If you’ve listened to episode 15 “Substance Abuse and Suicide“, you know that many people have a hard time admitting that their substance use has become problematic. It is often said that denial and substance abuse go hand in hand. In fact, being in denial (that you are drinking/using too much) is often considered a cardinal sign that you have a problem. Most of us have known someone who drinks too much, for example, yet is quick to say, “But I am not an alcoholic….” So what is denial, and how do you know if you have a substance use problem?
We Deny All Types of Things
Actually, most of us have a hard time admitting problems in our lives. This is especially true if the problem is embarrassing or has a social stigma attached to it. If you have a criminal record, have been fired from a job, or even have an illness like cancer, you may not want others to know. People are reluctant to admit that they have experienced such issues, especially if they feel it puts them in a bad light. So, the concept of denial is not about alcohol or drugs specifically. Rather, it is about embarrassment, shame, or fear of being seen negatively.
Rationalizations
Denial is related to rationalization (i.e. giving a plausible, even if untrue, reason for something occurring). When asked about their drinking or using, people may explain that they know they don’t have a problem because:
The Rationalization vs The Reality
- Rationalization: “I don’t do it every day.” REALITY: How often you drink/use is less important than what happens when you drink or use.
- Rationalization: “But I have a job.” REALITY: Often, people can hide their substance abuse problems from employers.
- Rationalization: “I never drink alone.” Or “I don’t use drugs by myself” REALITY: Even when with others, you can still drink/use to excess.
- Rationalization: “Other people drink/use more than me.” REALITY: That doesn’t mean you don’t drink or use too much.
- Rationalization: “I only drink beer.” Or “I only smoke pot.” REALITY: The type of substance makes no difference. Your actions while under the influence do.
Do I Have a Substance Abuse Problem?
So, are you in denial about your substance abuse? Most mental health professionals don’t even use the term alcoholic or addict. In fact, there are no mental health diagnoses of “alcoholism” or “addiction”. To be clear, though, there are diagnoses for substance abuse (excessive use) and substance dependence. Dependence means the person uses more and more of the substance over time and has withdrawal symptoms when they stop. A person with alcohol/drug dependence typically is experiencing severe impairments in their life related to their use. For example, their drinking/drug use may be leading to marital conflict or being late to work.
Maybe I Have a Problem?
It is generally better to ask yourself, “Is my drinking/using causing me a problem?” The issue could be in your family life, your relationships, your work, your physical health, your mental well being, or with legal troubles.
Examples: Could this be a drinking/drug problem?
- My wife/husband says I drink/use too much.
- I have frequent hangovers at work.
- I got a DUI.
- My doctor says my liver enzymes are elevated/physical health is impaired.
- A drink helps me steady my nerves.
- The only way I can relieve my anxiety is by getting high.
- I find myself drinking/using more than I used to do.
- A few drinks/getting high helps me forget about my worries.
- I often overuse alcohol/drugs.
- When I stop, I get the “shakes”/experience withdrawal.
Although this is not an exhaustive list, if you answered “yes” to any of these statements, you may have a substance abuse problem. There are no hard and fast rules. If you are having some of these experiences, talk honestly with either a physician or a mental health professional about your drinking/using.
In Closing…
People commonly deny substance use problems. Most of us are reluctant to admit to any sort of embarrassing issue. The frequency of your use is not nearly as important as what happens when you drink/get high. If you are experiencing problems as a result of your substance abuse, get off the “denial train” and seek a professional opinion.