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Drug and Alcohol Information - Melbourne

Alcohol Related Brain Damage

Acquired brain injury refers to any brain damage that happens after birth. Alcohol is one of the many causes of acquired brain injury. The injury inflicted by alcohol abuse is referred to as alcohol related brain injury (ARBI). More than 2,500 Australians are treated for ARBI every year. Just how much damage is done depends on a number of factors. These include individual differences, as well as the person's age, gender, nutrition and their overall pattern of alcohol consumption.

A person with ARBI might experience problems with memory, cognitive abilities and physical coordination. A younger person has a better chance of recovery because of their greater powers of recuperation. However, the effects of alcohol related brain injury can be permanent for many sufferers.

Alcohol and brain injury
Brain injury can be caused by alcohol because it:
Has a toxic effect on the central nervous system.
Results in changes to metabolism, heart functioning and blood supply.
Interferes with the absorption of vitamin B1 (thiamine), which is an important brain nutrient.
May be associated with poor nutrition.
Can cause dehydration, which may lead to wastage of brain cells.
Can lead to falls and accidents that injure the brain.

Alcohol consumption and ARBI
Alcohol is one of the most popular drugs in Australia, with around half of the population over 14 years of age drinking at least once a week . Alcohol consumption ranges from light (social drinkers) to heavy consumption. Decline in cognitive functioning is gradual, and depends upon the amount of alcohol consumed and for how long.

Alcohol related brain injury is more likely to occur if a person drinks heavily on a regular basis over many years. It is possible to develop ARBI over a short period of time, if the drinking is aggressive enough. This can be known as 'binge drinking', which means drinking more than six drinks at a time. Safe levels of alcohol consumption include:
For men - a maximum of four standard alcoholic drinks per day with at least two alcohol free days every week.
For women - a maximum of two standard alcoholic drinks per day with at least two alcohol free days every week.
Disorders associated with ARBI
ARBI is associated with changes in cognition (memory and thinking abilities), difficulties with balance and coordination, and a range medical and neurological disorders. Some alcohol related disorders include:
Cerebellar atrophy - the cerebellum is the part of the brain responsible for muscle coordination. Damage results in difficulties with balance and walking, which is called 'ataxia'.

Frontal lobe dysfunction - the brain's frontal lobes are involved in abstract thinking and planning. Damage results in cognitive difficulties.

Hepatic encephalopathy - many people with alcohol related liver disease develop particular psychiatric symptoms, such as mood changes, confusion and hallucinations.

Korsakoff's amnesic syndrome - a loss of short term memory.

Peripheral neuropathy - the extremities are affected by numbness, pain, pins and needles.

Wernicke's encephalopathy - a disorder caused by a severe deficiency of vitamin B1. Some of the

symptoms include ataxia, confusion and problems with vision.

A person with suspected alcohol related brain injury needs to be assessed by a neuropsychologist. Treatment depends on the individual and the type of brain damage sustained.

Helping people with ARBI
People with impaired brain function can be helped, if the demands placed on them are reduced. A predictable routine, which covers all daily activities, can also be a great help. Carers might like to consider the following points when communicating with people with ARBI:
Break down information and present one idea at a time
Tackle one problem at a time
Allow the person time to work at their own pace
Minimise distractions
Avoid stress
Allow for frequent breaks and rest periods.

Where to get help
Your doctor
Acquired brain injury associations
Support groups for alcoholism.

Things to remember
Alcohol has a toxic effect on the central nervous system and can cause significant brain injury.
Alcohol related brain injury is more likely in people who drink heavily over a long period of time, but aggressive binge drinkers are also at risk.

Alcohol related brain injury affects the way people think, feel and behave. People living with alcohol related brain injury often exhibit challenging or difficult behaviour. This can be the result of medical, cognitive, psychological or environmental causes or simply the frustration of coping with everyday life.

Common types of behaviour
Carers, family and friends of people with alcohol related brain injury can find themselves faced with a range of behaviours that cause problems. Some common behaviours include:
Aggressive and angry outbursts
Lack of motivation
Untidiness and poor hygiene habits
Sexually inappropriate behaviour
Refusal to shower or dress
Poor control of emotions, for example excessive tearfulness.

Causes of challenging behaviour
There are a number of possible causes or reasons why people with alcohol related brain injury may exhibit these types of behaviour. It could be related to a medical problem, their cognitive disability, physical discomfort, adverse effects of medication or fatigue from lack of sleep. Alternatively, problem behaviour may be a reaction to stress, anxiety or a change or upset to daily routine.

Dealing with challenging behaviour
There are two key things to keep in mind when trying to deal with challenging behaviour: ignore problem behaviour (where possible) and reward appropriate behaviour immediately. Other helpful strategies include:
Reassure the person that you are there to help them.
Speak in a calm, soothing tone.
Give praise when the person regains their composure after an outburst.
Set clear and firm limits and repeat them as often as possible.
Be prepared to listen - people with alcohol related brain injury need to feel listened to and understood.
Acknowledge feelings.
Where to get help

ARBIAS - a specialist disability service for people impaired by alcohol related brain injury, their carers and their families Tel. (03) 9417 7071
You're regional Department of Human Services.

Amphetamines, Speed, Ice

If you think that you have just scored a few points of great speed; may I suggest that you think again? Speed disappeared from the market many years ago as the access to the chemicals required for its manufacture are now tightened and strictly monitored and controlled. So today what you are actually handing your hard eared money over for or someone else's is anyone's guess. It now usually consists of a mixture of ephedrine, or pseudo ephedrine; cut with caffeine, citric acid, glucose or what ever your dealer can get their hands on at any given moment and as it moves down the food chain.

It is typically jumped on a few more times so bye the time it goes up your nose or into you vein chances are that the purity may run as low as 5 percent in most cases. So that the rush that you may experience if your lucky may be just a bit of needle fever or the other rituals associated with its use. As well we are now faced with is an ever-increasing number of back yard cooks fucking around with allsorts chemicals that eventually makes its way on the streets and sold under the guise as pure crystal methamphetamine with great colouring I might add, such as pink, green, yellow and so on. There is also dexamphetamine and Ritalin being crushed and sold.

But the flavour of the day seams to be ice, and is not for the faint hearted or the inexperienced user. The purity can run as high as 95 percent with imported product so it can be a frightening experience for individuals who have not had a bit of a play with it before and can have devastating and lasting consequences that may trigger intense psychosis for the uninitiated or the recreational user. So its not much fun watching your best mate or your partner panicking about what the hells happening to them; as well as trying patiently to talked them down for hours on end with the constant reassurances that they will eventually come down. Last but not least of all it is fucken addictive, so if you are going to start having a bit of a play with the shit I have listed the adverse effects associated with playing a bit to hard with the amphetamine family and its offspring.

Amphetamines frequently asked questions

What adverse effects are associated with ice?

Despite limited experience with ice, a variety of adverse effects have been reported with its use. So far toxicity appears to be similar to that seen with the older forms of methamphetamine. Reported adverse effects include severe weight loss, aggressive behaviour, fatal lung and kidney disorders, and long-lasting psychological problems characterized by paranoia and hallucinations. More serious lung disorders are anticipated with the smoking it in a crack pipe.

As with most amphetamines and amphetamine-like drugs, ice can potentially cause increases in blood pressure and heart rate, abnormal heartbeats, heart attacks, strokes, convulsions, and coma. Furthermore, continued use of ice can rapidly lead to addiction and the various social problems associated with an expensive drug habit.

As experience with ice increases, additional adverse effects may be discovered. It is unknown at the present time whether the adverse effects already reported are dose-dependent. In other words, as with cocaine, it may be possible for adverse effects to occur with ice regardless of the amount used. In addition, it may be possible for life-threatening reactions to occur with ice whether it is being used for the first or fiftieth time. One case has been reported of an individual experiencing a stroke after snorting methamphetamine for the first time. This type of unpredictability may be even more extreme with ice, due to its more rapid and more intense effects.

However, just as the pull of heroin is over dramatised, the pull of speed is dramatically understated. The combination of the physical rush and psychological boost is a strong draw for many users.

The danger comes from over-regular use, and over familiarity, becoming more dependent on the release of energy and more uncomfortable with the body's natural energy levels.
Paranoia and nervous tension are common after even mild recreational use. Even occasional, light users can suffer depression and lasting fatigue.

Heavy users hit severe, sometimes suicidal lows, and can slump into deep sleeps lasting well over 24 hrs.

Speed Psychosis

Consistent heavy use or a single large dose can induce amphetamine psychosis, almost identical in symptoms to schizophrenia.

Vivid auditory hallucinations and paranoid delusions are the real frighteners and, unlike hallucinogens, the "trip" cannot be turned around. This is a very real mental state caused by over-excitement of the brain's fright centres.

Its effects often start with curiosity, deep thought, and paranoia. Its slow build up makes it all the more dangerous, as it is harder to recognise the symptoms.

Some people get into obsessional activities, ironing or scrubbing floors though the night or dismantling and reassembling electrical equipment.

While amphetamine psychosis is much more common amongst heavy regular users there are real dangers that any small amount of speed used by a person with schizophrenic tendencies could push them over the edge.

Handy websites to have a look at if you need a bit more information about prolonged use of amphetamines

Pills Reducing the Risks

The substitution of drugs of choice with others when a drought is on, or your broke, just cant be bothered with all the shit involved in rorting, or you're out of the food chain because you've just about fucked everyone over, is common practise. But it's not much fun falling flat on your face and breaking your nose, when your motor skills fail after hitting up 20 temazapam. Nor is presenting at casualty at your local hospital with psychosis after hitting up 30 or so Ritalin thinking that you are being tracked by the FBI and you want them to remove the micro tracking devise they implanted. Pills are pharmaceutical grade drugs, and designed for particular purposes and to be taken orally. They are not designed to mulled up and put into a 3 or 5 ml barrels. They have coating additives such as wax just to name one

The following are key harm reduction tips that all Intervenes Drug Users should know about injecting temazepam or pills. IT IS NOT SAFE TO INJECT TEMAZEPAM OR PILLS BUT THERE ARE WAYS TO REDUCE THE RISKS

Use a pill filter they can be obtained from most needle exchanges.

Look after your veins. Temazepam or other pills causes more damage to your veins than any other drug. This damage could be permanent. If a vein blocks, see your doctor. Give the vein a chance to recover and try injecting somewhere else.

Injecting into the groin is not safe. If you do inject into your groin, make sure you hit your vein, not your artery. Ask for help if you're not sure. It might take longer to notice the damage to this vein, but injecting them will still cause damage no matter where you inject it.

Remove rings and other close fitting jewellery from hands and feet. They might get stuck on if you get swelling. This could cut off blood flow.

Don't inject into small veins. This includes veins in your hands, wrists, feet and breasts. These veins are too small to cope with.

Beware of hitting an artery. For example, veins at the elbow and groin are close to arteries. Always draw blood into the syringe before injecting:
Dark red blood vein
Bright red blood artery

You may bleed heavily from an artery if you hit it - apply pressure firmly for at least 15 minutes to stop the bleeding, and see a doctor.

Pain down your arm or leg means you may have hit an artery. If so, there is a high risk of gangrene; the limb will become blotchy, swollen and cold. Get help immediately.
If you get a lump, swelling, redness, heat or soreness where you are injecting, you might have an abscess or other infection. Get medical help now to stop more serious problems later.

Temazepam and other tablets don't dissolve in water. Injecting them will not work very well, if at all. Avoid injecting chalky particles of tablet - it can cause serious damage.

Drug and Alcohol Dental Programs

It's a foregone conclusion that the years of using drugs of choice apart from the psychological problems that might emerge there are the obligatory physiological. And yes teeth are properly among the most neglected.

It's very rare to brush your teeth before having a shot or a glass of wine from you room temperature cask. So when you're on the straight and narrow it's a bit hard to smile and tell the world how great it all is with the majority of your teeth missing. There are clinics that can replace those missing teeth, but sadly not the missing years and its well worth the wait.

Dental services are provided to clients who have a drug or alcohol related problem.

The North Yarra Special Needs Dental Program provides dental care for people with drug and/or alcohol dependencies who are holders or dependants of holders of valid Health Care or Pensioner Concession Cards. They are generally referred for dental care by a caseworker.

The Dental Fix Program provides dental care for clients who are registered with local Drug and Alcohol Programs and are holders or dependants of holders of valid Health Care or Pensioner Concession Cards. They are generally referred for dental care by a caseworker.

The service is free to eligible clients. There are no waiting lists for the service with waiting times for general dental care ranging from 3 to 6 weeks. Emergency care is provided within 24 hours, where possible.

North Yarra Special Needs Dental Program

North Yarra Community Health

Dental Fix Inner South Community Health Service

Carlton Centre
622 Lygon Street,
North Carlton 3054
Ph: (03) 9349 7333

Collingwood Centre
154 Hoddle Street,
Collingwood 3066
Ph: (03) 9411 4333

Fitzroy Centre
75 Brunswick Street,
Fitzroy 3065
Ph: (03) 9411 3555

Methadone and Buprenorphine Clinics

Next Door
350 Smith St Collingwood
Ph: 9417 1299
Mon- Fri 10.30 am-6.00 pm Sat 12.00 pm to 8.00 pm

Austin Hospital
Methadone Program
Address: 145-163 Studley Road
Phone: (03) 9496 5000
Fax: (03) 9458 4779

Barkly Street Medical Centre
Drug Treatment & Support Service
Address: 60 Barkly Street
Phone: (03) 9534 0531
Fax: (03) 9534 6159

Barwon Health: Alcohol & Drug Program
Methadone & Other Pharmacotherapies Clinic
228 Pakington Street
Phone: (03) 5222 1700
Fax: (03) 5222 2270

Boroondara Community Health Centre
Methadone Prescription & Treatment
378 Burwood Road
Phone: (03) 9818 6703
Fax: (03) 9818 6714

Mount View Corner House
Methadone & Buprenorphine Program
4 Mount View Street
Phone: (03) 9723 2206
Fax: (03) 9723 2144

Specialist Methadone Program
Austin Hospital, Studley Road
Phone: (03) 9496 5999
Fax: (03) 9459 4546

Turning Point Alcohol & Drug Centre
Specialist Methadone Service
54-62 Gertrude Street
Phone: (03) 8413 8413
Fax: (03) 9416 3420

Women's Alcohol & Drug Service
Royal Women's Hospital
Methadone Stabilisation Program
264 Cardigan Street
Phone: (03) 9344 3631
Fax: (03) 9344 2719

Safer Using

So you've just scored the better part of a filthy half weight or maybe a hundred dollar rock or a few pills and you can't wait the get the shit up your arm. Here's where common sense goes out the window and needle fever kicks in. You've got a coke can to make up your mix, your best mate that you met that morning has one fit and swears it's never been used — despite the fact that its not in a packet and it has a flash of red just inside the barrel, and then tells you he's never shared a needle before, and what the hell is a swab, and no, I don't like pill filters.

You see, the story is that doctors' surgeries are full of stories like that (just before he tells you that you are hep C positive) and so are hospital operating rooms as well (as the surgeon explains, when you wake up after the operation, that you may not have your right hand anymore because you waited too long and thought the abscess on your hand might just go away). If you think that it can't happen to you, then you're not thinking. So if you are going to inject at least try and take care of yourself and other people.

If you can, only use your fit once, make sure you cap the end and dispose of it properly. If you are going out to get on and have a shot the moment after you score (as most of us do), have a clean fit, a swab, and sterile water ready. There are plenty of needle exchanges in the metro area and a mobile delivery service is just a phone call away. This web directory has links to sites that list needle exchanges and safe injecting information.

Don't share a fit; don't get your water out of a toilet bowl; don't be an idiot.

Needle Exchanges

Foot Patrol Mobile Needle Exchange

Operating hours: Mon-Fri 11.45am-11.15pm
Weekends:12pm-3.45pm & 7.30pm-11.15pm
Public Holidays 7.30pm- 11.15pm
Ph:0412 155491 Free call:1800 700 102

Turning Point Alcohol & Drug Centre
Phone 8413 8413 Clinic 8413 8444
54-62 Gertrude Street, Fitzroy
Outpatient services, drug and alcohol services, methadone program,
Psychiatric services, needle exchange. Specialist clinics

St. Kilda Crisis Centre
Hours Mon-Thur 10 am - 12 noonFri 10am-2am, midnight
Sat 9am-2am, Sun9-12 Pn: 9536 7777
29 Grey Street, St Kilda Victoria 3182

Melbourne Inner City
Tuesday-Friday 12.30pm - 6.30 pm
(03) 9417 1466
Every night 7.30pm - 11.30pm
Outreach Phone 0418 179 814
Syringe Disposal Hotline
(03) 9417 5125
348 Smith Street
Victoria 3066

North Yarra Community Health Fitzroy
(03) 9419 5266
Mon Tues Thurs Fri 8.30am-5pm
Wed 11am-5pm
75 Brunswick St Fitzroy

North Eastern
Monday-Friday 9am - 5pm
(03) 9478 5711
Every night 7.30 pm - 11.30 pm
Outreach phone: 0418 545 789
Syringe Disposal Hotline: 0418 545 789
(Needle Exchange)
Monday, Tuesday, Wednesday, Friday 9am-5pm 0418 996 838
Cnr Blake & Crevelli Streets
Reservoir Victoria 3073

Monday 10.00am - 2.00pm,
Tuesday to Friday 10.00am - 5.00pm
(03) 9781 3111
Thurs and Sat 7.30pm - 11.30 pm
Outreach Phone: 0417 345 750 or 1800 642 287
Syringe Disposal Hotline 0417 345 750 or 1800 673 046
Suite F, 459A Nepean Highway
Frankston Victoria 3199

Monday to Friday 10.00am - 6.00pm Sat 10am-2
(03) 9632 8100
(03) 9688 0257 (Maribyrnong Council)
Syringe disposal Hotline (03) 9689 6115 A.H.
6-12 Buckley st
Footscray Victoria 3011

Monday-Friday 8.30am - 8.45pm
Saturday-Sunday 9.30am - 8.45pm
(03) 9301 9766
Corner Pearcedale Parade & Coleraine Street
Broadmeadows Victoria 3047

Dandenong Hospital
Monday- Wednesday 12 noon - 4.00pm
(03) 9794 0790
Thursday and Saturday 7.30 pm - 11.30 pm
Outreach Phone (0418) 566 147 or 1800 642 287
Syringe Disposal Hotline (0418) 566 147 or 1800 673 046
86 Foster Street
Dandenong Victoria 3175

Inner South
Monday-Friday 9.00am - 5.00pm
(03) 9690 9144Every night 7.30pm - 11.30pm
Outreach Phone: 018 170 481
Syringe Disposal Hotline 0418 175 249
341 Coventry Street
South Melbourne Victoria 3205

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