Fourteen years
ago on finishing graduate school, I took my first job as a therapist
in a residential substance abuse program in Denver, Colorado. The
first day of my job began in chaos when my supervisor informed me that
a colleague whom I never met had just relapsed. Thus, I was
immediately and solely responsible for almost thirty drug addicts and
alcoholics. What a start!
While working
in the program, I began to realize that my personal drinking habits
were excessive. In fact, my drinking pattern—thought to be normal
for a college student—was in reality alcoholism. I want to share
some of the things I have learned in the field as a substance abuse
and a mental health therapist, and from my personal experiences, in
hopes that others may also start the journey of recovery.
How
can you recognize if you or a loved one may have a substance abuse
problem?
First, let us
keep in mind that the ‘substance’ in substance abuse refers to
alcohol and/or drugs. An individual is likely to be abusing substances
if that action is interfering with any area of one’s life. This may
include being arrested for possession or use of the substances, having
family problems due to the substances, or experiencing work-related
problems, such as not going to work.
When I meet
with parents of teenagers who may be using drugs or alcohol, I ask if
there are changes in the child’s school performance, behavioral
changes such as aggression, and/or changes in groups of friends. For
family members of adults who may be using drugs or alcohol, I suggest
evaluating whether the person is neglecting family obligations, if
there are sudden changes in job performance, or changes in personality
that otherwise are not explainable by life circumstances. Other signs
of substance abuse include spending large amounts of money in short
period of time, leaving and returning much later without a reasonable
explanation, and changes in personal habits.
Why
seek treatment?
It has been my
experience that substance abusers often come to treatment because
family members are pressuring them to take a closer look into their
substance abuse or because of legal problems, including court
mandates. Court mandated clients are often disgruntled and are only
marginally willing to participate in counseling sessions. My job with
these clients is to help motivate them to look for alternative
lifestyles and to help them evaluate their current life situations in
a more realistic perspective.
Clients who
are chemically dependent on substances are often willing to take a
closer look at how substance abuse has impacted both their life and
the lives of their loved ones. For some people, a serious car accident
while under the influence can be a wake-up call; for others, family
confrontation may be helpful. I often include family members to
participate in treatment with the substance abuser. This can be
especially helpful for those clients who are having difficulty with
denial and have trouble seeing how their substance abuse has impacted
others. I help clients look at what life would be like without
substances and what changes they might make in order to reach this
goal. I often suggest that clients try an Alcoholics Anonymous (AA)
meeting and stay sober for one week just to see how they feel
afterwards. It is often much easier for a person to agree to a small
commitment first, rather than asking for a big step.
What is the difference between
substance abuse and substance dependency?
Substance dependency is
often easier to recognize than substance abuse. When an individual is
chemically dependent on substances, his or her tolerance has
increased. The person is now using more substances in order to get the
same effect. When a substance dependent person stops using the
substances, he or she is likely to have problems with withdrawal, such
as tremors, sweating, nausea, and insomnia.
The substance
dependent person is often not able to stop using, spends a lot of time
using or obtaining the substance, and continues to use even when aware
that it is causing psychological or physical problems. Most of the
chemically dependent clients whom I have met are painfully aware that
they are addicted to substances. However, being able to stop using has
been a struggle.
What
are the options for treatment?
When a person
is abusing substances, she or he will benefit from a combination of
substance abuse education and counseling. I often suggest starting by
attending a community support group, such as Alcoholics Anonymous
(AA). An AA meeting is a self-help support group offered at no cost,
held at different times of the day and in numerous locations, in order
to accommodate an individual’s daily obligations.
Narcotics
Anonymous (NA) meetings are meant for those having difficulties with
drug addictions. Individuals that are dependent on substances may also
need to seek detoxification in a medical or social setting.
Residential treatment facilities may be recommended if an individual
needs detoxification. For many others, recovery is a life-long process
and they maintain sobriety through outpatient programs and AA
meetings.
What
help is available to family members?
I have
referred many family members to attend Ala-non or Ala-teen meetings.
Why? Oftentimes an individual using substances is not ready or willing
to enter treatment. In this situation, family members who attend
programs may learn how to stop enabling and evaluate how their own
behavior permits a substance abuser to use or obtain substances.
Enabling can come in many forms, from calling in sick for the
substance abuser to giving money when they know it will be used for
purchasing alcohol or drugs. Sometimes family members are so caught up
in the chaos of the substance abuser that it is difficult to see how
they may be contributing to the problem.
What’s
the bottom line?
Overall,
recovery from substances starts with the realization that there is a
problem and then seeking a treatment modality that matches the
problem. Recovery from dependency and abuse of drugs and alcohol is
often fraught with relapses and may involve re-entering programs. For
me, it has been a humbling experience to help people on the road to
recovery and an honorable experience to see so many succeed. It has
also taught me that relapses are often a part of the journey. And yet
this, too, is a learning experience that the substance abuser may grow
from.
Sirpa
Lahtinen-Gorman is a Licensed Professional Counselor. She is an
EMDR provider and has a private practice in Eagle River, Alaska. Visit
her on www.alaskatherapy.com
or call at (907) 720-1878.
