1)What is Alcoholism/Substance abuse?

It is maladaptive pattern of use of mood altering substances (drugs /alcohol) leading to clinically significant impairment or distress as manifested by

• Tolerance i.e
  • Need for increased amount of the substance to achieve the intoxification
  
  
  • Reduced effect with continued use of the same amount of the substance
    • Withdrawal symptoms when the substance of use is withdrawn.

2)How can I tell that someone I know is using alochol?

Some of the early warning signs of dug addiction are:

• Loss of appetite /loss of weight
• Personal neglect in form of unkempt hair, uncut nails, dirty clothes, decreased frequency of bathing, poor dental hygiene.
• Frequent mood fluctuations ranging from grandiosity to depression.
• Monetary and emotional demands increase
• Drooping eyelids or mouth partially open
• Hollowed eyes and dark circles under eyes.
• Comes home late and at odd hours
• A new set of friends may call or frequent the residence of the person
• Compulsive lying
• Disappearance of articles and personal belongings
• Loose tobbaco - unburnt- in ashtray
• Needle marks or abscesses on forearms, burnt tips of thumb, forefinger and middle finger (commonly seen in chasers).
• Direct evidence in the form of a pudi, a vial, stained coin, candle, foil may also be found.

3)Why can’t alcoholics /addicts quit on their own? Is an admission to a treatment program necessary?

When an alcoholic or an addict begins to use, the symptom of craving kicks in, and the brain demands more alcohol or drugs.

Even when they stop using, alcoholics and addicts have the symptom of poor insight/denial which tells them that they can successfully use again, even though their history demonstrates that they clearly cannot. Euphoric recall is one way the brains of alcoholics and addicts trick them into remembering the good times and not the bad.

The symptom of craving, the symptom of poor insight/denial, and the symptom of euphoric recall are basic elements of the disease of addiction, which is a treatable disease.

4)Why does a substance abuser/ alcoholic keep relapsing? What can be done about it?

Studies on relapse have consistently shown that relapse is a process, whose final step is drinking or drug use. Many things happen before a person picks up the drink or drug. The relapse process is inevitable; it is a basic symptom of the disease of addiction. However, the process can be arrested before patients get to that first drink or drug, and reversed. Arresting and reversing the relapse process is a lifelong aspect of recovery from alcoholism and drug addiction.

5)Can I safely use drugs/alcohol in limitation, now that I have completed treatment?

Addiction is a lifelong, chronic progressive illness. Experience shows it to be a stable diagnosis (i.e., even after a period of time of sobriety, a return to drinking will result in rapid deterioration to worse levels than previously). One often quoted aspect of alcoholism is that it is "cunning, baffling and powerful." Often the desire to "safely" use addictive drugs is a symptom of the disease, and addicts and alcoholics may not know it. In this case, the only safe course of action is to address the relapse trigger, rather than take the drug. Alcoholism and drug addiction are not curable illnesses. But they can be arrested and then recovery is possible.

6)My brother is addicted to alcoholbut he doesn’t want help? What can I do for him?

Remember that not wanting treatment is a typical symptom of the disease of addiction. It is a treatable symptom. All patients with the disease of addiction go through periods where they don't want help. Some people stay there and never want help, some people do have moments of great pain where they are ready to accept help on their own. Often, an intervention can be instrumental in helping him get help. Alcohol addiction is a chronic, progressive, and ultimately fatal (if not treated) disease. An intervention can help him get treatment even when he is suffering from the core symptom of denial. Meanwhile you can start your healing process by joining by connecting with people affected by the disease of addiction.

7)My friend believes that drinking is the only thing that makes life manageable. If she stops drinking life would be miserable. Is this true?

This is a common fear, and it is based on some truth. The fact is, that during active alcoholism and drug addiction, staying "dry" (abstinent from alcohol and drugs but without a program to manage the rest of the illness) can be quite miserable. Without an active recovery program, she will simply be an alcoholic with sick behaviors, painful problems and no way to manage the feelings. This will clearly not be enjoyable.

However, the practical experience of recovering alcoholics and addicts is that their lives have become more enjoyable, not less. The feeling that the alcoholic needs alcohol to be happy is a symptom of the disease of alcoholism and it will respond to treatment/recovery.