*Originally featured in the North Shore Coalition for Drug Free Communities (https://www.nscdfc.org) newsletter

Determining whether you have an unhealthy relationship with alcohol or drugs (substances) is not always straightforward. Every situation is unique, and there are many factors to consider.

This article will describe four common signs that could indicate you have an unhealthy relationship with substances. If you feel that you or a loved one may have an issue, reach out to your healthcare provider.

1.     You continue to use despite negative consequences

What differentiates a heavy user from a problematic one is how the individual responds to the consequences of their use. For example, if Bill has lost relationships, been hospitalized, and has a fatty liver due to his use but continues to use anyway, he may have a problem. In contrast, a heavy user may also experience negative consequences, but respond by cutting back on, or outright eliminating substances.

2.     You need to frequently increase your consumption to achieve the desired effect

As one increases their use, the body adapts to process the higher amount of the substance, also known as tolerance. For example, during the early stages of Bill’s drinking it took him a few drinks to achieve the desired effect. Many years (and many drinks) later Bill needs three times as much to feel a buzz. For those who build a tolerance, consumption increases, but the pleasurable effects decrease in intensity and duration.

3.     You experience unpleasant side effects from not using

Sometimes you can tell a lot about your relationship with something by removing it. To determine whether your relationship with substances is unhealthy, try not using for 1 month and see how you feel (before abruptly stopping your use, make sure to speak with your healthcare provider, as withdrawal from certain substances, such as alcohol, can be dangerous or even fatal). Problematic users will usually experience some form of withdrawal. For example, physical withdrawal symptoms from alcohol include shakiness, sweating, and elevated blood pressure, among others.

4.     When you are not using you are preoccupied with using

We have thousands of thoughts every day. For those who have an unhealthy relationship with substances, a high percentage of those thoughts may concern using. Sometimes this is referred to as a mental obsession - where one is so preoccupied with their next use that it is impossible to focus on anything else.

The only sure way to know if you have an unhealthy relationship with substances is to speak with a behavioral healthcare provider. If you start to notice these in yourself or a loved one, act quickly, as early detection of a substance issue is associated with better outcomes.

Remember that you are not alone. Substance issues are quite common and there are many resources available to help you and your loved one through this.