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Twenty questions

1. Q: What is addiction NOT?

A: Addiction is not any of the following:

It is NOT a "character" or moral defect.

It is NOT a simple failure of willpower.

It is NOT a sign of inadequate intelligence.

2. Q: What is the nature of addiction?

A: Addictive behavior creates a vicious cycle. "Gotta have it", or "craving" (drugs, alcohol, gambling, sex, food, shopping, cigarettes), for many of us becomes a biologically driven problem that demands satisfaction. The search for that satisfaction increasingly dominates our lives and in the process offends and alienates loved ones, leads us to violate our own principles and values, and causes tremendous financial, physical, emotional, and spiritual turmoil. That very turmoil, pain and shame leads us back to seek relief in the behaviors and substances that we have come to depend upon.

3. Q: "I don’t have a problem… do I?"

A: Denial is a cardinal feature of addiction. A wise professional in recovery noted that alcohol and drug addiction "is the only disease … that argues with you and says, "Look, despite all the evidence, you don’t have a problem." (Coombs, 1997).

Ultimately, only you can decide whether you have a problem. However, while you are wondering and deciding, there are many resources available to you, including tools that will help you to challenge your own beliefs about your behavior. Alcoholics Anonymous and Narcotics Anonymous provide useful information.

4. Q: What do people mean when they talk about workaholics?

A: In our culture working extra hours, meeting even unimportant deadlines and making yourself painfully available is often seen as a positive trait. You’ve heard the expression "hard work never hurt anyone". That’s not entirely true. We know that stress contributes to a variety of illness including heart disease, stroke and depression. If you are consistently unable to give time and attention to your family and friends; if you find it hard to engage in any activities that aren’t work related, if you use job related activities to gain a sense of control over your life and validate your personal worth; or if you use work as a substitute for intimacy or relationships, you may need to look at this area of your life. Additional information about workaholism can be found at About the Workaholics Anonymous 12-Step Recovery Program and Workaholics Anonymous.

5. Q: How is addiction to alcohol and drugs diagnosed by a physician or counselor?

A: Addiction is a chronic and progressive disorder characterized by the compulsive use of a substance or activity resulting in physical, psychological or social harm to the user and continued use despite the harm that it causes. In other words, addiction involves dependence upon a "drug" or behavior to experience euphoria or relief despite harm to oneself or others. Eventually, the user may not get any relief or achieve any euphoria.

The CAGE questionnaire is often used as a tool to assess the likelihood of the presence of alcoholism (and can be modified to help assess other addictions):

Have you ever felt the need to Cut down on your drinking?

Have you ever felt Annoyed when people criticized your drinking?

Have you ever had Guilty feelings about your drinking?

Do you Ever take a morning drink?

If one question is answered "Yes", there is a 62% probability of addiction, and if two or more are answered positively that probability is about 82% or higher.

6. Q: What is "sexual addiction"?

A: Like an alcoholic unable to stop drinking, sexual addicts are unable to stop their self-destructive sexual behavior. Sexual addition takes many forms and there is no single type of behavior that can determine whether you are a sexual addict. As with other addictions there are certain hallmarks (see the four C’s below) that can define and help you identify any problem. For further information about sexual addiction and a self-test check out Sex Addicts Anonymous.

7. Q: What is gambling addiction?

A: Compulsive gambling has been defined as chronic and progressive failure to resist impulses to gamble, and gambling behavior that compromises, disrupts or damages personal , family or vocational pursuits. Gambling urges and behaviors increase during stressful times and the problems caused by gambling lead to even more of these addictive behaviors - the classic vicious circle. Again, look at the four C’s. For more information and a screening test go to Gamblers Anonymous.

8. Q: How are addictive processes similar?

A: The "four C’s" of addiction are:

Loss of Control


Continued use despite adverse Consequences

Craving — psychological/physical

9. Q: How many people are affected by addiction?

A: Based upon survey and interview results we know that approximately 10 percent of the United States population is chemically dependent or alcoholic. We also know that chemical dependency crosses gender, race, ethnicity, income and education lines. In other words, no one is immune.

10. Q: Are specific groups of people more likely to have problems with addition?

A. Addiction is a very democratic and non-discriminating disease. However, chemical and alcohol dependency does indeed run in families and many studies indicate a genetic predisposition. Life style, learned habits and stress are all factors which may increase your risk. Remember, risk is not destiny and not all children of alcoholics suffer from the same disease. Knowing your background and assessing your life style are important so you can take steps to protect yourself.

11. Q: How do I recognize alcohol or drug addiction?

A: Consider the following questions:

Do you worry about how much someone drinks/uses drugs?

Do you have money problems because of someone’s drinking/drug use?

Do you tell lies to cover up for someone’s drinking or drug use?

Do you feel that if the user truly loved you they would stop drinking/drugging to please you?

Are your plans disrupted or cancelled or meals delayed because of drinking or drug use?

Are you afraid to upset someone for fear it will trigger drinking/drug use?

Have you been hurt or embarrassed by a drinker/drug user’s behavior?

How often do you ride in a car with a driver who is impaired?

Do you refuse social invitations out of fear or anxiety related to your loved one’s alcohol/ drug use?

In the end, you really have only one question to ask and answer:


YES_____ NO_____

12. Q. Does an addict have to "hit bottom" before recovery is possible?

A: The "old approach" was that the addict had to "hit bottom" in order to be ready to recover. Unfortunately, due to the nature of this illness and the dogged determination of denial, this meant that many addicts experienced huge losses, died or became severely mentally and physically disabled before they sought help. And the truth is that through intervention the addict’s "bottom" can be raised. One does not have to fall so low or so hard.

13. Q: What is an intervention?

A: Every addict in recovery has "hit bottom," the point at which the consequences of addictive behavior becomes intolerable to them. Intervention is designed to "raise" that "bottom" and halt the "free fall". They bring the bottom up to hit the alcoholic. An Intervention occurs whenever someone speaks to you about your behavior. Trained facilitators can organize a formal intervention to guide friends, colleagues, family, and loved ones who have witnessed or experienced the negative consequences of the addict’s behavior to share this with the abuser in a specific but non-judgmental manner. The goal is to help the addict move to the point where treatment is accepted willingly.

14. Q: How are families of addicted individuals affected?

A: Chemical dependency is a family disease. Everyone is affected by one family member’s addiction. Spouse, children and extended family develop coping strategies to deal with the turmoil created by the addict’s behavior. They may learn to withdraw in response to the addict’s fluctuating moods and erratic or volatile activity. Often they learn to make excuses and even cover up for the addict. On one level they feel frustrated, defeated, lonely, responsible and even guilty. On another level, secrecy and avoidance reign. The unwritten family "rule" is "don’t talk, don’t think, don’t feel". The family believes that the addict’s first priority and love is for the substance. Nothing they have done or said has changed that. Helplessness, passivity, unspoken anger and increased tolerance to the addict’s use and behavior pervade the family system.

15. Q: What is co-dependence?

A: In a relationship in which one individual has an addiction the other partner often becomes over involved in the addicts life. They try to "fix" or "rescue" the addict, in so many ways large and small, they try to protect their addicted loved one from the consequences of his or her own behavior. This in turn can lead to neglect of their own needs and aspirations. A co-dependent can be a spouse, a son or daughter, a friend, even a co-worker.

16. Q: Are there issues unique to healthcare professionals who suffer with addiction?

A: Many professional tell themselves that they are too smart for this to happen to them or believe that they should know better and be able to handle addiction alone. Some may feel they are too busy to address the problem and that their businesses depend upon them too much for them focus elsewhere. Helping these professionals accept the reality that their business will suffer if they do not receive treatment is crucial. They also must address their business health and protect their reputation.

17. Q: What is the good news? Can you really treat addiction? How?

A: Addiction is highly treatable. Chemical and alcohol dependencies have a treatment success rate that is roughly comparable to that of other chronic diseases such as diabetes, hypertension, and asthma. As with other chronic illnesses, addiction treatment provides tools to manage symptoms and enhance quality of life. Addictions are put into remission, not cured.

Addicted professionals, who are involved in peer support groups (e.g. physicians, lawyers, accountants, pharmacists), have recovery rates as high as 84%.

Recovery can begin with an evaluation regarding addiction and acceptance of that reality. Treatment provides counseling, education, peer support and spiritual growth.

18. Q: I suspect that a colleague may have a problem with drugs or alcohol. Should I get involved?

A: Yes. Call us at 952-920-5582 for guidance. The workplace is usually the last place an addiction is likely to show up. People protect their income source, so if you are seeing a problem at work, chances are good that the addiction is having a major effect on other areas of their lives.

19. Q: What if a colleague has a problem with alcohol or drugs yet seems to be doing an adequate job for their clients? Isn’t it better to leave well enough alone?

A: NO! Intervene before the addiction gets worse and the consequences greater.

20. Q: Finally, is there life after treatment?

A: Indeed there is. Life will continue to offer opportunities, challenges, sorrows, joys problems and wonders. But your approach and appreciation and ability to handle these situations without relying on dependencies will be changed.


1300 Godward Street NE, Suite 2000, Minneapolis, MN 55413
Phone: 612-362-3747
Email: PSP@metrodoctors.com 

Physicians Serving Physicians is a nonprofit 501(c)(3) organization