Substance Use Versus Abuse: A Place to Start

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By Rikki Clos, MSW 

I find a number of clients I’ve worked with don’t know where to start if they are worried about their substance use. The topic of alcohol and drug use is so highly stigmatized in our society that even breathing the word “addiction” is frowned upon. This is problematic for a number of reasons, not the least of which is it keeps people isolated in their struggles with substances, unable to ask for help or expertise from others for fear of social retribution. Addiction is also criminalized; Folks caught using or in the possession of illegal substances can get legal charges that, for adults, follow them for the rest of their lives and can affect everything from employment to housing options to eligibility for student aid[1].  

So where can you start if you’re concerned about your use and nervous to meet with a professional for an assessment? A good place to start is the CAGE screening tool, a standard 4-question assessment used by mental health providers to screen for potential abuse[2]. Let’s look at the questions:

1.     Have you ever felt you should cut down on your drinking or drug use?

2.     Have people annoyed you by criticizing your drinking or drug use?

3.     Have you ever felt bad or guilty about your drinking or drug use?

4.     Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?

Asking yourself these questions from a position of nonjudgment and honesty can help you to figure out if your substance use may merit intervention by mental health professionals. Answering “yes” to two or more of these questions is considered “clinically significant”, which may indicate that further assessment and/or treatment may be beneficial to you. 

While society may stigmatize substance use to the point of criminalization, you’re not in this alone. Everyone’s recovery journey looks different. Below are a few resources for getting help:

Umbrella Collective for Therapy - https://www.umbrellacollective.org/appointments

We currently have one therapist with experience working with substance use treatment and assessment (Rikki Clos).

Alcoholics Anonymous or Narcotics Anonymous - https://www.aa.org/ or https://na.org/

AA and NA are great resources for social support and mentorship from other folks in recovery. Good advice is trying more than one group if the first or second don’t feel like they fit for you—every group culture is different and finding the right one is important.

Mental Health Partners - https://www.mhpcolorado.org/addiction/

MHP offers a few different substance use programs including a Medication-Assisted Therapy program for substance use.

[1] https://www.michigan-drug-attorney.com/how-will-a-drug-conviction-on-my-record-affect-my-future.html

[2] https://www.hopkinsmedicine.org/johns_hopkins_healthcare/downloads/all_plans/CAGE%20Substance%20Screening%20Tool.pdf

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Umbrella Collective

Mission Statement:

We are a group of depth-oriented mental health therapists who strive to embody values of liberation, welcome and honor all parts of our humanity, deeply appreciate intersectionality and empower all people to tell their story and experience acceptance, belonging and more meaningful relationships with self and others.

Who We Are:

The Umbrella Collective was developed to be a group practice where clients can see themselves reflected in their therapists from an inclusive standpoint. We consist of a network of talk therapists who specialize in working with an intersectional lens, centering the margins in the therapeutic work. We offer many different psychotherapy modalities, including psychodynamic, somatic, EMDR, CBT, Hypnotherapy, and Substance Abuse treatment. We provide consultation to individuals, families, and groups. Umbrella Collective mental health professionals are passionate about social justice, dedicated to ongoing training and education in best practices for BIPOC, LGBTQ people, and people who experience life on the margins. We are skilled at working with you and your intersecting identities.

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