Using alcohol or drugs in an excessive manner is rarely about “making a poor choice” or wanting to hurt loved ones. Rather, substance use often serves as an attempt to fill a very real need or to cope with a difficult struggle. This can be loneliness, stress from work or home, feeling inadequate, difficulties interacting comfortably in social situations, feelings of sadness or worthlessness, effects of trauma, or even simply liking oneself and one’s experiences more when using than when sober.
When treating substance abuse or dependence, the underlying issues and needs MUST be addressed alongside one another in order for there to be real change and healing. We cannot ask people to give up their primary coping while leaving the root problem untouched. This is why therapy can also be beneficial to those who are in recovery, even if they have been sober for some time.
Do I have a problem with alcohol or drugs?
Not all alcohol or drug use is inherently harmful, so when should a person begin to wonder if their use is drifting into a realm that might not be healthy? Here are a few questions to ask for consideration:
Do I ever use drugs or alcohol to feel better about myself or to relax?
Do I like myself less when I am sober? Do I dislike how I feel when I am sober?
Is my alcohol or drug use affecting my ability to perform my job or fulfill other responsibilities?
Have I gotten into trouble while using alcohol or drugs?
Have any of my friends or family members voiced concerns about my alcohol or drug use?
Do I ever forget things I do while using drugs or alcohol?
Do I participate in any unsafe or risky behaviors while using alcohol or drugs?
Do I use alcohol or drugs when I’m alone? How often?
Have I ever driven while under the influence of drugs or alcohol or ridden in a car with someone who was under the influence?
Do i need professional help to stop using?
There are always many factors to consider with substance use, such as genetic predisposition (Do many of my extended family members abuse drugs or alcohol?), biological dependence (Am I using in a manner that my body now requires this substance to function effectively?), and appropriate level of care (Is outpatient therapy adequate, or is a higher level of care such as an intensive outpatient program or a detox facility needed at this time?) There is also a higher likelihood of any substance use becoming problematic the younger a teenager is, due to how the brain is developing at this time in life. A therapist who specializes in substance abuse/co-occurring issues can be helpful in exploring appropriate support and how to move forward.
Gaining control over my substance use
One of the most important items for a person seeking to lessen or stop substance use is to have connection. This includes having personal relationships that one can be open with as well as establishing a support system within the recovery community. Many people find this through 12 step meetings such as Narcotics Anonymous (NA) or Alcoholics Anonymous (AA), which are free meetings solely run by others in recovery. It can be very helpful to hear other's accounts that are so relatable, and there is also the opportunity to gain a sponsor (someone who has been in recovery for longer) to guide you in working through the 12 steps. Sometimes people need to try several different meetings before finding a group that feels like "a good fit." If this is still difficult, consider joining a support group in a church setting or some other community setting to provide consistent support. Identify people who you can call in-the-moment when you have the urge to use.
It's important to identify what brings you joy and then to do lots of it. Finding activities or hobbies that you enjoy and find meaningful is important, whether they be related to art, music, cooking, or the outdoors. Exercise is a great activity and outlet, as it increases health, decrease stress, can improve self-esteem, and may also provide opportunities for community connection.
Having other means for coping with difficult feelings and stress is also essential. Consider learning more about meditation and deep-breathing. Begin journaling. There are many grounding techniques and relaxation methods that can be taught by a therapist.
As much as possible, avoid the people, places, and scenarios that are connected to your struggle with alcohol or drugs. This is not a matter of not being "strong enough;" rather, you're protecting your new ways of living and acknowledging with humility that this is difficult. This sometimes means developing new friendships and/or setting clear boundaries with old friends.
Truly carry the mindset of "one day at a time." It is overwhelming to think of making changes that last a lifetime when even living a day or a week sober feels impossible. Focus on living each day the way that you want to. Be proud of each hour that goes by that you don't use and choose to embrace health, life, and all the messy and beautiful feelings and experiences that come with it. Expect that there will continue to be some hurt and suspicion with certain friends and family members in your life -- know that this is normal and part of the process of rebuilding trust and just takes time. Don't let that shame take hold of you -- this is a common reason for relapse. Give yourself heaps of grace. Surround yourself with people who speak positive truth and encouragement into your life and also recognize the victory of another day sober.
Next, read about Therapy for Children in Orange County.