About addiction
Understanding Alcohol and Drug Addiction
If alcohol or drugs have started to take up more and more space in your life, or in the life of someone you love, you probably have questions. This page explains what alcohol and drug addiction is, what common signs look like, and how addiction affects the whole family. It also offers three short self-tests as a first step, and shows you how to reach us for a confidential conversation.
You are welcome here whether you are worried about yourself or about someone else. Nothing on this page is a diagnosis, and you do not need to have made up your mind about anything to keep reading.
The basics
What is addiction?
Addiction is a chronic, progressive condition. Someone living with addiction finds it very hard to control or stop their drinking or their drug use, even when it clearly harms their health, their relationships or their work. It affects people of every age, background and walk of life.
Addiction is not a moral failure and not a lack of willpower. There is rarely a single cause. Family history, the environment someone lives in, stressful or traumatic life events, and mental health difficulties can all play a part. What begins as social drinking or self-medication can, over time, develop into dependence.
If you want to read more about how addiction works, we have written about it here: Addiction: a chronic, progressive and relapsing disease.
Alcohol
Alcohol addiction
Alcohol addiction is a chronic, progressive condition marked by an inability to control or stop drinking despite negative consequences. It affects people across age, gender and socioeconomic lines.
Alcohol dependence is not only about heavy drinking. It is when alcohol becomes a destructive part of someone's life. Some people who can abstain for long periods, but lose control when they do drink, are also dependent. Prolonged alcohol use alters brain chemistry, which can lead to tolerance and withdrawal symptoms, and that makes stopping harder.
Common signs of alcohol dependence include drinking more, or longer, than intended; unsuccessful attempts to cut down; spending a lot of time drinking or recovering; neglecting responsibilities; withdrawing from social activities; mood swings; and continuing to drink despite knowing the harm.
If you are unsure whether alcohol has become a problem for you, the self-test below is one first step.
Self-test 1
Am I an alcoholic? A first step, not a diagnosis
The 20 questions below come from a widely used questionnaire known as the Johns Hopkins Twenty Questions, developed in the 1930s by Dr. Robert Seliger at Johns Hopkins Hospital.
Remember: this test is not a substitute for an evaluation by a professional. It is only a first step. Only a proper assessment can say what is going on, and there is no need to wait for one to reach out for support.
Show the 20 questions
- Do you lose time from work due to drinking?
- Is drinking making your home life unhappy?
- Do you drink because you are shy with other people?
- Is drinking affecting your reputation?
- Have you ever felt remorse after drinking?
- Have you gotten into financial difficulties because of drinking?
- Do you turn to lower companions and inferior environments when drinking?
- Does your drinking make you careless of your family's welfare?
- Has your ambition decreased since drinking?
- Do you crave a drink at a definite time daily?
- Do you want a drink the next morning?
- Does drinking affect your sleeping patterns?
- Has your efficiency decreased since drinking?
- Is drinking jeopardizing your job or business?
- Do you drink to escape from worries or trouble?
- Do you drink alone?
- Have you ever had a complete loss of memory due to drinking?
- Has your physician treated you for drinking?
- Do you drink to build your self-confidence?
- Have you ever been to a hospital or institution on account of drinking?
Answering yes to one or two questions is a reason to pay attention. Answering yes to several is a good reason to talk to a professional. The test cannot tell you what stage anything is at. Only a proper evaluation can.
Drugs
Drug addiction
Drug addiction is more than a bad habit. It is a condition where someone cannot stop using drugs despite the damage to their health, relationships and life. Without help, drug addiction can be fatal. With the right support, change is possible.
Self-test 2
Drug use: a first step, not a diagnosis
The questions in the self-test below are an adaptation of the same Johns Hopkins Twenty Questions, with drinking replaced by drug use. As with the alcohol test: this is not a diagnosis, only a first step.
Show the 20 questions
- Do you miss work due to drug use?
- Is your home life affected by drug use?
- Do you use drugs to overcome shyness?
- Has drug use hurt your reputation?
- Do you feel regret after using drugs?
- Have drugs led to financial problems?
- Do you associate with others who use drugs?
- Are you neglecting your family's well-being?
- Has your ambition declined since using drugs?
- Do you crave drugs daily?
- Do you need drugs in the morning?
- Does drug use affect your sleep?
- Has your efficiency decreased?
- Is your job at risk due to drug use?
- Do you use drugs to escape problems?
- Do you use drugs alone?
- Have you experienced memory loss?
- Have you been treated for drug-related issues?
- Do you use drugs for confidence?
- Have you been hospitalized for drug use?
Answering yes to several questions is a good reason to seek help. The test cannot tell you what is going on. Only a proper evaluation can.
Substances
Some drugs people ask us about
Prescription medication. Medicines that are medically necessary can still lead to addiction. Commonly misused medicines include opioid painkillers, anti-anxiety medication, stimulants used for ADHD, and sleep aids. Do not stop or change a prescribed medicine without talking to your doctor.
Cannabis. Cannabis addiction, or cannabis use disorder, involves compulsive use despite negative effects. It can lead to withdrawal symptoms, neglect of social life and work, and in some cases psychosis.
Cocaine. Cocaine addiction leads to compulsive use, tolerance, and severe mood swings. It disrupts personal lives, finances, and careers.
Ketamine. Ketamine was originally developed as an anaesthetic. It is sometimes misused for its dissociative effects, and regular use can lead to strong dependence.
Heroin. Heroin is highly addictive, and physical dependence can develop quickly. Despite the stigma that still surrounds it, change is possible, and everyone deserves the chance to live a fulfilling life.
Family
How addiction affects the family
When one family member struggles with addiction, the effects reach far beyond that person. Tension, worry and unpredictability become part of everyday life for everyone in the household.
Family members often carry feelings that are rarely spoken aloud: guilt, and the question of whether they could have done something differently; denial, as a way to cope; a sense that it is their duty to fix the situation; shame fed by the stigma around addiction; confusion, anger and sadness. None of these feelings are a sign of weakness. They are ordinary responses to a difficult situation.
Over time, communication breaks down. Difficult conversations are avoided, misunderstandings grow, and the unity that once held the family together can begin to fray. Often the family's struggles mirror the progression of the addiction itself.
Every person in the family experiences the situation in their own way, and every person may need their own support. Recovery is something the whole family can take part in, each in their own way.
If you want to read more, these posts go deeper: Family illness: the ripple effect of addiction and The invisible impact: exploring the unseen effects of alcoholism on families.
Self-test 3
Am I codependent?
Codependency describes patterns where your own wellbeing becomes closely tied to another person's drinking or drug use: putting the other person's needs first, finding it hard to set boundaries, or staying in situations that harm you. The questions below are a widely shared checklist of this kind, used in the family-programmes tradition around Al-Anon and adult children of alcoholics.
This test is not a diagnosis. It is a first step, and answering yes to several questions is a good reason to talk to someone.
Show the 20 questions
- Do you constantly seek approval and affirmation?
- Do you fail to recognize your accomplishments?
- Do you fear criticism?
- Do you overextend yourself?
- Have you had problems with your own compulsive behavior?
- Do you have a need for perfection?
- Are you uneasy when your life is going smoothly, continually anticipating problems?
- Do you feel more alive in the midst of crisis?
- Do you still feel responsible for others, as you did for the problem drinker in your life?
- Do you care for others easily, yet find it difficult to care for yourself?
- Do you isolate yourself from other people?
- Do you respond with fear to authority figures and angry people?
- Do you feel that individuals and society in general are taking advantage of you?
- Do you have trouble with intimate relationships?
- Do you confuse pity with love, as you did with the problem drinker?
- Do you attract and/or seek people who tend to be compulsive and/or abusive?
- Do you cling to relationships because you are afraid of being alone?
- Do you often mistrust your own feelings and the feelings expressed by others?
- Do you find it difficult to identify and express your emotions?
- Do you think parental drinking may have affected you?
If you recognise yourself in these questions, you are not alone, and support exists. Our post Codependency: the dark side goes deeper. If you grew up with a parent who drank, Did you grow up with a problem drinker? may also speak to you.
You do not have to work this out alone.
Next steps
What you can do next
You do not have to work this out alone, and you do not have to wait until things are bad enough.
The Zenit Room offers confidential counselling and guidance for individuals and families: recovery counselling, CRAFT family training, CRA / A-CRA counselling, family coaching and guidance, aftercare planning, and help finding the right treatment centre. We work online and in person, in English, Swedish, Norwegian, Danish and German.
The first step is a free, confidential consultation. We reply within 24 hours.
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