Q: How can I tell if I’m addicted?
A: If you’re asking this question about addiction, it may be because you can see that your use of a substance or a compulsive behavior is disrupting your life. An addiction, though, isn’t the same as using a lot of drugs or alcohol or frequently indulging in an activity like sex, shopping or gambling. If you’re truly heading towards an addiction, you won’t be able to stay away from the drug or the activity or cut back, as much as you want to. You’ll experience cravings and will continue to use the substance or repeat the behavior, no matter who or what it hurts: your relationships, your career, your finances, your health. Addicts often miss important family, social and work/academic obligations and forego hobbies and other activities in order to use. The addiction becomes their single focus, crowding out the rest of life. If something interferes with your ability to use, you’ll experience psychological withdrawal symptoms, which vary depending on the addiction; these can include feeling angry, upset or anxious. For substance users, physical withdrawal symptoms can include vomiting, headaches, muscle aches, fevers, chills and/or seizures.
Q: Is it true that you can be addicted to more than one substance/behavior at a time?
A: Yes, and in fact this is common. Those who have an addiction are also likely to have what are called “co-occurring disorders,” such as a mental health issue(s) like depression or anxiety. And it is common for people to have more than one substance or process/behavior addiction. Research clearly links substance use to problems with gambling, video gaming, disordered eating, Internet use and compulsive sexual behavior. Not every addict has multiple addictions or another psychological problem, but in general, there is a lot of overlap between these issues.
Q: What if I have a mental health issue (like depression), too?
A: First, if you’re struggling with addiction and a mental disorder, you’re definitely not alone; many people are in the same situation. If you decide to seek treatment, it’s essential that whatever program you choose addresses both issues at the same time. Treatment that factors in both addiction and mental health will give you the best possible chance for a successful, lasting recovery.
Q: What kind of treatment is right for me?
A: There’s no easy or short answer to that question about addiction. That’s because everyone dealing with addiction has their own history, values and beliefs. Plus, factors like where you live, your job and what health insurance you have are bound to play big roles, too. Simply put, professional treatment can take place on an inpatient basis (at a rehab facility where you stay for a period of weeks) or on an outpatient basis. Outpatient means you sleep at home but attend either a day treatment program (for seven or eight hours a day) or an evening outpatient program for a couple of hours several times a week. If your home environment is contributing to your addiction or is not a supportive place that’s conducive to recovery, an inpatient facility might be your best bet. For more details on the various options available, go to Treatment Options. You can also use the Behavioral Health Treatment Services Locator directory offered by the Substance Abuse and Mental Health Services Administration (SAMSHA).
Q: How can I find a treatment center for my type of addiction?
A: Once you’re diagnosed with an addiction, your physician or counselor may strongly recommend a type of treatment center based on your needs — whether inpatient, outpatient or day treatment. That recommendation should help you to start researching options. SAMHSA’s directory is one resource to try; you can also reach them by calling 800-662-HELP. Other good resources for recommendations include your health insurance company, friends and family. Keep in mind that if you’re choosing inpatient treatment, you may not need to stay close to home and can broaden your search to include inpatient treatment centers across the country.
Q: How do I find a therapist/counselor who understands my type of addiction?
A: Almost any accredited treatment center you choose — whether inpatient, outpatient or day treatment — will have experienced staff to help you. That should include master’s-level counselors or other psychotherapists and a consulting psychiatrist or physician, along with a team that includes care coordinators, recovery coaches, case managers and nursing staff. Ideally, your team should have expertise in the type of addiction(s) you’re struggling with, but for some newer problematic behaviors such as technology and video game addictions, it may be harder to find someone with deep experience, training or credentials in that particular field. Fortunately, many of these addictions are treated in ways that are very similar to substance use disorder and other addictions. Make sure you always check that any center you’re considering is certified by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF). To learn more, go to How to Choose Treatment.
Q: What if I’m not ready for treatment?
A: Some addicts know when they’ve had enough and that it’s time to get some kind of help. Others may debate their readiness to quit for months, years or decades. Even if you’re not convinced you’re ready — and even if you flat-out don’t want to stop using — it’s important to understand that treatment can still be successful. Put another way, you don’t need to be willing to stop or have “hit bottom” in order to move toward a life of recovery. And that includes being forced into treatment by a loved one, your employer or even the court system. As the National Institute on Drug Abuse (NIDA) puts it, “Treatment does not need to be voluntary to be effective.”
Q: Do I have to stop using forever?
A: The idea of giving up something you crave for the rest of your life can seem daunting at best and impossible at worst. In most, but certainly not all cases, addicts find they must permanently abstain from using the substance they’ve become addicted to, and they must limit or stop a problematic activity (depending on what it is). That’s because these substances and behaviors powerfully affect the brain of someone who’s addicted. Through effective treatment, though, addicts can and do recover and learn to seek pleasure through healthier outlets. And sometimes, of course, complete abstinence simply isn’t possible or reasonable. For example, food addicts cannot avoid eating and someone with an addiction to love, relationships or technology likely still needs these to be part of their life in recovery. Your treatment might include signing a “sobriety contract,” too, in which you agree to not indulge in some problematic behaviors, but that others when used responsibly are okay; in this case, the goal is to help you learn how to use things like the Internet or sex in ways that are reasonable and healthy.
Q: Do I really need to attend a treatment program? Can’t I just go to 12-step meetings?
A: Millions of lives have been changed with the help of AA and similar self-help support groups for other types of addiction. And there are certainly people who start attending 12-step meetings and find that the support, information and camaraderie they find there is enough to help them start and stick with sobriety. If, though, you find that you need more intensive treatment and the help of credentialed professionals — perhaps you’re dealing with multiple addictions or a mental health issue, too, or your doctor has recommended professional treatment for your addiction or you’ve relapsed and want to try something else — there are lots of options to suit your needs and situation. Most treatment programs will include some version of a 12-step program, in addition to individual, group and/or family counseling and/or medication therapy. “Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention,” reports the National Institute on Drug Abuse. This multifaceted approach helps address every aspect of your addiction, giving you the best shot at living a healthy, happy life in recovery.
Q: How can I afford to pay for treatment?
A: While addiction treatment can carry a hefty price tag, there are also many low- or no-cost options. Self-help support groups, for example, are free and available for all sorts of addictions either in-person or online. (These include Alcoholics Anonymous, Narcotics Anonymous (NA), Marijuana Anonymous, Crystal Meth Anonymous, Gamblers Anonymous, Food Addicts Anonymous and Sex Addicts Anonymous, to name a few.) They are offered nearly everywhere with dozens of locations and times — and you can attend as many meetings as you’d like. Treatment for mental health and substance abuse is also likely covered by your insurance — and without restrictive co-pays, deductibles and visit limits, thanks to the new Mental Health Parity and Addiction Equity Act and the Affordable Care Act (ACA). Under the ACA, most major insurers and Medicaid are required to cover services for mental health and substance abuse care as one of 10 “essential health benefits” categories. They must be covered at parity (equal cost) with other health issues and insurance companies can’t deny coverage to those with pre-existing conditions, including drug or alcohol dependence. That said, coverage can vary by plan and state, so it’s important to call your insurance company to find out the specifics of your plan. For more information on ACA, visit Healthcare.gov.For those without health insurance, many treatment facilities and healthcare providers offer sliding scale fees, or fees based on your income. Some treatment centers even offer financing options (through their own facility or through third-party lenders). To learn more about payment options, try the Behavioral Health Treatment Services Locator provided by the Substance Abuse and Mental Health Services Administration. This free tool offers payment information for each of the treatment services listed, including information on sliding-fee scales and payment assistance. You can also contact your state substance abuse agency to find out if your state will help pay for substance abuse treatment. For more information, visit Paying for Treatment.
Sources: Commission on Accreditation of Rehabilitation Facilities; Joint Commission on Accreditation of Healthcare Organizations; Health Cost Institute; Health Services Research; HHS.gov/HealthCare; National Institute on Drug Abuse; Substance Abuse and Mental Health Services Administration; United States Department of Labor.