How Self-medication Becomes a Problem

September is National Recovery Month, which promotes awareness of substance use disorders. Behavioral health conditions are often linked with substance use disorders, so understanding the nature of that relationship and how to spot subtle signs of a problem can be the key to connecting a loved one or yourself with the appropriate help.

Sandon Bull, LCSW at Parkridge Valley Hospital Cleveland Outpatient, specializes in helping people overcome substance use problems. He discussed how using alcohol to self-medicate symptoms of anxiety or stress can lead to a cycle of abuse.

What is self-medicating behavior?

"Self-medicating is when someone uses a maladaptive coping behavior, such as drinking, to treat an underlying mental or emotional condition instead of seeking proper professional help."

At what point does self-medication become a problem?

"Alcohol is a huge part of our culture, and because it is so socially accepted, it takes people longer to recognize when it has become problematic. For example, I hear casual conversations in which people describe becoming so intoxicated that they blackout or have memory lapses. Such situations can be very dangerous in many ways, but people may not recognize that initially.

"Many people use alcohol as a result of perceived or real social pressure. Every day, we hear messages from various outlets about how alcohol is necessary in certain situations to have more fun, cope with stress or unwind. I work with people who have substance abuse issues, and many of their problems began by using alcohol to treat anxiety, to sleep, or to reduce racing thoughts or hallucinations."

Why is self-medicating such a problem?

"The biggest problem with self-medicating is that the underlying issue isn't being addressed and can often be exacerbated. I frequently see people who began using alcohol to treat mild anxiety which became more extreme and made it more difficult for them to stop using alcohol. In this way, alcohol use as a treatment for an underlying mental or emotional health issue becomes a cycle in which people can become easily trapped.

"It's always best that the underlying issue - anxiety, stress or something else - be treated by an appropriate behavioral healthcare professional."

How can you tell the difference between self-medication and a problem with alcohol?

"Anytime someone feels he or she needs alcohol, it's problematic. If someone can't imagine attending certain events without drinking, then there is likely some degree of social anxiety caused by those public situations.

"On the other hand, if someone feels a need for alcohol after a stressful day, then it would be wise to avoid alcohol and seek other ways to decompress from that stress.

"Struggling to go any length of time without alcohol is also indicative of a problem."

Is there a difference between self-medicating behavior and alcoholism?

"It is possible to have problem behaviors associated with alcohol without being dependent on the substance itself. Some people use alcohol very rarely, but when they do they find themselves in bad situations. If someone looks back on times when he or she drank, and those times are associated with problems with family, relationships, the law and/or finances, it's worthwhile to avoid alcohol altogether."

How does someone who recognizes a tendency to self-medicate get help?

"If someone realizes that drinking is connected with feelings of anxiety or stress, he or she should see an appropriate healthcare provider, whether it be a primary care physician, psychiatrist, counselor, social worker or any combination of those. If anyone is unsure of whom to contact, I recommend discussing the issue with a primary care provider who will make a referral to the correct specialist."

If you or someone you love needs help for a drinking problem, call the RESPOND psychiatric help line at (423) 499-2300 for 24/7 behavioral health information and referral assistance.