Approaching the person about drug use problems
Before talking to the person, reflect on their situation, organize thoughts and decide what has to be said. Recognize the value that the person may react negatively when accosted, on a consideration that the person may not consider their drug use a problem.
When in doubt on how best to approach the person about your concerns, talk to a health professional who specializes in problem drug use. Consulting with others who have dealt with problem drug use about effective ways to help may also be helpful.
Fix up a time to talk to the person. Communicate concerns non-judgmentally in a supportive, non-confrontational manner. Be assertive, but not do blame or be aggressive. Let the person know the readiness to listen to her/him without judging them.
Tips for effective communication
Stay calm and reasonable
Ask the person about their drug use rather than make suppositions about their use.
When the person finishes talking, repeat back what is being heard and allow them to clarify any misapprehensions.
Concentrate on the person’s behavior rather than their character.
Use “I” statements instead of “you” statements (e.g. “I feel worried/angry/ frustrated when you…” instead of “You make me feel bothered/irritated/ perturbed…”).
Stick to the point (i.e. concentrate on the person’s drug use) and do not get drawn into disagreements or conversatoins about other issues.
Refrain from criticizing the person’s drug use.
Refrain from calling the person an “addict” or use other negative labels. As much as possible talk to the person in a quiet, private environment at a time when there will be no interruptions and when both of you are in a calm mental condition.
Ask about what areas of their life are affected by drug use (e.g. their mood, work performance and relationships).
Inquire if they would like information about problem drug use or any related threats. Once allowed, give them with significant information (e.g. amplified risk of physical and mental health problems).
There are several factors why people take drugs and the person may not be clear about why they use. Try to detect whether the person wants help to change their drug use. If so, offer help and discuss what you are willing and able to do.
Be ready with alcohol and other drug helpline number so the person can call for confidential help or ask for more information. Do not expect an abrupt shift in the person’s drug use; this conversation may be the first time they have thought of their drug use as an issue.
What to do if the person is unwilling to change their drug use
No one can change any person who does not want to reduce or stop their drug use. Do not feel guilty or responsible for their choice on drug use.
It is significant to maintain a good relationship with the person as one may be able to have a beneficial effect on their use. Let the person know the availability to talk in the future. If the person is unwilling to change their drug use:
- Do not use negative approaches (such as lecturing or making them feel guilty) as these are improbable to encourage transformation
- Refrain from controlling them by bribing, nagging, threatening or crying
- Do not use drugs with them
- Do not take on their accountabilities
- Do not cover up or make excuses for them
- Do not deny their basic needs (e.g. food or shelter)
When drug use continues, encourage the person to seek out information (e.g. trustworthy websites or pamphlets) about approaches on reducing risks on drug use. If the person is using or planning to use drugs while pregnant or breastfeeding, encourage them to consult with a health professional or doctor.
Only disclose the person’s drug use to a professional if the she/he is at risk of hurting others.
Professional and other help
There are effective interventions for problem drug use which include education, counseling, therapy, rehabilitation and self-help groups. It is significant to be aware that while abstinence may be appropriate treatment aim for some people, many programs are aware that for others this may not be possible or sensible.
If the individual prefers professional help
Provide the person with a range of alternatives that they can pursue including information about local services. Persuade the person to find a health professional who they feel relaxed talking to and to make an appointment. Reassure the person that professional help is private.
If the individual does not prefer professional help
It is common for people with drug use problems to initially oppose seeking, or to have difficulty accepting when recommending a professional help so be prepared when offering it.
Drug use is often linked with shame and prejudice, which are obstacles to seeking help. It is ultimately the individual’s decision to acquire professional help.
Forcing the person or using negative methods may be counterproductive.
Be patient and remain hopeful because opportunities will show themselves to recommend professional help again.
Altering patterns of drug use is a process that takes time. Be ready to talk to the person again in the future.
In the meantime, set boundaries around what behavior that is willing and unwilling to accept from her/him.
If the individual requires other supports
Persuade the person to talk to someone they trust (e.g. a friend, family member or community support worker).
Tell the person of supports they may turn to (e.g. self-help resources, support groups, family members) and let them to decide which would be most suitable or hepful for them.
Drug-affected condition
This refers to temporary alterations in the person’s mental condition or behavior as a result of drug use, resulting in trouble or harm.
The effects of drugs differ from person to person and the behavioral signs of drug-affected condition are different depending on the individual’s level of intoxication. Likewise, illegal drugs can have unpredictable effects as they are not manufactured in a controlled manner.
Lastly, it is often hard to make a distinction between the effects of different drugs.
What to do if the affected is in a drug affected condition
Remain calm and assess the situation for possible risks.
Try to ensure that the person, yourself and others are safe.
Communicate with the person in a polite manner using simple, clear language.
Be prepared to reiterate simple requests and instructions as the individual may find it hard to understand what has been said.
Do not speak in an angry manner.
Try to discourage the affected person from engaging in risky behaviors, like driving a vehicle or operating machinery.
Inform the affected that it is risky to drive even though they may feel ready to act.
Persuade the affected to call emergency services if they have an adverse reaction or they begin to feel ailing or uneasy.
Unpleasant reactions leading to a medical emergency
Drug use can lead to a range of medical emergencies. Albeit there may be legal repercussions for the individual, it is important to seek medical help if needed and tell the medical staff that the person has been using drugs.
Unpleasant physical reactions
Be able to identify and help someone who is showing signs of an unpleasant physical reaction after drug use, like worsening or loss of consciousness, overheating, dehydration and overhydration.
Worsening or loss of consciousness
It is a medical emergency if the person shows signs of a rapid worsening in consciousness (i.e. abrupt confusion or disorientation) or unconsciousness (i.e. falling asleep and cannot be woken).
When the affected shows these signs, it is necessary to:
Safeguard the person’s airway, breathing and circulation. Clear the person’s airway if it is blocked. If not breathing, give the person expired air resuscitation (EAR). If without a pulse, give the person cardiopulmonary resuscitation (CPR). If clueless on how to give resuscitation (EAR, CPR), ask some assistance in the vicinity who knows or call the ambulance service and follow the directions of the telephone operator.
Place the affected in the recovery position. If unconscious, or slipping in and out of consciousness, place them in the recovery position. Make sure they do not roll out of the recovery position onto their back.
Call an ambulance. When calling for an ambulance, it is essential to follow the instructions of the telephone operator. When asked, describe the affected symptoms and tell that she/he has been using drugs (e.g. ‘my friend has taken a drug, has collapsed and is unconscious’). Be detailed on information about what drugs have taken by asking the person, their friends or visually examine the environment for indications.
Have the address of where you are ready to give to the telephone operator and stay with the person until the ambulance arrives.
Overheating and dehydration
Lengthened dancing in a hot surrounding (like dance party) while on some drugs (e.g. ecstasy) without sufficient water intake, can cause the person’s body temperature to go up to unsafe levels, which can lead to symptoms of overheating or dehydration, including:
- feeling hot, tired and weak
- persistent headache
- pale, cool, sticky skin
- fast breathing and shortness of breath
- weariness, energy, thirst and nausea
- giddiness and feeling faint
- When showing symptoms of overheating or dehydration, it is a must to keep the affected calm and seek medical help instantly.
- Persuade the person to stop dancing and to rest somewhere cool and chilly.
- While waiting for the arrival of assistance, reduce the person’s body temperature slowly to avoid shock (a serious condition caused by a sudden drop in blood flow throughout the body). Do this by slackening any restrictive clothing or taking away any additional layers, and persuade the affected to drink non-alcoholic fluids (e.g. water and soft drinks).
- Prevent the affected from drinking excessive water at once as this may lead to coma or death.
- Dissuade the affected from drinking alcohol as it furthers dehydration.
Assisting an unconscious individual
Any unconscious individual requires urgent medical attention and their airway kept open.
Once left lying on their back, they could choke on their vomit or their tongue could block their airway.
Placing the affected in the recovery position will help to keep the airway unblocked.
Check the ground for sharp objects (e.g. broken glass or syringes) before rolling the affected in the recovery position. If needed, clear the person’s airway after they have vomited.
Keep the affected warm without letting them to overheat.
Avoid injecting any substances into the affected including salt solution or amphetamine.
Unpleasant psychological reactions
Mental health problems can be caused or aggravated by drug use. Nevertheless, it can be hard to distinguish between the symptoms of mental illness and drug-affected behavior.
Be able to identify and help someone who is experiencing an unpleasant psychological reaction to drugs, such as panic attacks, suicidal thoughts and behaviors , psychosis, and aggression.
Panic attacks
If the affected is anxious and panicky, take them to a quiet environment away from crowds, loud noise and bright lights and monitor them in case their psychological condition worsens.
Panic attacks: first aid curses of action.
Psychosis
If the affected is experiencing psychosis, encourage them to seek professional help whether it is thought that the psychosis is drug related or not.
What to do if the person is aggressive
Once the affected becomes aggressive, measure the risks to yourself, the person and others. Ascertain your own safety at all times to be a constant effective helper. If personal safety is at risk, ask assistance from others. Do not stay with the person if safety is in danger.
Stay as calm as possible and try to de-escalate the situation with the following procedures:
- Talk in a calm, non-confrontational mode.
- Speak slowly and confidently with a gentle, caring tone of voice.
- Try not to provoke the person; refrain from speaking in a hostile or threatening manner and avoid arguing with them.
- Use positive words (such as “stay calm”) instead of negative words (such as “don’t fight”) which may cause the person to overreact.
- Consider taking a break from the conversation to allow the person a chance to calm down.
- Try to provide the person with a quiet environment away from noise and other distractions.
- If inside, try to keep the exits clear so that the person does not feel penned in and you and others can get away easily if needed. If violence has occurred, seek appropriate emergency assistance.
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