What is Substance Abuse?
A substance use disorder has a few key areas that are important to identify prior to making a diagnosis. Tolerance, withdrawal and interference with social functioning or day to day living, are the most prominent aspects of a substance use disorder. However, there are additional features that are sometimes minimized by people or overlooked. For years the Diagnostic and Statistical Manual of Mental Disorders did not list cravings as a criteria for chemical dependency. However, with the most recent update, DSM V, cravings are now listed.
I think for most people who deal with substance abuse, or addiction experience cravings. For some people cravings may very strong, and depending on the drug, may fully impair someone from being able to avoid use. However, keep in mind that just because a person does not have cravings does not mean that they are not addicted. Also, it depends on how cravings are defined. When I think of a craving, it is a feeling, but also a type of thinking. Some people may not even be aware of cravings, but may notice themselves thinking about drinking or using regularly, visualizing, remembering fun times or wanting to "have a good time." Working in treatment centers for much of my career, I have seen many people come in highly motivated to change, wanting help and then shortly after they settle in, they want to leave. It is my hunch that most of the time people are either struggling with adjustment or are having cravings/urges to use.
Another important feature of addiction, as mentioned before, is experiencing interference in day to day activities or daily living. Some people miss work frequently, or school, and fail to live up to their responsibilities. Sometimes this can be chronic or mild. Depending on the frequency, drug and amount of use, withdrawal or preoccupation with using may be what is causing problems with day to day living. Preoccupation means that they will spend large amounts of thier time attempting to find a substance to use. Also withdrawal does not have to be a long term, severe problem, it can be as simple as a hangover or as complex as heroin withdrawals and alcohol withdrawal (which in some circumstances can be lethal). Additionally, based on a person's tolerance (their ability to increase thier intake of a substance to get high) their withdrawal may also be more difficult. For instance, a person with alcohol withdrawal may experience moderate symptoms if they are drinking smaller amounts of alcohol, whereas, if someone is drinking larger amounts of alcohol, with greater frequency, they are more likely to deal with more complicated withdrawal features.
It is my experience that people will ask where is the line with addiction / substance abuse and substance use? And unfortunately there is no hard line that people cross into addiction or dependence on drugs or alcohol. It happens slowly over a course of time. For some people there are genetic predispositions to alcoholism or drug addiction, which can escalate the path much more quickly. However, if you are reading this and concerned about yourself or about a close family member, this is a flag. If you are asking yourself this question, then that is an indicator that something isn't right. And sometimes that is enough, someone or yourself notices that something isn't right, and they begin to question the behavior and as a result make a change. The most important question that one can ask themselves or another person is, if it isn't an issue, why can't I (or they) give it up?
If you are concerned about yourself or another person, please make sure that they are not medically compromised. This information is not intended to diagnose. If you are concerned about the health of someone, or are worried about potential lethal use, call 911 or go to the nearest hospital for help.
Click here to go to Signs of Addiction
I think for most people who deal with substance abuse, or addiction experience cravings. For some people cravings may very strong, and depending on the drug, may fully impair someone from being able to avoid use. However, keep in mind that just because a person does not have cravings does not mean that they are not addicted. Also, it depends on how cravings are defined. When I think of a craving, it is a feeling, but also a type of thinking. Some people may not even be aware of cravings, but may notice themselves thinking about drinking or using regularly, visualizing, remembering fun times or wanting to "have a good time." Working in treatment centers for much of my career, I have seen many people come in highly motivated to change, wanting help and then shortly after they settle in, they want to leave. It is my hunch that most of the time people are either struggling with adjustment or are having cravings/urges to use.
Another important feature of addiction, as mentioned before, is experiencing interference in day to day activities or daily living. Some people miss work frequently, or school, and fail to live up to their responsibilities. Sometimes this can be chronic or mild. Depending on the frequency, drug and amount of use, withdrawal or preoccupation with using may be what is causing problems with day to day living. Preoccupation means that they will spend large amounts of thier time attempting to find a substance to use. Also withdrawal does not have to be a long term, severe problem, it can be as simple as a hangover or as complex as heroin withdrawals and alcohol withdrawal (which in some circumstances can be lethal). Additionally, based on a person's tolerance (their ability to increase thier intake of a substance to get high) their withdrawal may also be more difficult. For instance, a person with alcohol withdrawal may experience moderate symptoms if they are drinking smaller amounts of alcohol, whereas, if someone is drinking larger amounts of alcohol, with greater frequency, they are more likely to deal with more complicated withdrawal features.
It is my experience that people will ask where is the line with addiction / substance abuse and substance use? And unfortunately there is no hard line that people cross into addiction or dependence on drugs or alcohol. It happens slowly over a course of time. For some people there are genetic predispositions to alcoholism or drug addiction, which can escalate the path much more quickly. However, if you are reading this and concerned about yourself or about a close family member, this is a flag. If you are asking yourself this question, then that is an indicator that something isn't right. And sometimes that is enough, someone or yourself notices that something isn't right, and they begin to question the behavior and as a result make a change. The most important question that one can ask themselves or another person is, if it isn't an issue, why can't I (or they) give it up?
If you are concerned about yourself or another person, please make sure that they are not medically compromised. This information is not intended to diagnose. If you are concerned about the health of someone, or are worried about potential lethal use, call 911 or go to the nearest hospital for help.
Click here to go to Signs of Addiction