My name is (fill in the blank) and I’m an alcoholic! These are the words you would need to say in order to attend a 12-step recovery program such as Alcoholics Anonymous. The first step after all is admitting your powerless over alcohol or other drugs. It used to be that there were all or nothing labels, either you are an alcoholic or addict, or you’re not. If you can’t admit you’re an alcoholic you don’t qualify for the program. For many years, 12-step programs, which are abstinence-based, were considered the only option for treating alcohol and substance use disorders. Today, this is certainly one option, but research is showing that there are other modalities that are likely to be as equally effective, if not more so.
Identifying as an “addict” or “alcoholic” is one end of the spectrum, but like most things in life, substance/alcohol abuse problems exist along a continuum from mild to severe and are influenced by a variety of factors (co-occurring disorders, socioeconomic status, past history of trauma, as well as genetic and neurobiological factors). Today we know that you can have a substance/alcohol abuse issue without qualifying as an “alcoholic” or “addict” and that doesn’t necessarily mean a life of abstinence to work on the issue. We now consider someone’s relationship with substances and whether they are maladaptive or not to inform whether someone has a problem. Of course ultimately you would need to decide for yourself whether your patterns of drinking or using are causing you problems or interfering with your life. Here are some things to consider:
Does your use of drugs/alcohol lead to:
-You tend to consume larger amounts of alcohol/substance than you had initially intended.
-You’ve been finding it difficult to control or cut down on your use despite a desire to do so.
-Significant time and energy is spent in activities related to obtaining the substance, using it, and recovering from it.
-You experience cravings or strong urges to drink or use.
-Your alcohol or substance use interferes with your daily responsibilities (school, work, obligations at home, etc.).
-Your drinking or substance use is creating problems in your relationship(s).
-Engagement in other activities or areas of interest are given up or reduced because of alcohol/substance use.
-You drink or use in situations that could be physically hazardous to you or others (i.e. drinking and driving).
-Alcohol/substance use is continued despite having a physical or psychological problem that is negatively affected by it.
-You build a tolerance and need larger amounts of the substance to feel its effects.
-Discontinued use of the substance results in withdrawal symptoms that vary according to the substance.
It would be worthwhile to examine your relationship with alcohol or other substances if you are able to identify with more than a couple of these patterns. If you think that your pattern of use is unhealthy and you want to make some positive changes, the good news is that there are more options available to you then ever before. I have chosen to list the approaches that are most commonly used and/or supported by scientific research (evidence-based), along with their advantages and disadvantages.