Substance Abuse

SUBSTANCE ABUSE vs. DEPENDENCE

 

any of the clients that we work with consider themselves social users of their drug of choice.  It’s a rare client who admits to abuse and fewer still who admit to dependence.   If they acknowledge their abuse it’s usually qualified with the statement,“ sometimes I abuse” or “I abuse here and there”.  One of the difficulties we encounter is that they really do not have a realistic or accurate concept of what the terms trruly mean.  Most, when asked, will state dependence means “you need it all the time”.  Thus, we cannot not address their denial until the basics are covered.

The Diagnostic and Statistical Manual of Mental Disorders defines abuse as one who continues to use despite re-occurring problems in their life.  This includes one or more aspects of their life; legal, psychological, physical, social, spiritual and/or occupational.  Those who are dependent meet the above criteria but will also exhibit some or all of the following.

-Increase in tolerance

-Withdrawal symptoms

-Craving

-Physical compulsion

-Using and seeking  behavior

-Return to use after being adamant about abstinence

When this concept is understood then we can move into the realm of denial and enabling.  These two topics will be addressed in future newsletters.

One might ask what difference does it make if one abuses or is dependent?  Traffic safety doesn’t improve because one inebriated driver is labeled alcoholic while another is labeled an abuser. Families don’t become closer and less dysfunctional because they only have an abuser in the home.  Job performance still suffers if you have an employee that is continually hung -over but not identified as dependent.

All the above is true.  For those in the field of treatment, how-ever, the differences are extremely important.  The approach and mode of therapy taken with the abuser as compared to the dependent is dissimilar.  One has a disease where the only successful treatment has been total abstinence.  The other may be able to control their use if they choose to do so.  Their beliefs, attitudes and level of maturity would need to be openly addressed and altered.

 

QUICK DEFINITIONS:   QUOTES:

 

Denial– An assortment of defensive mechanisms that allow a person to continue with their behavior and not suffer the consequences of guilt, anxiety and shame.  Some other forms are rationalization, blaming and aggression.

Loss of control– When behavior cannot be predicted after taking a mood altering chemical.

“First the man takes a drink, then the drink takes a drink, then the drink takes the man”. Japanese Proverb

“You do anything long enough to escape the habit of living until the escape becomes the habit”.  David Ryan

“Whatever causes a problem-is a problem”. Fr. Joseph Martin

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