How do I know if someone I care about has an alcohol or drug problem?

It’s not always easy to see when your drinking has crossed the line from moderate or social use to problem drinking or drug use.  We often only identify the “alcoholic” or “addict” when they seem to have hit the bottom:  loss of a job, legal problems, health issues, serious family strife, etc, but the warning signs start long before then.  In my nearly 30 years as a therapist, alcohol and other drug abuse is one of the most common factors in separation and divorce.  For the alcoholic or addict, their drug becomes the most important relationship in their life.

Alcoholism and other drug abuse are due to many factors, such as genetics, family environment, social environment, and your emotional health. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol may be used to self-medicate.

There are some levels of drinking that may seem normal or okay but are actually warning signs.  If you have a habit of coming home from work most days and having a drink to relax but on the days you can’t drink after work you can’t relax, then you are starting to associate something normal (relaxing) that can only be done with the help of alcohol.  That’s a warning sign.

How well do you, “hold your liquor”?  We often think that tolerance—have less of an effect when you drink your usual amount or needing more to feel drunk—is a good thing but it’s not.  Think about tolerance developing in two different areas at different rates.  You have your physical tolerance (balance, coordination, etc), and psychological tolerance (decision making, risk taking).  You may be able to walk a straight line or touch our nose but in your head you are thinking, “Sure, I can make that stop light.”  Part of tolerance is withdrawal: If you don’t drink or use for a couple of days do you get shaky, sick on your stomach, have headaches, or get really depressed?

There are some other signs, too:

  • Regularly drink more than you intend to
  • Have you neglected your responsibilities at home, school, or work?
  • Used or drank when it could be dangerous, such as while driving,
  • Continued to drink or use even if it’s causing problems in your relationships?
  • How much effort or work do you put into being able to drink or use?
  • How much risk is acceptable to you to drink or use?

The good news is that alcohol & drug addiction can be treated.  There is help available.  One of the most important things to remember is that the earlier it is identified, the sooner you can change.

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