How do I know if I am addicted to drugs or alcohol?
The short answer is you are likely addicted if you can’t stop. The long answer is an addiction is something that takes place over time through a process of physical and behavioral changes. Over time, the body will change to regular and repeated exposure to a substance. This is how tolerance and dependence happen. The body becomes used to the drug. That becomes apparent when the drug does not do the same thing unless you take more. Withdrawals can be another sign of tolerance and dependence. Over that same time, there are behaviors changing and habits forming, often related to life issues and stressors. You may find using to ease the emotional pain of depression, anxiety, bad relationships, etc. As addiction deepens, you may neglect other responsibilities, often family, friends, work, and school. Over time, taking a risk for the substance heightens. This may be driving under the influence; being intoxicated at work; stealing to get money for drugs; being in bad neighborhoods or associating with dangerous people to get drugs, and even selling sex for drugs.
How do I know if someone else is?
It can be hard to know if someone is addicted to drugs or alcohol. With repeated use, people become tolerant. If someone is tolerant, intoxication may not be as obvious. People are often aware of the problem so try to conceal it. They may hide substances and use in secret. They may drink in private. There are physical changes of withdrawal and intoxication unique to each drug one can look out for. It may be more obvious in changes in mood and behavior. Many people with substance use problems also suffer from depression, anxiety or other mental health diseases. Friends who are using drugs may be more withdrawn, isolated and less dependable. They may look unhealthy or gaunt as drugs are toxic. It never hurts just to ask. It may make all the difference to have an empathic friend reaching out in genuine concern.
When does someone know they are ready for addiction treatment?
You are ready for help when you say you are ready for help. If you can’t reduce or quit on your own, it is time to reach out and get help. But this has to come from within; change can only come when it starts at ground zero.
An individual is ready for addiction treatment when they can determine for themselves they are ready to change the lifestyle and patterns of use. No one can begin the recovery process for someone else, and therefore the individual must want to change. This does not mean that others won’t be there along the way to help, it just means the individual is ready to ask for help and accept help as well.
A lot of time there is underlying trauma or other mental health factors that can impact someone’s substance use, and therefore these issues may also need to be addressed.
What are some of the challenges of recovery?
First and foremost having the wrong expectations may be the biggest setback to recovery. No matter what support or medical care, recovery can be a long and challenging process. The body has changed to put up with drugs and alcohol regularly over months or years. There is a lot of physical healing that needs to take place. Most of that healing needs to happen in the brain. Neurons take months to years to get back to healthy functioning. On top of that, habits must change, coping skills, patterns of thinking, etc.
Another challenge of recovery is changing the current lifestyle that that person is used to. That involves new friendships, different jobs and for some living in a different place. Lack of support can be a challenge as during their use some people might have lost friends and families. Another challenge is to find the right program and have the financial resources to afford treatment.
Change does not occur in an instant, and recovery can be difficult. Accepting that the change process involves commitment and that you may experience uncomfortable feelings both emotionally and physically can be difficult. The willingness to accept help can also be difficult for some people, therefore finding the right fit for treatment, individual therapy, or twelve-step groups is important. Changing patterns and establishing healthy boundaries may mean losing using friends and family members. Recovery is a life-long process, but it is not impossible.
What if I relapse?
Get back on the horse. Addiction is a chronic disease with relapse rates similar to other chronic diseases like diabetes and high blood pressure. Typical relapse rates range from 40 to 60%. This is all the more important than to have a good support system. The more skills learned and support available, the quicker to getting back on track. With a relapse behind you, it is an opportunity for grown and understanding. That will help in the future to reduce the risk even further.
What is withdrawal, how long does it last, will it ever go away entirely?
The effects of withdrawal come from the body reacting to a substance it has become dependent on. The body does all it can to create a balance with whatever we do to it. This is called homeostasis. Physical changes occur when we change diets or altitude. It takes the body time to adjust and adapt. Drugs and alcohol over time create an adaptation where the body become more tolerant. Intoxication is not a natural state so the body tries to adapt to have a balance. Withdrawal occurs when that balance is thrown off.
Withdrawal has physical and mental manifestations. Generally, the physical withdrawals are over within 1-2 weeks. Mental issues can take longer. These may sometimes be referred to as post-acute withdrawal. People may be more irritable, anxious, depressed, keyed up. They may have insomnia. These symptoms may last months. There are many meds that can help alleviate some of these symptoms, but it is the brain healing from the substance use.
How can I talk about addiction to my friends and family?
Sometimes beginning the conversation can be the hardest thing you do. Chances are those around you, already know something is off, and talking about it may not come as a surprise. Letting others know that you are struggling with substances allows you to begin the process of recovery. Say, “I need help,” “I love myself enough to tell you this,” “I trust you, and this is why I am telling you that I have a problem.” Sharing this with people who you know will be loving and supportive no matter what is key. If you feel that you do not have someone who will be loving and supportive, then beginning the process by calling a therapist, helpline, or clinic may be the best way to begin the process.
Can I cut back or do I need to stop using completely?
Not all substances are equal. Some have more intense effects and carry a higher risk of addiction. Some are legal, and some are not. The majority of people using substances–alcohol being the greatest of these–are not addicted. Use has been sporadic and recreational. For more dangerous and illegal substances, it would be wise to quit as soon as possible and stay away. If there has been misuse, one may have to take a hard look at the risk of dependence. Support or education may help them cut back to healthy levels of use or quit.
Can I quit using drugs but still drink alcohol?
No, and yes. You need to take a hard look at why you have been drinking. It is also important to look back to see if there has been a history of overusing or misusing the alcohol. It can be a slippery slope to get back into any substance use. The safest thing would be to give it all a break. Let the body heal. Then with the support of family, friends, and counselors, you can decide what place alcohol has, if any, in your life.
Do I need to go away to rehab? (when is inpatient required)
Most people do not need to go to residential rehab. Studies have shown similar success rates between residential services and Intensive Outpatient Programs. As providers, we look at support in varying levels of intensity that needs to meet up with how severe the addiction has been or what levels of care have not worked so far. For someone new to treatment with a good support system, individual therapy and community programs may be enough. For someone with more medical concerns or limited social support, residential services may be warranted. Each case is unique. It helps to reach out to an addictions specialist to help one figure out what may be the best course of care.
How does “Therapy” help with my addiction?
Addiction is a complex mix of physical changes, social factors, and psychology. Mental health and addiction counselors can be very helpful in working through the psychological and social issues that may have gotten us into the addiction. Without knowing how you got into something, it can be challenging finding the way out. Therapy can look at current coping skills, stress triggers, and healthy thinking. It may also involve going back to process things from the past. In any case, the more proactive you are in the therapy process, the more you will get out of it. This will greatly improve chances of success.
Do I need the Intensive Outpatient Program (IOP) or can I just see a therapist?
It would be good to discuss this with a therapist. An addiction counselor or mental health therapist can help you look at how you got where you are now and what support you have to go forward. Depending on these factors, you will need varying levels of support. Therapy may be 1-3 hours of time a week, depending on visits and if you are in any support group as well. Intensive Outpatient Programs are generally at least 9 hours a week for a few months. It is best to treat this as a part-time job or going back to school. Getting to where we are in our addiction may have taken a great deal of time and effort, so it will need a great deal of time and effort to get out. This is respecting what needs to change and how much work that is going to take. It can be amazing to see the transformation take place over a matter of weeks.