**FACES OF CHANGE:**

**Do I have a problem with alcohol or drugs?**

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

Center for Substance Abuse Treatment

www.samhsa.gov

Alcohol and drug problems affect many people. Some people see that
drinking alcohol or using illegal drugs is hurting them. But there are a
lot of other people who don't even know they have a problem. They ignore
the warning signs, even when their friends and family tell them that
they have a problem.

This booklet looks at five people: Eric, Sue, Yolanda, Derrick, and Don.
They come from different backgrounds, but they all have a problem with
alcohol or illegal drugs.

As you read about these five people, think about your own life and the
role that alcohol or drugs may play in it. Could drugs or alcohol be
causing problems that you weren't even aware of? Could you or someone
you know be in denial about a problem with alcohol or drugs? Look at
what the characters do. Will their actions help or hurt? Would you do
the same thing or something different?

ERIC

Eric drank and smoked pot (marijuana) and got high on it a lot in high
school. He also went to "keg" parties where he drank a lot of alcohol.
He dropped out of school in his senior year.

Eric has a job at a repair shop. He hates it. Sometimes he thinks he has
to have a few beers or smoke some pot at lunch just to get through the
day.

Eric's girlfriend Julie complains that he spends too much time drinking
and getting high with his friends. She says she'll move out if he
doesn't stop.

*Julie says, "Eric, this has to stop or I'm gone."*

Now some friends invite Eric to a party where there is beer and pot.
Eric goes and gets drunk, even though he knows his girlfriend will be
upset.

*At a party, Eric thinks, "My girlfriend is a nag!"*

What could happen to Eric if he keeps on drinking and using marijuana?

-   Eric might be arrested for drunk driving or for having marijuana,
    and could be referred to treatment by the court.

-   His girlfriend might leave him.

-   His boss might smell Eric's breath after lunch. Then he might be
    fired. Or his employer might have an Employee Assistance Program
    (EAP) that will send him to treatment.

SUE

Sue is a wife and a mother. She also works at a museum part time and
goes to school. As the semester goes by, she finds herself under a lot
of stress.

A fellow student tells Sue that he can sell her "uppers" (amphetamines)
that will help her stay awake and get more done. Sue doesn't like doing
something illegal, but she starts taking the pills.

Two months go by, and Sue is still taking the pills. She is becoming
irritable. She slaps her child for asking for a cookie. Her husband is
upset and worried about how Sue is acting, and he wants her to talk to a
substance abuse counselor about the pills she takes.

Sue doesn't think she needs treatment, but she wants to please her
husband. She doesn't want to stop taking her pills, but she admits to a
friend that they might be creating problems.

*Sue says to a friend, "I don't know what to do."*

Now Sue has a test coming up at school. She thinks about what her
husband said, but she takes some pills to stay awake and study. At the
same time, she knows she'll be tired the next day if she doesn't sleep.
Sue feels guilty and frustrated. She doesn't know what to do about her
situation.

What kinds of things could a substance abuse counselor do to help Sue?

-   Help her explore the pros and cons of taking the pills.

-   Describe the harmful effects of the pills.

-   Describe what other people have done in a similar situation.

-   Help her set goals for quitting.

-   Suggest ways she can find support from others.

YOLANDA

Yolanda drinks a lot when she comes home from work. She wakes up feeling
"hung over" at least three times a week. She has quit drinking a few
times, but always started up again. It's making her late to work more
and more often.

Yolanda has been thinking about what her life would be like if she
stopped drinking. She would do better at her job, and she wouldn't wake
up with headaches and stomach aches all the time.

Yolanda's father is in recovery from an alcohol abuse problem. He has
moved back to Mexico, but she still calls him for advice. He explains
that alcoholism often runs in families.

He tells Yolanda that she should think about treatment. He suggests that
she create a Change Plan Worksheet, listing the pros and cons of not
drinking.

Now Yolanda is watching TV at home. She wants to get a beer out of the
fridge, but she knows that she'll end up having more than one. She takes
all of the beers and pours them down the sink. She fills out the Change
Plan Worksheet that her father talked about.

-   The changes I want to make are: To either cut down or quit drinking.

-   The most important reasons I want to make these changes are: Keep my
    job. Stop waking up feeling sick. Get some balance in my life again.

-   I plan to do these things to reach my goal: Throw away my collection
    of shot glasses and call the treatment center.

-   The first steps I plan to take in changing are: Call my father this
    week and tell him what has happened and what I plan to do.

-   Some things that could interfere with my plan are: Job stress,
    missing my family, feeling alone.

-   Other people could help me in changing in these ways: Regular phone
    calls with Dad, members of my church group, my neighbor Helen who
    doesn't drink.

-   I hope my plan will have these positive results: I'll feel better,
    be more productive on the job, make new friends who don't drink.

DERRICK

Derrick used to drink a lot and take drugs when he partied with his
friends at the clubs. Then one night he got arrested for possession of
an illegal drug. The judge told him he had to get treatment.

At first, Derrick didn't like treatment. He didn't want to talk about
his drug use. There were times when he wanted to quit treatment because
it was really hard. But this slowly changed.

After time, Derrick started to trust his substance abuse treatment
counselor. He helped Derrick to know the "triggers" that could cause him
to start using drugs again. He encouraged Derrick to create a support
network of family and friends who don't use drugs.

*Derrick's mother says, "I'm glad things are better for you now."*

Now Derrick's old buddies still call him sometimes to go out partying.
Derrick says no and goes to a 12-Step meeting instead. It lets him meet
other people he has things in common with. He's got a new job and he
feels good about himself.

Together, Derrick and his counselor have come up with several things he
can do whenever he thinks about drinking or using drugs:

-   He can do volunteer work in his spare time. This can help Derrick
    connect with people who don't do drugs.

-   He can spend more time with his family, and with friends who don't
    use drugs.

-   He can work out at the gym as or take a computer course.

DON

When he was younger, Don hung out with a tough gang at the reservation
where he lived. They often used drugs. He was arrested and told to enter
a drug treatment program. Even though treatment made him feel better
about himself, Don ran into his old gang and slipped back into using
"meth" (methamphetamines) every day. He got arrested again and was sent
to prison.

With the help of the prison's substance abuse treatment counselor, Don
moved into a halfway house and joined a drug treatment program. Away
from the gang, and without drugs in his life, Don was able to finish
high school and find a good job.

Don is now 40. He has been married for six years and enjoys going
camping with his wife and children. He hasn't touched drugs in 10 years.
He likes to work out at the gym, and he has made a new set of friends
who don't drink or use other drugs. Some of his friends are also in
recovery and go to 12-Step meetings with him.

Now Don is thinking about a career change. He would like to become a
counselor for people with drugs problems like he had. He wants to work
in the clinic back on the reservation. He knows he needs to get more
education, though, and make sure his own recovery is stable before he
makes the change.

*Don thinks, "Today is fine and tomorrow will be better."*

Every day, Don practices the coping skills he learned in treatment:

-   He's aware of negative feelings. He talks with a trusted person
    about them.

-   He works out at the gym to relieve stress.

-   Don **HALT**s sometimes. HALT stands for **H**ungry, **A**ngry,
    **L**onely, **T**ired. When he feels these things he stops and
    thinks. Don knows that it is important to do something positive at
    these times. He knows drugs won't solve his problems.

**What Can You Do About Drugs And Alcohol In Your Life?**

Know if there's a problem:

-   Are drugs or alcohol affecting your work or health?

-   Do you feel like you need alcohol or drugs to get through the day?

-   Are your friends or family members telling you there's a problem?

Avoid the personal "triggers" that could set off an urge to drink or use
drugs:

-   Don't try to do too much and get stressed out.

-   Don't ignore the negative feelings that drugs and alcohol can cause.

-   Avoid people, places, and activities where you usually use drugs or
    drink alcohol.

Think about the benefits of making a change:

-   Being healthier and stronger without alcohol or drugs.

-   Having family and friends who know they can depend on you.

-   Having a future with lots of choices.

If you think you might have a problem with alcohol or drugs, fill out
the Change Plan Worksheet below. You can even cut it out and carry it
with you, or give it to a friend if you think it could help.

**CHANGE PLAN WORKSHEET**

-   The changes I want to make are:

-   The most important reasons I want to make these changes are:

-   I plan to do these things to reach my goal:

-   The first steps I plan to take in changing are:

-   Some things that could interfere with my plan are:

-   Other people could help me in changing in these ways:

-   I hope my plan will have these positive results:

-   I will know that my plan is working if:

-   A counselor or professional I can call if I think I have a problem
    is:

Here are some helpful phone numbers and Web sites for more information
about the warning signs of an alcohol or drug problem and how to get
help:

Center for Substance Abuse Treatment (CSAT)

Substance Abuse and Mental Health Services Administration (SAMHSA)

U.S. Department of Health and Human Services (HHS)

1-800-662-HELP

www.findtreatment.samhsa.gov

SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI)

1-800-729-6686

ncadi.samhsa.gov

Alcoholics Anonymous

212-870-3400 (literature)

212-647-1680 (meeting referral)

www.aa.org

Cocaine Anonymous

1-800-347-8998

www.ca.org

Marijuana Anonymous

1-800-766-6779

www.marijuana-anonymous.org

NAFARE Alcohol, Drug, and Pregnancy Hotline

1-800-638-BABY

Narcotics Anonymous

818-773-9999

www.na.org

Women for Sobriety

1-800-333-1606

www.womenforsobriety.org

This list of resources is not exhaustive, and does not necessarily
signify endorsement by CSAT, SAMHSA, or HHS.

Do not reproduce or distribute this publication for a fee without
specific, written authorization from the Office of Communications,
Substance Abuse and Mental Health Services Administration, U.S.
Department of Health and Human Services.

This brochure was created to accompany the publication *Enhancing
Motivation for Change in Substance Abuse Treatment,* #35 in CSAT's
Treatment Improvement Protocol (TIP) Series. The TIP series and its
affiliated products are available free from SAMHSA's National
Clearinghouse for Alcohol and Drug Information (NCADI). Call
1-800-729-6686 or 1-800-487-4889 TDD (for the hearing impaired), or
visit www.csat.samhsa.gov.

DHHS Publication No. \[SMA\] 05-4109. Printed 2005.