Psychosis and substance use
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Transcript of Psychosis and substance use
Contents:Who is this booklet for and What does it do? 1
What is psychosis? 1
What is substance-induced psychosis? 2
What are psychotic disorders? 3
hoW common is psychosis? 4
What causes psychosis? 4
psychosis and substance use 4
When should i seek help? 6
hoW are psychotic symptoms treated? 6
tips for staying Well 7
techniques for staying Well 9
Where to get help 15
About this booklet:this booklet is part of a series on mental health and substance use funded by the australian government department of health and ageing.
substance use in this booklet refers to the use of alcohol, tobacco and other drugs.
Other booklets in this series include:• TraumaandSubstanceUse• MoodandSubstanceUse• AnxietyandSubstanceUse• PersonalityandSubstanceUse
Available at www.ndarc.med.unsw.edu.au
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Who is this booklet for And WhAt does it do?• Thisbooklethasbeenwrittenforpeoplewhousealcohol,tobaccoorotherdrugs
whoareexperiencingsymptomsofpsychosis.• Itaimsto:
—Helpexplainwhysomepeoplefeelthewaytheydo.—Givesuggestionsaboutthingspeoplecandotohelpmanagethesymptoms
ofpsychosisandsubstanceuse.
WhAt is psyChosis?• Psychosisisacollectionofsymptomsthatoccurtogetheroveraperiodoftime.The
mostprominentsymptomsofpsychosisaredelusionsandhallucinationswhereapersonlosestouchwithreality,andhastroubletellingthedifferencebetweenwhatisrealandwhatisnot.Psychosiscanaffectthewayapersonthinks,feelsandbehaves(seeTable1).
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WhAt is substAnCe-induCed psyChosis?• Substance-inducedpsychosisisaformofpsychosisbroughtonbyalcoholorother
druguse.Itcanalsooccurwhenapersoniswithdrawingfromalcoholorotherdrugs.• Themostcommonsymptomsincludevisualhallucinations,disorientationand
memoryproblems.• Symptomsusuallyappearquicklyandresolvewithindaystoweeks.However,the
personmayhaveanotherpsychoticepisodeinthefutureiftheyusethatdrugagain.• Whilesubstance-inducedpsychosisistypicallybrief,alcoholorotherdrugusecan
triggertheonsetoflonger-lastingpsychoticdisordersinindividualswhoarepredisposedtodevelopingthem.
table 1. Symptoms of psychosis
Psychosiscanaffectthewayyoufeelemotionallyandphysically,thewayyouthink,andthewayyoubehave.Thistableshowssomecommonsymptomsofpsychosis.Have you experienced any of these symptoms? Tick (4) the box next to the symptoms that you have experienced.
thoughts
Jumbledordisorganisedthoughts Delusions—falsebeliefsthatusuallyinvolveamisinterpretationofperceptions
orexperiences(e.g.,thinkingthatsomeoneisouttogetyou,thatyouhavespecialpowers,orthatpassagesfromthenewspaperhavespecialmeaningforyou)
Hallucinations—seeing,hearing,smelling,sensingortastingthingsthatotherscannot
feelings
Confusion Fear Agitation Lackofinterestinactivities
behaviours
Difficultycarryingonorkeepingtrackofconversations Havingtroublerememberingthings Difficultymaintaininghygieneandotherdailyactivities Inappropriatebehaviour(e.g.,silliness,laughinginappropriately) Becomingangryorupsetfornoparticularreason Becomingveryinactiveorlethargic Becomingcompletelyunawareofthesurroundingenvironment
WhAt Are psyChotiC disorders?• Thereareseveraldifferenttypesofpsychoticdisorders(seeTable2).Psychoticdisorders
arecharacterisedbasedonthetypeofsymptomsexperiencedandhowlongthepersonhashadthem.Somepeopleexperienceshortepisodesofpsychosisthatlastafewdaysorweeks.Others,suchasthosewithschizophrenia,experiencelongerepisodesofpsychosis.
• Psychoticsymptomsmayalsobepresentinpeoplewithmajordepressivedisorderorbipolardisorder.ForfurtherinformationontheseconditionspleaseseethebookletMood and Substance Useinthisseries.Psychoticsymptomsmayalsoarisefromamedicalcondition(e.g.,headinjury,braintumour).
table 2. Types of psychotic disorders
brief psychotic disorder
Apersonwithbriefpsychoticdisorderexperiencespsychoticsymptomsforlessthanonemonth.Symptomsareusuallytriggeredbyanextremelystressfulevent(e.g.,deathofalovedone).
schizophreniform disorder
Thisiswhenapersonhassymptomssimilartoschizophrenia,thatlastmorethanonemonth,butlessthansixmonths.
schizophrenia
Adiagnosisofschizophreniaisgivenwhenapersonhashadsymptomsofpsychosisforatleastsixmonths.Themajorsymptomsofschizophreniaincludedelusions,hallucinationsandjumbledthoughts.Apersonwithschizophreniamightalsohavethinkingdifficulties(e.g.,troubleconcentratingandrememberingthingsmuchmorethanusual);theymightexperiencelossofmotivationtoperformeverydayactivities;theycouldhaveasignificantreductionintheirabilitytoexperienceandexpressemotions;andtheymightwithdrawfromsocialsettingsandpersonalrelationships.
schizoaffective disorder
Apersonwithschizoaffectivedisorderexperiencesthesymptomsofschizophreniaaswellasthesymptomsofamooddisorder,suchasdepressionormania.Formoreinformationonmooddisorders,seethebookletMood and Substance Use.
delusional disorder
Apersonwithdelusionaldisorderhasstrongbeliefsaboutthingsthatcouldoccurinreallifebutwhicharenottrue.Forexample,theymightthinkthatpeoplearefollowingthem,orarelisteningintotheirphonecalls.Thesebeliefsneedtobepresentforatleastonemonth.
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hoW Common is psyChosis? • Psychosisisnotuncommon—aboutthreeinonehundredAustralianswillexperience
apsychoticepisodeatsomepointduringtheirlife.Peoplewithpsychosisaremuchmorelikelytohaveanalcohol,tobaccoorotherdrugproblemthanpeoplewhodonotexperiencepsychosis.
WhAt CAuses psyChosis?• Thecausesofpsychosisarenotfullyunderstood.However,itislikelythatacombination
offactorsleadtothedevelopmentofpsychosisorpsychoticdisorders,including:—Afamilyhistoryofpsychosisorpsychoticdisorders—Chemicalimbalancesinthebrain—Lifeexperiences(e.g.,stress,traumaticevents,illness)—Alcoholorotherdruguse
psyChosis And substAnCe use• Asmentionedinthesectionofthisbookletonsubstance-inducedpsychosis,alcohol
orotherdruguse(orwithdrawal)cantriggerapsychoticepisode.• Peoplewhohaveexperiencedasubstance-inducedpsychoticepisodeareathighrisk
ofexperiencinganotherpsychoticepisodeinthefutureiftheyusethatdrugagain.• Peoplewhohaveexperiencedpsychosistendtobeparticularlysensitivetotheeffects
ofdrugsandcanexperiencenegativeeffectsevenatverylowlevelsofuse.• Sometimespeoplewithpsychoticdisordersuse
alcoholorotherdrugstohelpthemcopewiththeirsymptomsofpsychosis.Thisisoftencalled‘selfmedication’.Whilethismayprovidesomeshort-termrelieffromsymptoms,alcoholandotherdrugusecanmakeaperson’sexistingsymptomsworse.Inaddition,somepeoplefindthattheydevelopalcoholorotherdrugproblemsbecausetheyusegreateramountsmorefrequentlytocopewiththeirpsychosis.
• Thiscanleadtoacyclewherepsychosissymptomsandalcoholorotherdrugusefeedoffeachother(seeFigure1).
Figure 1:Cycleofpsychosissymptoms,cravings,andalcohol,tobaccoorotherdruguse
Alcohol, tobacco or other drug use
Psychosis symptoms, low mood or anxiety
Craving
What happens to your symptoms of psychosis when you reduce or stop drinking, smoking or using? do you notice any changes?
What happens to your alcohol, tobacco or other drug use when you are experiencing symptoms of psychosis?
Aside from using alcohol, tobacco or other drugs, what are some other things you can do to distract yourself from your symptoms of psychosis (e.g., going for a walk, listening to music, reading a book, watching tV and so on)? Are there situations where your psychotic symptoms don’t seem so bad?
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Alcohol, tobacco or other drug use
Psychosis symptoms, low mood or anxiety
Craving
When should i seek help?• Earlyinterventionisveryimportantinthetreatmentofpsychosis.Thesooneraperson
getstreatment,thelesslikelytheyaretodevelopalong-termpsychoticdisorder.• Ifyoubelievepsychosismaybeaproblemforyou,orifyouansweryestoanyofthe
followingquestions,youshouldseekprofessionalassistance(seepages15–16): Haveyouexperiencedhallucinationsordelusions? Areyoursymptomsverydistressing? Dotheyinterferewithyourhome,work,study,relationshipsorsociallife? Doyouusealcohol,tobaccoorotherdrugstocope? Haveyouthoughtaboutharmingyourselforothers?
hoW Are psyChotiC symptoms treAted?• Effectivetreatmentsareavailable.Bothpsychologicaltherapyandmedicationcanhelp
peopleaffectedbypsychosis.
psychological therapy• Psychologicaltreatmentsusuallyinvolvehands-onsupportandguidancewhichisaimed
atteachingyouabouttheearlywarningsignsofpsychosis.Treatmentsarealsoaimedatstressmanagementandanxiety,relaxationtraining,employmentprograms,socialandlivingskillstrainingandfamilyeducation,aswellasdrugandalcoholprograms.Thesetreatmentswillalsoencourageyoutokeephealthyandgetplentyofexercise.
• Ifyou’reinterestedinseeingapsychologist,yourGPcanhelpyoubypreparingamentalhealthplan,andreferringyoutoanappropriatepsychologist.
medication• Medicationmaybehelpfulalongsidepsychologicaltherapy.Therearemanydifferent
typesofmedication,whichincludeanti-psychoticandanti-depressantmedications.• Medicationscanbehelpfulinmanagingyourpsychoticsymptoms;however,somepeople
experienceunpleasantanddistressingsideeffects.Inmostinstancesthereisachoiceofmedicationavailable,butitmaytaketimetoestablishwhichmedicationisbestsuitedtoyourneeds.Tellyourdoctoraboutanysideeffectsthataredistressingyou.
interactions with alcohol, tobacco or other drugs
• Itisveryimportantthatyoufollowyourdoctor’sinstructionswhentakinganymedicationthathasbeenprescribedtoyou.
• Beforebeingprescribedmedicationitisimportanttotellyourdoctoraboutyouralcoholorotherdrugusesothattheymaygiveyouthebestpossiblecare.Alcohol,tobaccoandotherdrugscaninteractwithsomeprescriptionmedicationsandthisinteractionmayalterthe
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effectivenessofthemedication.Mixingprescribedmedicationswithalcoholorotherdrugscanalsohavedangerousconsequencesincludingoverdoseandpossiblydeath.
• Ifyouusealcohol,tobaccoorotherdrugsandareonmedication,letyourdoctorknowifyouareplanningtostopusingalcohol,tobaccoorotherdrugs.Whenyoustopdrinking,smokingorusing,thebloodconcentrationsofothermedicationscanalsobeaffectedsothedoctormayneedtoadjustthedoseofyourmedication.
tips for stAying WellThereareanumberofthingsyoucandotolookafteryourself:• Recognise early warning signs. Earlywarningsignsofpsychosisincludenotsleeping
well,feelingmoreanxious,stressedorfearfulthanusual,hearingorseeingthings,andfeeling‘strange’.Ifyouexperiencethesesymptoms,itisimportantthatyouseekprofessionalhelptoreducetheriskofdevelopinglong-termpsychosis.
• Take care of yourself.Makesureyoueathealthilyandgetregularexercise.Exercisecanhelpbygivingyouanoutletforthestressthathasbuiltupinyourbody.
• Plan to do something you enjoy each day.Thisdoesn’thavetobesomethingbigorexpensiveaslongasitisenjoyableandprovidessomethingtolookforwardtothatwilltakeyourmindoffyourworries.
What are some things that you like to do that are pleasant or enjoyable?
• Make time for rest and relaxation.Stressandanxietycanmakeanyproblemsseemworse.Trytoreducestressandanxietybygivingyourselftimetorestandrelax.Youcanusetechniquessuchascontrolled breathing, progressive muscle relaxation,ormindfulness(thesetechniquesaredescribedonpages9–12),oranyotheractivityyoufindrelaxing(e.g.,reading,listeningtomusic,goingforawalk).Thesetechniquescanalsohelpyoumanageyourcravingsorurgestousealcohol,tobaccoorotherdrugs.
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• Avoid or limit your use of alcohol, tobacco or other drugs.Alcohol,tobaccoandotherdrugscanintensifyyourpsychoticsymptoms.Itisrecommendedthatnomorethantwostandarddrinksshouldbeconsumedeachday(forfurtherinformationrefertotheAustralianDrinkingGuidelines).Avoidhighdosesofsubstances,andriskydrugtakingbehaviour,suchasinjectingdruguse.Takeregularbreaksfromdrinkingorusing,andavoidusingmultipledifferenttypesofdrugs.Ifyouhavebeendrinking,smokingorusingregularlyitcanbedifficulttocutdown.Theactivitieslistedonpages9–14ofthisbookletmayhelpyoucopewithyourcravingsandurgestouse.
• Take medication as prescribed.Avoidmixingprescribedmedicationwithalcohol,tobaccoorotherdrugs,asthiscouldhavedangerousconsequences,suchasmakingprescribedmedicationineffective,orincreasingtheeffectsofalcoholorotherdrugs.
• Seek support.Everybodyneedssupport.Talktofamilymembersorfriendsthatyoutrustaboutyourfeelings,orwritethemdowninadiary.Theserviceslistedattheendofthisbookletmayalsobeuseful.
• Plan to do something each day that brings a sense of achievement.Ofteneverydaytaskslikewashing,cleaning,payingbillsorreturningphonecalls,tendtopileupwhenapersonisgoingthroughahardtime.Thiscanbecomeoverwhelmingasthepilegetsbiggerandbigger.Byjustchoosingoneoftheseactivitiestodoeachday,youcanpreventthingspilingup,whichcanhelpyoufeelabitmoreincontrolofyourlife.Theflow-oneffectcanbearealsenseofachievement(orrelief)thatthisactivityhasbeencompleted.
• Monitor your emotions.Trykeepingtrackofyouremotionsandpsychosissymptomsinadiary.Writedownhowyouhavefeltatdifferenttimesoftheday.Whenwereyoursymptomshighest?Whenwereyoursymptomslowest?Whatwereyoudoingandwhatwereyouthinkingatthosetimes?Whendidyouhavecravingstousealcohol,tobaccoorothersubstances?Howmuchsleepdidyouhaveeachnight?Keepingadiaryofyoursymptomsandemotionscanhelpyoulearnthepatternsbetweenthewayyoufeel,thethingsyoudoandthewayyouthink.
What strategies do you find help manage your psychotic symptoms?
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teChniques for stAying Well Theactivitiesandtechniquesonthefollowingpagescanbeusedtohelpyoumanageyourpsychoticsymptomsandtocontrolcravingstousealcohol,tobaccoandotherdrugs.Youcanalsousethemeverydayaspartofageneralplantostaywell.Whilemanypeoplefindthetechniquesonthefollowingpagesuseful,theydon’tworkforeveryone.Donotusethemifyoufindthemdistressingorunpleasant—itisimportanttofindwhatworksbestforyou.
Controlled breathing exerciseHaveyounoticedsometimesthatyou’rebreathingtoofast?Stresscanaffectyourheartrateandbreathingpatterns.
Arelaxedbreathingrateisusually10to12breathsperminute.
Practisethisexercisethreetofourtimesadaywhenyou’refeelingstressedoranxioussothatyoucanusethisasashort-termcopingstrategy.
1 Timethenumberofbreathsyoutakeinoneminute.Breathingin,thenoutiscountedasonebreath.
2 Breathein,holdyourbreathandcounttofive.Thenbreatheoutandsaytheword‘relax’toyourselfinacalm,soothingmanner.
3 Startbreathinginthroughyournoseandoutslowlythroughyourmouth,inasix-secondcycle.Breatheinforthreesecondsandoutforthreeseconds.Thiswillproduceabreathingrateof10breathsperminute.Inthebeginning,itcanbehelpfultotimeyourbreathingusingthesecondhandofawatchorclock.
4 Counttoyourself.
5 Continuebreathinginasix-secondcycleforatleastfiveminutesoruntilthesymptomsofoverbreathinghavesettled.
6 Afterpractisingthisexercise,timethenumberofbreathsyoutakeinoneminute.Practisethecontrolledbreathingexerciseeachdaybeforebreakfast,lunch,dinnerandbedtime.Usethetechniquewheneveryoufeelanxious.Gradually,you’llbefamiliarenoughwiththeexercisetostoptimingyourself.
Source:beyondblueFactSheet6–ReducingStress2010
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mindfulnessMindfulnessisatechniquethathelpsyoufocusonyourinternalorexternalenvironment,withoutbeingdistractedorconcernedbywhatsurroundsyou.Mindfulnesscanbeappliedtoanytaskthatyoudo,suchasdoingthewashingup,orbrushingyourteethforexample.Thisparticularactivityistoshowyouhowtousemindfulnessskillstopayparticularattentiontoaroutineactivity(walking).Thistechniquemightseemdifficulttostartwith,butifyoupractise,itwillbecomeeasier.
1 First,findaplacewhereyoucanwalkupanddownwithoutworryingaboutwhomightseeyou.Itdoesn’tmatterwhereyouare,aslongasyoucantakeabout10steps.
2 Standinarelaxedposturewithyourfeetpointingstraightaheadandyourarmshanginglooselybyyoursides.Lookstraightahead.
3 Youwillpractisewalkinglikeitisthefirsttimeyouhaveeverwalked.Startwalkingandwhileyouarewalking,practisepayingattentiontoallthephysicalandothersensationsthatoccur—sensationsthatyouprobablywouldnotnormallybeawareof.Startbybringingyourfocustothebottomsofyourfeet,noticingwhatitfeelslikewhereyourfeetcontacttheground.Feeltheweightofyourbodytransmittedthroughyourlegsandfeettotheground.Youmayliketoflexyourkneesslightlyacoupleoftimestofeelthedifferentsensationsinyourfeetandlegs.
4 Next,transferyourweightontotherightfoot,noticingthechangeinphysicalsensationsandyourlegsandfeetasyourleftleg‘empties’ofweightandpressureandyourrightlegtakesoverassupportforyourbody.
5 Withtheleftleg‘empty’,allowyourleftheeltoriseslowlyfromthefloor,noticingthechangeinsensationsinyourcalfmusclesasthishappens.Allowtheentireleftfoottoliftgentlyofftheflooruntilonlyyourtoesarestillincontactwiththeground.Slowlyliftyourleftfootcompletelyoffthefloorandmoveyourleftlegforward,noticingthephysicalsensationsinyourfeet,legsandbodychangeasyourlegmovesthroughtheair.
6 Placeyourleftheelonthegroundinfrontofyouandallowtherestofyourleftfoottomakecontactwiththefloor.Asthishappens,noticethechangesinphysicalsensationsthatoccurasyoutransfertheweightofyourbodyontoyourleftfootfromyourrightfoot.Allowyourrightfootto‘empty’ofweight.
7 Repeatthisprocesswiththerightfoot.Firstliftyourrightheelofftheground,thentherestofyourfoot,andmoveitslowlyforward,noticingthechangesinphysicalsensationsthatoccurthroughoutthismotion.
8 Keeprepeatingthisprocessasyouslowlymovefromoneendofyourwalktotheother,beingawareoftheparticularsensationsinthebottomsofyourfeetandheelsastheymakecontactwiththefloor,andthemusclesinyourlegsastheyswingforward.
9 Continuethisprocessupanddownthelengthofyourwalkforabout10minutes,beingawareasbestyoucan.
10 Yourmindwillwanderawayfromthisactivityduringyour10minutesofpractice.Thisisnormal—it’swhatmindsdo.Whenyounoticethishashappened,gentlyguidethefocusofyourattentionbacktothesensationsinyourfeetandlegs,payingparticularattentiontothecontactyourfeethavewiththefloor.Thiswillhelpyoustayinthepresentmoment,concentratingonwhatishappeningnow,ratherthanworryingaboutthepastorthefuture.
11 Tobeginwith,walkmoreslowlythanusual,togiveyouabetteropportunitytopractisethisexercise.Onceyoufeelcomfortablewiththeexercise,youmayliketoexperimentwithdifferentspeedsofwalking.Ifyouarefeelingagitated,youmayliketostartoffwalkingfast,withawarenessthatthisiswhatyouaredoing,andthenslowdownnaturallyasyoubegintosettle.
12 Trytoworkthisactivityintoyourdailyroutine—practisewhenyouarewalkingtothebus,ortotheshops,oraroundthehouse.
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progressive muscle relaxationProgressivemusclerelaxationinvolvestensingandrelaxingdifferentmusclegroupsoneaftertheother.Ithelpstoreducephysicalandmentaltension.Afullsessionofrelaxationtakesabout15to20minutes.
1 Sitinacomfortablechairinaquietroom.
2 Putyourfeetflatonthefloorandrestyourhandsinyourlap.
3 Closeyoureyes.
4 Dothecontrolledbreathingexerciseforthreeminutes.
5 Afterthreeminutesofcontrolledbreathing,startthemusclerelaxationexercisebelow.
6 Tenseeachofyourmusclegroupsfor10seconds,thenrelaxfor10seconds,inthefollowingorder:» Hands:clenchyourhandsintofists,thenrelax» Lower arms:bendyourhandsupatthewrists,thenrelax» Upper arms:bendyourarmsupattheelbow,thenrelax» Shoulders: liftyourshouldersup,thenrelax» Neck:stretchyourneckgentlytotheleft,thenforward,thentotheright,
thenbackwardsinaslowrollingmotion,thenrelax» Forehead and scalp: raiseyoureyebrows,thenrelax» Eyes:closeyoureyestightly,thenrelax» Jaw: clenchyourteeth,thenrelax» Chest:breatheindeeply,thenbreatheoutandrelax» Stomach:pullyourtummyin,thenrelax» Upper back:pullyourshouldersforward,thenrelax» Lower back:whilesitting,rollyourbackintoasmootharc,thenrelax» Buttocks:tightenyourbuttocks,thenrelax» Thighs:pushyourfeetfirmlyintothefloor,thenrelax» Calves:liftyourtoesofftheground,thenrelaxand» Feet:gentlycurlyourtoesdown,thenrelax
7 Continuecontrolledbreathingforfivemoreminutes,enjoyingthefeelingofrelaxation.
Source:beyondblueFactSheet6–ReducingStress2010
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Coping with CravingsTheeasiestwaytocopewithcravingsorurgestousealcohol,tobaccoorotherdrugsistotry to avoidtheminthefirstplace.Thiscanbedonebyreducingyourexposuretocravingtriggers(e.g.,gettingridofdrugsandfits/pipesinthehouse,notgoingtopartiesorbars,reducingcontactwithfriendswhouse,andsoon).Sometimescravingscan’tbeavoided,andyouneedtofindwaystocopewiththem.
Cravingsaretime-limited,thatis,theyusuallylastonlyafewminutesandatmostafewhours.Ratherthanincreasingsteadilyuntiltheybecomeunbearable,theyusuallypeakafterafewminutesandthendiedown,likeawave.Everywave/cravingstartssmall,andbuildsuptoitshighestpoint,beforebreakingandflowingaway.
Cravingswilloccurlessoftenandfeellessstrongasyoulearnhowtocopewiththem.Eachtimeapersondoessomethingotherthanuseinresponsetoacraving,thecravingwilllosesomeofitspower.Thepeakofthecravingwavewillbecomesmaller,andthewaveswillbefurtherapart.
Below are some things for you to try out, to cope with the symptoms of cravings. Put a tick (4) in the box next to those things you think you could do.
Eat regularly,evenwhenyoudon’tfeellikeit.
Drink plenty of water—especiallywhenyougetacraving.
Insteadofdrinking,smokingorusing,drink water or chew gum.
Use‘Delaying’and‘Distraction’whenyourcravingissetoff.Whenyouexperienceacraving,putoffthedecisiontodrinkorusefor15minutes.Goanddosomethingelselikegoforawalk,read,listentomusic,ordothedishesetc.Thiswillhelpyoutobreakthehabitofimmediatelyreachingforalcohol,tobaccoorotherdrugswhenacravinghits.Youwillfindthatonceyouareinterestedinsomethingelse,thecravingwillgoaway.
What are some things you could do to distract yourself?
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Usetherelaxationanddeep breathingtechniquesdescribedearliertocopewithacravingonceitissetoff.Ifacravingdevelopsinresponsetostressfulsituations,relaxationtechniquesanddeepbreathingexercisesarereallyuseful.
Ride out the craving by ‘urge surfing’.Formapictureinyourmindofawaveatthebeach.Thisisacravingwave,andrememberthatthecravingwavewillbuilduptoitshighestpoint,andthenfallawayasitrollsintoshore.Picturethecravingwavebuildingup,gettingreadytobreak,seeitbreak,seethefoamform,andseethewavefadeawayasitrollsintoshore.Now,pictureyourselfridingthewave,surfingthecravingwaveintoshore.Youdon’tfalloff,youdon’tgetdumpedandchurnedaround,justpictureyourselfcalmlysurfingthecravingwaveintoshore.
Talk to someone,perhapsafriendorfamilymember,aboutcravingwhenitoccurs.
Use positive self-talk.Tellyourselfthatcravingsonlylastabout10minutes.Tellyourself‘thisfeelingwillpass’.Youwillfindthattheurgesandcravingsthemselveswillbeeasiertodealwith.Saytoyourself,‘yes,thisfeelsprettybad,butIknowitwillbeoversoon’.
Challenge and change your thoughts.Whenexperiencingacraving,manypeoplehaveatendencytorememberonlythepositiveeffectsofusingdrugsandoftenforgetthenegativeconsequencesofusing.Remindyourselfofthebenefitsofnotusingandthenegativeconsequencesofusing.Thisway,youcanremindyourselfthatyoureallydon’tfeelbetterifyouhave‘justonedrink’andthatyoustandtolosealotbydrinking,smokingorusing.Are there other things you do that help you cope with cravings?
Coping with Cravings continued
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Where to get helpThebestplacetostartistosee a doctor.Theycanprovideyouwithfurtherinformationandareferraltoanappropriatehealthprofessional.Theorganisationsbelowmayalsobeuseful.
Talkingwithtrustedfamily members or friendscanalsobeveryhelpful.Yoursupportnetworkcanassistyouinmakingdecisions,helpyouaccessservices,andgiveyouvitalsupportthroughyourrecovery.national
FamilyDrugSupport: 1300 368 186Lifeline: 13 11 14Quitline: 13 78 48SANEHelpline: 1800 187 263ACt:
Alcohol&DrugInformationService: (02) 6207 9977CanberraAllianceforHarmMinimisationandAdvocacy: (02) 6279 1670nsW:
Alcohol&DrugInformationService: (02) 9361 8000or1800 442 599NSWUsersandAIDSAssociation: (02) 8354 7300or1800 644 413nt:
Alcohol&DrugInformationService: (08) 8922 8399or1800 131 350NorthernTerritoryAIDS&HepatitisCouncil: (08) 8953 3172qld:
Alcohol&DrugInformationService: (07) 3236 2414or1800 177 833QLDInjectorsHealthNetwork: (07) 3620 8111or 1800 172 076QueenslandIntravenousAIDSAssociation: (07) 3620 8111sA:
Alcohol&DrugInformationService: 1300 131 340SouthAustralianVoiceinIVEducation: (08) 8334 1699tAs:
Alcohol&DrugInformationService: (03) 6230 7901or1800 811 994TasmanianCouncilonAIDS,Hepatitis&RelatedDiseases: (03) 6234 1242
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ViC:
Alcohol&DrugInformationService: (03) 9416 1818or1800 888 236HarmReductionVictoria: (03) 9329 1500VictorianDrugUsersGroup: (03) 9329 1500WA:
Alcohol&DrugInformationService: (08) 9442 5000or1800 198 024WesternAustraliaSubstanceUsersAssociation: (08) 9321 2877
Therearealsosomehelpful websiteswhichgiveinformationandguidance.Herearesome:
AustralianCentreforPosttraumaticMentalHealth: www.acpmh.unimelb.edu.auAustralianDrinkingGuidelines: www.alcohol.gov.auAustralianDrugInformationNetwork: www.adin.com.auBeyondblue: www.beyondblue.org.auBlackDogInstitute: www.blackdoginstitute.org.auClinicalResearchUnitforAnxietyandDepression: www.crufad.unsw.edu.auDruginformationandadvice: www.saveamate.org.auDruginformationandresearch: www.druginfo.adf.org.auDruginformation,services,informationandsharedstories: www.somazone.com.auDualDiagnosis:AustraliaandNewZealand: www.dualdiagnosis.org.auEarlyPsychosisPreventionandInterventionCentre: www.eppic.org.auFamilyDrugSupport: www.fds.org.auHeadspace: www.headspace.org.auHIV,sexualheathanddruginformationforlesbian,gay,bisexualandtransgendercommunities: www.acon.com.auMentalHealthNet: www.mentalhelp.netMentalIllnessFellowship: www.mifa.org.auQuitnow: www.quitnow.info.auReachOut!: www.reachout.com.auSANE: www.sane.orgSchizophreniaFellowship: www.sfnsw.org.auSchizophreniaResearchInstitute: www.happinessanditscauses.com.au
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©NationalDrugandAlcoholResearchCentre2011
ThisbookletwasproducedbytheNationalDrugandAlcoholResearchCentre.ItwaswrittenbyKatherineMills,ChristinaMarel,AmandaBaker,MareeTeesson,GlenysDore,FrancesKay-Lambkin,LeonieMannsandTonyTrimingham.Thankyoutoeveryonewhowasinvolvedindevelopingthisbooklet.
DesignedandtypesetbyPetaNugent
ISBN978-0-7334-3049-7
ThisbookletispartofaseriesonmentalhealthandsubstanceusefundedbytheAustralianGovernmentDepartmentofHealthandAgeing.
Thisbooklethasbeenwrittenforpeoplewhousealcohol,tobaccoorotherdrugswhoareexperiencingsymptomsofpsychosis.
Itaimsto:• Helpexplainwhysomepeoplefeelthewaytheydo.• Givesuggestionsaboutthingspeoplecandotohelpmanage
theirsymptomsofpsychosisandsubstanceuse.
Otherbookletsinthisseriesandfurtherinformationonmentalhealthandsubstanceuseareavailableatwww.ndarc.med.unsw.edu.au