Health Society of South Africa

ALCOHOL OR DRUG USE

Have you been thinking about your ALCOHOL OR DRUG USE?

Is It Time to Make a Change?

Are you worried about how much you're drinking or using other drugs, like marijuana, cocaine or a painkiller? Is someone close to you concerned? Maybe it's time to take a closer look at your substance use. This information can help you decide if your use is a problem. It also shows you how to get help.

When Use Becomes Abuse
Substance use becomes abuse when you can't control your use of alcohol or other drugs. (Alcohol may be legal, but it's still a drug.) Use also becomes abuse when it disrupts your life. For example, substance use may be making it hard for you to:

Stay close to family and friends
Get to work on time or do your job well
Keep up with your bills

If this sounds like you, you may be abusing alcohol or other drugs. You're not alone. Substance abuse is a common problem. Just know that there's help whenever you're ready to make a change.

Is This You?
These questions can help you take a closer look at your use. Check any that apply to you:

Have you ever felt you need to cut down on your substance use?
Do you ever feel annoyed when people criticise your use?
Have you ever felt embarrassed or guilty about your use?
Have you ever used substances first thing in the morning?

If you checked one or more of these boxes, maybe it's time to think about your substance use.

You Can Choose the Path to Recovery
Admitting that you have a substance abuse problem isn't easy. It takes courage. But once you're ready to look at your use, you've taken a big step towards overcoming the problem. It's also the first step to getting your life back together. The next steps on the path to recovery involve:

Getting treatment. You may want to see a counsellor or other health care provider or seek help from a clergy member. Or, you may decide to join a 12-step programme or other support group.
Making changes in your life. When you stop using, you'll want to find new activities and get back in touch with family and friends who aren't using. This will help you feel better about yourself and make it possible to build a new life.

How Addiction Can Happen

Not everyone who takes a drink or tries a drug has a substance abuse problem. But for some people, what starts as social use can lead to problem use and then addiction. As the disease gets worse, a person has less and less control over his or her substance use. The desire to use becomes a craving, and the person needs help to stop using. Can you see yourself in any of these stages?

Social use: You can take it or leave it.
You have a drink at a party or a glass of wine with dinner.
You tried a street drug once or twice, but never used again.
You take medications only when needed and only as directed.
You don't think about using or plan the next time you'll use.

Problem use. You're using more.
You use more than you used to.
You need to use to feel OK.
Someone close to you has commented on how much you're using.
You have called in sick or been late to work because of a hangover.
You've been stopped for driving under the influence.

Addiction. You've become dependant.
You focus more and more on activities that involve using.
Your use is causing more problems, such as money troubles or losing your job, a spouse or a friend.
You wake up and can't recall what happened the night before.
You use to avoid withdrawal symptoms.

Social Use: You can Take It or Leave It

Some people can have a drink or use another substance and then stop. They don't think about drinking or using again for a while. For some this will never lead to heavier use. For others, it may.

Using is Still a Choice
A social user can choose to say "yes" or "no" at any time. This person is in control of his or her substance use.

Think about these statements:
I can put down a drink without finishing it.
I can enjoy myself at a social event without using it.
I can go without using or thinking about using.

If this describes you, you're most likely a social user. But ask yourself, can you really take it or leave it? You might try for a few weeks or even a month. If you find it hard or you just can't do it, maybe you need to think about your use again. Read on.

Problem Use: You're Using More

At first, alcohol and other drugs can seem to make you feel better or help solve your problems. But that "I'm OK" feeling doesn't last. What does last are the problems that using causes. That's when substance use becomes abuse.

Use Becomes Abuse
Using becomes a problem when the substance begins to take control. You need to use more just to get the same feeling. You may start to have money problems or problems with your job or relationships.

Think about these statements:
I promise to cut down or quit, but I don't.
I'm using more, even when I'm alone.
I try to hide my use or feel embarrassed about it.

If this describes you, your use may have become abuse. This kind of substance use can also lead to the next stage: addiction. Changing your use may take time. And you may need help. But you can choose to cut down or stop now.

Addiction: You've Become Dependent

The desire to use now becomes a craving. You need more and more to get the same effect. You have little or no control over your use because the substance is now controlling you. You feel you can't get along without it.

Abuse Becomes Addiction
By now, using is causing real consequences in your life. You may have blackouts or get into arguments or fights. You may be aware that your use is having a bad effect on your work or your relationships.

Think about these statements:
I use to get through the day.
I feel angry or anxious if I can't use.
I plan my activities around when and how I can use.
All my friends drink or use other drugs.
I use to get rid of a hangover or the shakes.

If this describes you, you may be addicted. You could be heading toward serious health problems. But know that it's never too late to choose to stop. The next pages will tell you where to get help and what to expect next.

Take a Closer Look at Your Use

Did you see yourself in some of the statements on the last pages? Have you been thinking that you're using more than you want to? Ask yourself the following questions. The answers can help you see where you might have problems caused by substance abuse. Then you can decide whether you're ready to do something about your use.

Ask yourself these questions:

Do you ever have trouble remembering things or concentrating on what you're doing because you're thinking about using?

Have you ever broken promises because of your substance use?

Have you ever done things when you were using that you wouldn't normally do?

Have you ever lost a job or had money troubles because of your use?

Do you ever make excuses for your use or lie to hide it?

Does someone make excuses for you when you're hung over?

Do others ever seem embarrassed about your use?

Have your children ever asked you to stop using or been afraid of you when you were using?

Has your spouse or a girlfriend or boyfriend ever left you because of your use?

Have you ever had sexual problems that might be caused by your use?

Have you ever had severe shaking, heard voices or thought you were seeing things after you've been using?

Have you noticed that you've been sick more as you use more?

Have you tried to quit but found you just couldn't?

If you answer "YES" to one or more of these questions, you may need to change or stop your substance use.

The Next Steps

If you think you have a substance abuse problem, you probably do. But know that you can do something about it. Many people have. It takes courage and honesty to admit you're abusing alcohol or other drugs. But once you do, there are many programmes and people who can help you overcome your problem. And remember, it's OK to get help.

Facing Your Problem
Admitting that you abuse alcohol or other drugs is the first step towards changing your life. When you face your problem, you also accept that you're accountable for your actions and for changing them.

Getting Help and Support
Recovery doesn't happen overnight. It's a lifelong process with many steps along the way. During those steps, you'll work on changing the things that were part of your substance abuse. A counsellor or other health care provider can give you support. So can a priest, minister or rabbi who is trained in substance abuse counselling. Friends and family can also help. Together you can decide on lifestyle changes you need to make. And you can deal with problems that may come up.

Your Options for Treatment

There are many drug treatment programmes. Some are live-in (inpatient), others are drop-in (outpatient). All offer some kind of counselling, and some include medical treatment. Check with your health insurance representative or your Employee Assistance Programme (EAP) to find out what your options are.

One-on-One Counselling
In individual counselling, you meet alone with a counsellor. This allows you to focus on your own goals and problems. One-on-one counselling may be better for you if you need special help or don't like talking in groups.

Group Counselling
In group counselling, you meet in a small group with a counsellor. The others in the group are also substance abusers who want to get help. You can give each other support and help each other to learn to cope with problems. Hearing other life stories and sharing yours help you know that you're not alone.

12-Step Programmes
Programmes such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are free support groups that guide you through a 12-step recovery process. Many people choose a sponsor to help them along the way. AA and other 12-step programmes are found in nearly all communities.

Treatment Centres
A treatment centre is a facility where you get medical care and counselling during withdrawal and the early stages of recovery. Some are live-in and some are day (outpatient) programmes. Most live-in programmes last at least 30 days. Day programmes may last longer.

Halfway Houses
A halfway house is a drug-free place to live while you're recovering. Everyone in the halfway house is going through the same things that you are. You take part in support groups and other activities each day. You may also go to work.

Other Treatments
Acupuncture, hypnosis and biofeedback are sometimes used along with other treatment options. You might want to talk with your health care provider about these.

Dealing with Withdrawal
Stopping your use may cause withdrawal symptoms. These can include:

Sleeplessness, nausea, and sweating
Anxiety or depression
Muscle spasms
Convulsions

Talk to your health care provider. Be honest about your use. You may need to be under medical care. This care is called detoxification, or "detox". During detox:

You may be given medication to help you through the first stages of withdrawal, or
You may decide to stop using under medical care but with no medication.

Your Ongoing Recovery

Recovery also means making a new life for yourself. Finding new interests, building new relationships and taking better care of yourself will help you replace substance use with a new and better lifestyle. They will also help you avoid things that could make you want to use again.

Make Lifestyle Changes
A big part of recovery is changing habits that may have led to your substance abuse. It's also time for personal growth. Below are some lifestyle changes you may want to make.

Finding new activities and goals. You may decide you want to explore new hobbies and interests or join an activity group to meet new people.

Building relationships. You may choose to spend more time with loved ones or friends you lost touch with while you were using. You may also want to make new friends. And there may be some friends you'll want to stop seeing because they're still using.

Exercising and eating well. Getting some physical activity on most days and eating healthy meals with lots of fruits, vegetables and whole grains can make you feel better. A nutritionist or physical fitness expert can help you.

Relaxing and getting enough rest. Reducing stress and getting a good night's sleep can also help you feel better. Ask your counsellor about medication, relaxation exercises or stress management classes.

Continue Counselling
Working with a counsellor will help you decide on the lifestyle changes you want to make. You might also want to start working on things like anger management, problem-solving skills or assertiveness training.

Be Aware of Your Triggers
Triggers are things that make you want to use again. They can be people you used with or places, things and events that make you want to use. Stress and feelings like loneliness, anxiety or depression can also make you want to use again. When you know what your triggers are, you can plan ways to avoid them whenever possible. You can also learn to cope without using.

What are your triggers?
List the people, places, events or feelings that could make you want to use again.

What to Do if You Relapse

Your goal is to stop using. But if you use again, don't give up. You may have slipped, but you haven't failed. Look at your list of triggers and try to see what caused you to relapse. This will help you plan what to do the next time you feel the urge to use. For most people, this urge gets weaker with time.

Know Your Warning Signs
A relapse is most often brought on by negative feelings or events. Knowing the warning signs can help you head off a relapse. Signs include:

Feeling angry, resentful or powerless
Focusing on the past or the future
Having trouble dealing with special events or changes in your routine
Skipping counselling sessions or meetings
Spending time with people you used with or going places where you used
Thinking you're cured

Have a Plan
Planning ahead for how you'll cope with these feelings or events can help you avoid a relapse. When you notice any of your warning signs, try:

Calling your sponsor or going to a support group
Talking to a counsellor or a friend
Doing something you enjoy
Exercising or going for a walk

Getting on with Your Life

Recovery is a day-to-day process. The longer you don't use, the better you'll feel about yourself. You may wonder why you would ever want to use again. And you'll probably find yourself thinking about what you want to do with your life now that you're no longer using.

Picture What You Want
Imagine your life as you'd like it to be. You could picture it in your mind, draw it or write about it. Having a clear idea of what you want in life can help you stay drug-free. It also gives you something to work toward. Try picturing:

Ways you'll spend time with family and friends
Activities and hobbies you'll enjoy doing
The kind of work you'd like to do
What it's like to feel relaxed and good about yourself

My Reasons To Stay in Recovery
Write down some things you would like to do with your life now.