Clues For When Drug Use Turns To Abuse

If you are the person you’re concerned about, pay attention to how often your rational mind tells you that you might have a problem. (For me, it was just after my first generous triple that I was most convinced I needed to stop, perhaps because the relief the drink brought allowed me to relax enough to see the absurdity of giving up every day, one day at a time.) If that happens with increasing frequency you might want to try some controlled drinking, which is what AA’s Big Book recommends. Make a deal with yourself to have just one or two drinks and see if you can live up to that promise. If you find yourself shit-faced again, it could mean you’ve lost the ability to control your drinking once you start.

When my doctor suggests to patients that they try controlled drinking he adds an exercise: write down how you feel every hour after your first drink and review what you’ve written the next morning. Did you have more than you swore to? Did you go from a short period of fun to deep demoralization? Were you able to write at all as the evening progressed? These are clues.

Do you simultaneously deny you have a problem while hiding or minimizing how much you use from others? Do you find excuses to have another drink or drug? Do you think, for example, that chores like washing the dishes will be more palatable if you have a couple belts?  Do you get pre-loaded before going out to dinner, a movie, a party, a bar? Do you need drink or drugs to have a good time? (Ironically, as the science of tolerance demonstrates, drug abuse winds up devaluing the normal rewards you used to be able to enjoy.)

Do you drink to get back back to sleep in the middle of the night? Do you wake up with a hangover every day? Do you have blackouts — periods where you simply can’t remember where you’ve been and what you’ve done? Do you wake up in strange places among people you don’t really know? Do your hands shake until you’ve had some alcohol?

Do you believe you won’t be able to cope without drugs or alcohol? Do you promise yourself you’ll quit someday, but make excuses for why it can’t be today? Are you sick and tired of being sick and tired? More clues.

Among the most important indications are the emotional states active addicts share: guilt, shame, fear, and feeling fraudulent, among others, as amplified in The Addict Experience articles. If you share the feelings described there, chances are you may have crossed the line from use to abuse.

For another clue as to whether use has turned to abuse, you can take any number of readily available self-diagnostic tests. For one example, developed originally by Johns Hopkins University, click on the Addiction 20-Question Self-Diagnostoc Test.

If the person you’re concerned about is a loved one, most people with experience dealing with addiction suggest you go to Al-Anon to learn about the disease so you can model how others have dealt with addiction’s irrationality.


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