Out of Harm’s Way Taking the violence out of drug use

IntroductionThere are many different reasons why people take drugs – to experiment, have fun or pleasure, or to ease pain or boredom. Without a doubt, drugs affect the way a person reacts to people and situations around them. Some of these reactions can be very pleasant, but drugs can also trigger a range of negative responses in some people, similar to symptoms of mental health problems such as fear, anxiety, panic and paranoia, all of which can result in aggression or violence.

This resource is aimed to give you some tips on how to handle some of these problems if they happen to you or your friends after taking drugs.

Which drugs can cause aggression or violent reactions? Some of the drugs that can cause these problems include:

• Alcohol

• Stimulants(suchasmethamphetamineandcocaine)

• Hallucinogens(suchasLSDandmagicmushrooms)

• Cannabis

• Benzodiazepines(sleepingpills/sedatives).

These drugs can cause fear, anxiety, panic or paranoia in some people, which in turn can result in aggression or violence during periods of intoxication. For most people, once the effects of the drug wear off, their behaviour gradually improves.

For other people, these drugs can trigger a mental illness that may have previously been hidden, and the symptoms produced can be the beginning of a period or several periods of mental illness for this person that can last from weeks to months.

What is certain is that if your friend has a mental illness, he or she is more vulnerable to these unwanted side effects of alcohol and other drugs.

We also know that there is a greater risk of a violent situation happening if the person:

• isyoung • ismale • hasahistoryofviolence • hasusedalcoholorotherdrugs • hasacutepsychiatricsymptomssuchasparanoia,hallucinations ordelusions

Warning signs

Just as the effects drugs can have on people may be unpredictable, so too can knowing when a potentially violent situation can happen. These situations are very complex, can erupt quickly and change minute by minute. Violence usually happens in the following sequence

Level 1: Anxiety A person may feel anxious when there is some confused or muddled thought – a very common side effect of using alcohol or other drugs. When a person becomes anxious and nervous their behaviour changes and they may start to:

• wringtheirhands •changethepitchandtoneoftheirvoice

• getangryorshowsignsoffrustration •pace•rock•cry

Understanding why your friend is losing control

If you want to try and help a friend, trying to understand what is happening to him or her is a good place to start.

Drugs can produce strange behaviour and reactions in people that are similar to psychosis and paranoia and because of this they may be:

• confusedandmisunderstandwhatisgoingonorwhat someonehassaidordone • feelingthreatenedorfrightened • paranoid-hearingvoicesorthinkthatpeopleareout togetthem

Noisy,crowded,hotandunfamiliarenvironmentscanmakeallthesesymptomsworse.

When people feel any of these things they can get angry, which is an emotional response

to feeling threatened or frustrated. Anger ranges from mild irritation to violent rage. Some people can express their anger in a controlled and constructive way while others lash out in an aggressive, uncontrolled way, either immediately or letting their feelings build up. This can lead to intimidating, violent or bullying behaviour endangering themselves, other people and property.

Level 2: Defensive/AggressiveIf anxiety escalates, the person may become defensive and they may:

• becomeirrational

• changehowtheyspeak,theymayevenstarttoyell

• showsignsofbecomingintimidating,belligerent(readytofight) andsarcastic

• makeverbalthreats

• makethreateninggesturesorstance-shakesfistsorstandoveryou

Level 3: Acting OutIf defensiveness continues to escalate, the person may then ‘act out’ by:

• losingcontrol

• becomingphysicallyviolentonapersonorobject

Level 4: Tension reductionOnce a person loses control and ‘acts out’ in violence there follows a ‘cooling off’ period when the person regains self-control.

How can you respond to threatening or violent behaviour?

The impact and the effects of violence on an individual can be profound and long lasting, so doing all you can to prevent violence actually occurring is doing everyone a favour. The best time to intervene is when a person is feeling anxious.

The aim of calming someone down is not to prove them right or wrong, but to allow them

to regain control of their behaviour without resorting to violence. Here are some tips that can help you calm a person down.

Level 1: Anxiety• besupportiveandshowthatyoucare

• listenandaskopen-endedquestions

• don’thurrythem• movethemtoaquiet,coolplace

• exploretheirthoughtsandfeelings• offerrealisticsolutions

•iftheycalmdown,trytodistractthemwithotherthingsthatmaytake

theirmindoffthings.

• staywiththemuntiltheyaresafeandtheeffectsofthedrugwearoff.

• getmedicalhelpifanxietycontinues

Level 2: Defensive/Aggressive

• beforetryingtointerveneitisimportanttorememberthesafetyof

yourself,thethreateningpersonandallpeopleandthingsaround

them.Ifyouthinkyoucanachieveasafeoutcomeforall,trytocalm

yourfrienddown

• trytogetotherpeoplewhodon’tneedtobetheretoleavethearea.

• evenifyou’rescaredandnervous,actcalm.Usetheirnameandtalk

inasoft,eventone–donotshoutbackatthem.Havearelaxed

postureandbenon-confrontational.

• askthem“What’smadeyoufeelupset/angry?”

• listencarefullyandshowthatyoucare,acknowledgingtheirconcerns

orfrustrationswithoutbeingpatronising

• letthemknowthatyouareheretohelpthem.Ifthereissomething

youcandoforthem,doit

• givethemtimetoexpressthemselves.Don’thurrythem

• trytogetthemawayfromthearea/situationintoaquietplace

withnonoiseandnootherpeople

• keepthemtalkingandaskopen-endedquestions

• betruthful•don’ttouchthem.

• helpthemsetlimits–“Comeonmate,keepyourvoicedown”

• don’ttakeanyunnecessaryrisksandremainvigilant-toothers’behaviour,

toyourbehaviour,andtowhatishappeningaroundyou

• re-assessthesituation.Iswhatyouaredoingworking?Ifit’snottry

somethingdifferentorgethelp

• iftheycalmdowntrytodistractthemwithotherthingsthatmaytaketheir

mindoffthings

• staywithyourfrienduntilheorshe,andothers,aresafeandtheeffectsof

thedrugwearoff

• getthemhelpifneedbe–AccidentandEmergency,Policeorotherfriends

Level 3: Acting Out

• beforetryingtointerveneitisimportanttorememberthesafetyofyourself,

thethreateningpersonandallpeopleandthingsaroundthem.Ifyouthink

youcanachieveasafeoutcomeforall,trytocalmyourfrienddown

• cleartheareaifpossible–allowroomforthethreateningpersontoexit

fromtheareaandthesituation

• beawareofyourbodylanguage.Backoffandgivethemspace,standtothe

side,don’tclenchyourfists,slowdownyourbreathingandstaycalm

• maintainsympatheticeyecontactwiththem-increaseyourblinkratebut

don’tstare/glareatthem

• stayneutral•ifthereisnothingyoucando,retreatandgethelp

Level 4: Tension reduction• attempttoregainrapportwiththem•getmedicalhelpifneedbe

• callthePoliceifnecessary

After the drugs wear off, talk to your friend about what happened, how it affected you and

those around you, and how this can be prevented in future.

How to help prevent aggressive and violent behaviour happening again

As a friend, you can do things that may help prevent a repeat performance.

• ifyourfriendhasamentalillnesslikedepression,anxietyorschizophrenia,encouragethemnottotakeanydrugs

• encourageyourfriendtoseekhelpfromtheirGPoracounsellorabouttheiralcoholandotherdruguseand/orangerissues

• remindthemwhathappenedlasttimetheytookthatdrugthatway

• ifyourfriendinsistsontakingthatdrug,doitinasafe,familiarenvironmentawayfromotherpeople

• avoidbingeing,injectingorpolydruguseoranythingthatwillintensifytheeffectsofadrugandincreasetheriskofsomethinggoingwrong

• talkaboutcopingmechanisms

• dootheractivitieswiththemthatdon’tinvolvealcoholandotherdruguse

Call the Alcohol and Drug Information Service (ADIS) in your state and territory to find out where the closest alcohol and other drug counselling service is available.

This pamphlet was written by Annie Malcolm

Copies of this brochure can be purchased from the National Drug and Alcohol Research Centre, University of NSW, SYDNEY, NSW, 2052

ISBN: 978 0 7334 2494 6