How do I know if someone is an addict?- Part two- The diagnosis of substance use

How do I know if someone is an addict?- Part two- The diagnosis of substance use

Hopefully you read part one of my blog last week How do I know if someone is an addict?- Part one- The stages of substance use

This week, I’ll focus on the diagnosis of substance use. To put it simply, I think if someone has a problem with substance use, then they need help. In our culture, we seem to always want some sort of diagnosis.

 

How we diagnose

 

The ICD-10 International Statistical Classification of Diseases and Related Health Problems (mental and behavioural disorders) is what medical professional use to diagnose health problems. It is led by the World Health Association and is the main reference guide in the UK.

Interestingly, the ICD-10 does not even refer to ‘addiction’ as a disorder and hasn’t done since 1964.

Instead, it refers to:

Harmful use– A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected drugs) or mental (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol).

 

The diagnosis requires that actual damage should have been caused to the mental or physical health of the user and not just the social impact on themselves or their family members.

 

OR

 

Dependence syndrome– A cluster of physiological, behavioural, and cognitive phenomena in which the use of a substance or a class of substances takes on a much higher priority for a given individual than other behaviours that once had greater value.

The explanation given is that people have an overwhelming desire to take their particular drug(s) of choice or alcohol and if they do give up temporarily, they are more likely to return to old behaviours quickly, as opposed to someone who does not have a problems with substances but uses them.

 

Criteria

 

ICD10 states, ‘A definite diagnosis of dependence should usually be made only if three or more of the following have been present together at some time during the previous year:

(a) a strong desire or sense of compulsion to take the substance;

(b) difficulties in controlling substance-taking behaviour in terms of its onset, termination, or levels of use;

(c) a physiological withdrawal state (see F1x.3 and F1x.4) when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms;

(d) evidence of tolerance, such that increased doses of the psychoactive substances are required in order to achieve effects originally produced by lower doses (clear examples of this are found in alcohol- and opiate-dependent individuals who may take daily doses sufficient to incapacitate or kill nontolerant users);

(e) progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects;

(f) persisting with substance use despite clear evidence of overtly harmful consequences, such as harm to the liver through excessive drinking, depressive mood states consequent to periods of heavy substance use, or drug-related impairment of cognitive functioning; efforts should be made to determine that the user was actually, or could be expected to be, aware of the nature and extent of the harm

 

Screening tools

 

Here are some handy screening tools which can be self-scored. If you can get your loved one to complete it, great! If not, you may know enough about their substance using patterns to be able to give it a go yourself.

AUDIT

The Alcohol Use Disorders Identification Test (AUDIT) is considered the most accurate alcohol screening tool for identifying potential alcohol misuse, including dependence. Here is a self-screening that you could explore with your loved one or have a look yourself on their behalf.

 

DUDIT

The Drug Use Disorder Identification Test is here in PDF form to use if you suspect your loved one is using drugs.

 

A note about language

 

I always refer to ‘people who have problems with substance use’ or something similar. I don’t like labels, but what individuals choose to refer to themselves as is their choice. As long as we are not labelling each other, then I think that’s fair enough. There is lots of choice around the help people get for their drug and alcohol use which means that people tend to label themselves depending on the model they use to get help. This doesn’t mean we should be doing it on behalf of individuals or making assumptions.

 

In summary then, although most of us are not medical professionals and therefore technically shouldn’t diagnose others, we can get a fair idea from the above to figure out whether we are on the right track with our loved one’s substance use.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area or via Skype worldwide.

I also have an online therapeutic programme. Take a look at my services here

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

Take care,

Victoria.

 

Drugs, alcohol and lies

Drugs, alcohol and lies

It’s tough for family or friends of people who use drugs to understand why their loved one lies to them about their drug or alcohol use (I’ll refer to drug use from this point on, to include alcohol). It’s also incredibly frustrating because when we know someone is lying to us, it’s always really hard to call someone out about their lies because it’s all a bit embarrassing. Either that, or when we do challenge someone about catching them out, they are likely to react with anger or denial which can provide a great excuse to go and have a drink.

 

Why do they lie?

 

We know that when people are addicted to a particular substance, they struggle to find interest in anything other than their alcohol or drug of choice. This means that they are likely to do anything to get their drug, which inevitably includes lying through their teeth!

Here’s the reasons why your loved one is lying to you:

  1. Avoiding help- even if someone is aware that their drug use is causing problems, it is a HUGE hurdle to admit it to themselves, let alone anyone else. This means that in order to stay comfortable, it is easier to lie. Admitting it, getting help, being challenged, is not a nice place to be.
  2. Denial- it’s so much easier to deny drugs are a problem. It feels much safer and denial means that a loved one can continue using their drug of choice, which is their priority. It’s easier to blame every man and his dog for the problems that go on than the drug. It is important that the drug is protected, as, for whatever reason, your loved one is benefiting from their substance. It is helping them to get away from something, or it is giving them something they need.
  3. Fear- It is far too scary to admit drugs are a problem or to think about making the changes your loved one needs to make for themselves. It is easier to lie to others and ourselves when we feel frightened about facing up to something.
  4. Loving the drug- People who use drugs cannot imagine their life without their drug so they truly believe it is a part of their life and that they need it and want to continue using it.
  5. Shame- Loved ones go through periods of wanting to change. During these times, they will experience shame about using their drugs, how they have treated their own family and friends, their desperation. Then, it can becomes clear that burying their head in the sand and lying to themselves about the situation is much more manageable than face up to their lives and the hurt they have caused other people. Some people even start to believe their own lies!
  6. Survival- yep. Right down to survival mode… Lying is simply a way to survive and help people feel safe.

 

How to handle lying

 

  1. Call it out compassionately- This is cringeworthy, but you’ll get used to it. Use positive communication such as I-messages to feed their lies back to them. This is done in a way that is non-confrontational and gentle which focuses on YOUR feelings, not their behaviour.
  2. Remember it’s not you, it’s them substance- try not to take it personally as your loved one is avoiding reality and thinking they are making it easier for you if you don’t know the whole truth.
  3. Enabling (bleugh! Hate the word)- if you want to help your loved one do something that they are not capable themselves of doing as an adult, then feel free. Do not protect them from the negative consequences of their substance use. Avoid lying anf covering up to friends and family, don’t cover for them and don’t clean up messes. This is hard, but, if they don’t see the damage their substance use is doing, and you start lying too, then this gives a message to your loved one that lying is acceptable. This is always done with a balance of being kind and compassionate.
  4. Create open communication- I have supported many people that use the strategies I suggest, but this does not mean ignoring your loved one! It is absolutely crucial that positive communication methods are used. What we are aiming for is to reduce the covering up and lying, and create a secure environment where your loved one feels they can come to you and speak to you without judgement.
  5. Acceptance- accepting your loved one’s substance use, instead of fighting against it will save your energy and allow you more time to use effective strategies to reduce or stop their substance use and to learn how to put your self first and lead a better life. This will tip the balance so that your loved one learn that being sober is an attractive option.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you live your most happiest and peaceful life.

I have a closed Facebook Group Not My Addiction, for professional women living with a loved one’s alcohol or drug use.

If you are affected by a loved one’s substance use, come and join me https://www.facebook.com/groups/notmyaddiction

Take care,

Victoria.

Why you need help when you live with a person using alcohol or drugs

Why you need help when you live with a person using alcohol or drugs

Living with someone who has problems with drugs or alcohol is usually an all-consuming, emotional and relentless journey. You love them so you keep going and before you know it, every waking moment is spent thinking about them, their problems and how you can make it better. You haven’t even time to think about help for yourself. Sound familiar?

 

Your feelings are determined by what your loved one’s behaviour is like that particular day. Have they had a drink? Have they used? How much have they used? How will I find out? I’ll ring so and so. They’ve let me down again. The children are upset. Oh no, will there be another row? Might they get violent? How can I stop it?

 

I get it.

 

Are they really addicted?

 

You may be in a bit of denial or not so sure yourself that your loved one has a problem. Some people spend most of their time together with their loved one and friends using substances themselves so maybe you’re thinking have I really got room to talk? Everybody else does it. Maybe because they are not using every day then they can’t be an “addict?”.

 

Forget that word, “addict”, for now. I prefer the term, “someone who has problems with alcohol or other drugs”. It’s a bit easier to understand that if somebody is having problems in other areas of their life because of drugs or alcohol then they are having problems. These problems aren’t a one-off, and a number of aspects of life such as relationships, work, finances, health and so on may be affected. Something needs to change. Sometimes, this might be a friend or family member having a chat and helping them realise. Sometimes, they may be in denial or need some specialist help. This all depends on the individual, the amount of their substance being used, frequency and how long it has been going on. Unfortunately, nobody can make your loved one access support. You can only influence it. It is their decision to get help.

 

If your instinct is telling you that you loved has a problem and you also have evidence for this, then they probably have. It might also be completely obvious.

 

What is so hard about asking for help?

 

If you know your loved one has a problem, you can influence them to access treatment, but when it comes down to it, it is their choice. There are lots of treatment options for substance misuse which I can talk about another time. It is useful for you to know this, in case an opportunity arises for you to discuss this with them at a time when they are sober.

 

What we are never good at is asking for help or admitting we need this ourselves! Why?

 

There are loads of reasons. You might be so intently focussed on your loved one getting help that you don’t even consider yourself at all! Unsure about what support is out there for you? Perhaps you are worried about people finding out for all different reasons, like wanting others to just think you are living a “normal” life. Lots of powerful emotions like fear, anger, worry, shame, embarrassment, frustration and guilt, as well as not wanting to let our loved one down are barriers to accessing help.

 

These are all common feelings and thoughts of family members affected by a loved one’s substance use. You’re not on your own, have a look at the stats from ADFAM’s evidence pack which was published in 2012! ADFAM are amazing. Have a look here. 

 

Remember that your loved one choosing to drink is not your fault. NACOA have lovely words for children with parents who have problems with alcohol which I think are important for you to remember too:

I…

  • didn’t cause it
  • can’t cure it
  • can’t control it
  • can take care of myself
  • can communicate my feelings
  • can make healthy choices

 

I hope you can take some comfort in the fact that you are definitely not alone in your situation.

 

What next?

If you’re still here, you know that your loved one has a problem, we’ve considered some of the feelings and daily thoughts you might be experiencing and you know you’re not on your own.  So, what have you got to lose? I’m wondering if there is anything else stopping you from getting your own help.

 

I know from working with families affected by substance misuse for many years that there can also be a number of practical reasons why it is difficult to get help (as well as the above):

 

  1. Work may mean you can’t go for sessions during the day.
  2. Childcare- you might not want to leave your children with your loved one.
  3. Evenings may be taken up with other responsibilities, if not work.
  4. You might just be knackered all the time and not have the energy.
  5. What’s out there might not be your thing.
  6. Fear of leaving your loved one alone.

 

There is some help out there to suit everyone. You might think that once your loved one gets into treatment, you will get help too. Unfortunately, this is not always the case as your loved one needs to give consent for you to be involved in their treatment journey. If they don’t, you may not get support yourself. Some services do offer family services as part of their recovery process which is fantastic. Have a look yourself online and see what’s available for you in your area.

 

How the Vesta Approach is different

 

I set up The Vesta Approach because I know how difficult it is for some of you to even get out of the house. I offer my service face to face in Manchester, UK. Don’t worry though, as you don’t even need to go out to access my programme as I offer Skype sessions and soon, an online therapeutic programme. Read more here.

 

This service is for you. I will teach you how to respond differently to your loved one’s substance use in an evidence based programme that supports you to recover from your loved one’s drug or alcohol use, get them into treatment and improve your quality of life.

 

If you want to know more, sign up to my mailing list and receive my “Ten Steps to Family Recovery Guide” to give you a taster of the programme and my top tips to starting your recovery journey.

 

Remember that you are not alone so take that first step and have a look at what help is out there for you.

 

I can help

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area. You can also get help via Skype  and my online group therapeutic programme which is launching in the next few weeks!

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

See you next week,

 

Victoria.

Living with drug or alcohol user? I can help.

Living with drug or alcohol user? I can help.

Hi Everyone,

 

I hope you’ve all had a happy Christmas/holiday. If yours has been affected by living with a drug or alcohol user, let me ask you:

  1. Is someone you love having a problem with alcohol or drugs?
  2. Are they refusing to get help or admit they have a problem?
  3. Have you tried to help but you’re not getting anywhere?

Want some help? Read on… (click on the links for more info)

 

The Vesta Programme

The Vesta Programme

The Vesta Approach supports families affected by a loved one’s substance use. I have created The Vesta Programme, a twelve-week therapeutic programme. It’s a programme that teaches ‘concerned others’ (that’s you!) how to change the environment to shape a loved one’s behaviour towards their substance use.  In other words, you cannot change their substance use but you can influence it by making being sober or drug free more rewarding than alcohol and other drug use. You can motivate and unmotivated substance user to get treatment for their alcohol and other drug use.

 

The Vesta Programme aims to:

  1. Help you to recover from a loved one’s alcohol or other drug use.
  2. Improve your quality of life.
  3. Get your loved one into treatment.

The Vesta Online Programme will be launched soon and is an amazing, unique and confidential service that people can access anywhere in the world. It’s based on an evidence based programme by Phil Harris.

 

Why work with the family member and not the person using alcohol or drugs?

 

When we look at the number one reason why people enter into a substance misuse service the biggest single factor is family pressure.  Studies show that 80% of people sought help for drug and alcohol problems because of family pressure to do so.  Families are a central force that drive change. Through working with people close to a drug or alcohol user, you are in a far better position to help them to change than many professionals! You just need to know how to do it. That’s where I come in.

As well as influencing your loved one to make changes to their substance use, the programme also works for the family members in other ways.   After what might be years of battling with the loved one and the incredible toll this can take, it is a huge relief to share this with someone who is prepared to understand and not judge.  It can help remind you of your own needs and sense of self after a long period of self-neglect.

I know, having worked with young people and families affected by substance use for a decade, how difficult it is to get out of the house and get support for yourself. It’s hard enough to admit you need help in the first place when you’re constantly looking after somebody else’s needs. That’s why I’ve taken this programme and developed it so that anyone living someone else’s drinking and other drug use can get the help they need to change their life.

I also offer my confidential programmes one to one via Skype, wherever my support is needed, and face to face in the Manchester (UK) area.

 

Five Days Towards Family Recovery

 

The Five Days Towards Family Recovery Programme is an introductory week-long programme. I’ve created this as my vision is to provide services and forge a community, helping as many families as possible live their lives fully and free from addiction. I realise that the Vesta Programme being twelve weeks long is quite a commitment, so I wanted to give you the opportunity to gain some wonderful learning and strategies to take away with you from the week so that you can start putting yourself first. It will also give you the opportunity to see how I work and a taste of what the complete programme looks like.

If you complete Five Days Towards Family Recovery, you will:

  1. Have an understanding of what addiction and recovery are.
  2. Have reviewed the strategies you have tried, to stop your loved one using drugs or drinking, and planned which to continue and which to stop.
  3. Explored the costs and benefits of your loved one’s substance use and why you need to know.
  4. To map the possible reactions of your loved when you make changes in your behaviour towards their substance us.
  5. To make a plan to lead a better life, regardless of whether your loved one chooses to use substances or not.

 

Who is it for?

 

  • The programme is for anyone who is worried about a loved one’s drinking or drug use.
  • The programme works best if you see them regularly.
  • You might be a friend, partner, child, parent, grandparent or any other extended family member. If you are worried about your loved one’s substance use, this is for you.
  • At the moment, this programme is for adult family members and your loved one must be 18 or over. If you or your loved one are under 18, please call me, email me or message me on my Facebook page. I will direct you to some alternative support.

 

How do I get more information

 

Call or text me on 07984 837302, email me or join my Facebook page and message me

 

To sign up

 

Contact me if you are interested. You can also request individual support from me.

When you complete the course, you will have access to a Facebook group where you will get ongoing support from others in the same situation as yourself and information and advice from me.

 

Make time for you

 

help for loved ones drug or alcohol use

When living with a problem user, it is really difficult to get time for yourself.  This is especially true if you have sought sanctuary from home life in work or other commitments.  Vesta offers the flexibility, ease and convenience to give you the help you need at a time and place that is best for you. The added benefit is that you will be accessing an evidence based programme of support. That means it has been tried and has

The important thing I want you to remember is that you are not alone. For every problematic substance user in the country, five people are negatively affected. Living with a problematic drug or alcohol users is the country’s best kept secret.  It is a not your fault that the loved one uses, but you can influence their use.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area. You can also get help via Skype  and an online group therapeutic programme.

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free 10 Steps to Family Recovery download.

 

 

Take Care.

See you next week,

 

Victoria x