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Substance Abuse

People who become dependent on drugs or alcohol typically go through several stages.  Understanding these stages can help you recognize a problem and seek help before substance use becomes substance abuse. Early intervention may save you many “wasted” years.


Alcohol or drug use starts with experimentation. In this stage the use is infrequent and, in the case of young people, the substance is usually obtained from and used with friends. Older people who start to use drugs or drink heavily often do so in response to problems in their lives, such as losing a spouse or a job.

Some people in this stage are able to stop using without help. Others believe their substance use is making them feel better and so move on to regular use.

Regular Use

The person may continue to use with friends or acquaintances or may use the substance while alone. This takes on a predictable pattern (e.g. every weekend or when lonely, bored, or stressed). 

Problem or Risky Use

The user may begin to experience substance-related legal, emotional, physical, or social problems. They may be booked for DUI (driving under the influence) or have problems at work or in their relationships. They may have frequent fall-related injuries. Teenagers may have declining school performance, behavioural problems or change of friendship groups.


Someone who has become dependent on drugs and/or alcohol will continue to use these substances regularly despite the harm the use is causing.
These are characteristics of dependence:

  • Chronic use of alcohol or other drugs that leads to failure to fulfill responsibilities related to work, family or school

  • Repeatedly drinking or using drugs in situations that are hazardous, such as driving

  • Increased tolerance to the substance, meaning more of the drug is needed to have the same effect

  • Symptoms when the person cuts back on use


At this stage substance use is compulsive and out of control. The person may become preoccupied with sourcing their substance of choice. Addiction is a medical condition involving psychological and physical changes from repeated heavy use of a substance.

The area of drug/substance abuse is enormous, highly specialized and changes over time. For specific information please see


In S.A., the Alcohol and Drug Information Service 1300 131 340

The National Direct Line for Addiction Counselling 1800 888 236

How We Care

People can become addicted to either legal or illicit substances. In Australia and the USA, there has been a worrying trend in abuse of both over-the-counter (OTC) and prescribed medications, especially those that contain an opioid component.

 Codeine belongs to the same class of drugs as morphine, pethidine (and heroin)…hence the term “hillbilly heroin” to describe opioid medication. Even in the small quantities found in OTC preparations, codeine if taken regularly, is notorious for causing tolerance and a rebound of symptoms when it wears off. For this reason, these compounds are likely to be removed from OTC listing soon. Even if a person is not addicted, impaired hand-eye coordination, poor decision-making, dizziness, respiratory depression and even coma and death can result from overdose of opioids (as well as some other classes of prescribed drugs).

Our doctors have a policy of never prescribing drugs known to cause dependence to persons unknown to the practice. Neither will they use these medications on a long-term basis for an individual without a relationship with specialists in the field of pain management (or palliative care). 

When a person believes they have a substance abuse problem and is committed to getting their life back on track, our doctors will help identify the best course of action and resources to help them.

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