Drug and Alcohol Use

We live in a society where drug and alcohol use is the norm; from the morning coffee to headache tablets, to the office party where alcohol flows freely, to relaxing at home with a cigarette or a joint. Use becomes abuse when it impacts negatively on your life: work, relationships, health, self-esteem etc. and when your use is no longer experienced as a choice. This is when a substance is using and controlling you. The most common substances that are physically addictive are: Alcohol, Nicotine, Prescription drugs (such as Valium), Cocaine, Amphetamines, and Heroin.

Addiction is about coping with stress and, often, routinely avoiding emotional pain. For some individuals, simply being present in their physical bodies for 24 hours without alteration of mood creates an almost intolerable anxiety or depression. Addictive behaviours are often learned. Growing up in a home where stressful events are "dealt with" by pouring a stiff drink, a person learns this skill-set as a coping strategy. Without information to the contrary, this (deficient) skill-set becomes the norm. Theraputic work with addiction acknowledges the attempt to self-soothe through substance use and supports the exploration of developmentally appropriate strategies that achieve the same goal.

One strategy for dealing with addiction is total abstinence, the model supported by Alcoholics Anonymous, Narcotics Anonymous etc. Another strategy is harm reduction. This strategy looks at the harm brought about by the addictive behaviour (to self and/or others) and seeks to reduce it. For example, if drinking a half bottle of Scotch every night leads to being unable to function at work the next morning, starting to drink earlier in the evening on weeknights would allow for a longer time to recover before work. Or deciding to drink a third of a bottle on weeknights would also reduce the harm. All behaviour is motivated toward a goal, consciously or not.

Therapy can help the individual to uncover the goal of the addictive behaviour (trying to get fired, hoping my partner will leave, continuing to avoid painful emotional states) and consider other ways of achieving the same goal which are less damaging, learning skills and capacities previously unavailable. Change is not easy [see "Change Process" under self-esteem] and is more likely to succeed with support.