IS IT A DRUG OR ALCOHOL PROBLEM?
By William Loving, MD, ABAM
People with drug and alcohol problems often are the last to recognize and accept their chemical dependency problems. In their own mind, they deny the problem, and they rationalize their difficulties and lack of control. Often, family members unconsciously collaborate in this denial and rationalization. The spouse, family member or friend may make excuses for the chemically dependent person, call in sick for the person, pay off hot checks and take care of other responsibilities for them. This "codependent behavior" or "enabling" just cushions the fall of the out of control persona and "enables" the disease of the chemical dependency to continue and flourish.
People in the throes of addiction tend to act in irresponsible, unethical, amoral and erratic ways. These people are generally decent, intelligent and very sane people when not affected by drugs and alcohol. When the brain is bathed by addictive substances, behavior becomes very erratic and out of control. Most of these substances "disinhibit" the brain. This means that the usual inhibitions and social constraints are not in place, so that the person "shoots off their mouth," acts out their anger and is socially inappropriate. It is interesting that if we visit a recovery room where people recover from anesthesia after surgery, you will see people that are groggy and out of control. In the recovery room, the nurses expect the person to "not be themselves," however we readily understand that it is due to the brain being disinhibited and affected by the anesthesia. We don't blame the behavior on the person's basic personality, but rather on the chemicals. When people take addictive substances, their brain is affected in much the same way and, of course, they are "not themselves" and therefore act in inappropriate ways.
So, if a person around you acts in an erratic way and has 101 excuses for his or her behavior, you might suspect an alcohol or drug problem. People with drug and alcohol problems generally don't look very healthy. This is because they are generally not sleeping or eating well. They are not taking care of themselves and the drugs and alcohol cause stress on the body. Many people with chemical dependency problems are extremely capable and likable people when not intoxicated or affected by drugs and alcohol. The person may function quite well for several days but then suddenly be overly agitated, angry, depressed or will act inappropriately. We usually don't actually see the person ingesting the drug, but we do see the effects on his or her behavior.
If you suspect someone you know has a drug or alcohol problem, what do you do? If you confront the person in the wrong way, you will get a very defensive and angry response. Remember, the chemically dependent person even denies to themselves they have a problem and certainly they will deny it to someone confronting them in a critical way. You should look for a pattern of behavior and give the person the benefit of the doubt, but only to a point. It is a good idea to be open, direct and honest about your concerns. It is not helpful to be judgmental, critical and angry when confronting the person. Concern for the person's well-being should be communicated. Sometimes it becomes necessary for a group of concerned persons to confront the person in a very loving, yet firm way. This is called an intervention, and there are trained counselors who know how to organize this type of confrontation. There is not one perfect formula for dealing with people who have chemical dependency problems, but is important to be direct and honest when dealing with them. The good news is that people with chemical dependency problems can recover and can change their behavior through treatment and involvement with 12-step programs such as Alcoholics Anonymous or Narcotics Anonymous.
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