Alcohol and Drug Addiction Treatment in Calgary

If you or someone you love has an addiction or are seeking addiction treatment in Calgary for an alcohol use disorder or drug use disorder, we can help. The following page provides some general information about alcohol and drug use disorders to help you get started, but please feel free to contact us for further information at the phone number above if you have questions or would like to book an appointment.

What is Addiction?

There are many misconceptions about what an addiction is. First, let me say a few things about what it is not. Common misconceptions about addiction can be found in the type of statements that people say to make the case that they are not addicted. These include:  "I don't consume alcohol or use illicit drugs every day." "I can--and do--stop using for periods of time." "I don't use or drink alone." "My drinking or using patterns are no different from that of my friends." "I'm not hiding it. I only drink on social occasions."

In my experience as an addictions counsellor, I have heard all of these statements used at one point or another to rationalize drinking or using patterns that are, in fact, problematic. Addiction is not defined by how frequently one uses, how much one uses at a time, how much one uses overall, when one uses, or who one uses with. More correctly, none of these factors, by themselves, are indicators of an addiction, although all of them are, in fact, taken into consideration when looking at the big picture.

So, then, what is an addiction? One definition of addiction, is as follows:

As you can see, this definition starts to get at the heart of addiction -- repeated use of a substance despite evident and repeated negative consequences.

First, there is an element of repetition. In other words, there has to be a pattern of use that leads to harm. If you go overboard on how much you drink once or twice a year and do something while drinking that you regret later, that, by itself, does not mean you are addicted. But if you've been drinking heavily, or binging, every month, or every two weeks, or weekly, or at some other regular interval for at least the past twelve months, and on many of those occasions you feel guilty about it afterward, or there is damage to your relationship from it, or you end up doing something you regret, then that might be a red flag.

Second, there is an element of harm involved. You and your spouse might fight more destructively when you're drinking, for example. You might experience blackouts. You might miss important obligations because you were drinking or hungover. You might become more aggressive with others. Other harmful consequences include giving up important recreational activities with your family, breaking the trust of one's spouse or partner, not taking care of one's body, feeling guilty and ashamed about one's drinking or using, experiencing legal problems, underperforming at work, or feeling awful, depressed, irritable or anxious the next day.

Third, despite the consequences, you continue to drink or use. Think about it this way. If a person drank socially, and on occasion they consumed too much alcohol and encountered some trouble because of it, they would say, "I'm not doing that again," and they would change something about their behavior so as to prevent further negative consequences of their drinking. And they would most likely be successful.

But someone who is addicted cannot do this, or cannot do this consistently, even when they try. Sooner or later, despite their efforts to control or prevent the harm, they end up consuming too much of the substance again. This happens again and again. Not necessarily every day, and not necessarily every time, but regularly and repeatedly, it happens enough that the harm continues to pile up over time.

How Can I know if my alcohol or drug use is a problem?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, most often referred to as the DSM-V or DSM-5, outlines the criteria that is currently used to diagnose a substance use disorder. There are eleven criteria. You may not meet all of them, but the more of them that are descriptive of your using or drinking patterns, the more severe is the problem you are experiencing with the use of that substance.

The eleven criteria are listed below in bold. I've included additional questions that you might ask yourself or reflect on to determine the extent to which you meet each criteria. These are, by no means, an exhaustive list of questions but they can give you an idea of what each criteria is looking at.

1. The substance (i.e. alcohol or drug) is often taken in larger amounts or over longer periods of time than was intended. (Do you start out thinking you'll just have a couple drinks, and then end up consuming much more than that? Do you find that you have difficulty stopping after a certain number of drinks? Are there times when stopping by at the pub for what you said would only be an hour after work turns into coming home many hours later?)
   
   
2. There is a persistent desire or unsuccessful efforts to cut down or control the substance use. (Have you made promises to yourself or to others to stop drinking or using and then broken those promises? How many times? Have you ever decided to stop drinking intentionally for a period of time because you thought it would be good for you or to prove that you could? How often have you done that? Have you been thinking that you should cut down on your drinking?)
   
   
3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects. (How much time are you spending at the pub or at the bar? How many hours are you spending consuming alcohol or using the drug? Are family members complaining about how much time you spend drinking or using drugs or not being involved with the family because you were using? How long do you feel ill, irritable, or moody and unable to engage fully in your activities afterward?)
   
   
4. Craving, or a strong desire or urge to use the substance. (Do you experience a strong desire, at times, to drink alcohol or use the substance? Does it occupy your thoughts for periods of time? Do certain places, people, sights, times of day, or mood states trigger a powerful desire to use the substance? Does the craving feel all-consuming at times?)
   
   
5. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home. (Have you called in sick at work because you were hungover or using? How many times? Have you been late for family functions or missed altogether family activities that you were expected to attend because you were drinking or using? Has that happened often? Have you neglected household chores that needed to be done in favor of using or because you were not feeling good after using? How often has that happened?)
   
   
6. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance. (Are you and your spouse or boyfriend/girlfriend arguing often about your drinking? Are your family members concerned about your drinking? Have you lost friends because of your drinking or using? Are your friends put off by your actions when you are drinking?)
   
   
7. Giving up important social, occupational or recreational activities because of substance use. (Have you avoided social functions that you've been invited to attend because they were not serving alcohol? Have you disengaged from your family or from extracurricular activities because you were using or drinking? Do you have hobbies and interests that you don't do anymore because of your drinking or use of substances?)
   
   
8. Recurrent substance use in situations in which it is physically hazardous to use. (Have you driven while impaired? How many times? Do you work in a safety sensitive occupation, using heavy equipment, firearms, construction tools, or a motor vehicle? Have you been impaired while engaging in such activities, including not just the impairment caused by intoxication, but also the secondary impairment features -- feeling ill, poor judgment and concentration, foggy thinking, etc. -- that follow heavy use, and that are due to the withdrawal effects from using, or fatigue and lack of sleep from being up all night, etc.? Has this happened more than once? Have you ever been charged with a DUI? It is statistically improbable to be charged with a DUI without a significant history of driving while under the influence; in fact, typically a person has driven while impaired 75+ times before they are charged with a DUI.)
   
   
9. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance. (Have you continued drinking even though your doctor has advised you to stop because of a health concern? Have you ever been told you have liver trouble? Have you ever been hospitalized because of your drinking or using? Have you continued to drink even then?)
   
   
10. Tolerance, as defined by either of the following:  a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect, or b) a markedly diminished effect with continued use of the same amount of the substance.
    
    
11. Withdrawal, as manifested by either of the following:  a) The characteristic withdrawal syndrome for the substance, or b) the substance is taken to relieve or avoid withdrawal symptoms.

If you meet two or three of these criteria, that would indicate a mild use disorder; four or five indicate a moderate use disorder and six or more indicate a severe use disorder.

The preceding list of criteria and related questions is not intended to provide you with a diagnosis, only to offer education and increased awareness. A diagnosis is arrived at through a comprehensive assessment with an addictions professional who can explore your personal, medical, family and work histories, as well as your current mental health status, relationship quality, and substance use patterns. All of the information gleaned from such an assessment is used together to determine a diagnosis.

Our hope in providing this information, however, is that it helps you gain a better understanding of what an addiction looks like and how it manifests in daily life, so that you can make more informed decisions regarding your well-being.

If you are answering yes to some or most of these types of questions, there is a strong likelihood that you are experiencing a problem with the use of your substance of choice. We strongly recommend that you consult with a health professional, psychologist or other therapist who is trained in the field of addictions assessment and treatment, and who can provide further guidance and recommendations as to what steps you can take to address these issues in a meaningful way.

how are alcohol and drug addiction treated?

There are multiple initiatives involved in the effective treatment of an alcohol or drug addiction. The more comprehensive your recovery plan the higher the probability of achieving the goal of sustained sobriety, improved health and functional living.

Typical treatment steps in a comprehensive treatment plan include: (for the following list, an asterisk (*) means that the step is typically necessary or highly recommended; no asterisk means that the step may or may not be required):

• Detoxification
  
• Permanent abstinence from all mood-altering and non-prescribed substances*
  
• Attendance and active participation in a twelve-step support group such as Alcoholics Anonymous or Narcotics Anonymous, at the rate of 2-3 meetings per week in the first year, more if needed*
  
• Applying the twelve steps in sequence with the help of a dedicated sponsor*
  
• Participating in relapse prevention counselling with the help of a qualified addictions professional*
  
• A psychological evaluation to identify potential co-occuring mental health issues and additional counselling for any issues identified
  
• Enrollment in a long-term (i.e. 30 or 45 day) treatment rehabilitation program
  
• A medical evaluation and follow-up by an addictions physician or psychiatrist*
  
• In some circumstances, medication-assisted therapy
  

Initial detoxification in a controlled medical setting may be a necessary first step, particularly if you have been using heavily and frequently up to the point of abstaining. Detoxification will assist you to safely cope with highly unpleasant and potentially lethal withdrawal symptoms that follow sudden withdrawal of a substance.

Twelve-step support groups such as Alcoholics Anonymous or Narcotics Anonymous have been particularly effective at helping individuals receive the support, information, and inspiration needed to remain clean and sober. One of the main benefits of AA lies in the mutual support both given and received in a setting that emphasizes accountability, honesty, deep personal change instead of behavioral change only, and practical tools for maintaining sobriety. An important part of twelve-step work is selecting and working with a sponsor who has sustained sobriety and who can guide you in implementing the steps.

Relapse prevention counselling can be an essential component of a good treatment plan. An addictions counsellor will help you plan strategies for avoiding relapse, better understand your triggers and risk factors and how to neutralize them, learn to deal with cravings, help you shift distorted thoughts and beliefs that perpetuate addictive behaviors, replace addictive behaviors with healthier alternatives, and bring to light underlying affective, behavioral, cognitive, familial and social factors that help drive the addictive acting out so that they can be worked out or worked through. Combining twelve-step support in a group setting alongside relapse prevention counselling with a trained addictions specialist can augment the benefits derived from utilizing either approach alone. Such counselling would typically take place following in-patient or out-patient treatment (it may also begin before rehabilitation if there is a wait time involved).

Enrollment in an in-patient or out-patient rehabilitation program may or may not be necessary. In-patient treatment means that you reside in the treatment facility for the duration of your stay there. Out-patient treatment means that you report in each day for care, but return to your home at night. 

In-patient care provides many benefits, including lack of access to substances, separation from addiction-triggering or distracting elements of life, intensive individual and group counselling, education, round-the-clock monitoring, and introduction to twelve-step work.The main advantages of in-patient treatment include lower risk of relapse due to inaccessibility to substances, close monitoring, and intensive education. Disadvantages include the cost and disruption to your work and family life (the latter disadvantage may need to be put in perspective considering the cost of addiction to one's work or family life). The main advantages of out-patient care include generally lower costs and the ability, potentially, to maintain some of your routine.

Generally, if your living or work environment is not conducive to the goals of recovery; if your resources for change are minimal, if your supports are minimal, if your addiction is moderate to severe in intensity, if you have been using heavily for a long time, and/or you have never attended a treatment program before, you may be a good candidate for in-patient treatment. Treatment centres typically require that you are five days clean upon entry to the program and that you are willing to abide by the inpatient center's requirements for recovery to remain in the program.

If, however, the following conditions are true, you may not need in-patient or out-patient treatment as part of your treatment plan:

• You have access to educational and relational supports, and are familiar with and use tools, strategies and resources for maintaining sobriety,
  
• Your living or work environment is supportive of your sobriety,
  
• You are meeting regularly with an addictions counsellor and your twelve-step group,
  
• You have successfully abstained from substances previously without moving into one of three types of problematic recovery modes:  dry-drunk recovery (where you stop using, but remain stuck in the same patterns of thinking and acting the way you did when you were using), transfer addiction recovery (stopping one substance, but increasing use of another substance), or narcissistic recovery (using the psychological and interpersonal principles you learned while attending counselling and AA to continue to manipulate the people around you).

The risks and benefits of attending in-patient or out-patient treatment should be discussed and reviewed with your addictions specialist to determine a plan that is right for you.

How can counselling help with an addiction?

One of our qualified counsellors can work with you in two important ways:  1) to provide a safe and trusting environment to begin to talk about and explore your usage patterns, and 2) identify recommendations and tools for moving forward. Research on the therapeutic components of effective therapy indicates that some of the most important elements—as influential as the specific techniques and tools your therapist uses to treat addiction—include the helping relationship itself that you develop with a caring and trusted professional who will listen to you carefully and provide guidance and support, and an environment that instills hope, or a positive expectancy.

In addition, one of our counselors can help you learn more about the psychological and physical factors involved in addiction; get connected with community resources and in-patient treatment facilities, as needed; develop and implement a relapse prevention plan; receive help in overcoming any other co-occuring social-emotional issues that co-exist with alcohol or drug addiction, and provide an accountability system and support for you in your journey toward healthier living. 

Recommended Reading

Being Sober: A Step-by-Step Guide to Getting To, Getting Through, and Living in Recovery

by Harry Haroutunian

An excellent resource on understanding treatment of substance addiction. I especially like the chapter on the Twelve Steps of Alcoholics Anonymous. In  this chapter, the author describes each Step in detail, including the principles and potential pitfalls of each step, as well as his own simplified version of the meaning of each step. Dr. Haroutunian rewords Step One, for example, "We admitted we were powerless over alcohol -- that our lives had become unmanageable" to "There is a power that wants to kill me." Step Two, "Came to believe that a Power greater than ourselves could restore us to sanity," becomes "There is a Power that wants me to live."  Includes a chapter on the high functioning addict, what to expect in recovery, a discussion on abstinence vs. harm reduction, a discussion of the distinction between spirituality and religiosity, a description of AA meetings, and more. A very good introduction to the world of addiction recovery.

In Canada? Click here to order from Amazon.ca instead

Beyond the Influence: Understanding and Defeating Alcoholism

by Katherine Ketcham and William F. Asbury

Much of what this book is about could be described by the phrase found on the back cover:  "Alcoholism is a disease. It's time we started treating it like one." In the first half of this book, the authors describe the science behind the neurobiology of alcohol addiction, how alcohol affects the brain and the body, along with a comprehensive description of the early, middle and late phases of alcoholism. The second half of the book includes chapters on inpatient treatment, relapse prevention, counselling for co-morbid issues, spirituality and nutrition. It's a bit dated now, but its still very informative and one I would recommend. The author, Katherine Ketchum is also author of Under the Influence, considered a classic in the field.

In Canada? Click here to order from Amazon.ca instead

Where Can I Get More Information?

The following links lead to online resources that may help further:

Alcoholics Anonymous
Official site of Alcoholics Anonymous World Services Inc..

What its Like to Attend Your First Meeting
Here is an excellent online article that addresses one of the most common psychological barriers to attending AA: anxiety about attending your first meeting. This article, produced by professionals at Futures Palm Beach, can help you feel better prepared with an understanding of what to expect at your first and subsequent meeting(s) and helps to dispel some of the common myths about attending AA.

Evolution Health Care for Everyone
An online support group providing help to those who are seeking to quit or cut down on their drinking. One helpful resource on this site is an online questionnaire you can use to evaluate your drinking. This is the same one used by the Centre for Addiction and Mental Health (see below). I prefer the final report format on this site, however, as it provides a little more information. An excellent resource with which to evaluate your drinking.

   Alcohol Help Center 2.0 Links and Resources
   Check Your Drinking Assessment Online Questionnaire

American Society of Addiction Medicine
An excellent educational resource, information rich, written in a strong academic style, outlining what addiction is, including the characteristics, neurobiology and genetic components of addiction. The American Society of Addiction Medicine and its Canadian counterpart the Canadian Society of Addiction Medicine both offer comprehensive online information (see the "Research and Treatment" menu of the navigation bar at asam.org) to both addiction professionals and the public.

Centre for Addiction and Mental Health
Canada's leading addiction and mental health teaching hospital.

   CAMH Articles and Resources
   Information about Drug and Alcohol Addiction
   Evaluate Your Drinking
   Information about Alcohol, Other Drugs, and Driving
   Low-Risk Drinking Guidelines
   Dealing with Drinking: How to Quit or Cut Down

Addiction Center
This is another excellent site filled with articles, resources, and information on addiction. It is also a good site to find out about treatment centers available near you.

Recovery Village
The Recovery Village provides comprehensive alcohol and drug rehab programs. Their website, here, is a wealth of information on alcohol and drug addiction and treatment, inpatient and outpatient programs, co-occurring disorders, and so much more. 

To Book an Appointment

Just call us (403) 255-8577 or use our easy online scheduler here. 

If you have any questions or would like to contact us by email, you can complete a brief confidential contact form here. Once you submit the contact form, a Cobb & Associates intake staff member will respond as soon as possible.

The Calgary Couples Counselling Centre (a subsidiary of Cobb & Associates Inc.) is located in southeast Calgary (near Leons and Trail Appliances on 11th Street SE). Please click here for our full address and a map to our location. We are currently accepting new clients and warmly welcome self-referrals and referrals from physicians and other professionals.

We appreciate your interest in our services and hope this information has been helpful to you. Please do not hesitate to call if you have any questions.

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