Message stick An orientation manual for Koori alcohol and other drug workers in Victoria
Message stick
Acknowledgements
The artwork has been reproduced Jones, Gregory Sloan, Matthew Graham, Published by Mental Health and with the kind permission of Telkaya Alan Thorpe, Erryn Nundle, Ringo Hood, Drugs Division, Victorian Government Statewide Koori Alcohol and Other Lloyd Hood, Chrisy Charles, Shaun Department of Human Services, Drug Network and created by artist Stewart, Chastity Prior, Carl Braybon, Melbourne, Victoria, Australia Joe Chatfield, descendant of the Sandra Neilson, Jim West, Nick Hayne, May 2009 Gunditjmara Nation in western Victoria. Dianne Press, Alan Miller, Thomas Marks, Neal Daly, Stephanie Bunce, © Copyright State of Victoria, The Department of Human Services Department of Human Services, 2009 acknowledges and respects Aboriginal Ronnie Burns, Lynne Parker, Phil Perry, Victorians as the first Australians and Ron Appo, Brian Thomson, Charmaine This publication is copyright. No part original custodians of the land. Clark, Chris Wallace, Frank Hassell, may be reproduced by any process Herman Oogjes, Janet Egan, Jesse Mac, except in accordance with the This manual is largely based on work Joshua Ramamurthy, Karen McGee, provisions of the Copyright Act 1968. conducted by Swinburne University of Katrina Neal, Kylie Quirk, Larry Taylor, Authorised by the State Government Technology and Ngwala Willumbong Mark Poplewell, Michael Grant, Michael throughout 2004. of Victoria, 50 Lonsdale Street, Wilson, Russell Owens, Sid Clarke, Melbourne. None of this manual would be possible Bernie Hoffmann, Lennie Anderson and Printed by Thaker Print, 19 Mill Ave, without the invaluable contribution and many more. Forest Hill 3131. input from current and former members Special thanks to Mr Kevin Coombs for of the Koori AOD Network, including: his lifetime contribution towards the John Murray, Jumbo Pearce, Craig establishment of Koori AOD services Holloway, Glenn Howard, Wayne throughout Victoria. Prior, Di Griffin, Donna Mansbridge, We would also like to acknowledge Rosemaree Jones, Tammy Sayers, De- the following organisations for their Joel Upkett, Lynette Walsh, Faye Thorpe, contribution towards the manual: Tony Williams, Stephen Edge, Frank Hassall, Mike Richardson, John Arber, Australian Drug Foundation (ADF) Mark Hammersley, Rondon D’Antoine, Ngwala Willumbong Brook Perry, Jeff Cuell, Andrew Green, Victorian Aboriginal Community Debra Cahill, Jeff Lyell, Jeremy Newell, Controlled Organisation (VACCHO) Joanne Dwyer, Joan Kirby, , Grant Drage, Vernus Mobourne, Lionel Victorian Aboriginal Corporation for Buckley, Sarah Morris, Kay Tulloch, Languages (VACL). Ross Morgan, Francie Boundy, Wendy If you require any further information Rotumah, Hughie Pepper, Peter Luttrell, on the Department of Human Services Doreen Lovett, Joe Day, Troy Litster, Ray about the Message stick for Koori Meehan, Richard Thorpe, Brett Walker, alcohol and other drug workers, please David Dryden, Craig Edwards, Bootsie contact: Thorpe, Bev Hanley, Dickie Bedford, Department of Human Services Sydney Chilli, Krishna McCloskey, – Mental Health and Drugs Division Shawn Ilsley, , Trish Johnson, Maurice Level 17, 50 Lonsdale Street, McCleod, Len Harrison, Bea Edwards, Melbourne 3000 Chyvonne Aiello, Rod Norman, Derek Ph: (03) 9096 5631 or (03) 9096 0308 Message stick
Abbreviations used in this document
AAV Aboriginal Affairs Victoria ACSO Australian Community Support Organisation ACCHO Aboriginal community controlled health organisation ADF Australian Drug Foundation AOD alcohol and other drug AOD RC alcohol and other drug regional coordinator COATS Community Offenders Advice & Treatment Service DD dual diagnosis IDDI Illicit Drug Diversion Initiative ICAP Improving Care for Aboriginal Patients KCA&DW Koori community alcohol and drug worker KCA&DRS Koori Community Alcohol and Drug Resource Service KHSU Koori Human Service Unit KMHLO Koori mental health liaison officer NAIDOC National Aboriginal Islander Day Observance Committee NIDS National illicit drug strategy NSP needle and syringe program OATSIH Office for Aboriginal and Torres Strait Island Health VACCHO Victorian Aboriginal Community Controlled Health Organisation YSAS Youth Substance Abuse Service Message stick
Contents
A message from Statewide Koori Alcohol and Other Drug Network...... 4 Introduction...... 5 Section 1: Aboriginal people in Victoria...... 7 The history of policy and practice in Aboriginal affairs in Victoria...... 7 Victoria’s Aboriginal people today...... 11 Section 2: Alcohol and other drugs in Victoria ...... 15 Alcohol and other drug services...... 15 AOD programs and services for Koori communities ...... 21 AOD and mental health issues...... 29 Section 3: About your role in the community ...... 31 Your role as a worker in your community ...... 31 Your agency and your community...... 35 Qualifications, training and professional development ...... 37 Section 4: Working as a Koori AOD worker...... 39 Safety and duty of care ...... 39 Working with other services...... 40 Working with clients...... 42 Managing your workload ...... 44 Section 5: Resources...... 47 Drugs and their effects...... 47 Contact list ...... 85 Glossary...... 96 References...... 104 Message stick
A message from Statewide Koori Alcohol and Other Drug Network
A message stick is a form of The network meets a number of communication traditionally used by times throughout the year for the Aboriginal people. We have used it as same reasons as when it first began. a title for this manual to symbolise the The meetings provide an opportunity importance of communicating in a way for workers to come together, share that honours the culture of Aboriginal experiences and provide support people in your role as an alcohol and to one another. The meetings also other drug (AOD) worker for the Koori feature activities and presentations community. for professional development of the This orientation manual was developed workforce. We always encourage over a number of years by Swinburne workers to become formally qualified University and Telkaya (the official as we believe a professionally skilled name of the Statewide Koori Alcohol workforce will help to meet the needs of and Other Drug Network), and was the client and their community best. funded by the Department of Human All Koori AOD workers are welcome to Services. It contains information about attend our meetings. the requirements and responsibilities On behalf of Telkaya, we welcome you you take on when you become an AOD and encourage you to use this manual worker for the Koori community. The to help you get started as a Koori AOD manual also gives you information about worker in Victoria. some of the challenges and rewards that come with working with Koori Members of the Telkaya Executive Planning communities throughout Victoria. Group 2009 This manual is a great introduction to Victoria’s AOD services and will help you understand the activities you will be involved in when supporting clients and as well as when you assist your local Koori community. Telkaya forms part of the statewide AOD services in Victoria. Our history dates back to the late 1980s when a small number of Aboriginal health workers from different communities decided to hold regular meetings as a way to provide support, opportunities for debriefing and to share information. Since then, as the number of Koori AOD workers has grown, so has the network and now includes workers from Koori communities throughout the state. Message stick
Introduction
Welcome to the Message stick: An Community is about interrelatedness the Koorie Heritage Trust at orientation manual for Koori alcohol and belonging and is central to
Checklist
Once you have worked your way through the manual and watched the accompanying DVD, you can have a look at the six key orientation areas checklist and make sure you can answer ‘yes’ to each one. Yes No
I understand my job role and duties. I know how to get the information I need to do my job. I know who to report to and how. I understand my occupational health and safety responsibilities. I have the resources to do my job, or I know how to get them. I have the skills and knowledge necessary to do my job, or I know how I will develop them. If you have ticked ‘no’ to any of the points above, it might be a good idea to talk to your manager or mentor and ask them to go over it with you. Message stick
Section 1: Aboriginal people in Victoria
The following information has been extracted The history of policy from the Department of Human Services and practice in 2006 publication Building better partnerships – Working with Aboriginal communities and Aboriginal affairs in organisations: a communication guide for the Victoria Department of Human Services. Victoria is rich in Aboriginal culture and traditions. Koori people ‘belong to one Past government policy and practice, when the official Port Phillip settlement of the oldest living cultures in the world. particularly relating to Aboriginal was established. Aboriginal people have lived in the Australians’ disconnection from The European colonisation that area now known as Victoria for at least traditional lands and the removal of followed was rapid and resulted in an 30,000 years. Aboriginal culture and children from their families, has had extraordinary decline in the Aboriginal cultural identity are bound up in a deep a profound influence on the health, population from an estimated 15,000 to spiritual connection to country and wellbeing and attitudes of Victoria’s fewer than 2,000 by 1863. The causes links today’s Aboriginal people with the contemporary Aboriginal community. of this excessive mortality are almost ancestors going back more than 1600 The following is a brief history of clichés: increased intergroup warfare, generations. Aboriginal people continue Aboriginal affairs in Victoria since the violence of settlers and the punitive to honour and maintain their culture colonisation, most of which is quoted expeditions of police, intemperance through many and diverse means. from the Human Rights and Equal and, above all, the introduction of alien Aboriginal communities are strong and Opportunity Commission report of the diseases. resilient, have an enduring and essential National Inquiry into the Separation of connection to country, and have Aboriginal and Torres Strait Islander In response to this situation, the survived and grown despite colonisation Children from Their Families, Bringing colonial government introduced a series and dispossession.’ Them Home (1997). For more detailed of well-meaning but counterproductive information about the history of policy measures. The Port Phillip Protectorate and practice in Aboriginal affairs, refer (1839 to 1849) issued occasional to Bringing Them Home at
the Protection of the Aborigines was were told they were ‘legally white’ and Assimilation established in June 1860 to administer must find homes and jobs away from In 1955 the newly elected Premier this expenditure. the Aboriginal stations and reserves appointed Charles McLean to review and merge into white society. The board and recommend changes to the state’s The Board for the Protection of refused assistance to those it expelled Aboriginal affairs policy. Soon after his the Aborigines from the reserves. appointment, McLean reported back In 1869 the Victorian Parliament passed Between 1886 and 1923 the number of on the dire conditions in which many the Aborigines Protection Act 1869. Aboriginal reserves in Victoria declined Aboriginal people lived: This Act gave powers to the Board from six to one. All Aboriginal people On these two areas [at Mooroopna] live for the Protection of the Aborigines, who wished to receive assistance from about 59 adults and 107 children, in which subsequently developed into the board had to move to Lake Tyers, most squalid conditions. Their humpies an extraordinary level of control of the only staffed institution after 1924. are mostly constructed of old timber, people’s lives, including regulation The number of people there fluctuated, flattened kerosene tins, and Hessian... of residence, employment, marriage, with a maximum of about 290 in the social life and other aspects of daily life. 1930s. There were many Aboriginal They are not weatherproof, have earthen floors, very primitive One of the regulations made under people living off the reserve, whether arrangements, and no laundry or the Act allowed for ‘the removal of any by force or choice. Those not living on bathing facilities except for the river... Aboriginal child neglected by its parents the Lake Tyers reserve were denied any or left unprotected’. Children were welfare assistance from the government The police had the most power to removed to a mission, an industrial or and the board. Facing hostility from remove Aboriginal children. Until 1985, reform school, or a station. Another the non-Aboriginal community, these the Victorian police were empowered regulation allowed the board to remove Aboriginal people moved into shanty to forcibly remove Aboriginal children any male child under 14 years and towns on the outskirts of country under the Child Welfare Act 1954. female child under 18 years living on towns or the sites of former reserves. During 1956 and 1957 more than 150 reserves and relocate them elsewhere. Aboriginal communities grew in the children were living in government-run These powers of removal were even Goulburn Valley, East Gippsland and children’s institutions. This is more than given to station managers. These along the Murray River. Many also 10 per cent of Aboriginal children in regulations were used to separate moved to Melbourne. Victoria at that time. Aboriginal children from their parents The inadequacy and inhumanity of and to house them in dormitories the policy and legislation led to the Self-determination and on the reserves at Lake Hindmarsh, Aborigines Act 1910. In this Act, Victoria recognition of past injustices Coranderrk, Ramahyuck, Lake Tyers and moved away from the extreme control The Victorian Aborigines Advancement Lake Condah. over Aboriginal people established in League emerged in May 1957. Its At first the Board for the Protection the 19th century. The legal distinction members played a role in the formation of the Aborigines aided all persons of between the rights of the white of the Federal Council for Aboriginal Aboriginal descent, but in 1886 the population of the state and those of Advancement which pushed for rights Aborigines Protection Act was amended Aboriginal people within Victoria’s for Aborigines across Australia and to require the removal of Aboriginal borders was lessened, but not removed. was behind the 1967 referendum. people of mixed descent from The league became a powerhouse Aboriginal stations and reserves. Those of ideas and began to critique the who were not genetically ‘full-blood’ assimilation policy. It sought practical Message stick
help for Aboriginal people (emergency performed multiple functions, providing assistance, employment, legal advice) welfare and emergency assistance and spoke to countless public and club beyond their legal, health or housing meetings. briefs. These Victorian organisations Following the federal election in were also social and information 1972, the assimilation policy that centres. had dominated Aboriginal affairs for The efforts of Aboriginal-operated 20 years was replaced by a policy organisations resulted in a 40 per cent of self-determination. The policy of reduction in the number of Aboriginal self-determination shifted the focus to children in homes as early as 1979. empowering Aboriginal people to decide In 1979 the Victorian Government on and achieve their own futures. This adopted the Aboriginal Child Placement approach, based on the recognition that Principle. Under the principle, an Aboriginal people should be actively Aboriginal family must be the preferred involved in all decision making that placement for an Aboriginal child in affects their lives, gave support to need of alternative care. This is now the development of many Aboriginal included in the main child welfare and organisations in Victoria. protection laws. Community control by Aboriginal The reports of the Royal Commission people came about because too often into Aboriginal Deaths in Custody in mainstream services failed to meet 1987 and the National Inquiry into the community needs. Geographical, Separation of Aboriginal and Torres financial and cultural barriers made Strait Islander Children from their access to services difficult. Mainstream Families 1995 drove further policy and services were found to be unwelcoming program change in Victoria. In 1997 and openly discriminatory. Aboriginal a bipartisan initiative in the Victorian community controlled organisations Parliament saw the passing of a motion were seen to better understand of unreserved apology to Aboriginal Aboriginal people’s needs and cultural people for past government policies of beliefs and as such to provide a separating Aboriginal and Torres Strait more welcoming, friendly, culturally Islander children from their parents. appropriate service and setting. Aboriginal people have fought long In the 1970s an Aboriginal Legal and hard for their rights, and many Service, Aboriginal Child Care Agency, important milestones mark modern Aboriginal Health Service, Aboriginal Aboriginal history. A number of Education Consultative Group and significant developments at a national Aboriginal Housing Cooperative were and state level have helped to promote formed by Aboriginal people with the a wider understanding within the assistance of professionals (lawyers, community of issues facing Aboriginal doctors and dentists), some of whom Australians. provided their services free. They all 10 Message stick
The following information has been extracted Community events – key dates from the Department of Human Services 2006 publication Building better partnerships – Working with Aboriginal communities and 26 January – Survival Day organisations: a communication guide for the Aboriginal Australians choose to mark Australia Day as a day to highlight the invasion Department of Human Services. of Australia by Europeans and to acknowledge the survival of their cultural heritage.
13 February – Anniversary of formal apology to the Stolen Generation On 13 February 2009 at the opening of Commonwealth Parliament, Prime Minister Kevin Rudd apologised to the Stolen Generations – Aboriginal people who were affected by the forcible removal of children from their families.
26 May to 3 June – National Reconciliation Week This week begins with National Sorry Day on 26 May and ends with Mabo Day on 3 June.
26 May – National Sorry Day This day marks the anniversary of the 1997 tabling of the Human Rights and Equal Opportunity Commission National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families, Bringing Them Home (April 1997).
3 June – Mabo Day This day commemorates the anniversary of the 1992 High Court decision in the case brought by Eddie Mabo and others that recognised the existence in Australia of native title rights. On the 10th anniversary of this day in 2002 there were many calls for the day to become a public holiday, an official National Mabo Day.
First full week of July - NAIDOC Week The first Sunday of July sees the beginning of a week dedicated to Aboriginal and Torres Strait Island people to celebrate NAIDOC (National Aboriginal and Torres Strait Islander Day Observance Committee) Week. It is a celebration for Aboriginal and Torres Strait Island people of their survival. It is also a time for all Australians to celebrate the unique contribution of Aboriginal and Torres Strait Islander traditions and cultures and to bring issues of concern to the attention of governments and the broader community. Message stick 11
Victoria’s Aboriginal people today
Language complex traditional cultures. Prior to retrieving, recording and researching colonisation there were approximately Aboriginal languages and providing a The following information has been extracted 250 Aboriginal languages spoken in central resource on Victorian Aboriginal from the Department of Human Services Australia (approximately 36 in Victoria). languages with programs now looking 2006 publication Building better partnerships Some of these had several varieties, at educational tools to teach the – Working with Aboriginal communities and organisations: a communication guide for the and there were altogether about Aboriginal community about language. Department of Human Services. 500 language varieties used across The map below, produced by the Australia. Aboriginal people have lived in Victorian Aboriginal Corporation for Victoria for at least 30,000 years. Before settlement, Aboriginal people Languages, is a reconstruction of Archaeological evidence of the great were capable of fluently speaking five Aboriginal language areas in Victoria antiquity of Aboriginal occupation of all or more languages. Since colonisation, prior to colonisation. Spelling and parts of Victoria is well documented. more than three quarters of the original pronunciation of language names varies During this time, dramatic changes languages have already been lost. throughout Victorian communities of climate and environment occurred In recent years there has been an depending on oral knowledge and but Aboriginal culture responded upsurge of interest in the Aboriginal beliefs. Please visit
Health and wellbeing delivery to the Aboriginal community • Aboriginal Justice Agreement had many problems such as: According to the Australian Bureau • Overcoming Indigenous disadvantage of Statistics the Victorian Aboriginal • The needs of Aboriginal people report population is approximately 0.6 per weren’t considered. • Closing the gap cent of the total Victorian population • All people with language and cultural • Victorian Indigenous affairs and 6.1 per cent of the total Australian differences found services difficult framework Aboriginal and Torres Strait Island to access and often ‘culturally population. unfriendly’. • Improving the lives of Indigenous Victorians. Aboriginal Australians present a • Many people felt shame in seeking considerably younger age structure than help so they didn’t. These reports and reviews have helped that of the non-Aboriginal population, and continue to help the Victorian • Services were hard to get to, with 57 per cent being under the age Government to make better decisions especially for people in remote and of 25 years, compared with 34.1 per about services for Aboriginal people. rural areas. cent of the total population. Further, 2.9 per cent of Aboriginal Victorians • Women who needed help and had National Aboriginal and Torres are over the age of 65 years compared children often couldn’t get help Strait Islander Health Survey with 12.6 per cent of the total Victorian because there was no childcare. population (ABS 2001). The following information has been extracted • Young people did not like to use the from the Australian Institute of Health and Aboriginal Victorians have a lower life services. Welfare’s Statistics on drug use in Australia expectancy than the general population. • Specialist services were not linked 2006 report. Life expectancy for Aboriginal people up to other general services (such as The ABS conducted the National (both male and female) is approximately health services and hospitals). Aboriginal and Torres Strait Islander 18 years less than that for non- The problems that lead to alcohol Health Survey (NATSIHS) in 2004–05. Aboriginal people (ABS 2004). and other drug use are complicated. The survey collected information Aboriginal Victorians in every age group Aboriginal Australians often experience about personal and household are more likely than other people to inter-generational trauma caused characteristics for Aboriginal and be hospitalised for most diseases and by experiences of colonisation, Torres Strait Islander people aged 15 conditions, indicating a high occurrence dispossession and disempowerment. years and over throughout remote and of illness at more acute levels. These Government removal of children from non-remote areas of Australia during illnesses include high levels of injury families under ‘assimilation’ policies 2004 and 2005. The NATSIHS included and poisoning, drug and alcohol has also resulted in enduring social and questions on smoking status, alcohol disorders, kidney disease, digestive emotional issues. consumption and substance use. A diseases, diabetes and social and total of 10,439 Indigenous Australians After the Royal Commission into emotional and behavioural disorders aged 15 years and over responded to Aboriginal Deaths in Custody (1987), a (Department of Human Services 2005). this survey. According to the survey, number of key reviews led governments 32 per cent of Aboriginal and Torres Alcohol and other drug issues and other decision-makers to pay Strait Islander people aged 15 years attention to the particular needs of and over consumed alcohol at a low Providing Victoria’s Koori community Aboriginal Australians, some of them level of risk for alcohol-related harm in with access to human services has include: the long term and 16 per cent drank historically been poorly managed. • the Bringing Them Home report at risky or high-risk levels, based on Former approaches to AOD service Message stick 13
consumption reported in the week in their struggle for improved health prior to interview. Around half (52 per status. Better health for Aboriginal cent) of the Aboriginal and Torres Strait people will only happen when Aboriginal Islander population aged 15 years people and their organisations are and over reported that they currently able to act on their own behalf. That’s smoked tobacco. Marijuana/cannabis what VACCHO is about, building was used by 23 per cent of Indigenous know-how and getting resources to Australians in the 12 months prior to local communities that can make real the survey, and over one-quarter (28 improvements. Both the state and per cent) used any illicit substance. federal governments formally recognise VACCHO as the peak representative The Role of VACCHO – Victorian organisation on Aboriginal Health in Aboriginal Community Victoria. Controlled Health Organisation To find out more about VACCHO, please visit their website at The following role description has been extracted from the VACCHO website at
Section 2: Alcohol and other drugs in Victoria
Alcohol and other drug substance use (rather than just the people with particular problems alcohol and other drug use itself), and services • forensic services that provide how these harms can be minimised or treatment programs for offenders In 1985 the State and Commonwealth reduced. It is the approach adopted by (clients with referral from the courts, governments and the non-government Victoria’s AOD treatment services and police or the Parole Board). sector began working together with is based on the premise that people the aim to improve health, social and must be provided with knowledge and The following provides an overview of economic outcomes for Australians by skills necessary to make informed the different types of counselling and reducing the harm to individuals and choices about risk behaviours. treatment services that are available in the community that occurred as a result Victoria. For full description of services, In this approach an AOD worker can of alcohol and other drug use. A joint please visit the department’s Mental focus on understanding the negative strategy called the National campaign Health and Drugs Division website at health, social and economic results against drug abuse (now called the
Victorian drug treatment services
Metropolitan and regional services Statewide services
Youth substance use services Young people General adult Ante and postnatal support Outreach Withdrawal Family Residential Rehabilitation • Residential Program Counselling consultancy and • Home-based continuing care • Outpatient Family Drug Information & Support • Rural Telephone Helpline Withdrawal Pharmacotherapy Parent Support Program Supported accommodation • Methadone • Buprenorphine Homeless Persons HOD Program Peer support Counselling consultancy and Koori services Koori services continuing care • Galiamble • Koori Youth Drug and Alcohol • Winja Ulupna Healing Service Residential rehabilitation • Percy Green • Baroona Youth Healing Place • Warrakoo • AOD Worker Program Supported accommodation • Substance use programs Treatment programs for Peer support offenders Residential rehabilitation Koori services • Community Offenders Advice Day programs • AOD Worker Program & Treatment Service (ACSO/ • Drug and Alcohol Resource COATS) Centre • Substance use programs • Drug diversion programs • Koori Withdrawal Access Program • Koori drug diversion programs
Mobile overdose response • CHAD nurses Mobile drug safety • Drink and drug driver program Continuity of care • Children’s court clinic drug program Extended hours • Court Referral and Evaluation Methadone outreach for Drug Intervention and Treatment (CREDIT) ABI resource workers • The intensive post-prison release drug treatment service (Stepout) Message stick 17
Youth – Victorian drug treatment regional services
Young people
Provide assessment, support and ongoing case coordination for young people in their own Outreach services environment.
Counselling consultancy Counselling is provided by social workers, health professionals, psychologists, general and continuing practitioners, consultant physicians and psychiatrists. The range of services provided includes care services assessment, treatment and consultancy, outreach referral and ongoing case management.
Provide a 24-hour staffed residential program at a community residential drug withdrawal service Withdrawal services or hospital for young people undergoing substance withdrawal.
Supported Provide short-term support in a safe, drug-free environment to young people who require accommodation assistance in controlling their alcohol and drug use. services
Provide mutual support and information by individuals with a personal experience of alcohol and Peer support programs drug use. Peer support groups or activities are usually established by current or past alcohol and drug users.
Residential Service comprising a 15-bed statewide facility to provide 24-hour staffed residential programs that will provide a range of interventions for young people whose established use of drugs has caused Rehabilitation Service them significant harm.
Activity-based programs used as therapy for young people experiencing alcohol and drug Day programs problems. 18 Message stick
General adult – Victorian drug treatment regional services
General adult Residential: Usually involves Outpatient: Service for people whose withdrawal can be appropriately a short stay in a community managed without admission to a residential service and involves a residential drug withdrawal series of intensive individual consultations over a short period, followed Withdrawal service or hospital. by ongoing counselling and support to help complete the withdrawal. • Residential • Home-based Home-based: Provided by an experienced nurse Rural: In country Victoria, GPs and health services • Outpatient and a medical practitioner where the withdrawal often provide treatment and support involving a • Rural is of mild to moderate severity and support is short hospital stay (where required) with a period available from a family member or friend at home. of home-based withdrawal.
Substitute Provides alternative medication to eliminate the need for heroin-dependent people to inject heroin (methadone, buprenorphine). Methadone is usually administered through GPs trained to prescribe it and is available through pharmacotherapy a range of community pharmacists.
Counselling Provides a range of services and supports appropriate to the needs of clients who have alcohol and drug use consultancy and problems, include assessment, treatment and consultancy, referral and ongoing case management. Provided in a range of settings including stand alone alcohol and drug agencies, community health centres, hospital-based continuing care alcohol and drug services and other generalist health and welfare services.
Residential Provides a 24-hour staffed residential treatment program of an average of three months’ duration offered to people who have previously undergone a drug or alcohol withdrawal program. It includes a range of rehabilitation interventions that aim to ensure lasting change and to assist reintegration into community living.
Supported Service for people who do not have a stable home environment. It helps them achieve lasting change and assists in their re-introduction to the community. Services include, as a minimum, a day support worker from a accommodation community-based setting, usually within public housing.
Peer support Service that provides mutual support and information by individuals with a personal experience of alcohol and drug use. Peer support groups or activities are usually established by current or past alcohol and drug users.
Continuity of care Service that supports clients who completes a withdrawal program and ensures they are linked to post- withdrawal support at a specialist drug treatment counselling service or to a residential rehabilitation service.
Mobile overdose Service that offers non-fatal overdose survivors support, information and assistance with access to rehabilitation services. The service offers mobile non-medical support to ambulance officers and emergency department staff response who encounter people who have overdosed.
Mobile drug safety Provide education on drug safety, supplies needles, clean water and sterile supplies in areas of high drug use. workers They are trained in resuscitation. They are able to refer users for treatment and rehabilitation.
Counselling, consultancy and continuing care drug treatment including assessment, care, referral and ongoing Extended hours case management. Provides face-to-face counselling as well as telephone contact outside standard working hours.
Employed by specialist drug treatment services, workers have been appointed in three rural regions to support Methadone outreach and enhance the role of trained GPs in encouraging, recruiting and retaining opiate-dependent persons in treatment and ultimately assisting in an effective withdrawal.
Acquired brain injury Workers employed to identify clients with an ABI already in the drug treatment system; facilitate access for (ABI) resource workers clients with ABI in need of treatment; keep clients with ABI in the service system. Message stick 19
Victorian drug treatment statewide services
Statewide services
YSAS provides a range of services for young people aged 12–21 who are experiencing significant problems Youth substance related to their alcohol and/or drug use, including outreach, withdrawal, residential rehabilitation, supported use services accommodation and day programs.
Ante and post-natal Providing antenatal and postnatal support, inpatient methadone program, training and education care for support pregnant women with drug and alcohol issues and their infants.
Provided by Odyssey House, service is directed to drug-addicted parents and is unique in alcohol and drug Family Residential rehabilitation in that it features qualified preschool teachers and a fully operational childcare/preschool centre. Rehabilitation Program Both custodial and non-custodial parents are assisted, as part of their programs, in parenting and family skills.
Family Drug Family Drug Help is a Victorian service for people concerned about a relative or friend using alcohol or other drugs. The service operates 24 hours, seven days, and is staffed by volunteers with experience of alcohol Information and and other drug issues within their family. The Helpline is staffed by volunteers from 9am to 5 pm Monday to Support helpline Saturday, and professional counsellors at all other times.
Short-term therapeutic group programs for families of drug users, which are facilitated by drug and alcohol Parent support professionals. These programs will provide assistance in communication between parents and their programs adolescents.
Support the development of better treatment practices relationships between drug treatment and mental health Dual diagnosis services by the development of local networks, training, consultation and modelling of good practice through workers direct clinical intervention, and shared care arrangements.
Homeless Persons Program that focuses on addressing the alcohol and drug-related needs of homeless people who seek Drug and Alcohol assistance at specific crisis supported accommodation services in Melbourne. Provides intensive case Dependency Program management support to up to 100 people at any one time for periods of between three and 12 months.
Stand-alone service that provides sterile needles and syringes to injecting drug users (IDUs), provides health Primary needle and information and education, make referrals into voluntary drug treatment and liaise with local agencies such syringe programs as police, local government, health, drug treatment and welfare agencies. They also distribute sharps disposal containers, alcohol swabs, condoms and water-based lubricant.
Secondary needle and Programs providing all the services of a primary NSP program, however it operates within existing organisations, syringe programs such as community health services and hospitals (not a stand-alone service).
Specialised pharmacotherapy services provide assistance and support to clients with associated medical, Pharmacotherapy psychiatric or psychological problems. Specialist methadone services operate in association with a general services hospital. 20 Message stick
Victorian forensic community statewide treatment services
Statewide forensic
Community Offenders Service for offenders referred from the courts, police (via DirectLine) or the Parole Board. COATS undertakes Advice and Treatment an assessment, provides an alcohol and drug treatment plan and purchases any necessary treatment from Service (ACSO/ community-based alcohol and drug treatment agencies for parolees and offenders who receive community- COATS) based dispositions or a combined custody and treatment order.
Diversion option for people apprehended by the police for use or possession of an illicit drug other than Police Illicit Drug cannabis. Police may offer the offender a caution on the condition that they undertake a clinical drug Diversion assessment and attend at least one session of any prescribed drug treatment. A number of conditions apply.
Rural outreach Provides a link between the community, police, courts and the drug treatment service system. Primarily target diversion workers young offenders aged below 25 years, whose drug use is a clear factor in their criminality. (RODW)
Drug Education Provides drug education sessions for first time offenders found in possession of a small (non commercial) for First Offenders quantity of illicit drugs other than marijuana. The offender is released on an undertaking to attend the program Service (FOCiS) as part of their conditions.
Court Referral and Option for offenders who are apprehended and charged with an offence and it is clear that the person has Evaluation for Drug an immediately presenting drug problem. Offender is referred by the police to a drug clinician based at the Intervention and Magistrate’s Court and, where appropriate, and the offender agrees, he or she is diverted into a recommended Treatment (CREDIT) treatment regime by the magistrate as a condition of bail.
Drink and drug driver Program comprises of a range of measures including attendance at an eight-hour education course and program assessment for alcohol and other drug problems.
Custodial Health Full-time CHAD nurses located within selected Category ‘A’ watch houses (cells) provide medical supervision Alcohol and Drug to offenders held in police custody who have a drug problem and who require drug treatment/withdrawal or Nurses Program substitute pharmacotherapy services while they are in detention. (CHAD)
The intensive post- Provides in-prison assessment and, where appropriate, intensive counselling and case management to people prison release drug on release from prison who are high risk or for whom a further period of counselling and support will continue to treatment service support the treatment received in prison. (Stepout)
Provides early intervention drug treatment for alleged young offenders who are engaged in problematic drug Children’s court clinic use, by facilitating contact with the children’s court drug clinician and drug treatment services upon referral drug program from the magistrate. Message stick 21
AOD programs and services for Koori communities
Koori-specific AOD treatment services Sam’s story are provided to Koori people who are Sam is a 35-year-old father of three with a long-term addiction to alcohol and affected (either directly or indirectly) or marijuana. He does not live with his partner and their children. Sam drifts from are at risk of being affected by alcohol supported accommodation services to ‘sleeping rough’ and the occasional stopover in and/or other drugs. They provide a friend’s lounge room. AOD support in ways that reflect the culture and history of Koori people. In Sam suffers from mild brain injury (also known as an acquired brain injury or ‘ABI’). Victoria both state and Commonwealth His brain injury happened because of his addictions and caused poor memory governments fund a number services and regular violent outbursts. He wants to get control of his life and become more and programs for Koori communities of a father to his children. He has tried several times to detox and overcome his that feature a holistic approach that addictions. recognises the physical, emotional, The AOD worker linked him up with a supported accommodation assistance program social and spiritual needs Koori clients, (SAAP) service that works with people like Sam. This gave him 6–12 months of stable their families and communities. accommodation with regular meals. Because he had an ABI, the AOD worker also Koori AOD workers undertake a number checked what other support he could get. The worker found out Sam was eligible for of activities with the people they support from the Community Connections Program and Home and Community Care. support. These activities include health This meant a case worker made sure Sam was receiving all of his entitlements from promotion, providing information, rolling Centrelink. He also linked him to an intensive literacy program after his detox so he out education activities, developing could learn to read and write at an adult level. and maintaining community linkages, The AOD worker referred Sam to a withdrawal service that recognised his culture and referrals and counselling. These workers life experience. The AOD worker also linked Sam’s family to family support services to liaise with services in an advocacy role help them deal with what they had experienced and gave them a 24-hour telephone on behalf of the service user. support option should any incident occur again. These services include: Five different services are assisting Sam with his goal of getting control of his life and • Koori Youth Alcohol and Drug being a better father to his children. His AOD worker linked him to all of them. Healing Service (state) • Substance use programs (Commonwealth) • Koori Community AOD Worker program (state) • Koori Community Alcohol and Drug Resource Centre Service (state) • Koori drug diversion workers (state/ Commonwealth) • Koori Withdrawal Access Program (Commonwealth). 22 Message stick
Koori community AOD services and locations
AOD worker
Resource service worker
Diversion worker Warrakoo Mildura Healing service
Robinvale Substance use programs Koori Access Program Swan Hill
Echuca Albury-Wodonga
Shepparton
Mooroopna Horsham Bendigo
Ballarat Northcote Moreland Healesville Heywood Ringwood Bairnsdale St Kilda Dandenong Sale Lake Tyers Warrnambool Warrakoo Portland Frankston Morwell Bittern
Activity Find out what alcohol and other drugs services are available in your area. You may want to find out information such as: • Where are they located? • What are the service hours? • Does your agency have regular contact with them? Message stick 23
Koori community AOD worker program and substance use programs (SUP)
Program and service workers for the use programs undertake a number of • referrals to treatment and Koori communities (including AOD activities to reduce the use of and harm counselling services (such as worker program and substance use caused by alcohol and other drugs in withdrawal or rehabilitation services) programs) provide support services to their communities, including: • liaising with services on behalf of individuals and families each community. • health promotion (such as the QUIT the clients (such as mental health The majority of workers are based program) services and legal services) in Aboriginal community controlled • providing information (such as • supporting and advocating on behalf health organisations (ACCHOs). Koori pamphlets) of Koori people affected by alcohol AOD workers are also employed in • education activities (such as men’s and other drugs (such as court, mainstream health services. All workers police) outreach to Koori communities in the fishing camps, women’s groups, surrounding area where the agency is sporting activities) • liaising with generalist health and located. • developing and maintaining welfare organisations (such as doctors, Centrelink and hospitals). Both Koori AOD workers and substance community linkages (such as community Elders)
Koori community AOD worker and substance use programs – agency and locations
1 Murray Valley Aboriginal Co-op, Robinvale 2 Mildura Aboriginal Co-op, Mildura 3 Swan Hill Aboriginal Health Service, Swan Hill 4 Njernda Aboriginal Co-op, Echuca 5 Rumbalara Aboriginal Co-op, Shepparton 2 6 Victorian Aboriginal Health Service (VAHS), Northcote 1 7 Albury-Wodonga Aboriginal Health Service, Albury-Wodonga 3 8 Ngwala Willumbong Co-op - Northcote, Ringwood, St Kilda 9 Yarra Valley Community Health Services, Healesville 7 10 Lake Tyers Trust, Lakes Entrance 4 11 Gippsland & East Gippsland Aboriginal 5 Co-op, Bairnsdale 21 12 Ramahyuck Aboriginal Co-op, Sale 22 13 La Trobe C.H.S., Morwell 14 South Eastern Alcohol & Drug Service (SEADS), 20 6 9 Dandenong 8 8 19 10 15 Peninsula Drug & Alcohol Program (PenDAP), 16 8 14 11 Frankston 17 12 15 13 16 ISIS Primary Care, Western Metropolitan 18 17 Wathaurong Aboriginal Co-op, North Geelong 18 Gunditjmara Aboriginal Co-op, Warrnambool 19 Winda Mara Aboriginal Co-op, Warrnambool 20 Ballarat & District Aboriginal Co-op, Ballarat 21 Goolum Goolum Aboriginal Co-op, Horsham 22 Bendigo & District Aboriginal Co-op, Bendigo Key AOD worker Substance use program 24 Message stick
Koori community alcohol and drug resource services Workers at the Koori Community Alcohol and Drug Resource Service (KCA&DRS) provide clients with information, support and referrals. The KCA&DRS was established following a Royal Commission into Aboriginal Deaths in Custody and operates ACCHOs across six locations throughout metro and regional Victoria.
Koori community AOD resource services – agency and location
1
2
5 3 6 4
1 Mildura Aboriginal Co-op (MAC) 4 Gippsland & East Gippsland Aboriginal Mildura and surrounding areas Co-op Morwell and surrounding areas 2 Rumbalara Aboriginal Co-op Shepparton and surrounding areas 5 Ngwala Willumbong Co-op Northcote Metropolitan Service 3 Gippsland & East Gippsland Aboriginal Co-op 6 Wathaurong Aboriginal Co-op Bairnsdale and surrounding areas Geelong and surrounding areas Message stick 25
Koori drug diversion workers A Koori drug diversion worker works The Aboriginal Diversion Unit (ADU) with the client and the client’s located at Ngwala Willumbong is a Koori drug diversion workers help refer supervisor/counsellor and organises statewide support service for Koori drug Koori offenders to diversion programs for Koori Court clients to attend diversion workers. The primary focus of and link in with AOD treatment programs such as AOD counselling, the ADU is to coordinate and manage agencies. anger management, community work drug diversion services to Koori clients Koori drug diversion workers provide and employment/education. A Koori with alcohol and other drug issues that assistance to clients in their area, division worker will also support and need to appear before the courts. for example, a worker based in advocate on behalf of Koori clients Mildura provides support to clients in outside the Koori Court system in surrounding areas such as Swan Hill the mainstream court and with self- and Robinvale. referrals.
Koori drug diversion workers – agency and location
1
2
6 5 3 4 7
1 Sunraysia Community Health Service, 4 La Trobe Community Health Service 7 Western Region Alcohol & Drug Service Mildura Morwell (WRAD), Warrnambool Mildura Koori Court sits at Mildura, Morwell Koori Court Warrnambool Koori Court & Hamilton Robinvale & Swan Hill courts 5 Koori Diversion Unit - Ngwala 2 Goulburn Valley CHS, Shepparton Willumbong Shepparton Koori Court Statewide 3 Gippsland Lakes Community Health 6 Moreland Hall Alcohol & Drug Centre, Service, Bairnsdale Moreland Bairnsdale Koori Court Broadmeadows Koori Court 26 Message stick
Koori Withdrawal Access Metropolitan withdrawal services working with the Koori Withdrawal Access Program: Program Agency Location The Koori Withdrawal Access Program DAS West Footscray aims to develop protocols and build strong partnerships with mainstream Peninsula Drug and Alcohol Program (PenDAP) Frankston withdrawal services to improve the Salvation Army – Abbotsford Abbotsford access and treatment outcomes for Salvation Army – The Bridge Centre St Kilda St Kilda Koori clients. South East Alcohol and Drug Services (SEADS) Dandenong The program aims to assists clients to gain access to a withdrawal service and St Vincent’s Health – DePaul House Fitzroy be supported through the withdrawal UnitingCare Moreland Hall Moreland, Heildelberg programs that operate from most of Windana St Kilda, Dandenong the Melbourne-based mainstream Youth Substance Abuse Service (YSAS) Fitzroy withdrawal services (see shaded box). For more information contact Ngwala Willumbong (see Contact list in the and other support services. Galiamble (funded by OATSIH) Further resources section of this manual). Workers at the Koori Youth Alcohol and Galiamble is a 24-hour residential Drugs Healing Service provide support alcohol and rehabilitation centre Koori residential programs young people to assist with: for men located in the Melbourne Residential programs and services metropolitan area. Admission to the • their alcohol and other drug issues offer Koori people an environment centre is on a voluntary basis and court for positive change for those whose • strengthening their identity referrals are also taken. The facility lives have been affected by drugs and • providing guidance in reaching their can take up to 16 clients at a time and alcohol. The programs adopt a holistic potential and future goals accepts men over 18 years of age. approach that recognises the physical, • identifying and developing their skills Clients are required to participate in emotional and spiritual needs of Koori and talents a range of culturally relevant self-help people. and self-development programs and • acknowledging and recognising the activities each day. Residential programs and services are value they offer their communities. available to Koori men, women and For more information contact Ngwala youth throughout the state. The program includes and integrates aspects of Koori culture with a focus Willumbong. Koori Youth Alcohol and Drug Healing on individual and peer learning, and Winja Ulupna (funded by OATSIH) Service (funded by the Department of vary according to the background and Human Services) Winja Ulupna is a 24-hour residential cultural awareness of the individuals alcohol rehabilitation centre for Koori The Koori Youth Alcohol and Drugs and the group. women who suffer from alcoholism or a Healing Service offers residential drug dependency problem. Admission For more information contact YSAS or Ngwala rehabilitation facility for Koori people to the centre is on a voluntary basis and Willumbong (see Contact list). aged 15–20 years with AOD-related court referrals are also taken. problems. It is available statewide and The facility can take up to eight clients provides access to health, education at a time and accepts women over Message stick 27
18 years of age. It offers clients a identities sense of belonging. relaxed home like atmosphere for their recovery. Clients are required For more information contact Njernda Aboriginal to participate in a range of culturally Cooperative. relevant self-help and self-development Warrakoo Residential Rehabilitation programs and activities each day. and Treatment Program (funded by Professional tutors and qualified OATSIH) counsellors run the following programs Warrakoo is a residential rehabilitation and activities for clients. program for Aboriginal and Torres Strait Islander men with alcohol or other drug For more information contact Ngwala issues. Located in a bush setting 100 Willumbong. km from Mildura, the facility can take Percy Green (funded by OATSIH) up to 12 clients at a time. Admission is Percy Green is a 24-hour residential on a voluntary basis and court referrals alcohol rehabilitation centre for Koori are also taken. men who suffer from alcoholism or Clients participate in a range of a drug dependency problem. The culturally relevant self-help and self- centre is located in a rural setting in development programs and activities. Mooroopna in central Victoria with statewide catchments. For more information contact Mildura The centre can take up to eight clients Aboriginal Corporation. at a time and accepts men over 18 years of age. Admission to the centre is voluntary. It offers clients a relaxed homelike atmosphere for their recovery.
For more information contact Ngwala Willumbong. Baroona Youth Healing Place (funded by OATSIH) Baroona is a 24-hour residential rehabilitation program located in a bush setting. The service is a residential rehabilitation facility for Koori people aged 14–25 years with AOD-related problems. Through a combination of individual and group work, the staff assists each client to deal with their alcohol and drug issues as well as identifying their individual strengths, networks, cultural 28 Message stick
Residential programs – agency and location
1 1 Warrakoo Mildura Aboriginal Co-op near Mildura 2 Baroona Youth Healing Place Njernda A.C, Echuca 3 The Percy Green Memorial Recovery Centre, Ngwala Willumbong Co-op, Mooroopna 4 Koori Youth Alcohol and Drug Healing 2 Service, Ngwala/YSAS, Bittern 5 Winja Ulupna Ngwala Willumbong Co-op, 3 St Kilda 6 Galiamble Ngwala Willumbong Co-op, St Kilda
5 6
4
Activity Have a chat with your manager or mentor to see if they can offer some information about the way AOD services have changed. Here are some questions to help you start the conversation: • How are Koori AOD services different from mainstream services? • How can they work together? Message stick 29
AOD and mental health issues
Helping people with AOD Public area mental health services – a brief summary and mental health issues Information extracted from: Purro Birik Social and Emotional Wellbeing Strategy 1999- Many people with drug and alcohol 2002 (Indigenous Mental Health Services) evaluation report problems have a range of mental health The Victorian public mental health service system has a number of components problems at higher rates than in the intended to provide a comprehensive clinical and disability support service for people general community, most commonly with a mental illness. depression and anxiety. Alcohol and • Clinical services include community treatment, residential services and inpatient other drug use is also increasingly services. common among those experiencing psychosis and other serious mental • Disability services include day programs, home-based outreach support, respite disorders. Dual diagnosis is a term used and residential programs. to describe when a person is affected There are different services for children and adolescents, adults and older people. by both mental illness and substance Adult mental health services assist people aged 16–64. These services are misuse (also known as comorbidity). delivered and coordinated by area mental health services (AMHS) and include both A dual diagnosis initiative has been community/outreach services and inpatient services. AMHS operate a single intake set up to improve treatment practices and assessment function (often called ‘triage’). and collaborative working relationships Child and adolescent mental health services (CAMHS) provide specialist mental between drug treatment and mental health services for children and adolescents up to the age of 18 years with mental health services. illness. CAMHS services often work in conjunction with other community services, such as schools, child and family services and GPs. If appropriate, older adolescents experiencing adult disorders may be treated at the adult mental health service. Aged persons mental health services assist people aged 65 years and over who have grown old with a mental illness, have developed a mental illness later in life or have psychiatric or severe behavioural difficulties associated with organic disorders such as dementia. If a person is younger than 65 but requires a service from an aged mental health service the decision is made based on the person’s clinical needs. Service provision in the community The majority of mental health services are provided in the community. Some people receive a mixture of hospital inpatient and community services while others access private mental health providers, including psychiatrists, psychologists and GPs. Some people may move between the two systems depending on their needs or receive services from both. 30 Message stick
Services for Koori people Improving Care for Aboriginal Activity with a co-occurring mental Patients (ICAP) Ask your manager what mental health health/spiritual, social and The ICAP program requires all health services are available in you area. emotional (SEWB) wellbeing services with Aboriginal patients to Ask your manager about how your issues identify and undertake initiatives to approach to dual diagnosis clients improve identification and quality of might differ from other clients you work A significant number people who seek care for Aboriginal patients. The scale with. help from your agency for AOD issues and cost of these initiatives is based may also require assistance with on the number of Aboriginal patients co-occurring mental health/SEWB it caters for. Cultural change and difficulties. relationship building with Aboriginal people and organisations is seen as Aboriginal community the key to enabling Aboriginal people controlled health organisations to better access hospitals while feeling (ACCHOs) safe about identifying as an Aboriginal There are Koori-specific mental health/ person. SEWB services provided for Aboriginal people in Victoria. These services are Victorian Aboriginal Health usually, but not always, able to be Service (VAHS) and St Vincent’s accessed at an ACCHO. Other services Hospital such as the MAYA Living Free Healing The Victorian Aboriginal Health Service Association can be contacted directly. (VAHS) has a mental health/SEWB service called the Family Counselling Koori Mental Health Liaison Service. It also has close links with the Program St Vincent’s Hospital AMHS and the The Mental Health and Drugs Division Royal Children’s CAMHS. funds 11.6 Koori mental health liaison St Vincent’s Hospital AMHS has (KMHLO) positions that provide services designated five of its 44-bed mental in rural regions. A priority for KMHLOs health inpatient beds for exclusive use is to provide information about mental by Koori people. health treatment and care options to Aboriginal people and assist with developing culturally sensitive practice within area mental health services. There is also a KMHLO located at the Royal Children’s Hospital who supports Koori children and their families who are hospital patients or clients of the child and adolescent mental health service. 2 The Purro Birik Social and Emotional Wellbeing Strategy 1999–2002 (Indigenous Mental Health Services) Evaluation Report Message stick 31
Section 3: About your role in the community
Your role as a worker they believe they need to build the Once you have a job description you community and reduce alcohol and can always refer to it to make sure you in your community other drug use are doing your job. The job description Whether you are a Koori AOD worker, • keeping records and reporting on can also help you when you talk to your resource service worker, drug diversion client activity. manager about your performance. worker, substance use worker or a worker in a residential facility, starting work in a new organisation can Job descriptions sometimes be a little confusing. Your specific role and duties will depend Asking questions is a great way for on what your agency has been funded you to find out about your job and to do, and how it goes about providing your agency. You’re encouraged to its service to clients. You can refer to ask as many questions as you like, your job description to find out about remembering that ‘there are no stupid your specific duties and responsibilities. questions’. A job description usually has a job There are duties and responsibilities title followed by a list of duties and that are common to all Koori community responsibilities. AOD service workers. Some of these Read your job description carefully responsibilities include: and ask your supervisor to explain • case managing and supporting if something is not clear. If a job clients with AOD-related problems description is not available, sit down with your manager and write one. You • providing information, support may want to talk to other workers in and education to Koori families, different agencies that provide similar individuals and clients on the effects services and ask for a copy of their of alcohol and other drugs job description so you can use it as a • providing support to other Koori basis to develop your own. This should health organisations on AOD-related include: issues • the aims of your position • networking with health and welfare • any qualifications or experience you agencies in order to link clients are expected to have affected by alcohol and other drugs to other services they might need • your major tasks (duties) and where you are to do them • promoting good health and giving talks at community events about • who you are to report to, and who healthy lifestyles and choices might report to you • supporting community events and • information about your wages activities (industrial agreements or awards) • keeping in contact with Koori • conditions (hours of work, time community organisations and people sheets, leave, future learning and to make sure programs reflect what development opportunities). 32 Message stick
Sample job description
Koori Community Alcohol and Drug Worker (KCA&DW) Position reports to Program Coordinator
Duties and responsibilities: In consultation with the local Koori community and the regional office of the Department of Human Services, to assess and identify alcohol and drug related problems and implement strategies to reduce the incidence of alcohol and drug use. • Provide information to Koori individuals and the Koori community regarding alcohol and drug use. • Provide input into the development of programs to meet the needs of Koori communities. • Establish supports and programs to facilitate harm minimisation strategies. • Encourage the development of cooperative links between Koori groups, service users, mainstream organisations and networks, to ensure that Koori people have access to those organisations and services. • Provide advocacy and support to service users which would include the joint development of individual treatment plans. • Provide individual and group support where appropriate to carers and families of those effected by alcohol and drug use. • Other duties as directed.
(This information is based on position description by Ngwala Willumbong Co-operative) Message stick 33
Working with the Koori Uncle Jumbo’s story community Uncle Jumbo is an Elder and experienced AOD worker. He describes how he uses his Gaining the trust of the community knowledge of Koori culture to conduct an assessment over time. you are working in is essential. If you Uncle Jumbo: Sometimes the fellow isn’t ready, or in any state to answer lots of are new to the community you should questions. We get the basics first. It might be better to have your talk outside too, or find out who the Elders are and the in a place the person is comfortable. most appropriate way to make contact Some of our people don’t like to sit in an office answering questions for a long time. with them. In most cases, your agency, It makes them nervous. You have to read the situation. You might get the information the cooperative or someone else who you need over time and in different situations like when you’re having a meal, or a knows the Elders well would make yarn. the first contact. From that point they would either say it is appropriate to ring We get to know a lot of the fellows. They get to know us too and what they can them directly or the Elder may want to expect. They might trust us more because they know we understand their situations, ring you. It is best to be guided by the past and present. Koori organisations in the community. Explain what your role is to Elders and agency to respond appropriately. local football or netball game as part discuss how you can help each other. If you become burnt out from being ‘on of their role. The community and their You should spend time with the Elders call’ 24/7, you will not be any help to organisation could view this activity as and other key Koori organisations in your clients and your own life will suffer part of building trust and community the area to be guided by their local as well. You may need to let people relationships. knowledge and understanding of the know you are not ‘on call’ day and night The reality for workers is that being issues. Attend their meetings, go to but will respond to their message during involved in community activities is community functions and let them know working hours. considered friendly and culturally you value their advice. This empowers appropriate and helps people to form a both you and them and is more likely Prevention and holistic relationship that can help them to deal to lead to positive outcomes for your with AOD-related problems. clients. support Be mindful that workers in both Koori At the heart of Koori culture is the vital Privacy and providing importance of family. Family for Koori and mainstream agencies are often services to a family member expected by community members to people is defined widely and inclusively be on call 24 hours a day, seven days and extends beyond formal blood ties or friend a week. Community members may not to include parents, aunties and uncles, There are some potential challenges recognise time boundaries for people cousins, grandparents, Elders and other faced by workers when providing taking on these roles. If there is a need, significant people in the community. services to clients who are friends or for example, at 10.30pm on a Sunday Prevention and whole-of-family supports family members. You might want to night, they might expect action. are part of services provided by suggest that they see another worker in your agency or refer them to another Responding to the needs and workers. Activities such as sport, music, agency. At times you may feel pressure expectations of the community is art and culture programs can also play from the client’s family members or something that each service agency a part in healing of clients, their families friends to give information about a needs to monitor and feedback from and the community. client; however, it is important that you AOD workers is vital in order for the For example, a worker might attend the 34 Message stick
respect your clients’ privacy. appropriate person and work together Your agency is an excellent source of For information about privacy visit with providing support to the client. information and it is a good idea to use the Office of Victorian Privacy every opportunity available to learn Commissioner website at Non-Koori workers based in the history and current issues facing
Your agency and your community
Each agency has a history and it is The people you need to • client service provision protocols useful for new workers to understand know in your agency • equipment and resources needed to a little about how the agency came to do the job (if any) exist. This will also give you a chance It is important to understand who does to get to know some of the people who what in your agency. Some agencies • details of other staff member’s roles you work with a little better. have an organisational chart that shows and duties or an organisational chart how everyone fits in relation to each • training and professional We recommend that you take the time other. Check with your manager to see to find out information about your development opportunities in your if your agency has one. If one is not agency agency, including: available you may want to ask your • performance management protocols • the history of the agency manager to tell you a little bit about the • the agency’s vision, goals and structure of the agency. • reporting requirements of the services agency. Legislation, policies and • the management structure Your manager may choose to ask one of procedures of your agency the experienced workers to give you a • who works in the agency and what hand while you settle down in your role. they do Your agency is responsible for working within the legislation of • who funds the agency (there might the Commonwealth, state and local be more than one funding body) governments. These are the laws each • policies and procedures agency has to follow in order to provide • the agency’s ideas and policies services in a responsible manner to about providing AOD services. clients. For example, if your clients are children, legislation requires that you Most agencies also have a vision undergo a police check before you are statement. Your agency’s vision allowed to work with children. Your statement should explain what its agency will have other policies and services are trying to achieve (ask your procedures for working with clients as manager if your agency has one). well as tasks such as using agency of cars and accessing leave. Where does funding come Learning all this information can take a from? number of weeks or even months. Your In Victoria, funding for Koori AOD main priorities at the start are to learn services is provided by state and information about your agency that is Commonwealth governments. Agencies essential to you being able to provide receive funding to deliver services to a high level of service and a safe the community and need to meet ‘key environment to your clients, including service requirements’ set out in the occupational health and safety, code of contract or service agreement. conduct and duty of care. Some important things to learn at the start include: • occupational health and safety protocols 36 Message stick
Activity Ask your manager to give you some details about the agency you are working for. Here are some questions that may assist you: • When was the agency formed? What was its relationship with the community? • How did the agency get its name? • Are any of the founding members still working with the agency? • How does it work with the community now? Most agencies have policies and procedures written down in documents. You will need to ask: • Where is our policies and procedures manual? • Can you show me the policies that directly affect my role? • If there is no manual, or if the manual is too difficult to use, who can help me to understand our policies and procedures? Message stick 37
Qualifications, training and professional development
There are many ways you can Minimum qualification strategy keep building your knowledge and Information extracted from The Victorian alcohol and other drugs workforce skills. In order to provide the best development strategy – minimum qualification strategy (Department of Human Services possible service to your community, 2006). it is important to get the training and qualifications you need. Talking to your To ensure consistent and high-level drug and alcohol client services and to manager about your career is a good be regarded by other health sectors as competent and knowledgeable AOD starting point as they may be able to professionals, training and qualifications in the specialty of alcohol and other drugs is assist you in achieving your goals and recommended for all AOD workers. meeting your training needs. The aim of the Minimum qualification strategy is to ensure the development and maintenance of a consistently competent and professional AOD workforce. The Qualifications strategy’s implementation mechanisms provide a consistent approach to learning and Depending on the role you have been skills development based on minimum, nationally recognised competency standards. hired for, you may need to get formally qualified. Informal training Example of training offered The types of qualifications may include: Informal training might include to AOD service providers • Level 2, First Aid Certificate workshops, conferences, network Although the type of courses offered qualifications meetings and opportunities for by education and training organisations • Certificate IV in Drugs and Alcohol workplace based activities. Many varies from time to time, here is a list regions have regular AOD meetings. The • Certificate III in Community Services. of the type of courses that have been Koori AOD Network conducts meetings delivered recently: throughout the year with a strong • Certificate IV for Alcohol and Other Formal training for Koori emphasis on professional development Drugs AOD workers of the Victorian Koori AOD workforce. A number of agencies and Training and • Certificate IV for Koori Alcohol and Further Education (TAFE) institutions Other forms of informal Other Drugs offer formal training in alcohol and training • mental health first aid other drugs. There are different levels of You can ask someone to be your • dual diagnosis courses offered and there may be some mentor. A mentor is an experienced • first aid. associated costs (see the Contact list in Koori AOD worker who will guide you Section 5). and help you to understand and manage Activity If you are interested in gaining or you work. You may choose to ask your Talk with your manager about completing a qualification, contact the manager if there is an opportunity to qualifications. local TAFE or other organisation that participate in an exchange program you think may provide relevant training. with another agency. Under this • What qualifications are desirable for Ask what they have to offer, and if they arrangement you can exchange roles your role? offer recognition of prior learning (RPL). with a worker from another service and • If you don’t have the desired RPL can assist you in obtaining formal feed back what you learned to your own qualifications, how you can go about qualifications if you have worked in the organisation. obtaining them? field for a while. You could also talk to workers either in your organisation or in the network who have done this before. 38 Message stick Message stick 39
Section 4: Working as a Koori AOD worker
Safety and duty of care who may be interacting with clients. client may display self-harming and Your agency is responsible for the Here are some websites that can assist suicidal behaviours. It is therefore safety of staff, clients and visitors and, you if you are having difficulties getting important that workers identify of course, yourself. Safety while you are information about your OH&S rights and situations where clients are clearly at work is everyone’s responsibility. responsibilities. ‘at risk’ and respond immediately by alerting the appropriate people (you Each agency has someone in charge Australian Safety and Compensation manager, the ambulance, the police, of occupational health and safety. Ask Council etc). your manager who this person is and http://www.acosa.org.au/contact.asp introduce yourself. Training to deal with a range Victorian Equal Opportunity and Human of behaviours is available and Always remember that occupational Rights Commission recommended. Your service will have health and safety is everyone’s http://www.humanrightscommission. advice on the most appropriate training responsibility so if you see anything that vic.gov.au/Home.asp and how to access it. may be dangerous or cause harm or Alcohol and other Drugs Council of injury to you or others, report it to your Australia Incident reporting manager. http://www.adca.org.au/ If something happens in your agency Working with Children check that is outside the normal daily practice What about aggressive and you might need to complete an incident In 2006 the Victorian Government demanding clients? report form. introduced a new checking system to People can be ‘aggressive’ and help protect children under 18 years of Incidents need to be reported because: ‘demanding’ for many reasons and it age from physical or sexual harm. • information needs to be recorded is likely you may come across some for reference (such as by police or a The Working with Children (WWC) check throughout your career. creates a mandatory minimum checking funding body) Experienced workers have suggested standard across Victoria. If you work • some incidents may require further that, in most circumstances, people with children you may need to apply for action showing these behaviours will respond a WWC check. well to being listened to. • other people might need to be Agencies must ensure that any of their involved Knowing how to handle these situations staff who need a WWC check have can make your life a lot easier. If you • everyone can learn from incidents applied by the due date. For more have any questions about what to do that occur, so you and your agency information visit
Working with other services
Sharon’s story: ‘But nobody told me!’ Some clients will come to you asking for assistance about a number of issues, Sharon was new to her role as a Koori AOD worker. She was working in an some of which may not be directly organisation that kept medications in a locked cabinet. Unfortunately, in Sharon’s first related to alcohol and other drug use. In week she was confronted by a client who demanded the key to the cabinet. order to help the client, you will need to The client abused Sharon and hit her as she tried to persuade him to calm down. contact other services and ask for their Sharon was unaware there was an alarm she could have triggered to get more assistance. support. Sharon was also unaware the client regularly tried to get this key. The role of an AOD worker is to What should the organisation have done to keep everyone safe? determine the services required to help What could Sharon have done differently? the client and make the necessary arrangements and phone calls so that the client can access the services. Activity For example, you might discover that a client needs to access housing, Ask your manager to give you some examples of incidents in your agency. You may mental health, parenting or other want to ask: health services. They will need your • What do I do if something happens to me that I want to report? help to get connected with these • When do I have to fill in an incident report? Ask for some examples. services. You might also need to work with other AOD-specific services, like residential withdrawal services, home- based withdrawal services, nurses or rehabilitation services. A collaborative approach recognises the many different ways a person may be affected by their use of alcohol and other drugs. It also recognises the affects on other people like partners, children and community members. Other agencies work with a similar approach so you might find that a client is referred to you from another service. Making assisted referrals and forming strong partnerships with Koori and mainstream services is an essential part of your role.
Building relationships The term ‘networking’ is often used to explain the process of establishing working relationships between agencies and it could mean meeting people in Message stick 41
other organisations and getting to know Key services in your supporting hostels run by community what they do. community organisations. Each state in Australia For example, a client may come to your has a number of hostels that offer agency and, after having a chat with Housing services comfortable, homely environments and them, you identify that apart from AOD are staffed by Aboriginal or Torres Strait services, the person needs to talk to a Supported Assistance Islander people. qualified psychologist, and needs legal Accommodation Program (SAAP) For more information visit
Working with clients
For more information about Healing and Time The Aboriginal Family Violence Many people choose to work in AOD Out services visit
For more information visit
Ask for advice if you come across a • Assist your clients to understand Activity situation or a client you are not sure your role and responsibilities. It’s healthy to think about your values, how to manage. Your manager or other • Make sure the person knows when, attitudes and personal stories. How experienced AOD workers can help you how and who to ask for help. might they affect how you work with to find a solution as they may have been clients? You can share your thoughts through similar situations in the past. Assessments and referrals with your manager, or you may wish to keep them private. Think for a moment Most agencies use forms to record Communication with your of the following: information relevant to working with client individuals. Experienced workers find • Why did you decide to work in this Many of your clients will share their that the assessment can be done in a area? stories. By listening carefully to what a cooperative discussion during the first • Are there personal stories that have client tells you, you may be able to get session with the client. influenced your decision and your a better understanding of strengths, Most assessment and referral forms work? interests and underlying issues about normally do not need to be filled out their substance misuse. • What do you see as your role in in one sitting with the client. Many assisting people who are having When you first meet a client, take the workers report that the relevant alcohol and other drug problems? time to explain the service you provide, information is collected informally and what you can and cannot do to over a period of time and the relevant support them. Explaining this right at forms filled in back at the office. The the start is a good way to establish a important thing is to make sure that professional relationship so both you client information gathered is recorded and your clients are clear about each clearly in the client file. other’s rights and responsibilities. Some When you make referrals to other workers draw or write this down for services, the same type of client clients. By doing this you can refer back information is required. Client files to it if you have to remind clients in the are also essential when you do a hand future. over anytime you go on holidays or you change jobs. Engaging your client Building a strong and mutually respectful relationship with your client can take time. Engaging is about building trust and creating a safe environment for clients to share their stories and needs with you. Some hints from experienced Koori AOD workers include: • Explore the person’s strengths and hopes for the future. • Build the person’s knowledge about their rights and responsibilities. 44 Message stick
Managing your workload
In Section 3 we discussed how a job • changes in health, accommodation Individual treatment plans description can help you understand arrangements, employment, contact and management systems the duties you are required to perform details. as part of your role. In the following Each organisation may do this part pages we will discuss some of the Health Records Act of the job differently. However, the day-to-day responsibilities of a service principles that support case planning The Victorian Health Records Act is worker, including administration tasks, are that: a framework to protect the privacy record keeping as well as some of the • Individual treatment plans (ITPs) are of individuals’ health information. It basic protocols to be followed when created with the client’s needs and regulates the collection and handling providing your service to clients. There goals as the priority. of health information. For more are also some tips from experienced information visit:
Data is often used as supporting Data recording requirements when the treatment ceased. evidence for resources, funding bids There are different data recording Agencies that are funded by and so on. requirements depending on the service government to provide drug treatment When services throughout the region, agreement your agency has with the services are required to record and the state and the country combine funding body. report this activity. this information, governments and There are two common data recording There are several software applications other decision-makers can make better systems for agencies that provide that are being used by agencies to policies and funding decisions. AOD services: the Alcohol and Drug record and report this information. Information System (ADIS) and When agencies report the activity to Activity Statewide Information Technology for the department, it is consolidated in a Ask your manager the following Community Health (SWITCH). database that collects the information questions. from all Victorian government-funded Ask if the agency has a service drug treatment services. • What information do I have to get agreement (a contract) with a funding from my clients? Are there forms I body that requires you to record data. If The data is used by the department have to fill in? the answer is ’yes’, you will need to get to gather information about services • Where do I keep the client files? familiar with the process. Training may provided to clients in the AOD sector be required for you to learn the system. and to monitor agency performance. • Have you had any problems with It is also used to help the government privacy and confidentiality of client make accurate decisions about where information? What is ADIS? resources need to be put to meet the The Alcohol and Drug Information • Can you tell me the Individual needs of clients. treatment plans and management System (ADIS) is the system that the To protect the privacy of the client, their systems that I must follow? department uses to gather information about services provided to clients in name and address are automatically • What do I do if another service asks the AOD service sector. The information removed from the information that is me to provide sensitive information is used to help the government make reported to the department. about a client I am referring them to? accurate decisions about where resources need to be put to meet the When is the data due? needs of clients. ADIS is available on a The data is forwarded for each reporting computer in your agency to record data quarter. Below is a table showing dates about the work you do with your clients. by which quarterly information must be There are three main components to reported to the department’s central the data you are required to report: office. • information about the client such Quarter Dates Due by as their name, age, address, living Q1 1/07 – 30/09 15 October arrangements and employment status Q2 1/10 – 31/12 15 January • details about the client’s alcohol Q3 1/01 – 31/03 15 April and/or other drug problem Q4 1/04 – 30/06 15 July • details about the service provided to the client, what was achieved, and 46 Message stick
What happens if the data is The following is a scenario withdrawal worker and during her late? demonstrating the delivery of a course of course of treatment achieves one of the treatment. goals identified in the ITP. On 12 June Your Department of Human Services 2007, Jane completes her course of regional coordinator will be in contact home-based withdrawal treatment. with your agency. John Smith commences treatment in counselling at Agency A on 15 AOD reporting support services April 2007. An Individual treatment This scenario is a course of treatment Each reporting application has support plan (ITP) is developed in which the that is also counted as an episode of services such as a helpdesk and counsellor and John identify and plan care because Jane has achieved at least training that is provided on a regular for the achievement of three significant one of the goals that were set. basis. treatment goals (STGs). What is SWITCH? If you are unsure of who you need John attends two appointments to talk to, you can contact the ADIS (contacts) with the specialist AOD State Wide Information for Community Helpdesk on 9096 5351 for assistance. counsellor, and is progressing through Health (SWITCH) is a client and services treatment. However, on 25 May database developed specifically for AOD service definitions 2007 John doesn’t turn up for his community health services. It covers community health, HACC and AOD Provided below are some definitions appointment with the counsellor and services in Victoria. It is also used as a you will come across in your AOD doesn’t re-appear for treatment in client master index for most community reporting: over three months. John’s course of counselling treatment is ceased, with health services. SWITCH counts hours of service, contacts, group sessions, Course of treatment (COT) a termination date of 25 May 2007. clients (including casual, registered and • A period of treatment in one service No significant treatment goals were organisational clients) as well as alcohol type. achieved. and drug episodes and AOD contact- • Occurs between a specialist AOD Episode of care (EOC) based services. SWITCH is currently treatment worker and a client. • A course of treatment that has at being replaced by HealthSMART • Involves one or more contacts with least one significant treatment goal products in community health agencies. the client. achieved by the client. • Has a commencement (start) date, The following is a scenario demonstrates and an end (termination) date. the delivery of an episode of care. • May, or may not, include the achievement of a significant Jane Smith commences treatment in treatment goal by the client. home-based withdrawal at Agency B on 6 April 2007. An ITP is developed in which the agency’s home-based withdrawal worker and Jane identify and plan to achieve two significant treatment goals. Jane attends eight appointments (contacts) with the home-based Message stick 47
Section 5: Resources Alcohol
Drugs and their effects http://www.druginfo.adf.org.au/ throughout the water in the body, but druginfo/drugs/drugfacts/alcohol.html not into fatty tissue. How alcohol leaves the body What is alcohol? The liver breaks down about 91 per cent Alcohol is a liquid produced by of alcohol, and a small amount leaves fermentation, which is the action of the body in urine, sweat and the breath. yeast on liquids containing sugars and The liver can only work at a fixed rate, starches. Pure alcohol has no colour getting rid of about three-quarters of a or taste. Alcoholic drinks vary in colour standard drink an hour. Sobering up and taste because of other ingredients takes time, and cold showers, exercise, that are added to them. black coffee, fresh air or vomiting will Alcohol is a depressant drug – not a not speed up the process. Someone stimulant as many people think. Alcohol who drinks a lot at night may still have slows down activity in the central a high concentration of alcohol in their nervous system, which means it slows bloodstream the following day. down the messages going between Immediate effects the brain and the body. Depressant drugs affect concentration and • After a few drinks the person may coordination, and slow the person’s feel more relaxed, have reduced response time to unexpected situations. concentration and slower reflexes. In small quantities, depressants such • After a few more drinks, they as alcohol cause people to become may have fewer inhibitions, more relaxed and lower their inhibitions. They confidence, reduced coordination, feel more confident and often act in slurred speech and intense moods a more extroverted manner. In larger (for example, sad, happy, angry). quantities, depressants can cause • If the person continues to drink they unconsciousness and even death. may experience confusion, blurred vision and poor muscle control. Effects of alcohol • Continuing to drink may result in nausea, vomiting and sleep. How alcohol is absorbed into the body • Consuming more alcohol could possibly result in coma or Alcohol is absorbed directly into the death. bloodstream through the stomach and the small intestine. Food in the stomach ‘Binge’ drinking slows down the rate at which alcohol is absorbed, but does not prevent Binge drinking can be described as intoxication or drunkenness. All alcohol drinking heavily over a short period of consumed will reach the bloodstream, time or drinking continuously over a regardless of how much food is in number of days or weeks. the stomach. Alcohol is distributed Binge drinking is harmful because
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it results in immediate and severe • for men, impotence, shrinking important than other activities in intoxication. As well as health risks, this of testicles and damaged and their life. People who are physically can lead people to take risks and put reduced sperm dependent upon alcohol find that their themselves in dangerous situations. • for women, greater risk of body is used to functioning with alcohol Common effects of binge-drinking gynaecological problems. present. episodes are hangovers, headaches, nausea, shakiness and vomiting. Social problems Withdrawal Excessive alcohol use can effect all If a person who is physically dependent Long-term effects areas of a person’s life, including on alcohol suddenly stops drinking Heavy consumption of alcohol over a family, work and personal they will experience withdrawal long period of time can cause damage relationships. symptoms because their body has to readjust to functioning without alcohol. to many parts of the body. Impairment • Family problems: Arguments over of brain and liver functions can be someone's drinking can cause family Alcohol withdrawal symptoms include: permanent. If the person’s diet is and relationship problems that may • loss of appetite also poor, this can further affect their lead to break up. • nausea health. Emotional difficulties, such as depression and relationship problems, • Work problems: Drinking alcohol • anxiety at work and hangovers can lead to are also likely. • insomnia poor performance and accidents Other possible long-term at work, while illness can result in • irritability effects include: absenteeism. • confusion • cancer of the mouth, throat, • Legal problems: Drink-driving may • tremors lead to fines, loss of license and oesophagus, lips, liver • sweating. even imprisonment. • brain injury, loss of memory, In severe cases, alcohol withdrawal confusion, hallucinations Tolerance and dependence may cause convulsions, cramps, • high blood pressure, irregular pulse, People who drink heavily usually vomiting, delusions, hallucinations and enlarged heart and changes in red develop a tolerance to alcohol. This even death. A person dependant on blood cells means that they need to drink more alcohol considering withdrawing should • weakness and loss of muscle tissue to experience the same effect. As a first consult a doctor or other health professional. • sweating, flushing and bruising of the result, some people can drink large amounts of alcohol without appearing skin Treatment to be intoxicated. However, the amount • inflamed stomach lining, bleeding of alcohol consumed can still damage There are a number of drug treatment and stomach ulcers their health. options available in Australia. While abstinence may be a suitable treatment • increased risk of lung infections People who regularly drink heavily aim for some people, many programs • severe swelling of the liver, hepatitis may become dependent on alcohol. recognise that for others this may not and cirrhosis Dependence can be psychological be possible or realistic. Most programs or physical, or both. People who are • inflamed pancreas adopt strategies that have an overall psychologically dependent on alcohol • tingling and loss of sensation in aim of reducing the harms and risks find that drinking becomes far more hands and feet related to the person’s alcohol use.
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Some treatment options include get rid of alcohol in their bodies than planning to take any substances while counselling, withdrawal (detoxification) women not on the pill. pregnant or breastfeeding, including and medication (pharmacotherapy). For all these reasons, health authorities alcohol, and prescribed and over-the- Residential and ‘outpatient’ programs recommend that women should drink counter medications. are available. less alcohol than men. Treatment is more effective if tailored Standard drinks to suit a person’s circumstances, Pregnancy and breastfeeding The use of standard drinks can and usually involves a combination of Alcohol consumed during pregnancy help people to monitor their alcohol methods. crosses the placenta to the baby. It can consumption and exercise control over For referral to a treatment service, cause problems in pregnancy, such the amount they drink. contact the alcohol and drug as bleeding, miscarriage, stillbirth and A standard drink is defined as one that information service in your state or premature birth. contains 10 grams of pure alcohol. territory. There is evidence to suggest that if a Different types of alcoholic drinks pregnant women drinks two or more contain different amounts of pure Women and alcohol standard drinks a day the baby can alcohol. For example, each of the drinks Research has shown that alcohol be affected and grow more slowly. below are equal to approximately one affects women differently than men. Babies born of women who are heavily standard drink: • Higher blood alcohol concentration dependent on alcohol can suffer alcohol • two 285ml pots/middies/ (BAC): If a man and a woman drink withdrawal symptoms after birth; have schooners/handles of light beer exactly the same amount of alcohol, poor coordination and movement, and (2.7% Alc./Vol) the woman will almost always have foetal alcohol syndrome (FAS). Babies • one 375ml stubbie of mid strength a higher BAC. One reason is that a with FAS may be born with facial beer (3.5% Alc./Vol) woman’s body contains more fatty defects and physical and intellectual disability. • three-quarters of a 375ml stubbie tissue and less water than a man’s of full strength beer (4.9% Alc./Vol) body and women are often smaller The World Health Organization suggests than men. there is no safe level of drinking alcohol • one 285ml pot/middy/schooner/ during pregnancy, and recommends handle of full strength beer (4.9% • Health problems: Women may Alc./Vol) develop liver damage and other that the safest approach for pregnant health problems at lower levels of women is not to consume any alcohol • 100ml of wine (12% Alc./Vol) alcohol consumption than men. at all. • two-thirds of a 330ml bottle of Women who drink alcohol are at an There is evidence that alcohol alcoholic soda (5.5% Alc./Vol) increased risk of developing breast is excreted into breast milk and • 30ml of spirit or liqueur (40% Alc./ cancer and gynaecological problems can reduce the milk supply. During Vol). than women who don’t drink. the first 12 months of a baby’s life Keep in mind: • Hormonal differences: Some alcohol can cause damage to the • The ‘standard’ size of drinks served research suggests that a woman’s developing brain. For women who in some hotels may be bigger than reaction to alcohol may vary at are breastfeeding it is better to avoid the standard drinks you are used different stages of her menstrual consumption of alcohol as much as to. Large wine glasses can hold two cycle, due to differences in hormone possible. standard drinks or even more. levels. Women who take the See your doctor or other health contraceptive pill may take longer to professional if you are taking or • Drinks served at home often contain
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Amphetamines
more alcohol than a standard drink. • Sex: After consuming the same http://www.druginfo.adf.org. • Cocktails can contain as many as amount of alcohol, a female will au/druginfo/drugs/drugfacts/ five or six standard drinks, depending almost always have a higher BAC amphetamines_ice.html on the recipe. than a male. Because of all these variable factors, What are amphetamines? Blood alcohol concentration counting the number of standard drinks Amphetamines belong to a group Blood alcohol concentration (BAC) you consume can only give a rough of drugs called ‘psychostimulants’. is the amount of alcohol in the guide to your BAC. Amphetamines stimulate the central bloodstream. A BAC of 0.05 means the nervous system and speed up the person has 0.05 grams of alcohol in messages going to and from the brain every 100ml of their blood. to the body. Since the liver metabolises alcohol Most amphetamines are produced in at a rate of about three-quarters of a backyard laboratories and sold illegally. standard drink an hour, the BAC level People who buy amphetamines illegally drops over time, unless more alcohol is are often buying these drugs mixed consumed. with other substances that can have unpleasant or harmful effects. BAC is measured with a breathalyser, or by analysing a sample of blood. What do they look like? Factors affecting BAC Amphetamines are a whole family of The more a person drinks, the higher related drugs – each with its own recipe their BAC. However, two people who – and are taken in different ways. They drink the same amount might register can be in the form of powder, tablets, quite different BACs. This is due to a capsules, crystals or red liquid. range of factors, including: Amphetamines can come as a white • Body size: A smaller person will have through to a brown powder, sometimes a higher BAC than a larger person, even orange and dark purple. They have because the alcohol is concentrated a strong smell and bitter taste. in a smaller body mass. Amphetamine capsules vary • Empty stomach: Someone with an considerably in colour and are empty stomach will reach a higher sometimes sold in commercial brand BAC sooner than someone who shells. They are packaged in ‘foils’ has just eaten a meal. Food in (aluminium foil), plastic bags or small the stomach slows down the rate balloons when sold on the street. at which alcohol passes into the Amphetamine tablets vary in colour, bloodstream. and can be a cocktail of drugs, binding • Body fat: People with a lot of body agents, caffeine and sugar. fat tend to have higher BAC. Alcohol Crystal methamphetamine, or ‘ice’, is not absorbed into fatty tissue, generally comes in large ‘sheet-like’ so the alcohol is concentrated in a crystals, or as a crystalline powder. smaller body mass.
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The reddish-brown liquid is sold in size, weight and health, how much and can be highly poisonous. They can capsules. how the drug is taken, whether the cause collapsed veins, tetanus, MDMA, or ‘ecstasy’ as it is more person is used to taking it and whether abscesses and damage to the heart, commonly known, is another illicit drug other drugs are taken. It also depends lungs, liver and brain. And because the related to amphetamines. It is usually on the environment in which the drug is person doesn’t know whether they are available in small tablets. used; for example, whether the person using 5 per cent or 50 per cent pure is alone, with others or at a party. amphetamines, it is easy to overdose by Why are they used? accident. Immediate effects People use amphetamines for different In greater quantities reasons. Some use the drugs to get Soon after taking amphetamines, the ‘high’ and dance all night. Others following effects may be experienced: Very high quantities of amphetamines use the drugs to help stay awake • speeding up of bodily functions can cause paleness, headaches, dizziness, blurred vision, tremors, for long periods of time, to improve • more energy and alertness performance in sport or at work, irregular heartbeat, stomach cramps, • reduced appetite or to boost their self-confidence. sweating, restlessness, irregular Amphetamines can reduce tiredness • irritability. breathing and loss of coordination. Some users have collapsed after taking and increase endurance. • Amphetamines speed up the body’s amphetamines. High quantities can also activity. Heart rate, breathing For medical purposes, amphetamines create an ‘amphetamine psychosis’, and blood pressure increase. A are prescribed to treat narcolepsy characterised by paranoid delusions, dry mouth, increased sweating, (where a person has an uncontrollable hallucinations and aggressive or violent enlargement of the eye’s pupils and urge to sleep) and attention-deficit behaviour. hyperactivity disorder (ADHD). headaches may occur. • Users may feel energetic and full Effects of overdosing How are they taken? of confidence, with a heightened Due to the unknown strength and mix Amphetamines are most commonly sense of well being. Other effects of street amphetamines, some users swallowed, injected or smoked. They include feeling wide awake and have overdosed and experienced are also ‘snorted’, or sniffed, through alert, becoming talkative, restless strokes, heart failure, seizures and high the nose. Some people insert them and excited, and having difficulty body temperature. Some have died as anally (‘shafting’). sleeping. Panic attacks may also be a result. Injecting runs a greater risk experienced. of overdosing due to large amounts of Street names • Some users become anxious, the drug entering the blood stream and Common names for amphetamines irritable, hostile and aggressive. quickly travelling to the brain. are ‘speed’, ‘up’, ‘fast’, ‘louee’, ‘goey’, Sometimes people feel a sense of ‘whiz’, ‘pep pills’, ‘uppers’. Crystal power and superiority over others. Coming down methamphetamine is also known as As the effects of amphetamines begin ‘ice’, ‘shabu’, ‘crystal meth’, or ‘glass’. Impure amphetamines to wear off, a person may experience Most amphetamines sold a range of symptoms including Effects of amphetamines illegally contain a mixture of pure uncontrolled violence, tension, radical The effects of any drug (including amphetamines and other substances mood swings, depression and total amphetamines) vary from person to such as sugar, glucose, bicarbonate of exhaustion. person, depending on the individual’s soda and ephedrine. These additives
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Long-term effects Tolerance and dependence bleeding, early labour and miscarriage. Amphetamine use during pregnancy Regular use of amphetamines may People who are physically dependent has also been linked to an increased result in chronic sleeping problems, on amphetamines usually develop risk of foetal abnormalities, including anxiety and tension, high blood tolerance to the drug, making it smaller head size, eye problems, cleft pressure and a rapid and irregular necessary to take more and more to palate, delayed motor development, heartbeat. In order to combat these get the same effect. The quantity taken limb defects and changes to the brain. drug-related effects, people who use can reach a stage at which no further Amphetamines also cause the heart amphetamines may also use alcohol, increase in the amount taken will rate of mother and baby to increase. benzodiazepines, other sedatives/ produce the desired effect. If amphetamines are used close to hypnotics, cannabis and opiates. Dependence on amphetamines can birth the baby may be unsettled and Other possible long-term effects include: be psychological or physical, or may be over-active and agitated. both. People who are psychologically • malnutrition Babies of mothers who regularly use dependent on amphetamines find • psychosis amphetamines may also experience that using them becomes far more withdrawal symptoms in the first few • reduced resistance to infections important than other activities in their weeks after birth. • violence life. They crave the drug and will find it very difficult to stop using it. People Not much is known about the effects • brain damage. who are physically dependent on of amphetamines on the mother during • Amphetamines reduce appetite, amphetamines find that their body has breastfeeding. There is evidence that resulting in people being less likely become used to functioning with the babies feed poorly and may be irritable. to eat properly. amphetamines present. • Frequent heavy use can cause ‘amphetamine psychosis’. Symptoms Withdrawal may include paranoia as well as If a person who is dependent on delusions, hallucinations and bizarre amphetamines suddenly stops taking behaviour. These symptoms usually it, they will experience withdrawal disappear a few days after the symptoms, because their body has person stops using amphetamines. to readjust to functioning without the • Regular amphetamine users often drug. don’t eat or sleep properly and Amphetamine withdrawal symptoms are generally run down, so their may include hunger, extreme fatigue, resistance to infections is reduced. anxiety, irritability and depression. • People who use amphetamines People may also have a long but regularly or in high quantities may restless sleep, often interrupted by suddenly become violent for no nightmares. Some experience severe apparent reason. distress or feelings of panic.
There is some evidence that Pregnancy and breastfeeding amphetamine use may damage brain cells. This damage can result in reduced Amphetamine use during pregnancy memory function and possibly other can affect foetal development. impairments in thinking. Amphetamine use has been linked with
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Benzodiazepines/minor tranquillisers http://www.druginfo.adf.org. Non-medical uses vision. The person may experience au/druginfo/drugs/drugfacts/ Some people use benzodiazepines a dry mouth, slurred speech benzodiazepines.html illegally to become intoxicated. They and stuttering, tremors, nausea and may use them when they can’t get vomiting, loss of appetite, constipation What are benzodiazepines? heroin, when they are trying to get or diarrhoea. Feelings of euphoria or Benzodiazepines (pronounced BEN- off heroin or to increase the effects isolation and emotional depression may ZOH-DIE-AZ-A-PINS) are depressant of heroin. People who use stimulant also occur. drugs. Benzodiazepines, also known as drugs such as amphetamines (speed) ‘minor tranquillisers’, are prescribed by or MDMA (ecstasy) may use Higher doses doctors to relieve stress and anxiety benzodiazepines to help when they are Higher doses can result in drowsiness, and to help people sleep. Some people ‘coming down’ from a ‘high’, and to help over-sedation and sleep. They may use benzodiazepines illegally, to them sleep. produce an effect similar to alcohol become intoxicated. intoxication. Other effects can Chemical and brand names Like other depressants, include confusion, slurred speech, poor Benzodiazepines are known by their benzodiazepines work by slowing down coordination, impaired judgement, chemical (generic) names and their the activity of the central nervous difficulty thinking clearly, loss of brand/trade names. In each case, system. In the short term, they can help memory, blurred or double vision these are exactly the same drug, with relaxation, calmness and relief and/or dizziness. Mood swings and usually made by different companies. from tension and anxiety. But they do aggressive outbursts may also occur. There are over 24 different prescribed not solve the problem that caused the The symptoms intensify as the dose benzodiazepines, including: anxiety in the first place and they can increases. Feelings of jitteriness and have a range of unwanted side effects. • diazepam: Valium, Ducene excitability often become evident as the effects of large doses wear off. • oxazepam: Alepam, Murelax, What do they look like? Serepax Overdose Benzodiazepines usually come in the • nitrazepam: Alodorm, Mogadon form of tablets and capsules, in a Very high doses of benzodiazepines • temazepam: Normison, Euhypnos, range of colours and designs. They are can cause respiratory depression, Temaze. generally stamped with their name and unconsciousness or coma. Death milligram quantity. rarely occurs from overdose of Effects of benzodiazepines benzodiazepines alone, but deaths can How are they used? The unwanted negative effects of occur if large doses are combined with benzodiazepines vary according to alcohol or other drugs. Deaths can also Medical uses dose. occur from inhalation of mucus or vomit Benzodiazepines are prescribed as when a person is unconscious. sedatives/hypnotics (to induce sleep) Low to moderate doses Bingeing or anxiolytics (to relieve anxiety). They The immediate effects of low vary in how quickly they work and how to moderate doses include mild A ’binge’ is when a large amount long they last. They are also used to impairment of thought processes, of benzodiazepines is taken in one treat epilepsy, to relax muscles, to help memory and coordination; drowsiness, session, rather than as prescribed by people withdraw from alcohol, or as an tiredness and lethargy; dizziness; a doctor. There is a strong possibility anaesthetic before surgery. vertigo; and blurred or double of overdosing and that a high level of benzodiazepine will remain in the
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bloodstream the day after a binge. This Injecting benzodiazepines People who are psychologically makes it dangerous to drive or operate dependent feel as though they can’t Injecting benzodiazepines can be very machinery. If the binges are fairly close cope without benzodiazepines. They dangerous and can result in serious together, there is a risk of developing crave the drug and find it very difficult health problems. Most benzodiazepines dependency on the drug. to stop using it. are intended for oral use but some people inject them. Serious effects People who are physically dependent Long-term effects include: on benzodiazepines have become used The use of benzodiazepines over a long to functioning with the drug present. • collapsed veins period of time (more than two to three weeks) should be carefully monitored by • red, swollen, infected skin Withdrawal your doctor. Some of the health effects • amputation of limbs due to poor If a dependent person suddenly stops of using high doses of benzodiazepines circulation taking benzodiazepines, or severely cuts in the long term include: • damage to organs down their dose, they may experience • muscle weakness physical withdrawal symptoms as their • stroke and even death. • skin rashes body readjusts to functioning without Sharing needles, syringes and other the drug. • weight gain injecting equipment can greatly Withdrawal symptoms from • increased risk of accidents increase the risk of contracting benzodiazepines vary from person to blood-borne viruses such as hepatitis • increased risk of falling person, but can be quite severe. Some B, hepatitis C and HIV (human people have no symptoms at all, while • sexual problems immunodeficiency virus—the virus that others may have symptoms lasting • menstrual irregularities causes AIDS). from a few weeks or months to a year. • memory loss Call the alcohol and drug information Symptoms tend to come and go, but service in your state or territory to find • confusion and difficulty thinking all withdrawal symptoms eventually out where to obtain clean needles and clearly disappear as the body adjusts to syringes. functioning without the drug. • lethargy and lack of motivation Withdrawal symptoms can include: • fatigue Tolerance and dependence • headaches • drowsiness People who are physically dependent on benzodiazepines can develop tolerance • aching or twitching muscles • difficulty sleeping and disturbing to the drug. This can happen very dreams • tremor quickly and means that more of the • faintness or dizziness • nausea drug is required to get the same effect. • sweating • personality change and changes in Dependence on benzodiazepines can emotional responses be psychological or physical, or both. • nausea, vomiting and stomach pains • anxiety Dependence can occur after using • bizarre dreams them for a few months and is not • irritability, paranoia and aggression • inability to sleep properly related to the size or physical effect of • depression. the daily dose taken. Dependency can • fatigue still develop for people on long-term, • difficulty concentrating low doses. • anxiety and irritability
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Buprenorphine
• altered perception http://www.druginfo.adf.org. program that addresses the physical • heightening of the senses of sight, au/druginfo/drugs/drugfacts/ (the body), psychological (the mind) touch, hearing, smell and taste. buprenorphine.html and environmental issues relating to the person’s drug use. This may Other less common withdrawal What is buprenorphine? involve combining several treatment symptoms may include delirium, Buprenorphine (‘bup’, ‘B’) is available approaches, such as buprenorphine delusions, hallucinations, seizures and maintenance, counselling, alternative or paranoia. by prescription, under the name of Subutex, as a treatment for heroin holistic therapies such as massage and People who have been using dependence. It has been found to naturopathic treatment; and developing benzodiazepines for more than a month be effective in reducing the need to a positive support network including should not suddenly stop taking them continue using heroin (buprenorphine peers, family and friends and support without seeing a doctor or health maintenance) and also in helping groups. worker. A slow reduction in dose over people to withdraw from heroin and As with any type of treatment or time is recommended to reduce the methadone. Buprenorphine is also approach to heroin dependency, severity of the withdrawal symptoms. prescribed to treat severe pain. buprenorphine maintenance may be If you suffer from anxiety and/or The information provided here effective for some people but will insomnia keep in mind they may simply not suit everyone. A doctor or drug be withdrawal symptoms. If so, these discusses buprenorphine maintenance treatment. counsellor who spends time assessing symptoms will eventually cease. the person’s specific situation and Buprenorphine has been found to be explaining different options will Pregnancy and breastfeeding effective in treating heroin dependence recommend an approach that is by: Benzodiazepines taken during appropriate for that individual. pregnancy cross the placental • preventing withdrawal symptoms, Buprenorphine is one in a number of barrier and can affect the growth such as cravings for heroin maintenance treatments for heroin and development of the foetus, • blocking the effects of heroin. Using dependence. Others include Methadone especially if the mother is taking heroin will not provide the ‘high’ and Naltrexone more than the prescribed dose or that would normally be expected, taking benzodiazepines that have not therefore it takes away one of the Advantages of buprenorphine been prescribed for her. High doses main reasons to use heroin. maintenance treatment of benzodiazepines during pregnancy There are many benefits of being on may lead to the baby being born with How effective is buprenorphine? a temporary loss of muscle tone, buprenorphine maintenance, when The effectiveness of any treatment, poor feeding, drowsiness and a low compared with continuing the use of including for heroin or other opioid temperature. heroin: dependency (addiction), is more • Maintenance treatment holds the Benzodiazepines can be passed from likely to be successful if it is part of a person stable while they readjust mother to baby through breast milk and comprehensive treatment program. may have a sedative effect. The baby’s their lives. The person may decide Often, a range of factors contribute body cannot process these drugs later to work towards reducing their to an individual’s use of drugs. quickly, and they can accumulate in dose of buprenorphine until they no Thus, it is strongly recommended high doses. longer require medical treatment. that those wanting to remain free • Using buprenorphine on its own is of heroin engage in a treatment unlikely to result in an overdose.
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• Health problems are reduced or includes the length of the program, how just as withdrawal symptoms begin. avoided, especially those related much it costs, what other supports are People on a methadone program with a to injecting, such as HIV, hepatitis included or recommended, all the risks daily dose of 30 milligrams or less can B and hepatitis C viruses, skin and side effects, and any other health transfer straight onto buprenorphine, infections and vein problems. issues to consider. When deciding and are unlikely to experience • Doses are required only once a day, on the suitability of buprenorphine withdrawal symptoms. Those on sometimes even less often, because maintenance, the following issues methadone doses above 30 milligrams buprenorphine’s effects are long should also be discussed with a health may need to have their methadone lasting. professional: dose reduced before transferring • Buprenorphine is much cheaper than • existing liver conditions, such as to buprenorphine. If transferring to heroin. acute hepatitis buprenorphine from methadone doses • respiratory illnesses above 30 milligrams, withdrawal • Staying off heroin can provide the symptoms may be experienced similar opportunity to experience more • if a woman is pregnant, wanting to to those listed under ‘Buprenorphine ‘life opportunities’, such as. greater become pregnant or breastfeeding (it withdrawal’. It is not recommended personal happiness, more close and has not been established that using that anyone on a daily methadone dose stable relationships with others, buprenorphine during pregnancy is of more than 60 milligrams transfer to employment and more money to buy safe) buprenorphine. goods for personal enjoyment. • buprenorphine may impair the ability In general, people on methadone to drive and operate machinery What are the side effects? programs have a slightly higher risk of safely, so it may not be appropriate experiencing withdrawal symptoms than Buprenorphine is generally well for people in certain occupations. those taking heroin when transferring to tolerated; however, some side For referral to a buprenorphine buprenorphine. This means that some effects have been reported. Most of prescribing doctor or dispensing people may feel slightly uncomfortable these symptoms occur very early in pharmacy, contact the alcohol and drug for a short period of time before the treatment—in the first week or so. Side service in your state or territory. buprenorphine stabilises them. effects may be due to the combined experience of withdrawal from opioids Starting on buprenorphine How is buprenorphine taken? and taking buprenorphine. It is maintenance important to report any side effects to a A Subutex tablet must be placed under health professional. People who use heroin and those the tongue and allowed to dissolve. on a methadone program can use Chewing or swallowing the tablet will The most common side effects are buprenorphine. After beginning on daily make it ineffective. Injecting Subutex is similar to those listed under the section doses of buprenorphine, the dose is dangerous, and can lead to severe vein ‘Buprenorphine withdrawal’. adjusted until the person is stabilised damage, blood clots and other health (free from withdrawal symptoms such complications. Related issues as cravings). The dose may then be Subutex dissolves within 2–8 minutes Before a person commences any drug reduced to every second day or three after placing it under the tongue. The treatment program, it is important that times a week. effects begin within 30–60 minutes of all the relevant information has been For people who use heroin, the first taking the dose and peak within 2–4 explained to them by a qualified health dose of buprenorphine is taken at least hours, lasting between four hours to professional and, where appropriate, to 6 hours after last using heroin; ideally, three days, depending on the dosage. carers such as family, friends etc. This
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Cannabis (Yarndi)
What is the right dosage? Using buprenorphine with heroin or http://www.druginfo.adf.org.au/ other opiates, such as methadone, druginfo/drugs/drugfacts/cannabis. The dosage of buprenorphine often increases the chances of experiencing html varies for each person. As a guide, ongoing withdrawal symptoms. doses range from 4 milligrams to What is cannabis? 32 milligrams per day for people Always check with your doctor or with heroin dependence. A health pharmacist before using buprenorphine Cannabis is a drug that comes from practitioner should be informed of any with alcohol, medicines or other drugs. Indian hemp plants such as Cannabis side effects that are experienced, so sativa and Cannabis indica. The active that the dosage can be adjusted where Buprenorphine withdrawal chemical in cannabis is THC (delta-9 appropriate. When first starting on Withdrawal from long-term use of tetrahydrocannabinol). buprenorphine maintenance, it may buprenorphine may produce symptoms Cannabis is a depressant drug. take a number of days (typically from similar to those experienced from Depressants do not necessarily make three to seven days) for the effects of heroin withdrawal. However, withdrawal the person feel depressed. Rather, buprenorphine to become stable in the symptoms tend to be milder with they affect the central nervous system body. Continuing heroin use can make buprenorphine than those from by slowing down the messages going it difficult for the person to stabilise. methadone and other opioids. between the brain and the body.
Missed doses Withdrawal symptoms vary from person to person, but may include: What does it look like? If a person misses their buprenorphine • cold- or flu-like symptoms There are three main forms of cannabis: doses for more than five days in a row, • Marijuana – the most common and they will need to undergo a review by • headaches least powerful form of cannabis. the prescribing health professional. If • sweating It is the dried leaves and flowers this occurs, it is recommended that the • aches and pains of the plant. Marijuana looks like person start again on a lower dose of chopped grass, and ranges in buprenorphine. • sleeping difficulties colour from grey-green to greenish- • nausea Using buprenorphine with other brown. Marijuana is smoked in hand- • mood swings drugs rolled cigarettes (joints) or in a pipe • loss of appetite. (a bong). Combining the use of any drugs can • Hashish (hash) – dried cannabis increase or alter the effects that are These effects usually peak in the first resin which comes in small blocks. usually experienced from using the two to five days. Some mild effects may The blocks range in colour from individual drug. It is often difficult to last a number of weeks. light brown to nearly black. The predict the consequences of combining concentration of THC in hashish is the use of different drugs. Where can I get buprenorphine and what does it cost? higher than in marijuana, producing It is particularly important to avoid stronger effects. Hash is added Buprenorphine may only be prescribed using other depressant drugs, such to tobacco and smoked, or baked by a doctor who has a permit from the as benzodiazepines (‘benzos’), such and eaten in foods such as ‘hash Department of Human Services. Like as Valium, with buprenorphine. Using cookies’. benzodiazepines with buprenorphine methadone, buprenorphine is subject to • Hash oil – a thick, oily liquid, may lead to breathing difficulties, coma a dispensing fee, currently about $5.00 golden-brown to black, that can or death. per dose. be extracted from hashish. It is
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the drug is taken, how much is taken, • Respiratory illness – Marijuana usually spread on the tip or paper of whether the person is used to taking cigarettes have more tar than cigarettes and then smoked. Hash it and whether other drugs are taken. tobacco, placing cannabis users oil is more powerful than the other at an increased risk of respiratory forms of cannabis. This form is rarely Immediate effects illness such as lung cancer and found in Australia. Small doses of cannabis can have chronic bronchitis. Cigarette A non-potent form of cannabis (Indian effects that last 2–4 hours after smokers who also smoke cannabis hemp) is used to produce fibres for use smoking. These effects include: have an even greater risk of in paper, textiles and clothing. respiratory disease. • relaxation and loss of inhibition • Reduced motivation – Many regular THC • increased appetite users have reported that they have THC (delta-9 tetrahydrocannabinol) • affected perception of colour, sound less energy and motivation, so that is the chemical in cannabis that and other sensations performance at work or school makes you feel ‘high’. This means you • impaired coordination suffers. experience a change in mood and • Brain function – Concentration, may see or feel things in a different • affected thinking and memory. memory and the ability to learn way. Some parts of the plant contain a Other common immediate effects can all be reduced by regular higher level of THC. For example, the include increased heart rate, low blood cannabis use. These effects can flowers, or ‘heads’, have more THC than pressure and reddened eyes. last for several months after ceasing the stems and leaves. cannabis use. THC is absorbed into the bloodstream In greater quantities • Hormones – Cannabis can affect through the walls of the lungs (if Larger quantities of marijuana make the hormone production. Research cannabis is smoked), or through the above effects stronger, and also tend to shows that some cannabis users walls of the stomach and intestines (if distort a person’s perceptions. have a lower sex drive. Irregular eaten). The bloodstream carries the Very large quantities of marijuana can menstrual cycles and lowered sperm THC to the brain, producing the ‘high’ produce: counts have also been reported. effects. Drugs that are inhaled get into the bloodstream quicker than those • confusion • Immune system – There is some eaten. • restlessness concern that cannabis smoking may impair the functioning of the immune • feelings of excitement Street names system. • hallucinations ‘Grass’, ‘pot’, ‘hash’, ‘weed’, ‘reefer’, ‘dope’, ‘herb’, ‘mull’, ‘buddha’, ‘ganja’, • anxiety or panic, or detachment from Cannabis and psychosis ‘joint’, ‘stick’, ‘buckets’, ‘cones’, reality It is believed that cannabis use ‘skunk’, ‘hydro’, ‘yarndi’, ‘smoke’, • decreased reaction time – especially if heavy and regular – may be linked to a condition known ‘hooch’ • paranoia. as a drug-induced psychosis, or Effects of cannabis Long-term effects ‘cannabis psychosis’. This can last up to a few days. The episodes are The effects of any drug (including Research shows evidence of some long- cannabis) vary from person to person. It often characterised by hallucinations, term effects in some regular cannabis delusions, memory loss and confusion. depends on many factors, including an users. individual’s size, weight and health, how There is some evidence that regular
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Cocaine cannabis use increases the likelihood nervousness, anxiety, sweating http://www.druginfo.adf.org.au/ of psychotic symptoms occurring in and upset stomach. Sometimes druginfo/drugs/drugfacts/cocaine_ an individual who is vulnerable due to chills, increased body temperature info.html a personal or family history of mental and tremors occur. The withdrawal illness. Cannabis also appears to make symptoms usually last for less than a What is cocaine? psychotic symptoms worse for those week, although the sleep disturbances Cocaine belongs to a group of drugs with schizophrenia and lowers the may persist for longer. known as ‘stimulants’. Stimulants speed chances of recovery from a psychotic up the messages going between the episode. Pregnancy and breastfeeding body and the brain. If cannabis is used during pregnancy Medicinal use of cannabis Cocaine is extracted from the leaves the baby may be born smaller and of the coca bush (Erythroxylum coca), Cannabis has been used medicinally lighter than other babies. Low birth which is native to South America. The for many centuries. There is evidence weight can be associated with coca leaf extract is then processed to to suggest it is useful in providing relief infections and breathing problems. create cocaine hydrochloride, freebase from nausea and vomiting caused by There is also some evidence that and crack. chemotherapy, wasting and severe cannabis use during pregnancy may weight loss, pain, glaucoma, epilepsy affect the baby’s behaviour. The leaves of the coca bush have long and asthma. been chewed and brewed into tea by Little is known about the effects of indigenous people in South America for cannabis use on breastfeeding. It is Tolerance and dependence its stimulant and appetite suppressant believed that some of the drug will pass properties. Cocaine has been used in With regular use, people can develop a through the breast milk to the baby, and a range of energy providing medicines, mild tolerance to cannabis. This means the baby may become unsettled and foods and drinks. It has also been used they need to take more and more to get demand frequent feeding. as a local anaesthetic. the same effect. See your doctor or other health Heavy and frequent use of cannabis can professional if you are taking or What does it look like? cause physical dependence. Physical planning to take any substances while The most common from of cocaine dependence occurs when a person’s pregnant or breastfeeding, including is cocaine hydrochloride. This is a body has adapted to a drug and is used prescribed and over-the-counter white, crystalline powder with a bitter, to functioning with the drug present. medications. numbing taste. It is possible to become psychologically Reducing the risks Cocaine hydrochloride can be further dependent on cannabis. This means processed to produce cocaine base, that using cannabis becomes far more Australian drug policy is based on known as ‘freebase’ and ‘crack’. important than other activities in their harm minimisation. This is about Freebase is a white powder, while life. Some people crave the drug and reducing drug-related harm to both the crack generally comes in the form of find it very difficult to stop using it. community and individual drug users. crystals that range in colour from white Harm-minimisation strategies range or creamy colour to transparent with a Withdrawal from encouraging ‘non-use’ through to pink or yellow hue. Abrupt termination of cannabis use providing the means for people who use Cocaine hydrochloride is often mixed, can produce withdrawal symptoms. drugs to use them with reduced risks. or ‘cut’, with other substances such as Withdrawal symptoms include sleep lactose and glucose, to dilute it before disturbance, irritability, loss of appetite, being sold.
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How is it used? and mental capacity take cocaine in high-dose ‘binges’, which means that they take cocaine Cocaine hydrochloride is most • increased libido and elevated sexual repetitively over several hours or days. commonly ’snorted’ (sniffed through arousal The binge is followed by the ‘crash’, the nose). It can also be injected. Some • feelings of wellbeing whereby a person experiences feelings people rub it into their gums, where it is • anxiety, agitation and panic of intense depression, lethargy and absorbed into the bloodstream. Others hunger. add it to a drink or food. Freebase and • paranoia crack are usually smoked. • unpredictable violent/aggressive Overdose behaviour Street names The risk of overdose is high, since the • feeling more awake and alert, strength and mix of street cocaine C, coke, nose candy, snow, white lady, reduced need for sleep is usually unknown. An overdose of toot, Charlie, blow, white dust and • increased performance on simple cocaine can result in increased heart stardust. Freebase is also known as tasks rate and body temperature, seizures, base, and crack is sometimes referred heart attack, brain haemorrhage, to as rock or wash. • headache kidney failure, stroke and repeated • increased blood pressure and heart convulsions. All of these can lead to Effects of cocaine rate (after initial slowing) coma and death. • reduced appetite Immediate effects Long-term effects The effects of cocaine can last • increased body temperature Long-term effects of cocaine use anywhere from a few minutes to a • indifference to pain and localised include: couple of hours, depending on how the pain relief. cocaine is taken and the person taking • insomnia it. When the immediate ‘rush’ of the In greater quantities • depression cocaine has worn off, the person may The immediate effects of cocaine • anxiety, paranoia and psychosis experience a ‘crash’. Other immediate intensify when the drug is taken • eating disorders and weight loss effects that may be experienced in greater quantities. People may include: also experience tremors, muscle • sexual dysfunction • physiological arousal, including twitches, nausea and vomiting, rapid • hypertension and irregular heart beat and weak pulse, arrhythmia, chest pain, increased body temperature and • sensitivity to light and sound heart rate heart attack, hyperthermia, seizures and stroke. • hallucinations – some people may • enlarged pupils even experience sensations of High quantities and frequent, heavy • exhilaration insects crawling under the skin and long-term use of cocaine can • anxiety lead to a ‘cocaine psychosis’, which is • cerebral atrophy (wasting of the • dry mouth characterised by paranoid delusions, brain) and impaired thinking. hallucinations, bizarre, aggressive or • increased breathing rate Some of the other long-term effects of violent behaviour. These symptoms cocaine are related to the method of • increased talkativeness or quiet usually stop a few days after the person using cocaine: contemplation and rapture takes cocaine, although some people • Repeated snorting damages • feelings of great physical strength may need treatment. Some people the lining of the nose and nasal
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passages, and can also damage the to whether it is possible to develop a provoke memories of taking the drug. structure separating the nostrils. physiological dependence on cocaine. These cravings may surface months or • Smoking crack cocaine can cause years after cocaine use has stopped. breathing difficulties, chronic cough, Withdrawal bronchitis and other respiratory If a person who is dependent on Pregnancy and breastfeeding problems. cocaine suddenly stops taking it, or Cocaine use during pregnancy can • Cocaine is ‘cut’ with substances significantly cuts down the amount affect foetal development. Cocaine that are poisonous when injected. they are using, they can experience increases the heart rate in both the They can cause collapsed veins, withdrawal symptoms. mother and the unborn baby, reducing abscesses and damage to the heart, Cocaine withdrawal generally occurs the supply of blood and oxygen to the liver and brain. in three phases: the ‘crash’, the baby. This means the baby is more likely ‘withdrawal’ and the ‘extinction’. to be small and grow slowly after the • If injected into the skin cocaine can birth. Cocaine use during pregnancy cause severe vasoconstriction, which The crash, which usually occurs in the may cause bleeding, miscarriage, may prevent blood flowing to the first few days, describes the withdrawal premature labour or stillbirth. tissue, potentially resulting in severe symptoms experienced immediately tissue damage. after the person stops using cocaine. Some research has indicated that Symptoms can include: children of women who use cocaine Tolerance and dependence may experience long-term mental or • agitation physical effects. A number of foetal People who use cocaine can develop • depression or anxiety abnormalities have been reported a tolerance to the euphoric effects • feelings of intense hunger including malformations of the brain, of cocaine very quickly. This makes skull, genitor-urinary tract, heart, limbs • intense craving for cocaine it necessary to take more and more and/or face. cocaine to get the same effect. • insomnia or prolonged, but If cocaine is used close to birth, the disturbed, sleep In contrast, some people who use baby may be born unsettled and cocaine regularly may develop a • extreme fatigue and exhaustion. showing symptoms of hyperactivity ‘reverse tolerance’, whereby they The withdrawal phase may last up to and agitation. Babies of mothers experience the adverse effects of ten weeks. During this phase, people who regularly use cocaine may also cocaine more intensely. experience severe cravings for cocaine. experience withdrawal symptoms after Dependence on a drug can be Other withdrawal symptoms during this birth, including distressed breathing, psychological, physiological, or both. phase include: sleepiness, poor feeding and lack of responsiveness. A person who is psychologically • lack of energy dependent on cocaine finds that using It is likely that, if a mother continues • anaerobia (inability to feel pleasure) cocaine becomes more important than to use cocaine while breastfeeding the other activities in their life. Because of • anxiety drug will be present in her milk, which its powerful euphoric effects, people • angry outbursts. may have adverse effects on the baby. who use cocaine may develop a strong The baby may be irritable, unsettled and The extinction phase may last psychological dependence upon it. difficult to feed. indefinitely. It involves intermittent Physical dependence on a drug occurs cravings for cocaine. These generally See your doctor or other health when a person gets used to functioning occur in response to people, places or professional if you are taking or with the drug present. It is less clear as objects that are conditioned cues and planning to take any substances while
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Ecstasy
pregnant or breastfeeding, including http://www.druginfo.adf.org.au/ Swallowing is the most common way prescribed and over-the-counter druginfo/drugs/drugfacts/ecstasy.html that ecstasy is used. Ecstasy tablets medications. are also crushed and snorted. They What is ecstasy? are sometimes inserted into the anus Cocaine, hepatitis and HIV Ecstasy is a street term for (known as ‘shafting’ or ‘shelving’). Sharing needles, syringes and other a range of drugs that are Injecting ecstasy has increased in injecting equipment can greatly similar in structure to MDMA Australia over recent years. increase the risk of contracting of (methylenedioxymethamphetamine). blood borne viruses such as hepatitis Ecstasy is similar in structure and Effects of ecstasy B and hepatitis C and HIV (human affects to amphetamines and (in high The effects of any drug (including immunodeficiency virus – the virus that doses) hallucinogens. ecstasy) can vary from person to causes AIDS). Amphetamines, such as ‘speed’, are person. Because ecstasy is commonly The alcohol and drug information stimulants that speed up activity in the taken prior to, or during, dance or service in your state or territory can nervous system. Hallucinogens, such ‘rave’ parties, the stimulant effects are provide information on where to obtain as LSD, typically affect perception and likely to increase. Hence, the person clean needles and syringes. can cause things to appear distorted taking the drug may be more prone to or things that don’t exist to be seen or prolonged and vigorous dancing, further heard. exacerbating some of the dangers listed below. Ecstasy is illegal in Australia, and its ingredients are often hard to People having any of the following obtain. Therefore, manufacturers may conditions put themselves at greater substitute a wide range of substances risk of physical and psychological when making the drug. It is possible harm by taking ecstasy: hypertension, that when you buy ecstasy it will heart disease, diabetes, liver problems, contain little MDMA. epilepsy, a history of mental illness or panic attacks. Like other illegally manufactured drugs, such as speed, there are no controls The effects of ecstasy usually begin on factors such as the strength and within 20 minutes of taking the drug, hygiene of the drug. This increases the and may last up to six hours. Some chances of a person overdosing, being people have reported symptoms poisoned or experiencing other adverse persisting for 32 hours after using reactions after taking the drug. ecstasy. There are usually three phases: Street names • coming up – where the effects can Ecstasy is also known as ‘E’, ‘XTC’, be smooth and bumpy, and users ‘eccy’, ’the love drug’. may feel a rush • plateau – where the user may feel How is it used? good, happy, relaxed Ecstasy usually comes in tablet form, • coming down – where the user may in various colours, sizes, shapes and feel physically exhausted, depressed, designs. irritable. Reproduced with approval from the Australian Drug Foundation, © Australian Drug Foundation 2009. Message stick 63
Immediate effects Death evidence suggesting that ecstasy causes damage to some parts of the Many people have experienced the Although it is difficult to determine the brain. following effects soon after taking exact number of ecstasy related deaths ecstasy: that have occurred, the toxic effects of Tolerance and dependence • increase in confidence ecstasy that can lead to death include: Tolerance to a drug occurs when a • heart attack • feelings of wellbeing person needs larger amounts of a drug • feelings of closeness to others, • brain haemorrhage over time to achieve the same effects. hence the term ‘love drug’ • blood clotting Research suggests that, while some people may develop tolerance to the • anxiety • kidney failure effects of ecstasy, using larger amounts • dilated pupils • overheating – the combination of will increase the severity of undesirable • jaw clenching, teeth grinding taking ecstasy with prolonged and effects, rather than increase the vigorous dancing raises the body • increase in heart rate, body pleasurable effects. temperature to dangerous levels There is evidence that people can temperature and blood pressure (because it is often taken in hot, become psychologically dependent on • nausea humid venues the risk of death by ecstasy and it can be very difficult for overheating (hyperthermia) is further • loss of appetite them to stop or decrease their use. increased) • sweating. Physical dependence occurs when a • drinking too much – several deaths person’s body gets used to functioning Higher doses have occurred from dilutional with the drug present. At present, there hyponatremia (a condition whereby Higher quantities don’t appear to is no conclusive evidence that people a person’s brain swells from excess enhance the desirable effects and may can become physically dependent on fluid intake, inducing a coma). cause: ecstasy.
• convulsions (fits) Long-term effects Pregnancy and breastfeeding • vomiting Research indicates that few people Most drugs cross the placenta, and • floating sensations tend to use ecstasy for a long time. therefore have some effect on the This is possibly due to the severity • irrational or bizarre behaviour foetus. It is possible that miscarriage of undesirable effects, which tend can result from using ecstasy. The • hallucinations. to increase the longer ecstasy use use of amphetamine-like substances continues, while the pleasurable such as ecstasy during pregnancy has Overdose effects diminish. A person taking also been associated with delayed Overdose from ecstasy can occur. ecstasy regularly may find that they development and subtle abnormalities It is usually characterised by very are not eating or sleeping enough and in the newborn. high body temperature and blood are neglecting their health. They may It is possible that if a mother uses pressure, hallucinations and an elevated become ‘run down’, have reduced ecstasy while breastfeeding the drug heartbeat. This is especially dangerous energy levels and be more susceptible will be present in her milk and may have for those who have an existing heart to colds,’flu and infections. adverse effects on the baby. condition or breathing problems, and Currently, much research is being Check with your doctor or other for people with depression or other undertaken to investigate the effects of health professional if you are taking or psychological disorder. ecstasy on the brain. There is limited
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Fantasy/GHB
planning to take any substances during http://www.druginfo.adf.org.au/ trialled as a treatment for alcohol and pregnancy or while breastfeeding, druginfo/drugs/drugfacts/ghbfantasy. opiate (for example, heroin) withdrawal, including prescribed and over-the- html and sleep disorders such as narcolepsy. counter medications. GHB has been marketed as a dietary What is GHB? supplement for body builders. It is Ecstasy, hepatitis and HIV Gamma hydroxybutyrate (GHB) is a claimed that GHB can increase the Research has shown that, due to some depressant drug. Depressants slow release of human growth hormone by effects of ecstasy, certain people down the activity of the brain and other prolonging slow-wave sleep, the stage are more prone to practising unsafe parts of the central nervous system. of sleep when the highest amount of sex. This increases the chances of Alcohol, heroin and benzodiazepines growth hormone is released. There is contracting HIV, hepatitis or other are drugs that also have depressant no evidence to support this theory. GHB sexually transmissible infections. effects. has been known to be used to facilitate Sharing needles, syringes and other GHB occurs naturally in the brain. It sexual assault. Due to its appearance, injecting equipment can also increase was first manufactured and studied in GHB is easy to slip into a drink and the risk of contracting blood-borne the 1960s, and has been used in several it can cause drowsiness, sleep and viruses. countries as a general anaesthetic. short-term memory loss. This means You can search for needle and syringe GHB was withdrawn from use in that victims may not be able to resist or programs in your area or call the most countries – including Australia recall a sexual assault. alcohol and drug information service in – because of unwanted side effects. Some people take GHB for its ability your state/territory. to increase relaxation, sociability and Street names disinhibition. Others may take it to help Fantasy, grievous bodily harm (GBH), with the symptoms of the ‘comedown’ liquid ecstasy, liquid E, liquid X, salty after using stimulants, such as water, Georgia Home Boy, soap, scoop, amphetamines and ecstasy. organic Quaalude, cherry meth, blue nitro. Effects of GHB The effects of GHB appear to vary What does it look like? greatly according to the amount used GHB commonly comes as a colourless, – a small increase in amount can result odourless, bitter or salty-tasting in a dramatic increase in effect. One of liquid, usually sold in small bottles or the most dangerous aspects of using vials, such as soy sauce containers. GHB is the small difference between It also comes as a bright blue liquid an amount that produces the desired (sometimes called ‘blue nitro’) and less effect and the amount that results in commonly as a crystal powder. overdose. A further risk is that there is often no way to be sure that the drug How is it used? is manufactured correctly. Improperly made GHB may result in an extremely GHB is generally swallowed, although toxic mixture of GHB and the chemical a small number of people have been sodium hydroxide. reported as injecting or ‘shelving’ it (inserting into anus). GHB has been
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Immediate effects • blackouts and memory lapses to get the same effect. Generally, the effects of GHB are • seizures Withdrawal experienced within 15 minutes of use, • coma and last for approximately three hours. If a physically dependent person stops • respiratory arrest (stop breathing) Effects of a low to moderate dose may taking GHB, they may experience and death. include: withdrawal symptoms because their body has to readjust to functioning • feelings of euphoria Signs of overdose without GHB. • increased libido • Person appears to be asleep but Withdrawal symptoms usually start • lowered inhibitions cannot be woken. about 12 hours after the last dose and • memory lapses • Person is incoherent, sweating can continue for about 15 days. profusely, vomiting and has irregular • drowsiness Some of the withdrawal symptoms that or shallow breathing. may be experienced include: • sleep • Person is not able to stand and/or • confusion, agitation, anxiety, panic, • dizziness and headache has involuntary muscle contractions. feelings of doom • tremor Long-term effects • paranoia • decreased body temperature, blood • insomnia pressure and heart rate Little research is known about the long- term effects of GHB but it is possible to • tremor • nausea become physically and psychologically • muscle cramps • diarrhoea dependent on it. • perspiration • urinary incontinence. Tolerance and dependence • delirium Overdose There is evidence that GHB is highly • hallucinations Using GHB carries a high risk of addictive. People who use GHB • tachycardia (rapid heartbeat). overdose, due to the small difference regularly can develop a tolerance and Sudden withdrawal from high doses between the amount required to dependence very quickly. Dependence may also result in bowel and bladder produce a ‘high’ and that which causes on GHB can be psychological, physical incontinence and blackouts, and may overdose. Not knowing the strength of or both. require medical assistance. GHB increases the risk of overdose. People who are psychologically High doses of GHB can result in: dependent on GHB find that using the Pregnancy and breastfeeding drug becomes far more important than • dizziness other activities in their life. They crave Little is known about the effects of GHB • vomiting the drug and will find it very difficult on the unborn child. As is the case with many other drugs and medication, it is • tremors to stop using it. Physical dependence not recommended that people use GHB • tunnel vision occurs when a person’s body adapts to GHB and gets used to functioning while pregnant or breastfeeding. • loss of coordination (ataxia) with the GHB present. People who are Many drugs can cross the placenta • confusion, irritation and agitation physically dependent on GHB usually and therefore have some effects on • hallucinations develop tolerance to the drug, making it the unborn child. In general, drug use necessary to take more and more GHB during pregnancy can increase the
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Hallucinogens
incidence of premature labour, resulting http://www.druginfo.adf.org. Hallucinogens became fashionable in in low birth-weight babies. au/druginfo/drugs/drugfacts/lsd_ the United States and Europe in the If a mother continues to use GHB while hallucinogens.html 1960s, when many young people were breastfeeding, it is possible that the pursuing greater personal freedom and drug will be present in her milk and may What are hallucinogens? questioning old values and ideas. have adverse effects on the baby. Hallucinogenic drugs, also known as Generally, people who use Check with your doctor or other ‘psychedelics’, are drugs that change hallucinogens don’t take them on a health professional if you are taking or the way a person perceives the world. regular basis, but on occasions that planning to take any substances during Hallucinogens affect all the senses, may be weeks or months apart. This pregnancy, including prescribed and altering a person’s thinking, sense of may be because the effects require over-the-counter medications. time and emotions. a long recovery time or because the They can cause a person to pleasurable effects are unpredictable. hallucinate—to see or hear things that do not exist or are distorted. Medicinal uses There are many different kinds of Some hallucinogens are used in clinical hallucinogens. Some occur naturally, medicine. For example, ketamine in trees, vines, seeds, fungi and is sometimes used in medical and leaves. Others are manufactured in veterinary settings as a short-acting laboratories. anaesthetic. Some examples of hallucinogens In the 1950s and early 1960s, LSD include: was unsuccessfully trialled in some countries as a treatment for a range of • LSD (lysergic acid diethylamide) psychiatric and other disorders. • magic mushrooms (psilocybin) • morning glory seeds LSD (lysergic acid • datura diethylamide) • mescaline (peyote cactus) LSD is produced by processing a substance found in ergot, which is a • PCP (phencyclidine) fungus that infects rye. It is a highly • ketamine potent drug, so only very small doses • ecstasy (MDMA and related drugs, in are usually taken. high doses) Street names • cannabis (in high quantities). Acid, trips, microdots, dots How are they used? What does it look like? Naturally occurring hallucinogens have been used since ancient times, In its pure state, LSD is a white, by various cultures throughout the odourless powder. It usually comes world, for their mystical and spiritual in the form of squares of gelatine associations. or blotting paper that have been
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impregnated with the drug. LSD is also What does it look like? Effects of hallucinogens sold in liquid form, or as tablets or Magic mushrooms look much like The effects of any drug (including capsules. ordinary dried mushrooms, or they hallucinogens) vary from person to come as a powdered material in person. How hallucinogens affect a How is it used? capsules. Synthetic psilocybin appears person depends on many factors, LSD is usually swallowed, sniffed, as a white crystalline powder that may including the person’s size, weight and injected or smoked. be formulated into tablets or capsules, health, how much and how the drug is or dissolved in a liquid. taken, whether the person is used to PCP (phencyclidine) taking it and whether other drugs are PCP is a dissociative anaesthetic. It was How is it used? taken. originally trialled with humans before Magic mushrooms are usually eaten The effects of hallucinogens also being limited to use as an anaesthetic fresh, cooked or brewed into a ‘tea’. depend on the environment in which in veterinary medicine. Occasionally, they may be mixed with the drug is taken and the mood and tobacco or cannabis and smoked. expectations of the person taking it. Street names It is easy to mistake poisonous For example, whether the person is in a Angel dust, peace pill mushrooms for those containing good mood or feeling anxious, is alone, psilocybin. Certain kinds of poisonous with others or at a party. What does it look like? mushrooms can cause death or More than any other drug, the effects In its pure state, PCP is a white permanent liver damage within hours of of hallucinogens vary greatly from crystalline powder. It usually comes in ingestion. person to person, and from occasion the form of pills, capsules or powders of to occasion. It is hard to know how the various colours. Mescaline hallucinogenic experience, or ‘trip’, will turn out and if someone will experience Mescaline is a naturally occurring the adverse effects of hallucinogens (a How is it used? hallucinogen that comes from the ‘bad trip’). PCP is usually swallowed, sniffed or peyote cactus, Lophophora williamsii. It injected. It is sometimes also sprinkled can also be produced synthetically. Immediate effects onto tobacco or cannabis and smoked. What does it look like? The effects of hallucinogens can last several hours and vary considerably Magic mushrooms In its pure state, mescaline sulphate is depending on the specific type of (psilocybin) a white crystalline powder. Synthetic hallucinogen. Some of the typical mescaline may appear in powder form There are several varieties of magic effects of hallucinogens include: and in various colours. Dried, ground mushrooms: ‘golden tops’, ‘blue peyote buttons are usually in the form • blurred vision meanies’ and ‘liberty caps’ are some of of capsules. the types found in Australia that have • increased breathing rate the active ingredient psilocybin. How is it used? • euphoria • sense of relaxation and feeling of Street names Mescaline is usually swallowed. Peyote wellbeing buttons are sometimes chewed, or Shrooms, mushies, magics, golden ground and smoked. • hallucinations and distorted sensory tops, blue meanies, liberty caps processing, including visual, auditory,
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body, time and space perception Occasionally, these effects can last poisonous plant material. • disorganised thoughts, confusion weeks or even months. A severe overdose of PCP and ketamine and difficulty concentrating, thinking can result in respiratory depression, or maintaining attention Long-term effects coma, convulsions, seizures and death • anxiety, agitation, paranoia and The most consistent long-term effect due to respiratory arrest. feelings of panic of hallucinogen use is the flashback. Days, weeks or even years later, some Tolerance, dependence and • dizziness people re-experience the effects of withdrawal • impaired coordination the drug. The person may see intense Tolerance to the euphoric and • increased heart rate and blood colours and experience hallucinations. psychedelic effects of hallucinogens pressure Flashbacks can be triggered by the use develops rapidly if taken repeatedly over of other drugs, or by stress, fatigue • nausea and vomiting several days. Any tolerance developed or physical exercise. The flashback quickly goes away once regular use is • increased body temperature and experience can range from being stopped. sweating; may alternate with chills pleasant to producing severe feelings of and shivering anxiety. They are usually visual and last People who regularly use hallucinogens for a minute or two. may develop a psychological • numbness. dependence. They may find they feel Long-term, frequent use of some compelled to use hallucinogens to ‘Bad trips’ hallucinogens may impair aspects function effectively or feel good in Sometimes a person may experience of memory and selected cognitive certain situations—such as at a party. the adverse and negative effects of functions. It may also be linked to Generally, there is little evidence that hallucinogens and have what is called a personality and mood changes. people experience physical withdrawal ‘bad trip’. Some people may experience a symptoms if they suddenly stop taking They may experience strong feelings ‘drug-induced’ psychosis after using hallucinogens. of anxiety, paranoia, panic or fear. hallucinogens. This can occur after a The hallucinations can be unpleasant, single dose or after chronic use, and Pregnancy and breastfeeding is characterised by hallucinations, such as feeling like insects are crawling Many drugs can cross the placenta and delusions and bizarre behaviour. These on the skin, or they can be so intense have effects on the unborn child. that the person feels they are losing episodes may last several hours, or control. longer for some people. The use of LSD and other hallucinogens appears to be linked to an increased Feelings of panic, paranoia and fear can Higher doses and overdose risk of miscarriage and birth lead to risky behaviour that can cause Higher doses of hallucinogens can complications. There may also be a injury, such as running across a busy higher incidence of birth defects among street or jumping out of a window. increase the immediate negative effects. babies born to women using LSD. The reasons for ‘bad trips’ are not If a mother continues to use known. Usually, the negative feelings Deaths exclusively from acute overdose of LSD, magic mushrooms hallucinogens while breastfeeding, it is disappear when the drug wears off. possible that the drug will be present in However, there have been reports of and mescaline are extremely rare. Deaths generally occur due to suicide, her milk and may have adverse effects people experiencing hallucinations, on the baby. bizarre behaviour and paranoia for accidents and dangerous behaviour, or several days after taking the drug. due to the person inadvertently eating Check with your doctor or other
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Heroin health professional if you are taking or http://www.druginfo.adf.org.au/ codeine by a chemical process, but has planning to take any substance during druginfo/drugs/drugfacts/heroin.html a stronger painkilling effect than either pregnancy, including prescribed and of these drugs. The potency and purity over-the-counter medications. What is heroin? of heroin used can vary substantially, Heroin is one of a group of drugs known depending on a number of factors, as ‘opioids’. Other opioids include including: opium, morphine, codeine, pethidine, • how it is manufactured oxycodone, buprenorphine and • the ingredients used (for example, methadone. morphine and codeine) Heroin and other opioids are • what the final products is diluted depressants. Depressants do not (‘cut’) with. necessarily make you feel depressed. Rather, they slow down the activity How is it used? of the central nervous system and messages going to and from the brain Heroin is most commonly injected into and the body. a vein. It is also smoked (‘chasing the dragon’), added to marijuana or tobacco What does it look like? cigarettes, or snorted. Heroin can range from a fine white Street names powder to off-white granules or pieces of brown ‘rock’. It has a bitter taste but smack, skag, dope, H, junk, hammer, no smell and is generally packaged in slow, gear, harry, horse, black tar, china ‘foils’ (aluminium foil) or small, coloured white, Chinese H, white dynamite, balloons. dragon, elephant, homebake, poison.
How is it made? Effects of heroin When the seedpod of the opium poppy The effects of heroin may last 3–5 is cut, a sticky resin (opium) oozes hours. out. This resin is refined to produce Immediate effects opium. Opium takes its name from the opium poppy, Papaver somniferum, • Intense pleasure and a strong feeling which grows in many parts of the of wellbeing world—commonly in Asia and the Middle • Confusion East, but also in the United States and • Pain relief Australia. • Slowed breathing For centuries, opium has been used by many cultures as a medicine and as a • Decreased blood pressure and heart recreational drug. Morphine, codeine rate and pethidine are still widely used for • Constricted pupils medical purposes. • Dry mouth Heroin is made from morphine or
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• Suppressed cough reflex (such as Narcan) to restart breathing. Tolerance and dependence The Narcan may not last as long as • Reduced sexual urges People who are physically dependent on the heroin, so the person will feel heroin usually develop tolerance to the • Drowsiness ‘stoned’ again and may even become drug, making it necessary to take more • Slurred and slow speech unconscious again. It is important that and more to get the desired effects. another quantity of heroin is not taken • Reduced coordination Eventually, a dose plateau is reached, again on that day, as it may combine • Nausea and vomiting at which no amount of the drug is with the original quantity of heroin sufficient. When this level is achieved, taken and could cause an overdose. In greater quantities the person may continue to use heroin, After an overdose, it is strongly but largely for the purpose of delaying The immediate effects intensify and last advisable to seek advice at a hospital. withdrawal symptoms. longer with higher quantities of heroin. Dependence on heroin can be The following effects are also likely to Short-term effects occur: psychological, physical or both. Apart from overdosing, the major • The ability to concentrate is People who are psychologically problem with short-term use of impaired. dependent on heroin find that using it any opiate is the way it is used. For becomes far more important than other • The user is likely to fall asleep (‘on example, injecting heroin can result activities in their lives. They crave the the nod’). in skin, heart and lung infections, and drug and will find it very difficult to stop diseases like hepatitis and HIV. • Breathing becomes shallower and using it, or even to cut down on the slower. amount they use. Long-term effects • Nausea and vomiting are more likely People who are physically dependent on In its pure form, heroin is relatively to occur. heroin find that their body has become non-toxic to the body, causing little • Sweating, itching and increased used to functioning with the drug damage to body tissue and other urinary output are also likely. present. organs. However, there are some long- term effects, including dependence, Overdose Withdrawal constipation, menstrual irregularity and Using a large quantity of heroin can infertility in women, loss of sex drive If a dependent person suddenly stops cause death. Breathing becomes very in men, intense sadness and cognitive taking heroin, or severely cuts down the slow, the body temperature drops and impairment. amount they use, they will experience the heartbeat becomes irregular. withdrawal symptoms because their Many of the other long-term problems body has to readjust to functioning Overdose may occur if: may be the result of other factors, such without the drug. This usually occurs as the person’s poor general care of the • too much heroin is injected within a few hours after last use. self, drug impurities and contaminants • the strength or purity is high and blood-borne viruses. Withdrawal symptoms can include: • heroin is used with alcohol Heroin is usually a mixture of pure heroin • a craving for the drug or sedatives (alcohol or and other substances, such as caffeine • restlessness benzodiazepines). and sugar. Additives can be highly • yawning To reverse the effects of a heroin poisonous. They can cause collapsed overdose, the attending ambulance veins, tetanus, abscesses and damage • low blood pressure officer will inject the drug naloxone to the heart, lungs, liver and brain. • elevated heart rate
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• stomach and leg cramps, muscle provide the ‘high’ that would normally severe NAS may need to be treated spasms be expected. with medication to help with the • loss of appetite, vomiting Naltrexone – Naltrexone works by withdrawal. and diarrhoea blocking the analgesic and euphoric Pregnant women who want to stop • goose bumps effects of heroin and other opioids. It taking heroin need to be very careful. can assist in maintaining abstinence Sudden withdrawal from heroin may • tears and a runny nose from heroin because the person is harm the baby and increase the risk • increased irritability aware that they cannot achieve a ‘high’ of miscarriage, premature birth and • insomnia from using heroin. stillbirth. • depression. Ultra Rapid Opiate Detox (UROD) If a mother continues to use heroin – UROD is a quick method of while breastfeeding, it is possible that These withdrawal symptoms get withdrawing or detoxifying from the drug will be present in her milk and stronger and usually peak around 2–4 opioids. It involves high doses of may have adverse effects on the baby. days after last use. They usually subside naltrexone given over a 48-hour period after 6–7 days, but some symptoms, It is recommended that you check with or less along with heavy sedation. By such as chronic depression, anxiety, your doctor or other health professional the end of the process, the patient insomnia, loss of appetite, periods if you are taking or planning to take any should be physically withdrawn from of agitation and a continued craving substances during pregnancy, including opiates. UROD is currently under trial for the drug, may last for periods prescribed and over-the-counter in Australia. of months and even years. Sudden medications. withdrawal from heroin rarely causes Pregnancy and breastfeeding direct death, unless the user is also Heroin, hepatitis and HIV using other drugs and is in poor health. Using heroin while pregnant can affect Sharing needles, syringes and other Withdrawal from heroin or opioids is foetal development. Heroin use has injecting equipment can greatly much less dangerous than withdrawal been associated with an increased risk increase the risk of contracting from some other drugs like alcohol or of miscarriage and premature birth, blood-borne viruses such as hepatitis benzodiazepines. and babies may be born smaller than B, hepatitis C and HIV (human average and may be prone to illness. immunodeficiency virus – the virus that Pharmacotherapy based The substances that are cut with heroin causes AIDS). treatments may also cause problems during the pregnancy and affect the developing The alcohol and drug information Methadone – A synthetic opioid that foetus. service in your state or territory can can be used as a substitute for heroin. provide information on where to obtain The intention is to reduce the impact Injecting heroin can increase the risk clean needles and syringes. that heroin has on the lives of people of both the mother and baby becoming who are dependent on heroin by infected with blood-borne viruses, reducing the harms associated with such as hepatitis and HIV. Heroin injecting an expensive illicit drug of can pass through the placenta to the unknown strength and purity. foetus, and after birth the baby can experience heroin withdrawal, known as Buprenorphine – Can help treat heroin neonatal abstinence syndrome (NAS). dependence by preventing withdrawal Most babies can be comforted with symptoms and by blocking the effects supported care, but some babies with of heroin, so using heroin will not
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Ice
http://www.druginfo.adf.org. Immediate effects Long-term effects au/druginfo/drugs/drugfacts/ice_ Soon after taking ice, a person may Long-term use of ice can result in a general_info1.html experience a number of psychological number of health issues, including: and physical effects including: What is ‘ice’? • high blood pressure and increased • feelings of euphoria, excitement and risk of heart-related complications ‘Ice’ is a street name for crystal wellbeing such as heart attack and heart methamphetamine hydrochloride, which failure is a powerful, synthetic stimulant drug. • increased alertness, confidence Stimulant drugs speed up the messages and libido, more energy, feelings of • malnutrition and rapid weight loss going to and from the brain. increased strength, talkativeness, due to reduced appetite restlessness, repeating simple acts, Ice is more potent than other forms of • chronic sleeping problems and itching, picking and scratching amphetamines. It is more pure than • reduced immunity and increased • tremors of the hands and fingers the powder form of methamphetamine susceptibility to infections due to (‘speed’). • speeding up of bodily functions, the person not sleeping or eating Ice often appears as large, transparent such as increased breathing rate, properly body temperature, blood pressure, and ‘sheet-like’ crystals that may have a • depression, anxiety, tension and a rapid and irregular heartbeat and hint of pink, blue or green colour. paranoia excessive sweating Other street names for ice include • brain damage (there is some • difficulty sleeping, reduced appetite, ‘meth’, ‘d-meth’, ‘crystal’, ‘crystal evidence that amphetamines may dilated pupils, dry mouth, stomach meth’, ‘shabu’ ‘batu’, ‘tina’ and ‘glass’. damage brain cells resulting in cramps, nausea, dizziness, blurred reduced memory function and other vision and severe headaches How is it used? impairments in thinking) • abrupt shifts in thought and speech, Ice is known to be smoked, swallowed, • dental problems (from grinding teeth) snorted, injected or inserted anally which can make someone using ice • smoking ice can damage the lungs (‘shafting’). Some people smoke ice difficult to understand using a glass pipe, while others heat • nervousness, panic attacks, anxiety, • snorting ice can damage the lining of it on aluminium foil and inhale the paranoia the nose vapours (‘chasing’). • irritability, aggression, hostility and • injecting ice can lead to scarring, ‘amphetamine psychosis’, including abscesses and vein damage. Sharing What are the effects of ice? hallucinations, paranoid delusions injecting equipment increases the The effects of any drug (including ice) and bizarre behaviour. risk of contracting blood-borne viruses, such as hepatitis B and C, vary from person to person, depending The variable purity of each batch of ice and HIV. on the individual’s size, weight and increases the risk of negative effects health, how much and how the drug and overdose. is taken, whether the person is used Other effects and issues to taking it and whether other drugs Coming down Due to some of the effects of ice, some are taken. Effects also depend on people may be more prone to practice As the effects of ice wear off, a person the environment in which the drug is unsafe sex. This increases the chances may experience a range of symptoms used—such as whether the person is of contracting sexually transmitted such as tension, depression, radical alone, with others or at a party. infections and blood-borne viruses, mood swings, uncontrollable violence such as hepatitis B and C, and HIV. and exhaustion. Reproduced with approval from the Australian Drug Foundation, © Australian Drug Foundation 2009. Message stick 73
Inhalants/solvents
As well as health problems, using ice (or it they may experience withdrawal http://www.druginfo.adf.org.au/ any drug) can result in family, financial, symptoms. druginfo/drugs/drugfacts/inhalants_ legal, work, school and other personal general_info.html problems. These problems can be made Withdrawal much worse because some people Some of the symptoms people may What are inhalants? who use ice can become irritable, experience once they have stopped Inhalants are a range of products that hostile and violent and/or experience using ice include: produce vapours which, when inhaled, other psychological problems. It is also • disorientation may cause a person to feel intoxicated dangerous to drive a vehicle or operate or ‘high’. Inhalants are ‘depressants’, machinery after using ice. • hunger which means that they slow down the • extreme fatigue and exhaustion activity of the brain and central nervous Ice and pregnancy • decreased energy, apathy and the system. As a result, the messages going Using ice while pregnant can affect limited ability to experience pleasure between the brain and the body are the development of the foetus. slowed down. • anxiety, irritability and depression Amphetamine use has been linked with Inhalants include the organic solvents • craving ice. bleeding, early labour, an increased risk present in many domestic and industrial of foetal abnormalities and changes to products (such as glue, aerosol, paints, the brain. industrial solvents, lacquer thinners, If amphetamines are used close to birth gasoline or petrol, and cleaning fluids) the baby may be unsettled, overactive and the aliphatic nitrites such as amyl and agitated. Babies born to mothers nitrite. who regularly used amphetamines during their pregnancy may experience Street names withdrawal symptoms after birth. ‘glue’, ‘gas’, ‘sniff’, ‘huff’, ‘chroming’ (as in the use of chrome paint), ‘poppers’ Tolerance and dependence People who use ice can quickly Method of use develop a tolerance to the drug so The substance is inhaled through the that increasingly greater doses are nose or mouth, or sprayed into a plastic needed to achieve the desired effects. bag, poured into a bottle, or soaked Ice can also lead to physical and/or onto a cloth before being inhaled. psychological dependence. People who are psychologically dependent on ice Who uses inhalants? find that using it becomes far more Teenagers have been identified as the important than other activities in their most prevalent group of inhalant life. They crave the drug and find it users. Some adults involved in the very difficult to stop using it. Physical ‘dance scene’ also use inhalants to dependence occurs when a person’s heighten their experience. There are body adapts to the drug and the body three broad categories of people gets used to functioning with the drug who use inhalants: present. If a person who is physically dependent on ice suddenly stops taking • The experimenter – The majority of
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people fall into this category. They is often followed by drowsiness. Long-term effects try it once or twice, then stop by • Flu-like symptoms – Inhalants may People who use inhalants heavily and themselves. cause sneezing, coughing, glazed frequently may experience the following • Social/situational user – Usually eyes or a runny nose, like having a effects: done with a group of friends. The cold or the flu. • Health problems – pale amount of use varies, depending • Nausea – Inhalants can make people appearance, tremors, weight on what else is going on in their feel sick and have diarrhoea. loss, tiredness, excessive thirst, lives. These people often develop loss of sense of smell and hearing, other interests and move out of this • Unpleasant breath – After using anaemia due to affected blood practice. inhalants people often have the smell of the product on their breath. production, irregular heart beat and • The long-term, dependent user – A damage to heart muscle, liver and • Nosebleeds and sores – Inhalants small number of people go on to use kidney damage. on a regular basis over a long time. may also cause nosebleeds, • Logical thinking – memory They generally have other major bloodshot eyes and sores around the impairment, reduced ability to think problems in their lives. They may use mouth and nose. clearly. inhalants alone, or with other people These effects usually occur over who use regularly. within an hour of inhaling. Hangovers • Irritable – users may feel irritable, and headaches may occur after the hostile, depressed or persecuted. Effects of inhalants immediate effects have passed. Most long-term effects are not Inhalants are rapidly absorbed into the Sometimes these last for several days. permanent and can be reversed if bloodstream from the lungs, so small use is stopped. However, inhalation of amounts can affect you quite quickly Overdose cleaning products, correction fluid and (3–5 minutes). The effects are usually Large amounts of inhalants can aerosol sprays can cause permanent over within an hour of inhaling. increase the chances of feeling damage. The lead in petrol, and some disoriented, experiencing visual of the chemicals in other inhalants, may Immediate effects distortions and can further build up in the body. This irritates the lining of the stomach and intestines, • Fewer inhibitions – Feeling less decrease coordination. Very high doses and can cause damage to the brain, inhibited, laughing, becoming excited can cause black out, convulsions or nervous system, kidneys and liver. and generally feeling intoxicated are coma. Prolonged and heavy use may even effects felt within 3–5 minutes of cause stupor or coma, problems with using inhalants. A sustained ‘high’ Short-term use breathing, irregular heartbeat and can be achieved by repeated use. With short-term use, most products sometimes seizures. Using inhalants rarely cause damage to the body. • Excitement – The person’s mood (chroming, in particular), can cause However, some glue snuffers have been can vary from mild excitement to blood vessels in the eyes to burst, admitted to hospital unable to control euphoria. Sometimes they may making them completely red and their movements or speak properly, become agitated and uneasy. eventually leading to blindness. and sometimes have convulsions. Most • Confusion and disorientation of these symptoms clear within a few Other risks – Inhalants can also cause hours. Some people may experience hallucinations and delusions. problems with their breathing passages, A small number of people have died • Drowsiness – The initial excitement but this improves over time. from using inhalants.
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Ketamine
The main danger comes from accidents withdrawal symptoms. Withdrawal http://www.druginfo.adf.org. when ‘high’, such as suffocation caused symptoms include anxiety, depression, au/druginfo/drugs/drugfacts/ice_ using plastic bags to inhale, choking on loss of appetite, irritation, aggressive general_info1.html vomit when unconscious, and behaving behaviour, dizziness, tremors and recklessly. nausea. What is ketamine? Inhalants are highly flammable, so there Ketamine hydrochloride is a dissociative is also the risk of severe bums if the Pregnancy anaesthetic. It is used in medical inhalants ignite or explode. Using inhalants during pregnancy can and veterinary settings as a short- ‘Sudden sniffing death’ has followed harm the foetus. The most likely result acting anaesthetic. Some people use the use of aerosol sprays, cleaning and will be early labour, a premature baby ketamine illegally, for its psychedelic or correction fluids, and model aeroplane and the associated breathing problems, hallucinogenic effects. Ketamine has cement. It is believed that chemicals in and risk of infection. There is also an also been implicated as a drug used to these products can cause heart failure, increased risk of birth defects, seizures, facilitate sexual assault. particularly if the user is stressed or miscarriage and sudden infant death Like other hallucinogens, ketamine does heavy exercise after inhaling. This syndrome (SIDS). changes the way a person perceives is very rare. Check with your doctor or other the world. It can affect all the senses, health professional if you are taking or cause hallucinations and alter a Tolerance and dependence planning to take any substances during person’s thinking, sense of time and Tolerance can develop with regular use pregnancy, including prescribed and emotions. of inhalants. This makes it necessary to over-the-counter medications. Ketamine can also make a person feel inhale more and more to get the same they are detached from their body, as effect. though their mind “leaves” the body. Dependence can be psychological, physical or both. What does it look like? Regular use of inhalants can result Ketamine is a white crystalline powder. in psychological dependence. They may It can be made into tablets and pills or find that using them becomes far more dissolved in a liquid. important than other activities in their How is it used? life. They crave the substance and will find it very difficult to stop. Ketamine is often swallowed, snorted or injected. It is also sometimes smoked Chronic abuse of inhalants may result with other substances such as cannabis in physical dependence. This means the or tobacco. body gets used to functioning with the inhalant present. Street names Withdrawal Special K, K, ket, kitkat, super K. Withdrawal symptoms are not common Effects of ketamine but some people who are dependent on inhalants and suddenly stop using Some people experience very extreme them may experience some mild adverse reactions to ketamine, which
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are sometimes known as “bad trips”. • breathing rate increased but shallow that repeated use may impair some People who use ketamine try to “fall • nausea and vomiting aspects of memory and selected cognitive functions. into a k-hole”. The experience of • sweating being in a k-hole varies but generally Long-term, frequent use of ketamine • reduced sensitivity to pain and involves being socially detached, having has been linked to personality and hallucinations and experiencing a numbness of the extremities. mood changes tolerance, dependence, distorted sense of time and space. reduced ability to concentrate and Higher doses and overdose Two of the major dangers associated depression. Higher doses of ketamine can intensify with ketamine use are a loss of the effects experienced at lower doses. judgement and the potential for people Tolerance and dependence Large quantities of ketamine can also to hurt themselves while anaesthetised Tolerance to ketamine can develop very cause: without realising. quickly, with people needing more and • drowsiness more to achieve the same euphoric and Immediate effects • erratic, hostile and bizarre behaviour psychedelic effects. The effects of ketamine may be • feelings of panic and terror There is evidence that people who experienced within 30 seconds (if taken regularly use ketamine can develop • paranoia intravenously) to 20 minutes (if taken a psychological dependence. People orally) and can last for one to three • depression who are psychologically dependent on hours. • amnesia ketamine may experience cravings. They may feel compelled to use Some of the effects that may be • anaesthesia experienced after taking low to ketamine to function effectively or feel • muscle rigidity moderate doses of ketamine are: good in certain situations—such as at a • hypersalivation dance party. • blurred vision • increased body temperature or fever • constricted pupils Withdrawal • cardiac arrhythmia • impaired motor coordination There is currently little evidence to • convulsions • euphoria and relaxation support the view that people who are dependent on ketamine experience • feelings of dissociation (being • coma physical withdrawal symptoms if they detached from the body) • "near death" experience suddenly stop taking it. • hallucinations and distorted sensory • risk of accidents. processing, including visual, auditory, Pregnancy and breastfeeding bodily, time and space perception Long-term effects Many drugs can cross the placenta and • disorganised thoughts, confusion Little is known about the long-term have effects on the unborn child. and difficulty concentrating, thinking effects of ketamine use. Little is known about the effects of or maintaining attention It has been reported that some people ketamine on the unborn child. As is • anxiety, agitation, paranoia and experience “flashbacks”, from when the case with many other drugs and feelings of panic they used the drug. Flashbacks can medications, it is not recommended • slurred speech occur days, weeks or months after a that people use ketamine while person has used ketamine. pregnant or breastfeeding. • increased heart rate and blood pressure There is also some emerging evidence Reproduced with approval from the Australian Drug Foundation, © Australian Drug Foundation 2009. Message stick 77
Methadone
If a mother continues to use ketamine http://www.druginfo.adf.org.au/ detoxification program, which lasts while breastfeeding, it is possible that druginfo/drugs/drugfacts/methadone. approximately 5–14 days, that aims the drug will be present in her milk and html to ease the discomfort of coming off may have adverse effects on the baby. heroin. Check with your doctor or other What is methadone? A person can only become a client health professional if you are taking or Methadone belongs to the group on methadone treatment after being planning to take any substance while of drugs known as opioids. Opioids assessed by a doctor who is an pregnant or breastfeeding, including are drugs (naturally occurring and approved methadone prescriber. prescribed and over-the-counter synthetic) with chemical structures In Victoria, doctors must apply to medications. and actions similar to morphine. One the Drugs and Poisons Unit of the subgroup of opioids is the family of Department of Human Services to opiates, which includes pain-relieving become registered as a methadone drugs such as codeine, morphine prescriber. Generally the client should and heroin. Opioids are classed as be 18 years of age or over and be depressant drugs as they work by physically dependent on opiates. The slowing down the functions of the doctor’s assessment takes into account central nervous system ¹ . Alcohol, other characteristics such as alcohol cannabis and benzodiazepines or other drug use and psychological (including Valium, Rohypnol and health. Serepax) are examples of other depressant drugs. The advantages of methadone Methadone is synthetically treatment manufactured and used as a substitute Many people believe that it is preferable for the treatment of people dependent for heroin users to stop taking drugs on heroin and other opioids. Its effects altogether. Although for some heroin are much longer lasting than heroin, users this is achievable, for others there a single dose being effective for is a high risk of relapse into heroin use. approximately 24 hours; the effects Methadone maintenance has helped of heroin may only last for a couple many people reduce the recurrence of of hours. In a treatment program, compulsive heroin use. methadone is usually given out in syrup Methadone treatment, like any other form and drunk with cordial or fruit drug treatment, is not a ‘cure’ for heroin juice. dependence. However, research has Generally, there are two types of shown that it can improve the health methadone programs: of people dependent on heroin in a • a maintenance or long-term number of ways: program, which may last for months • people are less likely to use heroin or years, that aims to reduce the that may be contaminated with other harms associated with drug use and substances improve quality of life • methadone is taken orally, which • a withdrawal (short-term) makes it cleaner and safer than
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injecting heroin. This reduces the of these criteria include family • loss of appetite risks of sharing equipment and commitments, illness and travelling • tremors becoming infected with blood-borne long distances. • muscle spasm and jerking viruses such as hepatitis B , hepatitis Other considerations with a methadone C (which may lead to long-term program • goose bumps liver problems) and HIV - the virus • tears causing AIDS • It is recommended that clients on a methadone program also receive • nausea/vomiting • the routine involved in methadone professional counselling. • yawning treatment encourages people to lead a balanced and stable lifestyle • Methadone, like heroin, is a potent • diarrhoea drug and can be dangerous if used - including improved diet and sleep • back and joint aches incorrectly. • people are less stressed, as they do • high temperature but feeling cold not have to worry about where their • While people are on methadone, • sweating next 'hit' of heroin is coming from they are still physically dependent on opioids. • irritability/aggression/feelings of • methadone lasts longer in the body uneasiness than heroin, so it only has to be • There is no 'high' experienced from a taken once a day methadone dose. • difficulty sleeping Clients must commit to attending • it allows people to handle the • • cravings for the drug. daily for their dose, therefore, withdrawal process with less A person who suddenly stops taking holidays etc may be difficult to discomfort methadone may experience many organise. • criminal activities conducted to of the symptoms listed above. The obtain illegal drugs are reduced • There are side effects. withdrawal symptoms usually begin one to three days after the last dose, and • it helps people cut their connections Effects peak around the sixth day, but can last with the drug scene Some people on methadone programs longer. • it's cheaper - although there is will experience unwanted symptoms Symptoms of too high a dose include: usually a dispensing fee with during their treatment. These may be • drowsiness/nodding off methadone, this is relatively cheap caused by the dosage they are receiving compared to the cost of illicit drug being too low or too high, which can • nausea/vomiting use (the recommended dosage fee occur particularly at the beginning of • shallow breathing at the time of writing this information treatment. Some symptoms may also • pinpoint pupils was $7.50, although this amount occur due to the side effects of the may vary between dispensers); drug itself. • below normal drop in body temperature • under certain conditions, take- Symptoms of the methadone dose away doses of methadone are also being too low may resemble having a • slow blood pulse, lowered blood available, which help clients return to bout of the flu. They include: pressure a more stable lifestyle. To be eligible, • runny nose, sneezing • heart palpitations clients must meet the criteria as outlined by the state/territory health • abdominal cramps • dizziness department as well as those of • feeling physically weak • problems with sexual functioning the methadone prescriber. Some
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• poor blood circulation. The use of other drugs with methadone, Other dangers especially other depressant drugs such Some people may also experience • Access to methadone by those not in as alcohol , opiates (including heroin) certain side effects that are unrelated a methadone program-children, for or benzodiazepines (including Valium, to the dosage including: example – is very dangerous and can Serepax and Rohypnol), increases lead to accidental overdose. Take- • sweating (clients should drink at the risk of overdose. Drinking large away doses of methadone should be least two litres of water per day to amounts of alcohol over days or supplied in child-proof containers avoid dehydration) weeks can also shorten the duration and stored in cabinets that cannot • constipation of methadone’s effects, causing the be accessed by children. • aching muscles and joints person to experience withdrawal symptoms before their next dose. • Injecting methadone is a serious • lowered sex drive health risk as it increases the risk • skin rashes and itching Overdose and death of overdose and can lead to blood clotting, collapsed veins and other • sedation Methadone deaths are rare. Methadone medical complications. • fluid retention related deaths have almost always been due to combining methadone with other • loss of appetite, nausea/vomiting Pregnancy and breastfeeding drugs, particularly benzodiazepines • abdominal cramps such as Valium and Rohypnol, and/or Pregnant women who are dependent on opiates are encouraged to enter • tooth decay alcohol. a methadone program as early as It is generally accepted among health • irregular periods. possible into their pregnancy, as it is professionals that methadone treatment Side effects should diminish soon after likely to result in fewer complications is effective in reducing deaths among the methadone program is completed. than the use of other opiates, such as heroin-dependent people. Deaths As with all opiates, methadone alone heroin. This is because: involving those in methadone treatment in its pure form will not cause any have occurred in Australia mainly due to • The unexpected periods of drug damage to the major organs of the the following reasons: withdrawal experienced by pregnant body. Prolonged use will not cause women using other opiates (that can Accidental overdose – research any physical damage, apart from tooth • be harmful to the baby) do not occur indicates that the abuse of alcohol decay. For those with pre-existing when on a daily dose of methadone. impaired liver function (following and benzodiazepines is common • The lifestyle of women is often conditions such as hepatitis B, hepatitis among methadone clients. Any enhanced when on methadone C infection, or prolonged alcohol use), combination of sedative drugs, treatment, resulting in improved the methadone dose may require including opiates, such as heroin nutrition and less stress, which all careful monitoring. and methadone, alcohol, and benzodiazepines, results in an contribute to a healthier baby. People who are not dependent on increased risk of respiratory • Methadone supplied by a pharmacy opiates who take methadone will depression, coma and death. or treatment centre hasn't been experience some of the short-term cut/mixed with any other potentially effects similar to those on a methadone • Suicide - emotional disorders are harmful substance that may be program receiving too high a dose (as common among methadone clients. passed on to the baby. listed above). • Accidents – including those involving Like all opiates, methadone crosses Mixing methadone with other drugs a motor vehicle. the placenta to the unborn child. Many
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Naltrexone
of the babies born to methadone- heavy fines and/or imprisonment. http://www.druginfo.adf.org.au/ dependent mothers go through Mixing methadone with other druginfo/drugs/drugfacts/naltrexone. withdrawal at birth. Their symptoms substances further increases the html vary in length and strength. These risk of accident. For instance, even can be successfully treated while the a small amount of alcohol taken with What is naltrexone? baby is still in hospital. Overall, women methadone can impair an individual’s Naltrexone is a drug prescribed to using methadone have fewer problems driving skills and put them at risk of help people maintain abstinence after during their pregnancy than those who a serious accident. Methadone may they have withdrawn (detoxified) from continue to use heroin. also affect the client’s ability when heroin or other opioids . It is also used As small amounts of methadone may be operating heavy machinery or playing in an experimental treatment to bring passed on through breast milk, mothers sport. Until a client is stabilised on about rapid withdrawal from opioids. that are on a methadone program are a particular dose of methadone, it Naltrexone has also been used as a often encouraged to breastfeed in order is safer if they avoid driving a car or treatment to support abstinence for to help ease the baby’s withdrawal from operating machinery. This is particularly people who are dependent on alcohol. important during the first few weeks of methadone. Methadone has been found This information explains the use treatment or when the methadone dose to reach its maximum level in breast of naltrexone to assist people in is changed. milk between two and four hours after maintaining abstinence from heroin a dose, therefore feeding the baby just ¹ Depressants here refers to the use. before a dose or taking the methadone slowing/reduction in function of the just before the baby has a long sleep central nervous system, rather than What does naltrexone do? will reduce the amount available to the mood changes or emotional depression Naltrexone is classed as an opioid baby. antagonist . It works by blocking the The law opioid receptors in the brain and therefore blocking the effects of heroin Injecting methadone, taking more and other opioids. It can assist in than one dose at a time, or giving maintaining abstinence from heroin methadone to somebody else is illegal. because the person is aware that they In Australia, as in most other western cannot achieve a ‘high’ from using countries, methadone is legal providing heroin. Therefore, any money spent it is prescribed by a doctor who has on heroin will be wasted. It does not been registered as a methadone directly stop a person wanting to use prescriber. heroin, although it may reduce or prevent cravings in some people. You Methadone and driving cannot become physically dependent It is illegal for anyone to drive if, by on naltrexone and it does not produce being under the influence of a drug(s), any euphoric effects. they are incapable of having proper control of a vehicle. This includes How effective is naltrexone? methadone and, if suspected, the There have been a lot of media reports driver can be subjected to a drug test. on naltrexone, often describing it as Breaking this law carries penalties a ‘miracle cure’ for heroin. There is, including disqualification from driving,
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however, general agreement from drug includes combining various treatments, environment is crucial in helping the professionals that the effectiveness such as methadone maintenance person give up and, perhaps more of naltrexone treatment is very much with counselling, or progressing importantly, stay off heroin. dependent on: from withdrawal to counselling/ • Support – The support of family, • the person’s particular situation, rehabilitation. friends, doctor and/or drug including their level of commitment A doctor or drug counsellor that spends counsellor (practical and emotional to staying off heroin and the level of time assessing the person’s situation support) is very important to help support available to them and explaining the different treatment the person through the process of • it being one part of a comprehensive options will more likely recommend withdrawal. treatment program, which includes a program that is appropriate for that • To be away from drugs – To be out regular counselling. person. of the environment in which drugs In fact, recent studies have suggested If applying for the naltrexone program, are readily available (this may mean that many clients do not remain on see a doctor who is experienced in this giving up old friends, moving to a naltrexone treatment and will often treatment (your statewide drug phone different area) return to heroin use. More studies are service can provide an appropriate • To understand his or her drug use currently being conducted that may referral). – To understand why the person provide a clearer picture of naltrexone’s To be eligible for naltrexone treatment, uses a particular drug, what might effectiveness. It is important to the following needs to be considered: trigger them to using, what other recognise that naltrexone treatment • The person must be free of emotional and practical issues they may be effective for some people, but heroin and other opioids for 7–10 might be facing (a drug counsellor will not suit everyone. days, or 10 days for methadone, can help the person through this). before commencing naltrexone How do you know if naltrexone maintenance treatment, otherwise What are the side effects? maintenance treatment is right there is a risk that the individual may Naltrexone is generally well tolerated, for you? experience acute, instant withdrawal. however some side effects have been Naltrexone is one of a number of • Existing liver conditions, such as reported. Most of these symptoms treatments for heroin dependence. acute hepatitis, may exclude a occur very early in treatment – the first Other treatments include: person from naltrexone treatment. week or so. It is important to note that • methadone maintenance some of these effects may be due to • If a woman is pregnant or the combined experience of withdrawal • withdrawal/detoxification (residential breastfeeding further advice should from opioids and taking naltrexone. or home-based/medical or non- be sought, as it has not been medical) established that using naltrexone Most commonly reported: during pregnancy is completely safe. • counselling (outpatient or as part of Difficulty in sleeping, anxiety, residential rehabilitation). • People who are highly motivated to nervousness, abdominal pain/cramps, It is strongly recommended that a be opioid free and have support from nausea and/or vomiting, low energy, person wanting to remain abstinent family and/or friends are more likely joint and muscle pain and headache. to benefit from the treatment. from heroin engages in a treatment Less commonly reported: Loss of program that addresses both the Other considerations appetite, diarrhoea, constipation, physical and psychological aspects increased thirst, increased energy, of drug dependency. This usually Having the right support and feeling depressed, irritability, dizziness,
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Tobacco
skin rash, delayed ejaculation, numbness/pins and needles) has been http://www.druginfo.adf.org.au/ decreased potency, and chills. infrequently reported with the use of druginfo/drugs/drugfacts/tobacco. naloxone. html What does the treatment involve? Risks What is tobacco? Treatment involves taking a prescribed The greatest risk associated with Tobacco comes from the leaves of amount of naltrexone for as long as it is naltrexone is when heroin is used the tobacco plant (Nicotiana tabacum perceived to be required; the length of either after a naltrexone dose has been and Nicotiana rustica), which contain the program depends on the individual’s skipped or if a person stops taking nicotine. Nicotine is a stimulant drug. situation. The tablets are taken orally, naltrexone altogether. While the person Stimulant drugs act on the central once a day, the usual dose being 50mg, is on naltrexone, tolerance to heroin nervous system to speed up the or every couple of days at a higher dose decreases. Therefore, if heroin is used messages travelling between the brain (such as 100mg on alternate days or (and the effects of naltrexone are either and the body. 150mg every three days). Daily doses diminished or worn off completely), The leaf of the tobacco plant is dried, are often recommended in order for the risk of overdosing from heroin is cured and aged before having other the person to develop a routine, and to greatly increased. People who are ingredients added to manufacture a keep a stable level of naltrexone in the planning to use heroin after being on range of tobacco-based products. For blood. Often a carer, family member, naltrexone should consider themselves example, cigarettes (including some doctor or pharmacist supervises the ‘new’ users. Overdose may occur if the herbal cigarettes), cigars, pipe tobacco, administration of the dose. person uses the same or even a smaller chewing tobacco, and wet and dry amount of heroin compared to what snuff. The Naloxone (Narcan) they did before being on naltrexone. In Challenge Test (NCT) Australia, there have been a number of What’s in cigarette smoke? naltrexone-related deaths, due mainly Following abstinence from opioids There are more than 4000 chemicals to this reason. for a period of 7–10 days, and after a in tobacco smoke. Many of these negative urine test has been achieved If a naltrexone dose is skipped, it chemicals are poisonous and at least for opioids, a naloxone (Narcan) is important to remember that the 43 of them are carcinogenic (cause challenge test is usually administered blocking effect wears off gradually (for cancer). The three major chemicals in by a doctor to determine the remaining example, the usual daily dose of 50mg tobacco smoke are: degree of physical dependence on will wear off in 24–72 hours). Therefore, • Nicotine – the chemical on which opioids. if heroin is used in the meantime, a smokers become dependent. Naloxone is injected into the individual ‘high’ may not be achieved immediately and they are then monitored for and there may be a temptation to use • Tar – which is released when a approximately 20 minutes to assess again and/or increase the dosage. As cigarette burns. any signs of withdrawal. If moderate the naltrexone slowly wears off, the • Carbon monoxide (CO) – a to severe withdrawal symptoms are ‘full’ effects of all of the heroin can be colourless, odourless and very toxic identified, the test can be undertaken experienced, increasing the chances of gas that is taken up more readily again 24 hours later. If the symptoms overdose. by the lungs than oxygen. Smokers indicate only mild withdrawal, the first typically have high levels of CO in the dose of naltrexone can be provided. blood. Agitation, parathesia (temporary
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Effects of tobacco smoke • decreased blood flow to body Tolerance and dependence extremities like the fingers and toes Tar in cigarettes coats the lungs and People who use tobacco tend to can cause lung and throat cancer in • dizziness, nausea, watery eyes and develop a tolerance to the effects of smokers. It is also responsible for the acid in the stomach the nicotine in the tobacco very quickly. yellow–brown staining on smokers’ • decreased appetite, taste and smell. This means they need to smoke more fingers and teeth. and more in order to get the same Carbon monoxide in cigarettes robs the Overdose effect. muscles, brain and blood of oxygen, Although rare, it is possible to overdose With repeated use of tobacco, the making the whole body – especially on the nicotine in tobacco. risk of dependence on nicotine is the heart – work harder. Over time this high. Dependence on nicotine can be Very large doses of nicotine can result causes airways to narrow and blood physiological, psychological or both. in an increase in the unpleasant effects, pressure to rise, and can lead to heart including feelings of faintness and People who are physically dependent attack and stroke. High levels of CO, confusion, and a rapid decrease in on nicotine find their body has become together with nicotine, increase the blood pressure and breathing rate. used to functioning with the nicotine risk of heart disease, hardening of the present and may experience withdrawal In some cases, it can lead to arteries and other circulatory problems. symptoms when they reduce their convulsions and death from respiratory A first-time smoker will often feel dizzy nicotine intake. and sick. failure. Sixty milligrams of nicotine taken orally can be fatal for an adult. People who are psychologically ‘Light’ or ‘low tar’ cigarettes dependent on nicotine may find they Long-term effects feel an urge to smoke when they are in Research has shown that there is little specific surroundings, such as at the It is estimated that more than 140,000 difference between the amount of pub, or in particular situations such as hospital episodes and 19,000 deaths in chemicals inhaled by people who smoke during their lunch break or socialising Australia can be attributed to tobacco ‘light’ or ‘low tar’ cigarettes and those with friends. who smoke regular cigarettes. People use every year. The principal diagnoses who smoke ‘light’ cigarettes have the are cancer, heart disease and chronic Research has shown that smoking is same risk of developing smoking- obstructive pulmonary disease. often associated with different roles related diseases as people who smoke and meanings for smokers, including: regular cigarettes. Passive smoking • social roles – such as enjoyment of Passive smoking can cause a number the company of friends, the drinking Immediate effects of health problems including heart of coffee or alcohol, and promoting Soon after smoking tobacco, the disease, lung cancer and irritation social confidence and feelings of following effects may be experienced: of the eyes and nose. It involves independence (particularly for young breathing in tobacco smoke from other women) • initial stimulation, then reduction in people’s cigarettes: smoke that has brain and nervous system activity • emotional roles – caring for the self, been exhaled or smoke from the end of such as helping to deal with stress • enhanced alertness and a lit cigarette. and anxiety, weight control and concentration 50 Australians die every day from providing ‘companionship’ • mild euphoria smoking, compared to 10 who die from • temporal roles – such as connecting • feelings of relaxation alcohol-related conditions and four who the flow of events or time in the die as a result of road accidents. • increased blood pressure and heart smoker’s day, providing a break rate Reproduced with approval from the Australian Drug Foundation, © Australian Drug Foundation 2009. 84 Message stick
from work or activities and relieving through the placenta. These substances Although most people who try to quit boredom. can reduce the amount of oxygen smoking do so without assistance, This may be why smoking is sometimes available in the mother’s blood, which research generally shows that quitting referred to as the most difficult drug to reduces the amount of oxygen available rates improve with assistance. A give up. to the baby. This and the effects of combination of methods tends to the other chemicals found in tobacco improve a person’s chances of quitting; Withdrawal smoke can affect the baby’s growth for example, combining nicotine and development, increasing the risk of replacement therapy and behavioural If a person who is dependent on the low birth weight, premature birth and assistance. nicotine in tobacco suddenly stops spontaneous abortions. using it or reduces the amount they Benefits of quitting use, they will experience withdrawal Babies whose parents smoke also have symptoms because their body has to an increased risk of sudden infant After a person stops smoking: readjust to functioning without the death syndrome (SIDS). They are more • Almost all the nicotine is out of their drug. likely to suffer from asthma and other system after 12 hours. respiratory infections than babies of Most of these symptoms will disappear • The level of carbon monoxide in their non-smokers. within days or weeks of quitting blood is reduced and they will have smoking, but cravings may persist for Nicotine and many of the other more oxygen in their bloodstream years after stopping using tobacco. substances in tobacco smoke are after 24 hours. passed through breast milk to the Symptoms include: • Most of the nicotine by-products are baby. These substances can reduce out of their system after five days. • cravings the supply of breast milk. Smoking just • irritability, agitation, depression and before breastfeeding may also delay the • Their sense of taste and smell will anxiety milk ‘let down’ process. have improved after a couple of days. • insomnia and disturbed sleeping Quitting tobacco patterns • Their blood pressure returns to its Quitting tobacco is more effective normal level within a month. • increased appetite and weight gain if tailored to suit a person’s • Their immune system starts to show • restlessness and loss of circumstances. signs of returning to normal within a concentration Methods include: month. • headaches • going ‘cold turkey’ • Blood flow to their hands and feet • coughing and sore throat has improved within three months. • nicotine replacement therapy (such • body aches and pains as transdermal patches, gum, • After a year, the increased risk of • stomach and bowel upsets. lozenges, inhalers, nasal sprays and dying from heart disease is half that sublingual tablets) of a person who has continued to smoke tobacco. Pregnancy and breastfeeding • other pharmacotherapies such as Smoking tobacco can affect fertility in bupropion (Zyban SR) both males and females. • individual counselling or advice Nicotine, carbon monoxide and many • support groups other chemicals found in tobacco • alternative therapies, such as smoke are passed on to the baby acupuncture and hypnosis. Reproduced with approval from the Australian Drug Foundation, © Australian Drug Foundation 2009. Message stick 85
Contact list
Telephone support DACAS The 24-hour Drug and Alcohol Clinical Advisory Service set up to assist and support health and welfare 1800 812 804 professionals with the clinical management of drug and alcohol problems. Website: www.turningpoint.org.au/service_information/si_treatment.html
DirectLine DirectLine is a statewide telephone service network providing 24-hour, seven-day counselling, information 1800 888 236 and referral to alcohol and drug treatment and support services throughout Victoria. DirectLine is a service for people of all ages and backgrounds, including health and welfare professionals. DirectLine can be a useful source of immediate information for drug and alcohol workers, such as where you: • are not aware of the risks of particular drugs that have been used by a client • are looking for suggestions for a support service in an area that your are not familiar with • need to check the contact details of a particular service • can find out about doctors prescribing and pharmacies dispensing methadone, buprenorphine and suboxone. DirectLine also provides direct telephone support to: • people using drugs • families, relatives or friends of someone using drugs • anyone in the community who has been affected by an alcohol or drug problem. Website: www.health.vic.gov.au/drugs/directline.htm YSASline YSASline is a 24-hour telephone service that provides information, counselling and referral to the services 1800 014 446 provided by the YSAS and youth-specific alcohol and drug services throughout Victoria. YSAS staff can be a good source of information and support to workers dealing with unfamiliar challenges to practice, such as inhalant use and other youth related drug use. YSASline is also open to young people, their families, police and the wider community. YSAS have been closely involved with a number of Koori communities, including training initiatives with Koori workers. Website: www.ysas.org.au/ysasline.html 86 Message stick
Information on drugs and alcohol Australian Drug The Australian Drug Foundation (ADF) is one of the largest sources of information on alcohol and Foundation other drugs. (03) 9278 8100 The ADF have established a web site specifically for Koori Workers and their communities. You can access the web page www.kooridruginfo.adf.org.au: The Koori page provides access to updated information about: • the koori page provides access to updated information about: • facts on the effects of drugs and alcohol • research • community building • work force development • links to other websites. You can search all the ADF catalogues and resources via the Koori web page. The ADF home page provides a computerised directory of drug and alcohol services, via the links page. The ADF also produces a wide range of brochures and wall charts, and have an extensive library and training videos, including some produced for Aboriginal workers. Website: www.adf.org.au Australian Drug The Australian Drug Information Network (ADIN) provides a central point of access to quality Information Network internet-based alcohol and drug information provided by prominent organisations in Australia and (03) 9278 8100 Internationally. Organisations and individuals can search and share relevant information on licit and illicit drug issues. Website: www.adin.com.au/content.asp?Document_ID=1 Better Health Channel The Better Health Channel was established in May 1999 by the Victorian Government. Its role is to provide the community with access to online health-related information, which is: • quality assured • reliable • up to date • locally relevant. Consumer health information on the Better Health Channel is constantly expanded and regularly reviewed. Website: www.betterhealth.vic.gov.au Message stick 87
Information on drugs and alcohol Tranquilliser TRANX provides a range of resources to help people recover from dependency on tranquillisers or Recovery and New sleeping pills. The Australian Drug Foundation (ADF) is one of the largest sources of information on alcohol and Australian Drug Existence (TRANX) Foundation other drugs. These include education and training and community awareness, as well as support services for withdrawal, counselling, telephone support and anxiety management. (03) 9278 8100 The ADF have established a web site specifically for Koori Workers and their communities. You can access the web page www.kooridruginfo.adf.org.au: Website: www.tranx.org.au The Koori page provides access to updated information about: Turning Point Alcohol Turning Point is a specialist alcohol and other drug organisation that conducts research, training and education as well as providing treatment services and support for workers in the field. • the koori page provides access to updated information about: and Drug Centre Turning Point publishes a range of material relevant to Koori drug and alcohol workers. • facts on the effects of drugs and alcohol (03) 8413 8413 The website also provides information about Turning Point’s involvement in: • research • education and training • community building • producing material and training on specific topics such as drug diversion, including initiatives • work force development directed at koori workers • links to other websites. • research about new pharmacotherapies treatment and support. You can search all the ADF catalogues and resources via the Koori web page. The ADF home page Website: www.turningpoint.org.au provides a computerised directory of drug and alcohol services, via the links page. The ADF also produces a wide range of brochures and wall charts, and have an extensive library and training Victorian Alcohol and The Victorian Alcohol and Drug Association (VAADA) is the peak body representing alcohol and videos, including some produced for Aboriginal workers. Drug Association drug agencies in Victoria. Website: www.adf.org.au (03) 9416 0899 VAADA provides conferences, forums and policy development initiatives. VAADA also produces a newsletter that keeps readers in formed of current developments. Australian Drug The Australian Drug Information Network (ADIN) provides a central point of access to quality Information Network internet-based alcohol and drug information provided by prominent organisations in Australia and Website: www.vaada.org.au (03) 9278 8100 Internationally. Victorian Aboriginal VACCHO provides a range of resources and training initiatives relevant to Koori drug and alcohol Organisations and individuals can search and share relevant information on licit and illicit drug Community workers. These include brochures on alcohol and other drugs, specifically for Koori people. These issues. Controlled Health brochures and related posters are available free to Koori workers. Website: www.adin.com.au/content.asp?Document_ID=1 Organisation VACCHO also provides a range of training that maybe relevant to workers in the AOD sector. (03) 9419 3350 Better Health Channel The Better Health Channel was established in May 1999 by the Victorian Government. Its role is to provide the community with access to online health-related information, which is: Website: www.vaccho.org.au • quality assured • reliable • up to date • locally relevant. Consumer health information on the Better Health Channel is constantly expanded and regularly reviewed. Website: www.betterhealth.vic.gov.au 88 Message stick
Metropolitan services funded to provide Koori community AOD programs Victorian Aboriginal Health Service 279 High Street, Northcote Vic 3070 Ph: 9403 3300 Fax: 9403 3333 Website: www.vahs.org.au Moreland Hall Alcohol and Drug Centre 26 Jessie Street, Moreland Vic 3058 Ph: 9386 2876 Fax: 9383 7828 Website: http://www.morelandhall.org/index.php Ngwala Willumbong Co-operative 93 Wellington St, St Kilda Vic 3182 Ph: 9510 3233 Fax: 9510 6288 Website: www.ngwala.org South Eastern Alcohol and Drug Service (SEADS) 2nd Floor, 229 Thomas St, (PO Box 208), Dandenong Vic 3172 Ph: 8792 2330 Fax: 9791 1247 Website: www.southernhealth.org.au/seads Frankston Integrated Health Service (PenDAP) PO Box 52, Frankston Vic 3199 Ph: 9784 8100 Fax: 9784 8122 Website: www.peninsulahealth.org.au/contactus Youth Substance Abuse Service PO Box 2950, Fitzroy Victoria 3065 Phone: 9415 8881 Fax: 9415 8882 Yarra Valley Community Health Service 377 Maroondah Highway, Healesville, 3777 Phone: 1300 130 381 Fax: 5962 3429 Message stick 89
Regional services funded to provide Koori community AOD programs Gunditjmara Aboriginal Co-operative Region: Barwon-South Western PO Box 732, Warrnambool Vic 3280 Ph: 5564 3312 Fax: 5561 1650 Website: www.gunditjmara.org.au
Western Region Alcohol and Drug Service 172 Merri Street, Warrnambool Vic 3280 Ph: 1300 009 723 Fax: 03 5564 5730 Website: www.warrnambool.org/wrad Wathaurong Aboriginal Co-operative PO Box 402, North Geelong Vic 3215 Ph: 5277 0044 Fax: 5278 4123 Website: http://home.vicnet.net.au/~gcforum/WContactUs.htm
Winda Mara Aboriginal Cooperative 21 Scott St, Heywood, VIC 3304 p: (03) 5527 2051 Gippsland & East Gippsland Aboriginal Co-operative Region: Gippsland 37 Dalmahoy St (PO Box 634), Bairnsdale Vic 3875 Ph: 5150 0700 Fax: 5152 3115 Gippsland & East Gippsland Aboriginal Co-operative (Morwell) PO Box 634, Bairnsdale Vic 3875 Ph: 5134 3816 Fax: 5152 3115 Lake Tyers Trust PO Box 115, Lakes Entrance Vic 3909 Ph: 5155 8500 Fax: 5156 5791 Gippsland Lakes CHS Princes Highway, Bairnsdale Vic 3875 Ph: 5152 0052 Fax: 5153 1087 Ramahyuck Aboriginal Co-operative PO Box 1240, Sale Vic 3850 Ph: 5143 1644 Fax: 5144 6725 Latrobe CHS 251 Princes Drive, Morwell Vic 3840 Ph: 5134 2011 Fax: 5134 2667 90 Message stick
Regional services funded to provide Koori community AOD programs Ballarat & District Aboriginal Co-op Region: Grampians 5 Market St (PO Box 643), Ballarat Vic 3350 Ph: 5331 5344 Fax: 5333 1637 Website: http://badac.ballarat.net.au/heritage/co-op/co_op.htm
Goolum Goolum Aboriginal Co-operative PO Box 532, Horsham Vic 3400 Ph: 5381 6333 Fax: 5381 1563 Website: http://www.connectingcare.com/provider.asp?site_id=59&lga_id=23190
Goulburn Valley CHS Region: Hume 399 Wyndham Street, Shepparton Vic 3630 Ph: 5823 3200 Fax: 5823 3299 Website: www.gvchs.com.au/index.php Rumbalara Aboriginal Co-operative 69 Numurkah Road, Shepparton Vic 3630 Ph: 5825 2111 Fax: 5825 4493 Website: www.raclimited.com.au Albury-Wodonga Aboriginal Health Service PO Box 3040, Albury NSW 2640 Phone: 02 6042 1200 Fax: 02 6021 3966 Website: http://www.awahs.com.au/ Bendigo and District Aboriginal Co-operative Region: Loddon Mallee 13-15 Forest Street, Bendigo Vic 3550 Ph: 5442 4947 Fax: 5442 4942 Mildura Aboriginal Corporation 120 Madden Ave, Mildura Vic 3500 Ph: 5022 1852 Fax: 5023 7852 Murray Valley Aboriginal Co-operative PO Box 680, Robinvale Vic 3549 Ph: 5026 3353 Fax: 5026 4332 Njernda Koori Corporation 84 Hare St, Echuca Vic 3564 Ph: 5482 3075 Fax: 5480 6116 Sunraysia CHS Ramsay Court, Mildura Vic 3500 Ph: 5023 7511 Fax: 5023 7518 Swan Hill Aboriginal Health Service 70 Nyah Road, Swan Hill Vic 3585 Ph: 5032 5277 Fax: 5032 5299 Message stick 91
Department of Human Services metropolitan offices Central Office – Mental Health and Drugs Division Level 17/50 Lonsdale Street, Melbourne Vic 3000 Ph: 9096 5631 Fax: 9096 9170 Eastern region 883 Whitehorse Rd, Box Hill Vic 3128 Ph: 9843 6678 Fax: 9843 6225 North & West region 145 Smith Street, Fitzroy Vic 3065 Ph: 9412 5407 Fax: 9412 2633 Southern region 26 Macrae St, Dandenong. 3175 Ph: 8710 2826 Fax: 8710 2850
Department of Human Services regional offices Barwon-South Western region (covering areas such as Geelong, Warrnambool, Portland, Heywood) Cnr Fenwick & Little Malop streets, Geelong Vic 3220 Ph: 5226 4242 Fax: 5226 4610 Gippsland region (covering areas such as Morwell and Bairnsdale) 64 Church Street, Traralgon Vic 3844 Ph: 5177 2534 Fax: 5177 1169 Grampians region (covering areas such as Ballarat) 35 Armstrong St, Ballarat Vic 3350 Ph: 5533 6033 Fax: 5333 1169 Hume region (covering areas such as Shepparton) 43-47 Rowan St, Wangaratta Vic 3677 Ph: 5722 0902 Fax: 5722 0577 Loddon Mallee region (covering areas such as Mildura, Swan Hill, Echuca and Bendigo) 37 Rowan St, Bendigo Vic 3550 Ph: 5434 5619 Fax: 5434 5671
Office for Aboriginal and Torres Strait Islander Health (OATSIH) 595 Collins Street, Melbourne Vic 3000 Ph:9665 8902 Fax:9665 8903 92 Message stick
Family violence healing services East Gippsland Yoowinna Wurnalung Healing Service 11 Heatherlea Grove, Lakes Entrance Vic 3909 Ph: 5155 8420
Loddon Mallee South Ngurelban Healing Service Service to be located at Rochester from July 2009. Interim contact details: Nyernda Aboriginal Co-operative PO Box 201, Echuca Vic 3564 Ph: 5480 6252 Eastern metropolitan region Boorndawan Willam Indigenous Healing Service Site to be acquired in 2009. Interim contact details: Eastern Access Community Health 46 Warrandyte Road, Ringwood Vic 3134 Ph: 9871 1800 North and West Metropolitan Healing Service Victorian Aboriginal Health Service (VAHS) 186 Nicholson Street, Fitzroy Vic 3065 Ph:9419 3000 Maya Healing Centre 11 Rossmoyne Street, Thornbury Vic 3071 Ph: 9480 1111 Message stick 93
Family Violence Time Out services Loddon Mallee North Murray Valley Aboriginal Co-operative Ltd 87 Latje Road, Robinvale Vic 3459 Ph: 5026 3353
East Gippsland Yoowinna Wurnalung Time Out service is located at Nicholson. Ph: 5155 8420 Hume Location of service to be advised.
North and West metropolitan VACSAL Interim contact details: 171 Smith Street, Fitzroy Vic 3065 Ph: 9416 4266
Funds for new programs
The Australian Aboriginal guide to philanthropy Many Aboriginal communities are not aware of the potential of the philanthropic and private sectors to support their projects and create change. This guide, produced by VACCHO, provides details on how to access funds made available by philanthropic (charitable) trusts. The guide is available from VACCHO (03 9419 3350), or can be downloaded from their website at
The Department for Victorian Communities Phone: 1300 366 356 Website: www.grants.dvc.vic.gov.au
The Alcohol Education & Rehabilitation Foundation (AER Foundation Ltd) Phone: (02) 6122 8600 Website: www.aerf.com.au Fax: (02) 6232 4400 Sources of advice on preparing submissions for funding include: • management of your agency • Department of Human Services regional coordinators. 94 Message stick
Training TAFE colleges For the most current information about obtaining a Diploma of Alcohol and Other Drugs Work or a Certificate IV in Alcohol and Other Drugs work being provided in Victoria visit the TAFE website at
Other information
The following websites provide further information about training in the Victorian AOD sector. http://www.health.vic.gov.au/drugservices/training/tr_dev.htm This website provides information about training and development http://www.health.vic.gov.au/drugservices/training/tr_wd.htm This website provides information workforce development http://www.health.vic.gov.au/drugservices This website provides information about all drug-related services in Victoria Message stick 95
Other information
COATS For more information contact COATS directly on (03) 9320 4000 or visit
Glossary
http://www.druginfo.adf.org.au/ despite severe negative social and instruments and tests used in about/glossary physical consequences. screening, identification and diagnosis A Amotivational syndrome: Thought of individuals for alcohol and other drug use or abuse. Abstinence: Not using or refraining to be associated with substance use from using a drug; being drug-free. (especially of cannabis). Symptoms B include apathy, loss of effectiveness, ABI: Acquired brain injury Barbiturate: A depressant derived diminished capacity to carry out from barbituric acid; for example, Abuse: Consumption of a substance complex or long-term plans, low amobarbital, pentobarbital, despite persistent or recurrent social tolerance for frustration, impaired phenobarbital and secobarbital. or interpersonal problems caused concentration and difficulty in following Used as anti-epileptics, anaesthetics, or exacerbated by the effects of the routines. sedatives, hypnotics, and less substance. Amphetamine: A synthetic stimulant commonly, as anti-anxiety drugs. Addiction: Physical or psychological drug that affects the central nervous Increasing dosage produces progressive dependence on a drug. The term drug system and speeds up the messages central nervous system depression, dependent is preferred. going between the brain and the body. ranging from mild sedation to Adverse drug reaction: Harmful, Also known as ‘speed’. anaesthesia. unintended or unwanted consequences Amyl nitrate: Sold in tablet form Base: Another term for of taking a drug. For example, the and administered sublingually as a methamphetamine. experience of psychotic symptoms after heart medication. These are not used Benzodiazepines: Minor tranquillisers taking cannabis by someone already recreationally and are not ‘poppers’. that affect the central nervous system predisposed towards schizophrenia. Amyl nitrite: A substance belonging by slowing down the body physically, Agonist: A drug that mimics naturally to a group of chemicals called ‘alkyl mentally and emotionally. Prescribed occurring chemicals that stimulate nitrites’, sometimes used as an inhalant by doctors to treat anxiety, sleeping receptors in the brain and central drug referred to as ‘poppers’. Inhalants problems, epilepsy, alcohol withdrawal nervous system. produce a depressant effect. See amyl and muscle spasms. AIDS: Acquired immune deficiency nitrate for comparison. Betel nut: Also known as Areca nut, syndrome (AIDS) is caused by a Antagonist: A substance that blocks is a stimulant similar to nicotine. Areca human immunodeficiency virus (HIV), the effects of another drug by binding nut is usually sliced into thin strips, which attacks and weakens the body’s with the receptor site for that drug in rolled in a betel leaf and chewed. immune system, making it a target for the brain; for example, naltrexone is an Binge: An episode of intense infections and diseases. antagonist for opioids. (concentrated) or excessive alcohol Alcohol: A liquid produced by Antidepressant: A drug used to treat or other drug use over a short period fermentation, which is the action of depression, for example, selective of time or continuously over a number yeast on liquids containing sugars and serotonin reuptake inhibitors (SSRIs) of days or weeks with the intention of starches. A depressant drug that slows such as Prozac and Zoloft. becoming intoxicated. down activity in the central nervous Anxiolytic: Any drug or therapy used in Blood alcohol concentration (BAC): system. the treatment of anxiety disorders that A measure of the amount of alcohol in Alcoholism: A clinical syndrome works on the central nervous system to a person’s blood. Generally, the more characterised by very heavy alcohol relieve the symptoms of anxiety. alcohol a person drinks the higher their consumption and continued drinking Assessment: Specific methods, BAC.
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Blotter: Paper on which LSD has been vapours from volatile substances. Other Court diversion: A program of absorbed. modes of administration are huffing treatment, re-education or community Bong: A type of water pipe used for (saturated material is held against the service for individuals referred from smoking cannabis. mouth or nose) and bagging (vapours criminal courts (criminal diversion) inhaled from a plastic or paper bag held after being charged with driving under Brief intervention: A minimal over the nose or mouth). the influence of alcohol (drink-driver interaction with a medical or mental diversion) or another drug, with the sale health professional, ranging in duration Cocaine: A powerful central nervous system stimulant used to produce or use of drugs (drug diversion), or with from several minutes to several another crime. sessions. This term is used primarily in euphoria. Most commonly comes in the context of treatment for substance the form of a white, odourless powder Crack: A pure form of cocaine obtained use problems. called ‘cocaine hydrochloride’. The by heating cocaine salt combined with powder is extracted from the leaves of baking soda (freebasing) and sold in the Buprenorphine: A synthetic the coca bush. form of small crystals or rocks. agonist/antagonist that can be used in substitution treatment for heroin Coca leaves: The leaves of the coca Crash: The ‘down’ that typically follows dependence. It has been used for the bush Erythroxylon coca that are a period of concentrated use of a short-term treatment of moderate traditionally chewed or sucked in stimulant drug, such as amphetamine to severe pain. Withdrawal from Andean cultures. or cocaine, over a period of several buprenorphine is milder and the Coca paste: Coca paste is the product days. The ‘crash’ begins when use is overdose risk is lower than with other of the first step in the process of discontinued and the immediate effects opioid agonists. extracting cocaine from coca leaves. start to wear off. C Codeine: Extracted from morphine Cut: To adulterate or dilute drugs with other substances. Caffeine: A stimulant that acts on the and sold commercially to treat mild to central nervous system to speed up the moderate pain. D messages to and from the brain. It is a Come-down: To experience the gradual Decriminalisation: Drug policy substance found in the leaves, seeds or wearing off of the effects of a drug after whereby possession of a drug fruit of a number of plant species, such experiencing a ‘high’. for personal use is treated as a as coffee and tea plants. Community mobilisation: misdemeanour rather than a criminal Cannabis: A depressant and a Interventions that encourage a offence. Often applied to substances hallucinogen (if taken in high doses) community to develop collective considered to be less likely to cause that comes from the hemp plant ownership and control over health- dependence. Cannabis sativa. Marijuana, hashish related choices and activities. Demand reduction: The aim of and hashish oil come from this plant. Comorbidity: See dual diagnosis. reducing consumer demand for The active chemical in cannabis is THC controlled substances. (delta-9 tetrahydrocannabinol). Cone: A device into which cannabis is packed, used together with a bong. Dependence: Occurs when a drug Central nervous system (CNS): is central to a person’s life, they have The brain and the spinal cord. The Controlled substance: A term that trouble cutting down their use and main ‘processing centre’ for the whole refers to a psychoactive substance experience symptoms of withdrawal nervous system. The CNS controls all whose availability is forbidden under the when trying to cut down. Can be the workings of the body. international drug control treaties or physical or psychological, or both. limited to medical and pharmaceutical When a person’s body has adapted to a Chroming: The practice of inhaling channels.
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drug and is used to functioning with the depend on the type and quantity of the are similar in structure to the drug present, the person is said to be additive used and can include vomiting, synthetic stimulant MDMA physically dependent upon that drug. loss of consciousness, respiratory (methylenedioxymethamphetamine). When a person feels compelled to use difficulties and loss of control. The chemical structure of MDMA is a drug in order to function effectively Drug: A chemical substance that related to stimulants (amphetamines) or to achieve emotional satisfaction, affects the processes of the mind or and some hallucinogens. Drugs sold as the person is said to be psychologically body. ‘ecstasy’ often contain a range of drugs dependent upon that drug. such as amphetamine, amphetamine Drug use/abuse: The use of any derivatives, caffeine, aspirin, Depressant: A drug that causes the substance under international control body to slow down and relax. These paracetamol or ketamine, in addition to, for purposes other than medical or in place of, MDMA. drugs can also cause drowsiness, slow and scientific, including use without heart rate and breathing. prescription, in excessive doses, or over Euphoria: Sense of elation commonly Designer drug: A substance that an unjustified period of time. The terms sought by drug users. has been synthesised by changing misuse and illicit use are generally Evaluation research: Carried out the structure of an existing drug to preferred to abuse. to establish the effectiveness of create a new substance. sometimes Drug use-related harm: Any adverse an intervention among a defined done to avoid the legal consequences social, physical, psychological, legal or population during a defined period of associated with the drug being copied/ other consequence of drug use that is time. altered. The term was first used in the experienced as harmful to a drug user Experimental drug use: Short-term 1980s to refer to MDMA (ecstasy). and those affected by the actions of a use of a drug to satisfy curiosity. Detoxification: The process by drug user. F which a person who is dependent Dual diagnosis: Refers to a person Flashback: The recurrence of an on a psychoactive substance ceases diagnosed as having an alcohol use, in such a way that minimises the hallucinogenic experience without or drug abuse problem in addition recent use of an hallucinogen. symptoms of withdrawal and risk of to some other diagnosis, usually harm. May involve the administration of psychiatric, for example, a mood Foetal alcohol syndrome (FAS): An medication. See withdrawal. disorder, schizophrenia. Also known as alcohol-related birth defect. Women who drink heavily during pregnancy Diversion: Diversion of drug users from comorbidity. may place their baby at risk of FAS. the criminal justice system into drug E treatment Also known as foetal alcohol spectrum Early intervention: A therapeutic disorders (FASDS). Dopamine: A brain chemical produced strategy that combines early detection naturally by certain brain cells. Specific Freebase: Slang term for the base form of hazardous or harmful substance of cocaine, as opposed to the salt form drugs may block specific effects of use and treatment of those involved. dopamine, they may act like dopamine of cocaine hydrochloride. It is extracted Treatment is offered or provided before from cocaine and smoked. at specific receptor sites, or increase the user might present of their own the availability of dopamine. volition and in many cases before they G Drink spiking: The practice of adding are aware that their substance use GHB: Gammahydroxybutyrate (GHB) is alcohol or another substance to a drink might cause problems. a drug that has a depressant effect on the brain and central nervous system. without the knowledge of the person Ecstasy: Ecstasy is a street who will be consuming it. The effects term for a range of drugs that It was originally developed as an anaesthetic but was withdrawn due to
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unwanted side effects. GHB has been Hashish: A type of cannabis that IDU: An abbreviation for an injecting used to facilitate sexual assault. comes from the resin of the plant. The drug user or injecting drug use. Glue: A solvent that acts as a resin is dried and pressed into a solid Illicit drug: An illegal drug. depressant. lump. Hash is added to tobacco and smoked, or baked and eaten in foods. Inhalant: A range of products (many H of which are familiar household items) Hash oil: A thick, oily liquid that is Habit-forming: Used to describe which, when vaporised and inhaled, extracted from hashish. It is usually substances or behaviours that result in may cause the user to feel intoxicated spread on the tip or paper of cigarettes dependence. or ‘high’. and then smoked. Half-life: The time needed for the blood Injecting equipment: Includes Hepatitis: Inflammation of the liver level of a particular drug to be reduced needles and syringes, spoons, filters, caused by viruses A, B, C, D, E and G. by 50 per cent. swabs, water and tourniquets. Heroin: Heroin is a depressant that Hallucinogens: Drugs or chemicals Intoxication: A condition that follows affects the brain by slowing down the that produce hallucinations. A the administration of a sufficient activity of certain chemicals. This drug hallucination is a false perception amount of a psychoactive substance belongs to a group called narcotic through one of the senses that makes a and which results in behavioural and/or analgesics or opioids. person see, hear or feel something that physical changes. The capacity to think is not there. HIV: Human immunodeficiency virus and act within a normal range of ability (HIV) is the blood borne virus that diminishes. Harm minimisation: A form of drug causes AIDS. HIV can be contracted prevention that acknowledges that Intravenous (IV): Within a vein. by having vaginal or anal intercourse abstinence is the most effective way with an infected person without using K to avoid harms related to drug use, a condom, by sharing needles and Kava: A drink prepared from the but that this is not always possible other equipment for injecting drugs roots of the shrub Piper methysticum, in certain individual circumstances. with an infected person, through widely used in the South Pacific both Minimising the adverse effects of drug blood transfusion with infected blood ceremonially and socially. It produces use to the individual and the community or during pregnancy and childbirth. mild euphoria and sedation. through supply reduction strategies, Transmission can be prevented by demand reduction strategies and harm Ketamine: An hallucinogenic practising safe sex (such as using reduction strategies. dissociative anaesthetic that is used condoms or dams), and not sharing in surgery and veterinary medicine. It Harm reduction: Aims to reduce the needles or injecting equipment. causes amnesia (memory loss) and impact of drug-related harm within Hypnotic: An agent that can induce analgesia (pain-relief). Low doses society, at the individual and community hypnosis or sleep. produce stimulant effects; medium to levels. It includes reducing the physical high doses produce possible out-of- and social harms associated with drug I body or near death experiences. use, encompassing the prevention Ice: Street name for crystalline of disease, death, incarceration and methamphetamine. It is a powerful, Khat: A stimulant derived from the isolation. synthetic stimulant drug that is leaves and buds of an East African plant, Catha edulis, which are chewed Harmful use: A pattern of use of more potent than other forms of or brewed as a beverage. psychoactive substances that causes amphetamines. It is more pure than damage to the health of the drug user the powder form of methamphetamine or family, financial, legal and other (‘speed’). personal problems. Reproduced with approval from the Australian Drug Foundation, © Australian Drug Foundation 2009. 100 Message stick
L tends to reduce desire to use heroin sometimes referred to as narcotic Licit drug: A legal drug. and other opiates, eliminates opioid analgesics. withdrawal and blocks the euphoric Another name for Needle exchange: Provision of Liquid ecstasy: effects of the other opioid drugs. GHB. needles to intravenous drug users to Methamphetamine: A stimulant drug, reduce the transmission of infectious Lysergic acid diethylamide (LSD) LSD: also called speed or amphetamine. diseases by the repeated use and is a hallucinogenic drug, which is Most commonly it is found as a sharing of needles. synthesised from ergot, a fungus that colourless crystalline solid, sold under a grows on rye and various other grains. Nicotine: The drug in tobacco smoke variety of names, such as crystal meth, that causes addiction. M crystal or ice. O Magic mushrooms: Fungi that contain Morphine: Major sedative and pain- psychedelic substances, such as relieving drug found in opium. Opiate: One of a group of alkaloids psilocybin or muscimol. derived from the opium poppy (Papaver Motivational interviewing: A somniferum) with the ability to induce Treating drug Maintenance therapy: counselling and assessment technique analgesia, euphoria and, in higher dependence by prescribing a substitute that follows a nonconfrontational doses, stupor, coma and respiratory drug (such as methadone) that is similar approach to questioning people about depression. The term opiate excludes to the drug of dependence. difficult issues like alcohol and other synthetic opioids such as heroin and Marijuana: The dried greenish-brown drug use and assisting them to make methadone. leaves or flowers of the cannabis plant. positive decisions to reduce or stop Opioid: The term applied to alkaloids Marijuana is the most common form of their drug use altogether. derived from the opium poppy cannabis and is smoked in hand-rolled N (Papaver somniferum) and synthetic cigarettes (joints) or in a pipe (a bong). Naloxone: Naloxone is a narcotic drugs that interact with the same Mentor: For the purpose of this antagonist that reverses the respiratory, specific receptors in the brain. These manual, a mentor is an experienced sedative and hypotensive effects of substances have the capacity to relieve Koori AOD worker from within the Koori heroin overdose. It can be injected pain and produce a sense of wellbeing AOD network intramuscularly, intravenously or (euphoria). Heroin, methadone, MDA: Methylenedioxyamphetamine subcutaneously. Sold in Australia under codeine, morphine and opium are (MDA) is an amphetamine similar to the trade name Narcan. opioids. ecstasy. It is more hallucinogenic than Naltrexone: A drug that antagonises Opium: The crude mixture obtained MDMA and its effects last almost twice the effects of opioid drugs. Its effects by the air drying of the juice that oozes as long. are similar to those of naloxone, but it is from incisions made in the ripened MDMA: more potent and has a longer duration seedpod capsule of the opium poppy, Methylenedioxymethamphetamine of action. It is prescribed to help people Papaver somniferum. It contains a (MDMA), also known as ‘ecstasy’, maintain abstinence after they have number of important alkaloids such as is a synthetic stimulant and has withdrawn (detoxified) from heroin or morphine, codeine and papaverine. hallucinogenic properties. other opioids. Outreach: A community based activity Methadone: A synthetic opiate often Narcotic drug: A chemical agent with the overall aim of facilitating used to treat heroin dependence. When that can induce stupor, coma, or improvement in health and reduction of given in an adequate dose to opioid insensibility to pain. The term usually drug-related risk or harm for individuals dependent individuals, methadone refers to opiates or opioids, which are and groups not effectively reached by
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existing services or through traditional have anabolic properties (the Psychedelic substance: Chemical health education channels. ability to increase muscle mass substance that alters mood or Overdose: When the amount of the and strength) and substances that behaviour by altering the functioning of drug taken exceeds the body’s ability to increase muscle definition through the brain. cope with the drug, resulting in stupor, ‘fat-burning’ properties. For example, Psychoactive substances: Drugs coma, respiratory depression, or death. anabolic steroids, growth hormones, that affect a person’s central nervous reproductive hormones. Over-the-counter drug: Drug that system; they alter brain activity, and can can be sold or administered without a Pharmaceutical drug: An over-the- change the way a person thinks, feels or prescription. May be misused for self- counter or prescription drug available behaves medication or psychoactive effects. through a pharmacy or supermarket. Psychosis: Any significant mental P Pharmacotherapy: The use of disorder, characterised by a loss of medications in responding to problem contact with reality. Party drug: A drug associated with drug dependence. Used to alleviate the ‘rave’ or ‘dance party’ scene. The Psychostimulants: A group of drugs withdrawal discomfort, as maintenance that produce euphoria, a sense of most notable of the ‘party drugs’ are substitution (for example, methadone) MDMA (ecstasy), amphetamine and wellbeing, wakefulness and alertness. or to reduce craving (for example, Prolonged use or high levels of use can LSD, although other substances such nicotine replacement therapy). as GHB, ketamine, cocaine and amyl produce behavioural disturbances. nitrate have also been associated with PMA: Paramethoxyamphetamine (PMA) R is a particularly toxic amphetamine, raves. Cells in the brain that often sold as ecstasy. Receptors: PCP: Phencyclidine (PCP) has both are sensitive to particular drugs; for hallucinogenic and dissociative Poly drug use: Occurs when two or example, the effects of heroin are properties. The dissociative effects of more drugs are used at the same time. experienced once the drug attaches PCP leaves users feeling removed from Potentiation: May occur when more itself to the opioid receptor in the brain. their body and their environment. This than one drug is used at the same time. Recreational drug use effect produces a trance-like state. PCP The joint drug actions are not merely Use of drugs for leisure, pleasure or also has strong anaesthetic effects, additive in effect, but may produce social reasons. Often used to refer to which produces amnesia (memory loss) a particularly intense and/or unique the use of ‘party drugs’. and analgesia (pain-relief). Also known action; also termed a synergistic effect. as ‘angel dust’. For example, the use of heroin after Relapse: A recurrence of harmful drug use after a period of improvement. Peer education: Programs that involve drinking alcohol greatly increases the Relapse is common among people who training same-age or same-background risk of a fatal overdose over that for are drug-dependent when they are people to educate a target group about either drug taken in isolation. attempting to stop drug use. issues relating to alcohol and other Protective factor: A factor that drug use. will reduce the probability of an Risk reduction: Policies or programs that focus on reducing the risk of harm Peer support: One of the components undesirable event occurring. This from alcohol or other drug use. of a peer outreach relationship whereby term is often used to indicate the the outreach worker provides some characteristics of individuals or their Rohypnol: A powerful benzodiazepine form of assistance to a peer. environment that reduce the likelihood that induces sleep. of experimentation with alcohol and Rush: Sudden onset of euphoria after Performance and image enhancing other drugs. drugs (PIED): Substances that injection of heroin or cocaine.
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S the aim of increasing strength and include stopping drug use, cutting down Screening for drug use: Testing a performance. or using with reduced risk. Treatment person in order to determine drug use. Stimulants: These drugs act to options include pharmacotherapies used as part of a maintenance program Depressant drug that acts stimulate certain chemicals in the brain. Sedative: (for example, methadone, counselling on the central nervous system to lessen They increase alertness, heart rate, and withdrawal). These treatments can anxiety and induce sleep. blood pressure and breathing rate. be conducted as part of an in-patient or Self-help group: Voluntary group Supply reduction: Policies or residential program, on an out-patient dedicated to recovery from substance programs usually involving law basis or home-based (withdrawal use dependence. enforcement agencies designed to program). reduce the manufacture and/or A neurotransmitter that Serotonin: distribution of illicit drugs. Tripping: Refers to the ‘hallucinogenic has a prominent role in sleep regulation experience’. and mood. It is affected by a number T Twelve-step program: Fellowships of psychoactive substances. Its THC: Delta-9-tetrahydrocannabinol that aim to aid in the recovery of synaptic concentration is increased (THC), the chemical in cannabis the consequences of an obsession, by stimulants; for example, ecstasy that produces depressant and dependence or a physical or mental (MDMA) and its release is inhibited by hallucinogenic effects in the user. compulsion. The first program was opioid receptors. Therapeutic community: A structured Alcoholics Anonymous (AA), which was Snorting: Ingesting powdered drugs environment in which individuals begun in 1935 by Bill Wilson and Dr through the nose. with drug-related problems live while Bob Smith. Requires members to place Social norms: The implicit or explicit undergoing rehabilitation. Such their faith in ‘a higher power’. Includes rules and expectations that guide social communities are often specifically Al-Anon, Alateen and Narcotics behaviour in a certain community or designed for drug-dependent people; Anonymous (NA). they operate under strict rules, are run social environment. U mainly by people who have recovered Volatile substances such as Solvents: from dependence and are often Urinalysis: Testing of urine for the petrol, glue and aerosols. geographically isolated. presence of drugs or drug metabolites. Speed: Another name for amphetamine Tobacco: Any preparation of the User group: Community-based or methamphetamine. dried leaves of Nicotiana tabacum organisations representing the interests Stages of change: Model developed or Nicotiana rustica. The main of people who use drugs. by Prochaska and DiClemente (1983) psychoactive ingredient is nicotine. V to describe the stages involved in Tolerance: Tolerance to a drug means Volatile substance: A substance that changing a behaviour or problem. that the body becomes used to a drug vaporises at ambient temperatures. Standard drink: A drink that contains being present and more of the drug Some volatile substances are inhaled 10 grams of pure alcohol. is required in order to achieve the for psychoactive effects (also called Steroid: One of a group of naturally same effect felt previously with smaller inhalants). Inhalant includes the organic occurring or synthetic hormones that amounts. solvents present in many domestic affect the chemical processes in the Tranquilliser: Prescription drugs used and industrial products (such as glue, body, growth and sexual and other for their calming effect. aerosol, paints, industrial solvents, physiological functions. Anabolic lacquer thinners, gasoline or petrol, and Treatment: Assisting people to address steroids are misused by athletes with cleaning fluids) and the aliphatic nitrites problems relating to their drug use. May such as amyl nitrite. Reproduced with approval from the Australian Drug Foundation, © Australian Drug Foundation 2009. Message stick 103
W Withdrawal: Withdrawal describes a set of symptoms that can occur when a user cuts down or stops the use of a particular drug. Withdrawal symptoms can range from mild to severe, and are different depending upon what drug it is the user is withdrawing from. Y Yarndi: A Koori term to describe cannabis. Please refer to cannabis. Z Zero tolerance: A term commonly associated with strict policing measures, based on the belief that activities associated with illegal drugs should not be tolerated at any level. This approach emphasises the law as the main method of dealing with drugs and drug issues.
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References
Australian Bureau of Statistics (ABS) 2001, Victorian Aboriginal population, ABS, Canberra. Australian Bureau of Statistics (ABS) 2004, Deaths Australia, ABS, Canberra. Australian Institute of Health and Welfare (AIHW) 2007, Statistics of drug use in Australia 2006 report, AIHW, Canberra. Department of Education and Early Childhood Development 2008, Dardee Boorai: Victorian Charter of Safety and Wellbeing for Aboriginal Children and Young People, State Government of Victoria, Melbourne. Department of Human Services 2005, Aboriginal services plan key indicators 2003-04, State Government of Victoria, Melbourne. Department of Human Services 2006, Building better partnerships – Working with Aboriginal communities and organisations: a communication guide for the Department of Human Services, State Government of Victoria, Melbourne. Yuruga Enterprises & Stephen Kerr and Associates 2003, The Purro Birik social and emotional wellbeing strategy 1999-2002 (Indigenous mental health services) evaluation report, Prepared For the Victorian Aboriginal Community Controlled Health Organisations Incorporated and the Victorian Department of Human Services Mental Health Branch.