Do I Need Rehab?

The “treatment gap” is a critical problem in the United States, according to the National Institute on Drug Addiction. Out of the 21.6 million people who needed rehab in 2011, only 2.3 million received addiction treatment at a substance abuse treatment facility.^{1 top} Regardless of the type of substance you use or how mild, moderate, or severe your addiction, getting treatment is crucial for starting the road to recovery and taking back control of your life.

Do I Need Help with My Addiction?

The short answer is, yes. However, it’s not always easy to be objective about the situation and admit to a problem even when you suspect that you or someone you care about are struggling with addiction. When substance abuse has a negative impact on your life, it’s important to face the facts and admit that you have an addiction before things become even more unmanageable and your life spirals out of control. Acceptance is a sign that you are ready to make positive changes in your life; once you can say to yourself, “Yes, I have an addiction,” you’ve already begun taking the first steps toward recovery and you’re ready to learn more about how to get help with substance abuse.

Substance abuse is a major preventable public health problem in the United States. In 2018, 20.3 million people had a substance use disorder, including 14.8 million people with an alcohol use disorder and 8.1 million with an illegal drug disorder. Additionally, accidental overdose was the top cause of death in the U.S. in people under the age of 45. More than 700,000 people died because of drug overdoses between 1999 and 2017. And while there was a 4.1% decline in drug

overdose deaths between 2017 and 2018, the number of synthetic opioid overdose deaths continues to rise.^{2 General Drug Use Statistic halfway down section and drug-related deaths in the US}

By seeking substance abuse help, you can avoid becoming yet another statistic in this global health crisis before it’s too late.

What are Tolerance, Dependence and Addiction?

People often confuse tolerance and dependence with addiction, but they are very different terms. Tolerance means that your body becomes accustomed to the presence of the substance due to repeated administration and you require more of the substance to achieve previous results. For example, if you drink alcohol for the first time, you might get drunk after just 1 or 2 drinks, but someone who has been drinking for years needs to drink a much higher amount just to get a buzz. Dependence means that you need the substance to feel normal and to function; when you stop using it, you experience withdrawal, which is a group of symptoms that can range from mild to severe, depending on the specific substance you use.^{3 tolerance, dependence}

Addiction is a chronic, relapsing brain disease that is characterized by cravings, substance-seeking behaviors, and continuing substance use despite the negative impact it has on a person’s life. It is synonymous with a substance use disorder (SUD), which is the diagnostic term used by the American Psychiatric Association (APA). According to the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the criteria for a SUD diagnosis include:^{4 DSM p. 483-484 and 5 top paragraph in bold for alcohol withdrawal (last bullet)}

• Taking the substance in larger amounts or for longer periods of time than originally intended. You might say that you’re going to have only 1 drink, yet 1 drink turns into an entire bottle.
• Expressing a desire to cut down your substance use yet being unable to do so. You may tell family members or friends that this time, you’re going to stop using. Yet although you mean well, you start using again as soon as you experience a craving.
• Spending a lot of time trying to obtain, use, and recover from the effects of the substance. This could mean that you spend a lot of time in bed recovering from a hangover or spend a lot of time trying to find a new supply of drugs.
• Experiencing cravings, or strong urges to use. These can occur at any time of day but are more likely when you are exposed to environments in which you have obtained or previously used the substance. For example, you may feel a strong urge to drink if you’re at a restaurant or bar with friends.
• Being unable to fulfill obligations at work, home, or school due to substance use. For example, you might miss work because you are hungover or you forget to pick up your children from school because you’ve been using drugs.
• Continuing to use the substance despite experiencing interpersonal or social problems caused by the effects of the substance. For example, you may be on the verge of a divorce or you may be fighting with your friends because they want you to get help for your addiction.
• Giving up activities you once enjoyed so you can use the substance. You may have previously spent your weekends engaged in sports or other hobbies, but now you feel only like drinking or using drugs.
• Using the substance in situations where it is risky or dangerous to do so. For example, you might get high before driving or operating machinery or while taking care of children.
• Continuing to use the substance even though you know (or suspect) that you have a physical or mental health problem that is likely due to substance use. For example, if you have an alcohol-related health problem like cirrhosis, you may continue drinking despite knowing that this is detrimental to your health.
• Experiencing tolerance, meaning you need increasing amounts of alcohol or drugs to get high or drunk.
• Experiencing withdrawal symptoms when you try to stop using, which usually leads to relapse. Withdrawal symptoms can vary by substance and may only result in mild symptoms with some substances, but in some cases, such as in alcohol withdrawal, you can experience serious issues such as seizures, delirium, hallucinations, and even death.

If you are wondering how to know if you’re an addict, the APA says that people who meet at least 2 of the above criteria are said to have a SUD.^{6 DECISION, above the how should severity be represented section}

Do Your Friends Acknowledge Your Addiction?

Your friends and social circle can play an important role in both your addiction and recovery. On the one hand, if you have friends who also use drugs or alcohol, it can be more difficult to stop using, especially if you feel pressure to use with them or if you experience cravings when you are together. On the other hand, your supportive friends could be the first to notice if you have an addiction. This can create friction, for example, if they want to help you but you are not ready to admit that you have a problem. If this is the case, you may notice that you’re fighting more with them or avoiding seeing them so you won’t have a confrontation.

Ask yourself the following questions:

• Do your friends also use drugs or alcohol?
• Have you been hiding your drug use from them?
• Would you be able to tell them if they (or you) had a problem?

Is Your Addiction Impacting Your Job?

Your career is another place that can be affected by addiction, especially if you find that you aren’t able to keep up with your job responsibilities or if you’re taking too many days off to recover from substance use. People known as high-functioning addicts can maintain a job, fulfill family duties, and maintain relationships. This amounts to living a double life because you can keep up the façade of normalcy while still suffering from the addiction.

High-functioning addicts often are in denial about their situation. They feel that they have everything under control and can still function in their day-to-day lives, so they may not think that their addiction is a problem. They never ask themselves, “Am I addicted to drugs or alcohol?” In an article published in the Canadian Medical Association Journal, Dr. Steven Melemis, a Toronto-based physician specializing in addiction, says that “a [person with an addiction] knows you need your job first and foremost to continue with your addiction.” ^{7 section above the picture}

However, if you are a high-functioning addict, you should also know that your addiction will probably get worse over time. Your work will begin to suffer and without drug abuse help, you will face physical, mental, social, job, and economic consequences.

Addiction Progressively Gets Worse Over Time

Addiction is a progressive disease considered to be both a mental illness and a brain disorder.^{8 what is drug addiction} It is measured on a spectrum ranging from mild to severe, so it’s possible that even if you suffer from a mild addiction now, you may have a significant risk of it developing into a more serious diagnosis in the future. The best way to know when to go to rehab for alcohol or drugs is to consider why you might be reading this article. If you are asking yourself, “Do I need rehab?” then you probably already realize on some level that seeking drug addiction help now is crucial to preventing things from becoming worse. 

Getting Help for Substance Abuse

Professional rehab offers the best chance for you to get your life back and avoid the negative consequences of remaining in the cycle of addiction. Beating addiction requires that you eliminate your physical dependence on the substance and address the underlying behavioral and psychological issues associated with substance use. If you want to know how to get help for addiction, keep in mind that one of the best ways to start the process is to engage in a detox program that provides medical supervision in an appropriate setting. This will allow you to eliminate the physical dependence as safely and comfortably as possible while the substance is gradually removed from your body.

It’s never too late to seek help. If you’ve answered yes to the question, “Do I have a substance abuse problem?” then you know you need help with your addiction. Getting help for substance abuse is one of the most important steps you may ever take to regain your health and well-being.