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How Problematic Is My, Or Someone I Know, Drug Or Alcohol Use?

woman arguing with man over her drinking, surrounded by alcohol on table - Problem Drinker

A Self Test

Unfortunately, many people still consider problematic alcohol and drug use and addiction to be a problem of personal weakness, initiated for self-gratification and continued because of an unwillingness or lack of sufficient willpower to stop. However, as we have said so many times before this is simply just not true, but it is worth repeating again

Drug and alcohol addiction is defined as a chronic, relapsing disorder characterized by compulsive substance seeking, continued use despite harmful consequences, and long-lasting changes in the brain. It is considered both a complex brain disorder and a mental illness. Addiction is the most severe form of a full spectrum of substance use disorders, and is a medical illness caused by repeated misuse of a substance or substances.

Dr Owen Bowden-Jones, Consultant in Addiction Psychiatry and an Honorary Senior Lecturer at Imperial College in the Division of Brain Science, says: “One way to describe addiction is to think about it as a disorder with biological, psychological and social aspects. People who are vulnerable to addiction may be ‘wired’ differently, particularly in the brain’s pre-frontal cortex. This part of the brain is involved in the weighing up of the pros and cons of a particular action, in other words, decision making.”

As with other chronic illnesses substance use disorders should be seen along a continuum i.e. mild, moderate, and severe. For some having a mild disorder might very well be manageable in terms of not being a huge impact on life but as with other disorders, if left “untreated” they will get worse and moving into moderate and severe will have a massive impact.

How Problematic Is My Drug Or Alcohol Use – The Self Test

In order to see where you are on the spectrum look at the 11 factors below and then score yourself or someone you are concerned about.

Those of you who have identified only two or three criteria are considered to have a “mild” disorder, four or five is considered “moderate,” and six or more symptoms, “severe.”The diagnostic criteria are as follows based on your use over the last 12 months:

  1. The substance used is often taken in larger amounts or over a longer period than was intended i.e. you are using more than you did 12 months ago, more frequently and for longer periods.
  2. There is a persistent desire or unsuccessful effort to cut down or control use of the substance. In other words, you have tried to cut down or stop but can’t do it at all or sustain it.
  3. A great deal of time is spent in activities necessary to obtain the substance, using the substance, or recover from its effects. In other words, this could be more and more time chasing down dealers to get drugs, particularly when you are running low or have run out. Alternatively, you find yourself spending more time drinking or using or spending more time dealing with the come down or aftereffects of your use i.e. being “out of commission” due to your hangover.
  4. Craving, or a strong desire or urge to use the substance, occurs.
  5. Recurrent use of the substance results in a failure to fulfil major role obligations at work, Uni, or home.
  6. Use of the substance continues despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use i.e. arguments, being unreliable, violence etc.
  7. Important social, occupational, or recreational activities are given up or reduced because of use of the substance.
  8. Use of the substance is recurrent in situations in which it is physically hazardous such a drink driving, using machinery or electrical equipment, using knives if you are chef, when you are out of it and wandering home late at night or getting out of it and finding yourself in compromising sexual situations that you would not have been in if you had not had used.
  9. Use of the substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance. This can cover a whole host of things such as panic attacks, paranoia, depression, anxiety, nose bleeds, stomach and bladder problems, headaches, insomnia, loss of weight…..
  10. Tolerance, as defined by either of the following: (a) A need for markedly increased amounts of the substance to achieve intoxication or desired effect (b) A markedly diminished effect with continued use of the same amount of the substance.
  11. Withdrawal, as manifested by either of the following: (a) The characteristic withdrawal syndrome for that substance i.e. shakes, sweats, cramps etc. (b)The use of a substance (or a closely related substance) to relieve or avoid withdrawal symptoms i.e. using one drug/alcohol to deal with the effects of the other

So What Now?

So you have just scored yourself, or scored someone that you care about, and have come to the conclusion your situation is either mild, moderate or severe.

The most common approach is for anyone to score mild to do……nothing. In fact, even if your scored moderate or severe many people still do nothing, so why is this? Mostly its to do with denial and the excuses made to justify continued use such as:

Excuse 1: I’m not hurting anyone but myself!

Excuse 2: I just want a bit of relief.

Excuse 3: If you had my problems, you would drink and use drugs too.

Excuse 4: This is who I am.

Excuse 5: I need to drink or do drugs to be social.

Excuse 6: I’m a creative I need to drink or do drugs to release my creativity

Excuse 7: I’m don’t have a real problem with alcohol or drugs. I can stop whenever I want.

Excuse 8: I don’t drink or do drugs like real addicts.

Excuse 9: Everyone else drinks and does drugs and is okay

Excuse 10: Life is full of problems and I’m going to die anyway. I might as well go out on my terms.

Not doing anything at any stage is not logical when you look at it.

As I have said before substance use disorders are real illnesses, if you had a diagnosis of cancer would you really brush it under the carpet and not get treatment as soon as possible? Or would you leave it a week, a month a year to do anything? Of course not. You should approach your relationship with drink and drugs in the same manner. Why wait to have liver failure, heart attack or an overdose before you do anything. Why wait until you’ve lost your relationship, access to your kids, your job or you home.

Whether you score mild, moderate or severe you really do have a problem, and you really do need to do something about it now.

You may fear the future and be terrified of facing the realities of your life but getting on top of your drink and drug use is possible. First, however, you must be honest with yourself.

Sometimes you will come up with other reasons as to why you shouldn’t quit right now.  You may say, ‘Life under COVID is too stressful to be sober and drug-free’, or ‘Things are not going well at home or work’, or you may just tell yourself that “you’ll do it soon but not now”.

Whatever reason you come up with to delay getting help should be carefully examined.  Is it possible things at home and work might improve if you weren’t taking drugs and getting drunk?  Is your using causing tension with friends or family?  While there are many reasons that things may not be going well – and they may have little to do with drugs and alcohol – it’s certain that drugs and alcohol are not helping.  It’s best to get to the root of the problem and work on solving it, rather than resorting to getting drunk or high to mask your issues.

Moreover, you don’t need to go through this alone, we’re here to offer help, support and treatment. We are here to help you identify and handle your triggers, cravings and other challenges. We are here to help you identify and deal with the underlying reasons for your use, be that stress, trauma, self-esteem, depression, or anxiety.

New methods of drug and alcohol treatment are changing. If you or someone you care about is struggling with alcohol or drug use, there are options. Help Me Stop’s intensive non-residential 6-week face to face Dayhab programme is effective and accessible. With inclusive aftercare and family support options to minimize the risk of relapse and to maximize the support of friends and loved ones it is a real alternative to residential treatment.

Alternatively, our 6-week evening online drug and alcohol treatment programme is an excellent choice for adults who are working and can’t access face to face services in the day or get to our centre in West London due to COVID restrictions or other reasons. Families can also access support online. The online programme is delivered by the same therapists that deliver the face to face programme so whatever your choice you know you are in safe, experienced hands.

If you would like to know more then call us now on 0208 191 9174 or jump onto Live Chat or e-mail us directly at

Chris Cordell is Help Me Stop’s General Manager and is a senior associate member of the Royal Society of Medicine, Certified International Recovery Specialist, member of the International Society of Addiction Medicine and a member of the Federation of Drug and Alcohol Professionals.

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