It takes courage to ask for help under any circumstances. It is an especially brave choice to seek assistance for an alcohol or substance use disorder.
In 2020, a mere 6.5% of the 23 million Americans struggling with alcohol or drugs sought treatment. This number, which is from the National Survey on Drug Use and Health, represents fewer than 1.5 million people aged 12 or older. Additionally, there was a record number of opioid overdose deaths at over 100,000 between April 2020 and April 2021. In 2019, that number was roughly 80,000, meaning the following year saw more than a 20% rise in overdose deaths. Even with these staggering numbers, there is always hope for those willing to reach out to friends, loved ones, health care providers, and treatment centers.
While one complicating factor is the COVID-19 pandemic limiting health care options, there are several other reasons for the rise in alcohol and substance use disorders. As you learn about these reasons, it is important to remember three things:
1. You are not alone in your struggle. In fact, you probably know at least one other person who wrestles with substance use.
2. In any community, there is help nearby. This help can take on a number of forms, many of which are detailed below.
3. The first and perhaps bravest step you can take is admitting that there is a problem. If you are reading this, you are at least curious for yourself or a loved one. That takes courage.
What Are the Warning Signs of a Substance Use Disorder?
Both the National Institute on Drug Abuse and the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders describe the warning signs or symptoms of a substance use disorder. These can be presented in the form of 11 questions.
1. Do you (or a loved one) take more and more of the substance over an increasing period of time? This goes for illicit drugs, prescriptions, alcohol, and other chemicals.
2. Have you tried to go off or reduce the amount of the substance you are taking and been unsuccessful? Have you made several attempts to cut down that have not worked out?
3. Are you spending an increasing amount of time obtaining, using, or recovering from use of a substance?
4. Do you experience cravings for the substance? Do you feel anxious or physically ill if you do not have access to the substance?
5. Is use of the substance hampering your ability to perform daily tasks at work, home, or school? Have you had to make excuses for missed deadlines or other issues due to your substance use?
6. Has substance use caused or increased the above problems with performance, your personal or professional relationships, or other social interactions?
7. Has substance use caused you to abandon or decrease time spent on important projects, social gatherings, or recreational activities you used to enjoy?
8. Has use of a substance put you in a position where you could be physically harmed? Has this happened more than once or in an increasing amount?
9. Have you been unable to quit using the substance, even when it has caused or worsened physical or psychological conditions?
10. Have you developed a tolerance to the substance? Tolerance is defined as a need to increase the amount of the substance used in order to create the desired effects. Have you noticed a decrease in the effect of the substance over time?
11. Do you experience physical or psychological withdrawal symptoms when you try to quit using the substance? Have you ever had to take the substance in order to reduce, manage, or eliminate withdrawal symptoms?
While it is always a good idea to seek advice from a physician or health care professional, you can self-assess the approximate severity of a substance use disorder based on the number of times you said “yes.” If you answered yes to two or three of the numbered questions, that is usually indicative of a mild substance use disorder or dependence. If you answered yes to four or five of them, that can be a sign of a moderate substance use disorder. If you answered yes to six or more of the questions, you may have a severe substance use disorder.
Please remember that these questions are meant to help you gauge whether you need and are ready to seek help. Even if you suspect that you have a severe substance use disorder, healing is possible. If you are here and still reading, you have already taken a step toward recovery.
What Are the Main Reasons People Don’t Seek Help?
A 2004 study published by the National Institutes of Health reveal several reasons why a person may delay or choose not to seek help:
• 96% of clients who did not seek treatment felt that the substance helped them cope with everyday problems. However, substance and alcohol use are temporary, ineffective, and ultimately unsustainable coping methods that cause healthy psychological coping to atrophy.
• 91% cited the feelings that the substance created. However, these are temporary and do not lead to long-term feelings of contentment or happiness.
• 88% felt that treatment options or facilities were not available in their area. However, treatment is available in nearly every community in the United States, and even more are within a relatively short traveling distance.
• 88% felt that treatment was either too far away or too expensive. However, most facilities will communicate with insurance companies on your behalf to help make recovery more affordable.
• 81% felt that the substance either did no harm or was so readily available that it was hard to resist. Over time, any substance used in excess takes its toll, and something that is readily available does not automatically improve your quality of life.
• 75% expressed fear of withdrawal symptoms. However, withdrawal can be medically managed in a way that minimizes pain, discomfort, and other effects.
• 75% felt that treatment would not work. While treatment may not be immediately effective, it can lead to lifelong recovery.
• 41% felt that other prescriptions used to treat the problem would lead to yet another substance use disorder. When overseen by professionals, this can be prevented. In fact, many medical treatments, including prescribed medications, present a very low risk for misuse.
• 41% felt that the rate of relapse was too high. While relapse is a fairly common occurrence, it is not guaranteed. Also, continual treatment is available. Relapse does not have to mark the end of your recovery. Instead, it is one of many steps on the journey to recovery.
• 22% were concerned about the stigma of a substance use disorder, especially when it could lead to inpatient treatment. However, many inpatient programs either are remote or diligently protect your privacy.
You may agree with some of these justifications. Even so, if you look at the long-term effects of substance use on your life, many of these reasons do not hold up under scrutiny. When you are ready, help is available.
What Are the Main Reasons People Do Seek Help?
It is a common fallacy that a person must “hit rock bottom” before seeking help or before that help is effective. There are times when a personal crisis such as an arrest, failed relationship, financial troubles, or loss of a job spurs someone to begin recovery. However, overcoming a substance use disorder begins when you decide to end it. There may be nervousness or even fear that accompanies your choice, but there can also be a feeling of self-empowerment.
The same 2004 study as above details the many reasons why people choose to enter treatment:
• 83% of people surveyed cited “social rejection” as a major reason to start treatment, but many people in society actually look at recovery as a means of overall self-improvement.
• 75% entered treatment because they were physically ill or afraid of becoming ill.
• 52% of people in treatment cited financial problems or debt as a reason.
• 48% entered treatment because their substance of choice was no longer readily available.
• 31% entered treatment because they feared losing their jobs over substance use.
• 31% cited religious reasons such as obedience or gratefulness to a higher power.
If any of these circumstances describe you, you have the incentive to begin recovery. The above reasons can also help you see your treatment through and sustain your recovery. It is vital to keep your personal reasons for quitting in front of your mind because they are things you can return to when you are concerned about relapse.
What Other Things Should You Keep in Mind?
Just because a drug is prescribed to you does not mean that you are immune to dependence or a substance use disorder. The NIH defines misuse as taking a drug in a way that the prescribing doctor did not intend. This can take several forms, including:
• Taking too much of a prescription
• Taking a prescription too frequently
• Taking a prescription to cope with personal problems
• Taking a prescription to get high
• Taking a prescription for a symptom, disease, or disorder for which it was not prescribed
• Taking a drug that is not prescribed to you
Everyone Has a Different Road to Recovery
No matter where you are in life or how severe your substance use disorder is, recovery is always a viable option. There are many ways to begin and sustain a drug-free life. Some people choose to use an outpatient facility like a clinic. Others attend Alcoholic Anonymous or Narcotics Anonymous. Still others seek private or group counseling. Some choose an inpatient program or a rehab facility where options such as medically assisted withdrawal are possible.
Relapse Is Not Failure
You may be tempted to despair at the fact that many people, 85% in fact, will relapse within the first year of treatment. It is important to consider that a relapse is not an end to your story. It is not failure. A person who has cancer would not give up if a single session of chemotherapy did not cure them. Like cancer, an alcohol or substance use disorder is a disease. At times, there will be factors that are beyond your control. Still, the disease is treatable.
You Can Get Better
Now that you know more about seeking help, you probably want to know about specific treatment options near your location. There are many referral services, both statewide and national. These can point you in the right direction and get you on a treatment plan that is best for you. The Substance Abuse and Mental Health Services Administration’s National Helpline at (800) 662-HELP (4357) is in service 24 hours a day, 365 days a year. This service is entirely free and confidential. The helpline is available in both English and Spanish. The people on the line can help you find facilities and explain the variety of treatment options.
The National Rehab Hotline at (866) 210-1303 is also available 24 hours a day, each day of the year. The Illinois Helpline for Opioids and Other Substances is available at (833) 234-6343 or by texting “HELP” to 833234. Finally, rehab facilities like First City Recovery Center are available in both Illinois and Indiana. We can help guide you through the process of treatment options, insurance coverage, residential stays, and ongoing sobriety programs. We offer a broad array of therapies from partial hospitalization and medication management to medical detox and treatment for co-morbid mental disorders.
If alcohol or other substances have claimed your life, you have the opportunity to reclaim it starting today. Remember that by even reading this, you are taking that initial step toward recovery. All you have to do now is pick up the phone.
Dr. Vahid Osman, MD is a psychiatry specialist in Indianapolis, IN.
Dr. Osman completed a residency at Austin State Hospital. He has over 32 years of experience in Psychiatry & Behavioral Health. He is board certified by the American Board of Psychiatry and Neurology.