Substance Use and Addiction

What is addiction?

Addiction can take many forms and shapes. It involves a compulsive or uncontrollable need to find and use a substance. Addiction can be psychological, which means that you need it to feel better mentally; or addiction can be physical, which means that your body craves the substance. All types of addiction cause similar harms to a person’s social and emotional life, and the lives of those around them. One simple way of describing addiction is the presence of the four Cs:

• Having craving for a substance;
• Loss of control of amount or frequency of use ;
• Having compulsions to use; and,
• Using despite the consequences.

Nobody chooses to become addicted, and addiction is not about personal weakness or character flaws. When addicted, it can be difficult to give up the substance or stop the behaviour. Most people usually need extra support from friends, families or health-care professionals. Whether its alcohol, nicotine, drugs, gambling, the Internet, or some other form of addiction, there is hope and help available. Call your local mental health and addictions office to speak to a counselor.

What about gambling, sex, or shopping addiction?

People can become dependent on some types of behaviours such as gambling, shopping, sexual activity, and playing computer games. These compulsive behaviours are common and can require professional treatment to overcome. A behavioural addiction does not involve the use of an addictive substance and is often overlooked. All types of addiction cause similar harm to a person’s social and emotional life, and the lives of those around them.

Why do people keep using substances?

When it comes to substance use, there are two kinds of dependence:

1. Psychological dependence occurs when a person feels he or she needs the drug to function or feel comfortable; and,
2. Physical dependence occurs when a person’s body has become used to the presence of a substance. Tolerance means the person needs to use more of the substance to get the same effect. When the person stops using the drug, symptoms of withdrawal occur.

Substance use can be hard to change. One thing that makes change so difficult is that the immediate effects of substance use tend to be positive. Initially, the reward the brain receives is often pleasurable and we may call this a “high.” Over time, as our bodies become dependent on that substance and we experience withdrawals, the reward of using the substance may be to avoid the negative withdrawals.

Experimentation versus problematic substance use

Not everyone who uses alcohol or other drugs will become addicted. Every person’s body and brain are different. Your relationships, surroundings, lifestyle, and other mental health issues can make you more or less likely to become addicted.

The progression of substance use to addiction is on a continuum, ranging from no use to dependency. Generally people advance from no use, to use, misuse, abuse, and finally to dependency. As a general rule, when substance use starts to cause problems in your relationships, or begins to negatively affect your work, finances or health, it’s probably time to think about making some changes.

Substance Use Facts

1. Alcohol is considered a drug, and it can cause just as much damage as other drugs if misused.
2. After tobacco, alcohol is the substance that causes the most harm in Canada.
3. Alcohol is the most commonly used substance followed by cannabis and tobacco.
4. Newfoundland and Labrador has the highest heavy drinking rate in the country.
5. Addiction affects all genders, all socioeconomic classes, and all communities. Addiction impacts our friends, family, and coworkers.
6. Legal substances (tobacco and alcohol) account for 79.3 per cent of the total cost of substance abuse in Canada. Illegal drugs account for 20.7 per cent of substance abuse.
7. Ecstasy, cocaine and heroin are a few examples of illegal drugs.
8. Psychoactive pharmaceuticals are the third most commonly-abused substances among Canadian youth.
9. Prescription drug abuse is intentionally taking medication in a way that was not prescribed. The most common types of prescription drugs abused include opioids (used to treat pain), benzodiazepines (used to treat anxiety and sleep disorders), and stimulants (used to treat attention deficit disorder).
10. Many people are not aware of the potential risks to using substances. Abuse of these medications can cause serious health effects, including addiction, overdose and even death.

Warning signs

Consider these warning signs:

• Do you feel an overwhelming desire to use?
• Is the problem behaviour suddenly frequent? Does it feel out of control?
• Is it on your mind often? Interfering with the ability to complete work or manage your day-to-day life?
• Is the addiction causing problems at work or home?

The Centre for Addiction and Mental Health (CAMH) is a resource for addictions.

What’s normal? What’s addiction?

We all get cravings, but when does it become problematic? Be aware of the warning signs in yourself and your loved ones.

• Insatiable craving.
  Is it a craving that doesn’t seem to pass?
• Loss of control.
  Is the behaviour occurring more frequently? Is the amount taken or spent increasing? Does it seem like life is centred around this one thing?
• Compulsion to use.
  Are thoughts about the behaviour obsessive? Is the behaviour interfering with the ability to complete work or manage day-to-day life?
• Use despite consequences.
  Is the behaviour causing problems at work or home but you or your loved one just can’t stop? Is the behaviour having a negative financial impact?

What are the signs of substance abuse and when to get help?

Someone does not have to show clear signs of a problem to have an addiction. It’s easy to become dependent on a drug or an activity without realizing it right away. Harmful consequences and loss of control are two important signs that a person’s substance use is risky, or is already a problem. Substance use may be a problem when you:

• Have difficulty meeting responsibilities at home, work or school.
• Use more than you intended despite wanting to cut down or quit.
• Have recurring problems with health, safety, relationships, finances or the law through the substance use.
• Need the substance to cope with everyday life or particular experiences.
• Organize other events or needs around your substance use.
• Need increasing amounts of the substance to have the same effect.
• Feel sick or moody without the substance, but feel a little improved upon resuming use; and.
• Have tried unsuccessfully to reduce or cease use.

If you are experiencing any of the above you may have a substance abuse problem. Remember, no matter what type of addiction or problem you are facing, hope and help is available.

I think my family member may have an issue with substance use. What should I do?

The most important thing to do is be there for your friend or family member if s/he needs to talk. It is important to remind yourself that you cannot fix it, but you can support your friend if he/she chooses to get help. It can be really tough to watch a friend or loved one struggle with addiction. Remind yourself of the four C’s: you didn’t create it, you didn’t cause it, you can’t cure it and you can’t control it. If your loved one is not ready to make changes with his/her substance use, you can still seek support for yourself so that you can learn how to cope and take care of yourself. Having the support of family members and/or friends may help people feel more supported to take steps toward treatment. Here are some simple things to start with:

• Raise your concerns with the person and let him or her know you are available to listen.
• Provide factual information about the consequences or concerns associated with their substance use. If the person gets angry or denies there is a problem, be patient but firm.
• Be positive and encourage change instead of blaming the person or making him or her feel guilty.
• Find out about available treatment programs and tell the person about them.
• Learn about the nature of drug abuse and addiction to give yourself a better understanding of the problem and how to best deal with it.

I think I need help. Where do I turn to?

Sometimes you might feel like no one really understands you or your struggles. Many people question their use of tobacco, alcohol and other drugs. Some people are able to overcome their problems on their own, or with self-help materials. Most of us need support from other people, family members, friends, therapists, and medical professionals.

You are not alone and help is available. There is no “one-size-fits-all” approach to addiction treatment. Choosing the appropriate treatment depends on the severity and type of addiction; the support available from family, friends and others; and the person’s motivation to change.

Examples of help available include:

• self-help materials
• self-help groups
• harm reduction approaches
• professional individual or group counselling
• education, medication
• withdrawal management and
• other holistic treatments.

Change is a process and relapse can be part of the process, but recovery is possible.

Services related to this information

• Bridge the gApp
  Newfoundland and Labrador’s ‘go-to’ website for mental health information. Bridge the gApp offers self-help resources, links to local services, and invites people to share their personal stories. Bridge the gApp is free of cost and available to every resident in the province. The site is divided into adult and youth sections, however many services are appropriate for both.
• Mental Health Crisis Line – 709-737-4668 / 1-888-737-4668
  A free, confidential service for individuals, family and friends. The crisis line is province-wide, 24 hours a day.
• 811 HealthLine (Newfoundland & Labrador) – Call 811 or 1-888-709-2929 / TTY 1-888-709-3555