Self help guide for Substance Misuse, using effective CBT strategies. Make sense of the problem, then learn how to make positive changes
"Substances" includes any substance that an individual wants to reduce to stop using, so this may include nicotine, or caffeine, for instance, in addition to alcohol or drugs.
Misusing substances, perhaps alcohol or drugs, often starts as a way of coping with difficult situations or feelings, and finding that the substance helps you feel better, more relaxed. Every time a similar situation comes up, you know it helps, so you get into the habit...
After a while though, as you start to rely more and more on alcohol or drugs to help you feel better, other problems seem to emerge as a result. Things like problems in your relationships. not being able to keep up with work or study, getting into trouble with the police, getting into real financial problems.
You might start to feel more depressed, anxious or angry and frustrated. All these things get worse as you continue to drink or use drugs, and so you drink and use more drugs in order to help you feel better, which results in making the problems worse. A real vicious cycle:
IMPORTANT - BEWARE!
You must seek help before stopping or cutting down suddenly on drinking or using drugs - you must obtain the advice of an appropriate professional. This might be your GP in the first instance. It is potentially dangerous, even life-threatening, and can be a very unpleasant and distressing experience to suddenly stop taking something your body has become accustomed to having. You may require a prescribed detox (whether in hospital or at home), or to reduce your drinking or drug use gradually. The self help information on this page can then help you overcome your cravings.
Substance Misuse Workbook PDF
Identify Your Triggers
What or when are the times when you are more likely to drink or use? If you can see the patterns, then maybe you can do something about those situations, and do something different.
Understanding the problem is perhaps the easiest part. The most important part of resolving the problem, is being motivated enough to change. Having motivation to not only stop the drinking or drug taking, but making changes that will affect whole lifestyles and friendships. Use this form to weigh up the pros and cons of making changes now: Advantages & Disadvantages Of Change PDF
Identify the factors that help keep the problem going
Use the cogs diagram (PDF) to help you identify what keeps you drinking/taking drugs. Put the name of the problem in the middle big cog, then write in other factors, such as: isolation, life stress, low mood, habit, low self esteem, want to be like my friends, physical addition etc.
Then you can look at each factor and try to make changes in each. You may need help for some of them - so look for the best and most appropriate person or organisation to get that help from.
Doing things Differently
STOPP! Pause, take a breath (visualise the sign if it helps)
What am I reacting to? What have I been thinking about here?
Am I getting things out of proportion?
How important is this really? How important will it be in 6 months time?
What would be the consequences of doing what I normally do?
Am I expecting something from this person or situation that is unrealistic?
What's the worst (and best) that could happen? What's most likely to happen?
Is this fact or opinion?
Am I using one of those unhelpful thinking habits?
Am I seeing things through that negative filter? Those gloomy specs? Is there another way of looking at it?
What's the helicopter view?
What advice would I give to someone else in this situation?
Am I spending time ruminating about the past or worrying about the future? What could I do right now that would help me feel better?
Am I putting more pressure on myself, setting up expectations of myself that are almost impossible? What would be more realistic?
Am I jumping to conclusions about what this person meant? Am I mis-reading between the lines? Is it possible that they didn't mean that?
What do I want or need from this person or situation? What do they want or need from me? Is there a compromise?
Am I just focusing on the worst possible thing that could happen? What would be more realistic?
Is there another way of looking at this?
Am I exaggerating the good aspects of others, and putting myself down? Or am I exaggerating the negative and minimising the positives? How would someone else see it? What’s the bigger picture?
Things aren’t either totally white or totally black – there are shades of grey. Where is this on the spectrum?
This is just a reminder of the past. That was then, and this is now. Even though this memory makes me feel upset, it’s not actually happening again right now.
What would wise (clean) mind say about this?
Is there another way of dealing with this? What would be the most helpful and effective action to take? (for me, for the situation, for the other person)
What do I really value in life? What's really important to me? Is it my family and friends, my work, my academic career, enjoying nature, helping others, making a success of my life? What defines that? In what way? Is drinking or using drugs helping me in the service of my values? What would be more helpful? Every time you're faced with a difficult situation, or craving, ask yourself: "will this help me in the service of my values?"
Coping with cravings:
Learn Mindfulness Ttechniques to cope with cravings.
The mindfulness technique of “urge surfing” (Marlatt 2002) says that we can ‘feed’ cravings by thinking about them, by trying to distract from them, by trying to avoid situations that trigger them. There is another way. Start with mindful breathing, then bring your attention to an itch. Notice those sensations and thoughts – that urge to scratch – without reacting to them.
Each time, just notice those sensations and thoughts, and bring your attention back to your breathing. Your thoughts will increase, and the urge will initially get stronger. Just keep bringing your attention back to your breath. You will notice that the urge (to scratch) crests, then subsides, then eventually goes away. Once we’ve practiced that technique, then we can use it to deal with cravings in exactly the same.
See NOW - Mindfulness For Busy People
Once you've stopped drinking or using, you can start to tackle problems:
Talk to someone about other difficulties which may include:
Talk to your health worker for sources of appropriate support. Your local Citizens Advice Bureau will be able to advise you directly, or give you information about other agencies who can help.
Substance Misuse Self Help - this page as PDF
Learn effective skills online - The Decider Skills for Self Help online course.
Worksheets And Diaries: PDFs
Self Help Books