It’s not just the opioid crisis — substances commonly associated with street drugs or addiction are a huge part of the health industry.
- Societal pressures can play a huge roll in the development and management of substance use disorders, which means if you see someone abstaining from a potentially addictive substance, do not prompt them to relapse
- SUDs are considered mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)
- SUDs are not covered under the National Disability Insurance Scheme (NDIS), however a person with a history of alcohol or drug dependence will not become ineligible for psychosocial support
This edition of Disability Support Guide will address substance use, substance abuse and substance use disorder (SUD), along with addressing addictive substances and their utility for disability management and the health industry.
It is important to note that moderation is important for any substance use if legal or prescribed which may have addictive properties. Substance addiction is an invisible disorder which people are not equally vulnerable to develop and those who do are by no means ‘bad’ people for simply having the mental disorder.
This article refers to use of the 10 following substances, as outlined by the DSM-V in diagnosing SUD:
- Hypnotics, or anxiolytics
- Stimulants (including amphetamine-type substances, cocaine, and other stimulants)
Substance use is distinct from substance abuse and SUD. Substances which are considered street drugs such as stimulants, cannabis, hallucinogens, inhalants, sedatives and hypnotics are used to treat a variety of different psychosocial, developmental, learning or acquired disabilities or conditions.
In Australia, medicinal cannabis (prescribed by a doctor) is legal in Australia throughout all States and Territories in the country, whereas recreational use is only legal in the Australian Capital Territory (ACT). Medicinal cannabis is used to treat depression, anxiety, pain and glaucoma.
Psilocybin (magic mushroom) is a hallucinogen which will be used to treat treatment-resistant depression in Australia from July 1, 2023.
Nitrous oxide is an inhalant administered by dentists and is also legal under certain regulations in Australia.
Hypnotics such as Zolpidem (‘Stilnox’) are used to aid Australians with prolonged difficulties getting sleep and may be prescribed for the treatment of anxiety and insomnia.
Sedatives are similar to hypnotics, as they decrease activity and response time, however sedatives are intended to have a numbing or calming effect, rather than induce sleep. Benzodiazepine may be prescribed to Australians with an anxiety disorder or insomnia for use.
Stimulants may be legally prescribed for people with narcolepsy or attention deficit hyperactivity disorder (ADHD), such as methylphenidate (Ritalin). However, amphetamine medications such as mixed amphetamine salts (Adderall) are strictly prohibited for use in Australia.
Opioids and synthetic opioids such as fentanyl may be used for chronic or severe pain relief, but are otherwise strictly illegal. The ‘opioid crisis’ refers to an epidemic of substance abuse as a result of addiction to prescribed opioid medicines.
Alcohol, caffeine and tobacco are all available for Australians over the age of 18 for legal and recreational use. As a result, most instances of addiction throughout the nation are related to alcohol, caffeine and tobacco dependence.
Substance abuse refers to an excess or habitual consumption of addictive substances or their misuse through polypharmacy for adverse effects (ie. drinking alcohol in tandem with consuming prescribed sedatives).
Substance abuse does not necessarily constitute an SUD, as a person with an SUD is either physically or mentally dependent on repeated consumption. Alcohol use disorder, for instance, can lead to alcohol withdrawal syndrome, also known as delirium tremens — which is fatal in 37 percent of cases.
Substance use disorders
SUDs can be personally embarrassing, professionally and socially detrimental, potentially fatal and incredibly difficult to overcome without support. The NDIS does not consider SUDs to be an impairment which requires funding, as mainstream support options are available to combat and overcome a dependence. The NDIS does not support ‘comorbidity’ of dependence disorders, such as a person suffering from both drug and alcohol addiction. However, a history of SUD does not rule out the possibility of NDIS funding for a psychosocial disability, provided documentation can support an impairment which requires ongoing support.
Substance use can quickly spiral into substance abuse and a SUD, which can then develop into substance-induced disorders. Substance-induced disorders are characterised by tremors, hallucinations, memory loss, mood swings, seizures and a history of dependence. In extreme cases, withdrawals may require immediate medical attention. If you or a loved one wishes to seek help and overcome addiction, please visit the Government support portal for more information.