Between Substance Use Problem and Action: What Does It Take To Make a Change?
Many people that come to us are excellent parents, partners and work colleagues. They show up for everyone and contribute to society. Yet during their intake, they share they are using substances regularly.
We’ve been led to believe that to have a substance use problem, our lives and relationships have to be a wreck filled with debt, conflict and instability. But is that really true?
What are the signs that you may have a problem with a substance?
Let’s start with the formal diagnostic definition.The DSM (Diagnostic and Statistical Manual of Mental Disorders) lists the following criteria, and to qualify for the diagnosis you must have experienced 2 of the 11 symptoms listed over the period of a year (12 months):
Using larger amounts: Using the substance in larger amounts or for longer than you meant to.
Failed attempts to cut down: Wanting to cut down or stop, but failing to do so.
Time spent: Spending a lot of time to get, use, or recover.
Cravings: Feeling a strong urge or desire to use the substance.
Neglected roles: Failing to do what you should at work, home, or school because of use.
Relationship problems: Continuing to use even though it causes trouble with family or friends.
Giving up activities: Stopping important social, work, or fun activities because of use.
Dangerous use: Using the substance in unsafe situations, like driving.
Knowing it causes harm: Continuing use even though it makes a physical or mental health problem worse.
Tolerance: Needing more of the substance to get the same high or effect.
Withdrawal: Feeling sick or having uncomfortable symptoms when you stop or cut back. [1, 2, 3, 4, 5]
When you read the list, how many of these criteria ring true for you?
Maybe you are able to show up at work with no problems. But how is substance use affecting your health? Are you waking up with a headache, or do you experience shaking if you don’t consume?
Perhaps your relationship is not struggling. Could your partner be enabling your use to keep the peace? Or maybe they, too, enjoy using substances with you. For many, substance use is a ritual tied with relaxation or escape from the everyday stressors of work, money and even politics.
If I were to ask you if you could stop using the substance right now, what would you say?
We commonly see people’s need to reach “rock bottom” for a change to be possible. An accident, a health crisis or losing a job can trigger a realization that it’s time to change one’s relationship with substances. But for many who don’t see substance use as a problem, finding a compelling enough reason to quit can be challenging. Consider whether you could quit using substances today, and answer yourself honestly. Could you? Would you want to? Or do you find yourself reasoning that you’ve managed until now, so maybe there is something you can do to keep it in your life?
What lies between the substance problem and taking action?
Now, consider what is keeping you from taking action. Is the substance your only way to escape hard things every day? Do you fear the discomfort of being present? If you do stop, will it create challenges with your partner who also uses? Are your challenges financial? There can be so many reasons here, but recognizing yours can be the start of a healthier relationship with yourself.
Remember: relapse is a part of recovery.
Substance use changes your brain and can leave you with increased cravings. Recovery often comes with relapse, and therefore shame. Having a therapist, group and sponsor to walk alongside you can increase your ability to continue working toward your goals rather than spiraling out.
How can talk therapy help you consider your relationship with substances?
Perhaps you are interested in making small changes in your substance use, or considering what it would be like to abstain completely. A therapist familiar with the challenges of substance use and how it can affect your life can be a safe, private, and understanding place to discuss your concerns and consider how you want to change your relationship with substances. A skilled therapist will explore your concerns alongside you, supporting you in your own goals and desired life changes. A good therapist will never judge you or set goals for you.
You can contact Intuitive Therapy Partners for a free consultation to determine whether one of us could be a good match for your substance use journey. Consultations are free of charge and are confidential.
Spencer Korte, LLMSW, specializes in substance use management and sobriety. Spencer meets you where you’re at, no matter where that may be. Schedule a free consultation or read more on Spencer Korte's therapist profile. Spencer sees clients in person in Ann Arbor, MI, with telehealth options available. He accepts BCBS, Aetna and has a sliding scale is available.