Anyone can develop a dependence on alcohol or other drugs. It often begins quietly. What starts as occasional use of a drug, or a single prescription of pain-relieving medication, can gradually get out of control over time, especially during periods of pain or stress.
Many people do not realize, or do not want to admit, that their use has become a problem. They may see it as a temporary response to physical pain or to a difficult situation such as grief, loss, anxiety or trauma. Asking for help as soon as you suspect there is a problem is important, because it lets you get support to make changes. The earlier you reach out the better, but it is never too late.
Recognizing a problem#
It can be hard to recognize that you have become dependent on alcohol or other drugs. There is no particular type of person who becomes dependent. It can happen to anyone.
Some signs that you may have an alcohol or other drug problem include:
- needing more of the substance to get the same feeling, or to ease pain
- having intense urges for the substance, perhaps once a day or several times a day
- focusing on making sure you always have a supply
- spending money on the substance even when you cannot afford it
- cutting back on social activities and hobbies you used to enjoy
- not meeting your work, family or study responsibilities, or missing appointments and classes
- lying to people about your use when they ask
- relying on alcohol or drugs to have fun or relax, or using them when you are alone
- having blackouts or keeping secrets from friends and family
- doing illegal things to get the substance, such as stealing
- taking risks, such as driving while under the influence
- trying to stop or cut down but not being able to
Other changes others may notice include altered eating or sleeping habits, caring less about your appearance, spending more time with people who drink or use heavily, getting into more arguments, or getting into trouble at school, at work or with the law.
How others may notice#
Often it is family or friends who first realize that someone they care about has an alcohol or drug problem. They may notice the person acting differently, such as being withdrawn, always tired, or increasingly hostile or easily upset. They may ask the person directly whether they are using alcohol or other drugs.
If that happens to you, you might feel threatened or criticized. Try to remember that they are looking out for your wellbeing. A positive first step is to listen, reflect, and be honest with yourself about what they have said.
Why dependence is hard to break#
Cutting down is difficult because repeated alcohol or drug use makes the body more dependent and changes the brain. Brain scans of people who are dependent often show changes in the areas that help you learn, remember and make decisions. You may find you need bigger doses to get the same feeling or to lessen pain, and eventually you may depend on the substance to feel good or simply to get through the day. Withdrawal symptoms when you try to stop are another sign of dependence.
The best thing you can do is to talk to someone you trust, so that you do not have to face this challenge alone.
Getting help#
If you think that you or someone close to you has an alcohol or other drug problem, speak with your doctor. You can also contact a confidential alcohol and drug telephone counseling or information service, where trained counselors experienced in alcohol and drug matters can talk with you and help you get started on the right track.
Where to get help#
Sources & further reading
For evidence-based global guidance on this topic, consult authoritative public-health bodies such as the World Health Organization (WHO), CDC, NHS, and ECDC.