What is drug or alcohol misuse?

Drug and alcohol misuse is when drug and alcohol use become 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 or general health and wellbeing. It can cause them to neglect other responsibilities such as school, work or family.

Drugs are substances that affect how the body or brain functions. Illegal drugs such as ecstasy and heroin can be harmful. Unlike prescription medicines, there is no government organisation that regulates the quality or amount of active ingredients in illegal drugs. This means that someone using them can’t know how strong the drug is or what is actually in it.

Alcohol is a legal drug that can be harmful if taken in large amounts or for a long time. 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.

Drug and alcohol misuse is common. More than 1 in 4 adults and 1 in 3 young adults in Australia drink alcohol at risky levels. About 2 in 5 people in Australia have used an illegal drug at some point in their lives, including taking pharmaceutical medicines for non-medical purposes.

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

It can be difficult to tell if a person is taking unsafe levels of drugs or alcohol, especially if they’re trying to hide their drug or alcohol use.

Some drugs can show noticeable physical symptoms including:

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

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 — for example, due to 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 more frequently to cope with everyday life or in specific situations
• feels sick or moody when stopping or cutting down on drugs or alcohol (withdrawal)

Remember that these signs aren’t always related to drug use. 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.

This is especially true if you spend time with young people who may be coping with the challenges of adolescence.

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

Here are some tips to start a conversation with your loved one 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 loved ones 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. But don’t make assumptions that the person is even 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…” or “I’ve noticed that lately…”.
• Give the person a chance to respond and express their views and opinions.
• Try to listen to the person without being judgemental or accusatory.
• Talk about the support available that can help the person reduce or stop their alcohol or drug use.
• Emphasise that you are happy to talk again and provide support. You might ask them if they want to chat again in a week or two.

The person may not agree that their alcohol or drug use is a problem and might become defensive or angry. If this happens, you haven’t failed — the person may 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
• lecturing the person
• 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 supporting someone who has a drug or alcohol problem?

There are many services available to help people who are struggling with drugs or alcohol. 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.
• Try not to 'overpromise' — be realistic about any emotional, practical or financial support you can provide.
• Help find self-help recovery programs such as Narcotics Anonymous and SMART Recovery.
• Suggest a private telephone service, if your loved one doesn’t like the idea of a support group.

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

If you're concerned that the person may overdose on an opioid, you can access naloxone (a medicine that can temporarily reverse the effects of an opioid overdose) 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. Sometimes even the best efforts aren’t enough to make them stop.

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

• Be careful not to nag or guilt trip the person. This isn’t helpful and could upset them or push them away.
• Clearly state any behaviours 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

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 them know if you need to take a break and when you’ll be available again so they don’t feel abandoned.
• 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?

You should see a doctor if you feel that you have a problem with drugs or alcohol. It takes courage to admit that you may have a problem. Getting help is an important first step to make a change.

You should also seek urgent medical help for someone who seems dangerously affected by drugs or alcohol.

Signs of an unusual or dangerous reaction to a drug can include:

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

You might also notice that the person has:

• blue fingernails or lips
• 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 or the person’s own safety, the safety of others or if someone dies. Paramedics will also notify a person’s parent or guardian if they are under 18 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

There are many organisations, services and resources that have further information or support hotlines such as:

• The National Alcohol and Other Drug Hotline directs you to your local state alcohol and drug information service for free and confidential advice — as well as referral to services. You can call them on call 1800 250 015 24 hours a day, 7 days a week.
• Drug Help from the Australian Government offers information and resources.
• Positive Choices from the Australian Government also provides information, resources and drug education.
• Al-Anon Family Groups Australia offers support to the family and friends of someone struggling with alcohol.
• Self-Help Addiction Recourse Centre (SHARC) provides professional help and practical support to people who are looking after a family member living with addiction.
• Cracks in the Ice from the Australian Government has information on crystal methamphetamine (‘ice’) use.
• 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.

Do you prefer to read in languages other than English?

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

Looking for 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.

Looking for information for sexually and gender-diverse people?

• Pivot Point offers resources and support for sexually and gender-diverse people.