Recovery Road

What is ADDICTION (a.k.a CHEMICAL DEPENDENCE)?

Answer yes or no to the following seven questions. Most questions have more than one part, because everyone behaves slightly differently in addiction. You only need to answer yes to one part for that question to count as a positive response.

1. Tolerance. Has your use of drugs or alcohol increased over time?

2. Withdrawal. When you stop using, have you ever experienced physical or emotional withdrawal? Have you had any of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting?

3. Difficulty controlling your use. Do you sometimes use more or for a longer time than you would like? Do you sometimes drink to get drunk? Do you stop after a few drink usually, or does one drink lead to more drinks?

4. Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?

5. Neglecting or postponing activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?

6. Spending significant time or emotional energy. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?

7. Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?

If you answered yes to at least 3 of these questions, then you meet the medical definition of addiction. This definition is based on the American Psychiatric Association (DSM-IV) and the World Health Organization (ICD-10) criteria.

Alcohol addiction, alcoholism, and alcohol dependence all mean the same thing. No one term is more serious than the other. Different terms have evolved over the years to overcome the negative stigma of addiction, and to make it easier for people to reach out and ask for help. The same is true for the terms drug addiction and drug dependence.

There are different levels of addictions. At one end of the spectrum is the non-functioning addict or alcoholic. They've lost their job and have to use everyday. This is what people think addiction is like, but that stereotype is rare.

At the other end of the spectrum is the functioning addict or alcoholic. They still have a job and their relationships are relatively intact, but their life is suffering because of their addiction. That is the most common scenario. You don't have to suffer major losses to have an addiction.

The consequences of addiction get worse over time. Addiction is a progressive disease. It's never easy to quit. But if you've already suffered negative consequences and don't want them to get worse, there's never a better time to quit than now.

Take the Quizzes
Alcohol Quiz
Drug Quiz

Is Addiction a Disease?

Addiction is like most major diseases. Consider heart disease, the leading cause of death in the developed world. It's partly due to genes and partly due to poor life style choices such as bad diet, lack of exercise, and smoking. The same is true for other common diseases like adult-onset diabetes. Many forms of cancers are due to a combination of genes and life style. But if your doctor said that you had diabetes or heart disease, you wouldn't think you were bad person. You would think, "What can I do to overcome this disease?" That is how you should approach addiction.

Addiction is not a weakness. The fact that addiction crosses all socio-economic boundaries confirms that addiction is a disease. People who don't know about addiction will tell you that you just need to be stronger to control your use. But if that were true then only unsuccessful people or unmotivated people would have an addiction, and yet 10% of high-functioning executives have an addiction.

If you think of addiction as a weakness, you'll paint yourself into a corner that you can't get out of. You'll focus on being stronger and trying to control your use, instead of treating addiction like a disease and focusing on stopping your use.

Cross Addiction

You can become addicted to any drug, if you have a family history of addiction.

If at least one of your family members is addicted to alcohol, you have a greater chance of developing an addiction to any other drug. Cross addiction occurs because all addictions work in the same part of the brain. If your brain is wired so that you're predisposed to one addiction, then you're predisposed to all addictions.

This is especially important for women who may come from alcoholic families, but who often develop addictions that go undetected, like addictions to tranquilizers, pain relievers, or eating disorders.

One addiction can lead to other addictions, and one drug can make you relapse on another drug.

That's one of the consequences of a brain that's wired for addiction. Suppose you're addicted to cocaine. If you want to stop using cocaine then you have to stop using all addictive drugs including alcohol and marijuana. You may never have had a problem with either of them, but if you continue to use alcohol or marijuana, even casually, they'll eventually lead you back to your drug of choice. Recovery requires total abstinence.

How does the use of other substances cause relapse?

1. All mind and mood altering chemicals work in the same part of the brain. A drug is a drug is a drug. Therefore, one drug can lead you back to any other drug.

2. Even moderate drinking or smoking marijuana lowers your inhibitions, which makes it harder for you to make the right choices.

3. If you stop using your drug of choice but continue to use alcohol or marijuana, you're saying that you don't want to learn new coping skills and that you don't want to change your life. You're saying that you want to continue to rely on drugs or alcohol to escape, relax, and reward yourself. But if you don't learn those new skills, then you won't have changed, and your addiction will catch up with you all over again.

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