Rehabs: What Makes Someone an Addict, as Opposed to a Heavy Drinker or a Recreational User?
There is a fine line between what makes someone an addict, as opposed to a recreational user. But where is this line and how do we define it? Many people think the answer to that question is simple, but it is far more complex than most realise.
At rehab, a common misconception is that the difference is that “an addict can’t stop”. This is not exactly correct. Addicts can often stop using, sometimes for a few days, weeks or even months at a time. Many high-functioning addicts can keep their substance use concealed and relatively ‘in-check’ well enough to hold down a job.
– ADDICTION VERSUS SUBSTANCE ABUSE –
Rehabs address the issue of consumption. Many believe that what makes someone an addict is how much they consume. However, rehab professionals assert that this isn’t true either. For example, one person might be able to consume 15 glasses of wine in an evening and be perfectly healthy, whereas an alcoholic could actually consume a smaller amount overall.
Regularity of substance use is another misconception that we address in rehab. A healthy person might drink something every night, while an addict might go for much longer periods without using. The quantity that someone consumes is not what makes someone an addict and is a common misconception that rehab professionals address.
Think about a university student who may drink enough at a party to end up in the hospital, for instance, but an addict might be able to limit their intake enough that no one at work notices. Rehabs look at the difference between addiction and substance abuse, as these two are not the same. For example, a businessman might have a lot to drink after work and get pulled over for driving under the influence. A university student might get blackout drunk and sleep with someone he didn’t mean to. A teenager might let her friends pressure her into getting high before a test.
Rehabs assert that all of these people are abusing substances. They are using bad judgement and causing harm to themselves and potentially to others. But this may not be what makes someone an addict. At rehab, we look at how a person can use judgement about alcohol or drugs and not be an addict … So what makes someone an addict?
– A CHEMICAL PROCESS –
ADDICTION is a chemical process in the brain. This process changes the way the brain reacts to drugs, and it impairs the person’s decision-making abilities. An addict loses the ability to make rational judgements with regards to substances. They view their actions as stemming from compulsion rather than CHOICE.
The key difference between addiction and heavy drinking is not that the addict can’t stop, but that they can’t freely choose to stop. This doesn’t mean that addicts have no free will at all when it comes to alcohol or drugs. They have free will to a certain extent, but their free will is impaired. They frequently make choices and decisions that they would never make if their brain was working normally.
This impairment in the functioning of their brain may manifest in other areas. Rehabs often see client’s who are admitted for addiction, yet they maintain that they are not addicts. These clients argue that they can stop using substances for considerable periods or in situations where it is necessary. However, they usually have difficulty regulating or moderating their consumption once they start using. Addicts will often lose control when they start using, even though they may stop for long periods at a time. Rehabs help addicts with this powerlessness.
– HIGH-FUNCTIONING ALCOHOLICS –
High-functioning alcoholics might get up everyday and breeze past the liquor cabinet on their way to work. They may come home and have a drink or two to relax in the evening. It may then be extremely difficult for them to stop there and go off and do something else. Another common trait is that addicts often have a blind spot when it comes to their own behaviour.
Rehabs work with the client’s difficulty with decision-making. Many addicts are impaired in this sense and are unable to freely and deliberately choose not to do destructive things. They have a lot of trouble acknowledging and taking responsibility for the harmful things that they do. Rehabs help clients recognise when their substance use has a destructive effect on their own lives and their loved ones. Recreational users are able to see the negative impact of their substance use and are capable of changing their behaviour.
– DENIAL –
Denial is a defence mechanism that is a refusal to accept reality and blocks awareness of external events. If a situation is simply too much to handle, the person in denial may refuse to experience this. Rehabs often work with people in denial, and this forms an integral part of the treatment process for most clients.
Rehabs process and deconstruct the addict’s denial system. This is often what prevents them from truly acknowledging the damages caused by their addiction. For most healthy people, being pulled over for driving under the influence, or having a partner break up with you over your drug use and behaviour is a ‘wake up call’ that’s likely to prompt a change in lifestyle. Addicts, however, are more likely to blame others or to deny their problems that are consequences of their own behaviour.
Rehabs work with clients who have had numerous ‘wake up calls’. The problem is that they often stay asleep and don’t actually wake up!
– ADDICTION: A BEWILDERING ILLNESS –
Rehabs aim to confront, process and treat addiction – which is no ordinary problem. It can be one of the most bewildering, maddening and frightening illnesses out there. An illness that requires intensive, addiction-focused treatment. Rehabs understand that for many people addiction can be extremely challenging. It often feels as though nothing makes sense and that people suffering with addiction have no control over their actions. People often ask:
“Why don’t they just stop?”
“Why are they doing this to themselves?”
Addiction is hard to understand because nothing about the addict’s body seems to be broken. Rehabs address the difficulties in understanding and treating addiction, highlighting that addiction is often not as obvious as other illnesses. In general, addicts are in touch with reality and are usually aware of the choices they are making. They know that they love their family, and yet their actions hurt their family. They may know they are losing their job or running out of money, yet they can’t stop.
– WHY ADDICTION IS SO SCARY –
Free will: Addicts seem to have free will about every other aspect of their life. They can decide what to eat and what to wear. However, their lack of free will is limited to one very specific choice.
Just Stop: Addiction can be bewildering to addicts and their loved ones because the solution seems too simple. Just stop using! Addicts often say that they wish they could stop using but they can’t.
Influence: Family members struggle to understand that they can’t influence an addict’s behaviour no matter what they do. Whether it be bargaining, yelling, pleading, shaming, threatening or punishing – they have no control. Rehabs help them understand that none of these tactics work. The client has to engage in their own treatment in order to begin their healing journey.
Blame Game: Families often feel hopeless, powerless and frustrated by their inability to stop the train wreck caused by addiction. Sometimes they blame themselves and may feel personally rejected. The problem can be worsened by the tendency of addicts to blame those closest to them for their problems.
Health: Addiction is a frightening illness. It threatens to take away the addict’s health, and everything that they and their families value along the way. Addiction strips people of their money, jobs, their friends, families, homes, their social respect, their autonomy, their sense of meaning and purpose and their ability to enjoy anything at all in life.
Cure: Although rehabs work well at treating addiction, there is no cure. At best, it can be managed as a lifelong chronic condition, similar to diabetes. But the fact that it can be managed, and often is, is still an enormous advance.
– IS REHAB THE ANSWER? –
Rehabs are far more available than ever before. Treatment options are available that can help people with addiction to understand and manage their illness. Rehabs, psychotherapy, medication and support groups all help to treat and assist those struggling with addiction. On their own, or with treatment, many addicts are able to put the problem behind them for good. Many others are able to enjoy long periods of recovery.
While rehabs can’t magically cure addiction, we can make it less bewildering for both the client and their families. Understanding the illness is a good start. Asking the question what is an addict versus a ‘heavy drinker’ or a social user is an important question. Here are some more questions to ask if you are worried about yourself or a loved one.
- Do they struggle to stop using once they start, and go for longer periods of time than expected whilst using?
- Are they experiencing negative consequences as a result of using?
- Do they need more and more to obtain the desired effect?
- Are they in denial about the effects of their use?
If the answer is yes to these questions, they may need the help offered by rehabs.
– ASSESSING ADDICTION –
Rehabs use certain criteria to diagnose and address the severity of the substance use disorder. Take a look at some of the things that Rustenburg Addiction Care uses to assess addiction:
- Use in larger amount or for longer periods of time than intended
- Unsuccessful efforts to cut down or quit
- Excessive time spent using their drug of choice
- Intense desire/ urge for drug (craving)
- Failure to fulfil obligations
- Continued use despite social / interpersonal problems
- Activities / hobbies reduced due to use
- Recurrent use in physically hazardous situations
- Recurrent use despite physical or psychological problems caused by or worsened by use
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