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2. Addictions

Homelessness Information Kit for Volunteers

 

Important note

The following is some basic information about addictions, drug and alcohol abuse and misuse. It should not be treated as medical or other professional advice or information about treating a person with an addiction or addictions.  

Addictions: Alcohol, Other Drugs and Gambling

Addictions can have a negative impact on the physical, mental and social health of any individual. 

Addiction can lead to a loss of skills in basic self care, health and nutrition and homelessness.

Addiction can lead people to engage in behaviours that they would not have otherwise participated in to support their dependency such as anti-social behaviour and crime, failure to prioritise self care and excessive risk taking behaviours.

Some consequences of addictions

Some of the consequences of addictions include:

  • Alienation and isolation from family and friends
  • Poor physical health
  • Terminal or chronic long term illness
  • Reduction in brain function
  • Poor nutrition
  • Loss of stability
  • Unemployment
  • Homelessness
  • Change of behaviour
  • Shame
  • Imprisonment
  • Overdose and possible death


People can and do recover from addictions

People who experience these problems may have varying degrees of insight into their addiction.  The window of opportunity in terms of an individual’s desire for change may be very small.  No one person can make another commit to recovery; however it is possible to continuously and gently remind and suggest to people that there are treatment options available.  It is worth persisting, recovery takes time, many people have recovered.

Treatment of addiction in any form requires a significant change in the lifestyle of the individual and more often than not the road to recovery can seem more challenging than continuing with using or drinking.

Many people who have successfully changed their lives and managed their addiction have had to try several treatment options before succeeding.  Each break in drinking or using and each attempt to change are important.

Harm Minimisation

Harm minimisation refers to those activities that our community can provide to help minimise injury or illness whilst someone may continue to use or be addicted to substances. Examples of harm minimisation programs include:

  • Needle and syringe exchange programs (reduce the incidence of conditions which can be transferred to other people through the sharing of needles).
  • Methadone and other drug replacement programs (where the illicit drug of addiction is replaced with a legal substitute which may increase people’s quality of life and reduce anti-social or criminal behaviour of people addicted to illicit drugs such as heroin).
  • Medically supervised injecting centres (provide clean equipment, supervision, immediate medical assistance and advice and referral to other support services to injecting drug users).
  • Controlled drinking programs (reduce the physical and psychological harms of excessive drinking). 

Treatment

‘Detox’

If a person decides they would like to stop using drugs or abusing alcohol and go into treatment for their drug and alcohol addiction they may want to consider going to detox first.  Many rehabilitation centres require a client to detox before admission. 

Detoxification addresses the physical impact of drug and alcohol withdrawal.  Some offer medication to manage the physical discomfort while others are non-medicated and simply offer medical supervision.

Some people may simply want a break from their drinking or using and this ought to be encouraged as it provides some respite and gives the body a break. 

A homeless person is more likely to eat well and have the opportunity to engage in other forms of assistance and general health care if he or she presents to an impatient detoxification.

Rehabilitation

Some rehabilitation programs are for 28 days, 6 months, 12 months and more.  Most rehabs require abstinence from residents.  Some rehabs are day programs without a residential facility.

Rehabilitation facilities operate different methods and philosophies.  Some are faith based, some are 12 step and others focus on cognitive behavioural therapy.  There are many different types of treatment available and different approaches work for different people.

It is not uncommon for people to require rehabilitation several times before significantly changing their life.

Some types of drugs

  • Alcohol – over the counter standard spirits, beer and wine, methylated spirits, vanilla essence, cough mixture
  • Cannabis – marijuana and hashish
  • Opiates – heroin, morphine, codeine, methadone, pethidine,
  • Stimulants - amphetamines (speed, ice, meth), ecstasy, MDMA, cocaine,
  • Gamma Hydroxy Butyrate (GHB)
  • Over the counter or prescription drugs – benzodiazepines, morphine, sleeping pills, cold and flu medicine
  • Hallucinogens – LSD, magic mushrooms,
  • Inhalants – petrol, paint, glue, butane gas (lighter gas), amyl nitrate

Alcohol

Alcohol is the most common and the most misused drug in our community. Most of us know about the short term effects of too much alcohol. These effects include:

  • Intoxication
  • Feeling of ‘well being’
  • Behavioural changes and loss of inhibition
  • Impaired perception
  • Slurring of speech
  • Disturbances of sleep
  • Memory loss (eg. Blackouts)
  • ‘Hangover’


Longer term effects of alcohol misuse or ‘dependence’ can include:

  • Tolerance to the effects of alcohol (needing more alcohol to ‘feel’ the same way)
  • Depression and/or anxiety
  • Inattention to other aspects of living (eg. Work, family etc)
  • Brain damage
  • Liver damage
  • Poor nutrition

Cannabis (Marijuana)

Cannabis is a fairly common illicit drug. For many years it was viewed as a relatively harmless drug, however, there is now significant evidence to indicate that heavy use of cannabis may result in psychosis (to those people who may be pre-disposed). The effects of this drug may differ from person to person, however some short term effects include:

  • Relaxation
  • Impaired concentration
  • Increased appetite
  • Reduced inhibition
  • Memory problems
  • Panic/anxiety
  • Paranoia

Longer term effects of high cannabis use include:

  • Memory problems/confusion/impaired brain function
  • Reduced motivation
  • Respiratory problems (because cannabis is usually smoked)
  • Psychosis (to those who may have a predisposition)
  • Tolerance and dependence 

Heroin

Heroin is an illicit drug made from opium and other chemicals that depresses the central nervous system and also acts as pain relief.
The short term effects of using heroin can include:

    • Lethargy
    • Drowsiness
    • Nausea
    • Constipation
    • Constricted pupils
    • Slowed breathing and heart rate
    • Slowed reactions


The longer term effects of using heroin can include:

    • High risk of addiction
    • Mood swings
    • Depression
    • Anxiety disorders
    • Chronic constipation
    • Infection at site of injection
    • HIV and hepatitis infections through sharing of needles and/or injecting equipment
    • Non-fatal  and non-fatal overdose

Mixing heroin with other drugs including alcohol contributes to the risk of overdose.

Amphetamines (speed, ice or meth)

The symptoms of using amphetamines can include:

    • Increased blood pressure and pulse rate
    • Increased breathing
    • Teeth grinding
    • Anxiety
    • Restlessness
    • Insomnia
    • Fever and sweating
    • Flushing
    • Dry mouth and lips
    • Dilated pupils
    • Nausea and vomiting
    • Mood swings

Consequences of using speed can include:

    • Paranoia
    • Hallucinations
    • Chronic sleep problems
    • Cracked and chipped teeth
    • High blood pressure
    • Receding gums
    • Panic attacks
    • Anxiety
    • Nervousness
    • Decreased emotional control
    • Severe depression
    • Violent behaviour
    • Speed psychosis
    • Nerve cell damage
    • Death from heart failure or suicide
    • High risk of addiction, especially if injected
    • HIV and hepatitis infections through sharing of needles or injecting equipment


Many of the negative effects of amphetamine use are related to mental health. Some of these effects are: anxiety, panic attacks, paranoia, depression, hallucinations and decreased emotional control. Regular use can induce personality changes with users typically becoming irritable, suspicious, dysphoric, anxious and at times aggressive.

One of the most common effects of amphetamine overdose is 'speed psychosis' which closely resembles the effects of a sudden attack of paranoid schizophrenia. It usually begins with a heightened awareness of the environment and feelings of anxiety and tenseness. A sense of suspicion and the feeling of being watched soon follows, and this may be vague or strong in terms of emotional intensity (NDARC 2004).

Research shows that both physical and verbal violence are associated with long-term amphetamine use. Heavy 'binges' on amphetamines are associated with reckless and aggressive behaviour.

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Overdose

If you are ever concerned that someone may have overdosed on any type of drug immediately TELEPHONE 000 FOR AN AMBULANCE.

People who have overdosed on illegal drugs will NOT be arrested or have police involvement. The most important thing is to ensure that medical attention is provided immediately. This can be life saving.
                    

Some indications of a possible drug overdose can be:

  • convulsions or tremors
  • agitation
  • breathing difficulties
  • drowsiness
  • excessive sweating
  • hallucinations, paranoia, or violent behaviour
  • co-ordination problems
  • abnormal pupil size or pupils that do not change when exposed to light
  • nausea and vomiting
  • staggering or unsteady walk
  • unconsciousness
  • complexion changes colour

NB: the indicators of overdose will vary depending on the drug (or drugs) used by the person overdosing.

Gambling

Obsessive gambling can result in financial ruin. Within our community there are a multitude of opportunities for gambling. These can include sports or race betting, poker machines, casino gambling and internet gambling.

It is usually only a small group of people who gamble that develop an addiction. Something that may begin as a harmless diversion of recreational activity can sometimes become an obsession. This can result in loss of family, financial problems, stress, bankruptcy, criminal behaviour and self harm. In some instances it may result in suicide.

There are a number of options for gambling counselling and recovery and these are provided as links at the end of this chapter. Many addicted gamblers have successfully recovered and gone on to regain their lives, families and self esteem.

Homelessness and addictions

The incidence of drug and alcohol use and misuse, other addictions and dependence is high in the chronically homeless population. It is the single most self-reported problem identified by people who contact the Homeless Persons Information Centre.

Addictions and physical dependence on substances can create such very strong cravings in people that they neglect other activities of daily life. Some gamblers have been known to be so obsessed with gambling that they might ‘sleep rough’ in preference to paying for housing or accommodation. They may also not eat properly. This then leaves all available income for gambling. This may seem like bizarre behaviour to other people, but to addicted gamblers the obsession can be so strong that it overwhelms all other social, health or self care needs.

A lot of people may become briefly homeless as a result of some kind of addiction. In many instances they may be so distressed by this experience that it provides a significant motivation to try to deal with the addiction. They may then attend counselling or detox or seek out self help groups.

Chronic homelessness and addictions

Some people with addictions may become chronically homeless. A lot of people associate alcoholism with ‘the older homeless man drinking from a brown paper bag’. However, these people represent a very small proportion of people with alcoholism. Most alcoholics and recovered alcoholics live and work amongst us and get on with their lives. The few alcoholics who live on the streets may have significant health and psychological problems. They may be regular users of Intoxicated Persons Units. Whilst leaving the streets may be difficult, it is possible and there are a number of people in the community who have done so. They may require long term rehabilitation, but it can be done.

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Links

Alcohol

Drugs

Gambling

Rehabilitation and other recovery and support services in NSW

 

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Please Note:
While care is taken to ensure accuracy, the City of Sydney cannot guarantee that information expressed here is correct and recommends that users exercise their own skill and care with respect to its use. The City of Sydney makes no warranty or undertaking, whether expressed or implied, nor does it assume any legal liability, whether direct or indirect.