As a substance abuse counselor I have worked with many clients who were on the fence about their addiction. They would have some issues in their life that made then think they were addicted but they would also have some reasons why they couldn't be addicted. I have found it helpful to explore various ways to help them get off the fence and let go of any possibility that they might not be addicted. Denial is expected in alcoholics and addicts. I have met many Jack Whinery, homesteader, repairing fence whi...professionals that complained about a client in denial. I would tell them they are doing just what they are supposed to do as an addict. It is a normal defense mechanism that occurs in all of us at times. In fact, I have learned to question when a client comes in and displays no denial—many time they are only agreeing because someone has referred them to treatment, someone like a judge, probation or parole officer, social services worker, etc. I am not saying that I automatically believe they are lying but I do reserve judgment and let the actions speak about whether they are sincere or not. I will treat them the same whether they believe they are addicted or not. If nothing else I will provide them with knowledge and the rest is up to them.

One of the tools I have used to help people make the decision to get off the fence is reviewing the diagnostic criteria for dependence in the Diagnostic and Statistical Manual (DSM-IV) published by the American Psychiatric Association. It sounds very clinical but its not. I encourage you to think about these question as the relate to your life and see where you stand. Any yes answers would need additional information to confirm and clarify the diagnosis but for this post I will just give you the basic questions. So here are the seven questions (answer yes or no; and a yes, but answer is still a yes):

1a – have you noticed that it takes more to get you high (or drunk) than it use to?


1b – have you noticed that you don't get as high (or drunk) than you did in the past when using the same amount?

2a – have you noticed any withdrawal symptoms when you stopped using or drink? (There are many possible symptoms and each substance has some differences but the basic idea is do you have any physical symptoms when you don't use?) Some possible symptoms are shakes, tremors, headache, sweats, nausea, diarrhea, etc.


2b – have you used another, similar, substance to relieve or avoid withdrawal symptoms?

3 – have you noticed that you often use more than you planned to use? (Example, "I told myself I would only drink 2 beers but ended up drinking 12.")

4 – have you had a persistent desire to quit or slow down your use (or control how much you use)?

5 – have you been spending a large amount of your time either getting, using, or recovering from using your substance? (Does it take up a lot of your day?)

6 – have you given up or reduced some important social, occupational, or recreational activities because of your use?

7 – have you continued to use your substance even though you know it is causing physical or psychological problems in your life?

There they are. If you said yes to 3 or more of these occurring within the same 12 month period then you are addicted?

Yep, you read that right. You only need 3 of these within a 12 month period to be considered an addict. The majority of the people I have worked with over the years have been surprised that you only need to say yes to 3 (any 3). The usual experience is they say yes to all or most of them.

Many people will say they are not addicted since they didn't have the physical withdrawal symptoms (indicated by questions 1 and 2). The truth is you don't have to have the physical withdrawal to be considered an alcoholic or addict. In fact, my experience is the psychological part of addiction is where the real trouble is. It's the psychological part of addiction that brings people back to using (relapse) due to stress, anxiety, or other emotional pain. It's the psychological nature of addiction that causes people to struggle with temptation long after they have quit using.

Now, one more question, are you still on the fence?

I would love to hear your response to this post—leave a comment and tell us your thoughts.

Author's Bio: 

Tim Gray, MA, CADC
Masters degree in Mental Health Counseling. Certified Alcohol and Drug Counselor. 20 years of experience as therapist working with mental health, addictions, and co-occurring disorders. I am very passionate about living a balanced, healthy life in recovery since I know the benefits in my life and struggles with additive behaviors.