substance use

trauma +

Contents:Who is this booklet for and What does it do? 1

What is a traumatic event? 1

hoW common are traumatic experiences? 1

common reactions to traumatic experiences 2

trauma and substance use 3

When should i seek help? 4

hoW are trauma symptoms treated? 4

tips for staying Well 5

techniques for staying Well 7

Where to get help 14

About this booklet:this booklet is part of a series on mental health and substance use funded by the australian government department of health and ageing.

substance use in this booklet refers to the use of alcohol, tobacco and other drugs.

Other booklets in this series include:

• AnxietyandSubstanceUse• MoodandSubstanceUse• PsychosisandSubstanceUse• PersonalityandSubstanceUse

Available at www.ndarc.med.unsw.edu.au

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Who is this booklet for And WhAt does it do?• Thisbooklethasbeenwrittenforpeoplewhousealcohol,tobaccoorotherdrugs

whohavegonethroughatraumaticexperience.• Itaimsto:

—Helpexplainwhypeoplefeelthewaytheydoafterhavinggonethroughatrauma.—Givesuggestionsaboutthingspeoplecandotohelprecoverfromthetrauma.

WhAt is A trAumAtiC event?• Atraumaticeventisanyeventwheresomeone’slifeorsafetyisatseriousrisk.• Peoplecanexperiencethemthemselvesortheymightwitnessthemhappening

tosomeoneelse.• Theycanbeone-offevents,likecaraccidents,armedrobberies,ornaturaldisasters

(e.g.,bushfires,floods,earthquakes).• Ortheymaybedrawnout,likebeingexposedtowar,domesticviolence,orphysical

orsexualabuse.

hoW Common Are trAumAtiC experienCes?• Traumaticexperiencesareverycommon—threeoutofeveryfourpeopleinAustralia

haveexperiencedatleastonetraumaticeventintheirlifetime.• Traumaticexperiencesareevenmorecommonamongpeoplewhohavealcohol,tobacco

orotherdrugproblems.Almosteveryonewhohasanalcohol,tobaccoorotherdrugproblemhasexperiencedatraumaticevent.

• Ifyouhaveexperiencedtrauma,youarenotalone.

What are some of the traumatic events you have experienced? You may wish to write them down here.

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2  •  trAumA + substAnCe use

Common reACtions to trAumAtiC experienCes• Eachpersonisdifferentandrespondstotraumaintheirownway.However,thereare

particulartypesofreactionsthatarecommon(seeTable1).• Manypeoplehavestrongemotionalorphysicalreactionsaftergoingthroughatrauma.

Traumaticeventsmayalsoaffectthewayapersonthinksandbehaves.Thesearenormalreactionstoanabnormalevent.

• Formostpeople,thesefeelingsstartsoonafterthetraumaticeventhasoccurred.Forsome,however,thesefeelingsmaynotappearuntilmonthsoryearsaftertheevent.

table 1: Reactions to trauma

Traumacanaffectthewayyoufeelemotionallyandphysically,thewayyouthink,andthewayyoubehave.Thistableshowssomecommonsymptomsoftrauma.Have you experienced any of these reactions? Tick (4) the box next to the reactions that you have experienced.

physical reactions

Feelingonedgeandonthelook-outforsignsofdanger Beingeasilystartled(e.g.,byloudnoisesorsuddenmovements) Difficultyfallingorstayingasleep Sweatingorhavingaracingheartbeatwhenremindedofthetrauma

Changes in thinking

Intrusivethoughts—memoriesoftheeventyoucan’tcontrol ‘Flashbacks’—feelingasifthetraumaishappeningagain Nightmaresabouttheevent Tryingtoblockoutthinkingabouttheevent Findingithardtoconcentrateandrememberthings Havinganalteredperceptionofyourself(e.g.,Iamabadperson)andtheworld

(e.g.,theworldisadangerousplace)

emotional reactions

Fearoranxiety Sadnessordepression,hopelessnessanddespair,thoughtsofsuicide Angerorirritability Guiltandshame Lossofcontrol Numbanddistantfromothers Lossofinterestinthingsyouusedtoenjoy Lossofinterestinsex

Changes in behaviour

Avoidingthinkingabout,orlettingyourselfhavefeelingsabout,thetrauma Avoidanceofpeople,placesoractivitiesthatremindyouoftheevent Usingalcohol,tobaccoorotherdrugstocope Withdrawingfromothers

trAumA And substAnCe use• Somepeopleincreasetheiruseofalcohol,

tobaccoorotherdrugstocopewithhowtheyarefeelingafterexperiencingtrauma.Thisisoftencalled‘self-medication’.

• Whilethisoftengivessomeshort-termrelief,unfortunately,inthelong-termitcanmakethingsworse.

• Alcohol,tobaccoandotherdrugusecaninterferewiththebrain’snaturalprocessingofthetrauma.Peopleoftensaythatwhentheyreduceorstopdrinking,smokingorusing,theirtraumareactionsbecomemorefrequentorintense.Thisisthebody‘swayofsayingthatthetraumaisunfinishedbusinessthatneedstobedealtwith.

• Somepeoplefindthattheydevelopalcohol,tobaccoorotherdrugproblemsbecausetheyneedtodrinkorusegreateramountsmorefrequentlytokeepthetraumareactionsatbay.Thiscanleadtoacyclewherereactionstotraumaandalcohol,tobaccoorotherdrugusefeedoffeachother(seeFigure1).

What happens to your trauma symptoms when you reduce or stop using alcohol, tobacco or other drugs? do you notice any changes?

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Alcohol, tobacco or other drug use

Trauma

Craving

Figure 1:Cycleoftrauma,cravings,andalcohol,tobaccoorotherdruguse

4  •  trAumA + substAnCe use

What happens to your alcohol, tobacco or other drug use when you are experiencing trauma symptoms?

When should i seek help?• Mostpeoplewhogothroughatraumaticeventwillnotrequiretreatment.• Formanypeople,thefeelingstheyexperiencewillbedistressing,buttheywillsettle

withinamonthorso.Butforsome,thesymptomsmaycontinueorgetworse.Inafewcases,thesemaydevelopintomoreseriousconditionssuchasdepression,posttraumaticstressdisorder,orotheranxietydisorders.

• Youshouldseekprofessionalassistanceifyouansweryestoanyofthefollowingquestions(seepages14–16):

Areyoursymptomsverydistressing? Haveyouhadthemformorethanacoupleofweeks? Dotheyinterferewithyourhome,work,study,relationshipsorsociallife? Doyouusealcohol,tobaccoorotherdrugstocope? Haveyouthoughtaboutharmingyourselforothers?

hoW Are trAumA sYmptoms treAted?• Effectivetreatmentsareavailable.Bothpsychologicaltherapyandmedicationcanhelp

peopleaffectedbytraumaticeventsrecover.

psychological therapy• Psychologicaltreatmentsusuallyinvolvetrauma-focusedtherapy.Thesefocuson

providingeducation,stressmanagementtechniques,andhelpingthepersontoconfrontfearedsituationsanddistressingmemories.

• Ifyou’reinterestedinseeingapsychologist,yourGPcanhelpyoubypreparingamentalhealthplan,andreferringyoutoanappropriatepsychologist.

medication• Medication,particularlysomeoftheanti-depressantdrugs,mayalsobehelpful

alongsidetrauma-focusedpsychologicaltherapy.

• Medicationscanbehelpfulinmanagingyourtraumasymptoms;however,somepeopleexperienceunpleasantanddistressingsideeffects.Inmostinstancesthereisachoiceofmedicationavailable,butitmaytaketimetoestablishwhichmedicationisbestsuitedtoyourneeds.Tellyourdoctoraboutanysideeffectsthataredistressingyou.

Interactions with alcohol, tobacco or other drugs• Itisveryimportantthatyoufollowyourdoctor’sinstructionswhentakinganymedication

thathasbeenprescribedtoyou.• Beforebeingprescribedmedicationitisimportanttotellyourdoctoraboutyouralcoholor

otherdrugusesothattheymaygiveyouthebestpossiblecare.Alcohol,tobaccoandotherdrugscaninteractwithsomeprescriptionmedications,andthisinteractionmayaltertheeffectivenessofthemedication.Mixingprescribedmedicationswithalcoholorotherdrugscanalsohavedangerousconsequencesincludingoverdoseandpossiblydeath.

• Ifyouusealcohol,tobaccoorotherdrugsandareonmedication,letyourdoctorknowifyouareplanningtostopusingalcohol,tobaccoorotherdrugs.Whenyoustopdrinking,smokingorusing,thebloodconcentrationsofothermedicationscanalsobeaffectedsothedoctormayneedtoadjustthedoseofyourmedication.

tips for stAYing WellThereareanumberofthingsyoucandotolookafteryourselfandhelprecoverfromatraumaticevent.• Take care of yourself.Recognisethatyouhavebeenthroughadistressingexperience

andallowyourselftoexperiencesomereactiontoit—don’tbeangrywithyourselfforbeingupset.Makesureyoueathealthilyandgetregularexercise.

• Make time for rest and relaxation.Stressandanxietycanmakemanyproblemsseemworse.Trytoreducestressandanxietybygivingyourselftimetorestandrelax.Youcanusetechniquessuchascontrolled breathing, progressive muscle relaxation, or mindfulness(thesetechniquesaredescribedonpages7–11,oranyotheractivityyoufindrelaxing(e.g.,reading,listeningtomusic,goingforawalk).Thesetechniquescanalsohelpyoumanageyourcravingsorurgestousealcohol,tobaccoorotherdrugs.

• Avoid or limit your use of alcohol, tobacco or other drugs.Alcohol,tobaccoandotherdrugscanintensifysometraumasymptoms.Itisrecommendedthatnomorethantwostandarddrinksshouldbeconsumedeachday(forfurtherinformationrefertotheAustralianDrinkingGuidelines).Avoidhighdosesofsubstances,andriskydrugtakingbehaviour,suchasinjectingdruguse.Takeregularbreaksfromdrinkingorusing,andavoidusingmultipledifferenttypesofdrugs.Ifyouhavebeendrinking,smokingorusingregularlyitcanbedifficulttocutdown.Theactivitieslistedonpages7–13ofthisbookletmayhelpyoucopewithyourcravingsandurgestouse.

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• Take medication as prescribed. Avoidmixingmedicationwithalcohol,tobaccoorotherdrugs,asthiscouldhavedangerousconsequences,suchasmakingprescribedmedicationineffectiveorincreasingtheeffectsofalcoholorotherdrugs.

• Try not to block out thoughts of what has happened.Althoughthisishard,itisimportanttoletyourmindprocesswhathashappened.Listentoyourthoughts,butdonotpaytoomuchattentiontothem.Donotthinkofthemas‘good’or‘bad’thoughts,butjustasthoughtsthatareequaltoeachother.Remember,whilethememoriesmaybedistressing,theeventisnothappeningagain—itisonlyamemoryandthememorycannothurtyou.Thiscanbeseenasnature’swayofhelping.

• Seek support. Everyoneneedssupport. Shareyourexperienceswithpeopleyoutrustorwritethemdowninadiary.Theserviceslistedattheendofthisbookletmayalsobeuseful.

• Plan to do something each day that brings a sense of achievement. Ofteneverydaytaskslikewashing,cleaning,payingbillsorreturningphonecalls,tendtopileupwhenapersonisgoingthroughahardtime.Thiscanbecomeoverwhelmingasthepilegetsbiggerandbigger.Byjustchoosingoneoftheseactivitiestodoeachday,youcanpreventthingspilingup,whichcanhelpyoufeelabitmoreincontrolofyourlife.Theflow-oneffectcanbearealsenseofachievement(orrelief)thatthisactivityhasbeencompleted.

• Monitor your emotions. Trykeepingtrackofyouremotionsandtraumasymptomsinadiary.Writedownhowyouhavefeltatdifferenttimesoftheday.Whenwereyourtraumasymptomshighest,whenyoufelttheworst?Whenwereyourtraumasymptomslowest,whenyoufeltbest?Whatwereyoudoingandwhatwereyouthinkingatthosetimes?Whendidyouhavecravingstousealcohol,tobaccoorothersubstances?Howmuchsleepdidyouhaveeachnight?Keepingadiaryofyouranxietyandemotionscanhelpyoulearnthepatternsbetweenthewayyoufeel,thethingsyoudoandthewayyouthink.

What strategies do you find help manage your trauma reactions?

6  •  trAumA + substAnCe use

teChniques for stAYing Well Theactivitiesandtechniquesonthefollowingpagescanbeusedtohelpmanagetraumasymptomsandcravingstousealcohol,tobaccoandotherdrugs.Youcanalsousethemeverydayaspartofageneralplantostaywell.Whilemanypeoplefindthetechniquesonthefollowingpagesuseful,theydon’tworkforeveryone.Donotusethemifyoufindthemdistressingorunpleasant—itisimportanttofindwhatworksbestforyou.

Controlled breathing exerciseHaveyounoticedsometimesthatyou’rebreathingtoofast?Stresscanaffectyourheartrateandbreathingpatterns.

Arelaxedbreathingrateisusually10to12breathsperminute.

Practisethisexercisethreetofourtimesadaywhenyou’refeelingstressedoranxioussothatyoucanusethisasashort-termcopingstrategy.

1 Timethenumberofbreathsyoutakeinoneminute.Breathingin,thenoutiscountedasonebreath.

2 Breathein,holdyourbreathandcounttofive.Thenbreatheoutandsaytheword‘relax’toyourselfinacalm,soothingmanner.

3 Startbreathinginthroughyournoseandoutslowlythroughyourmouth,inasix-secondcycle.Breatheinforthreesecondsandoutforthreeseconds.Thiswillproduceabreathingrateof10breathsperminute.Inthebeginning,itcanbehelpfultotimeyourbreathingusingthesecondhandofawatchorclock.

4 Counttoyourself.

5 Continuebreathinginasix-secondcycleforatleastfiveminutesoruntilthesymptomsofoverbreathinghavesettled.

6 Afterpractisingthisexercise,timethenumberofbreathsyoutakeinoneminute.Practisethecontrolledbreathingexerciseeachdaybeforebreakfast,lunch,dinnerandbedtime.Usethetechniquewheneveryoufeelanxious.Gradually,you’llbefamiliarenoughwiththeexercisetostoptimingyourself.

>> 7Source: beyondblueFactsheet6–Reducingstress2010

8  •  trAumA + substAnCe use

progressive muscle relaxationProgressivemusclerelaxationinvolvestensingandrelaxingdifferentmusclegroupsoneaftertheother.Ithelpstoreducephysicalandmentaltension.Afullsessionofrelaxationtakesabout15to20minutes.

1 Sitinacomfortablechairinaquietroom.

2 Putyourfeetflatonthefloorandrestyourhandsinyourlap.

3 Closeyoureyes.

4 Dothecontrolledbreathingexerciseforthreeminutes.

5 Afterthreeminutesofcontrolledbreathing,startthemusclerelaxationexercisebelow.

6 Tenseeachofyourmusclegroupsfor10seconds,thenrelaxfor10seconds,inthefollowingorder:» Hands:clenchyourhandsintofists,thenrelax» Lower arms:bendyourhandsupatthewrists,thenrelax» Upper arms:bendyourarmsupattheelbow,thenrelax» Shoulders:liftyourshouldersup,thenrelax» Neck:stretchyourneckgentlytotheleft,thenforward,thentotheright,

thenbackwardsinaslowrollingmotion,thenrelax» Forehead and scalp:raiseyoureyebrows,thenrelax» Eyes:closeyoureyestightly,thenrelax» Jaw:clenchyourteeth,thenrelax» Chest:breatheindeeply,thenbreatheoutandrelax» Stomach:pullyourtummyin,thenrelax» Upper back:pullyourshouldersforward,thenrelax» Lower back:whilesitting,rollyourbackintoasmootharc,thenrelax» Buttocks:tightenyourbuttocks,thenrelax» Thighs:pushyourfeetfirmlyintothefloor,thenrelax» Calves:liftyourtoesofftheground,thenrelaxand» Feet:gentlycurlyourtoesdown,thenrelax

7 Continuecontrolledbreathingforfivemoreminutes,enjoyingthefeelingofrelaxation.

Source: beyondblueFactsheet6–Reducingstress2010

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groundingTheremaybetimeswhenyouaresufferingemotionalpainthatyouwanttodetachyourselffrom.Ahelpfultechniqueoftenusedbypeoplewhentheyarefeelingthiswayistofocusontheoutsideworldinsteadoffocusingonwhatisbeingfeltinternally.Thistechniqueiscalledgrounding.Therearemanytypesofgroundingexercisespeopleusewithdifferenttypesworkingbestfordifferentpeople.Hereareafewdifferenttypesofexercisesyoumightfinduseful.

Examples of mental grounding:

• Describeobjectsinyourenvironmentindetailusingallyoursenses.• Describeaneverydayactivity,suchaseatingordrivingtowork,indetail.• Useagroundingstatement.“IamJo,Iam23yearsold,Iamsafehere,todayis...”.• Saythealphabetslowly.• Countingbackwardsfrom20.

Examples of physical grounding:

• Runcoolorwarmwateroveryourhands.• Pressyourheelsintothefloor.• Touchobjectsaroundyouasyousaytheirnames.• Jumpupanddown.• Changeyourposturetoamoreuprightone.• Stretch.• Asyouinhalesay“in”,andwhenyouexhalesay“out”or“calm”or“easy”or“safe”.

Examples of soothing grounding:

• Rubnicesmellinghandcreamslowlyintohandsandarmsandnoticethefeelandsmell.

• Sayencouragingstatementstoyourselfsuchas“You’reokay,you’llgetthroughthis”.• Thinkoffavouritesofanykindofobject(e.g.,cars)oranimal.• Thinkofaplacewhereyoufeltcalmandpeaceful,describewhereyouwere,

whatwasaroundyouandwhatyouweredoing.• Plansomethingniceforyourselfsuchasabathoragoodmeal.• Thinkofthingsyoulookforwardtodoinginthenextfewdays.

10  •  trAumA + substAnCe use

mindfulnessMindfulnessisatechniquethathelpsyoufocusonyourinternalorexternalenvironment,withoutbeingdistractedorconcernedbywhatsurroundsyou.Mindfulnesscanbeappliedtoanytaskthatyoudo,suchasdoingthewashingup,orbrushingyourteethforexample.Thisparticularactivityistoshowyouhowtousemindfulnessskillstopayparticularattentiontoaroutineactivity(walking).Thistechniquemightseemdifficulttostartwith,butifyoupractise,itwillbecomeeasier.

1 First,findaplacewhereyoucanwalkupanddownwithoutworryingaboutwhomightseeyou.Itdoesn’tmatterwhereyouare,aslongasyoucantakeabout10steps.

2 Standinarelaxedposturewithyourfeetpointingstraightaheadandyourarmshanginglooselybyyoursides.Lookstraightahead.

3 Youwillpractisewalkinglikeitisthefirsttimeyouhaveeverwalked.Startwalkingandwhileyouarewalking,practisepayingattentiontoallthephysicalandothersensationsthatoccur—sensationsthatyouprobablywouldnotnormallybeawareof.Startbybringingyourfocustothebottomsofyourfeet,noticingwhatitfeelslikewhereyourfeetcontacttheground.Feeltheweightofyourbodytransmittedthroughyourlegsandfeettotheground.Youmayliketoflexyourkneesslightlyacoupleoftimestofeelthedifferentsensationsinyourfeetandlegs.

4 Next,transferyourweightontotherightfoot,noticingthechangeinphysicalsensationsandyourlegsandfeetasyourleftleg‘empties’ofweightandpressureandyourrightlegtakesoverassupportforyourbody.

5 Withtheleftleg‘empty’,allowyourleftheeltoriseslowlyfromthefloor,noticingthechangeinsensationsinyourcalfmusclesasthishappens.Allowtheentireleftfoottoliftgentlyofftheflooruntilonlyyourtoesarestillincontactwiththeground.Slowlyliftyourleftfootcompletelyoffthefloorandmoveyourleftlegforward,noticingthephysicalsensationsinyourfeet,legsandbodychangeasyourlegmovesthroughtheair.

6 Placeyourleftheelonthegroundinfrontofyouandallowtherestofyourleftfoottomakecontactwiththefloor.Asthishappens,noticethechangesinphysicalsensationsthatoccurasyoutransfertheweightofyourbodyontoyourleftfootfromyourrightfoot.Allowyourrightfootto‘empty’ofweight.

7 Repeatthisprocesswiththerightfoot.Firstliftyourrightheelofftheground,thentherestofyourfoot,andmoveitslowlyforward,noticingthechangesinphysicalsensationsthatoccurthroughoutthismotion.

8 Keeprepeatingthisprocessasyouslowlymovefromoneendofyourwalktotheother,beingawareoftheparticularsensationsinthebottomsofyourfeetandheelsastheymakecontactwiththefloor,andthemusclesinyourlegsastheyswingforward.

9 Continuethisprocessupanddownthelengthofyourwalkforabout10minutes,beingawareasbestyoucan.

10 Yourmindwillwanderawayfromthisactivityduringyour10minutesofpractice.Thisisnormal—it’swhatmindsdo.Whenyounoticethishashappened,gentlyguidethefocusofyourattentionbacktothesensationsinyourfeetandlegs,payingparticularattentiontothecontactyourfeethavewiththefloor.Thiswillhelpyoustayinthepresentmoment,concentratingonwhatishappeningnow,ratherthanworryingaboutthepastorthefuture.

11 Tobeginwith,walkmoreslowlythanusual,togiveyouabetteropportunitytopractisethisexercise.Onceyoufeelcomfortablewiththeexercise,youmayliketoexperimentwithdifferentspeedsofwalking.Ifyouarefeelingagitated,youmayliketostartoffwalkingfast,withawarenessthatthisiswhatyouaredoing,andthenslowdownnaturallyasyoubegintosettle.

12 Trytoworkthisactivityintoyourdailyroutine—practisewhenyouarewalkingtothebus,ortotheshops,oraroundthehouse.

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Coping with CravingsTheeasiestwaytocopewithcravingsorurgestousealcohol,tobaccoorotherdrugsistotry to avoid theminthefirstplace.Thiscanbedonebyreducingyourexposuretocravingtriggers(e.g.,gettingridofdrugsandfits/pipesinthehouse,notgoingtopartiesorbars,reducingcontactwithfriendswhouse,andsoon).Sometimescravingscan’tbeavoided,andyouneedtofindwaystocopewiththem.

Cravingsaretime-limited,thatis,theyusuallylastonlyafewminutesandatmostafewhours.Ratherthanincreasingsteadilyuntiltheybecomeunbearable,theyusuallypeakafterafewminutesandthendiedown,likeawave.Everywave/cravingstartssmall,andbuildsuptoitshighestpoint,beforebreakingandflowingaway.

Cravingswilloccurlessoftenandfeellessstrongasyoulearnhowtocopewiththem.Eachtimeapersondoessomethingotherthanuseinresponsetoacraving,thecravingwilllosesomeofitspower.Thepeakofthecravingwavewillbecomesmaller,andthewaveswillbefurtherapart.

Below are some things for you to try out, to cope with the symptoms of cravings. Put a tick (4) in the box next to those things you think you could do.

Eat regularly,evenwhenyoudon’tfeellikeit.

Drink plenty of water—especiallywhenyougetacraving.

Insteadofdrinking,smokingorusing,drink water or chew gum.

Use‘Delaying’and‘Distraction’whenyourcravingissetoff.Whenyouexperienceacraving,putoffthedecisiontodrinkorusefor15minutes.Goanddosomethingelselikegoforawalk,read,listentomusic,ordothedishesetc.Thiswillhelpyoutobreakthehabitofimmediatelyreachingforalcohol,tobaccoorotherdrugswhenacravinghits.Youwillfindthatonceyouareinterestedinsomethingelse,thecravingwillgoaway.What are some things you could do to distract yourself?

12  •  trauma  + substAnCe use

Usetherelaxationanddeep breathingtechniquesdescribedearliertocopewithacravingonceitissetoff.Ifacravingdevelopsinresponsetostressfulsituations,relaxationtechniquesanddeepbreathingexercisesarereallyuseful.

Ride out the craving by ‘urge surfing’.Formapictureinyourmindofawaveatthebeach.Thisisacravingwave,andrememberthatthecravingwavewillbuilduptoitshighestpoint,andthenfallawayasitrollsintoshore.Picturethecravingwavebuildingup,gettingreadytobreak,seeitbreak,seethefoamform,andseethewavefadeawayasitrollsintoshore.Now,pictureyourselfridingthewave,surfingthecravingwaveintoshore.Youdon’tfalloff,youdon’tgetdumpedandchurnedaround,justpictureyourselfcalmlysurfingthecravingwaveintoshore.

Talk to someone,perhapsafriendorfamilymember,aboutcravingwhenitoccurs.

Use positive self-talk.Tellyourselfthatcravingsonlylastabout10minutes.Tellyourself‘thisfeelingwillpass’.Youwillfindthattheurgesandcravingsthemselveswillbeeasiertodealwith.Saytoyourself,‘yes,thisfeelsprettybad,butIknowitwillbeoversoon’.

Challenge and change your thoughts.Whenexperiencingacraving,manypeoplehaveatendencytorememberonlythepositiveeffectsofusingdrugsandoftenforgetthenegativeconsequencesofusing.Remindyourselfofthebenefitsofnotusingandthenegativeconsequencesofusing.Thisway,youcanremindyourselfthatyoureallydon’tfeelbetterifyouhave‘justonedrink’andthatyoustandtolosealotbydrinking,smokingorusing.Are there other things you do that help you cope with cravings?

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14  •  trauma  + substAnCe use

Where to get helpThebestplacetostartistosee a doctor.Theycanprovideyouwithfurtherinformationandareferraltoanappropriatehealthprofessional.Theorganisationsbelowmayalsobeuseful.

Talkingwithtrustedfamily members or friendscanalsobeveryhelpful.Yoursupportnetworkcanassistyouinmakingdecisions,helpyouaccessservices,andgiveyouvitalsupportthroughyourrecovery.

national

DomesticViolenceHotline: 1800 200 526Lifeline: 13 11 14Quitline: 13 78 48SANEHelpline: 1800 187 263VeteransandVeteransFamiliesCounsellingService: 1800 011 046ACt:

Alcohol&DrugInformationService: (02) 6207 9977CanberraAllianceforHarmMinimisationandAdvocacy: (02) 6279 1670CanberraRapeCrisisCentre: (02) 6247 2525DomesticViolenceCrisisService: (02) 6280 0900VictimServicesScheme: 1800 822 272nsW:

Alcohol&DrugInformationService: (02) 9361 8000or1800 442 599NSWUsersandAIDSAssociation: (02) 8354 7300or1800 644 413NSWRapeCrisisCentre: 1800 424 017ServicefortheTreatmentandRehabilitationofTortureandTraumaSurvivors: (02) 9794 1900TraumaticStressClinic: (02) 9845 7979VictimsAccessLine: (02) 8688 5511or1800 633 063nt:

Alcohol&DrugInformationService: (08) 8922 8399or1800 131 350DomesticViolenceCounselling: (08) 8945-6200or(08) 8952 6048NorthernTerritoryAIDS&HepatitisCouncil: (08) 8953 3172SexualAssaultReferralCentre: (08) 89 227 156VictimsofCrime: 1800 672 242

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qld:

Alcohol&DrugInformationService: (07) 3837 5989or1800 177 833DomesticViolenceMensline: 1800 600 636DomesticViolenceWomensline: 1800 811 811or1800 812 225QLDInjectorsHealthNetwork: (07) 3620 8111or1800 172 076SexualAssaultHelpline: 1800 010 120VictimsAssistQLD: 1300 546 587sA:

Alcohol&DrugInformationService: 1300 131 340DomesticViolenceHelpline: 1800 800 098Rape&SexualAssaultService: (08) 8226-8777or1800 817 421SouthAustralianVoiceinIVEducation: (08) 8334 1699VictimsSupportService: (08) 8231 5626or1800 182 368tAs:

Alcohol&DrugInformationService: (03) 6230 7901or1800 811 994FamilyViolenceCounsellingandSupportService: 1800 608 122SexualAssaultSupportServices: (03) 6231 1811TasmanianCouncilonAIDS,Hepatitis&RelatedDiseases: (03) 6234 1242VictimSupportService: 1300 300 238viC:

Alcohol&DrugInformationService: (03) 9416 1818or1800 888 236DomesticViolenceCrisisService: (03) 9322 3555or1800 015 188HarmReductionVictoria: (03) 9329 1500SexualAssaultCrisisLineVictoria: 1800 806 292VictorianDrugUsersGroup: (03) 9329 1500VictorianVictimsofCrimeHelpline: 1800 819 817WA:

Alcohol&DrugInformationService: (08) 9442 5000or1800 198 024DomesticViolenceWomensline: (08) 9223 1188 or1800 007 339DomesticViolenceMensline: (08) 9223 1199or1800 000 599SexualAssaultandReferralCentre: (08) 9340 1828 or1800 199 888VictimSupportandChildWitnessService: (08) 9425 2850WesternAustraliaSubstanceUsersAssociation: (08) 9321 2877

16  •  trAumA + substAnCe use

Therearealsosomehelpful websiteswhichgiveinformationandguidance.Herearesome:

AdultSurvivorsofChildAbuse: www.ascasupport.orgAnxietyOnline: www.anxietyonline.org.auAustralianCentreforPosttraumaticMentalHealth: www.acpmh.unimelb.edu.auAustralianDrinkingGuidelines: www.alcohol.gov.auAustralianDrugInformationNetwork: www.adin.com.auBeyondblue: www.beyondblue.org.auBlackDogInstitute: www.blackdoginstitute.org.auDualDiagnosis:AustraliaandNewZealand: www.dualdiagnosis.org.auDruginformationandadvice: www.saveamate.org.auDruginformationandresearch: www.druginfo.adf.org.auDruginformation,services,informationandsharedstories: www.somazone.com.auFamilyDrugSupport: www.fds.org.auHeadspace: www.headspace.org.auHIV,sexualhealthanddruginformationforlesbian,gay,bisexualandtransgendercommunities: www.acon.com.auMentalHealthNet: www.mentalhelp.netMentalIllnessFellowship: www.mifa.org.auQuitnow: www.quitnow.info.auReachOut!: www.reachout.com.auSANE: www.sane.org

©NationalDrugandAlcoholResearchCentre2011

ThisbookletwasproducedbytheNationalDrugandAlcoholResearchCentre.ItwaswrittenbyKatherineMills,PhilippaEwer,ChristinaMarel,AmandaBaker,MareeTeesson,GlenysDore,FrancesKay-Lambkin,LeonieMannsandTonyTrimingham.Thankyoutoeveryonewhowasinvolvedindevelopingthisbooklet.

DesignedandtypesetbyPetaNugent

ISBN978-0-7334-3048-0

ThisbookletispartofaseriesonmentalhealthandsubstanceusefundedbytheAustralianGovernmentDepartmentofHealthandAgeing.

Thisbooklethasbeenwrittenforpeoplewhousealcohol,tobaccoorotherdrugswhohavegonethroughatraumaticexperience.

Itaimsto:• Helpexplainwhypeoplefeelthewaytheydoafterhavinggone

throughatrauma.• Givesuggestionsaboutthingspeoplecandotohelprecoverfrom

thetrauma.

Otherbookletsinthisseriesandfurtherinformationonmentalhealthandsubstanceuseareavailableatwww.ndarc.med.unsw.edu.au