Help is available for people with alcohol or drug dependencies

There are four million people in the country with substance dependence, according to the 2005 Health Professionals Substance Abuse Education Act.

Drug and alcohol abuse is a problem that can touch many more lives than just those of immediate family and friends. The cost of loss of relationships and careers is great, but often, these issues spiral out of control with even greater consequences.

Fortunately, if you have a problem with substance abuse, there are answers. You can get help and you're not alone.

"We do now have evidence, in the past five years or so, that it is a brain disease; there are bio-chemical changes in the brain that occur with addiction," said Wendy Bailie, director of the Substance Abuse Program, Franklin Williamson County Human Services, Inc.

"Addiction is both a behavioral and bio-psycho social problem that has a basis in brain chemistry changes that come along with that, which is why it is so difficult to recover."

Behaviorally, there are many indicators of a problem, including using more of a substance to get the same effect and continuing use despite the negative consequences.

"Your life's falling apart, but because of those brain chemistry changes, you're not making rational decisions.

You're continuing to use because you have no control over that urge," Bailie said.

At some point, many people have a "moment of clarity" that will give them impetus to seek help for a problem, though most of the time this is not the case.

"Typically, people get into treatment because of outside intervention," said Shane Koch, associate professor and director of studies in addictions at the Rehabilitation Institute at Southern Illinois University Carbondale.

"Unfortunately, in our culture, most people get into treatment because of interaction with the legal system. By the time people get so severe to really need intervention on that scale, it becomes much more difficult to intervene with them."

Koch said because of the importance of early intervention, people must become familiar with the criteria for dependence.

"Particularly in the early stages, if a friend came up to you and said, 'I really care about you; I'm really worried about you,' I think you'd be more likely to listen to them than later in the process," he said.

If you have a friend or family member who you need to speak with about a problem, Koch recommends a three-step process.

First, sit them down and tell them you are concerned, and ask if they will talk to you.

Don't just tell them you think they have a problem; you have to be behaviorally specific. List the negative things you've noticed happening in their lives.

Then tell them you care about them and that is the reason for the conversation.

It may be that the person seems to be functional in dependence; however, this is often misleading

Koch said there are people who can perform at a minimal level, going through the motions of life and maintaining employment. He is hesitant to use work performance as a barometer, but instead looks at the dependence's effect on relationships.

"How functional are they really?" he asked. "How do they feel about their lives? How healthy are they psychologically?"

When a person is willing to recognize a problem and seek treatment, the good news is, there are many programs available, including state programs and programs in employer health care plans.

"People are terrified of talking about this stuff with their health care organizations," Koch said. "The reality is there is very good protection in federal legislation and federal code, protecting your confidentiality for substance use disorders."

There are also a number of 12-step programs and faith-based programs for people with substance abuse problems.

Koch, who has also been in recovery since 1988, said getting involved in 12-step groups helped him meet people who had similar problems but were doing well

"When people get to that place and get desperate, often it's difficult to conventionalize or identify what life would be like without alcohol or drugs," he said.

Koch likened the experience of addiction and coming to a moment of clarity as a person who is drowning who comes up out of the water.

"What you have to do when this person bobs up out of the water - you have to grab them and get somebody to them to get them a preserver to keep them up," he said.

How can you tell if someone has an alcohol problem?

Answering the following four questions can help you find out if you or a loved one has a drinking problem:

• Have you ever felt you should cut down on your drinking?

• Have people annoyed you by criticizing your drinking?

• Have you ever felt bad or guilty about your drinking?

• Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

One "yes" answer suggests a possible alcohol problem. More than one "yes" answer means it is highly likely that a problem exists. If you think that you or someone you know might have an alcohol problem, it is important to see a doctor or other health care provider right away. They can help you determine if a drinking problem exists and plan the best course of action.

The Southern