Section 1
An overview of alcohol and other drug issues

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Drugs and drug use

Throughout history, people have used different kinds of drugs to change the way they feel or see the world. Different cultures have developed social rituals and rules around drug use as a way to control their impact on society. Drugs and how they are used also have different meanings in different cultures. For example in the Pacific Islands, kava is drunk as a means of making contact with the supernatural, to welcome visitors to the community and to cure illnesses. Some Native American Indians use a mushroom that causes dream-like states as a way of getting in touch with the Great Spirit. We use alcohol to celebrate special events like birthdays and weddings.

What is a drug?

There are various definitions of what a drug is. For the purposes of this resource, we consider a 'drug' to be any chemical substance, natural or synthetic, that changes a person's mental state and that may be used repeatedly by a person for that effect. The term 'drug' includes legal and illegal substances such as alcohol, caffeine, tobacco, petrol, kava, heroin, anabolic steroids, cannabis (marijuana), psychoactive pharmaceuticals and inhalants (Commonwealth Department of Human Services and Health 1994:7). Some drugs have become accepted as a normal part of how we live. Most drugs are under some form of legal control.

Psychoactive drugs

The term 'psychoactive drug' is used to describe any chemical substance that affects mood, perception or consciousness as a result of changes in the functioning of the nervous system (brain and spinal cord).

Psychoactive drugs are divided into 3 groups:

Effects of using drugs

A drug can have psychological, emotional and physical effects and can change the behaviour of the person taking the drug. These behavioural changes are not the same for everyone. The effect of any drug will depend on

Why people use drugs

There are many reasons why people use drugs. Can you think of some reasons and list them? Compare them with the following most common reasons people give for using drugs:

Drugs and awareness

Drugs are fascinating because they change our awareness. The basic reason people take drugs is to vary their conscious experience. Of course there are many ways to alter consciousness, such as listening to music, dancing, exercising, day dreaming ... and participating in religious rituals. The list is probably endless, and ... suggests that changing consciousness is something people like to do.

Weil and Rosen in Saunders and O'Connor 1994:8

In remote Aboriginal communities and in town camps, life can be really tough, especially for young people. There is often little to do. People can feel caught between what their parents and elders say is important and the pressures and promises that western culture seems to offer. Community stress, boredom, frustration and peer pressure can draw people into drug using lifestyles.

The following diagram shows the three major influences on an individual's decisions about drug use. Addressing drug-related harm needs to consider the links between these different factors.

triangle.gif (15435 bytes)

'Learning' to use drugs

In every culture, people 'learn' how to use drugs. We learn the rules of drug use and what is acceptable behaviour and what is not. We learn from our parents, friends, people we work with, and what we see on television and at the movies. We are especially influenced by people we respect or who are powerful. They serve as role models for us. We also learn from our own experiences when using drugs.

Aboriginal people first learned how to use alcohol by watching British colonists and how to smoke tobacco from the Asian fishermen and then from Europeans. Aboriginal people from Arnhem Land learned about kava when they visited Fiji where it is a traditional beverage. Sometimes people learn to use drugs, like kava, but do not learn all the rules or customs that reduce the harmful effects of the drug.

Watching and following

When you watch, you follow, you know? When somebody do things, see them and you follow their example. They drink, well, you drink too! You get in there with them, they share you 'hey, come on, come on here, drink here!' And you drink. That's it. The grog get hold of you.

Brady 1993:405

Our views and beliefs about drugs change over time as we learn more about how they affect people. For example 50 years ago, health professionals thought smoking tobacco was safe to use and actually recommended it to help people with asthma. Now we know from scientific studies that smoking is very harmful and causes cancer and other diseases. It is becoming socially unacceptable to smoke around people who do not smoke tobacco.

Some useful terms and concepts

The following terms have been adapted primarily from those in Commonwealth Department of Human Services and Health (1994:7-15) and WHO (1994).


The word 'abstinence' is used when people decide not to use a drug or to stop taking a drug or substance at all times and under all circumstances. People who abstain usually do not intend to use the drug again.

Addiction, addictive behaviour

Addiction to a drug means that the person:

Sometimes this word is used in the same way as drug dependence. The problem with using the word 'addiction' is that people are often labelled as 'junkies' or 'drug addicts'. This term can make us think of them as criminals, dangerous and generally unpleasant people. It also suggests that they are unable to control their lives or change drug taking patterns.

Binge drinking

Binge drinking refers to the rapid consumption of alcohol over a short period of time to the point of intoxication. There are two forms of binge drinking:


The process by which an individual is withdrawn from the effects of a pychoactive substance… Typically, the individual is clinically intoxicated or already in withdrawal at the outset of detoxification. Detoxification may or may not involve the administration of medication (WHO 1994:29).

Disease model of drug addiction

In the western medical model, addiction to drugs has been seen as a 'disease' that affects the whole person. If people have the 'disease' then they are more likely to become addicted to the drug.

Some alcohol and other drug workers have criticised this model. They say that it suggests that people have no control over their drug use; they are victims. The disease view can be disempowering for the person, their family and the community as it suggests that the person is unable to change.

Note: in the disease model, the term 'alcoholic' is often used to describe someone with the disease 'alcoholism'. It is not recommended to use these terms except when talking clinically about alcohol-related disabilities, for example 'alcoholic liver disease'. Instead of 'alcoholic', use the phrase 'person with alcohol problems' or 'person who is dependent on alcohol'.

Drug abuse

This term is often used to describe drug use that causes harm. The problem with using this term is that it can create negative feelings or attitudes toward the user and is not a recommended term to use.

Drug misuse

This term is also used to describe harmful or inappropriate use of drugs. It is the preferred term because it does not have the same negative meanings about the user.

Drug dependence

Drug dependence occurs when a drug becomes central to a person's thoughts, emotions and activities. Using the drug takes on a higher priority than many other things in life and the person may neglect other responsibilities.

Being dependent makes it hard for people to stop or even cut down on the drug. They may want to take the drug continually for its effects or to avoid the discomfort and distress of not having it (withdrawal).

Drug use

This term means taking drugs. The term does not necessarily mean that the drug taking is harmful or ongoing.

Experimental use

Sometimes people try out a drug to see what it is like. They might try it once or a couple of times. Many children experiment with different drugs with their friends or family members.

Harm minimisation/harm reduction

A drug strategy based on a harm minimisation approach has the following primary objectives:

Harm-reduction strategies

Harm-reduction strategies are designed to reduce the impacts of drug-related harm on individuals and communities. Governments do not condone illegal risk behaviours such as injecting drug use: they acknowledge that these behaviours occur and that they have a responsibility to develop and implement public health and law-enforcement measures designed to reduce the harm that such behaviours can cause (Ministerial Council on Drug Strategy 1998:46).

Harmful use

This term describes drug use that causes damage to either mental or physical health. It can also refer to the harm caused to the drug user's family or community in general.


People are said to be intoxicated when they use an amount of a substance that produces noticeable changes in their behaviour.

Recreational or social use

Sometimes people use a drug or drugs on a casual basis to enhance socialising or to increase their enjoyment of leisure and recreational activities.


If a person repeatedly takes a drug, the person's body becomes used to working with a certain level of the drug in the bloodstream. The person's body adapts to the presence of the drug; that is, the person develops a tolerance to the drug. The person then has to increase his or her intake of the drug to get the desired effect, for example, to feel 'high'.

Tolerance can develop to most drugs if they are used on a regular basis. People who regularly use alcohol, tobacco, coffee and tea will have developed a tolerance to them. They may feel unwell when they stop taking the drug.


Dependence, both physical and psychological, results from regular use of some drugs. When a person stops taking the drug, he or she may experience certain unpleasant physical and mental effects. This group of effects is referred to as 'withdrawal symptoms'. They are different for each drug. When a person is experiencing these symptoms, the person is said to be 'in withdrawal'.

point.gif (93 bytes)   See 'Glossary' in Volume 1 for 'Brief interventions' and 'Early intervention

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