What is substance use and addiction?

Substance use disorder is when you use alcohol or other drugs (including tobacco) in a way that is harmful. Substance use disorder can lead to addiction, which is when you’re not able to stop using a substance and must have it to feel physically and psychologically well. Harmful substance use affects most areas of your life, and often controls your thoughts and decisions.

Addiction can be:

  • Physical — your body becomes dependent upon a particular substance and needs it to feel ‘normal’; for example, you may tremble, sweat, be distressed or irritable, and go through withdrawal symptoms without it.
  • Psychological — your craving is to meet an emotional rather than a physical need; for example, you crave it to feel relaxed or comfortable.

There are many types of addictions but the ones we are going to talk about are tobacco, alcohol and other drugs (including prescription medications). These are referred to as substances. Using these can alter your senses, affect your mood, change the way you interpret things, give you a ‘rush’ or make you feel ‘high’.

Substance use activates your brain’s reward system, which can make you want to keep taking these substances instead of engaging in other usual activities. It can change the way your brain functions by changing the balance of chemicals. This can lead to addiction, and it’s possible to be addicted to more than one substance.

How common is and substance use disorder and addiction in young people?

Substance use disorders are among the most common mental health disorders experienced by young people in Australia. Of those aged 16-24, 12.7% are estimated to have a substance use disorder, with higher rates among males than females.[i] Substance use disorders increase with age, with around half of all people with a substance use disorder first experiencing problems by the age of 20.[ii]

The substances that most commonly cause harm in Australia are tobacco and alcohol.

[i] Australian Institute of Health and Welfare 2011.Young Australians: their health and wellbeing 2011. Cat. no. PHE 140 Canberra: AIHW

[ii] Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005).Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602.

Why do young people engage in harmful alcohol, tobacco and other drug use?

Young people are particularly vulnerable to using alcohol, tobacco and other drugs. During adolescence, young people go through major physical, emotional and social changes, and may experiment with alcohol and other drugs or engage in risky use.

Young people are also likely to be heavily influenced by others (for example, family members, friends and celebrities) who may model harmful alcohol and other drug use. Young people may use alcohol and other drugs as a way to:

  • fit in with their peers
  • ease feelings of depression and anxiety
  • deal with academic, social or emotional stress
  • increase their confidence
  • rebel against parental or societal pressures and expectations
  • feel like they’re adults.

On top of the usual changes experienced throughout adolescence, young carers face higher levels of responsibility. They may be more stressed about keeping up with their studies or work, worry about their loved one’s health, and be concerned about how they can fit in with their friends and peers. Using alcohol or other drugs can be a way to try to fit in if others around you are doing it. Young carers who take care of someone with a substance use disorder may be particularly vulnerable.

What are the symptoms of a substance use disorder?

Symptoms that you may have a substance use disorder may include:

  • being unable to control impulses or cravings to use a substance
  • needing to use more of a substance to get the same effect
  • taking prescription medication for longer than you’re meant to
  • relying on the substance as a way to forget your problems or relax
  • finding it increasingly difficult to go without it
  • withdrawing from family or friends
  • not being able to keep up with your studies or work
  • not taking care of your appearance anymore
  • needing to steal to buy alcohol or other drugs
  • feeling anxious, angry or depressed
  • doing things you normally wouldn’t choose to, or participating in risky activities when you’re under the influence
  • continuing to use the substance when it causes relationship problems
  • using substances even if this puts you in danger
  • being unable to stop and, when you try, feeling intense cravings or having physical withdrawal symptoms
  • seeking out the company of those who support your harmful substance use.

This example helps give these symptoms a context:

Josie is 17-year old hairdressing apprentice who helps care for her mum. She lives at home with her parents and has an older sister. Josie’s mother has been fighting cancer for the past 3 years so Josie is doing a lot more at home to help care for her. She feels sad knowing that her mother is sick and she is angry at the world. When her mother was first diagnosed, Josie started to smoke and drink alcohol at parties she went to even though she is underage. At first, she did it because her friends were doing it and it made her feel good. She enjoyed spending time with others and taking a break from what was going on at home. Josie found that when she smoked and drank, she felt a lot more relaxed, happy, and less worried about her mum.

 Josie has been smoking and drinking more on the weekends since her sister moved out and it is taking more alcohol and cigarettes for her to start feeling carefree. Most Saturday and Sunday mornings, Josie wakes up with a hangover and often can’t remember everything she did the night before. Josie knows that she probably shouldn’t drink so much, but she enjoys being out with friends, the feeling drinking alcohol gives her, and can’t imagine being able to cope with her life without her regular drinking nights. However, Josie doesn’t think she has a drinking problem, because she is still able to go to work during the week and keep up with her apprenticeship.

 In the example above, Josie has some very normal reactions to her life:

  • feeling angry and rebellious when her mother was diagnosed with cancer
  • feeling sad about her mother’s illness
  • feeling stressed about caring for her mum
  • wanting to forget about her worries for a while.

However, Josie also shows some symptoms of emerging substance use disorder:

  • drinking to relieve stress or ‘blow off steam’
  • increasing the amount of alcohol she drinks to achieve the same effect
  • using alcohol to feel happier, relaxed, worry less, and forget about her problems
  • needing to drink every weekend, to the point of having a hangover
  • believing she doesn’t have a drinking problem because she can still function at work.

It is important to realise that alcohol and other drugs can cause harm even when a person doesn’t have a substance use disorder. Being intoxicated just once can lead to harmful effects, such as: accidental or deliberate injury to yourself or others; being in a road accident; engaging in risky behaviours such as unprotected/unwanted sex or illegal activities; alcohol poisoning; or even death.

While substance use disorder is treatable, it’s better to try to prevent it from happening in the first place. It’s important to be aware of the potential harms that alcohol and other drug use can cause, and to know where you can get help and support, to better deal with your feelings, fit in with your friends, relax and have a good time.

What can you do?

If you think you have a problem with tobacco, alcohol or other drugs, it’s important that you speak to someone else about what’s going on — whether it’s a teacher, support worker, counsellor, trusted friend or your doctor. They will be able to help you find the help or support you need. Treatment may involve counselling and/or medication.

You could also try:

  • joining a support group or network
  • talking to someone about how you feel — the Check-in App allows you to do this online
  • sharing your own story or reading stories of other young carers to know you’re not alone
  • looking after yourself by eating healthy food, getting regular exercise and getting enough sleep
  • being involved in positive activities (like sport, music, dance, hobbies) with other young people who are not interested in using alcohol or other drugs
  • reducing stress and anxiety by:

Where to go for help

There are a lot of people who can help you work through harmful alcohol and other drug use, or if you are worried about the way you are using substances.

To speak to someone, you can call:

Kids Help Line — 1800 55 1800

Headspace — 1800 650 890

Lifeline — 13 11 14. You can also ask for help via text message on 0477 13 11 14

Quit — 13 7848. You can also book a time for Quit to call you

You can find more information about alcohol and other drug use, how it might impact you and how to prevent its effects, via:

ReachOut

Youth Beyond Blue

Beyond Blue

Quit

Headspace

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