Whether measured in terms of statistical indicators or public concern, substance abuse represents a major health issue in the United States today. The use and misuse of tobacco, alcohol and illicit drugs accounts for a large proportion of the deaths and hospitalizations that occur each year. Other, perhaps equally important aspects of the role of substance abuse, relates to social costs. Substance misuse is linked directly to poor educational attainment, low economic productivity, inadequate income and weak social support systems. Although some addictive drugs (including alcohol) produce physical dependence, all addictive drugs activate brain circuits that produce powerful emotional memories and reinforce substance-abusing behaviors. Genetic factors have also be identified that can increase the risk of developing alcohol addiction among people who drink.

Alcohol Abuse

Alcohol is by far the most frequently abused substance by young and old in the U.S. Usually, a distinction is made between alcohol abuse and alcoholism. Experts agree that alcoholism is a disease. Alcoholism is a chronic disease that is often progressive and fatal. It is characterized by the following elements:

• Craving: A strong need, or compulsion, to drink;
• Loss of control: The frequent inability to stop drinking once a person has begun;
• Physical dependence: The occurrence of withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking. These symptoms are usually relieved by drinking alcohol or by taking another sedative drug;
• Tolerance: The need for increasing amounts of alcohol in order to get "high." Alcohol abuse is defined as a pattern of drinking that is accompanied by one or more of the following situations within a 12-month period;
• Failure to fulfill major work, school, or home responsibilities;
• Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
• Recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk;
• Continued drinking despite having ongoing relationship problems that are caused or worsened by the effects of alcohol.

Alcohol abuse is not ordinarily associated with an extremely strong craving for alcohol, loss of control, or physical dependence; and, abuse is less likely than alcoholism to include tolerance (the need for increasing amounts of alcohol to get "high").

While alcoholism is a treatable, there is no cure. Even if an alcoholic has been sober for a long while and has regained health, he or she remains susceptible to relapse and must continue to avoid all alcoholic beverages. "Cutting down" on drinking doesn't work; cutting out alcohol is necessary for a successful recovery.

Relapses are very common, even for individuals who are determined to stay sober and do not mean that a person has failed or cannot eventually recover from alcoholism. When a relapse occurs, it is very important to stop drinking once again and to get whatever additional support is needed to abstain from drinking.

Treatment of alcohol problems varies. In addition to detoxification and abstinence from alcohol, individual counseling and family involvement may be important to the recovery process. Some programs also link individuals with vital community resources, such as legal assistance, job training, childcare, and parenting classes.

Virtually all alcohol and drug treatment programs also include meetings of Alcoholics Anonymous (AA), which describes itself as a "worldwide fellowship of men and women who help each other to stay sober." While AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA's style and message, and other recovery approaches are available. Even those who are helped by AA usually find that AA works best in combination with other elements of treatment, including counseling and medical care.

For additional information please see our “related links” section.

Diagnosis

Unlike other diseases and physical ailments, the diagnosis of abuse of alcohol or other drugs may be difficult because the individual usually conceals consumption of the abused substance. A person does not have to be an alcoholic or addict to have problems. For example, every year many young people lose their lives in auto crashes, drownings and suicides related to alcohol or drug use.

Serious health problems can and do occur before a person reaches the stage of addiction or chronic use, especially when alcohol is the drug of choice. Some of the serious diseases associated with chronic alcohol use include alcoholism and cancers of the liver, stomach, colon, larynx, esophagus, breast, and a host of other disorders, such as diminished immunity to disease, sleep disturbances, muscle cramps, and edema.

Alcohol abuse also can lead to such serious physical problems as:

• Damage to the brain, pancreas, and kidneys.
• High blood pressure, heart attacks, and strokes.
• Alcoholic hepatitis and cirrhosis of the liver.
• Stomach and duodenal ulcers, colitis, and irritable colon.
• Impotence and infertility.
• Birth defects and fetal alcohol syndrome, whose effects include retardation, low birth weights, small head size, and limb abnormalities.
• Premature aging.

Aside from the physical effects of drugs, certain warning signs may indicate that a person is drinking too much alcohol or using other drugs. Although these warning signs are not foolproof, each by itself or many signs combined overtime should be cause for concern. These are some of the signs to look for which involve drinking:

• Does the person pour a drink as an immediate reaction when faced with any problem?
• Does the person drink until intoxicated?
• Is there a record of missed work because of drinking or an ill-disguised odor of alcohol on the breath during work hours even though attendance may be regular?
• Does the person drive a car while intoxicated?
• Has his or her home life become intolerable because of drinking or arguments resulting from drinking?
• Does he or she handle all social celebrations and stress with alcohol?

These are the signs of an adult problem drinker. It is important to note, however, that any use of alcohol by youth is abuse and cause for concern. When these signs are present, it means that a person's drinking pattern, if not already out of control, is heading that way. A person does not have to be an alcoholic to have problems with alcohol.

There are numerous signs of illegal drug use. For example, when a person is carrying drugs or has them hidden around the house, there is a strong possibility of use. Obviously, possession of drug paraphernalia also is a likely sign to use. Indications of prescription drug misuse vary according to the type of drug in question. Drug misuse may lead to dependence and withdrawal symptoms can be severe if drug use is stopped suddenly. Certain additional behavioral characteristics also seem to accompany the use of alcohol and other drugs. The clues can be found in all people who abuse alcohol or use other drugs, regardless of age.

Examples of these clues include:

• An abrupt change in mood or attitudes.
• Sudden and continuing decline in attendance or performance at work or in school.
• Sudden and continuing resistance to discipline at home or in school.
• Impaired relationships with family members or friends.
• Unusual flares of temper.
• Increased amount and frequency of borrowing money from family and friends.
• Stealing from the home, at school, or in the workplace.
• Heightened secrecy about actions and possessions.
• Associating with a new group of friends, especially with those who use drugs.

For additional information please see our “related links” section.

Treatment

If you have an alcohol or other drug problem, you should do three things immediately:

First, admit it to yourself. Acknowledge that you do have problem and that something must be done.

Second, contact a group that can recommend or provide treatment and moral support.

Third, admit your problem to the members of your immediate family and/or closest friends. Mobilize your family and friends to help provide you with the strength and support you will need to address your reasons for use and the difficulties of freeing yourself of addiction to alcohol and other drugs.

Sometimes the quickest way to find out what help is available in your local area is to join a group such as Al-Anon. Al-Anon is a group of family members and friends of problems drinker who meet to share practical suggestions on day-to-day living with someone who has a drinking problem. These family members and friends of problem drinkers usually know where help is available in the community. You can also contact your local ADAMH Board.

The U.S. Department of Health and Human Services maintains a directory of drug and alcohol treatment programs that includes the location of more than 12,000 residential, inpatient and outpatient drug and/or alcohol programs around the country. Listings include treatment programs for marijuana, cocaine and heroin addiction as well as drug and alcohol treatment programs for adolescents, teenagers and adults.

For additional information please see our “related links” section.

Housing

Permanent, quality housing of choice is a critical component in the process of recovery for any addicted individual without a place to live. A variety of options may be available to provide consumers with housing in the community. The Ohio Department of Mental Health provides the local ADAMH Board with Housing Assistance Program (HAP) funds for special loans and rental subsidies. In board areas around the state, ODMH funds Project for Assistance in Transition from Homelessness (PATH) to provide outreach services to homeless individuals with severe mental illness to engage them in mainstream mental health, health, and housing services. The federal government through the Department of Housing and Urban Development (HUD) provides funding to local communities with a comprehensive strategy to address housing and homeless services for those in poverty. For additional information please see our “related links” section.

Employment

Satisfying work with adequate pay to support the desired level of independent living is a critical component in the process of recovery for anyone jobless as a result of an addiction. Like all workers, people with addictions can benefit greatly from the security and self-sufficiency that come with stable and fulfilling employment. In addition to providing a living, work gives people a sense of belonging and community. It also creates a network of friends and colleagues.

The local ADAMH Board may direct consumers to resources that help people with substance abuse problems acquire the skills needed to find and keep a job. Services may include vocational training or retraining and job coaching, to help clients reenter to world of work. For additional information please see our “related links” section.

Recovery

In simplest terms, recovery is the process of overcoming a particular life problem such as alcoholism, drug abuse, gambling, etc. through inner change and personal growth resulting from participation in a self-help program, psychotherapy or a combination of both. Consumers seeking to recover from alcoholism or drug addiction often do so because of job loss, financial destitution, loss of family and other relationships, homelessness, and/or physical health problems resulting from their drug abuse. Recovery is the process of empowering individuals with hope and self-esteem to find new meaning and purpose in their lives. The concept of recovery implies that people can begin to heal not just through individual therapy or medication or self-help, but also by learning skills that apply to every aspect of their lives. Recovery does not mean a cure, but rather, learning to work within and beyond the limits of the addiction so relationships, housing, family, a satisfying job, decent pay and other elements of life quality can be restored. For additional information please see our “related links” section.

In Conclusion

If you or someone you love is abusing alcohol or other drugs, you need to first understand what is happening and then look for treatment options. The best way to help a person with a substance abuse problem is to remember that it is an illness. As such, it doesn't just go away when someone wants it to or when it is becoming a nuisance. As with other illnesses, it needs medical attention and attention from family member. Remember, each alcohol and other drug abuser is different -- different in human needs and responses, as well as in their reasons for drinking and taking other drugs, their reactions to these drugs, and their readiness for treatment. You are in a good position to help your relative or friend, because you know a good deal about their unique qualities and their way of life. Having made the effort to gain some understanding of the signs and effects of problem drinking or other drug abuse, you should be in a better position to consider a strategy for helping.

Be active, get involved. Don't be afraid to talk about the problem honestly and openly. It is easy to be too polite, or to duck the issue by saying, "After all, it's their private affair." But it isn't polite or considerate to let someone destroy his/her family and life. You may need to be persistent to break through any denial they have. You also may need to let them know how much courage it takes to ask for help, or to accept it. You will find that most people with drinking or other drug related troubles really want to talk it out if they find out you are concerned about them.

To begin, you may need to reject certain myths that in the past have done great harm to alcoholics and other drug abusers and hampered those who would help them. These untruths come from ingrained public attitudes that see alcoholism and other drug problems as personal misconduct, moral weakness, or even sin. They are expressed in such declarations as, "Nothing can be done unless the alcohol or drug abuser wants to stop," or "They must hit bottom," that is, lose health, job, home, family, "before they will want to get well." These stubborn myths are not true, and have been destructive. One may as well say that you cannot treat cancer or tuberculosis until the gross signs of disease are visible to all.

The truth is that with alcohol and other drug problems, as with other kinds of acute and chronic illness, early recognition and treatment intervention is essential -- and rewarding. Be compassionate, be patient -- but be willing to act. Experience proves that preaching does not work. A nudge or a push at the right time can help. It also shows that you care. Push may even come to shove when the person with alcohol or other drug troubles must choose between losing family or job, or going to treatment. Thousands of alcohol and other drug abusers have been helped when a spouse, employer, or court official made treatment a condition of continuing family relationships, job, or probation. You cannot cure the illness, but when the crucial moment comes you can guide the person to competent help. For additional information please see our “related links” section.

Eligibility

Eligibility for services varies by county of residence and your income. To learn more about the requirements to receive services please contact your local provider. Click here to find a provider in your county.

Client’s Rights

The Ohio Departments of Mental Health (ODMH) and Ohio Department of Alcohol and Drug Addiction Services (ODADAS) want to ensure that quality services are available to all Ohioans within their communities. The Departments work in partnership with local ADAMHS boards and behavioral healthcare providers to promote recovery and to respect the rights of people and the safety of the community.

To assure that the rights of clients are respected, client advocates have been identified at each local board and for each certified provider in the state. The mission of the client advocates is:

• To clearly inform clients of their basic and legal rights
• To promote recovery
• To promote client choice and participation in decisions affecting their lives
• To ensure the availability of quality advocacy to all persons receiving services in the public system

Your rights are specified in the Community Client Rights Statements published by ODMH. You may contact your client rights advocate at your local ADAMH board or behavioral health provider.