Substances - misuse, dependence, addiction - Nurse Midwife Health Program Australia

No one starts using substances with the intention of becoming dependent or addicted. But we know this does happen, and nurses and midwives are not immune.

Using substances – why we do it

We use substances to relax, socialise, ease physical or emotional pain, satisfy curiosity, manage boredom or to cope with stress or exhaustion.

For nurses and midwives, an after-work drink or occasional substance use might help us to wind down. Our work can be demanding, expose us to trauma, and put us under pressure to hold it all together.

Reading signs that there could be a problem

It’s helpful to be able to recognise the signs that you or someone you know might be having a problem with substances. Common signs can include:

using more than intended
needing more for the same effect (tolerance)
trying to cut down or stop, regularly, but never succeeding
craving your chosen substance
coming back to substance use again and again, despite the consequences
struggling to meet your responsibilities (work, school, home)
arguing with the people around you about your substance use.

But what's more important is understanding the impact your use has on your health, wellbeing, your daily life and relationships.

Understanding terminology – it’s confusing

‘Misuse’, ‘dependence’ and ‘addiction’ are terms that are used interchangeably (and sometimes incorrectly) about substance use. Understanding the differences can help you identify what’s going on for you (or someone you know) and find the right support.

Substance misuse

Using a substance (legal or not) in ways that increases the risk of harm is ‘misuse’. It can involve using:

more than intended
for reasons other than that for which it is prescribed (such as helping you sleep or manage stress)
despite negative consequences.

Misusing a substance doesn’t necessarily mean someone has an addiction or is dependent.

Dependence and tolerance

Our bodies can adapt to repeated use of a substance. We become tolerant physically, needing more for the same effect. Stopping use abruptly can cause withdrawal symptoms. You can be dependent on prescribed, legal and illegal substances.

Addiction (substance-use disorder)

Beyond physical dependence, addiction is marked by cravings, loss of control, and continued use despite harm. Addiction is a "treatable, chronic medical condition that involves complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences" (American Society of Addiction Medicine, 2019).

While often linked to alcohol or drugs, addiction extends to behaviours such as gambling, gaming, food or exercise.

Assessing your use and health risks

For comprehensive and trustworthy list of prescription and illegal drugs go to The Alcohol and Drug Foundation: Drug facts. Each listing describes what they look like, the short and long-term effects, withdrawals and getting help.

Find out if your substance use is posing a risk to your health and wellbeing with the Drug Use Disorders Identification Test (DUDIT). Your assessment and results are anonymous and confidential.

Getting support

Reaching out for help is a big step, and not always an easy one. But you don’t have to do it alone. Our program offers a safe, confidential space to talk things through and we can help you find the right service for your needs 1800 001 060.

Peer support groups are also available in many areas across Australia. These groups provide support for people who want to change their relationship with substances.