Kathi Whitten, LCSW - Individual, Couple & Family Psychotherapy

If you think that you, or someone you care about, might be having a substance abuse problem, here is a generic list of things to look for (based on criteria in DSM IV). You may need to seek advice or further information about the particular substance you are concerned with:


* Tolerance—either a need for increased amounts of the substance or markedly diminished effect with continued use

* Withdrawal, manifested by either:

        The characteristic withdrawal syndrome for the particular
        substance being used, or the same (or closely related)
        substance  is taken to relieve or avoid withdrawal symptoms

* The Substance is often taken in larger amounts or over a longer period than was intended

* There is a persistent desire or unsuccessful efforts to cut down or control substance use

* A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects

* Important social, occupational, or recreational activities are given up or reduced because of substance use

* The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

Substance abuse or dependency can encompass alcohol, tobacco, street drugs, over use of prescription medication, caffeine or any other substance that alters or changes one's physical or mental state.

It is very easy (and common) to convince oneself that no abuse or dependency exists where substances are concerned, and often it takes the observations (or even the emotional or legal pressures of significant others) to help a person recognize the severity of their substance use, abuse, dependency.

There is also the phenomenon of "cross addiction," in which people may stop using one substance, and begin with another--not realizing that their brain and body are going to react just as addictively to the new substance.

If you think you, or someone close to you, is either abusing substances or has become dependent upon them, a good assessment is necessary to decide upon the appropriate level of care. 

Other behavioral addictions can be just as destructive in one's life such as gambling, internet porn, disordered eating, shopping, etc.

Sometimes people are concerned about friends or family members who are abusing substances (or in fact dealing with any of the other serious addictions) but don't know what to do, it may help them to see a professional for further advice as well.

is important to know that there exist very good resources for help with every type of addiction (ranging from self-help groups, to out-patient or in-patient therapy for both the addict and family members). Getting an evaluation is the first step (even for a concerned family member or friend) and then a discussion of alternative ways to approach the situation can take place.