So I drink/use too much sometimes! Do I really need to see a psychologist – and is abstinence really necessary for recovery from substance abuse?
Nobody “needs” to do anything, however, sometimes the consequences of inaction are worse than the minor inconvenience of talking to a professional.
The consequences are sometimes obvious, for example when a magistrate orders drug and alcohol treatment and you don’t comply, then a prison term may be the consequence.
Or, if a family member offers an ultimatum that if something doesn’t change then the relationship is over, the consequence is usually the end of a relationship, with all the heartache that comes with this.
Sometimes the consequences are harder to see, like a shortened life span, or opportunities that would have come about if drugs and alcohol had not held you back.
Drug and alcohol treatment depends on the severity of the problem.
The Social User
Many people use alcohol in particular, but also drugs like cannabis, ecstasy and cocaine, in a social setting only. They may drink with friends/partner, on a Friday night, and stick to a few glasses of wine or bottles of beer. If this is you then you probably don’t have a problem, as long as you stay within the law (drink driving, public intoxication etc). Many people may take an ecstasy pill once a year or smoke cannabis once a month at a party and this is their choice, and relatively risk-free as long as the physical and legal consequences are fully understood.
Here are some questions to ask yourself if this sounds like you:
- Do I use when I am alone?
- Do I use when I am sad/anxious, to make these feelings go away?
- Do I look for excuses to use – like “it’s Friday”, or “it’s a celebration”?
- Do I get hangovers that ruin my day?
If so, then it may be worth talking to somebody about how healthy your habit is.
The Heavy Social User
A common first question I ask is: “Do you drink/smoke more than your friends?”
If the answer is no, then it is easy to believe that you don’t have an issue – however it also may mean your friends have problems as well.
If you do drink more that your friends you may have a problem. If you are the person in your circle who is pushing others to drink more, or hiding the fact that you are having a few more drinks, then you may have a problem. A heavy social user may drink alcohol a few times a week, occasionally drink to excess, and will probably have loved ones express concern about their use. It is a short jump from here to the next category.
The Dependent User
Dependence is a term that is normally used to describe the physical effects of substance use. For example, if you drink alcohol heavily every day and then try to go three days without, then your body will let you know about it, with sweating, nausea, seizures, and other symptoms – it can even lead to death.
The same is true for opiates (heroin, morphine, codeine) as well as benzodiazepines (valium, xanax etc). Just because a GP prescribes something, or you got it over the counter at a chemist, does not mean that you are immune to forming a physical dependence.
If you find that you need to drink alcohol every day to avoid feeling sick, then you definitely have a problem. This needs to be managed medically as well as psychologically.
How to Manage your Dependence
Your personal circumstances and level of dependence (as described above) will influence which approach will be most effective in returning to a healthy lifestyle.
Abstinence versus Cutting Down
New evidence is suggesting some interesting findings regarding whether a person needs to stop using a substance altogether, or if they can change their patterns of use.
If somebody has a mild problem with alcohol and they are able to quit drinking for one month, then they may be able to return to “healthy” levels of drinking. It is interesting that several charities have started campaigns to get people to stop drinking for a month (eg Febfast, Dry July). If you quit for a month, you may learn new ways to socialise, have fun, deal with stress etc.
If you are in the “heavy social user” category as described above and you can go for twelve months without using the substance, then you may be able to return to social use (although it could be argued that certain substances can never be used socially or safely). For many people, going a year without mind altering substances would be very hard. In order to do it the right way, the person would actually need to make many changes in their lives, and actually learn to thrive – not just survive – without their drug of choice.
For people with heavy substance use problems or in the “dependent user” category, often lifetime abstinence is the answer. This is in line with with well-known 12 step philosophy encouraged by Alcoholics/Narcotics Anonymous. The fact that you have had a serious problem probably means that you will never be able to safely use the substance again. I have spoken to a lot of clients who have tried to do otherwise, but it very rarely works.
In the rare cases where it does work the client has had a very long break, massive lifestyle change and even then do not return to their drug of choice. For example an ex-heroin addict has been to jail, then drug rehab, gotten a new job, a new circle of friends and then starts social drinking in the healthy range (less than 4 standard drinks). Even in this situation, the client would be at risk of becoming an alcoholic.
The Final Message
The upshot is there is a broad spectrum of people who will benefit from seeing a psychologist for substance abuse counselling. Whether you are someone who is not sure if you have a problem, or a recovering addict who did a long-term drug rehab years ago – there are many different approaches that will depend on your unique circumstances.
I have worked in a range of settings in the drug and alcohol rehabilitation sector (residential rehabilitation, drop-in services, private counselling) and have spoken to many people who struggle with substance abuse. If you think you would benefit from a confidential discussion about this topic please arrange an appointment with me.
Author: Jim Adsett, BA Psych (Hons).
Jim Adsett has worked in the drug and alcohol field for more than 11 years. Regardless of the substance, Jim has worked with clients at every point in their journey towards recovery, from admitting that they have a problem to maintaining a new healthy lifestyle. Jim tailors his treatment approach depending on the severity of use and the goals that the client has for themselves, then works collaboratively with his clients to help them practically and sensibly move towards these goals. His treatment approach is non-directive and positive and he uses Acceptance and Commitment Therapy (ACT) as a basic framework, as well as drawing on Cognitive Behaviour Therapy and Transactional Analysis.
To make an appointment try Online Booking. Alternatively, you can call M1 Psychology Brisbane on (07) 3067 9129
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