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How do I know if I have an addiction?

It’s usually hard for people to recognize they have a problem, which is why friends or family often step in. People with good intentions may have tried to pass on information to you about your behaviour or you may have some preconceived ideas about what behaviour actually constitutes an addiction. This information about addiction may sometimes be inaccurate and as long as you can stop for a while you may become convinced that you don’t have a problem.

Below are some issues to contemplate that may help you come to a decision about whether your drug use/behaviour may be considered problematic.

First things first – who is an addict?

The first thing to come to terms with is that addiction is NOT defined only on how much you use/engage in a behaviour or how often you do. But rather WHAT HAPPENS WHEN YOU DO. An alcoholic is not always someone who has a drink first thing in the morning nor is it always someone who can’t make it through the day without it. A drug addict isn’t always lying in the gutters of Hillbrow with a needle in his arm and a sex addict is not someone who seeks out sex all the time. The binge drinker, the drug user who uses only on weekends, the gambler who make s it a rule never to miss a day of work, the addict in Hillbrow, the first-thing in the morning drinker, the compulsive overeater who hides binge episodes and the compulsive sex addict may all experience similar effects of addiction, despite the fact that their using patterns differ. So while the frequency (how often) and quantity (how much) of their addictions may vary, they share a common compulsive (when I start I can’t stop) intensity in the relationship with their drug/behaviour.

So what do all addictions have in common?

What is generally shared by people who are addicted is a loss of control over their drug/behaviour resulting in a feelings of chaos, guilt, shame and general unmanageability. They also tend to continue using or engaging in the behaviour regardless of the consequences it has caused in their life. While initial drug use or initial engagement with a behaviour may have been voluntary, the repeated use of the substance or behaviour causes chemical changes in the brain which eventually result in drug use/the behaviour becoming compulsive in nature (i.e. they cannot stop). While the criteria for diagnosing different addictions may vary, what they all seem to share in common include: Tolerance as defined by any of the following:

A need for markedly increased amounts of the substance to achieve intoxication or desired effect “I need to use more, drink more, eat more/less, gamble more in order to feel the way I used to.” Markedly diminished effect with continued use of the same amount of the substance. “I don’t feel the same way I used to in the beginning.” Withdrawal, as manifested by either of the following:

The characteristic withdrawal symptom of the substance “When I stop I feel anxious; sweaty; nauseous, shaky; paranoid; guilty, sick and so forth.” The same or a closely related substance is taken to relieve or avoid withdrawal symptoms “I use more so I don’t feel anxious; sweaty; nauseous, shaky; paranoid; guilty, sick and so forth.” The substance is often taken in larger amounts or over a longer period than was intended:

“I only meant to use a little bit, I didn’t mean for it to go on for 2 days.” “I thought I would stop after one drink.” “I only drew R500 for the night. I promised myself I wouldn’t spend a cent more. So how did I go through R5 000 in one night?” There is a persistent desire or unsuccessful efforts to cut down or control substance use:

“I am never going to do this again (until next week).” “If I can just stop for a few days, that must mean I don’t have a problem.” “It’s the vodka that’s the problem. I am switching to wine.” “I will leave my credit card at home tonight. That will stop me from going overboard.” A great deal of time is spent on activities necessary to obtain the substance and or engage in the behaviour, or recover from its effects:

“I will use my credit card to pay for dinner but I will take the cash from everyone else to pay for my stuff.” “I know I am going to have a big night so I will cancel all my plans for tomorrow and make sure I have a believable story for why I shall not answer my phone.” Important social, occupational or recreational activities are given up or reduced because of substance use:

“I will have to leave the wedding early because there is a big poker tournament tonight.” “I feel so sick after last night I’m sure the family will understand if I don’t make it to lunch (again).” “I missed work again because of a bender. I better get a doctor’s note for my boss – he is starting to get fed up with me.” The substance use is continued despite knowledge of having a persistent or recurrent physical, psychological, social or legal problem that is likely to have been caused or exacerbated by the substance use:

” feel so guilty and ashamed about what I did last night. I can’t believe I did that!” “I just can’t seem to hold down a job, what’s wrong with people?” “Everyone is giving me hassles, telling me I have changed. They are all mad!” “I had a nose bleed/black out last week from using. That’s never happened before it kind of freaked me out a bit. I better try to cut back a bit.”

I haven’t done that… yet

Another thing to be bear in mind is that people often compare the things they have done as a result of their addiction in an attempt to justify why their addiction isn’t “bad”. While it is undeniable that some people have done things that you may not have in order to get drugs, alcohol, sex, money and so forth, the reality is that it’s probably because your addiction hasn’t gotten there YET and it doesn’t have to!. Addiction is a progressive disease, which means that over time IT IS GOING TO GET WORSE. We didn’t say in a day or a month or a year. The truth is the progression can be quick or it can be slow. However, of one thing we are certain: if you have an addiction eventually you will do things that you never imagined you would.

I think I may have a problem, what do I do now?

If any of the above rings true and you are compelled to do something about it, well done! We know it can be a harsh eye-opener and it may feel like a tough reality check but it is necessary to understand your addiction for what it is, so that you can take the necessary steps to get the help you need. In order to encourage you to do this, it may be a good idea to reach out to someone you love and trust and allow them to support you through this. If you are unsure about the type of help you need, here’s an outline of scenarios and options that may help you find an approach that works for you 1. I Want to go to a treatment Center 2. I want to go to a individual Therapist 3. I want to go to a support group in my area.

Please look at www.findHelp.co.za for any of the above.