Substance Use Disorder Counseling: How To Know If It’s Time To Get Help
Substance-Related And Addictive Disorders is a category in the Diagnostic and Statistical Manual of Mental Disorders (DSM) that encompasses a number of different disorders, including alcohol use disorder (also known as alcohol addiction) and opioid use disorder. Substance use disorders (SUDs) are not a choice, but recovery is possible, and various research-supported treatment options and treatment centers are available. Often, underlying concerns and comorbid conditions, like anxiety disorders, environment, family history, and trauma, play a role in developing or affecting a person living with a SUD.
SUDs can affect all areas of a person’s life, including social relationships, family and love life, work, education, physical health, and mental health.
You’re also not alone. According to the Substance Abuse and Mental Health Services Administration, more than 40 million Americans lived with an SUD in 2020, including 14.5 million who lived with alcohol use disorders.
If you’re considering support for a SUD, you’re likely well aware of the ways that it impacts or could impact your life. So, how do you know if it’s time to get help for substance abuse?
Potential Substance Use Disorder Symptoms
Everyone experiences symptoms differently. Understanding the possible symptoms of a substance use disorder may help you identify if you need care.
Here are some potential symptoms and signs of SUDs:
- Difficulty cutting down on or quitting a substance despite wanting to do so.
- Changes in performance at work or school.
- Withdrawal symptoms upon attempting to discontinue the use of a substance.
- Personality changes, such as secretiveness, irritability, or agitation.
- Changes in sleep patterns (IE, difficulty sleeping, or oversleeping).
- Mood swings.
- Outwardly visible symptoms, such as trembling or shaking, bloodshot eyes, and difficulty with personal hygiene.
- Slurred speech.
- Unexplained financial problems or needs due to spending money on substances.
- Legal problems related to the use of substances.
- Social changes due to the use of substances (IE, social isolation, or changing friend groups and hangout spots based on to substances).
- Difficulty or problems in interpersonal relationships related to the use of substances.
- Cravings for the substance.
The truth is that it’s never too soon to ask for help or start the recovery process. If you notice these symptoms in yourself, it may be time to reach out and ask for help.
Addiction Treatment Options For Substance Use Disorders
There are several different treatments available for SUDs, and combined approaches are used frequently. Some people go to detox first to prepare themselves for treatment. Detox is there to help you discontinue the use of substances safely. After detox, a person may enter residential or inpatient treatment, followed by outpatient treatment and ongoing support groups or therapy.
Some common complementary therapies to used effectively treat addiction include:
- Motivational interviewing (MI) — Also known as Motivational Enhancement Therapy, MI is a counseling approach that seeks to alleviate any doubts an addicted person may have about pursuing therapy. It’s listed as an evidence-based therapy by the National Institute on Drug Abuse.
- Family therapy —
- The Matrix Model —The Matrix Model combines the principles behind various therapeutic techniques, such as CBT, MI, and CM, implementing them in a mixture of individual and group therapy sessions. It’s especially useful for treatment of alcohol abuse.
- Step Facilitation Therapy —STP is a type of behavioral therapy intended to promote engagement with 12-step programs.
- Contingency Management — Contingency management is a type of cognitive-behavioral therapy. It involves using tangible rewards to incentivize treatment engagement on the part of the patient. These rewards may involve gift vouchers or small cash prizes in exchange for meeting small and achievable treatment milestones (ex: attending sessions every day for a month). It’s been successfully used to treat opioid use disorder.
- Rational Emotive Behavior Therapy (REBT) — Another form of behavioral therapy, REBT aims to replace irrational or limiting beliefs with more positive thought patterns. It’s an effective treatment for a large variety of co-occurring disorders, such as depression, anxiety, as well as various phobias and sleep issues.
In treatment, you often learn about and create a plan for relapse prevention, work on problem-solving skills and interpersonal relationships, address any legal or social issues that may be prevalent, address comorbid or co-occurring concerns and conditions, and more. There is no shame in seeking care, and it is important to destigmatize SUDs so that more people can get the life-saving support they need.
Addressing Co-Occurring Concerns In Treatment For SUDs
Addressing co-occurring or comorbid concerns is often a vital part of treatment for SUDs.
Common comorbidities seen in those living with SUDs may include:
- Post-traumatic stress disorder (PTSD). It said that roughly half of those living with a SUD meet post-traumatic stress disorder or PTSD criteria.
- Eating disorders*. People with eating disorders are five times more likely to live with a SUD when compared to the rest of the general population.
- Anxiety disorders. Anxiety disorders are a significant risk factor for the development of a SUD, especially alcohol abuse.
- Almost a third of those living with major depressive disorder or MDD meet the criteria for a SUD. Substance use can also pair with other types of depression, like persistent depressive disorder.
- Attention-deficit/hyperactivity disorder (ADHD). People with ADHD are more likely to live with a SUD when compared to those without ADHD.
Other conditions can play a role in the development of SUDs for some people. In cases like these, addressing other concerns is often highly beneficial and is an important part of treatment for SUDs. Other risk factors, like environment, may also be addressed in treatment. When a person receives care that acknowledges their needs as a whole person and does not shy away from the role the substance may play in a person’s life, it means that a person can speak openly about their experiences, find healthy coping mechanisms to use when triggers arise, learn how to advocate for themselves, and gain other skills that may be beneficial for them as a unique person in recovery.
*If you or someone you know is living with an eating disorder or might be, please contact the National Eating Disorder Association Helpline at 1-800-931-2237.
How Substance Use Disorder Counseling Can Help
If you’re considering SUD counseling, you might wonder how it works, what it will be like, or what the benefits of treatment might be.
Counseling for a substance use disorder can help you:
Name and navigate triggers
Learning to name and navigate triggers is often a crucial part of relapse prevention. Your triggers might be specific feelings, specific situations (such as situations where you may be in the same room as or get offered a particular substance), or something else. Once your name or identify your triggers, you will likely make a plan for how you can navigate them, helping you engage in more rational thinking. This might be turning to a support system, leaving the room or event, finding ways to cope after the fact, or something else.
Work on life goals
A big part of counseling or treatment for SUDs is thinking about what you want your future to look like. This could include learning skills that’ll help you build and maintain healthy friendships, job or work-related skills and goals, and implementing positive daily routines into your life.
Challenge negative thoughts
It’s very common to experience depression, negative thoughts, and other challenges when new to sobriety. Learning to challenge negative thoughts effectively is something that we can all benefit from, and in time, your general thought patterns can become more positive and balanced if this is something you’re working on.
Improve your overall mental health
Because mental illness often coincides with substance abuse, one of the key principles of substance use counseling is addressing mental health holistically. In other words, most often, you will address everything – or most things – that is impacting your mental health rather than the SUD diagnosis and the behaviors that might come with it alone. Many patients learn coping skills, communication skills, and so on that positively impact their lives and well-being overall.
Find solidarity and fight stigma
You will likely come to find a sense of solidarity in SUD counseling or treatment. Whether that is from the healthcare professionals you work with, of a support group, a sponsor, or someone else, finding people who take away the stigma of SUDs and provide solidarity for your recovery is something everyone who gets care deserves.
That said, this is by no means an extensive list. Counseling for a SUD can help you in many different ways, and it is the start of what truly feels like a new life for many people.
Where To Find Substance Use Disorder Treatment Or Counseling
What if you want treatment but aren’t sure where to find it?
Here are some ways to find care:
- Ask a professional. You can ask a general doctor for treatment information or ask a counselor, therapist, social worker, or psychiatrist you already work with.
- Use a treatment locator such as https://findtreatment.gov.
- Call a resource hotline such as the 211 hotlines. 211 is available in most areas in the United States. Dial “211” using any landline or cell phone, and you’ll be connected with an operator.
If you have health insurance, you can also contact your health insurance company directly to see what treatment resources they cover.
Loved Ones And Substance Use Disorders
If you live with a SUD and want to show someone in your life how to support or better understand what you’re going through, you may send online resources and other sources of information their way. SUD treatment often encourages the involvement of loved ones.
Alternatively, if you’re the loved one of a person with a SUD, you may want to find support for yourself. There are many support groups for loved ones of those with SUDs, including family and romantic partners. One common example is Al-Anon.
Individual therapy with a licensed mental health professional may also be advantageous if you are the loved one of someone living with a SUD. It can be challenging to watch someone you care about face a SUD or another similar condition. Among the many other reasons people might seek therapy, therapy is a safe space to talk about your feelings and help you cope with or manage stress when times are hard. In time, you can learn to replace the negative habits and thought patterns that lead to substance abuse with more positive behaviors.
Whether you have a loved one with a SUD or want to talk about something else that’s on your mind, seeing a mental health professional can support you in finding clarity and confidence as you move forward.
Frequently Asked Questions (FAQs)
What type of therapy works best for substance abuse?
No one therapy can fit all situations, but one of the most respected evidence-based therapies used to treat addiction is cognitive behavioral therapy (CBT). This therapy involves teaching patients to recognize the underlying self-destructive behaviors driving their alcohol or drug addiction. The patients learn coping skills to avoid these behaviors, helping them in maintaining sobriety. CBT is listed by the National Institute on Drug Abuse as an evidenced-based therapy.
What is a treatment plan for substance abuse?
A treatment plan for substance abuse is a multi-step strategy for treating substance abuse.
What are the four goals of drug therapy?
What are the five stages of treatment?
The five stages of addiction treatment are the following:
- Precontemplation — The addicted person at this stage typically has not yet acknowledged their need for therapy. Denial of the problem and excuse-making are not uncommon here.
- Contemplation —At this stage, the person understands they have a problem, but may still not quite be ready for treatment.
- Preparation — Now the is usually taking action, but generally on their own – they aren’t quite ready to go to an addiction treatment center. They may instead try to join a gym or quit their addiction on their own.
- Action — In the action stage, the person has decided to receive treatment. They may also be committed to abstinence and making substantial, positive lifestyle changes.
- Maintenance — After getting treatment, the person is now committed to maintaining sobriety through continuing to practice the valuable coping skills and lifestyle changes they’ve adopted.
What does CBT therapy do?
CBT aims to treat alcohol or drug abuse by addressing a person’s mental health, which is often at the root of addiction. The treatment process involves talking to the patient, teaching them coping skills to help them avoid the negative consequences brought on by their negative thought patterns. It’s considered the most effective of all behavioral therapies. Other therapies contained within CBT include Contingency Management and Rational Emotive Behavior Therapy.
What are three options for drug abuse treatment?
Broadly speaking, the three options for treating addiction to drugs or alcohol are as follows:
- For serious addictions, a person may check in to inpatient rehab to undergo a full detox. Stays in an inpatient program are typically two weeks, minimum. During this time, a person may be prescribed medication for substance withdrawal (this is known as a medically-assisted detox).
- After detoxing, therapy to address any underlying mental illness of negative thought patterns can begin. This can take multiple forms, including 1-on-1 mental health counseling, group therapy, or various behavioral therapies.
- After detox and therapy, a patient may enter what’s called outpatient rehab. The treatment process for outpatient rehab usually entails the person attending sessions during the day and then returning to their homes in the evenings. Treatment modalities here typically involve continued behavioral therapy, as well as support groups like AA to support the person’s addiction recovery.
What are the four steps of treatment planning?
Substance abuse treatment plans typically involve the following four steps:
- Identify the Problem — This involves the person working with a medical professional to identify the exact addiction issue. For example, the patient may write out a problem statement identifying the issue as “prescription drug addiction,” or, “opioid addiction.” This statement may also encompass any co-occurring disorders like generalized anxiety or clinical depression.
- Create a Goal — Next, the patient and professional would work together to address these issues. This could involve addiction treatment, therapy, medication, and learning coping skills.
- Define Objectives — After the overall goals are established, a strategy is devised to reach them. This typically involves establishing concrete, observable behaviors, like positive affirmations or keeping a journal.
- Intervention —The final step in a substance abuse treatment plan is doing an intervention. This may entail group therapy sessions in which a patient’s reactions and statements are observed and tracked.
Which is the first step in treating a drug abuse problem?
The first step in treating a drug abuse problem is typically detox, often done at a treatment center. Medication may be used to manage any substance withdrawal symptoms.
What are some goals of a substance abuse counselor?
The main goal of a substance abuse counselor is to help the patient identify their addiction and develop strategies to manage their addictive behaviors.