Understanding your options: a plain guide to substance use help in Australia
If you search for help with substance use in Australia, you'll find two kinds of results: government service directories and clinical information pages that read like they were written for health professionals. Neither is particularly useful if you're someone who's curious about your options and wants a plain explanation of what actually exists.
This is an attempt to fill that gap.
First: you don't have to be in crisis
The most important thing to say upfront is that nothing in this guide requires you to have hit a crisis point, identified as an addict, or decided to stop. Many of the options below are appropriate , and most effective , well before that point.
The idea that help is for people in trouble is one of the biggest barriers to people getting useful support earlier. If you're curious about your relationship with substances, have been wondering whether to cut back, or just want to understand your patterns better, these options are available to you.
Self-directed options
Self-monitoring. The most accessible starting point. Tracking your use, mood, and sleep accurately , in a diary or app , is itself a form of intervention. The evidence is clear that self-monitoring alone reduces use in people not yet seeking formal treatment. It requires no appointment, no commitment, and no disclosure to anyone. It's the appropriate first step for most people who are in the curious-but-not-in-crisis space.
Online resources and programmes. Several evidence-based online programmes are freely available for people who want structured support without clinical contact. Hello Sunday Morning's Daybreak programme is the most widely used in Australia , an app-based moderated community with behaviour change tools specifically for alcohol. It's free, anonymous, and designed for people who want to change their relationship with alcohol without necessarily stopping.
Self-help literature. Structured books like William Miller's Controlling Your Drinking (based on CBT principles) or Annie Grace's This Naked Mind have helped many people develop a different relationship with alcohol without clinical involvement. These aren't appropriate for everyone but work well for people with high intrinsic motivation and hazardous rather than dependent drinking.
GP and primary care
Your GP is a reasonable first port of call, particularly if you're unsure what level of support you need. GPs can:
- Administer validated screening tools like the AUDIT to give you a population-context picture of your use
- Provide brief advice and information , which has demonstrated efficacy for hazardous drinking
- Refer to specialist AOD services if that's appropriate
- Prescribe medications that support reduction or abstinence where indicated (more on this below)
- Address related health concerns , sleep, anxiety, liver function , in the same consultation
Many people avoid the GP conversation because they're concerned about judgment or about having something on their medical record. Both concerns are worth naming directly. GPs who work in primary care see this conversation regularly and the majority approach it without judgment. As for records , your medical record is confidential and protected by law; it cannot be accessed by employers, insurers, or anyone else without your consent in almost all circumstances.
Counselling and psychology
Psychologists and counsellors with AOD experience offer structured therapeutic support for substance use. Several approaches have strong evidence:
Motivational Interviewing (MI) is a collaborative, person-centred style of conversation that helps people explore their own ambivalence about change. It doesn't require you to have decided anything , it works precisely with the ambivalence. It's particularly well suited to people in the contemplative stage who aren't sure what they want to do.
Cognitive Behavioural Therapy (CBT) for substance use focuses on identifying the thoughts, emotions, and situations that drive use, and developing alternative responses. It's structured and skills-based, and has a strong evidence base for alcohol, cannabis, and stimulant use.
Acceptance and Commitment Therapy (ACT) works on developing psychological flexibility , the ability to experience difficult thoughts and feelings without acting on them automatically. It's increasingly used in substance use contexts with good results.
Under Medicare, you can access up to 10 psychology sessions per year with a GP Mental Health Care Plan. AOD-specific counselling is available through state government services and some community health centres, often free of charge.
Specialist AOD services
State-based AOD services offer more intensive support for people with more severe or complex presentations. These include:
Community-based counselling services , outpatient counselling, case management, and support programmes. Available through organisations like We Help Ourselves (NSW), Turning Point (VIC), Lives Lived Well (QLD), and equivalents in other states. Most are free or low-cost.
Day programmes , structured daytime programmes that provide intensive support without residential admission. Suitable for people who need more than weekly counselling but don't require 24-hour care.
Residential rehabilitation , live-in programmes that typically run 4–12 weeks. Appropriate for people with severe dependence or where the home environment is not supportive of change. Publicly funded options exist in all states, though waiting lists can be significant.
Medically supervised withdrawal , for alcohol and benzoate dependence in particular, withdrawal can carry medical risk and should be supervised. This can happen in hospital or in specialised community withdrawal settings. It's not appropriate for most people using alcohol hazardously; it's relevant for people with significant physical dependence.
Medications
Several medications have evidence for supporting reduced drinking or abstinence:
Naltrexone reduces the rewarding effects of alcohol, which can reduce craving and the tendency to escalate once drinking has started. It's available in oral form (daily) or as a monthly injection. Requires a prescription; Medicare-subsidised.
Acamprosate reduces withdrawal-related anxiety and discomfort in people who have stopped drinking, supporting abstinence. Most effective in combination with counselling.
Disulfiram (Antabuse) causes an unpleasant physical reaction when alcohol is consumed, acting as a deterrent. Its effectiveness depends significantly on motivation and compliance.
For opioid dependence, methadone and buprenorphine are the evidence-based pharmacological treatments, available through specialist prescribers and pharmacies.
Medication is not appropriate for everyone and the decision is best made with a GP or addiction medicine specialist who understands your full picture.
Finding services
NDARC (National Drug and Alcohol Research Centre): comprehensive information resource at ndarc.med.unsw.edu.au
DrugInfo (Victoria): 1300 85 85 84
Alcohol Drug Information Service (ADIS): operates in most states , confidential telephone counselling and referral
Hello Sunday Morning / Daybreak: daybreak.com.au , free app-based programme for alcohol
Your GP: the most accessible starting point for most people, and can coordinate referrals to any of the above
ayodee is a self-directed first step , tracking your patterns before, during, or alongside any of the options above. Anonymous, no email required. Free to start.