that you start to look at what mental health support and treatment you are entitled to.
In most parts of the country there are now services especially for people who have a mental illness and a drug problem at the same time.
These dual diagnosis services work with you and your case manager to make sure that both your mental health and drug problems are being treated.
You can find out about your local dual diagnosis service by asking your local community mental health service or the mental health branch in your State or Territory.
GPs should be able to tell you about the local mental health and drug and alcohol services.
It is a good idea to use the same GP regularly if possible. This way you get to know and trust your doctor so that you can talk about any difficulties you are having.
If you don’t have a regular GP, try to find one who is right for you. Ask family and friends, a local pharmacist or at a community health centre if they can recommend someone.
Psychiatrists are trained to help you with any concerns you might have about your mental health, especially when you are dealing with the extra challenges that drug use can bring.
Psychiatrists can work in the public system (at community mental health services) where there is no charge, or in private practice where there may be a charge, mostly claimable under Medicare. If you do not have a psychiatrist, a GP can give you a referral.
If you are in the public system and want to get long-term care you should ask about getting a case manager at your local community mental health service.
Case managers are like a ‘one stop shop’ for mental health services, and work with GPs and psychiatrists to providing information on various issues relating to mental illness (including education and support around drug use) to you and your family as well as referring you to relevant community agencies.
To find out about the closest community mental health service, contact your local council.
Community support agencies provide psychosocial rehabilitation programs, supported accommodation, and a range of recreational and creative activities.
These services can help you meet others, learn new skills and join in the life of your local community.
Availability of theses services varies widely around the country. Contact your local community mental health service for referral to services an agency in your area.
Research shows that people who have some kind of supportive relationship generally find it easier to tackle their drug problem. Having someone around to encourage you is important because there is someone to talk to if times get tough, and to help you learn new ways of dealing with old problems.
This support person could be a case manager or other support worker. It could be a neighbour, friend, someone in your family, or even a psychiatrist or GP. It can be anyone who knows you’re trying to change your drug and alcohol use and agrees to help keep a friendly eye on how you’re going.
The following things are important when thinking about who to ask to be your support person:
Getting into a routine and finding new ways to handle old problems can help you to change your drug use.
Sometimes changing your drug habits can be easier if you get into a routine that includes activities that aren’t related to using drugs. This can give you something to look forward to and achieve, however small. If you save any money by spending less on drugs, make sure you spend this on something else enjoyable – a reward to yourself.
Here are some tips for getting into a routine that suits you.
Getting back into a routine after much of your time has been taken up by drugs can be a challenge. That is why it’s a good idea to avoid over-doing it at first.
Try to be active and do things you enjoy, but not so much that you feel stressed. For example, start of with one or two activities a day until you see how long they take. If you find you have spare time and energy you might include other activities step by step.
Recognise and build on some of the good habits you already have or the things you have done in the past to move beyond your drug problem.
For example, if you like reading and find that it distracts you from taking drugs, join your local library or ask about local book clubs. Apart from being interesting, it’s also a useful place to meet people with similar interests.
The stress of trying to do something you don’t enjoy can make it harder to stay on track. The more you enjoy something, the easier it will be to stick to a good routine.
Spend some time thinking about what really interests you, or trying out something you always meant to do – enjoying what you do can give you the motivation to keep going and to develop your own sense of purpose and identity, away from drugs.
Don’t allow new activities to get boring – boredom can make it all too tempting to get into the cycle of taking drugs again.
For example, do some things on you own (like yoga or listening to music) and others with people (like going for a walk or seeing a movie). Doing something to help others, such as volunteer work, can also be a useful way of distracting yourself.
It’s not always easy to settle into a routine, especially if you are not used to it. Treat your plan as a general guide that can change if you find it’s not working for you.
Here is an example of a weekly plan:
Try making your own weekly plan.
Stressful events make life difficult for anyone. They can be especially difficult to handle if you have a mental illness and can act as a trigger for taking drugs.
By recognising the situation that you find stressful, you can plan how to deal with them. This can help you get more control in your life.
Here are some examples of common triggers and some ways you can deal with them:
Take another step in the right direction by writing down the things that trigger you to take drugs and how you might deal with this in a different way than you have in the past.
Changing any behaviour is a challenge for most people. With support and advice you can learn to move on from difficult times and be better able to deal with drugs in the future.
We all feel better on some days than others. On the bad days it is easy to go back to using drugs in the same way as before. Fortunately, there are ways of stopping this cycle before it gets too bad. Recognising early warning signs can reduce the risk of becoming unwell.
Below is a list of common early warning signs. Look at these and see if there are any you recognise:
Now that you know what are common early warning signs you might want to think about what signs you showed last time you went through a difficult time.
Looking back on this, what were some of the things that made you realise this? Have a go at writing these down.
It is important to have an action plan so that you can get the help you require at the first sign of problems. For example, you may want to have a list of important numbers next to the telephone that is in order of importance. These could be contacts such as support people or health professionals you can call quickly and ask for help and support. See ‘Who do I call for help’, for further information.
A big part of changing drug use is about changing the way you look at things. With the help of your support person spend some time finding new ways to look at old challenges.
Below are some examples of negative thoughts that people often have about drugs and how they can be turned into positive ones.
‘It’s the only thing that makes me feel good’.
‘I used to like doing lots of things that made me feel good. Now I’ll finally have the money or energy to do them’.
‘It’s not like I can get better if I stop using drugs– I have a mental illness’.
‘There are lots of ways I can manage my illness’.
‘I’ve tried changing my drug use before and couldn’t – why should this time be any different?’
‘Each time I try, I get closer to changing’.
‘I have spent so long taking one drug or another that I don’t think I can change now’.
‘There have been other times I have changed things for the better, so why not now?’
‘Changing my drug use is really hard’.
‘Changing my drug use altogether is hard, but I am still managing to make some small changes’.
‘Nothing I try seems to try seems to change the way I use drugs’.
‘I am going through a difficult stage, I think I’ll give my support person a call.’
‘I need it’.
‘I crave it sometimes, but if I keep on track this time, one day I won’t anymore.’
Going off a drug or even using less, can lead to cravings. Cravings can be difficult to fight, but there are some ways of controlling them so that they don’t get the better of you, these include:
Slipping up is when you go back to old patterns of drug use for a little while. While slip-ups happen from time to time with support, a plan and good advice you can learn to move on from this slip-up and be better able to control your drug use.
Here are some tips for getting back on track after you have slipped up.
Looking at what made you feel like you needed to return to your old patterns of problematic drug use after you have slipped up can also be a good way of helping to avoid these patterns in the future.
For example, you may have been sticking to your goal of no more than three drinks per night for the last couple of weeks, but you go to a family gathering where there is a large supply of alcohol and end up drinking more.
This may help you to understand that being in a social situation, around family or in a place with a large supply of alcohol is likely to trigger the kind of binge drinking you are trying to avoid.
When you slip up it’s easy to feel bad about what’s happened and punish yourself. Instead of this, take time to look at how far you have come.
For example, you may have felt like binge drinking but instead you only allowed yourself four beers and you forced yourself to take a bus home instead of driving.
Most people go back to old habits from time to time, especially when they are trying to stop using drugs altogether. Change can take practice. Slip-ups can be seen as test runs for the real thing. So when you get back to changing them again you will be that much closer to making that change.
When slip-ups happen it can be a good time to look at whether your goals are right for you. For example, you may have aimed to stop drinking altogether, until the cravings got too much. A better goal would be to lower your drug use slowly.
Feeling guilty about a slip-up is common and understandable, especially if it has got you into trouble. However, it’s in everyone’s best interest to dismiss any feelings of blame, and focus on the present and the future.
Watching someone you care about make choices that you don’t agree with can be very difficult.
Someone who has a drug problem may find it difficult to talk about what they are experiencing. They might feel very sensitive, that they are going to be criticised, especially if they are taking illegal drugs or feel unable to change their drug taking habits. This may mean they refuse to get help, or they may deny that there is a problem.
While you can’t get someone to stop taking drugs or even use them safely, there are some things that you can do to help yourself cope better with the situation. Here are some ways that you can do this.
Reassure them that there is help available and that a lot can be done to help them with their drug problem. Suggest you or another trusted person helps to find out about options, by making some calls or going along as support to appointments.
Encourage the person to talk about their problem in a relaxed way. People sometimes react to a relative or friend who is having problems with drugs by pretending it’s not happening, by never discussing it. This often means that the problem remains hidden and untreated.
Encouraging a friend or relative with a drug problem to talk openly and honestly about it is an important first step in helping them realise that you care for their safety, above all else. It also can provide a good opportunity to encourage them to seek help and support.
Trying to get someone to talk is much easier if you pick the right time. Choose a time when they are more likely to be relaxed and open up and when they’re not affected by drugs.
Contact a support group. Often people who are unwell are unwilling to get help for their problem and this leaves family and friends in a difficult situation.
Organisations working with family and friends of people who have a mental illness can be useful at these times, providing information about strategies to getting help. They may also be able to provide support after a drug-related incident.
Ask about support groups at the local community mental health service or contact the SANE Help Centre on 1800 688 382.
Dealing with a relative or friend who has a mental illness and is abusing substances can be difficult. Remember to give yourself a bit of time to treat yourself. Going for a walk, getting a massage, going to a bed-and-breakfast for the weekend or spending the whole day immersed in a book can help you recharge your batteries and give you the boost you need to get through the hard times.
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