Many people use substances to change how they feel. They might drink a cup of coffee to get started in the morning, or have a beer to unwind at the end of a day. While using substances may begin as a matter of choice, a way to relax, or an activity to do with friends, at some point some people may begin to get into trouble. Sometimes there is a direct connection between using substances and difficulties like when they miss work to spend the day in a bar, or when they use drugs and the police are called. They might experience cravings, spend more and more time in substance seeking, and use substance even in the face of potentially devastating consequences.
Sometimes the effect of alcohol might show up more subtly, as when individuals have more arguments with family members or, increasingly, do not get along with others. A person might begin to skip important family activities, become involved in dangerous activities (using equipment while drunk or high), or become involved with the law (e.g. DUI). What is really interesting about substance abuse is that the user can begin to have trouble without being aware of it (denial), even when experiencing escalating consequences.
Substance abuse is not a moral failing. It is a brain disease that affects multiple brain waves, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior.
It is sometimes tough to draw the line between substance use and substance abuse. One instrument that is used to begin to look at someone’s alcohol use is the CAGE questionnaire. (Other instruments may be used to look at other substance use). Take a minute now and answer these four CAGE questionnaire questions:
1. Have you ever felt you needed to Cut down on your drinking/drug use?
2. Have people Annoyed you by criticizing your drinking/drug use?
3. Have you ever felt Guilty about your drinking/drug use?
4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?
– Do you ever experience memory loss or ‘blackouts’ from your drinking/drug use?
– Has your drinking/drug use ever created problems between you and your spouse, or parents?
– Have you ever been in trouble at school or work due to your drinking/drug use?
– Have you ever had legal problems due to your drinking/drug use?
– Have you ever noticed, or been told, you become unpleasant when you drink/use drugs?
If you answered “yes” to two or more of these questions, you might want to give your alcohol/drug use a second look. In any case, if the effect of using substances is interfering in your life, it might be something to explore.
People who struggle with substance abuse issues may suffer from mental health issues as well. A dual diagnosis – the presence of substance abuse and mental health issues, presents challenges to both the individual affected and the treatment provider. Having two diagnosis signals a need for a more integrated approach to treatment.
At Psychological HealthCare we professionally assess each individual at admission. Patients who receive treatment for substance abuse – who are also suffering from mental health issues – will be seen and treated by a therapist to address underlying mental health issues.