Updated: Feb 12
“I can’t be an alcoholic, I don’t drink everyday.” “I have chronic pain. I need these pills.” As the Big Book of Alcoholic’s Anonymous states, alcoholism/ addiction is a “cunning and baffling disease.” Identifying the disease of addiction: and beginning treatment is a daunting task. The intent of this article is to outline the differences between substance abuse and dependency. A final discussion regarding treatment is to provide a springboard, for those considering a step towards recovery.
An individual does not have to demonstrate daily use of alcohol or drugs to be dependent. A chemically dependent person can still have a job, home, family, and friends. For most people, the use of alcohol is a pleasant addition to social activities. Moderate alcohol use, up to two drinks per day for men and one drink per day for women and seniors, is not harmful for most adults. At times, drug use may also be socially accepted.
Substances affect different people, in different ways. Some people undergo shifts in their personality after using alcohol or drugs. The problem with substances is not how much someone uses, but the effects. Overall, when an individual starts having negative consequences to their use, they need some help.
Substance Dependency includes four symptoms:
Craving: A strong need, or compulsion, to use alcohol or drugs.
Loss of control: The inability to limit one’s substance use on any given occasion.
Physical dependence: Withdrawal symptoms, such as nausea, sweating, and anxiety, occur when substance use is stopped.
Tolerance: The need to use greater amounts of alcohol or drugs in order to “get high.”
Other signs that might indicate a problem:
Periods of time when an individual "goes on the wagon" or moves from one drug to another.
Drives after drinking or reacts with anger when asked for their car keys.
Constant sniffing, has frequent colds or makes many trips to the bathroom
Blackouts or periods of time during use, the individual cannot recall.
Increase in the amount of time spent with friends who use substances.
Has money, legal, family or occupational problems.
Substance abuse is defined as a pattern of use, which results in one or more of the following situations within a 12-month period:
Failure to fulfill major responsibilities at work, school, or home.
Using in situations that are physically dangerous, such as while driving a car. Having recurring substance related legal problems, such as being arrested for driving under the influence.
Continued use despite having ongoing relationship problems that are caused or worsened by the substance use.
Substance dependency differs from substance abuse, in that dependency includes the following additional symptoms: a craving for substances, loss of control over use, or physical dependence or a change in tolerance. The sooner an individual reaches out for help, the better the treatment outcome. It may take time for someone with a substance abuse problem to take those first steps. Those who live with the addict are affected by the substance use as well. It is important for family members to get support and assistance as they deal with this disease. Gaining education and insight into the family problem of addiction is a good start to healing the family and addict. Once the decision has been made to seek out treatment, one will find myriad resources. It may be overwhelming at first to sort through yellow page advertisements and internet sites. The differing credentials, professional use, may not make any sense to the layperson. There are some simple guidelines to help sort through the listings. Using the Yellow Pages, one finds listings under alcohol, drug abuse and counselors. Individual therapists, treatment programs and residential programs will be listed. Individual counselor or therapist listings will have names followed by credentials. The most important credential to identify is that of a Certified Addictions Professional (CAP). Although all therapists, whether they hold a Masters degree or a Doctorate have a great deal of counseling expertise, only an addictions specialist has specialized knowledge and technique to address the special needs of addicts. Unfortunately, in this writer’s experiences, too many non-CAP therapists identify themselves as being knowledgeable in substance abuse. However, some are limited in their ability to identify substance dependency. Additionally some are unaware of the appropriate treatment options, outside of outpatient therapy. As mentioned above, the disease of substance abuse is a cunning and baffling disease, not only to the addict and family, but to the generalist therapist with limited addictions experience. When looking for information online, remember that not all you read is factual. Consider the source of the information. Consider the credentials of the individual writing the article. And finally, consider whether or not the article is attempting to sell you a product or service. Sources such as Substance Abuse & Mental Health Administration (SAMHA) will provide the reader with a great deal of factual information regarding substance abuse and its treatment. Often you can find individual therapists listed on sites such as PsychologyToday.com, FindATherapist.com and Sober.com. These sites may help you narrow down your search for a therapist. Once you make contact with a therapist, keep in mind this fact, the majority of treatment success depends on the therapeutic relationship with a particular therapist. This is one reason why it is important for the individual seeking treatment to speak directly to the therapist. Feel free to ask the therapist about their education, qualifications, and experience treating substance abuse. Perseverance is the key, continue to call and speak directly to therapists, until you find one who connects and is certified in addictions. After a complete evaluation, treatment options will be outlined. Treatment can include services, ranging from detoxification programs, residential treatment, partial hospitalization, outpatient treatment and support groups (12 step programs). Living in active addiction can create a sense chaos. There is hope. Help is available for those willing to embrace a life of recovery.