Before answering the substance abuce assessment test please read through my understanding of addiction and the paradigm in which I work. This includes understanding denial and the difference between substance abuse and dependence.
Becoming clean and sober is important. The operative definition of sober is "abstaining from mood and mind altering chemicals". This is the first change that needs to be made in salvaging your life. Recovery is about living a better life – about loving relationships, satisfying and meaningful work, invigorating play, about good health and an existentially meaningful existence.
If you are accustomed to immediate gratification the slow process of recovery may at first be difficult to comprehend. But if you look at the length of time it has taken you to this point of seeking help...be patient. Recovery from addiction is gradual like recovery from most illnesses.
The desire to become sober and the willingness to stop using all mood and mind altering substances is the first essential step on the road to recovery.
My understanding of addiction is that it is a disease. This disease, like any other disease, does not differentiate between class and colour but can affect anyone.
Having the disease does not mean that you are an immoral or weak-willed person.
"Denial is a river in Egypt" Mark Twain
One of the factors that makes it so difficult to seek help is denial (a symptom of the illness). Why people with certain illnesses, for example, addiction, make use of the defense denial to themselves and others is in order to protect themselves from facing a fearsome reality. Often the alcoholic/addict does not want to know because of the fear of being branded with the stigma attached to the diagnosis and an even greater fear of loosing their trusty chemical life support.
Denial is a mechanism of self deception which if over used becomes destructive and self- defeating.
Seeking treatment can assist in unraveling the web of denial and facilitate a shift towards recovery.
I use the term addiction to refer to a combined experience of mental and physical dependence. In addiction you compelled to use a substance or behavior in a certain manner, even though you know you face considerable harm by going through it. You addicted when you continue to use a substance or engage in a behavior that puts you in harms way.
In order to ascertain weather you have a problem that warrants seeking help it is important to understand the difference between substance abuse and substance dependence.
The difference between abuse and dependence is a matter of time and degree. Essentially the difference is that dependence is associated with tolerance (needing more of the substance for the same effect), withdrawal symptoms (substance specific withdrawal symptoms when usage stops) and loss of control ( continued use despite knowledge of physical and psychological problems caused by or exacerbated by use).
Abuse is associated with continued substance use despite adverse health, social and financial consequences. Abuse can occur without dependence.
To be more exact, the medical criteria for substance abuse is one or more of the following criteria within a 12 month period:
- Recurrent substance use resulting in a failure to fulfill major role obligations at work, home, school etc;
- Recurrent substance use in situations that are physically hazardous (example, drunk driving);
- Recurrent substance related legal problems;
- Continued substance use despite having persistent social or inter-personal problems caused or worsened by substance abuse.
From the medical perspective the diagnostic criteria defining substance dependence are as follows: at least 3 of the following criteria occurring within a 12 month period:
- tolerance which is defined as either increased amounts of a substance to achieve desired effect or a diminished effect with continued use of the same amount;
- withdrawal as evidenced by either the characteristic withdrawal symptoms or when medication or a substance is taken to relieve symptoms;
- loss of control which would include use of larger amounts or over a longer time period than intended; persistent desire or failed efforts at control or reduction; an increased preoccupation- time is spent in activities to obtain the substance; use continues despite knowledge of physical or psychological problems caused or exacerbated by use.
Now that you have a clearer understanding of the differences between abuse and dependence it would be well worth your while using the self-diagnostic test to confirm your underlying doubts. If your answer is "yes" to even two or three of these questions you should seriously consider the possibility that your alcohol or drug use is a problem. If there are more than a few "yes" answers, you should seek help now.
Tick which of the following apply to you:
- Have you ever felt that you should cut down on or tried to control your drinking or drug use?
- Have you ever felt bad, guilty or remorseful about your drinking or drug us and associated behaviours?
- Are you preoccupied: do you spend large amounts of time thinking about alcohol or drugs, look forward to using them, and do you plan your life around their use or make plans for specific times of abstinence?
- Do you ever drink in the morning to alleviate hang over symptoms or to function ?
- Do you use drugs daily or weekly? Have you ever used prescription drugs more often and in larger quantities than prescribed?
- Do you use alone? Is there secretive use? Is there urgency for the first drink or drug?
- Do you find yourself lying to your partner, friends, employee, children inspite of your discomfort with dishonesty?
- Are you using for the effect, the lift or buzz to alter the way you feel?
- Do you use more than planned or intended? Can you guarantee what will happen when you pick up the first drink?
- Have you had any problems connected with drinking or drug use in the past year? For example brushes with the law, school failure, absenteeism, financial problems?
- Do you protect your supply: hiding alcohol or drugs, unwilling to share your supplies?
- Are you developing a tolerance- do you need more to get the same effect?
- Have you ever experienced memory blackouts: loss of awareness about events and or conversations?
- Have you ever 'cross addicted', i.e. switched from one kind of drink/drug to another in the hope that this would not affect you as badly or to prove that you not addicted?
- Continued use despite negative consequences and the repeated concerns of others?
If you have answered "yes' to three or more of the above it would be helpful to make contact with me.
You do not have to be an alcoholic or addict to benefit from the professional care that I provide. If someone you care about has a problem I can help you understand what he/she is going through in both the addictive and recovery processes as well as what you can do to help yourself. I can also offer you help in giving family members the freedom to stop trying to unwittingly 'control' others, teaching you that each of us is responsible for our own life.
The degree of distress experienced by families affected by addiction is usually underestimated. In all normal situations families try to take care of each other, especially in times of illness. When the addict or alcoholic refuses the help, the family try even harder to get them to stop drinking or using. Ironically the harder the family members try to help the addicted person, the worse the addict/alcoholics problems seem to get.
So pease feel free to contact me if you need help in this area.
