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Advice and guidance on substance abuse


Substance abuse is a far-reaching term that accounts for the hazardous or harmful use of anything with mind-altering properties, including nicotine, alcohol, prescription and illicit drugs.

There are various indicators that help identify when substance use has tipped into substance misuse or substance abuse.

These include not being able to stop using the substance, regular use, using more than intended, using even when there are detrimental outcomes or consequences, beginning to fail to fulfil duties and obligations due to use and increased tolerance to the substance.

In some cases where substances are being abused, alcohol, for example, physical withdrawal symptoms may be present when use is reduced or stopped.

Some people would categorise any use of substances that can cause harm, as abuse. Certainly, someone doesn’t have to abuse substances in order to be harmed by them.

If you are worried about your own use of substances or that of someone else, speaking to someone about your concerns will help. Your call may prevent or relieve much heartache, allow you to take proactive and positive action and could even save a life.

Illustration of 2 drunk men suffering with alcohlism and one sitting down

Risks of substance abuse

The severity of the risks of substance abuse depends on which substance is being abused and to what extent. But, by its very nature, substance abuse causes harm to health, relationships, lives and society.

Abuse of illicit substances such as opiates create a very real risk of overdose which can result in death. Since 2006, more than half of all drug deaths in England and Wales have involved an opiate, with heroin and morphine involved in the majority of those deaths, according to the Office for National Statistics (ONS).

That is not to say that illicit drug use is necessarily the most worrying type of substance abuse. 

ONS figures show there were 3,756 deaths related to drug poisoning in 2017. In the same year, there were 7,697 alcohol-specific deaths – more than double the number of drug poisoning deaths. In addition, there were a further 1,952 deaths related to unspecified hepatitis and fibrosis and cirrhosis of the liver, causes that are often alcohol linked.

As the indicators of substance abuse show, it means an individual becomes focused on using to the detriment of themselves and others in their lives. This must be taken seriously whatever substance they are using. Help is available regardless of which substance is the issue.

Potential penalties for possession of illegal drugs

Possession of illegal drugs is a crime and can lead to prosecution, but seeking help for illegal drug use is unlikely to result in criminal action.

Recent news reports have indicated some police forces are even adopting policies of not prosecuting people when they are found in possession of drugs if they agree to undergo treatment.

However, officially, if someone is found in possession of class A drugs (such as cocaine, ecstasy, heroin, LSD or magic mushrooms) they could face up to seven years in prison. Possession of class B drugs, including amphetamines, ketamine, Spice and cannabis, could lead to five years in jail. Whilst possession of class C drugs, such as anabolic steroids, GBL and GHB, could lead to two years in prison. 

Any evidence of supplying or intent to supply a drug is much more likely to lead to prosecution and a severe penalty. For class A drugs this can mean a life sentence. It is worth remembering that giving a drug to a friend may be classed as supply.

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Substance abuse – medications 

In the case of opiate abuse, methadone can be prescribed as a substitute to reduce harm from injecting and the risks involved with using unlicensed substances. Methadone can also be used to help manage withdrawal symptoms.

There are various medications for alcoholism and alcohol dependency to help reduce cravings and manage withdrawal symptoms.

In the case of stimulant drugs, such as amphetamine, cocaine and crack cocaine, antidepressants are sometimes prescribed to provide an alternative to use.

It’s important to be aware that substance abuse is most likely a symptom of an underlying problem. People tend to end up abusing substances because other coping mechanisms have failed. They do not choose to abuse substances and may not want to abuse substances but have become ill with substance dependence and need help to get well.  

Removing substances without work to uncover the issue that led to substance abuse – and to put in place alternative coping mechanisms – is unlikely to lead to sustained recovery.

Naloxone – life saving drug to keep at home in case of overdose

Naloxone is a potentially life-saving medication that can temporarily reverse opiate overdose effects that cause breathing difficulties.

Friends and family of users of opiates, such as heroin, methadone and morphine, can carry naloxone to allow it to be administered immediately in an emergency overdose situation. 

Naloxone has a low risk of serious side effects and anyone capable of learning basic life support can be taught to recognise the signs of opiate overdose and administer naloxone.

Treatment for substance abuse

There is a wide range of treatments and help available for substance abuse, both via the NHS and privately.

GPs and hospitals may be able to prescribe medications to help with withdrawal symptoms or cravings. They are likely to offer signposting services to treatment providers, support groups and charities. They may be able to provide detox and counselling support. It is not unusual for there to be waiting lists for NHS drug and alcohol treatment services. 

Residential treatment is widely available in the UK for people who are heavily dependent on substances, including illicit or prescription drugs and alcohol. This is sometimes available via the NHS, with many private options for a range of budgets. Medical insurance may cover these costs.

Residential treatment is the most effective route to recovery from serious substance dependence.

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