Are you concerned about your – or someone else’s – alcohol or drug use? How do you know if your concern is warranted? The fact that alcohol is legal and drugs are often prescribed by doctors can make the answer to that question confusing.
Let’s start with alcohol, the most commonly used drug (yes, drug) in the U.S. Alcohol is a socially accepted fixture in almost all realms of society. It is even used in spiritual rituals. Restrictions on its use are limited to a legal drinking age because of its ability to impact decision making in those whose brains are not yet fully developed in critical thinking.
What we have seen over and over again, however, is that even adults have negative consequences as a result of poor decision making with alcohol use. And very simply put, when negative consequences occur as a result of alcohol use, that is when it is time to be concerned.
Same thing with prescription drugs: if taking them results in reoccurring problems, take note and be concerned.
Illegal drugs? No matter what your belief system is with regard to using what some consider “recreational” drugs such as marijuana, or stronger drugs like cocaine and heroin, the fact that they are illegal provides the first reason for concern.
Put in simple terms, alcohol or drug ABUSE is diagnosed if one or more of the following symptoms occurs over a 12-month period (for those who have never been diagnosed with a substance dependence):
- Recurrent use in situations that are physically hazardous (i.e., while driving, operating machinery, taking part in physical sports)
- Use that causes recurring legal problems (i.e., DUI, possession, disorderly conduct)
- Use that causes recurrent failure to fulfill obligations (i.e., late for or missing work or school, or not performing up to expectations? Neglecting family responsibilities such as caring for children or your home, not paying bills or unable to pay bills due to the costs of continued use?)
- Continued use despite recurring social or interpersonal problems caused by or made worse by use (i.e., arguments or fights with others, especially about substance use? loss of friends?)
If you or someone you know has one or more of those symptoms, talking to someone about it is the first step to avoiding escalation of use and problems and possible alcohol or drug dependence. Chemical dependence is a chronic and progressive disease that can also be fatal. Early intervention is key to arresting its continued development.
A DEPENDENCE diagnosis for alcohol or drugs requires the existence of at least three of the following seven signs/symptoms occurring over a 12-month period:
- Tolerance, which is either a need to increase the amount of the substance to reach intoxication or the desired effect, OR a noticeable reduced affect with continued use of the same amount of the substance (no longer feeling the high from the usual amount of use);
- Withdrawal – feeling negative physiological symptoms (which depend on the substance used) after using and the substance leaves the body OR the same (or similar) substance is used to avoid the negative physiological symptoms of withdrawal;
- often using more than or longer than planned, known as loss of control;
- a persistent desire to cut down or control use, or unsuccessful attempts to do so;
- a lot of time spent in activities to obtain, use or recover from the effects of the substance (i.e., driving long distances to get a drug, daily or all day use, the length of time you feel withdrawal or hangover symptoms);
- decreased interest in social, occupational or recreational activities resulting in reduction or discontinuation of the activity;
- continuing to use even with knowledge that it causes or makes worse physical or psychological problems (i.e., continued alcohol use despite knowing it aggravates an ulcer or increases blood pressure; continued use despite knowing depression will occur afterward).
If you now know your concern is warranted, you can take steps to get help.
Here are some options:
- For information about support groups for those who want to stop using, go to these websites:
- For information about support groups for family and friends of substance users, try these:
If you or someone you know is experiencing severe withdrawal symptoms, especially from alcohol, please call a professional, see a doctor, or go to the nearest Emergency Room. Withdrawal from alcohol can cause death if untreated.