Addiction is a disease of the brain. It is not due to a moral failure or a lack of willpower. It doesn’t happen because someone is a “bad” person. It is a chronic disease, just like diabetes or high blood pressure.
The first time a person takes drugs it is by choice. But over time, with continued use, the drugs “hijack” the reward system in the brain, as well as causing other changes. These changes affect a person’s ability to make good choices and control their behavior.
In time, they are addicted: they have strong cravings for drugs and compulsively seek out more, even when they know there could be devastating consequences, such as going to jail or dying.
The picture is similar with “alcohol use disorders.” In the early days, alcohol use is optional. But over time, it becomes more important, there are strong cravings for a drink, and it is difficult to stop drinking once started. As with drugs, alcohol becomes all-important, pushing aside and doing great harm to other parts of life, such as relationships, work, school, and health.
Are You An Addict or Alcoholic?
There is no blood test to diagnose addiction. A doctor won’t necessarily pick up on it, though he may notice some tell-tale signs, like liver damage. Family and friends might have noticed problems, but addicts typically brush off their concerns (often for years). The only way to know if you need help is to take an honest look at your life. If you answer yes to two or three of the questions below, you might have a problem. If you have even more yes answers, seek help now.
- Have you been drunk or high more than four times in the past year?
- Do you ever drink more than you meant to, or for a longer period of time? Do you sometimes stay drunk for days at a time?
- Are you taking any illegal drugs, such as cocaine or heroin?
- Are you taking any prescription drugs that were not prescribed for you, or using them more than was prescribed? Do you use them to change how you feel?
- Have you ever asked more than one doctor to prescribe a drug for you? Are you buying prescription drugs on the street? Do you spend a lot of time drinking or using drugs, or being sick as a result of it?
- Have you ever gone to work or driven a car while drunk or high?
- Do you do things while under the influence that you wouldn’t do otherwise? Do you regret them later?
- Do you ever wake up in the morning with no memory of the night before? Are these blackouts happening more often?
- Have you ever felt bad or guilty about your drinking or drug use?
- Have you ever felt you should cut down on your drinking or drug use, or have you tried to control it?
- Do you find you need more alcohol or drugs to get the feeling you’re looking for? Can you handle more than before? More than most people? Or do you suddenly find you can’t handle as much?
- Do you get anxious if you have to go someplace where there won’t be any alcohol or drugs? Do you feel uneasy when your supply of pills gets low?
- Do you scrounge for extra drinks at parties because you feel you aren’t getting enough? Do you keep going when everyone else has had enough?
- Do you sometimes carry booze or drugs around with you? Do you create situations where you can drink—like arranging a work meeting at a bar?
- Have you ever kept on drinking even though it was making you anxious or depressed, or making another health issue worse?
- Do you tell yourself you can stop drinking or using drugs any time you want to, but find you keep going back to them? Have you ever switched from one kind of drink to another hoping it would keep you from getting drunk? Or from one drug to another to prove you’re not addicted?
- Do you get withdrawal symptoms when you don’t get alcohol or drugs, such as shakiness, sweating, nausea, a racing heart, or trouble sleeping?
- Do you ever take a morning eye-opener to steady your nerves or get rid of a hangover?
- Do you need chemical help to do something (such as start the day, have sex, socialize) or to change how you feel (sad, scared, anxious, or angry)? Do you use chemicals to banish shyness or bolster your confidence?
- Do the people you spend most of your time with drink a lot or take drugs? Do you tend to avoid other friends and family when you’re drinking?
- Are alcohol or drugs sometimes more important than other things in your life—your family, your job, your school work, your values? Is drinking with your buddies more important than seeing your child in a play? Is smoking pot every evening more important than that last night course you need to get your degree?
- Do you find yourself lying to your partner, your kids, your friends, your boss, to cover up your drinking or drug use?
- Has your substance use caused trouble at home or work? Are those around you annoyed by it or concerned about it? Are you annoyed by their concern? Do you get defensive about it?
- Have you had other problems related to your drinking or drug use in the past year (a DUI, missed work days, failed exams, financial problems, car accidents)?
- Has a doctor found signs of alcohol damage and warned you to stop drinking or cut down?
- Have you ever thought your life might be better if you didn’t drink or take drugs?
- Have you ever thought that maybe life just isn’t worth living?
To find a treatment center near you, go to the Substance Abuse & Mental Health Services Administration’s Behavioral Health Treatment Services Locator, at http://findtreatment.samhsa.gov, or call the SAMHSA Treatment Referral Helpline: 800-662-HELP (4357) or 800-487-4889 (TDD). The Helpline is available 24 hours a day, in English and Spanish.