How do I know if alcohol or other substances have become a chronic illness for me?

You can use several tools to detect a loss of control with alcohol use. The CAGE questionnaire is one such example. The questionnaire asks the following questions:

• C: Have you ever felt you needed to Cut down on your drinking?

• A: Have people Annoyed you by criticizing your drinking?

• G: Have you ever felt Guilty about drinking?

• E: Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

Two "yes" responses indicate that your behavior should be investigated further.

If you suspect that you have a problem, then you probably do.

What can I do to manage a substance abuse problem?

Alcohol, some prescription medications, and the so-called "recreational drugs" can be addictive. If you suspect that you have a problem, then you probably do.

No approach to ending addiction will work unless the person wants it to work. If you are trying to quit because your spouse, friends, boss, parents, or children want you to, you are not likely to succeed. When the decision is yours, when you are doing this because you want it for yourself, you have a high chance of success.

The popular myth that no one gets clean and sober until they hit bottom is just that, a myth. People change when it is too painful to stay where they are. Some people recognize that pain sooner than others. Some people try to numb the pain instead. After the decision is made to change, what next?

Twelve-step programs exist for nearly every addiction. They work. Even if someone goes to a rehabilitation facility, they will be working a twelve-step-program. In some cases, doctors may be part of the solution, providing medications that ease the difficulty that some people experience when they withdraw from the substance. The first step is an admission that your life is out of control because of (fill in the blank). From there, you work through the other steps, often with the help of a sponsor who has been through the program. The last step is helping others who are experiencing the same problem. The steps work because people learn from one another. Twelve-step groups are anonymous. No one is going to tell your doctor or family or anyone else.

What is COPD?

COPD stands for chronic obstructive pulmonary disease. It is a disease that starts slowly and gets worse over time. COPD makes it difficult for people to breathe. Tobacco smoke is the leading cause of COPD, but it can also be caused by pollutants, chemical fumes, or dust. Emphysema results from damage to the small air sacs in the lungs. Chronic obstructive bronchitis is an inflammation of the airways. Both are part of COPD, and both make breathing difficult and inefficient. According to the National Heart, Lung, and Blood Institute, "COPD is a major cause of disability, and it's the fourth leading cause of death in the United States. More than 12 million people are currently diagnosed with COPD. An additional 12 million likely have the disease and don't even know it."

Symptoms of COPD begin long before the disease is problematic enough to prompt someone to get medical attention. A cough that is ongoing and produces a lot of mucous, shortness of breath especially after activity, and wheezing and tightness in the chest are all symptoms of COPD. Since other diseases can cause the same symptoms, it's a good idea to talk to your doctor about COPD.

What can I do to manage COPD?

The goals of treatment are to relieve your symptoms, slow the progress of the disease, improve your exercise tolerance, prevent and treat complications, and improve your overall health. Your doctor may prescribe medications and vaccinations. Medications open your airways. Inhaled steroids can be helpful. Vaccinations prevent complications from things like flu and pneumonia. Pulmonary (lung) rehabilitation engages a team of health professionals. Oxygen therapy can be given periodically or constantly to people with COPD. In some cases, you might need surgery or other interventions to manage complications brought on by COPD.

Although COPD requires medical management, you have a very important role. First and foremost, if you still smoke, stop! Ninety percent of all deaths from COPD can be attributed to smoking! Quitting smoking will slow the progress of the disease. Try to avoid lung irritants. If pollution is high, stay indoors with the windows closed. Follow the treatment plan the doctor has prescribed for you. Don't hesitate to call the doctor or go to the hospital if symptoms worsen. Remember, COPD is the fourth leading cause of death in the United States. Manage the disease and its symptoms. Your doctor is your best ally in managing COPD, but you are the one who has to follow through.