Wednesday, May 2, 2012

Do You Have a Substance Abuse Problem? If So, Options for Dealing With It

This is my next column in the Mensa publication, The Intelligencer. I thought you might like an advance look.

Smart people are particularly adept at rationalizing their substance abuse, for example:

"I can handle it."  Are you sure? Have people hinted that you might have a substance abuse problem? And look inward: Is your motivation, drive, and yes, even brainpower, not what it was? Might your substance use be contributing?

"I can stop whenever I want." For how long? Sooner rather than later, are you back off the wagon?

"Drugs or alcohol so help me cope with life that it outweighs substance use's liabilities."  Might you have less misery to cope with if you weren't so often under the influence?

"My life is unalterably miserable, so it doesn't matter if I kill some more brain cells." Most people's lives are alterable. Taking baby steps forward may help but it's hard to take them if you're often high.

"I'm more creative when I'm high." When you evaluate your creative efforts when you're sober, are they really better?

"I'm more likeable when I'm high."  Would your friends and family say that?

"I'm smarter than most people. I have brain cells to spare."  In this job market? With life ever more complicated?

"My kids won't be affected." Do you really believe you're as good a parent when you're under the influence? And we all know that kids imitate their parents, so it's likely that your kids will follow in your substance-abusing footsteps. Is that okay with you?

The most frequent rationalization: "I must satisfy my urge to feel good right now."  Really? Must you? And is there no better, less side-effect-ridden way to feel good than to get drunk or high?

As a former drug counselor and now a career and personal coach for 26 years, having worked with 3,900 clients, I have so often seen substance abuse damage people's careers and personal lives. Even a high IQ may not be enough to compensate. Sure, most Mensans have enough brainpower to avoid being permanently unemployable, but many admit that drugs or alcohol have made them so much less successful and happy than they otherwise could have been. Yet most of them can't kick the addiction for good.

How to know if you have a problem? So many people with a substance abuse problem claim they don't have one. Take a step back and think about the complications that substance use has brought into your life. It may also be helpful to ask those who care about you for candid feedback on your use of drugs or alcohol.

The following offer reasonable prospects for getting clean and sober. One size does not fit all, but I'm hoping you'll find at least one suggestion on this list that is worth trying. If necessary, treatment should also address your mental and physical health concerns.

Moderation? Some people can be functional alcohol/drug users--if they have the discipline to keep it moderate. Others cannot function well-enough with even modest drug/alcohol use.

12-Step programs.  These programs, for example, Alcoholics Anonymous and Drug Addicts Anonymous tend to work better for people of faith or who prefer a treatment that addresses emotions as well as the rational. To find a 12-step program for yourself or someone you care about: http://en.wikipedia.org/wiki/List_of_twelve-step_groups.

Cognitive behavioral therapy helps correcting people erroneous thinking such as those rationalizations listed above. It also includes teaching the person abuse-prevention skills, for example, having a scripted response to, "Would you like a drink or a joint?" "No, I've had enough." or, "I'll have to drive," whatever. To find a non-12-step self-help group, you might try SmartRecovery: www.smartrecovery.org.

Medication? A physician can prescribe a medication that often is very effective in helping you stop your abuse. Such pharmacotherapy can be particularly effective when someone you're living with starts each day by thanking you for committing to being clean and sober that day, then gives you the pill and a hug.

Picture how your life would be better? Keep front-and-center the ways your life would be better if you stopped, and the price you've paid for your substance abuse. San Francisco cognitive-behavioral therapist, Dr. Michael Edelstein recommends going further: "Five times daily, without fail, vividly read and write the pros and cons of kicking. Don't stop this discipline when you're doing better."

Can a relationship help? Sometimes, a partner's help is the most effective. If your partner has a substance abuse problem, yes be a good listener, yes praise their strengths, and don't be an enabler. For example, don't do their work for them to keep them propped up. They do need to experience the consequences of their abuse.

Some people stop only because of a relationship: for example, they fall in love, get pregnant, or their sibling stopped using drugs and the person didn't want to be the only family member with a substance abuse problem. 

Do you have to hit rock bottom? Alas, some people stop only when they've hit rock bottom: They're so exhausted from the toll of living the addict lifestyle that they just are sick and tired of being sick and tired. Edelstein urges, "Refuse to give up. You can succeed on the 100th try."

Is there a better way to derive pleasure? At the risk of sounding like a goody two-shoes, there really are ways to get high on life without drugs. For example, I get real pleasure from helping my clients, writing, hosting my radio show, playing in the garden, my wife and I having a couple over for dinner, walking my doggie, Einstein, indeed in writing this column. How could you fill your life with enjoyable activities that don't have negative side effects?

1 comment:

  1. Another great job, Marty! On a related note, my next-door neighbor and carpool buddy, who works at a sizable automotive supply and repair company, tells me that his company is chronically understaffed (even today) because this company drug tests its new employees, and about a third of its new hires fail the drug tests. And that's the urine test, which detects recent drug use; another third fail the hair test, which detects long-term drug use.

    When I heard this, I was quite shocked. Yes, I admit I've lived a somewhat sheltered life, but I had no idea that drug use was so widespread.

    So, getting clean and sober is a key factor in getting and keeping jobs. Furthermore, in more prosperous times, people may have turned a blind eye, but not anymore.

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