How to identify and address substance use and drug addictions-Q&A with Silvia Violante, Psychologist
How do I know if I have an addiction to drugs or other substances?
People may use substances on an occasional basis to relax or celebrate at social gatherings. However, if a person: a) cannot control their use, b) increases the frequency of use, and, c) is experiencing negative consequences as a result of their use, then it would be likely that they have an addiction. It is important to note, however, that some people with addictions will not always consider their substance use as problematic. If you (or one of your loved ones) fall into this group, we ask you to keep reading - even if you disagree - to at least see what applies to you and what doesn't. You are also welcome to give us feedback!
Individuals who have substance use addictions often lose control of their usage. They tend to spend a lot of their time and energy getting drugs, using them or recovering from their use. All of which can have a significant impact on their daily functioning. This also means that their substance use may impact other life areas, such as relationships with family and friends, work, education and leisure.
What are the common signs of addiction?
There are several indicators of addiction. For example, tolerance development may be a critical sign. Someone with a substance use addiction would usually begin using small recreational amounts that would make them feel better and then would increase their dose in order to obtain the same effect. This tends to lead to another sign of addiction - withdrawal symptoms. Withdrawal symptoms are understood as side effects of continuous and increased substance use which arise when the use is ceased or decreased (“the coming down effects”). These effects, at times, may cause high levels of discomfort which can also lead to other signs of addiction, such as having urges or cravings to use again in order to dissipate these negative symptoms.
Another useful indicator to know whether someone is addicted to a substance is people with previous unsuccessful attempts to stop or reduce their substance use. People with substance misuse would usually acknowledge that they use substances as a way to self-medicate with other mental health issues (e.g. anxiety, depression) or cope with life events. This may also result in people spending less time with their loves ones and worsen their relationship with them due to their substance use.
Does it matter if I have one night (now and again) where I use a lot of drugs?
Some people may think: "Because I limit my substance use to the weekend, it is not problematic." However, it is important to recognise if your substance use increases over time. In order words, the more tolerance you develop to a substance, the greater the likelihood that you may experience negative consequences, such as withdrawal symptoms and making decisions that harm yourself or others. It is also known that increased tolerance is linked with increased dependence, consequently, this may increase the frequency or dosage of your substance use.
How do I stop using or reduce my use of substances?
There is a variety of treatment modalities that are offered when it comes to dealing with substance use. As substance use is a complex issue, it is important to have a holistic approach. Some treatment options involve medication, family therapy, psychological interventions or accessing recovery supports (e.g., rehab, day programs, and detox).
In terms of psychological interventions, treatment initially focuses on the identification of cognitive and affective (i.e., emotional) triggers of substance use. Some aspects we commonly explore throughout treatment are: identifying the advantages and disadvantages of using substances, or, reasons for continuing use despite knowledge of the harmful consequences. It is also important to increase our awareness of the relationship between triggers, thoughts and emotions in substance misuse.
Unfortunately, we know from research and experience that substance misuse problems have a high relapse rate without appropriate treatment and support. Treatment, therefore, places a significant focus on relapse prevention. This means that we develop a self-management plan for when you face high-risk situations in advance. High-risk situations are those where it is foreseeable that someone would return to using substances. Part of a self-management plan involves the development of a range of adaptive coping strategies to affront these situations better. Lastly, it is known that the involvement of professional and personal supports may increase recovery rates. Having people that care about you and your recovery process may be a key aspect to achieve your goals on substance use.
Is it possible for family and friends to make their loved ones stop using substances?
With substance use issues, it is important to remember that there is a high relapse rate. Relapses can reduce our motivation to change and make the goal of maintaining abstinence extremely challenging. For that reason, it is pivotal that a person struggling with substance use issues access the right support. Even though friends and family can help someone to make a change, it is known that a person needs a combination of formal (e.g. professional help) and informal support (e.g. support network such as friends, family, social groups) in order to make significant changes. With adequate professional support and a good support network, the chances of recovery are higher.
So, if you are that support, recognise that we cannot control their behaviour and commit yourself to a) modelling a healthier way of living, b) remaining compassionate to their suffering while firm on their substance use and c) encourage access to support services.