Substance use falls on a continuum based on
frequency, intensity, and degree of dependency. The transition from use
that may be “normal” to use that is problematic can be a slow, gradual
process. Alternatively, problem substance use can occur more quickly,
such as heavy drinking following a relationship loss, or increased
dependence on pain medications following an accident. Addiction, the
most serious level of substance use, is a disorder identified with loss
of control, preoccupation with disabling substances, and continued use
or involvement despite negative consequences.

The problems that
can develop from substance misuse vary from mild to severe, and can
involve a multitude of life functioning areas. Problems experienced
from substance misuse can include immediate consequences such as a
hangover following a night of excessive alcohol consumption. However,
as substance use becomes more problematic, individuals can experience
larger losses such as legal consequences, job loss, health problems,
relationship problems or increased debt. How quickly the use of alcohol
or a drug becomes problematic, however, really depends on the
individual, their behaviour, and factors within the physical,
psychological, economic, spiritual, social, and legal contexts.

What Do I Do If I Have a Problem With My Substance Use?

Getting
help for a substance use problem can be scary. If you believe that you
have a problem with your substance use, you are likely feeling scared
already. It is important to recognize that you are not alone. There are
millions of people across North America struggling with substance use
issues, many successfully.

It is important to recognize that you
can get help at any point along the way, and the sooner you address
your problems, the sooner you can create the life that you really want.
Some important steps that you can take if you have a problem with
substance use include:

1. Get honest with yourself! You know
   deep down on some level that your use is a problem. It is time to be
   direct with yourself about this, so that you can address your needs
   head-on. The sooner you do, the easier it will be.

2. Challenge
   your fears! It is easy to believe that something is “wrong” with you,
   or that you are somehow weak, inadequate or sick because of your
   problems with substance use. These myths are not true. People use
   alcohol and other drugs to address a wide range of issues. It is
   important for you to discover yours.

3. Talk to someone
   about your problems and fears. You may want to involve someone close to
   you with your process, for additional support. This could be a spouse,
   friend, or family member. Just sharing your issues with someone you
   trust can make it much easier to reach out for additional support.

4. Reach
   out and get help! There are a variety of resources and services
   available for persons wanting help with a substance use problem. You
   can find out what kind of help is available from your doctor, clergy or
   an employee assistance program (EAP). Therapists, community health
   agencies and alcohol/other drug treatment programs also provide
   valuable services. Additional resource information can be found at the
   end of this article.

Helping Someone Close to You With a Substance Use Problem

Substance
use problems impact not only the person using, but others around them.
Experience shows that for every person with an alcohol or other drug
problem, at least four others are affected by their behaviour.
Frequently with problem substance use, it is family and friends who
first recognize that a person’s use of alcohol or other drugs has
become problematic.

Initially a person who sets out to help
someone with a substance use problem can feel alone, embarrassed, and
uncertain about where to turn to for help. You may not have much
information about substance misuse, or have misinformation, thinking of
persons who misuse drugs as having a lack of willpower or moral
weakness. It is important for you to gain some understanding about
substance use so that you can be as effective as possible in supporting
your loved one, as well as addressing the impact their use has had on
you. It is important to understand that each person is unique—in their
reasons for using alcohol or drugs, their reactions to these drugs, and
their readiness for treatment.

While you are not responsible for
their use or their recovery, you are in a good position to offer help
and support, because you know their personal qualities and lifestyle
well. On the previous page are some do’s and don’ts that may help you
in addressing the substance use of someone close to you.

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How Can I Tell If I Have a Problem?

The
following guidelines can help you determine how your substance use has
an affect on your life. You may have a drug problem if you:

• have increased your use since you first started

• use illegal drugs or have the same drug prescribed by more than one doctor

• take drugs for help through new situations or social occasions

• can't remember things you've said or done while using

• spend more time with people who use

• cover up or lie about your use

• have problems or miss time at work or school because of your use

• have relationship problems because of your use

• only go to parties or places where drugs are available

• are having financial problems due to drug use

• have hurt yourself or others while under the influence

• have tried to cut down or stop using, but couldn't

• have increased risk-taking behaviour (sharing needles, unprotected sex)

• break promises because of your use

• have been told by someone that your use concerns them

If
you checked off any of these your drug use is likely causing problems
in your life. The more you check off, the more serious your problem may
be.

Source: Adapted from Alberta Alcohol and Drug Abuse Commission

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Helping
What to Do

• Talk to the person openly and honestly in speaking about their behaviour and its day-to-day consequences.

• Let the person know that you are reading and learning about problem substance use.

• Discuss
  the situation with someone you trust – doctor, clergy, a counsellor, a
  friend or someone who has experienced problem substance use personally
  or as a family member.

• Establish and maintain a healthy atmosphere in the home, and try to include the person in family life.

• Explain the nature of problem substance use as an illness to the children in the family.

• Encourage
  new interests and participate in leisure time activities that the
  person enjoys. Encourage them to see old, non-using friends.

• Be patient and live one day at a time. Try to accept setbacks and relapses with calmness and understanding.

• Refuse to ride with anyone who's been drinking heavily or using other drugs.

• Support the persons individual treatment choices.

What Not To Do

• Don't attempt to punish, threaten, bribe or preach.

• Avoid emotional appeals that may only increase feelings of guilt and the compulsion to drink or use other drugs.

• Don't set up unrealistic goals for yourself or the person.

• Don't
  allow yourself to cover up or make excuses for the person or shield
  them from the realistic consequences of their behaviour.

• Don't take over their responsibilities, leaving them with no sense of importance or dignity.

• Don't hide or dump bottles, throw out drugs, or shelter them from situations where alcohol is present.

• Do not give a person who is actively using money.

• Don't argue with the person when they are impaired or high.

• Don't try to drink along with the problem drinker or take drugs with the problem drug user.

• Do not attempt to direct or push the person's treatment participation.

• Above all, don't feel guilty or responsible for another's behaviour.

Source: National Clearinghouse for Alcohol and Drug Information

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Contact your local NVHA office if you want to talk about these issues.