Substance Dependence: You have reason to be concerned

First I would like to address the criteria for substance dependence set forth by the DSM-IV-TR, the Diagnostic and Statistical Manual for Mental Health Disorders. This manual is governed by WHO, the World Health Organization and all healthcare providers use this criteria in determining diagnoses around the world.

The following is the criteria for substance dependence. Substance used here is referring to drugs or alcohol and any chemicals that has mind or mood altering affects.

I would like for you to read each criteria carefully and give an honest assessment and if any three or more of the following symptoms below would be correct to your current drinking and within the last 12 months then any treatment provider would diagnose substance dependence, which also means alcoholism or addiction:

1. Continued use of alcohol even when significant problems related to it's use have developed.
2. Increased tolerance or need for increased amounts of substance to attain the desired affect.
3. Withdrawal symptoms with decreased use.
4. Unsuccessful efforts to decrease use.
5. Increase in time spent in activities to obtain substances.
6. Withdrawal from social and recreational activities because of using, being intoxicated, or withdrawing
7. And continued use of substance even with awareness of physical or psychological problems encountered by the extent of substance use. 

You stated that you found it difficult to control your drinking and that you were having intense cravings, which tells me that you have lost control of your drinking. It is now beyond your control. There comes a point in abusing substances where one crosses over to dependence. This can sneak up gradually or subtly depending on the individual, the drugs, dosage, frequency and other factors such as early use and heredity. Like an invisible threshold that one crosses over to not return. Once the body becomes dependent on the chemical, the drug, or the alcohol, major changes happen in the brain. Basically the landscape of the brain changes and systems that were working seamlessly are now malfunctioning. The prefrontal cortex, which is the executive functioning part of the brain that houses our reasoning abilities, and promotes good judgment, decisions and planning is now interrupted. This system is no longer talking to the portion of the brain that seeks out pleasure. This pleasure seeking response system is now running rampant and over-rides the rational functioning of the frontal cortex, sometimes at the expense of one's own life. This is why you see some people who continue to take drugs, alcohol, chemicals, or food to an alarming extent that increases their risk for harm, and death and causes parents to choose their drugs of choice over their own children. No one sets out to grow up to be a drug addict or alcoholic, but with continued use the grim reeper seeks the user out. Our society is now recognizing that addiction is a disease of the brain albeit, one that is avoidable. Their have been great strides in treatment along with medications that can help turn down the intense cravings, while the individual seeks treatment.

I could sense in your story your concern over your children especially breaking your promise to your son that you would quit drinking. Unfortunately addiction is the one disease that doesn't only affect the individual but consequently affects the entire family. There is a saying in the big book of Alcoholics Anonymous that the sickness of alcoholism is like no other human sickness. If someone had cancer we would feel sorry for them but not angry or hurt. This is not true for the alcoholic illness. "With any addiction comes the annihalation of all things worthwhile". This means that one can lose their family their wife their children their homes their jobs their character their integrity, and financial security. This disease also leaves in its wake disgusted friends, blameless children, sad wives and parents and many others that care about the afflicted individual.

According to WHO in a study reported in Jan. 2011, alcohol kills more than 2.5 million people a year and more people die from alcohol use then they do from alcohol related causes. More people die each year as a result of alcohol abuse than from wars or high-profile diseases like HIV and cancer. So to answer your question my friend you have reason to be concerned.

You mentioned several times that you were not an alcoholic. You do meet the criteria for having alcohol dependence. And you are correct in assuming that you cannot do this yourself. I've included below some typical behavior patterns that synonymous with individuals that have substance abuse disorders.

Some of the behavioral patterns associated with substance use and dependence are:

1. Getting high on drugs are getting intoxicated on alcohol on a regular basis
2. Lying, especially about how much one is using or drinking
3. Avoiding friends and family members
4. Giving up activities one used to enjoy such as sports or spending time with non-using friends
5. Talking a lot about using drugs or alcohol
6. Believing one needs to use or drink in order to have fun
7. Getting in trouble with the law
8. Taking risk such as driving under the influence
9. Work performance suffers due to substance abuse before, after, or during working a business hours
10. Depressed, hopeless, or suicidal feelings

Unfortunately there is no easy way to get back to normal, as you will now have to come to terms with the fact you have the disease of addiction. From your point of view it appears you are in denial of this reality and still hold a notion that you can control it. However, now you have lost that control and nothing short of anything and everything you can do to arrest this disease is out of the question. Many of my clients complain of expensive treatment programs, the time involved in the recovery rooms of AA, the time from work if in-patient treatment is required, but fail to consider the ultimate costs of not seeking treatment. I believe the sooner one starts treatment the better, as becoming armed with with education on the negative effects of alcohol can help your future of your health and possibly your life, but also your children's future because you are setting the exampl for them and sadly the disease has a great genetic factor meaning that they to could be predisposed to substance abuse with a family history of it. It is my hope you seek medical treatment to rule out any medical problems and seek treatment immediately. If not now, when? Addiction is a progressive disease and only gets worse with time not better.

I hope I was able to answer some of your questions moreover, I hope the vail of denial has been lifted for you to see how serious this is and the importance of seeking treatment, as soon as possible.

Jeannie Cameron, LMHC

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