Am I an addict? Questions that say more than quantity

“I drink as much as everyone else.” That is probably the sentence I hear most often when someone first sits down on the sofa and carefully admits that something has been worrying them lately. Then a second: “It’s not like I drink every day.” And a third, offered as proof: “Never in the morning.”

All three sentences are about quantity and about timing. None of them tells me what I actually need to hear. That is why I almost never start with the question of how much. I start somewhere else: what happens when it isn’t there. What you promised yourself, and what became of the promise. How much room in your head the deciding takes up.

This piece is not a test. It has no points, no total, and at the end it will not tell you whether you are an addict. That is deliberate. Any score you work out on your own can be adjusted until it comes out right, and that is precisely the trap with addiction. What follows instead is a handful of questions that are harder to bend.

Why quantity is a poor question

Quantity is the only measure most people have to hand, and at the same time the one that is easiest to move. If you compare yourself with a colleague who drinks more, you are moderate. If you compare yourself with a sister who drinks nothing, you are a problem. The measure is therefore not inside you but in whom you have chosen for comparison — and people who worry about their own drinking tend to choose someone who drinks more.

The second difficulty is that quantity says something about physical risk and almost nothing about the relationship. For the liver it genuinely matters how much and for how long. For whether something has become an addiction, something else matters: what role the substance or behaviour has taken on in your life, and what happens when that role is empty.

I know people who drink little and are entirely dependent on that little — without it they go to no event, do not fall asleep, cannot bear the silence at home. And people who drank heavily for a period and developed nothing of the kind. Quantity is a data point. The relationship is the diagnosis.

What the word addiction actually means

The professional language has shifted over recent decades. Instead of a hard border between “addicted” and “not addicted”, we now speak of a substance use disorder that runs along a scale from mild to severe. The DSM-5 criteria describe eleven signs in four groups, and the mild form needs only a few.

This shift is not cosmetic. It means that the question “am I an addict” is badly framed to begin with, because it assumes a switch. A more useful question is where on that scale you are now and in which direction you are moving. Someone who five years ago drank on Fridays and now checks on a Tuesday evening whether there is enough in the house is not necessarily seriously ill — but they are in motion, and the direction matters more than the current point.

The same holds for behaviours without a substance. Gambling is already recognised as a disorder in the manual, the field is still arguing about gaming, and serious debate about shopping, work and screens continues without a conclusion. This does not mean people do not suffer around these things, only that for some patterns we have no reliable borders yet.

The questions I ask in the room

When someone comes with the question of whether they are an addict, I do not ask how much. I ask the following, and I ask them to pause at each one and picture a concrete situation.

What happens when it isn’t there? Not what would happen — what happened the last time. When the bottle was empty, the phone at the far end of the flat, the work finished. Was that an empty space you filled with something else, or was it an edginess that had to be put somewhere?

Have you ever negotiated with yourself? Addiction almost always leads to negotiations: only at weekends, only in company, only not before seven. Negotiating is not in itself a sign of illness. The sign is what happened to the negotiation — how many rounds are behind you, and whether the rules have softened over time.

How much room in your head does it take? People routinely underestimate this one. It is not the act itself but the planning, the checking of supplies, the calculating of when the opportunity will come, and afterwards the settling of accounts with yourself. If you add up those minutes, how much of the day is left?

Would you do this in front of someone you trust? Concealment is more often the first sign than quantity is. Empty packaging that goes into a different bin. A tab that closes when someone walks in. An hour of work presented as something else.

What would you lose if you stopped? The last question is the most honest and the most uncomfortable. The answer “nothing, it’s just a habit” is rarely true. More often something is hiding behind it that the substance or behaviour was genuinely doing: calm after a hard day, courage in company, an excuse to leave, quiet in the head.

Tolerance and withdrawal are not evidence of character

Two of the signs are purely physical. Tolerance means that more is needed for the same effect, because the nervous system has adapted. Withdrawal means the body reacts to the absence — restlessness, tremor, sweating, insomnia, anxiety arriving in waves.

Here is something I must not leave out. Withdrawal from alcohol and from benzodiazepine tranquillisers can be dangerous and in rare cases fatal. It is not like coffee and it is not like cigarettes. If you drink regularly and have done so for a long time, or if you take tranquillisers, never decide on sudden cessation by yourself — see a doctor first, who will judge whether you need supervised detoxification. That is the only safe order.

At the same time the reverse holds: the absence of physical withdrawal does not mean there is no problem. Many people with a serious disorder never have the classic bodily signs, because the substance or behaviour does not work that way. With gambling, screens and work there is usually no physical syndrome at all, and yet the distress on stopping is entirely real.

What is going on underneath

Addiction is not a failure of will. Repeated use gradually shifts the balance between two brain systems: the one that predicts reward and steers attention, and the one that inhibits and weighs consequences. The first becomes oversensitive to cues linked with the substance, while the second is less reliable under stress. This is why a person on a Friday evening at the shop where they always bought is not making the same decision as on a Monday morning in a consulting room.

It also explains why craving is at its strongest precisely when you have decided to stop. The reward system does not respond to your decision but to the circumstances it has linked with reward. I have written about this in the piece on how the brain changes through therapy — the same property that builds the pattern also dismantles it.

Where this reasoning does not hold

Now I have to say where this piece undercuts itself. The criteria I have listed were developed for populations, not for individuals. They work well when you compare groups in a study; apply them to yourself at midnight and they fall apart. Every one of us can explain away every single item.

The second objection is cultural. “Use despite arguments at home” means something different in a setting where every lunch begins with a toast than in a family where alcohol is taboo. Slovenia is among the countries with high alcohol consumption and a firm convention that refusing an offered drink is an insult. Part of what elsewhere would count as a sign is here a ritual. The risk is not absent — but the measure “nobody around me reacts” is nearly useless here.

The third objection is the most serious. For some people the question “am I an addict” is not the right question at all. If the substance is holding up severe anxiety, unprocessed trauma or chronic pain, then removing the substance without addressing what lies underneath will not hold. This is also why people often return after support is withdrawn — not out of weakness, but because something is still unsettled. I have written separately about how a symptom is often doing a job.

And one last thing: no piece of reading, this one included, replaces a conversation with a person who sees you. Self-assessment is a good first step and a poor last one.

If the answer is “I don’t know”

It very often is. And it is not a bad answer — it is an answer that can be tested. Instead of speculating, I suggest an experiment: choose a period long enough that it is not merely a weekend, and do not use during it. Not to prove that you can, but to see what surfaces.

Watch three things. First, how hard it was — not in terms of discipline, but how many thoughts went into it. Second, what appeared in its place: insomnia, irritability, boredom, a sadness that was not there before. Third, what happened in your relationships and what other people noticed.

If you plan this experiment repeatedly and it repeatedly does not happen, that is itself a data point, and one of the most eloquent. Repeated failure to cut down is one of the criteria precisely because it cannot be reinterpreted.

One important caveat: with alcohol and tranquillisers such an experiment is not neutral. If you drink regularly, talk to a doctor about it first.

Abstinence is not the only goal

Many people never begin this reflection because they fear the only possible outcome is total and permanent abstinence. That fear is understandable and not entirely justified. Harm reduction is an established and evidence-supported option: the aim is to reduce the consequences — for the body, for relationships, for safety — even if use does not stop altogether.

For some people complete abstinence really is the only stable solution, particularly in severe forms. For others harm reduction is the step that makes the conversation possible at all. Therapy that sets abstinence as a condition of entry loses exactly the people who need help most.

When a doctor comes before a therapist

With addiction I am often not the one who starts. A doctor or an addiction treatment centre comes first if physical signs appear on stopping, if you take tranquillisers, or if you have a co-occurring physical illness. I have described when a doctor is the first step in a separate piece; with addiction this applies more than anywhere else.

Therapy comes alongside, not instead. My work sits elsewhere: in what the substance or behaviour was doing for you, what is happening in the relationships around it, and how the roles get distributed in the family. If you are looking for a route through the Slovenian system, I have mapped out the paths to help separately.

What to remember

The question “am I an addict” is weaker than the question “what is this doing in my life and where am I moving”. Quantity is the least reliable measure you have to hand, because it can always be adjusted.

Four things say more: impaired control despite attempts, consequences at home and at work, carrying on despite harm, and the body’s adaptation. If you recognise yourself in several of these, that is not a verdict but a data point.

Withdrawal from alcohol and tranquillisers can be dangerous — never stop suddenly on your own, but consult a doctor first. And if the answer is “I don’t know”, that is a perfectly legitimate place to start a conversation. Many people arrive with exactly that sentence.