Take this short quiz to find the answer to this serious question
In 1956, the American Medical Association officially recognized alcoholism as a disease. Since then, the medical community has treated addiction to alcohol and drugs the very same it has treated cancer and schizophrenia. Although the classification of addiction as a disease has been unwavering, the actual criteria identifying someone as having the disease have, over the past half century, continued to be refined. The newest changes are set to go into effect this October 2014. How will they affect you and/or the person you know who is abusing chemicals? Based on these new changes, who is, and is not, an addict?
Treated as a disease is a good thing
The good news is that we understand addiction. Even without knowing the actual chemical of choice, we know what symptoms to look for. We know that addiction causes other diseases or makes existing illnesses worse. We know addiction will always get worse if untreated, and that there is no “cure.” If ignored, addiction is fatal. We also know how to treat addiction to put it into remission for life. Not only is it a treatable, but it’s diagnosis as a disease means insurance will pay for treatment. For the sufferer, such a diagnosis should be the genesis of hope because effective treatment known and available everywhere.
Who is, and is not, an addict?
As our culture evolves and abusive substances change, there is a constant need to refine the criteria that identifies someone as an addict. The year 2000 was the last time such changes were implemented. If you had an unhealthy relationship with alcohol or drugs you were classified as either an “abuser” or as “dependent.” A separate set of criteria applied to each. Soon problems became apparent. For example, under these guidelines, anyone under a physician’s care who was administered a drug over a lengthy period for legitimate reasons met the criteria for “dependence.” So, if you suffered from rheumatoid arthritis and were forced to rely on pain killers, your body would become physically dependent on that chemical. You would therefore be dependent and lumped in with the heroin users even though you would have no desire to use chemicals if not for your condition. Professionals and clients alike said… huh?!
This didn’t make sense. So, come October 2014, the criteria identifying a person as an addict will change. The old categories of abuser and dependent are done away with. Even the terms “addict” and “alcoholic” are to be used in the most general sense. The “addict” who had a disease of “chemical dependency” can now be assessed using a single set of criteria. If they meet the criteria they are diagnosed as having a “Substance Use Disorder.” One set of criteria, one disease. Equally important, the new guidelines allow the counselor or clinician to identify the disease as “mild,” “moderate” or “severe” substance use disorder based on the number of criteria met. That’s great news. It means more individualized treatment for everyone.
Do you, or does someone you love, have substance use disorder? Take the test. Which of the following apply?
• Compulsion, or using more or for longer periods than intended.
• A persistent desire or repeated unsuccessful efforts to cut down or control substance use.
• Considerable time is spent on activities necessary to obtain, use or recover from the substance.
• Craving, or a strong desire or urge to use the substance.
• Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
• Continued substance use despite having persistent or recurrent social or interpersonal problems caused or worsened by the effects of the substance.
• Isolation, or important social, occupational, or recreational activities are given up or reduced because of substance use.
• Recurrent substance use in situations in which it is physically hazardous.
• Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or worsened by the substance.
• Tolerance, as defined by either a.) a need for markedly increased amounts to achieve the intoxication, or, b.) a markedly diminished effect with continued use of the same amount of substance.
• Withdrawal, as defined by either a.) characteristic withdrawal syndrome, or b.) the substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms. (Note: no Withdrawal criteria for hallucinogens. No withdrawal criteria for sedative/hypnotic/anxiolytic or for stimulants if under medical supervision.)
Scoring is as follows: 2 – 3 = Mild substance use disorder. 4 – 5 = Moderate substance use disorder. 6+ = Severe substance use disorder.
This simple test can save your life. If you scored a 0 or 1 then congratulations. But you still have to watch your butt whenever chemicals are involved in your activities because you never know if you have a substance use disorder until it’s too late. For everyone who scored a 2 or above I urge you to 1.) be especially careful, and, 2.) be assessed by a professional to find out if you have a substance use disorder, the severity, and what to do about it. The worst thing you can do is do nothing. If you or a loved one is suffering, contact me and I’ll point you in the right direction.
Keith Angelin, MBA, CADC-II, CNDAI, is a Master’s level, board-certified alcohol and drug counselor, and nationally certified intervention specialist. He is the author of “At Home Recovery Workbook.” Learn more at www.InterventionRx.com. Send your comments to Keith4Counseling@gmail.com.