It can be very hard to recognize a substance abuse problem. Denial is the first thing that springs from the lips of anyone with a problem or from those close to them. No one would like to think that abuse is a part of their life or the life of anyone close to them.

How do you know what’s abuse? Often you don’t. But in the heart of anyone who has a friend or relation with a problem, there is a knowing. And it is that knowing heart that makes a difference. Can you help the person, even if it is yourself? Maybe and maybe not.

Sometimes it’s a matter of both having a problem and one not wanting to confront the other. You should give it up, but not me, I’m fine. It’s a difficult situation.

I have known several of my relations that seemed to have a problem. I would never accuse them of anything like it because it is not my place. Substance abuse is the most personal of matters. Some have given up the use of alcohol and all have given up any kind of street drug.

On the other hand, some have seemed to incorporate the use of prescription drugs and alcohol into their lives. In some cases, it seems to be working. They have successful lives and families. They seem to handle it. I think there is a hard line about addiction that maybe needs to be a little more forgiving. I’m not endorsing drugs at all, but legal alcohol and prescription drugs may be a way of coping that does not find much forgiveness in our modern world.

So, to recognize abuse or define it is one thing, and to deal with it is a very different thing. What is the line between abuse, addiction and using? Very interesting. I had a cousin who committed suicide after many years of alcohol abuse.

I firmly believe he was suffering from depression and maybe the drinking was a help to him. Did we know he drank too much and took the occasional drug? Yes. Did we advise him to get therapy? Yes. It was not the way of our family, so no surprise when he didn’t do so. When he stopped his drinking without any help because it was the right thing to do, he was overwhelmed. He was not the same person.

We loved him when he drank and when he didn’t. Was he a morally good person for not drinking? Probably. But it got him by for years and I’m not sure that abusing alcohol was precisely an abuse. If it helped him get along with the tragedies of his life, and there were many, I’m not sure I could call it abuse.

In the long run, recognizing substance abuse may be more a function of morality than a cognizance of what the problem might be.

We did not recognize my cousins’ situation as substance abuse, but more his “nature.” Most of those who knew him saw it as self medication. Is there a difference? I’m not sure. In his last two years he was “sober.” And then he was dead. Is a substance abuse problem if a problem keeps you alive?

This is a question I will take with me all my life. I feel I can recognize when someone has an issue, but am I qualified to take that issue/problem away from them? Possibly not. I think we may all walk a more fine line than we might be aware of in our everyday life, i.e., it’s not me it’s you…or maybe not.