This Learner Guide

About this Unit of Competency Introduction

As a worker, a trainee, or a future worker, you want to enjoy your work and become known as a valuable team member. This unit of competency will help you acquire the knowledge and skills to work effectively as an individual and in groups. It will give you the basis to contribute to the goals of the organisation which employs you.

It is essential that you begin your training by becoming familiar with the industry standards to which organisations must conform. 

This Learner Guide Covers

CHCAOD001 Work in an alcohol and other drugs context 

1. Establish the context for AOD work
2. Apply understanding of context to AOD practice
3. Integrate the core values and principles of AOD work into practice
4. Apply understanding of the impact of values in AOD practice

Learning Program

As you progress through this unit of study, you will develop skills in locating and understanding an organisation’s policies and procedures. You will build up a sound knowledge of the industry standards within which organisations must operate. You will become more aware of the effect that your own skills in dealing with people have on your success or otherwise in the workplace. Knowledge of your skills and capabilities will help you make informed choices about your further study and career options.

Additional Learning Support

To obtain additional support you may:

• Search for other resources. You may find books, journals, videos and other materials that provide additional information about topics in this unit.
• Search for other resources in your local library. Most libraries keep information about government departments and other organisations, services and programs. The librarian should be able to help you locate such resources.
• Contact information services such as Infolink, Equal Opportunity Commission, Commissioner of Workplace Agreements, Union organisations and public relations and information services provided by various government departments. Many of these services are listed in the telephone directory.
• Contact your facilitator.

Facilitation

Your training organisation will provide you with a facilitator. Your facilitator will play an active role in supporting your learning. Your facilitator will help you at any time during working hours to assist with:

• How and when to make contact
• What you need to do to complete this unit of study
• What support will be provided?

Here are some of the things your facilitator may do to make your study easier:

• Give you a clear visual timetable of events for the semester or term in which you are enrolled, including any deadlines for assessments
• Provide you with online webinar times and availability
• Use ‘action sheets’ to remind you about tasks you need to complete and updates on websites
• Make themselves available by telephone for support discussion and provide you with industry updates by email where applicable
• Keep in touch with you during your studies

Flexible Learning

Studying to become a competent worker is an interesting and exciting thing to do. You will learn about current issues in this area. You will establish relationships with other students, fellow workers, and clients. You will learn about your own ideas, attitudes, and values. You will also have fun. (Most of the time!)

At other times, studying can seem overwhelming and impossibly demanding, particularly when you have the assignment to do and you aren’t sure how to tackle it, your family and friends want you to spend time with them, or a movie you want to see is on television.

Sometimes being a student can be hard.

Here are some ideas to help you through the hard times. To study effectively, you need space, resources, and time.

Space

Try to set up a place at home or at work where you can: 

• Keep your study materials
• Be reasonably quiet and free from interruptions
• Be reasonably comfortable, with good lighting, seating, and a flat surface for writing.

If it is impossible for you to set up a study space, perhaps you could use your local library. You will not be able to store your study materials there, but you will have a quiet place, a desk and chair, and easy access to the other facilities.

Study Resources

The most basic resources you will need are:

• A chair
• A desk or table
• A computer with Internet access
• A reading lamp or good light
• A folder or file to keep your notes and study materials together
• Materials to record information (pen and paper or notebooks, or a computer and printer)
• Reference materials, including a dictionary 

Do not forget that other people can be valuable study resources. Your fellow workers, work supervisor, other students, your facilitator, your local librarian, and workers in this area can also help you.

Time

It is important to plan your study time. Work out a time that suits you and plan around it. Most people find that studying, in short, concentrated blocks of time (an hour or two) at regular intervals (daily, every second day, once a week) is more effective than trying to cram a lot of learning into a whole day. You need time to ‘digest’ the information in one section before you move on to the next, and everyone needs regular breaks from study to avoid overload. Be realistic in allocating time for study. Look at what is required for the unit and look at your other commitments.

Make up a study timetable and stick to it. Build in ‘deadlines’ and set yourself goals for completing study tasks. Allow time for reading and completing activities. Remember that it is the quality of the time you spend studying rather than the quantity that is important.

Study Strategies

Different people have different learning ‘styles’. Some people learn best by listening or repeating things out loud. Some learn best by ‘doing’, some by reading and making notes. Assess your own learning style and try to identify any barriers to learning that might affect you. Are you easily distracted? Are you afraid you will fail? Are you taking study too seriously? Not seriously enough? Do you have supportive friends and family? Here are some ideas for effective study strategies:

1. Make notes. This often helps you to remember new or unfamiliar information. Do not worry about spelling or neatness, as long as you can read your own notes. Keep your notes with the rest of your study materials and add to them as you go. Use pictures and diagrams if this helps.
2. Underline keywords when you are reading the materials in this Learner Guide. (Do not underline things in other people’s books.) This also helps you to remember important points.
3. Talk to other people (fellow workers, fellow students, friends, family, or your facilitator) about what you are learning. As well as helping you to clarify and understand new ideas, talking also gives you a chance to find out extra information and to get fresh ideas and different points of view.

Using this Learner Guide

A Learner Guide is just that, a guide to help you learn. A Learner Guide is not a textbook. Your Learner Guide will:

1. Describe the skills you need to demonstrate to achieve competency for this unit.
2. Provide information and knowledge to help you develop your skills.
3. Provide you with structured learning activities to help you absorb knowledge and information and practice your skills.
4. Direct you to other sources of additional knowledge and information about topics for this unit.

How to Get the Most Out of Your Learner Guide

Some sections are quite long and cover complex ideas and information. If you come across anything you do not understand:

1. Talk to your facilitator.
2. Research the area using the books and materials listed under Resources.
3. Discuss the issue with other people (your workplace supervisor, fellow workers, fellow students).
4. Try to relate the information presented in this Learner Guide to your own experience and to what you already know.
5. Ask yourself questions as you go. For example, ‘Have I seen this happening anywhere?’ ‘Could this apply to me?’ ‘What if…’ This will help you to ‘make sense’ of new material and to build on your existing knowledge.
6. Talk to people about your study. Talking is a great way to reinforce what you are learning. 
7. Make notes.
8. Work through the activities. Even if you are tempted to skip some activities, do them anyway. They are there for a reason, and even if you already have the knowledge or skills relating to a particular activity, doing them will help to reinforce what you already know. If you do not understand an activity, think carefully about the way the questions or instructions are phrased. Read the section again to see if you can make sense of it. If you are still confused, contact your facilitator or discuss the activity with other students, fellow workers or your workplace supervisor.

Additional Research, Reading, and Note-Taking

If you are using the additional references and resources suggested in the Learner Guide to take your knowledge a step further, there are a few simple things to keep in mind to make this kind of research easier.

Always make a note of the author’s name, the title of the book or article, the edition, when it was published, where it was published, and the name of the publisher. This includes online articles. If you are taking notes about specific ideas or information, you will need to put the page number as well. This is called the reference information. You will need this for some assessment tasks, and it will help you to find the book again if you need to.

Keep your notes short and to the point.  Relate your notes to the material in your Learner Guide. Put things into your own words. This will give you a better understanding of the material.

Start off with a question you want answered when you are exploring additional resource materials. This will structure your reading and save you time.

Introduction 

Alcohol and other drugs (AOD) refer to substances that can be consumed to produce a psychoactive effect. A psychoactive effect is when a substance, such as a drug, can alter a person’s mood, perception, behaviour and consciousness. Alcohol is a drug that can have short-term or long-term effects on one’s body and brain. When alcohol is consumed in excess, it can lead to negative consequences such as:

• Intoxication
• Impaired judgement
• Other negative consequences, such as high risks 

Other drugs affect the body or mind when ingested, injected, inhaled or consumed. Drugs can be legal or illegal and used for various purposes such as medical treatment, recreation or cultural practices.

There are instances where drugs are misused and abused. Drug misuse refers to using a drug that is not consistent with the prescribed or intended use, such as taking a higher dose than recommended, mixing medicines that should not be taken together or using a medication without a prescription. Drug misuse can also refer to the use of an illegal drug or a legal drug in a way that is not legal, such as driving under the influence of a drug.

Drug misuse can be intentional or unintentional. Drug misuse can be a deliberate choice made by an individual for various reasons, such as to achieve a particular effect of the drug, to self-medicate for a condition, to use illicit drugs for recreational purposes, or to experiment with new substances. 

Drug abuse, by definition, is intentional and involves the repeated use of a drug for non-medical reasons, leading to negative consequences for the user’s physical and mental health and social and legal problems that interfere with the user’s ability to function in daily life. Drug misuse and abuse can involve the same drugs, including prescription drugs, over-the-counter medications and illegal substances. However, drug abuse can involve the use of illicit drugs and typically involves more severe and problematic patterns of drug use. 

Drug abuse can include:

Using illegal drugs such as heroin and cocaine

Combining different drugs or using drugs with alcohol

Taking more quantity of drugs than prescribed, leading to a development of tolerance to drugs

Alcohol and other drug misuse and abuse can lead to different individual problems. In these situations, this is where AOD workers come in. AOD workers are professionals who work in the alcohol and other drugs sector. AOD workers provide support, treatment and education to clients affected by AOD use.

AOD workers may include:

• Alcohol and drug counsellors
• Addiction specialists
• Substance abuse therapists
• Mental health professionals
• Social workers
• Outreach workers
• Healthcare professionals

Although many jobs can be associated with the AOD sector, this learner guide uses the term ‘AOD worker’ to address them in general.

AOD workers should develop a strong foundation of knowledge and skills to work effectively in AOD. As an AOD worker, you must know the fundamentals of drugs.

Drug fundamentals refer to the basic knowledge about drugs and their effects on the human body, mind and behaviour. These drug fundamentals include the following:

Classes of drugs

Types of drugs and how they are administered

Signs and symptoms of drug use

Poly drug use

Classes of drugs

As mentioned earlier, substances can be classified as legal and illegal. Legal drugs are substances that can be purchased with a prescription from a licensed healthcare professional. The use of these drugs is allowed by the laws. Some examples of legal drugs are:

• Antibiotics
• Pain relievers
• Anti-depressants
• Over-the-counter drugs such as cold and flu medications

On the other hand, illegal drugs are prohibited by law and not available for legal purchase. These drugs have a high potential for abuse, no accepted medical use and lack of safety under medical supervision. Here are examples of illegal drugs:

• Amphetamines
• Cannabis (Marijuana)
• Ecstasy (MDMA)
• Heroin

Aside from the legalities of drugs, drugs can be classified by how they affect the bodies. These classes of drugs include: 

Other drugs are classified based on how and where they are commonly used. These classes of drugs include inhalants, opioids, party drugs and synthetic drugs.

This table shows the common classifications of drugs, which include their properties, types of drugs and possible harms:

Types of drugs and their administration methods  

Out of the listed drugs, here are the most common types of drugs: 

• Alcohol. This is a type of drug that slows down the brain and nervous system, leading to relaxation and impaired judgment. Alcohol is typically ingested orally in beverages such as beer and wine.
• Cannabis. This is a psychoactive drug that contains THC (tetrahydrocannabinol). Cannabis can alter mood, perception and cognitive functioning. Cannabis is typically consumed by smoking the dried leaves of the cannabis plant.
• Tobacco. This drug contains nicotine, a stimulant drug that increases heart rate and blood pressure. Tobacco is typically consumed by smoking the dried leaves of the tobacco plant.
• Illicit drugs. These are substances that are illegal to possess or use. They can have a range of effects on the body, from increasing energy and focus to producing euphoria and relaxation. Some examples of illicit drugs are cocaine, heroin and methamphetamine. Some illicit drugs can be administered by injecting the drug into the bloodstream.
• Prescription drugs. These are drugs that a doctor prescribes to treat specific medical conditions. However, they can also be misused, leading to addiction, overdose, and other health problems. Some examples of these drugs are amoxicillin, risperidone and oxycodone. Prescription drugs can be administered orally through tablets, capsules or syrups.

These types of drugs are administered using different methods. There are various ways drugs can be introduced to the body. The methods can significantly impact how the drug affects the body. These are the following methods on how drugs are administered in the body:

Oral ingestion

     Inhalation         

    Injection              

         Transdermal

           Rectal

• Oral ingestion. This involves taking drugs by mouth, usually in pill or liquid form. Oral ingestion can pose risks and harms such as the following:

• Dependence or addiction
• Overdose
• Adverse drug interactions

• Inhalation. This involves inhaling drugs, usually through smoking or vaporisation. Inhalation of drugs can pose risks and harms such as:
  • Increase the risk of lung cancer
  • Increase the risk of respiratory problems
  • Tooth decay
• Injection. This involves injecting drugs directly into the bloodstream through a needle. There are risks and harms incorporated into injection drug use. These are:
  • Overdose
  • Spread of infectious diseases such as HIV or Human Immunodeficiency Virus, a virus that attacks and weakens the immune system, which can lead to acquired immunodeficiency syndrome (AIDS) if left untreated and hepatitis C, a virus that infects the liver, which causes inflammation and lead to liver damage or liver cancer if left untreated
  • Development of infections
  • Transdermal. This involves applying drugs to the skin through a patch or cream. Here are some negative effects of transdermal use of drugs:
    • 1. Skin irritation and rashes
    • 2. Overdose

• Rectal. This involves inserting drugs into the rectum. This method is less common but may be used for certain medications. Some examples of these medications are diazepam and mesalamine. Here are some negative effects of rectal as an administered method in drug use:

• Risk of infection
• Bowel irritation
• Discomfort

Here is a table that shows the most common types of drugs and how they are administered:

Most Common Types of Drugs

Here is a table that shows the most common types of drugs and how they are administered: Understanding the potential risk of oral drug use can help you develop appropriate treatment and plans for safe and responsible drug use. Also, knowing the potential risks associated with transdermal and rectal drug use can help you develop appropriate prevention and treatment strategies, such as monitoring patients closely for adverse effects 

In addition, understanding the risks and harms can help you provide harm reduction strategies to clients, such as access to clean needles, syringes and preventive measures for overdose.

Signs and Symptoms of Drug Use 

As you will work with clients with alcohol and other drug (AOD) issues, it is important to know the signs and symptoms of drug use. Recognising these signs and symptoms can help identify potential problems to provide appropriate interventions and support.  

Signs of drug use are objective observations that others can see or measure. These can include the following: 

• Bloodshot eyes
• Dilated pupils
• Changes in personal hygiene and appearance
• Difficulty with balance or motor skills, including walking, running, fine and gross motor skills and coordination 
• Unstable walking
• Unclear speech
• The individual has drug paraphernalia like syringes, pipes or other related items

On the other hand, drug use symptoms are subjective experiences reported by the individual using drugs. The specific symptoms experienced by an individual may vary depending on the type of drug being used and the method of administration.

These are the common symptoms of drug use: 

• Decrease in the level of motivation or interest in activities previously enjoyed
• Agitation and irritability 
• Paranoia and hallucination
• Changes in sleep patterns
• Changes in appetite, such as increased or decreased hunger
• Anxiety or depression
• Withdrawal from social activities

Drug withdrawal 

There will be instances when you will also work with clients who have withdrawn or are in the process of withdrawing the use of drugs. Withdrawal refers to the process of stopping or reducing the use of alcohol or other drugs. 

Here are the different stages and symptoms of withdrawal: 

1. Early withdrawal

This is the initial stage of withdrawal from AOD. It typically occurs within hours to a few days after the last use of the substance. During this stage, the client’s body begins to adjust to the absence of the substance.

Here are some common symptoms of early withdrawal:

• The feeling of nervousness and restlessness
• Sweating
• Difficulty falling asleep or staying asleep
• Strong urges to use the substance
• Headaches
• Nausea and vomiting
• Irritation and frustration

2. Acute withdrawal 

The acute stage of drug withdrawal typically peaks within several days to a week after the last use of the drug, with the person experiencing strong cravings together with physical symptoms.

Here are some common symptoms of acute withdrawal:

• Tremors, shaking or seizures (in severe cases)
• Hallucinations or delusions (in severe cases)
• Diarrhea
• Increased heart rate 
• Nausea and vomiting
• Insomnia 

2. Post-acute withdrawal (PAW)

This stage lasts for several weeks to months after the last use of the drug, with the person experiencing emotional symptoms and intense cravings for certain drugs, which make them highly vulnerable to relapse. PAW symptoms can be unpredictable, and it varies from person to person. However, here are common symptoms of PAW:

• Anxiety
• Depression
• Chronic fatigue that challenges the client to concentrate and stay awake
• Sleeping problems such as insomnia with vivid dreams of frequent waking up
• Cognitive difficulties such as poor memory and concentration, irrational decision-making and difficulty in focusing
• Severe headaches, muscle aches and tremors. 

Effects of alcohol and other drugs 

AOD issues can have significant and long-lasting implications on an individual’s life. Some of the implications of AOD issues affect the following areas of an individual’s life.  

• Health

The impact of AOD use on an individual’s health can be significant and vary depending on the type of substance used, the frequency and amount of use, and the individual’s overall health status. Several signs and symptoms give you an idea that the individual is negatively affected by AOD. Some of the potential health impacts of AOD use include: 

AOD use can manifest in various ways in an individual’s health. These manifestations are often shown through signs and symptoms, which are the physical, behavioural, or subjective changes that are indicative of a particular condition, disease, or disorder.

Signs are objective indications of a health problem that can be measured through diagnostic tests and observed by someone other than the affected individual, such as a healthcare professional. For example, if someone has liver damage due to AOD use, a healthcare provider may observe yellowing of the skin (jaundice), abdominal swelling, or abnormal liver function test results. 

On the other hand, symptoms are subjective experiences reported by the affected individual that may indicate the presence of a health problem. For example, if someone is experiencing depression or anxiety due to AOD use, they may report feelings of sadness, hopelessness or fear. Physically, an individual might report experiencing pain, fatigue or nausea. Symptoms are not directly observable by others and may vary in intensity or presentation from person to person.

Signs and symptoms are not interchangeable but can also overlap because some health conditions can be caused by multiple substances or by the same substance in different amounts or patterns of use. 

Below are example signs and symptoms of the health conditions as a result of AOD use as discussed above:

•  Cognitive

Cognitive refers to the way an individual thinks, learns, remembers and makes decisions. It has to do with the brain and how it works. 

Many individuals seeking treatment for AOD use often encounter cognitive impairment due to the effects of the substances taken. Cognitive impairment refers to a condition in which a person has difficulties with thinking, learning, memory, attention and decision-making. Cognitive impairment can affect a person’s ability to function effectively in everyday life, including their ability to work, study and maintain relationships.

These are the common signs, symptoms and effects of AOD use in cognitive function:

• Social 

AOD use greatly affects the social aspect of an individual’s life. This aspect of the individual’s life refers to the individual’s ability to engage in social activities and relationships healthily and productively despite the challenges and obstacles posed by substance use. AOD use can make a person withdrawn and lose interest in work or any social activity. In worse cases, AOD use can even lead to violence towards friends and family and family and relationship breakdowns.

AOD workers have the goal of assisting people who have issues with drug or alcohol use. AOD workers aim to improve the ability of these people to interact with others in society. AOD workers do this by offering encouragement, knowledge and tools to assist these people in developing healthy ways to handle stress, enhance their ability to communicate and mend relationships that might have been negatively impacted by substance use.  

Some of the common signs and symptoms AOD use in an individual’s social functioning include:

• Emotional 

AOD use and emotional regulation are closely linked. Many AOD users turn to substances as a way to cope with emotional distress or to regulate their emotions. This emotional domain of the individual’s life includes emotions, feelings, attitudes and mood. 

It is an important aspect of overall human development and encompasses how individuals express, regulate, and experience emotions, as well as their ability to understand the emotions of others. 

The use of AODs can disrupt the normal development of emotional regulation, impulse control and decision-making skills, leading to emotional instability, impulsivity and poor judgment. 

For example, chronic alcohol use can cause damage to the prefrontal cortex of the brain, which is responsible for regulating emotions and decision-making. This damage may result in an individual becoming quicker to anger, prone to mood swings and having difficulty controlling their emotions in response to everyday stressors.

Aside from the general signs and symptoms provided above, below are also common signs and symptoms of AOD use relevant to the emotional development of an individual:

• Impact on others

It is important to recognise that the impact of AOD issues is not limited to the individual using substances. Effective interventions and support should consider the broader impacts of AOD issues on others.

The table below lists some of the people who can be affected by the AOD issues of an individual and outlines how each one of them may be affected: 

The signs and symptoms that may manifest in other people due to an individual’s AOD use can vary depending on their relationship to the person and their personal and social context. Below are some general examples of how AOD may manifest in signs and symptoms for each of the groups listed:

Patterns and prevalence of drug use  

Determining drug use patterns and prevalence is one way to understand AOD better. Patterns of drug use refer to how individuals consume drugs, including frequency, duration and quantity of drug use. Patterns of drug use may vary among individuals. Addiction is considered a disorder characterised by the compulsion of a person to use a particular drug with a lack of control to regulate their use. 

Meanwhile, the prevalence of drug use refers to how many people in a group or place have used a drug during a certain period. It shows how often people use drugs and what are the most commonly used drugs. Here are some patterns and prevalence of drug use:

     Experimental

Recreational or social

     Situational

     Dependence

• Experimental

This pattern refers to trying a drug out of curiosity or peer pressure. This pattern is considered the first use of the client. This pattern can be a one-time experience or involve several short-term drug exposures. After experimenting, some people may realise that the drug is not for them and choose not to continue using it. However, others may continue using the drug and develop a pattern that suits them in this pattern.

For the prevalence of AOD use, according to the most recent data from the 2019 National Drug Strategy Household Survey (NDSHS) in Australia, 16.4% of people aged 14 years or older reported using illicit drugs. Of those who reported using an illicit drug, 5.5% reported using an illicit drug for the first time in their life during that period.

• Recreational or Social 

Recreational drug use happens when a person uses drugs for enjoyment, relaxation and non-medical purposes. Drug use is seen as a way to unwind, have fun or escape from the stress of everyday life. 

Social drug use happens when a person uses drugs in social settings, such as parties or gatherings, as a way to bond with others. Social drug use is seen as a way to fit in with peers or to enhance social interaction. 

In this pattern, your client’s drug use may or may not cause them problems, and it is less likely that they will experience harm. This pattern involves using drugs regularly in a controlled way and is not considered an addiction. The client can change or limit their drug use depending on the situation.

For the prevalence of AOD use, the 2019 NDSHS reported that 29.6% of people aged 14 years or older have been using an illicit drug for recreational purposes in the past year. The survey also reported the following:

• 17.6% of respondents reported using illicit drugs at a party or club
• 11.7% reported using drugs with friends
• 9.6% reported using drugs at a music festival or concert.

• Situational 

Situational AOD use means that a person uses alcohol or drugs for a particular event situation, such as coping with anxiety or relieving body pain. While drug use may initially provide relief, it can also become a coping mechanism and potentially lead to dependence or addiction if not managed appropriately.

It is prevalent among young adults and college students but can also be seen in other cultural or ethnic groups. It’s important to note that even situational use can sometimes carry risks and negative consequences and lead to addiction.

• Dependence

This is the most severe pattern of drug use and involves physical and psychological dependence on a drug. This is where clients use drugs on a regular basis and have developed a reliance on them. This can be caused by prolonged use of the drug, where the person might depend on the drug just to function normally.

Clients dependent on a drug may experience withdrawal symptoms when they attempt to stop using it and may have difficulty controlling their use. 

According to the 2019 NDSHS, 1.4% of people aged 14 years or older reported using an illicit drug daily, and 4.4% reported using an illicit drug weekly. While not all of these individuals may meet diagnostic criteria for dependence, regular drug use is a risk factor for developing a substance use disorder (a medical condition characterised by the compulsive use of drugs or alcohol despite the negative consequences on a person’s physical, mental and social wellbeing.

Drug interactions 

There will be cases in which you will have clients who use multiple drugs. In these cases, you need to be knowledgeable about drug interactions.

Drug interactions occur when two or more drugs interact in the client’s body. These interactions can occur between prescription drugs, over-the-counter medications, herbal remedies and illicit drugs. There are three important concepts that you need to know about drug interactions, these concepts are: 

Poly drug use

Common drug interactions

Effects of of prescribed drugs on the use of other drugs

• Poly drug use 

Polydrug use refers to using more than one drug at a time, either simultaneously or in sequence. Here are some reasons why people use polydrugs:

• To enhance the effects of a particular drug
• To serve as an alternative to another drug
• To reduce the negative effects of a drug
• To overcome tolerance to the effects of a drug 

Polydrug use can increase the risk of the following:

• Drug interactions 
• Overdose
• Other negative health consequences, such as depression, anxiety, cognitive impairment and physical health problems (e.g. cardiovascular disease, liver and kidney damage, increased risk of infections and chronic pain).

You need to know about polydrug use and its associated risks. Here are common examples of polydrug use:

• Combining opioids and benzodiazepines. Both opioids and benzodiazepines can cause respiratory problems when used together. These drugs can amplify this effect which can be life-threatening.
• Combining alcohol and cocaine. Alcohol and cocaine create a toxic chemical called cocaethylene when used together. This chemical can damage the heart, liver and other organs.
• Combining multiple drugs of the same class. For example, taking multiple stimulants or opioids simultaneously can increase the risk of overdose and other health problems, such as respiratory depression, cardiovascular problems, seizures and coma. 

• Common drug interactions

Common drug interactions occur when two or more drugs are taken simultaneously, and the combination alters how the drugs work in the body. The effects of one or both drugs can be increased, decreased or changed leading to potential harm or reduced effectiveness. Here are examples of common drug interactions: 

Other common drug interactions can also be an interaction between drug and drug, drug and food, drug and alcohol and drug and disease. The table shows other types of drug interactions, examples and how they affect the body of the user: 

• Effects of prescribed drugs on the use of other drugs

Effects of prescribed drugs on the use of other drugs refer to how taking prescription medications can impact the use and effects of other drugs. It is important to be careful when taking prescription medications, especially if you already use or have drug problems. Mixing prescription medications with other drugs can be dangerous and cause health problems. Some prescription medications can be misused or abused, making things even riskier.

Here are the common effects of prescribed drugs on the use of other drugs:  

Prescription drugs can enhance the effects of other drugs

prescription drugs can make other drugs less effective by reducing their effects on the body

Prescription drugs can cause adverse reactions when taken with other drugs

Prescription drugs, when mixed with other drugs, can lead to the person’s addiction

These are the following drug fundamentals discussed in the introduction:

• Classes of drugs
• Types of drugs and how they are administered
• Signs and symptoms of drug use
• Patterns and violence of drug use
• Poly drug use

As you read this learner guide, these drug fundamentals will serve as your foundation knowledge. This learner guide will help you work in alcohol and other drug contexts. This learner guide will focus on the following discussions:

• Establish the context for AOD work
• Apply understanding of context to AOD practice
• Integrate the core values and principles of AOD work into practice
• Apply to understand the impact of values in AOD practice