How do I know if someone is an addict?- Part one- The stages of substance use
Let’s face it, most of us have overindulged with alcohol and/or drugs in our time. Many people do this either regularly or occasionally and this causes minimal or no problems. It is difficult to recognise in ourselves that we might be going too far because ‘everyone is doing it’. ‘Such-and-such-a-body drinks more than me’. ‘I’ve been round and had nothing before (*reality check* – it was once) many a time and watched everyone get wasted’.
What I’m getting at here is that it’s easy for people to deny they have a problem. Sometimes we don’t recognise it in ourselves. Sometimes we don’t recognise it in others. Sometimes, others recognise it in us. We might recognise it in someone else that doesn’t have a clue!
Some people use drugs or alcohol and, other than tiredness and feeling a bit rubbish, get on with life as usual (ba****ds!). For others, it causes problems in daily functioning.
It is these people who often deny they have a problem and make excuses to deflect from the fact that they need to part ways with their substance(s) of choice. This is often too difficult to face for many and requires a whole lifestyle change and a lot of energy.
The starting point
The first port of call is to get clued up on the different types and stages of substance use. (Just so you know, I refer to substance use to include both drugs and alcohol)
To simplify…
I believe that if drugs or alcohol are causing problems in somebody’s life, then they need help. Depending on the stage of substance use they are at, their current lifestyle, their mental and physical health, motivation to change, Adverse Childhood Experiences and other life experiences, the help they need will vary.
Everyone’s recovery journey is unique and not everyone will want to stop.
The language of substance use
Firstly, there are differences between the language of substance use. Some terms commonly used are ‘problematic substance use’, ‘addiction’ or ‘dependency’, and, as they are used interchangeably, it starts being confusing!
Problematic substance use refers to drug or alcohol use which is affecting one or more areas of a person’s life. This could be work, relationships, health or anything else. People often don’t realise that the reason they are having problems, is due to their drug or alcohol use. They often don’t understand the impact of their particular drug on the way they think, feel and behave.
Dependency– is where an individual requires a drug, in order to function. In my view, this can be either physical or psychological. For example, some people use drugs to mask their feelings and some people use drugs to either mask their physical pain, or have what we refer to, as physical withdrawals when the drug starts to leave their system. Dependency is mostly attributed to drugs that cause physical symptoms in the body when someone tried to stop using them.
Addiction is where a particular behaviour is compulsive or habitual, despite the fact that it is having a negative impact on an individual’s life. The way I describe it is that the drug is in control of the person, rather than the person being in control of the drug.
Someone can be dependent and addicted to certain drugs (such as alcohol and heroin)
Someone can be addicted but not dependent on other drugs (such as cocaine and caffeine)
Someone can be dependent but not addicted (such as someone who is taking medication for pain)
Stages of substance use
Here’s a handy diagram to help you to start thinking about the above. Notice that ‘addiction’ is not referred to here as ‘addiction’ is not actually a diagnosis used for someone having problems with their substance use…
Diagram source: http://www.cfdp.ca/bchoc.pdf
Beneficial use would generally be medicinal but, as stated, includes other benefits. Many substance users may say their drug use is beneficial for them. This could be true, but it could also be an excuse for continuing use. The minute the substance starts causing problems for them is the minute the negatives outweigh the positives.
Non-problematic use would be those people who manage their substance use with limited or no impact- This is sometimes where family members find out and start panicking. Talk to your loved one and get the facts. They might be taking them but managing their use well.
Problematic use (harmful use) can range from someone having a few problems or lots of problems- you may know more than your loved one that their substance use is causing them problems.
Dependence is where someone can no longer easily choose to stop taking their drug of choice. The individual’s priority is to source and use their drug and activities are centred around it.
Where is your loved one on the spectrum?
As I bring part one of this blog to a close, where do you think your loved one is on the spectrum of psychoactive substance use?
Head over here next week for part two where I will be focusing on the diagnosis of 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
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Take care,
Victoria.
