The Continuum of Chemical Health

Chemical health isn’t always black or white, using or not using. It falls on a continuum that describes frequency or patterns of use.  For more information, click here to go to Treatment Options.

Abstinence: No use

Selected abstinence: Use of prescribed and over the counter medications as directed.

Experimentation: Social or occasional use of alcohol and drugs.

High risk: Use of alcohol and other drugs offer a benefit to some perceived deficit.

Abuse: Behavioral and physical problems start to occur due to use.

Dependence: Physical signs of dependence appear and chemical changes occur in the brain. The dangers start when an individual moves from experimentation with alcohol and other drugs to high risk. This normally occurs when the person finds a perceived benefit from using the chemical such as stress management, pain reduction, etc. The person can move quickly into abusive behaviors and physical dependence.

The Continuum of Acceptance. Another factor to consider is what level the person at in regard to accepting that they have a problem with alcohol and/or other drugs.

No awareness is when the person is unable to recognize a problem. They need external structure to limit exposure to using situations, triggers and other environmental issues. These individuals need inpatient treatment.

Intellectual is when the person is able to see the issue but cannot predict what consequences will follow. They also need external structure, cuing about consequences and educational strategies with role playing, practice and memory aides. These individuals also need inpatient or extended care treatment.

Emergent is when the person is beginning to see the connection between use and problems or consequences. These individuals need strategies to help them to remember to stop and think before reacting. These individuals can be best served as inpatients, in extended care or in a halfway house setting. Some individuals will also do well in outpatient programming if they have support and structure at home.

Anticipatory is when the person is able to anticipate consequences of using chemicals. They are able to self-cue and use strategies. They do well in outpatient programming.

Detecting Chemicals

How are chemicals in the body tested?

There are three ways to detect the use of chemicals through urine, blood or hair.  The most common and inexpensive is a urine screen. Urine screens can be done at a lab or can be done using a quick strip. Quick strips can tell an individual that a chemical has been used but does not give a level of how much.

What factors affect chemicals?

Different chemicals stay in the body for different amounts of time. How long depends on how much was used, how long it was used, method of administration (drinking, smoking or injection), the type of chemical, and age, gender and body mass of the user.

How are they soluble?

Chemicals tend to be water, fat or water and fat soluble. If a chemical is water soluble, the body rids itself of the chemical by urinating, sweating or vomiting it out. An example of a water soluble chemical is alcohol. If a chemical is fat soluble, such as marijuana, the chemical is stored in the fat cells of the body and needs to be metabolized out. This is why alcohol is out of the body quickly and marijuana can be found several weeks after using.

Many prescriptions and narcotics are both water and fat soluble. That is, some of the chemical is processed out through urine, sweat and/or vomiting while other parts of the chemical are metabolized out. The general rule is: that the longer between doses of a prescription medication, the more fat soluble it is.