12/05/13: The single most common reason people seek counseling across the world is for Substance use problems. I'd personally estimate that 40% of people I have worked with over my career either primarily focused on a substance use issue, or had that as a secondary concern. The following is a brief overview of how to determine the severity of any level of use. Quick note: In this article when I use the term "substance," I am referring to any type of intoxicant (alcohol, marijuana, nicotine, caffeine, opiates, narcotics, prescription meds, hallucinogens, etc) that can become addictive.
Additionally, there is a lot of debate among psychologists, legal experts, doctors, philosophers, and sociologists on whether using any type of illegal substances even once is "OK." Instead of taking a position on that, this article will generally be written from a practical, open stance that accepts that we are curious, sensation-seeking beings that can make choices to have various experiences in our lives, some of which have been determined to be illegal by our governments or institutions we are affiliated with. This article is not going to cast many moral judgment or advocate any side, but instead will lay out the knowledge and facts about this subject.
Symptoms of Substance Use
In the past year, the main psychiatric diagnostic manual (DSM-5) updated its criteria for what constitutes substance "abuse" and "dependence" (addiction), into what is now called a "substance use disorder", which has various levels of severity. The symptoms related to substance use issues are below. Add the number of them that are experienced and plot this on the continuum below to determine what the level of concern should be. Additionally, only licensed mental health professionals can make accurate diagnoses. So only use the list below as a a rough guide, but consult with a psychologist for an accurate diagnosis.
Substance Use Spectrum
Substance Use Spectrum
Treatment
There is no one-size-fits-all treatment for substance use disorders. As you can see above, there are a huge number of configurations of symptoms, all at various severity levels, and all for different reasons. The reality is that many people can learn to control their use and reduce their problems (something called 'harm reduction'), whereas other people will truly never be able to do that, and need to quit altogether or dramatically change their lives ('abstinence'). This is especially tricky for highly addictive substances. Treatment options include counseling, support groups, and various hospital situations for the most severe addictions.
How to Be a Support
Many people who are struggling with some type of substance use problem have people that care about them who want to help. The advice I usually give is that it is very important to stay in the original role you have in the person's life, rather than trying to become the treatment professional yourself. In the meantime, check out How People Change, How to Help Others, Healthy Relationships, and Overfunctioning & Underfunctioning for some additional ideas.
Final Words
If you are reading this because you have a moderate or severe substance use disorder, I'd suggest:
a) being honest with yourself about how serious it is
b) coming to terms with what is driving it,
c) making efforts to cut down if you haven't before,
d) letting someone you care about know, and then
e) talking to a counselor, doctor, or support group.
Substance Use & Addiction
Tags:
substance
