Is someone you know drinking too much or too reliant on drugs, legal or illegal? Or maybe you wonder if you yourself have a problem. About 15% of the population develops a substance-abuse problem at some point in their lives, and even people who do not have a serious issue may find that stress tips them into consuming more than is healthy. Whether they turn to alcohol, prescription narcotics or street drugs, substance abuse can become a coping strategy.

One key to recovery is to learn other coping strategies. The warning signs and what to do next…


Has the following happened more than once in the last 12 months…

  1. Has drinking or drug use caused you to fail to meet an obligation, such as a deadline at work or picking up a child from school?
  2. Have you been under the influence of alcohol or drugs when driving or in any other circumstance where you need to be fully alert? Examples: While operating machinery, riding a bike or when alone in an unfamiliar place.
  3. Has your drinking or drug use hurt your relationships? Examples: Losing a friendship or triggering arguments with your spouse.
  4. Has drinking or drug use caused you a legal problem, such as an arrest for drinking and driving?

Answering “yes” to one or more of these indicates substance abuse.

Substance abuse can lead to dependence — a more severe problem. You may be dependent if you answer “yes” to three or more of the following…

  1. Are you using the substance more often or in greater amounts?
  2. Are you spending more and more time thinking about the substance, obtaining it and using it?
  3. Do you have physical symptoms when you stop, such as feeling “hung over” or agitated?
  4. Does it take more of the substance than before to give you the desired effect, so if you stick to the previous amounts, you feel dissatisfied?
  5. Do you wish you could cut back or stop, or have you tried and failed?
  6. Have you dropped or cut back on “good” activities, such as exercise or making an extra effort at work?
  7. Have you continued with the substance even though it is hurting your health, such as aggravating depression or causing stomach problems?


People often are surprised to realize that they drink more than is safe. “Low-risk” drinking is no more than seven drinks a week (no more than three on any given day) for most women, and no more than 14 a week (no more than four on any day) for men. Also, most people find it surprising that “one drink” is smaller than they think — five ounces of wine, 1.5 ounces of 80-proof liquor or 12 ounces of beer. For some people, such as those with a family history of alcoholism, the only safe limit is no drinking.

About 30% of Americans drink more than the low-risk limits and are considered “at risk.” This means that they are likely to develop a substance-abuse problem or may already have one. Heavy drinking also increases the risk for many health problems, including liver disease and cancer, as well as car accidents.


If you think you have a problem, there are several ways of reducing your use or quitting. Some people quit all at once… others cut down gradually. However, if you suspect that you have a severe substance-abuse problem, it is important to see a medical doctor before stopping. Quitting can be dangerous.

Example: If you are dependent on alcohol, within a few hours after your last drink, you may experience shakes, sweats, nausea and headaches. After six to eight hours, you may experience hallucinations, as well as convulsions, which can trigger a fatal heart attack or stroke. A doctor may recommend that you enter a hospital. Go to for a government listing of facilities, or call 800-662-4357.


Once you have decided to address a substance-abuse problem, it’s helpful to adopt new coping methods…

Identify your “substance-use thoughts,” and plan a rebuttal. What is going through your mind before you down the extra martini or take one more pill than prescribed? Come up with an effective counterresponse.

Examples: Instead of, “I can do what I want,” tell yourself, “My drinking hurts the people in my life.” Instead of, “This feeling will never go away unless I have a drink,” tell yourself, “It’ll pass.” Instead of, “I don’t care about the future,” ask yourself, “How will I feel later?”

Practice grounding, the technique of focusing outward when you are hit by strong emotions or cravings. This minimizes the pull of your inner state, keeping you from feeling overwhelmed and helpless. Grounding can be mental or physical. Experiment with different strategies until you find those that work for you. Try reading aloud, counting to 10 or repeating a phrase to yourself. Run cold water over your hands, or clench and release your fists. If you need physical grounding in public situations, carry an object, such as a piece of yarn or a stone, in your pocket and touch it when you’re stressed. Soothe yourself by recalling a peaceful place or thinking of favorite things (animals, songs, people).

Talk to yourself compassionately. Many people are harshly critical of themselves. Strive to coach yourself through challenges with kindness and understanding.

Example: Say to yourself, “I didn’t do well on that job interview, because I need to practice interviewing.” Don’t say, “You idiot, you’ll never get a job.” You might also write down some compassionate statements and read them regularly.

Examples: “You have suffered a lot and have overcome many challenges.” “Even when you were drinking heavily, you always supported your family and showed your children that you loved them.”

Be honest. Secrecy and lies are part of the problem. Honesty can be liberating. Choose the truth — within yourself and to people you can trust. Be aware that sometimes honesty can get a negative reaction.

Example: A drinking buddy feels that you have deserted him because you can no longer meet him in bars. But being honest gives you a chance to form supportive new relationships.

Ask for help. Some people take on too much, adding to their stress. Make reasonable requests of friends and family, staying specific and tailoring requests to their abilities. The help can be either emotional or practical.

Examples: Ask a friend to call or visit. Ask a family member to babysit your children once a week. Asking for help makes you stronger because it increases your resources and allows you to address your needs.