Substance Abuse


How do I know if I have a problem?  While there are certainly diagnostic criteria (as described below) in our experience working with people who are trying to figure out their substance use there is often a knowledge within the person that states the answer to that question.  In other words, a look in the mirror, an echoing within one’s own ear can usually help you tell yourself the truth.


According to the DSM-5, a “substance use disorder describes a problematic pattern of using alcohol or another substance that results in impairment in daily life or noticeable distress.” As with most addiction problems, despite any consequences a person who has a problem with either alcoholism or drugs suffers, they will generally continue to use their drug of choice. They may make attempts to stop or cut back their use, usually to no avail.


The DSM-5 states that in order for a person to be diagnosed with a disorder due to a substance, they must display 2 of the following 11 symptoms within 12-months:

  • Consuming more alcohol or other substance than originally planned

  • Worrying about stopping or consistently failed efforts to control one’s use

  • Spending a large amount of time using drugs/alcohol, or doing whatever is needed to obtain them

  • Use of the substance results in failure to “fulfill major role obligations” such as at home, work, or school.

  • “Craving” the substance (alcohol or drug)

  • Continuing the use of a substance despite health problems caused or worsened by it. This can be in the domain of mental health (psychological problems may include depressed mood, sleep disturbance, anxiety, or “blackouts”) or physical health.

  • Continuing the use of a substance despite its having negative effects in relationships with others (for example, using even though it leads to fights or despite people’s objecting to it).

  • Repeated use of the substance in a dangerous situation (for example, when having to operate heavy machinery, when driving a car)

  • Giving up or reducing activities in a person’s life because of the drug/alcohol use

  • Building up a tolerance to the alcohol or drug. Tolerance is defined by the DSM-5 as “either needing to use noticeably larger amounts over time to get the desired effect or noticing less of an effect over time after repeated use of the same amount.”

  • Experiencing withdrawal symptoms after stopping use. Withdrawal symptoms typically include, according to the DSM-5: “anxiety, irritability, fatigue, nausea/vomiting, hand tremor or seizure in the case of alcohol.”


Getting experienced help through counseling / therapy can help you make the changes you are desiring -- often uncovering what is surrounding the substance abuse / mis-use.