Do I need substance abuse treatment?


iStock-1140023499-1Stock photo: model is an actor

Entering treatment.

Considered in many circles to be a blessing in disguise, the “gift” of desperation is a moment of reaching a personal rock-bottom, whether it be emotional, legal, or financial that propels a willingness to accept help. This moment of vulnerability is, by no means, how all people enter treatment; the willingness can be gradual, starting from next-to-none at the start.

As the Head of Admissions at Project Courage, I have had the opportunity to discuss treatment options with a wide range of people – from those seriously desperate for help, to those being forced, and everything between. Treatment for the resistant population is difficult as personal motivation is a key factor in engagement; if a person doesn’t believe they need treatment, they are less likely to accept help (Yang, Perkins, & Stearns, 2018).

Asking questions.

My experience in admissions has shown that willingness to accept treatment is the most common barrier. With this in mind, how would someone know whether or not it is time to receive help?

Consider the following:

  • First of all, if you are contemplating whether or not you need substance abuse treatment, that is the first sign you or a loved one may need help.
  • If you are sitting, curious about the question, consider taking this recovery quiz (adolescents and young adults) based off the widely used and validated (Knight, Sherritt, Shrier, Harris, & Chang, 2002) CRAFFT interview. If you are older than a young adult, try this quiz.
  • Consider the consequences, both personal and environmental that substance use has created in your life. Many consequences are not as glaring as an arrest or bankruptcy; if you have one glass of wine every night, what is it like if you skip a night? Some are not even be aware of their dependency.
  • Explore the pros and cons of your substance use. What do I benefit from drinking and/or using drugs? What do I lose as a result of using drugs?

What it took for me.

From personal experience, I can attest that despite numerous external consequences, I was unwilling to receive help. By the age of 17, I had overdosed on opiates and nearly lost my life as a result. At the age of 19, I received a felony conviction for putting someone else in physical danger as a result of my use – this still was not enough to motivate me to accept treatment.

I’ll say what many before me have said: I wish I had gotten help sooner. For me, I needed to hit an emotional bottom; a place of hopelessness and cycled anguish that consisted of crying myself to sleep. I would ask myself, “who am I,” and, “where am I going?”

Be prepared.

While a person can be forced into treatment, they can’t be forced to accept the help that is offered. That being said, many people wait far too long – until things get unbearable. Education on substance abuse, addictive traits and patterns, and treatment options can be highly effective in chipping away at the wall of unwillingness. Awareness is crucial.

To help the process, here are some other barriers to look out for – the more you know now, the easier it will be to facilitate treatment. If you are a concerned family member or loved one, these resources are very useful to have on hand. Even if there is the slightest inkling of a problem, there is no harm in doing a little research.


Cahill, M. A., Adinoff, B., Hosig, H., Muller, K., & Pulliam, C. (2003). Motivation for treatment preceding and following a substance abuse program doi:

Knight, J. R., Sherritt, L., Shrier, L. A., Harris, S. K., & Chang, G. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. JAMA Pediatrics, 156(6), 607-614. doi:10.1001/archpedi.156.6.607

Yang, Y., Perkins, D. R., & Stearns, A. E. (2018). Barriers and facilitators to treatment engagement among clients in inpatient substance abuse treatment. Qual Health Res, 28(9), 1474-1485. doi:10.1177/1049732318771005

By: Tim Harmon