In episode 326, I received a question from a listener struggling with substance and alcohol abuse. In this post, I dive into this issue and offer my thoughts on what you can do to assess your own situation and start making changes to improve your life.
Hi Dr. Duff! I have a question regarding substance abuse/dependency. How do I know when there is a problem? Lately, I’ve been trying to be better about moderating how much alcohol and weed I have because I worry I like them too much. But I often wonder how to know when I like them a little TOO much. Since trying to moderate, I have had binging problems as well. It’s like knowing I am trying not to have it makes it harder to not have it, and then I indulge a lot because I tell myself to just get it out of my system. Then it all kind of starts over. I’m not binging like crazy but just enough that it makes me question what’s normal and what’s not.
Hello! Thank you for the question. As with many questions I get, I think a lot of people out there are in a similar boat. It is a great question. How do you tell the difference between regular use of a substance like alcohol or cannabis and problematic use? There are a few things to consider here.
What’s the impact?
First off, regardless of the amount that you are talking about, it’s important to look at the impact of alcohol or any other substance on your life. How it is actually impacting things? There are some people that drink a decent amount and for all intents and purposes see very minimal impact from it. There are others who drink a more moderate amount and end up running into trouble with relationships, work, or other important aspects of life. When it comes to describing something as a substance use disorder this impact on functioning in life, or significant health concerns are necessary.
It sounds like there isn’t a major immediate consequence or impact on your life at this point if I’m reading the question right. This is more about your sense that there might be a little more reliance, preference, or dependence on these substances than you are comfortable with. This is more a question about what this could turn into, I think. There are also some factors that you might consider regardless of whether substances are interfering in your life.
There’s a great neuroscientist named Matthew Walker, who has a podcast called the Matt Walker podcast. He talks a lot about sleep and some interesting things that you might not know. For example, the impact of alcohol on sleep is really surprising to a lot of people. With alcohol, you definitely have an easier time falling asleep, so it may seem actually beneficial. What you actually find however, if you do sleep studies with people that have been drinking is that the quality of the sleep that they get is severely diminished. You have all of these little moments of waking up that you actually don’t realize or remember in the morning. So you are left thinking that you got a full night’s sleep that was essentially uninterrupted, but in reality you are constantly being pulled out of the deep restorative sleep that you need. Poor sleep leads to a variety of poor health outcomes including increased susceptibility to neurological problems.
Understanding the behavior
Now, more to your question of how you know you have an issue – some of this is going to be about interpreting your own behavior. I think that some of boom and bust behavior that you are noticing here is due to the way you are approaching trying to moderate. It sounds like you are doing something to the effect of abstaining from alcohol during the week and then drinking on the weekends. Whenever we deprive ourselves of something until a certain benchmark or time limit, we definitely run the risk of falling into a binging pattern. You can also see this with “cheat days” during people that are practicing restrictive dieting where they just end up feeling like shit on their cheat days because they go all out.
You may need to experiment a little bit with what moderation looks like for you. If you have a tendency toward this type of behavioral pattern, you will want to watch out for it. Don’t set yourself up for failure by keeping temptation at arms length until you can’t possibly stand it anymore. Maybe instead, this needs to be about reducing the amount that you use overall rather than the frequency. Or you could try a more extended period of sobriety. My dad calls these his sabbaticals. It can be a good check-in with yourself and a bit of a physiological reset from dependence that you may have been building up. The whole get it out of your system thing is a good idea in theory, but unfortunately, we don’t really work that way….whether it’s alcohol or cheating in a relationship or any other behavior that we are trying to avoid. In the end, if you are drinking in a way that isn’t adversely affecting your health or causing you problems socially or occupationally, you really aren’t doing anything wrong. If you’re curious, you could get a physical and have your doctor run some labs to make sure that your drinking isn’t actually adversely impacting your health without you realizing it.
Other factors to consider
Just like with other issues, I think there can also be issues that come up from focusing TOO much on stopping behavior. As humans, we really aren’t the best at actively stopping ourselves from doing things. I wonder if part of the issue here is not that you are drinking so much, but that your life is structured in a way that facilitates drinking. In other words, could this be a sign that you need to add more to your life? This could be in terms of involvements or experiences, work, relationships, or really anything. For example, most people I know don’t really like working out when they’ve been drinking. If you are in a place where more physical exercise would be healthy for you, maybe you could get some personal training sessions instead of blowing that money on alcohol and such. The personal training sessions could be scheduled during times that you tend to drink, so you are redirected away from the drinking during those critical periods.
If you’re concerned that you may be dependent or abusing substances, talk to your doctor about it. There are many different types and levels of treatment and support available. I am not a fan of 12-step programs, but there are many alternatives out there. Some that allow people practicing moderations and some that don’t. From my limited understanding of your situation, I wouldn’t guess that you have a significant problem right now, but it does seem that the behavior of holding off then getting it out of your system over and over could lead to bad outcomes in the future.
You can listen to this on Episode 326 of the podcast!
Thank you for the great question!
If you know someone else who might benefit from this, please do share it with them. Send them a link or shoot over a screenshot, and share it on social media to show your support – you never know who needs to hear this type of information.
Got a topic or a guest you’d like to appear on the show? Or interested in having Duff answer a question on the podcast? Please get in touch! Email Duff and maybe you’ll hear it on a future episode!
Want to help out the show and Duff the Psych?
- Subscribe to the podcast on iTunes.
- Leave a podcast review on iTunes. These reviews really help Duff reach potential listeners, and he appreciates every one!
- Share the show on Facebook or Twitter.
- You can also buy Duff a cup of coffee, which helps fuel the energy that goes straight back into creating more content for YOU!