The newest revision of the diagnostic manual for mental disorders (the DSM-5) has updated the criteria commonly used to diagnose either an alcohol disorder (commonly referred to as alcoholism) or a substance use disorder.
According to the DSM-5, a “substance use disorder describes a problematic pattern of using alcohol or another substance that results in impairment in daily life or noticeable distress.” As with most addiction problems, despite any consequences a person who has a problem with either alcoholism or drugs suffers, they will generally continue to use their drug of choice. They may make half-hearted attempts to stop or cut back their use, usually to no avail.
I write this article because I struggle with substance abuse, and although my story revolves around benzodiazepines an addiction is an addiction is an addiction
But A Doctor Prescribes it
For years and I mean years I would never even consider that I had a substance abuse issue. I suffer from Generalized anxiety disorder and many years ago was given Klonopin a medication in the Benzodiazepine class. I have a legitmate Mental health disorder.
Therefore since the medication or drug was prescribed by a doctor, I couldn’t have a substance abuse problem, despite the fact I was taking double the amount prescribed. It didn’t start out that way but over time and events of life I grew a tolerance and began using for more than just therapeutic purposes. Still I convinced myself in the face of all logic and all outcry’s from loved ones that I was different. It took me way to many years to realize that wasn’t the case.
Today, my condition is under control, but I still take it one day at a time. I have weened down to a small amount, enough to manage my disorder yet not the excess amounts I had once taken
My life had changed for the better, I was now being honest with myself, I was now facing life head on, I was no longer in denial. That was the beginning.
By the grace of god and only by the grace of god I have been fortunate to get more chances, than a cat has nine lives. I hold on to that with dear life, as I don’t believe I have another chance left
It only takes one slip
Having said all that, I recently relocated from one city to another and instead getting my own apartment or house, I moved in with a roommate.
Unbeknownst to me this person is an Alcoholic. Not long into the relationship he mentioned about going to a meeting and that he was a recovering Alcoholic but was sober for some time. I took him at his word.
Anyone who has lived the life of substance abuse or Alcoholism can spot a bullshit artist a mile a way. So after he commented tonight I’m going to have a few beers, I knew that was the end of that and a few beers would turn into more than that. And it did, he got blitzed and blew all the money I had given him for rent on Alcohol.
Recovery is a selfish thing, which I had a hard time originally understanding. However now with a full grasp of the selfishness needed to maintain recovery, I watched and listened as he slowly got drunk and began to make a fool of himself.
While of course I felt bad for him, there was nothing I could do. However one thing that did happen, I was keenly reminded of how I use to act. It was embarrassing to me to think I use to act this way but at the same time, it reminded me that I never want to be like that again and how lucky I am.
Also, I had a sense of realizing how far I had come and it made me feel proud. But moreover, it made me thank God, that wasn’t me and for that I will cling to for the rest of my life.
The DSM-5 states that in order for a person to be diagnosed with a disorder due to a substance, they must display 2 of the following 11 symptoms within 12-months:
- Consuming more alcohol or other substance than originally planned
- Worrying about stopping or consistently failed efforts to control one’s use
- Spending a large amount of time using drugs/alcohol, or doing whatever is needed to obtain them
- Use of the substance results in failure to “fulfill major role obligations” such as at home, work, or school.
- “Craving” the substance (alcohol or drug)
- Continuing the use of a substance despite health problems caused or worsened by it. This can be in the domain of mental health (psychological problems may include depressed mood, sleep disturbance, anxiety, or “blackouts”) or physical health.
- Continuing the use of a substance despite its having negative effects on relationships with others (for example, using even though it leads to fights or despite people’s objecting to it).
- Repeated use of the substance in a dangerous situation (for example, when having to operate heavy machinery or when driving a car)
- Giving up or reducing activities in a person’s life because of the drug/alcohol use
- Building up a tolerance to the alcohol or drug. Tolerance is defined by the DSM-5 as “either needing to use noticeably larger amounts over time to get the desired effect or noticing less of an effect over time after repeated use of the same amount.”
- Experiencing withdrawal symptoms after stopping use. Withdrawal symptoms typically include, according to the DSM-5: “anxiety, irritability, fatigue, nausea/vomiting, hand tremor or seizure in the case of alcohol.”