I. How Do You Know if You or Someone You Love Needs Help?
Do you wonder if you or someone you know has a problem with drinking or using drugs? Are you confused, angry, or worried about what might happen, wishing you knew where to go for help?
1. Warning Signs That Alcohol/Drug Use is a Problem
How do you know if someone may have a problem with alcohol or drugs? This set of four questions can help to identify a drinking or drug problem:
1. Have you ever felt that you should cut down on your drinking or drug use?
2. Have you ever felt bad or guilty about your drinking or drug use?
3. Have others annoyed you because they criticized your drinking or drug use?
4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to try to get rid of a hangover?
Answering ‘yes’ to one of these questions may indicate that there is a problem with alcohol or drug use. If you answered ‘yes’ to more than one, there is a great likelihood that drinking or drug use is a problem. A ‘yes’ answer to any of these questions should prompt you to consult a doctor or a treatment provider, who can help assess if there is an alcohol or drug problem and provide recommendations for appropriate care.
2. Warning Signs That Alcohol/Drug Use is Abuse or Dependence
How do you know if the level of drinking or using drugs is abuse or dependence?
This set of seven questions can help determine if there is a need to consult a treatment provider to explore behaviors associated with substance use.
1. Have you ever driven a car after drinking or using drugs?
2. Do you experience a strong physical need to drink or use a drug to keep from feeling very sick?
3. Do you spend a lot of time drinking or using drugs?
4. Does it take you a long time to recover from a hangover?
5. Do you have legal, family, work, or medical problems as a result of substance-using behaviors?
6. Have you noticed that you can’t seem to stop, even though there have been a number of attempts?
7. Negative consequences: do bad things happen when alcohol or drugs are used?
A ‘yes’ answer to any of these questions may indicate that drinking or drug use has become more than a problem in your life. Within this question set is a sample of some situations that can indicate someone may be abusing or has become dependent on alcohol or drugs. An individual concerned about the use of substances should be referred to the appropriate resources. A number of helpful resources are provided later in this section.
All of the substances outlined in the section: Alcohol & Other Drugs: The Basics, can receive a
diagnosis of abuse or dependence depending on the pattern of use as reported by the substance
abuser and/or collaborative sources (i.e., partner, parent, sibling, friend). Complete symptoms of
abuse and dependence are also outlined in this section.
3. Warning Signs That Your Relationship May Need Help
There is evidence that substance abuse and relationship problems strongly influence each other. Not only does substance abuse add stress to the relationship, but relationship problems can lead to more problematic substance use.
For example, a higher incidence of marital friction, divorce, separation, and child and spousal abuse exists in families with abusive drinking1, 2.
Stressful marital relationships are related to increased problematic substance use and relapse among alcoholics and drug abusers3.
One study has reported that drug-abusing couples:
(a) were significantly dissatisfied with their relationships,
(b) desired significant change from their partners in several areas that influence relationship quality,
(c) felt that their partners used maladaptive methods of coping with conflict, and
(d) had taken steps toward breaking up the relationship4 .
Thus, the relationship between substance use and marital problems is not unidirectional, but rather each impacts the other.
The influence that the couple’s relationship has on substance abuse and that of substance abuse on the relationship cannot be understated. In most cases, there are underlying issues in the relationship that exist due to substance abuse in general.
For example, reports from couples with a substance abuse problem indicate substantial dissatisfaction with their marriages, as well as a significant amount of problems in other relationship areas. Unhappy or dissatisfied with their relationship, partners show a lack of caring toward one another.
Indeed, interpersonal violence can and does occur more often in couples that abuse substances. In addition, these relationships are often marked by poor communication between partners, which in turn can lead to recurring relapse or continued use.
Indeed, these are the reasons that couples decide to seek assistance from outside sources. Often these difficulties and problems can be addressed by enhancing couples’ skills. Some of these areas include learning how to cope with substance-related situations, positive self-expression, communication skills, and problem solving skills.
Helpful skills are discussed in sections: Building Support for Abstinence and He Said-She Said: A Discussion on Communication Barriers & Skills for Successful Communication.
For more information, please refer to the following sources:
3 Fals-Stewart, W. & Birchler, G. (1994). Marital functioning among substance-abusing patients in outpatient treatment. Poster presented at the Annual Meeting of the Association for Advancement of Behavior Therapy, San Diego, California.
4 Fals-Stewart, W., Birchler, G., & O’Farrell, T. (1999). Drug-abusing patients and their intimate partners: Dyadic adjustment, relationship stability, and substance use. Journal of Abnormal Psychology, 108, 11-23.
1 O’Farrell, T. J. (1989). Marital and family therapy in alcoholism treatment. Journal of Substance
Abuse Treatment, 6(1), 23-29.
2 O’Farrell, T. J. & Murphy, C.M. (1995). Marital violence before and after alcoholism treatment.
Journal of Consulting and Clinical Psychology, 63, 256-262.
4. Resources That Can Help
A number of resource outlets to access information related to alcohol and drug use and abuse, substance abuse treatment, domestic violence, and HIV and prevention are provided. What resources are available in your area? It is a good idea to be aware of services that are available in your city and state and how to contact them. Add your resources to the list: helpful resources can provide you with helpful information.
Information:
The National Institute on Drug Abuse: www.drugabuse.gov
The National Institute on Alcohol Abuse & Alcoholism: Frequently Asked
Questions: www.niaaa.nih.gov/faq
Research Society on Alcoholism: www.rsoa.org/
Face The Issue: www.facetheissue.com
Recovery Resources: www.recoveryresources.org
Drug & Alcohol Treatment & Prevention:
Addiction and Family Research Group: www.addictionandfamily.org
Alcoholics Anonymous: www.alcoholics-anonymous.org
Narcotics Anonymous: www.na.org
The National Drug & Alcohol Treatment Referral Routing Service:
1-800-662-HELP (4357)
Substance Abuse and Mental Health Services Administration Center for Substance Abuse Prevention:
www.samhsa.gov
www.FamilyTherapyResources.net/index_nm.asp
American Association for Marriage and Family Therapy (AAMFT):
www.aamft.org/index_nm.asp
Research Institute on Addictions: www.ria.buffalo.edu
Rutgers Center of Alcohol Studies: Barbara McCrady:
www.rci.rutgers.edu/%Ebmccrady/
Domestic Violence:
The National Domestic Violence Hotline:
1-800-799-SAFE (7233)
www.ndvh.org
HIV Symptoms, Prevention, & Testing:
http://content.health.msn.com/condition_center/hiv_aids/default.htm
www.aidsinfo.nih.gov/
National Center for HIV, STD and TB Prevention:
www.cdc.gov/hiv/dhap.htm or www.cdc.gov/hiv/pubs/facts.htm
Mental Health:
http://www.nimh.nih.gov/publicat/depression.cfm
National Mental Health Association
1-800-969-NMHA (6642)
Substance Abuse & Mental Health:
Substance Abuse and Mental Health Services Association www.samhsa.gov/
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See more of this publication on this site at Sobriety: A Couple’s Workbook
Learning Sobriety Together: A Couple’s Workbook is also available as a pdf download – see list of manuals on the Addiction and Family Research Group site
http://addictionandfamily.org/