Written by James Chadwick, MSW, LICSW, Radiant Living Therapist
Language has shifted around substance use and abuse, and it is critical to differentiate between the two. Indeed, it can be a challenge to distinguish between recreational and problematic use; heavy use does not necessarily equate to problematic use. At Radiant Living Therapy, our skilled therapists are trained to understand this distinction.
Understanding the Impact of Substances on Functional Impairment
One key factor in diagnosing problematic use/substance use disorders is functional impairment – that is, one’s ability to efficiently complete daily living tasks e.g. work, relationships, etc. The DSM-V, the manual therapists use to aid in diagnosing, outlines the following diagnostic criteria:
- The substance is taken in larger amounts/over a longer period of time than was intended
- Persistent desire/unsuccessful efforts to reduce/control use
- Significant time spent acquiring, using, and recovering from substances
- Craving/strong urge to use
- Continued use leads to disruption of major role obligations, activities, and relationships (functional impairment)
- Danger/high risk associated with substance use
- Use despite physical/medical consequences
- Tolerance and withdrawal
Living With Problematic Substances Use
It is likely that if you are living with problematic use, you don’t need this list to tell you as much! Maybe you have noticed that waking up for work, or really any life tasks, has gotten harder, or that it’s harder to get through the workday without using. Or perhaps you receive critical feedback from a partner, friend, or loved one about your use, contributing to friction in your relationships.
It could be that the monetary cost of using is seriously detracting from other pressing financial obligations. Maybe you have tried to reduce or alter your use in some way on your own, maybe limiting it to weekends, social opportunities, or times when it seems you have no pressing obligations coming up.
Substance Use Disorders, An American Epidemic
You are not alone
If this sounds familiar, you are not alone! As many as 21 million Americans face substance use disorders, and the vast majority of them struggle to recover left to their own devices. It’s much easier to numb out with substances than address some of the underlying factors driving substance use disorders (e.g. depression, anxiety, relationship concerns, shame, sexual concerns, etc.). It’s all too easy to put off addressing consequences.
Hitting bottom
Many people in recovery talk about “hitting bottom” as the catalyst that motivated them to get help. This can range from relationship concerns to medical concerns to job loss to legal concerns to homelessness. Sometimes a “bottom” doesn’t impact an individual until they arrest their behavior, or “stop digging” (figuratively).
The good news is that you can stop digging at any time! Think of your recovery as an iceberg. The smaller part that is more readily apparent is the behavioral change and coping strategies used in place of substances. The more nebulous “submerged” part is really understanding some of the underlying factors compelling you to use.
Substances: Omnipresent in Society
Clearly, substances are omnipresent in our society. The tried and true “change your people, places, and things” conventional wisdom from 12-Step programs presents a challenge when your things are bars, restaurants, clinics, and, increasingly, dispensaries. Moreover, many addictions are characterized by denial, meaning that your brain may actually be telling you that there is no problem!
Strategies for Substance Use Recovery
In early recovery, it may be necessary to avoid places like this altogether. Because of the ubiquitous nature of substances, you will likely want to develop effective coping strategies at some point to help handle these triggers effectively. Individual therapy can help!
Equally clearly, strategies like “DARE” (Drug Abuse Resistance Education) and “Just Say No” are insufficient in resolving problematic use. Many people struggling with problematic use have found recovery support groups (12 Step and others like SMART Recovery and Health Realization, etc.) to be of benefit. Prescribed medications like naltrexone and naloxone and suboxone can also support people seeking to change their relationships with substances.
Substances and Harm Reduction
Increasingly, many people in recovery turn to harm-reduction strategies. This means that one can still use (i.e. not total abstinence) yet boundaries are created and monitored to prevent more dire consequences. Using cannabis instead of “harder drugs,” using clean needle exchange programs, and altering routes of administration (e.g. smoking something instead of injecting it) are also some examples of harm reduction. Working with an individual therapist who is well-versed in problematic use can also greatly enhance clinical outcomes.
Assess Your Stage of Change
One thing you can do today is to assess which stage of change you are in regarding your substance use. The stages of change are pre-contemplation, contemplation, preparation, action, and maintenance.
Precontemplation is all about denial of the problem and it is nearly impossible to make any real headway toward recovery in this stage.
Contemplation acknowledges the presence of a problem but is marked by considerable ambivalence about what to do about the problem.
Preparation allows the individual to start making a plan for recovery and
Action is actually taking those steps toward recovery.
Maintenance integrates everything learned in previous stages to help an individual stay the course of their recovery/behavioral change.
Begin Counseling for Anxiety and Depression, or Substance Abuse Treatment in Plymouth, MN
You don’t have to live in the vicious cycle of substance use/abuse. It can get better and our therapists can help.
Starting therapy in our Plymouth, MN counseling office with one of our skilled therapists is simple. We want to talk with you and look forward to connecting soon! To begin, follow these simple steps:
- Schedule a free consultation
- Meet with a caring, professional therapist
- Move through your life with less anxiety and depression, feeling better and more in control.
Other Mental Health Services at Radiant Living Therapy
Often, we are not just dealing with one type of issue at a time. We know these issues are complex so, at our Plymouth, MN counseling office, our professional therapists also offer EMDR treatment, counseling for teens, couples therapy and marriage counseling, counseling for men, postpartum and maternal mental health, and therapy for infertility, and more. Let us help change your life in an individualized way.
If you are a helping professional, or therapist looking for supervision or consultation services, we can help you, too. No matter the need, we look forward to connecting with you!
Read more from the Radiant blog:
- Unload The Mental Load: Tips from a Twin Cities Therapist
- The Way You See Yourself Matters: Body Image and Sexual Functioning
- Attached at the Hip: How Attachment Styles Affect Our Adult Relationships
- New Year New Us: Relationship Resolutions
- Setting Boundaries: The Holiday Edition
- A Beginner’s Guide to Sex Toys
