How do I know if I have an addiction or substance use disorder?

The use of drugs and alcohol has been found to be high in the LGBTQ community by various studies. But how do you know when you are just having fun or actually have a problem that may need some form of treatment?

When it comes to substance use disorders (alcohol or drugs), otherwise commonly called addiction, they are categorised as being mild, moderate and severe. These are aligned to criteria that are listed in The Diagnostic and Statistical Manual of Mental Disorders (DSM), 5th Edition.

This clinical manual identifies that these disorders develop over time or can appear after the first time someone uses. During the early stage of substance use, it is often difficult to identify if this use is problematic. However, as negative consequences start being experienced, a substance user should start questioning the possibility they may be developing a substance use disorder.

What is critical is that the problem is identified as early as possible, so that steps may be taken to halt the progression of the disorder and move towards becoming healthy again.

How do you know if you have a substance use problem?

Everybody has a different physiology and life context and, as a result, does not experience the same issues with using substances. Some may experience physical dependence on the substance and go through withdrawal if they do not use, while others may experience mental or psychological dependence on the substance, where use creates a state of comfort in social situations. Others may use substances to cope and can be said to ‘self-medicate’.

Signs of dependence on substances include:

• Memory loss or blacking out
• Conflict with loved ones or the people you have close relationships with
• Irritability, depression, or mood swings
• Using substances to feel “normal” or to alter one’s mood
• Sleep difficulties or needing to use substances to cope with problems
• Headaches, panic attacks, insomnia, nausea, diarrhea, sweating, tremors and shaking, nightmares, hallucinations, or other withdrawal symptoms
• Appearance changes, including flushed skin, discolored eyes, and broken capillaries
• Using when alone, first thing in the morning, or in inappropriate or risky situations
• Keeping substance use secret or lying about how much or frequently you use

How are family and friends impacted?

Substance use disorders initially start to appear within your relationships that are closest to you. These signs are often exhibited as repetitions of the same fights, a sense of isolation from your loved ones, and a sense that you cannot ask for help. This means if you are using substances, it is vital to watch for any changes in your relationships with yourself and those around you. These changes may include:

Loss of Control: if you use more substances, for longer periods and when you hadn’t planned to, this is a sign that you are losing control over your substance use.

Neglecting Activities: If you find yourself not engaging in activities you used to enjoy and have replaced these with using substances or activities linked to it, such as socializing with people who you feel won’t judge your substance use.

Risk Taking: If you find you are engaging in behaviours that are unsafe or put yourself at risk in order to obtain your substance. The use of substances can drive a person to take risks they normally would not take, thus putting substance use about theirs or others’ safety.

Relationship Issues: People closest to a substance user are always the first to see changes and often engage in criticizing the substance user’s behaviours. These relationships often become characterised by conflict, anger and resentment as a result of substance use.

Is substance use a choice, a lifestyle, or a problem?

When you are using substances in spite of experiencing negative consequences, you can confidently say that you are showing signs that your use of substances has become problematic, and that you are exhibiting signs of a substance use disorder. In this case, using substances has moved from a conscious choice to a situation where use is driven by physical and psychological needs.

Signs that you need to seek help for your substance use:

Secrecy: You spend an inordinate amount of time and energy hiding your use, what you are using, the amount and frequency. This involves needing to lie and engaging in risky or illegal behaviours to do this.

Appearance Changes: Signs that your use is impacting your health or creating changes in personal hygiene and physical appearance are all signs that you need to get help.

Family History: If you have a family member who used or uses substances this puts you at a much greater risk of developing a substance use disorder.

Tolerance: In this situation, you find that you need to use more substance to get the same effect, or you find that using the same amount of substance has less of an effect than it used to. Along with needing to use the substance more frequently and for longer periods; this includes engaging in planning for substance use “holidays”. Planning how much substance you need to buy also shows that you have developed tolerance.

Though there are many negative consequences of using substances, seeking support has far more benefits. People often find that the physical, social, interpersonal, and psychological problems that came along with their substance use can be resolved once they begin to manage their substance use disorder effectively. If you think you might have an issue with substances take the test below:

1. Do you often think about or crave drugs or alcohol?
2. Have you ever tried to stop or cut down on your drug or alcohol use, but couldn’t?
3. Have you ever felt you wouldn’t be able to fit in or have a good time without being under the influence of drugs or alcohol?
4. Do you find yourself using more than you meant to or needing more to get the same effect?
5. Have you ever used a drug without knowing what it was or how it could impact you?
6. Have you ever taken one drug to get over the effects of another?
7. Have you ever made a mistake at a job or at school because you were using drugs or alcohol?
8. Does the thought of running out of drugs or alcohol scare you?
9. Have you ever stolen drugs from someone or stolen in order to pay for drugs?
10. Have you ever been arrested or hospitalised because of your drug or alcohol use?
11. Have you ever overdosed?
12. Has using drugs or alcohol hurt your relationships with family and friends?

If you answered yes to some or all of these, you may be struggling with a substance use disorder and you are urged to seek further qualified advise and support.

Inner Peace, a non-profit organisation, provides residential treatment to LGBTQ people with substance use disorders that meets these requirements, and more. It’s a unique safe place for treatment for all LGBTQ individuals. If you feel that substance use is taking control of your life, contact Inner Peace on their website or call 023 741 1029.