HOUGHTON — For many sufferers of Substance Use Disorder (SUD), one of the most difficult conversations they will ever have is with themselves. The conversation begins with the question: “Am I an alcoholic?” or “Do I have a drinking problem?”

American Addiction Center, at alcohol.org, states that these are questions that a person who drinks frequently, or has problems because of alcohol, might ask.

“The short answer is that anyone who experiences concerns or troubles due to alcohol use likely has a drinking problem,” the website suggests, adding that “a problem with alcohol does not necessarily make a person an alcoholic, though. Exploring the differences between alcohol abuse and alcoholism can help people determine whether they have an addiction.”

That is the beginning of the inward conversation no one wants to have. The American Addiction Center helps to guide the conversation.

“If your life and relationships are being negatively affected by your substance use,” the website states, “you probably have an addiction.”

Addiction is diagnosed on a spectrum, the site states. The criteria for addiction can help to determine if the person’s addiction is mild, moderate or severe. There is a total of eleven criteria, including:

— Lack of control

— Desire to quit but unable

— Spending a lot of time trying to get the substance

— Cravings

— Lack of responsibility

— Problems with relationships

— Loss of interest

— Dangerous use

— Worsening situations

— Tolerance

— Withdrawal

“The severity is determined by how many criteria you meet,” the center states. “For example, if two to three of the criteria apply to you, you would have a mild substance use disorder. But even if you have a mild diagnosis, you should still seek help to get sober.”

That, however, may not be as easy as it sounds. Shahram Heshmat, Ph.D., in his article, The Role of Denial in Addiction: Denial is a key obstacle to recovery, posted Nov. 13, 2018, on Psychology Today website, suggests that the reason the conversation is so difficult to start is denial, one of the characteristics of addiction.

“Addicts are notoriously prone to denial,” Heshmat states. “Denial explains why drug use persists in the face of negative consequences. Addiction cost them their job, their health, or their family. If they remain ignorant about the negative consequences of their actions, then these consequences cannot guide their decision-making.”

In short, denial is the refusal to acknowledge the reality of one’s situation, he says.

“To maintain a positive view of themselves, people revise their beliefs in the face of new evidence of good news but ignore bad news,” Heshmat explains. “Psychological processes such as distraction, forgetfulness, and repression, may serve as a variation of denial. It should be noted that these psychological processes may or may not be conscious processes.”

In a Sept. 23 article published in the Daily Mining Gazette, Former District Judge Linda Davis and co-founder of Families Against Narcotics, stated that for those needing to have the conversation with themselves, stigma is the No.1 block to treatment. However, that stigma may originate from within.

“People suffering from substance use disorder are self-loathing,” she said. “They hate the choices they’ve made; they feel like there’s no way out, then when we shame them and make them feel unworthy, because of the stigma around addiction, they often-times feel like there is no help available to them, which is totally the wrong message that we want to be sending the people.”

Heshmat, in his article, also touched on the topic of self-stigma, saying:

“Addiction can also be a source of terrible shame, self-hatred, and low self-worth,” he wrote. “For an addict, it can be terrifying to acknowledge the harm one has done by one’s addiction to oneself and potentially to others one cares for. When they are high, their fears of inadequacy and unworthiness fade away. Users often report a sudden dissociation from self. For example, alcohol and heroin are often sought for their numbness.”

There is hope, though. With anyone initiating the inward conversation that begins with “Do I have a problem?” that question is usually the first step to a path to recovery, and yes; recovery is possible.

“The first step is recognition of the problem,” states the American Psychiatric Association. “The recovery process can be delayed when a person lacks awareness of problematic substance use. Although interventions by concerned friends and family often prompt treatment, self-referrals are always welcome and encouraged.”

The Substance Abuse and Mental Health Services Administration (SAMHSA) offers the following definition”

Recovery is a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential. There are four major dimensions that support recovery:

— Health–overcoming or managing one’s disease(s) or symptoms and making informed, healthy choices that support physical and emotional well-being.

— Home–having a stable and safe place to live.

— Purpose–conducting meaningful daily activities and having the independence, income, and resources to participate in society.

— Community–having relationships and social networks that provide support, friendship, love, and hope.

“Hope, the belief that these challenges and conditions can be overcome,” SAMHSA goes to state, “is the foundation of recovery. The process of recovery is highly personal and occurs via many pathways. Recovery is characterized by continual growth and improvement in one’s health and wellness that may involve setbacks. Because setbacks are a natural part of life, resilience becomes a key component of recovery.”