April 9, 2017
By Maeve O’Leary-Barrett, PhD, Psychologist
Have you ever wondered whether alcohol or drug use is a problem for you? Sometimes it can be hard to tell. Take some of characters we have come to know and love (or hate) in TV shows. In The Mindy Project and Grey’s Anatomy, the main characters deal with break-ups and fights by downing wine and tequila. However, no-one bats an eyelid and they then return to work the next day- no worse for wear. At times, Don Draper’s drinking is considered macho and even romantic in Mad Men– at least not out of the ordinary compared to those around him (although we do start to realise that he is having problems with alcohol use in later seasons). For others like Jesse Pinkman (Breaking Bad) and Frank Gallagher (Shameless), it can seem clearer that substance use is getting in the way of them leading fulfilling lives- to say the least. But it’s not always that cut and dry. The upcoming legislation to legalise cannabis use across Canada this spring provides a good example of how public attitudes towards drug use can change over time. So how can we tell when substance use is problematic? Some questions clients have asked me include: “What if I only smoke weed to relax in the evening?” “What if I only drink alcohol at parties to help me feel more confident?” “What if I only take cocaine if it’s a special occasion?… is there something wrong with that?”
One of the main questions you may want to consider is: “Am I using alcohol or drugs to cope?” In other words: “Do I feel able to socialise/ have fun / relax/ feel sad/ be mad/ feel anxious/feel lonely without using alcohol or drugs?”
Some other questions to consider:
Has alcohol or drug use got in the way of my responsibilities, my relationships or my interests?
Do I feel bad or guilty about my alcohol or drug use?
Do people around me feel that my alcohol or drug use is a problem?
If the answer to some of these questions is yes, you may want to consider completing a self-assessment questionnaire regarding your level of substance use.
Addiction is a complex and multi-faceted problem, and research has identified numerous factors that can increase an individual’s likelihood of having problems with substances. Interestingly, one of these factors is our personality. Four personality traits (sensation seeking, impulsivity, anxiety sensitivity and hopelessness) can be measured from as young as 12 years old using a measure called the Substance Use Risk Profile Scale, and a high level of any of these personality profiles is associated with a greater risk of experiencing substance use and mental health problems. Just to be clear: we all have a certain level of these personality traits. But high levels can be difficult to manage at times (e.g., think Mickey from Love, who experiences multiple difficulties related to impulsivity, including substance use). Our personalities are associated with the reasons in which we may choose to seek out alcohol or drugs. In other words, substance use can be a way that we cope with difficulties that may be related to our personalities. Individuals with high levels of anxiety sensitivity, for example, are particularly sensitive to the physical effects of anxiety (e.g., racing heart beat, muscular tension, restlessness, sweaty palms) and experience these physical sensations as unpleasant and worrying. Alcohol or drugs can be used to dampen those physical sensations and to feel less anxious in the moment. Somebody with high levels of sensation seeking, on the other hand, is prone to risk-taking behaviours in general, and may seek out the “high” or adrenaline rush associated with substances (e.g. to get a buzz in social situations). These individuals can have a lot of difficulty tolerating boredom, and substance use can become problematic when social situations do not feel interesting or fun enough without using alcohol or drugs. Several studies have shown that personality-targeted interventions can help to prevent and treat substance use problems, both with adolescents and adults.
If you are concerned about your substance use, my final point to you is: be compassionate towards yourself. Individuals with alcohol or drug use problems are known to have difficulty accessing treatment due to multiple factors, such as perceived stigma, concerns about what treatment might entail, feeling ambivalent about whether or not to deal with the problem and not feeling sufficiently supported to address the issue. Unfortunately, this means that many people lack the support that they need, and can spend many years struggling with substance use problems before seeking help. This may perpetuate the problem- check out this great TED talk discussing the fact that feeling disconnected from others and from society can drive addiction problems
Remember that help is available, and treatment does work. Multiple studies have shown that cognitive or dialectical behaviour therapy (CBT and DBT) are effective in addressing substance use problems, and provide individuals with a wider range of coping skills to manage difficult situations or emotions. You can read more about these approaches in Andrea, Michelle, Lisa and Natsumi’s blog posts.
So be kind to yourself, and do what’s best for you. If you are concerned about your substance use or mental health, please consult a mental health professional to discuss your treatment options.
Online alcohol help centre: http://camh.alcoholhelpcenter.net/
Centre de Readaptation en Dependance de Montreal (CRDM- previous known as the Centre Dollard Cormier): https://ciusss-centresudmtl.gouv.qc.ca
The Foster Addiction Rehabilitation Centre (CRD Foster): www.crdfoster.org
Conrod, Stewart, Pihl, Cote, Fontaine & Dongier (2000). Efficacy of brief coping skills interventions that match different personality profiles of female substance abusers. Psychology of Addictive Behaviors, 14(3), 231-242.
Pearson, Caryn, Teresa Janz and Jennifer Ali. 2013. “Mental and substance use disorders in Canada” Health at a Glance. September. Statistics Canada Catalogue no. 82-624-X. Retrieved from: www.statcan.gc.ca/pub/82-624-x/2013001/article/11855-eng.htm
Rapp, Xu, Carr, Lane, Wang & Carlson (2006). Treatment barriers identified by substance abusers assessed at a centralized intake unit. Journal of Substance Abuse Treatment, 30 (3): 227–235.