GHB Factshttp://www.druginfo.adf.org.au/drug-facts/ghbhttp://www.druginfo.adf.org.au/images/GHB-25may16.pdfPlease note: The information given on this page is not medical advice and should not be relied on in this way. Individuals wanting medical advice on this issue should consult a health professional.

What is GHB?GHB (gamma hydroxybutyrate) is a depressant drug that slows down the messages travelling between the brain and body1.  

GBL (gamma butyrolactone) and 1,4-BD (1,4-butanediol) are chemicals that are closely related to GHB. Once GBL or 1,4-BD enter the body, they convert to GHB almost immediately.2

GHB usually comes as a colourless, odourless, bitter or salty liquid, which is usually sold in small bottles or vials. It can also come as a bright blue liquid known as 'blue nitro', and less commonly as a crystal powder.2

Other names

G, fantasy, grievous bodily harm (GBH), juice, liquid ecstasy, liquid E, liquid X, Georgia Home Boy, soap, scoop, cherry meth, blue nitro, fishies.

How is it used?

GHB is usually swallowed, but sometimes it's injected or inserted anally3,4.

Effects of GHBThere is no safe level of drug use. Use of any drug always carries some risk. It's important to be careful when taking any type of drug.

GHB affects everyone differently, based on:

The amount taken The strength of the drug (varies from batch to batch) Size, weight and health Whether the person is used to taking it Whether other drugs are taken around the same time

The following effects may begin within 15 to 20 minutes of taking GHB and may last for around 3 to 4 hours:

Feelings of euphoria Increased sex drive Lowered inhibitions Memory lapses Drowsiness

Clumsiness Dizziness or headache Lowered temperature, heart rate Tremors Nausea Diarrhoea Urinary incontinence2

The chemical composition of GHB is highly variable. It's very easy to take too much GHB: the difference between the amount needed to get high and the amount that causes an overdose can be hard to judge.

Symptoms of a GHB overdose include:

Vomiting Sweating Irregular or shallow breathing Confusion, irritation and agitation Hallucinations Blackouts and memory loss Unconsciousness that can last for 3 to 4 hours Seizures Death3

Long-term effects

Little is known about the long-term effects of GHB use. However, it is known that regular use can lead to tolerance and dependence, which means larger amounts of GHB are needed to get the same effect.

Using GHB with other drugs 

GHB + alcohol or benzodiazepines: chance of overdose is greatly increased. GHB + amphetamines or ecstasy: enormous strain on the body and risk of seizures5.

Using GHB to help with the symptoms of the 'comedown' after using stimulants can lead to a cycle of dependence on both drugs.

WithdrawalGiving up GHB after using it for a long time is challenging because the body has to get used to functioning without it. This is why it's important to speak to a health professional when planning to stop using GHB.

Withdrawal symptoms usually start about 12 hours after the last dose and can continue for about 15 days.

These symptoms can include:

Confusion and agitation Anxiety and panic

Feelings of doom and paranoia Restless sleep Muscle cramps and tremors Sweating  Hallucinations Fast heartbeat3

Sudden withdrawal from high doses can result in bowel and bladder incontinence and blackouts7.

Information about withdrawal

Further informationStatistics

Statistics on GHB

Reducing the risks

Pregnancy, alcohol and other drugs Driving Workplace Coping with a family member or friend with a problem Why do people use alcohol and other drugs? The Other Talk – Advice for parents Addressing problems in your community The law Treatment Help and support Overdose National drug policy

Resources

GHB pamphlet Free handouts and online resources Prevention Research SMS service: Get the effects by text

ADF SEARCH – Find further credible research and information on GHB.  ADIN – Find other credible websites and apps on GHB.

References

1. Julien, R., Advokat, C., & Comaty, J. (eds.). (2011). A primer of drug action (12th ed.). New York: Worth Publishing.

2. DrugWise. (n.d.) GHB/GBL/1,4-BD.

3. Hillebrand, J., Olszewski, D. & Sedefov, R. (2008). GHB and its precusor GBL: An emerging trend case study.

4. Dore, G. (2009). How to treat party drugs. 

5. Miotto, K., Roth, B. (2001) Emerging trends in GHB withdrawal syndrome, detoxification.

6. Galanter, M. & Kleber, H. (Eds.). (2008). The American Psychiatric Publishing textbook of substance abuse treatment (4th ed.). Washington, DC: American Psychiatric Publishing, Inc.

7. Galloway, G., Frederick, S., Staggers, F., Gonzales, M., Stalcup, S. & Smith, D. (1997). Gamma-hydroxybutyrate: an emerging drug of abuse that causes physical dependence, Addiction, 92(1) 89–96. Retrieved from Wiley Online Library.

Information about Withdrawalhttp://www.druginfo.adf.org.au/treatment-options/withdrawalhttp://www.druginfo.adf.org.au/attachments/328_Withdrawal_factsheet__290414.pdf

What is withdrawal?

Withdrawal or detoxification (also called detox) is the process of cutting back, or cutting out, the use of alcohol or other drugs. Withdrawal symptoms can range from mild to severe, and differ depending on the duration of use, type of drug, age, the person’s physical and psychological characteristics and the method of withdrawal. A person could develop physical or psychological dependence on a drug, or both.

Physical dependencePhysical dependence occurs when someone has taken a drug for a period of time and comes to rely on it, because if it’s not taken withdrawal symptoms will appear. 

Psychological dependencePsychological dependence occurs when a person believes they need the drug to function. This could be in certain situations, such as at a party, or it could be all the time.

What can I expect from withdrawal?Withdrawal symptomsYour body will need to adjust to working without the drug in your system, so you may experience a range of symptoms, some minor, and some serious.

Find withdrawal symptoms for specific drugs.

CravingsThe brain learns that the easiest and quickest way to feel good is by using the drug, and this becomes a way of dealing with problems and avoiding bad feelings.

Cravings can come and go. They are sometimes weak, and sometimes quite strong. You will need to learn to manage cravings as they can still occur many years after you have stopped using the drug. Managing cravings involves learning distraction and relaxation techniques such as reading, watching a movie, meditating or exercising.

Sometimes medication is used to treat withdrawal symptoms – this is known as pharmacotherapy.

Is withdrawal safe?Medical supervision may be needed to make sure you go through withdrawal safely. If you are considering withdrawal, be sure to discuss this with your doctor or with an alcohol and other drug treatment service. It is especially important that you get medical assistance when withdrawing from alcohol, GHB, benzodiazepines or ketamine.

How long will it take to go through withdrawal?This can depend on many factors, including the type of drug, how long you have been using it, whether other drugs have been used, your general health and the setting where you go through withdrawal.

Generally, it will last from a few days to a few weeks, but some symptoms, such as cravings, can continue much longer.

Where can I go for withdrawal?It is important to be in a safe and supportive environment when going through withdrawal. Speak to your doctor, health practitioner or a drug and alcohol service for advice on which setting would be best for your particular needs. They will probably suggest one of the following:

Home withdrawal is usually provided by a team including your doctor, a nurse and a support person such as a friend or family member. This may be a good choice if your withdrawal is not likely to be complicated.

Outpatient withdrawal may be your best choice if you don’t need to be admitted to a residential service. It will involve intensive individual consultations with a health professional over a short period of time, along with ongoing counselling and support.

Residential withdrawal will involve 5 to 10 days in a residential withdrawal unit or hospital, with staff to help you 24 hours a day. They can help you during withdrawal, and afterwards, to prevent relapse.

Some residential units do not allow you any contact with partners, friends or family for a period of time. This helps you to focus on your treatment, rather than worrying about what is happening at home. It also keeps you out of contact with people who use drugs, as this can cause cravings.

How can I prepare for withdrawal?To give yourself the best chance of a successful withdrawal, it is a good idea to take some time to prepare.

Doing some preparation before starting withdrawal will give you the best chance of success.

Talk with your doctor, or an alcohol and other drugs treatment service, and make sure you have a support person, and a supportive environment, during the withdrawal process.

Write down your own personal list of reasons for going through withdrawal.List the advantages and disadvantages of using and giving up the drug. This can help to keep you motivated when the withdrawal seems too hard and you want to give up.

Plan for what to do if you end up using drugs during withdrawal. This does happen sometimes and is a critical stage in treatment. You may choose to give up treatment and go back to using the drug, or you could think of it as a setback and continue with the withdrawal. It will be important to talk about why this happened, what worked well, what did not, and what could be done differently next time.

Remember that when you have been taking a drug regularly, your body gets used to it, so you need more of the drug to feel the same effect. If you stop taking the drug, even if it is only for 2 or 3 days, you may develop a lower tolerance, so if you begin taking it again, there is a real risk of overdose.

Try to eat a healthy diet, even though you might crave junk food. This can reduce mood swings that are often part of withdrawal.

Drink between 1 and 2 litres of water per day, but not more than 3 litres. You may need a multivitamin supplement if you feel unwell and can't eat much. Plan to keep busy so you don’t have time to dwell on how you are feeling. Remember you

probably won’t be able to concentrate for long periods, and your memory may not be working very well. Easy activities like watching TV or movies, walks, reading magazines and short trips may be good activities to try.

Learn some basic stress management techniques, such as relaxation, exercise, massage or just talking with your support person about how you feel, to help overcome anxiety during this time.

How can I help someone through withdrawal? 

If you are supporting a friend or family member through the withdrawal process, it's a good idea to do some preparation beforehand.

Understand the process Talk to the health practitioner supervising the withdrawal to make sure you are clear about your role and understand what you will need to do to help the person through their withdrawal.

Familiarise yourself with the effects of the drug that your friend or family member is using.

Find withdrawal symptoms for specific drugs.

Get support for yourself Have support organised for yourself, and make sure there is someone you can talk to if things get difficult.

The state and territory alcohol and drug information services can direct you to counselling, additional information and referral to services. These information services can put you in touch with specialist family help lines and support groups. They are often run by friends and family members of people who use drugs, so they will understand your situation.

Be there during the tough times

Try to stay positive for your friend, if they begin to question why they are going through the process. Challenging any illogical thoughts during withdrawal is a very important function of a support person.

Encourage them to read through their personal list of reasons for going through withdrawal if they begin to have unpleasant symptoms, or if they are questioning whether withdrawal was really a good idea.

Help them to deal with their relapse if they begin to use the drug again during withdrawal. It can be useful to make a plan for how they will deal with relapse before they begin withdrawal.

Be on the lookout for overdose if they do relapse. When a drug is taken regularly, people will build up a tolerance to the drug so that they will need a greater dose to feel the same effect. Even when the drug is stopped for only 2 or 3 days, tolerance may be affected, so if they return to using the drug in the same amounts, there is a real risk of overdose.

Encourage them to eat a balanced diet as this can reduce mood swings that are often a feature of withdrawal.

Remind them to maintain their fluid intake. 1 to 2 litres of water is recommended, but they should not have more than 3 litres a day.

Suggest a multivitamin supplement if they are struggling to eat. Keep them busy so they don’t have time to dwell on how they are feeling. Remember they will

have a short concentration span, and their memory may not be functioning very well. Watching TV or movies, walks, short car rides, reading magazines and short trips may be good activities to try.

Help them to manage stress by using basic techniques such as talking, exercise or massage. Know the rules of the unit. If your friend or family member is preparing for residential

withdrawal at a hospital or withdrawal unit, make sure you find out whether there are restrictions on visiting, or contacting them, and what items may be brought in to the unit.

Further information Treatment Supporting someone through home-based withdrawal Drug facts (individual withdrawal symptoms) Help and support

Resources

Alcohol and other drug withdrawal: Practice guidelines Drinking diary Cannabis diary  Prescribing for drug withdrawal Your guide to drug withdrawal

 

Statistics on GHBhttp://www.druginfo.adf.org.au/topics/quick-statistics#GHB

National

0.9% of Australians aged 14 years and over have used GHB one or more times in their life1.

Young people

Young Australians (aged 14–24) first try GHB at 20.1 years on average1.

Victoria

The number of GHB ambulance attendances in 2013/14 increased by 7.4% (up to 626 attendances) in metropolitan Melbourne and 3% (59) in regional Victoria from the previous year10.

View What 12–17 year olds are really using, an infographic about alcohol and drug use by young people in Australia.

Reducing the risksPregnancy, alcohol and other drugshttp://www.druginfo.adf.org.au/fact-sheets/pregnancy-alcohol-and-other-drugs-web-fact-sheethttp://www.druginfo.adf.org.au/images/pregnancy-AOD-29jun16.pdf

Pregnancy is a time of great change. If you are pregnant, or thinking about having a baby, it is important to consider the types of drugs you might be taking and how they might affect you and your pregnancy.

Drugs that may be harmful during pregnancy include:

Legal drugs such as alcohol, tobacco and caffeine Complementary medicines such as herbal preparations and nutritional supplements 'Over-the-counter' medicines such as antacids, cold and 'flu medicines, diet pills, laxatives and

painkillers Prescribed medicines such as painkillers, tranquillisers and sleeping pills Illegal drugs such as cannabis, amphetamines, cocaine, ecstasy, GHB, hallucinogens and heroin Drugs used to treat opiate or alcohol dependence such as methadone, buprenorphine and

naltrexone Other substances such as glues and aerosols (inhalants or volatile substances)

Why be concerned about drug use during pregnancy?Alcohol and other drugs can be harmful to a developing foetus throughout the pregnancy, as they will reach the baby through the placenta (the afterbirth).

However, there can be great variation in babies' responses to drugs, depending on:

The type of drug taken. The baby's response to a sedative drug will be different from its response to a stimulant such as caffeine or amphetamines.

How often the drug is used, how it is used and the amount taken. Whether one or more drugs are used—combining drugs can increase or alter the effects of the

drugs in unpredictable ways. Each individual baby's response.

Two of the most common complications of drug use during pregnancy are premature labour and small birth size. Babies born prematurely or with a low birth weight have a higher risk of illness and may experience a number of problems.

Sudden Infant Death Syndrome (SIDS) is the sudden death of a baby for no known reason. The risk of SIDS is greater if you smoke, use alcohol and/or other drugs during pregnancy or after your baby is born.

Planning your pregnancyThe first thing to do if you are planning to become pregnant is to seek advice from your doctor or other healthcare professional. They can assist you with information about the available health services and your choice in pregnancy care.

However, there are a few simple steps you can take to improve your health before you become pregnant. These will increase the chances of a healthy conception and baby:

Eat a well-balanced diet and drink plenty of water. If you are a smoker, ask your doctor or other health professional for information about quitting. Avoid caffeine, alcohol and other drugs. Seek counselling if you need help to reduce or stop using alcohol or other drugs. Unless specifically recommended by your doctor or health practitioner, avoid taking any

medications including those purchased over-the-counter. If you are taking complementary medicines or supplements, make sure you tell your prescriber

that you are planning to become pregnant, read the label for safety messages, and discuss these medicines and supplements with your doctor or health practitioner.

Get plenty of rest and exercise. Avoid stress.

Managing your pregnancy and drug useIf you haven't already done so, you should consult your doctor or healthcare professional as soon as you find out you are - or suspect you are - pregnant. Cutting down or stopping your alcohol and other drug use at any stage of your pregnancy, even late pregnancy, will benefit both your baby and your health.

It is important to tell your pregnancy care provider if you are drinking alcohol or taking any other drugs, or if you have any concerns about your use. If you are using alcohol or other drugs, your baby will need to be carefully monitored during your pregnancy.

Reducing the risk of complications of drug use in pregnancyTo reduce the risk of complications to yourself and your baby:

Speak to your doctor or healthcare professional to discuss your use of alcohol and other drugs. Get regular pregnancy care as soon as you know you are pregnant. Consult with your doctor or healthcare professional before you attempt to stop or reduce your

alcohol and other drug use. Contact your doctor or healthcare professional if you experience withdrawal symptoms.

Contact detailsWomen's Alcohol and Drug Service9:00am–5.00pm Monday to FridayThe Royal Women's HospitalCnr Grattan St & Flemington RdParkville Victoria 3052Tel: 03 8345 2000

DrugInfo Tel: 1300 85 85 84Contact DrugInfo

DirectLine (Victoria only)Free call: 1800 888 23624 hour counselling and referral service

Maternal and Child Health (Victoria only)Tel: 132 22924 hour help line

Further informationPregnancy, drugs & alcohol (Royal Women's Hospital)

Pregnancy, breastfeeding and alcohol (fact sheet)

Alcohol, other drugs and pregnancy (booklet) Contact DrugInfo for a single free copy, or visit the ADF Bookshop to buy multiple copies.

DrivingDrugs and drivinghttp://www.druginfo.adf.org.au/topics/driving2http://www.druginfo.adf.org.au/topics/how-do-drugs-affect-drivinghttp://www.druginfo.adf.org.au/information-for/information-for-drivers

Drugs and Driving UpdateA person who drives a vehicle under the influence of alcohol and other drugs (including some prescription and over the counter medications) poses a potential hazard to themselves, any passengers and other road users.

How drugs impair drivingAlcohol and other drugs impair a person's driving in various different ways. Even in low doses, alcohol can significantly reduce driving performance by reducing braking time, speed control and diverting attention. It can also contribute to motorists weaving between lanes or driving abruptly or aggressively1. For example, research shows drivers with a 0.5 per cent blood alcohol concentration (BAC) react much slower to potential road hazards than when they are sober2. 

A driver affected by cannabis may drive too slowly and find it difficult to drive within designated lanes or stay awake1.

Amphetamines and ecstasy can lead to speeding or erratic driving as well as reduced vision and increased risk taking behind the wheel1.

More information on how different substances affect driving can be found here:

Alcohol Amphetamines Cannabis Ecstasy Heroin and other opioids Medications Multiple substances

 

Prevalence of drug driving in AustraliaDrug driving is a serious road safety issue. For example, in Victoria more than one-third (37%) of all drivers and motorcyclists killed on Victoria roads during the past five years had drugs in their system, with cannabis and stimulants the most common substances detected. The Victorian data revealed approximately 21% of drivers and motorcyclists killed in 2012 tested positive to cannabis, ecstasy, speed, or crystal methamphetamine ('ice')3.

Prevention initiatives – testing and educationAustralia's approach to reducing drug driving rates focuses on detection through roadside drug testing, and education initiatives.

Police use roadside drug tests to detect the presence of illegal drugs such as cannabis, methamphetamine and ecstasy in a motorist's body. It should also be noted that if you are injured in a motor vehicle accident and transported to a hospital you will be asked to provide a sample of blood which will be analysed for drugs and alcohol.

Increased roadside testing in Australia in the past few years has led to police detecting more drug-affected drivers, however it is too soon to tell if it is likely to deter people from driving under the influence4.

More information on roadside drug testing

In Victoria, there are a number of prevention strategies to help prevent drug driving.

These include:

Education activities in schools Mass media advertising campaigns Increased roadside drug testing Information provided by health professionals1

Victoria's Transport Accident Commission's (TAC) drug-driving campaign began in 2004 and was designed to coincide with the introduction of roadside drug testing and focused on the risk of detection. TAC has also developed a wide range of primary and secondary school resources aimed at teaching the next generation of drivers about road safety, peer behaviour, decision-making and how choices can affect others.

Driver education is also considered a prevention strategy when used as part of the license restoration system. When someone loses their license they must undertake an education course and when combined with fines and disqualification periods, this has been shown to be an effective deterrent1.

Another prevention strategy is being implemented by pharmacists (when dispensing prescriptions) who are required to advise consumers about the possible effects of medicines on driving performance. This is achieved through warning stickers on medications and combined with verbal information1.

All of these approaches work together to reduce the number of individuals who drive under the influence of drugs.

Staying safe on the roadsAlcohol and other drugs can continue to affect a motorist long after the effects of the substances wear off, which means people still pose a risk even if they feel safe to drive. People may also feel tired or hung over when the drug effects wear off which can also impair their driving ability.

For that reason it is best to avoid driving altogether if alcohol or other drugs have been consumed.

All drivers, whether young or old, should avoid driving if they have recently consumed alcohol or other drugs.

Strategies to avoid drug driving and stay safe:

Use public transport Phone a friend, relative or taxi Stay overnight

It is important to remember that alcohol and other drugs can continue to affect you the next day4.

Prescription medication

A motorist who has taken prescription medication, whether legally or illegally, should be aware of the potential risks while driving. Some warning signs may include feeling drowsy, aggressive, dizzy, nauseous, light-headed or shaky. They also may experience problems with their vision.

If taking prescribed or over-the-counter medication, always:

Read the labels carefully and obey the directions and warnings  Ask a doctor or pharmacist if medicines likely to affect driving Arrange alternative transport1.

Further informationResources

Transport Accident Commission roadside testing Drug Driving Penalties

Medicines and Road Safety Medications and safe driving Information for drivers The facts about roadside drug testing Talking with clients about drugs and driving

References

1. Stough, C. & King, R. (2010). Drugs and driving. Prevention Research Quarterly, 12, 1–32.

2. Deery, H.A. & Love, A. W. (1996). The effect of a moderate dose of alcohol on the traffic hazard perception profile of young drink-drivers. Addiction, 91:6, 815–27.

3. Transport Accident Commission. (n.d.) Drugs and Driving. 

4. Monash University Accident Research Centre. (2007). Going Solo - A resource for parents of P-plate drivers. 

Information for drivers

Note: If you intend driving, the safest option is not to have any alcohol or other drugs in your system at all. This includes prescription medications that affect driving ability.

To drive safely, we need to be mentally alert, to have clear vision, physical coordination and the ability to react appropriately.

Avoiding the risksThe affects of alcohol and other drugs can make it difficult for a person to assess how much their driving skills are affected. Avoid driving if you are:

Feeling dizzy or light-headed Unable to think clearly Edgy Nauseous or otherwise unwell Drowsy or tired

Planning aheadIf you intend to use alcohol or other drugs and need to travel, plan ahead by:

Organising a driver who will not be using any alcohol or drugs Arranging to be picked up Using public transport or a taxi Arranging to stay overnight

 

It is important to remember that alcohol and other drugs can continue to affect you the next day. Fatigue, hangovers and 'coming down' can also impair your driving ability.

Drivers at high riskSome drivers are at particular risk of problems relating to drugs and driving. If you belong to any of the following groups, follow the links to find out more.

Young drivers Parents of young drivers Older drivers Commercial drivers Drivers taking medication

How do alcohol and other drugs affect driving?

Visit our resources section for fact sheets, posters and wallet cards about the effects of drugs on driving.

WorkplaceAlcohol and other drugs in the workplacehttp://www.druginfo.adf.org.au/fact-sheets/alcohol-and-drugs-in-the-workplacehttp://www.druginfo.adf.org.au/images/alcohol-drugs-workplace-29jun16.pdf

The impact of alcohol and other drugs on the workplaceThe use of alcohol and other drugs can impact on workplaces in a number of ways, including affecting relationships, safety and productivity.

The following statistics demonstrate the extent of this impact in Australia: 

Alcohol and other drugs cost Australian workplaces an estimated $6 billion per year in lost productivity1.

Recent research has estimated that 2.5 million days are lost annually due to alcohol and other drug use, at a cost of more than $680 million2.

One in 10 workers says they have experienced the negative effects associated with a co-worker's misuse of alcohol. The negative effects include reduced ability to do your job, involved in an accident or close call, worked extra hours to cover for a co-worker, and took at least one day off work3. 

How do hangovers and coming down affect work?Having a hangover or coming down from drugs at work can be just as problematic as being intoxicated. Headaches, blurred vision, irritability, problems concentrating, lost voice and extreme tiredness can all create problems for you and your co-workers.

Alcohol

Sobering up takes time. As a guide, an average person in good health can process one standard drink per hour.

Hangover cures like cold showers, doing exercise, strong coffee or being sick will not speed up the process. These cures may make you feel better, but they don't change your blood alcohol concentration (BAC).

Other drugs

It can take several days to come down from other drugs like ecstasy, ice and amphetamines, so using these drugs on the weekend can still affect your work.

Do prescription drugs affect work?There is always a level of risk when using any drug including prescription or over-the-counter medications.

Drug reactions vary from person to person. If you are taking a drug you haven't had before, you won't know how it will affect you. It's important to follow your doctor's advice when taking prescription drugs and discuss any side-effects and how this might impact on your work.

The effects of prescription drugs such as benzodiazepines (e.g. Xanax®) can have an impact on your work and you should discuss these with your doctor. Long term use in particular may become problematic.

What is an alcohol and other drug problem?An alcohol or drug problem isn't necessarily measured by how much, how many or what type of drugs a person uses, but by how the drug affects the person's life and the lives of those around them. It's often a matter of personal perception.

Here are some examples of a drug problem:

Regularly returning from lunch a bit tipsy, then disturbing everyone in the office and making it harder for them to work.

Taking prescription medication for a long time, which causes memory problems, clumsiness and tiredness. 

Often taking ecstasy or drinking alcohol heavily on the weekend and then coming into work tired, irritable and moody the next day.

Concerned about a co-worker?If a co-worker's use of alcohol or other drugs is affecting you then they do have a drug problem. This person may not be aware their drug use is affecting those around them, so you need to talk to them or the most appropriate person in your organisation such as a manager or someone from human resources.

Find out the facts

If you are concerned that a co-worker is intoxicated while at work, it is important to be very sure that the person is actually under the influence of drugs – and not unwell – before you take any further action. It is very difficult to know if someone is impaired by the use of drugs or if someone is misusing them. Read through the drug facts pages to find out about the effects of different drugs.

If you are concerned that a co-worker's drug use is affecting their work and/or the safety of others, it would be helpful to document evidence of incidents.

Speak up

If your workplace has an alcohol and drug policy, follow the procedures outlined in that document.

If your workplace does not have an alcohol policy you may wish to discuss the issue with:

Your health and safety representative A member of the health and safety or other formal workplace committee A manager, supervisor or employer

If you choose to talk to your co-worker directly about your concerns, there is no easy way to begin the conversation. The following suggestions may help:

Talk to a counsellor, health professional or your workplace's Employee Assistance Program (EAP) for advice on how to handle the situation.

Speak to a manager or supervisor about your concerns and seek their advice (you do not need to identify the co-worker).

It may be best to talk to the person away from the workplace and outside of working hours. Explain how the person's use of alcohol is affecting you and other people around them at work.

Give concrete examples. Try to remain calm and logical and stick to the point – refuse to be drawn into an argument. Offer your support and encourage them to seek professional help. Provide them with information

about available services (see below 'Further information').

Employee responsibilitiesIt's important to consider how your use of alcohol or drugs may impact on your co-workers because the OHS Act imposes a duty on all workers not to recklessly endanger any other person in workplaces.

Different industries and workplaces may have more specific rights and responsibilities for employers and employees detailed in a policy. For example, some industries and workplaces may require people driving vehicles to have a blood alcohol concentration (BAC) of 0.00. Others may have policies about testing employees for alcohol.

Make sure you are aware of your rights and responsibilities around alcohol within your workplace and/or industry.

Employer responsibilitiesYour employer has a legal obligation to address alcohol and other drug issues in the workplace through the 'duty of care' provisions in the OHS Act. These provisions require employers to take all reasonable or 'practicable' steps to ensure the health and safety of all workers and any other people who may be affected by the actions of the employer, such as contractors or clients.

The Alcohol and Drug Foundation works with employers to help them develop alcohol and drugs policies, train employees about alcohol and drugs, and organise safe parties. If you think your

workplace could benefit from these services, put your manager or human resources department in contact with the Alcohol and Drug Foundation's Workplace Services.

Further informationAlcohol and Drug Foundation's Workplace Services team: Tel. 03 9611 6100 or visit adf.org.au/workplace

Unions: If you are in a union, you should contact them for assistance.

WorkSafe Victoria Advisory Service: Tel. 1800 136 089 (toll free).

Your local doctor, other health professional, or workplace Employee Assistance Program should be able to provide you with confidential advice or refer you to a more appropriate service.

DirectLine is a 24-hour telephone counselling and referral service for people in Victoria wanting help with alcohol or other drug related issues. Tel. 1800 888 236.

Counselling Online offers free alcohol and drug counselling online 24 hours a day, 7 days a week. Visit counsellingonline.org.au.

Related articles

Safe partying for all ages

Simple strategies to prevent alcohol and drug related violence

PolicyTalk: Workplace drug testing

PolicyTalk: Workplace alcohol and drug programs

References

1. Manning, M., Smith, C. & Mazerolle, P. (2013). The societal costs of alcohol misuse in Australia. Trends and Issues in Crime and Criminal Justice. 454. Canberra: Institute of Criminology.

2. Roche, A., Pidd, K. & Kostadinov, V. (2015). Alcohol – and drug-related absenteeism: a costly problem.

3. Dale, C. & Livingston, M. (2010) The burden of alcohol drinking on co-workers in the Australian workplace, Medical Journal of Australia, 193(3), 138-140.

 

Coping with a family member or friend with a problemhttp://www.druginfo.adf.org.au/family-and-friends/drug-information/information-for/coping-with-a-family-member-or-friend-using-aod

The following resources provide advice and support for people affected by the alcohol or other drug use of their family members or friends.

Ice: family & friends support guideBrochure

A free support guide for family and friends, providing more information on how you can support a loved one using ice.

Inhalant use: a guide for parents and familiesBooklet

A booklet designed for parents, family members and other carers concerned that their young person could be using inhalants.

Strong Spirit Strong Mind: Aboriginal ways to reduce harm from alcohol and other drugsBooklet

Sniffing and Chroming: A guide for parents and carers worried about their children.Drug use in the familyFact sheetIt's normal to feel helpless, frustrated, worried and upset when someone close to you has a drug problem. This fact sheet outlines practical steps you can take to work through the issues. 

Healthy eating during treatment for alcohol and other drugsFact sheetGood nutrition should be a part of the withdrawal process as poor dietary habits can contribute to increased cravings and the risk of relapse. This fact sheet provides tips on a healthy diet and lifestyle.

Supporting children: a guide for grandparentsFact sheetIf you're one of the estimated 22,500 Australian grandparents acting as primary caregiver for your grandchildren, this fact sheet provides some helpful strategies for supporting your grandchildren and looking after yourself.

Supporting someone through home-based withdrawalFact sheetThis fact sheet focuses on home-based withdrawal, which involves the person going through withdrawal while living in their own home or some other safe place as opposed to going to a drug and alcohol treatment service or withdrawal facility. 

Is someone you care about using drugs?BookletThis 29 page booklet provides advice for people wanting to support a friend or family member who is using alcohol or other drugs. Call Family Drug Helpline on 1300 660 068 for a single free copy.

Why can't they just stop?BookletThis 32 page booklet provides support for people living with the consequences of having a family member or close friend who is a problem drinker. Call Family Drug Helpline on 1300 660 068 for a single free copy.

Myth busting alcoholBookletThis 33 page booklet helps parents to understand and deal with underage drinking. Call Family Drug Helpline on 1300 660 068 for a single free copy.

The merry-go-round of addictionBookletThis booklet provides proven strategies to help those dealing with a family member's addictive behaviours to regain control of their life and improve family relationships.  Limited hard copies available. Contact DrugInfo.

Walking a tightrope. Alcohol and other drug use and violence: a guide for families [PDF:854KB]PDF booklet This online booklet provides advice and strategies for people coping with the violent behaviour of a family member who uses alcohol or other drugs. 

A guide to coping: Support for families faced with problematic drug useBook

A resource guide developed by Family Drug Support providing families with practical strategies and information when facing problematic drug and alcohol use.Not my family, never my child: What to do if someone you love is a drug userBookWritten by Tony Trimingham, CEO of Family Drug Support, this book provides detailed information on warning signs, early intervention, coping and survival strategies, treatment, and where to go for additional advice and support.

Stepping Stones workbookBookPublished by Family Drug Support & the Alcohol and Drug FoundationThis is the essential workbook for families coping with problematic drug use of their loved ones. Developed by Family Drug Support, this workbook provides a step-by-step guide to help people turn crisis into coping.

 

Why do people use alcohol and other drugs?http://www.druginfo.adf.org.au/fact-sheets/why-do-people-use-alcohol-and-other-drugshttp://www.druginfo.adf.org.au/images/Why-Do-People-Use-AOD-30jun16.pdf

People use alcohol and other drugs (AOD) for a variety of reasons: to relax, to function, for enjoyment, to be part of a group, out of curiosity or to avoid physical and/or psychological pain.

Many may also use AOD to cope with problems, relieve stress or overcome boredom while others may experiment out of a sense of curiosity, excitement or rebellion1.

AOD use is influenced by a number of factors but most people use them to feel better or different. They use AOD for the benefits (perceived and/or experienced), not for the potential harm. This applies to both legal and illegal substances.

Some drugs are prescribed by medical practitioners or sold over-the-counter to treat medical conditions.

The vast majority of people who drink alcohol and/or use legal or illegal drugs do not become dependent on any of the substances2.

What drugs are being used in Australia?The majority of people in Australia drink alcohol (78.3%) with 12% of the population using illicit drugs. Cannabis is the most commonly-used illicit drug (10.2%). A much smaller proportion (2%) use illegal drugs, such as crystal methamphetamine (ice), cocaine and ecstasy, and even smaller misuse inhalants (0.8%).3

Types of AOD useThe list below details some of the different categories of AOD use. People can move between the categories, and one stage will not inevitably lead to another. The majority of people who use AOD do not become dependent or develop serious problems as a result of using them.

Experimental use: a person tries a substance once or twice out of curiosity.

Recreational use: a person chooses to use AOD for enjoyment, particularly to enhance a mood or social occasion. The majority of people use substances for this reason and never develop problems as a result.

Situational use: AOD is used to cope with the demands of particular situations such as responding to peer group pressure, overcoming shyness in a social situation or coping with some form of stress.

Intensive use or 'bingeing': a person intentionally consumes a heavy amount of AOD over a short period of time, which may be hours, days or weeks.

Dependent use: a person becomes dependent on AOD after prolonged or heavy use over time. They feel the need to take the substance consistently in order to feel normal and/or to avoid uncomfortable withdrawal symptoms.

Therapeutic use: a person takes a drug, such as a pharmaceutical, for medicinal purposes.4

Why do people choose certain drugs?People choose AOD for the specific feelings they get as a result of using them. For example, people may use codeine to relieve pain, drink alcohol to relax and relieve stress, take amphetamines to increase energy or use hallucinogens to alter their perception.5

Using one drug does not necessarily lead people to trying other drugs with research dismissing concerns about so-called 'gateway drugs'. There is no evidence suggesting people who use cannabis will graduate over time to other drugs such as heroin or amphetamines.6

However, a person's AOD use may be influenced by the availability, price and purity of specific drugs. It is worth noting that often it is the combination of such factors that determine which drug a person uses. For example, tougher law enforcement policies combined with lower profit margins made Australia a less attractive option for heroin traffickers, which led to the heroin drought in the early 2000s. Similarly, if supplies of a preferred drug fall (which in turn can significantly increase the price) then people may switch to an alternative drug to satisfy their needs. 7

Effects

The feelings people experience when taking a certain drug play a major role in their decision to use it. Some substances might be used for a specific occasion. For example, people often use ecstasy and amphetamines to increase their energy during a dance party.8

Another person may use performance and image enhancing drugs, such as steroids, or cognitive enhancers to improve their performance at work, study or sporting competitions. While others may turn to alcohol and tobacco to relax after work or to combat stress.9,10

Availability

Availability can be a major factor determining whether people use a specific drug. The greater the level of supply of a drug in a society, the more likely they are to be used and the more likely people are to experience problems with it11. For example, alcohol is the most commonly-used drug given its widespread availability. Whereas drugs such as heroin and amphetamines are less likely to be used because they are illegal drugs which make them more difficult to obtain.5

Even within the illicit drug market, availability plays a major role. Supplies of heroin and ecstasy have fluctuated in the past two decades for a number of reasons, including stronger law enforcement restricting supplies of the drugs.7,12

Price

Price is also a major influence, which is closely linked with availability. Drugs that are available in high quantities tend to be cheaper to buy, and lower drug prices may result in higher levels of drug consumption and drug-related harm.13,14

The cheaper the price the more likely the drug will appeal to more people. For example, an oversupply of heroin in the 1990s saw prices drop to a historic low, resulting in it becoming the most-commonly injected drug15. Conversely, a dramatic heroin shortage in 2000 saw the price skyrocket from $360 to $1200 per gram in Australia14.

It is also worth noting that the price of one drug can affect the demand for another. If the price rises too high, in some cases people who use a particular drug may seek a cheaper alternative if they can no longer afford their preferred choice.16

Purity

The purity of a drug refers to the strength or amount of the active ingredient. While a person's individual perception of purity can be influenced by their tolerance levels and frequency of use, the actual purity of a drug can be impacted by external market forces that affect its availability.

For example, the popularity of ecstasy fell in 2010 when international restrictions on the chemicals needed to make the drug saw its purity levels drop significantly. Although ecstasy demand is on the rise again, many people had already switched to using the synthetic compounds, which had been introduced as a substitute when ecstasy's availability and purity levels had fallen.6

Initial reports suggest the shift around 2013 to the more potent form of crystal methamphetamine (ice) from the more traditional powder methamphetamine form (speed) may be linked to the higher purity of crystal methamphetamine, which means the effects of the drug are much stronger3.

Multiple (poly) drug use

Some people combine different kinds of AOD to increase the intensity of the experience5. They may also combine substances such as alcohol with prescription drugs without thinking about the side effects. They may not be aware of the harms that may be caused when the different drugs interact with each other.16,17

People may also use some drugs to counteract the effects of another drug. For example, people may smoke cannabis to 'come down' from the stimulating effects of amphetamines. However, using one drug after another means the person may suffer the side effects from both drugs.5

Further informationDrug facts

Statistics

References

1. Ritter, A., King, T., & Hamilton, M. A. (Eds.). (2013). Drug use in Australian Society. Oxford University Press.

2. National Council on Alcoholism and Drug Dependence, Inc. (n.d.) Alcohol and Drug Information.

3. Australian Institute of Health and Welfare. (2014). National Drug Strategy Household Survey detailed report 2013. Canberra: AIHW.

4. Australian Drug Foundation (2000). Drugs in Focus: Dealing with drug issues for 9 to 14-year-olds. West Melbourne: ADF.

5. Brands, B., Sproule, B., & Marshman, J. (1998). Drugs and drug abuse. Addiction Research Foundation. Toronto, Canada.

6. Jadidi, N., & Nakhaee, N. (2014). Etiology of Drug Abuse: A Narrative Analysis. Journal of addiction, 2014.

7. Degenhardt, L., Reuter, P., Collins, L., & Hall, W. (2005). Evaluating explanations of the Australian 'heroin shortage'. Addiction, 100(4), 459–469.

8. Ritter, A., King, T., & Hamilton, M. A. (Eds.). (2004). Drug use in Australia: preventing harm. Oxford University Press.

9. Urban, K. R., & Gao, W. J. (2014). Performance enhancement at the cost of potential brain plasticity: neural ramifications of nootropic drugs in the healthy developing brain. Frontiers in systems neuroscience, 8.

10. Wan, W., Weatherburn, D., Wardlaw, G., Sarafidis, V. & Sara, G. (2014). Supply-side reduction policy and drug-related harm.

11. Gossop, M. (2000). Living with drugs. Ashgate Publishing, Ltd.

12. Scott, L., & Burns, L. (2011). Has ecstasy peaked? A look at the Australian ecstasy market over the past eight years. EDRS drug trends bulletin, April.

13. Angell, M. P., Chester, N., Green, D., Somauroo, J., Whyte, G., & George, K. (2012). Anabolic steroids and cardiovascular risk. Sports medicine, 42(2), 119–134.

14. Degenhardt, L. J., Conroy, E., Gilmour, S., & Hall, W. D. (2005). The effect of a reduction in heroin supply on fatal and non-fatal drug overdoses in New South Wales, Australia. Medical Journal of Australia, 182(1), 20–23.

15. Jofre-Bonet, M., & Petry, N. M. (2008). Trading apples for oranges?: Results of an experiment on the effects of Heroin and Cocaine price changes on addicts' polydrug use. Journal of Economic Behavior & Organization, 66(2), 281–311.

16. Nauert, R. (2015). Alcohol & many medications make a risky mix.

17. National Institute on Drug Abuse. (2011). Prescription Drugs: Abuse and Addiction.

Addressing problems in your communityhttp://www.druginfo.adf.org.au/information-for/addressing-alcohol-and-other-drug-use-in-your-community

Dignity, Diversion, Home and Hope:A Review of Interventions for Volatile Substance Misuse in Regional North Queensland.

Developing an Inhalant Misuse Community StrategyThis booklet aims to assist local communities to address inhalant misuse.

NT community group reduces sniffing harmsEducation workshops and camps succeed in lowering inhalant use among Darwin youth.

Warlpiri Youth Development Aboriginal Corporation (WYDAC)Strong community involvement and high engagement lies beneath the success of one of Australia's most successful programs combatting inhalant misuse in remote communities.

Targeting inhalant use head on in Mt IsaA holistic approach to inhalant misuse sees intervention, prevention and community engagement reduce inhalant misuse.

Follow the GrogWatch blogBecome part of an online community taking action on preventing alcohol-related harm in families and the wider community.

Community Drug Action Teams (CDATs)If you're in New South Wales, volunteer to join a CDAT. These teams work together to minimise and prevent harmful use of alcohol and other drugs in their neighbourhoods.

Targetting workplaces in your community projectsIssues relating to alcohol and drug use cost Australian workplaces an estimated $6 billion a year, mainly arising from lost productivity, absenteeism, injuries in the workplace and death.

Lobbying for change through the  mediaAdvocacy has played a key role in tobacco law reform. Communities can play an important role in continuing to send governments a message on the need for more change.

Tackling the root of alcohol and drug problemsRunning projects that focus on why people misuse alcohol and drugs, like dysfunctional family relationships, can be more effective than concentrating on the actual alcohol and drug use.  

What is alcohol and drug prevention?There are different types of alcohol and other drug prevention programs. Understanding each type can help you set clear aims for your next community project.

Coordinated approach needed for behaviour changeFrom schools, to GPs to bars and pubs to workplaces – ensuring your project covers a number of these community settings can help you be more effective and achieve behaviour change.

Keeping school leavers safe‘Schoolies’ events are often associated with risky drinking among young people. But the Surf Coast Shire community in Victoria has managed to develop a school leavers event that has reduced alcohol-related harm.

Preventing alcohol and drug problems in your communityTacking AOD problems can be challenging and it’s often difficult to achieve results. This publication looks at best practice approaches to community programs to give you some ideas for your next project.

6 steps to planning community alcohol and drug projectsDiscussion guide to assist your working group plan its next community project. Taking some time to follow these steps will help you achieve a better result.

Leveraging social mediaSocial media offers huge opportunities to connect with people. Learn how alcohol companies are taking advantage of these opportunities and how you can too in your community projects.

Preventing alcohol and drug problems through schoolsSchools can play a key role in preventing alcohol and drug problems. Learn how parents and the wider community can help them.

Sporting clubs prove an ideal setting for preventionResearch has shown that programs like Good Sports can reduce AOD harm in communities. Learn how sporting clubs have implemented this program to achieve significant results.

ADF SearchOnline access to reports, books and journal articles on AOD community interventions.

The lawhttp://www.druginfo.adf.org.au/topics/drug-law-in-australia#illegalPlease note: This information does not constitute legal advice and should not be relied upon in this way. The information is correct at the time of publication. For information specific to your situation contact a legal aid service in your state or territory.

Although we think of some drugs being legal, and others being illegal, many drugs are somewhere in between. Some substances are legal, but there are laws restricting their use or sale. Others are illegal to use, possess or produce.

New psychoactive substances (synthetics) - including synthetic cannabisA range of terms have been used to describe new psychoactive substances (NPS), including new and emerging drugs (NEDs), synthetics, legal highs, herbal highs, party pills, herbal ecstasy, bath salts, drug analogues and synthetic cannabis.

The laws surrounding NPS are complex, constantly changing and differ between states/territories, but in general they are increasingly becoming stronger.

In Queensland, New South Wales, and South Australia there is now a ‘blanket ban’ on possessing or selling any substance that has a psychoactive effect other than alcohol, tobacco and food.

In other states and territories in Australia specific NPS substances are banned and new ones are regularly added to the list. This means that a drug that was legal to sell or possess today, may be illegal tomorrow. The substances banned differ between these states/territories (G. Barnes, personal communication, April 23, 2014).

Get the facts on new psychoactive substances (synthetics) . Watch our seminar and read our publications on new and emerging drugs.

See below for an outline of laws relating to individual drugs in Australia. For more detailed information contact a legal aid service in your state or territory.

Legal and restricted drugsAlcoholThere are laws that govern how alcohol may be used. These laws may differ depending on the state, territory or local area. For example, in some areas local by-laws make it illegal to drink alcohol in public places such as beaches, parks and streets.

It is an offence for a person who is under 18 years of age to buy, receive or drink alcohol on licensed premises, unless they are with a parent or guardian.

In some states in Australia, it is also an offence to supply a person under 18 years of age with alcohol in a private home, unless the young person’s parent or guardian has given permission and the alcohol is supplied in a responsible manner. This is known as secondary supply.

It is illegal to drive under the influence of alcohol.

Penalties for breaking these laws can include fines, imprisonment and disqualification from driving.

Employers have legal obligations in relation to health and safety of their workers and people who visit their workplace. Find out more about the responsibilities of employers and employees.

AmphetaminesUse of amphetamines is restricted. They can only be prescribed by a medical practitioner for medical reasons.

Federal and state laws provide penalties for possessing, using, making, selling or driving under the influence of amphetamines without a prescription from an authorised person. There are also laws against forging or alerting a prescription or making false representation to obtain amphetamines or a prescription for them. Laws have been introduced that prevent the sale and possession of ice pipes in some states and territories.

BenzodiazepinesUsing benzodiazepines without a prescription from a doctor, or selling or giving them to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain benzodiazepines or a prescription for them.2

In 2014, in response to concerns about the use and harms associated with the benzodiazepine, alprazolam (Xanax®), it was rescheduled under the Pharmaceutical Benefits Scheme (PBS) as a Schedule 8 drug. Doctors must now follow additional state and territory laws when prescribing alprazolam and must notify, or receive approval from, the appropriate health authority.1

Betel nutThe active ingredient in betel nut is arecoline, which is a Schedule 4 poison (prescription only medicine) and therefore is illegal to possess or sell without proper authority.

BuprenorphineUsing buprenorphine without a prescription from a doctor, or selling or giving it to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain buprenorphine or a prescription for it.2

Cognitive enhancers (smart drugs)Modafinil is a Schedule 4 substance that can only be prescribed by a doctor or dentist in the ordinary course of their professions.

Methylphenidate is a Schedule 8 drug which means doctors must follow state and territory laws when prescribing it and must notify, or receive approval from, the appropriate health authority.

Using modafinil or methylphenidate without a prescription from a doctor, or selling or giving them to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain pharmaceuticals or a prescription for them.2

InhalantsInhalant use is not a criminal offence in any Australian state or territory.

In recent years, some Australian states and territories have revised police powers to intervene in inhalant use in two main ways. Police are authorised to:

Take away inhalants and related equipment Pick up young people who are misusing inhalants, and release them into the care of a responsible

person, or a place of safety.

It is also illegal in some states and territories to sell or supply products to someone if they believe they are to be used for inhaling.

State/territory legislation on inhalant salesIt is an offence in Queensland, Western Australia, Victoria, South Australia, New South Wales and the Northern Territory to knowingly supply an inhalant to a person for the purpose of intentional inhalation.

QueenslandSection 23 of the Summary Offences Act 2005 [PDF:373KB]Section 603 – 607 of the Police Powers and Responsibilities Act 2000 [PDF:3MB]Part 2 Section 10 of the Drugs Misuse Act 1986   [PDF:557KB]

Western AustraliaSection 206 (1) of the Criminal Code Act 1913. Sections 5-14 of the Protective Custody Act 2000Section 7 (1) (g) of the Aboriginal Communities Act 1979

VictoriaSections 57-60T of the Drugs, Poisons and Controlled Substances Act 1981Drugs, Poisons and Controlled Substances (Volatile Substances) Regulations 2004 [PDF:559 KB]

South AustraliaSection 19 of the Controlled Substances Act 1984. Section 42D of the Anangu Pitjantjatjara Yankunytjatjara Land Rights Act 1981.Section 7 of the Public Intoxication Act 1984

New South WalesThere is no specific legislation in NSW that refers directly to inhalant abuse only legislation referring to intoxicated persons. Part 14 and 16 of the Law Enforcement (Powers and Responsibilities) Act 2002Section 9 of the Summary Offences Act 1988

Northern TerritoryPart 2, Part 4 and Part 5 Sections 52 of the Volatile Substance Abuse Prevention Act 2005

Australian Capital TerritoryThere is no specific legislation in the ACT that refers directly to inhalant abuse, only legislation referring to intoxicated persons.

KetamineLegally produced ketamine is a restricted substance and only a doctor or vet may prescribe or administer it. All other ketamine is illegal in Australia.Federal and state laws provide penalties for the illegal use, possession, production, selling or driving under the influence of ketamine. Penalties can include fines, imprisonment and disqualification from driving.

KavaThe import, advertising and sale of kava in Australia are strictly controlled. Kava is listed as a controlled substance under the Customs (Prohibited Imports) Regulations Act.

As of 26 June 2007 commercial importations of kava are no longer allowed, except for medical or scientific purposes.

Passengers coming into Australia, who are over the age of 18 years, are allowed to bring 2 kg of kava without a license or permit, provided it is in their accompanied baggage.3

Read more about importation of kava.

Khat

It is illegal to import khat into Australia for personal use. Khat can only be imported for medical and/or scientific use. Importing khat without a permit is subject to fines or prosecution. For more information visit the Australian Government's Department of Health website.

MethadoneUsing methadone without a prescription from a doctor, or selling or giving it to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain methadone or a prescription for the drug. It is also illegal to inject methadone.4

OxycodoneUnder the Pharmaceutical Benefits Scheme (PBS), oxycodone is a Schedule 8 drug. Doctors must follow state and territory laws when prescribing oxycodone and must notify, or receive approval from, the appropriate health authority.

Using oxycodone without a prescription from a doctor, or selling or giving them to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain oxycodone or a prescription for them from a health professional.

Performance and image enhancing drugs (including steroids)It is illegal to manufacture, import, possess, use or supply steroids without a prescription or medical practitioner licence. The penalties for illegally administering steroids varies for every Australian state and territory5.

It is also against the law to inject another person with steroids, or for them to be self-administered without a prescription.

Medical practitioners can only prescribe steroids for legitimate medical reasons5.

Steroid use is banned in competitive sport. Testing positive for steroids can result in fines, suspensions or permanent bans6.

TobaccoFederal and state laws make it an offence to sell or supply tobacco products to people under 18 years of age. It is also illegal for anyone under 18 years to purchase tobacco products.There are laws that regulate and restrict how tobacco products are advertised, promoted and packaged.

There are also laws and regulations that restrict smoking in public areas such as shopping centres, cafes and workplaces. Most states and territories have laws that ban smoking in cars with children.

Illegal drugsThe following drugs are some of the drugs that are illegal in Australia. Federal and state laws provide penalties for possessing, using, making or selling them, or driving under their influence.

Cannabis, including some synthetic cannabinoids Cocaine Ecstasy (MDMA) GHB (gamma hydroxybutyrate) Heroin Ice (crystal methamphetamine) LSD (lysergic acid diethylamide)

Mephedrone PCP (phencyclidine) PMA (paramethoxyamphetamine) and PMMA (paramethoxymethamphetamine).

 

There are also laws that prevent the sale and possession of bongs and other smoking equipment in some states and territories. (For example, Victoria has passed legislation that will ban the sale of cannabis water pipes (bongs) from January 2012.)

Ice (crystal methamphetamine)Use of methamphetamine (ice) is against the law. Federal and state laws provide penalties for possessing, using, making, selling, importing or exporting, or driving under the influence of methamphetamine. The importation or exportation and the procuring of precursor drugs (such as pseudoephedrine) with the intention of manufacturing a controlled drug, is also against the law. Laws have been introduced that prevent the sale and possession of ice pipes in some states and territories.

MephedroneMephedrone is classified as a controlled substance and has been added to Schedule 4 of the Customs (Prohibited Imports) Regulations 1956. It can only be imported into Australia with a valid licence and permit.

Drug offencesDrug laws in Australia distinguish between those who use drugs and those who supply or traffic drugs.

The Federal Customs Act covers the importing of drugs, and each state has its own laws governing the manufacture, possession, distribution and use of drugs, both legal and illegal. 

The Drugs, Poisons and Controlled Substances Act (DPCSA) includes these major drug offences:

Use includes smoking, inhaling of fumes, or otherwise introducing a drug of dependence, into a person's body (including another person's body).

Possession is the most common offence. Possession means having control or custody of a drug. Knowledge of such possession must be proven in court. Possession applies both to drugs found on the person or their property, unless it is proven the drugs do not belong to that person.

Cultivation is the act of sowing, planting, growing, tending, nurturing or harvesting a narcotic plant.

Trafficking is a very serious offence. It includes the preparing of a drug of dependence for trafficking; manufacturing a drug of dependence; or selling, exchanging, agreeing to sell, offering for sale or having in possession for sale, a drug of dependence. If this is done in commercial quantities, the penalties are extremely severe.

DrivingIt is illegal to drive under the influence of drugs. Breaking this law carries penalties including disqualification from driving, heavy fines and/or imprisonment.

Some states have introduced random roadside testing for cannabis and amphetamines.

Read more about drugs and driving.

Find information for drivers.

PenaltiesPenalties for breaking laws in relation to alcohol and other drugs may include fines, imprisonment and disqualification from driving.

Drug diversionSome states and territories have drug diversion programs that refer people with a drug problem to treatment and/or education programs where they can receive help, rather than going through the criminal justice system.

For information specific to your situation contact a legal aid service in your state or territory.

Read the September 2012 issue of PolicyTalk, "Drug policy reform: Moving beyond strict criminal penalties for drugs"

References1. Australian Government Department of Health. (n.d). Prescribing Medicines – Information for PBS Prescribers.

2. Drugs, Poisons and Controlled Substances Act 1981 - Sect 36B. 

3. Australian Government Department of Health. (2011). Importation of Kava.

4. State Library NSW. (2011). Possession, use and supply.

5. Australian Institute of Criminology (2011). Steroids.

6. World Anti-Doping Authority (2014). Anabolic agents.

Treatmenthttp://www.druginfo.adf.org.au/treatment-options/treatment

How do I know if I need treatment?If your alcohol or other drug (AOD) use is affecting your health, family, relationships, work, school, financial or other life situation, you should seek help.

Support services are available for you, and also for your family and friends if they feel it would help them.

How can I get help? A good place to start is with your local doctor who is likely to know your medical history.

Your doctor can give you information, a referral to a treatment service and ongoing treatment after specialist AOD treatment is completed.

Another option is self-referral. Many treatment services allow this, and you can contact them directly. To find and discuss treatment services call DirectLine on1800 888 236. Note that

privately funded treatment services often require a referral from a doctor or psychologist, so it is a good idea to check first.

After you have made contact with a treatment service, an assessment will be arranged. This may be done over the phone, or face-to-face at first, and then your options for treatment can be discussed.

There may be a waiting list for some services, but if the appropriate treatment is not available at a particular agency, referral will be made to access those services elsewhere.

If you have any special needs you may be referred to a specialist service, such as those helping Aboriginal and Torres Strait Islander peoples, women, men, gay, lesbian, bisexual, transgender, intersex and queer, parents with young children, young people, or people with particular mental health issues.

What kinds of treatment are available? A range of treatment options is available to both private and public patients.

In line with Australia's National Drug Strategy, many treatment services follow the harm minimisation approach. This means that they work to reduce the harms caused by AOD, which doesn't always require stopping use because that isn't always possible.

There are a number of different types of help available, which may be combined, and include:

Withdrawal Pharmacotherapy Counselling Rehabilitation Complementary therapies Peer support Social support Family support

Withdrawal or detoxificationWithdrawal or detoxification (also called detox) is a process of stopping the use of AOD while minimising unpleasant symptoms and the risks of harm.

Read more about withdrawal.

PharmacotherapySubstitution pharmacotherapy is the use of medication to replace a harmful drug. This is given as a legal, measured, prescribed dose of a drug, and helps take away cravings so that you can work on other issues that will help you to recover.

Pharmacotherapy is only available for withdrawal from some drugs. For example, buprenorphine, methadone and naltrexone are used in the treatment of opioid dependence.

Your doctor or treatment service can give you more information about what is available to help you.

CounsellingThis is the most common kind of treatment, and there are a number of different approaches that might be taken. These might involve talking through your problems, learning to change the way you think, or thinking about how you might deal with difficult situations.

Counselling can be provided individually or in a group situation, and is available both to people who use AOD, and to their family members or support people. A support service can offer counselling or direct you to a service appropriate for you. Speak to your doctor, AOD treatment service or local community health service.

Find help and support services.

Rehabilitation

Rehabilitation programs take a long term approach to treatment to help you achieve an AOD-free lifestyle.

Residential programs can last from a few weeks to a number of years. No withdrawal medication is provided in the centres, so it is very important that you have already successfully completed your withdrawal treatment.

Residential withdrawal is also available from some treatment services.

Find out more about withdrawal.

Complementary therapies

These include treatments such as massage and relaxation therapies, which can be useful to help you manage withdrawal symptoms. Some herbal or natural remedies can also help, but you should first seek advice from your doctor or treatment service because withdrawing from alcohol and some drugs can be life-threatening.

Peer support 

These programs are provided both for people who use AOD, and their family members or support person. They are usually established by people who have had personal experience with AOD, and are often based on the Twelve-step Program model. Alcoholics Anonymous and Narcotics Anonymous are two examples of these.

Social support

A range of social support services can help you to access housing, financial, legal, general health, dental and other assistance. Speak with your local community health service or AOD treatment service for details.

Family support 

Services are available to support those who have been affected by a family member's AOD use. As well as providing understanding, these services can also provide information about how best to help during treatment.

Read a fact sheet about drug use in the family.

How much will it cost?There may be minimal costs for some services in the public sector, but a number of different treatment options (such as counselling and withdrawal) are generally free.

Before you start treatment, contact Medicare and/or your private health insurer, if you have one, to confirm exactly what you’re covered for. Private health insurance is recommended if you wish to access the private treatment sector.

Further informationRelated articles

Coping with a family member or friend using alcohol or other drugs Help and support Overdose Relapse Supporting someone through home-based withdrawal Withdrawal

Print resources

Your guide to alcohol and other drug treatment (booklet) Your guide to drug withdrawal (booklet) Your guide to mental health and alcohol and other drug problems (booklet) Take it away handbooks: Planning for change and Keeping going Cannabis diary Drinking diary

Help and supporthttp://www.druginfo.adf.org.au/contact-numbers/help-and-support

InformationCall 1300 85 85 84, email DrugInfo or browse online drug information.

Get information on prescription drugs.

Support or treatmentContact a national service or a service in your state or territory.

Read more about your treatment options.

Advice for friends and family members.

Visit the Australian Drug Information Network (ADIN) for more treatment and information services.

Telephone numbers below appear as links. Please note that these will only work if you are viewing this page on a smart phone.

National beyondblue1300 22 463624 hours a day, 7 days a weekSupport for depression, anxiety and related disorders.

CounsellingOnline24 hours a day, 7 days a weekFree alcohol and drug counselling online.

Cannabis Information and Helpline1800 30 40 5011am–7pm, Monday to Friday (including public holidays)

Family Drug Help1300 660 06824 hours a day, 7 days a week

Family Drug Support1300 368 186 24 hours a day, 7 days a weekSupport for families faced with problematic drug use.

Kids Help Line1800 55 1800 24 hours a day, 7 days a weekFree and confidential telephone and online counselling service for young people aged between 5 and 25.

Lifeline13 11 14 24 hours a day, 7 days a weekConfidential telephone counselling.

Quitline13 78 488am–8pm, Monday to Friday

SANE Australia helpline1800 187 263 9am–5pm, Monday to FridayInformation and referral about mental health issues.

Say WhenOnline support for monitoring alcohol intake.

Prescription drug help lines

Adverse Medicine Events Line1300 134 237

9am to 5pm, Monday to Friday (excluding NSW public holidays)Not for emergencies. Report and discuss adverse experiences with your medications.

Medicines Line1300 MEDICINE OR 1300 633 4249am to 5pm, Monday to Friday (excluding NSW public holidays)Information on prescription, over-the-counter and complementary (herbal, ‘natural’, vitamin and mineral) medicines.

State and territory servicesVictoria

DirectLine1800 888 23624 hours a day, 7 days a weekConfidential alcohol and drug counselling and referral line.

1800 ICE ADVICE1800 423 23824 hours, 7 days a weekAdvice and support for people who use ice, their families and health professionals.

Pharmacotherapy, Advocacy, Mediation & Support (PAMS)1800 443 84410am–6pm, Monday to FridayAdvice for anyone experiencing trouble with their pharmacotherapy program (Methadone, Suboxone etc.).

Youth Drug and Alcohol Advice (YoDAA) Line1800 458 6859am–8pm, Monday to FridayTelephone information and advice for young people and others concerned about them. 

New  South Wales 

Alcohol and Drug Information Service (ADIS) Sydney: 02 9361 8000 Regional NSW: 1800 422 599A 24-hour confidential information, advice and referral telephone service.

Ted Noffs Foundation help lineNSW/ACT: 1800 151 045QLD: 1800 753 30024 hours a day, 7 days a weekCounselling and support for young people and their families.

Queensland

Alcohol and Drug Information Service (ADIS)1800 177 83324-hour Alcohol and Drug Information ServiceTelephone information, counselling and referral. 

Western Australia

Parent Drug Information Service (PDIS)Perth: 08 9442 5050Regional: 1800 653 203

Alcohol & Drug Information Service (ADIS) Perth: 08 9442 5000 Regional WA: 1800 198 024 A 24-hour, confidential telephone service that provides information, counselling, referral and advice.

South Australia

Alcohol and Drug Information Service (ADIS)1300 131 34024-hours, 7 days a weekTelephone information, counselling, and referral service.

Australian Capital Territory

Alcohol and Drug Information Service (ADIS) 02 6207 997724-hour telephone service offering information, advice, referral, intake, assessment and support.

Tasmania

Alcohol and Drug Information Service (ADIS)1800 811 994 A 24-hour telephone information and counselling line.

Northern Territory

Alcohol and Drug Information Service (ADIS) 1800 131 350 24-hour Alcohol and Drug Telephone Information and counselling service.

Overdosehttp://www.druginfo.adf.org.au/topics/overdosehttp://www.druginfo.adf.org.au/images/overdose-9jun16.pdf

What is overdose?Someone overdoses when their body can't handle the effects of alcohol or another drug. This could happen because they take too much or because they take different drugs at the same time. Combining drugs increases the changes of overdose.1

Why do people overdose?Some people overdose intentionally because they want to end their life. Others overdose unintentionally, which could be due to a number of reasons including:

o The drug taken was stronger than or different to what was expected. It's impossible to know what substances illegal drugs contain or how strong they are as they vary from batch to batch.1 With new psychoactive substances ('synthetic drugs') entering the market and being added to common drugs, there is more chance of not knowing what illegal drugs contain. For example, there are reports of NBOMes being added to ecstasy pills.3

o Alcohol and other drugs affect memory, thinking and judgement. This makes it easy to forget what and how much has already been taken. A large amount or a mix of drugs can then be taken without enough thought for the possible risks.1 It can also lead to people making someone else's drink stronger than expected or adding a drug to it for fun, without thought for the serious mental and physical consequences. This is classed as 'drink spiking', which is illegal and can result in a hefty fine.

The decision to take a drug and/or the dose was based on someone else's reaction to it. Drugs affects everyone differently, depending on:

o Size

o Weighto Healtho Whether the person is used to taking ito Whether other drugs are taken around the same timeo The amount takeno The strength of the drug

Signs and symptoms of overdoseDepressant drugsDepressant drugs, including heroin and other opioids, benzodiazepines and alcohol, slow the messages travelling between the brain and the body.

Some signs of a depressant drug overdose include:

Vomiting     Unresponsive, but awake  Limp body  Pale and/or clammy face Bluish fingernails and/or lips  Shallow or erratic breathing, or not breathing at all  Slow or erratic pulse (heartbeat) Choking sounds or a gurgling noise  Loss of consciousness Death3

Stimulant drugsStimulant drugs, including amphetamines (such as ice) and cocaine, speed up the messages travelling between the brain and the body.

Some signs of a stimulant drug overdose include:

Agitation Paranoia Severe stomach pain Difficulty breathing Seizures Chest pain Heart attack Heart stops  Coma  Stroke Death4

ParacetamolParacetamol causes the largest number of overdoses where the person is taken to hospital. It's often involved in episodes of intentional self-harm by young people, where they take more than the recommended dose.

Some signs of paracetamol overdose include:

Yellowing of the skin and the whites of the eyes (jaundice) Loss of coordination Low blood sugar (hypoglycaemia), which can cause sweating, trembling and irritability Liver damage

Death5,6

Overdose and organ damageNon-fatal overdoses may still cause permanent organ damage. The liver and the kidneys are two organs at very high risk. Overdose can also cause brain damage due to the person not breathing for a period or limited oxygen intake.7

What to do if someone overdosesIf someone looks like they are in trouble or sleeping and can't be woken after consuming alcohol or using other drugs, it's very important that they receive medical help as soon as possible. A quick response can save their life.

o Call an ambulance. Dial triple zero (000). Ambulance officers are not required to involve the police.

o Stay with the person until the ambulance arrives. Find out if anyone at the scene knows CPR in case the person stops breathing.

o Ensure the person has adequate air by keeping crowds back and opening windows or taking them outside. Loosen tight clothing.

o If the person is unconscious or wants to lie down, put them in the recovery positionby gently rolling them onto their side and slightly tilting their head back. This is to prevent them choking if they vomit and allows them to breath easily.

Provide ambulance officers with as much information as you can, such as how much of the drug was used, how long ago and any pre-existing medical conditions. If they have taken a drug that came in a packet, give the packet to the ambulance officers.

If you can't get a response from someone, don't assume they are asleep. Not all overdoses happen quickly and sometimes it can take hours for someone to die. Action taken in those hours could save a life.

NaloxoneNaloxone (also known as Narcan®) reverses the effects of opioids, particularly in the case of an overdose. Naloxone can be injected intravenously (into a vein) or intramuscularly (into a muscle) by medical professionals, such as paramedics. It can also be administered by family and friends of people who use opiates. Speak with your doctor or general practitioner for more information.Overdose response plan

Further informationStatistics

Statistics on overdose

Reducing the risks Drink spiking Supervised injecting facilities Help and support Treatment

Resources

SMS service: Get the effects by text

References1. Pennington Institute. (n.d.) Overdose basics.2. Gerstner-Stevens, J. (2013). Analysis results for Victorian seizures of emerging psychoactive substances and pharmaceutical opioids for 2012–13. Drug Trends Conference 2013. Melbourne: Victoria Police.3. Harm Reduction Coalition. (n.d.). Recognizing opioid overdose.4. MedlinePlus. (2014). Methamphetamine overdose.5. Quay, K. & Shepherd, M. (2010). Starship Children's Health Clinical Guideline: Paracetamol poisoning [PDF:31KB].6. National Health Service. (2013). Symptoms of poisoning.7. E Medicine Health. (2014). Drug overdose. 

National drug policyhttp://www.druginfo.adf.org.au/drug-facts/national-drug-policyhttp://www.nationaldrugstrategy.gov.au/

National Drug StrategyThe National Drug Strategy (NDS) and its forerunner, the National Campaign Against Drug Abuse (NCADA), have been operating since 1985. Both NCADA and NDS were created with strong bipartisan political support and involve a cooperative venture between the Commonwealth and state/territory governments as well as the non-government sector.

WelcomeThe National Drug Strategy, a cooperative venture between Australian, state and territory governments and the non-government sector, is aimed at improving health, social and economic outcomes for Australians by preventing the uptake of harmful drug use and reducing the harmful effects of licit and illicit drugs in our society.

On this website you will find information about the National Drug Strategy and the advisory structures that support the strategy; links to the current drug campaign sites with information on initiatives at national, state/territory or community levels; the key research and data components supporting the strategy; publications; and key links to relevant government, professional organisations and drug-related portal sites.

What's New? Public consultation for draft National Drug Strategy 2016-2025 National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014-2019 National Alcohol and other Drug Workforce Development Strategy 2015-2018 Framework for a National Response to New Psychoactive Substance

National Guidelines for Medication-Assisted Treatment of Opioid Dependence National Pharmaceutical Drug Misuse Framework for Action (2012-2015) Updated Fetal Alcohol Spectrum Disorders in Australia: An Update Australian secondary students' use of tobacco, alcohol, and over-the-counter and

illicit substances in 2011 National Tobacco Strategy 2012-2018 National Drug Strategy 2010-2015

Public consultation for draft National Drug Strategy 2016-2025The Intergovernmental Committee on Drugs (IGCD) invites feedback on the draft National Drug Strategy 2016-2025.

National Drug Strategy 2010-2015The Ministerial Council on Drug Strategy approved the National Drug Strategy 2010-2015 at its meeting held in Perth on 25 February 2011. 

The strategy is the result of an extensive consultation process that began in December 2009 with the release of a consultation paper and concluded in December 2010 with the close of comments on a draft of the strategy.