Do I Have A Problem?
No one just wakes up one day as an alcoholic or addict; there is an identifiable progression from first use to dependence that if you understand and catch early enough may be halted.
|
Dr. Felgus’
Substance Use Continuum 
A: Non-pattern use B: Pattern use C: Negative consequence use D: Psychological dependence E: Physical dependence |
|
Zone A: The person does not drink/use in a predictable, regular fashion. When use does occur, it is at a modest to moderate level with no negative consequences resulting.
Zone B: Use falls into a predictable, consistent pattern. We are creatures of habit -- our brains are wired this way. Most non-problematic drinking falls here. There are no negative consequences resulting from drinking. Within this zone are those who remain pattern drinkers/users for life (e.g., two beers every Friday night or a brandy before bed) and those just passing through on their way to problem use. Other examples of patterns are having a few beers or hits every time you get together with a certain person or group even if this does not happen regularly, or needing to drink or use after arguments with a family member. One pattern defines this zone. Yes, the person who has one glass of champagne on New Year’s Eve and doesn’t drink the rest of the year is in Zone B. Zone C: Problem drinker. The person’s drinking or use, including the after-effects, has caused at |
least one negative life consequence or prevented an intended activity. A negative consequence would be that use of alcohol or drugs kept you from doing something you planned to do (getting to work on time, getting together with a friend, cleaning the garage when you promised your spouse you would) or caused you to do something you regretted (getting into a argument or physical fight, an unwanted sexual encounter.) Driving under the influence even if you didn’t get caught would qualify as a negative consequence. Alcohol use is typically to intoxication. Zone C is not a place people remain for long periods of time. When something bad happens, one will either say, ‘I’m not going to let that happen again,’ and return to Zone B, or continue to have negative consequences and advance.
Zone D: Pattern of Negative Consequences. This Zone usually is a sign of psychological dependence. While a small percentage of people in this zone can move backward into earlier zones on the continuum, most in Zone D have hit ‘the point of no return’ where they need to abstain from the drinking or use. The lack of physical withdrawal |
symptoms distinguishes this person from the final Zone E, but cravings to drink or usecan be just as powerful as can anxiety, sleep or mood problems. People in this Zone will leave the party as soon as the beer runs out, or try to set limits on how much they’ll drink or use and be unable to stay within those limits.
Zone E: Physical dependence in addition to psychological dependence. There is physical withdrawal consisting on stopping drinking or use. For alcohol, these can consist of tremors, sweating, nausea and anxiety, with hallucinations, agitation and seizures in severe cases. For opiates, these consist of goosebumps, runny eyes and nose, muscle aches/bone pain and a feeling of panic. Not all drugs have a physical withdrawal, but many do. Withdrawal from alcohol and certain benzodiazepines such as alprazolam (Xanax) can cause seizures that lead to death and require medical attention if you are in withdrawal. Other drug withdrawal will not cause death, but may feel like it will to the person suffering through it. |
