Out of Harm’s Way Taking the violence out of drug use
Introduction There 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 (such as methamphetamine and cocaine)
• Hallucinogens (such as LSD and magic mushrooms)
• Cannabis
• Benzodiazepines (sleeping pills/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:
• is young • is male • has a history of violence • has used alcohol or other drugs • has acute psychiatric symptoms such as paranoia, hallucinations or delusions
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:
• • •
confused and misunderstand what is going on or what someone has said or done feeling threatened or frightened paranoid - hearing voices or think that people are out to get them
Noisy, crowded, hot and unfamiliar environments can make all these symptoms worse. 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.
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:
• wring their hands • change the pitch and tone of their voice
• get angry or show signs of frustration • pace • rock • cry
Level 2: Defensive/Aggressive If anxiety escalates, the person may become defensive and they may:
• become irrational • change how they speak, they may even start to yell • show signs of becoming intimidating, belligerent (ready to fight) and sarcastic • make verbal threats • make threatening gestures or stance - shakes fists or stand over you
Level 3: Acting Out If defensiveness continues to escalate, the person may then ‘act out’ by:
• losing control
• becoming physically violent on a person or object
Level 4: Tension reduction Once 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 • be supportive and show that you care • listen and ask open-ended questions • don’t hurry them • move them to a quiet, cool place
• explore their thoughts and feelings • offer realistic solutions • if they calm down, try to distract them with other things that may take their mind off things. • stay with them until they are safe and the effects of the drug wear off. • get medical help if anxiety continues
Level 2: Defensive/Aggressive • before trying to intervene it is important to remember the safety of yourself, the threatening person and all people and things around them. If you think you can achieve a safe outcome for all, try to calm your friend down • try to get other people who don’t need to be there to leave the area. • even if you’re scared and nervous, act calm. Use their name and talk in a soft, even tone – do not shout back at them. Have a relaxed posture and be non-confrontational. • ask them “What’s made you feel upset/angry?” • listen carefully and show that you care, acknowledging their concerns or frustrations without being patronising • let them know that you are here to help them. If there is something you can do for them, do it • give them time to express themselves. Don’t hurry them • try to get them away from the area/situation into a quiet place with no noise and no other people • keep them talking and ask open-ended questions • be truthful • don’t touch them.
• help them set limits – “Come on mate, keep your voice down” • don’t take any unnecessary risks and remain vigilant - to others’ behaviour, to your behaviour, and to what is happening around you • re-assess the situation. Is what you are doing working? If it’s not try something different or get help • if they calm down try to distract them with other things that may take their mind off things • stay with your friend until he or she, and others, are safe and the effects of the drug wear off • get them help if need be – Accident and Emergency, Police or other friends
Level 3: Acting Out • before trying to intervene it is important to remember the safety of yourself, the threatening person and all people and things around them. If you think you can achieve a safe outcome for all, try to calm your friend down • clear the area if possible – allow room for the threatening person to exit from the area and the situation • be aware of your body language. Back off and give them space, stand to the side, don’t clench your fists, slow down your breathing and stay calm • maintain sympathetic eye contact with them - increase your blink rate but don’t stare/glare at them • stay neutral • if there is nothing you can do, retreat and get help
Level 4: Tension reduction • attempt to regain rapport with them • get medical help if need be • call the Police if necessary 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.
• if your friend has a mental illness like depression, anxiety or schizophrenia, encourage them not to take any drugs • encourage your friend to seek help from their GP or a counsellor about their alcohol and other drug use and/or anger issues • remind them what happened last time they took that drug that way • if your friend insists on taking that drug, do it in a safe, familiar environment away from other people • avoid bingeing, injecting or polydrug use or anything that will intensify the effects of a drug and increase the risk of something going wrong • talk about coping mechanisms • do other activities with them that don’t involve alcohol and other drug use 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