How Do I Know If I Have a Substance Abuse Problem?

According to an important national survey conducted in 2014, over 20 million Americans ages 12 and older had a substance use disorder within the previous year1. That is a shocking but perhaps not a surprising statistic. Substance Abuse

How do you know if you have a substance abuse problem? Often times, people attempt to answer this question based on the amount or frequency of their use, but numbers don’t give a very clear picture. It may be more useful to consider the impact that your use of alcohol and/or drugs has on the quality of your life. For instance, if you find that your use causes you to neglect important responsibilities or repeatedly leads to tension or arguments with important people in your life, you may have a substance use disorder.

When alcohol and drug counselors and mental health professionals assess for substance use problems, they ask a number of questions including the following:

* Do you use substances in larger quantities or over a longer period of time than you intended?

* Do you have a persistent desire—or have you made unsuccessful attempts—to cut down or control your use?

* Do you spend a great deal of time obtaining substances, using substances and/or recovering from the effects of your substance use?

* Do you experience cravings or a strong desire to use substances?

* Does your use repeatedly interfere with your ability to fulfill your obligations at work, school or home? For instance are you less able to focus at work or do you spend less time with your children because of your use?

* Do you continue to use despite recurrent social or interpersonal problems that are caused by or made worse because of your substance use? Examples include becoming more argumentative or isolative when using or having arguments with your spouse about your use.

* Have you reduced or given up important social, occupational or recreational activities because of your use? For instance, are there activities that you used to enjoy but now don’t care about or have time for because of your use?

* Do you use substances in situations that are physically hazardous? Examples include driving while under the influence, having unprotected sex, sharing needles, and putting yourself in potentially dangerous situations where you may harm someone or be harmed.

* Do you continue to use substances even though this causes or worsens a medical or psychological problem? Examples include neglecting a medical condition or finding that your use leads you to feel more depressed.

* Over time, do you find that you need to use a larger amount of a substance to achieve the desired effect? Or do you find that using the same amount has less of an effect than it used to?

* Do you experience withdrawal symptoms if you stop using a substance? Or do you use a substance to avoid withdrawal symptoms (such as drinking in the morning to alleviate a hangover)?

If you answered yes to two or more of these questions, you may have a substance use disorder. If you believe you have a problem with drugs or alcohol or are questioning whether you do, I urge you to discuss your concerns with a therapist or counselor who can assess your use, and if needed, recommend appropriate treatment options. It is not easy to admit a drug or alcohol problem, but recognition is the first step. Please know that support and help are available!


Written by Elena Walker, MA, LPCC



2014 National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration (SAMHSA).