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
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
- 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
- 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
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
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
For additional information please see our “related
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
- 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
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
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
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
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
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.
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
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
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
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
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.
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
- 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