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Do I Have to Hit Rock Bottom Before I Get Help?

No! Hitting rock bottom is not a prerequisite to seeking help for substance abuse; help is available whenever you are ready for it.

Unfortunately, statistics show that many people who are struggling with substance abuse will not seek help until they do hit rock bottom. The National Survey on Drug Use and Health reported that of almost 23 million people who needed substance abuse services in 2013, only 2.5 million actually sought out and received treatment.1

Substance abuse is a complicated illness that often requires some major life event such as divorce, loss of a job, death of a friend from overdose, or any other major life trauma to precipitate a desire to seek help.

But there is good news! The fact that you are asking yourself, “Do I have to hit rock bottom before I seek help?” means a) that you haven’t yet hit rock bottom and b) that you are showing signs of motivation to change.

Continue reading to learn why you don’t need to wait until you hit rock bottom to get help.

What do Stages of Change Have to do With Hitting Rock Bottom?

Dr. James Prochaska (Professor of Psychology and director of the Cancer Prevention Research Center at the University of Rhode Island) created a model of change called the Transtheoretical Model of Behavior Change. In this model he proposed that there are 5 stages that occur when someone decides to make a change—substance abuse-related or otherwise.

Stage 1: Precontemplation

If you’re in this stage, change is not even in your radar. You are not willing to read about, talk about, or even think about changing a certain behavior.

Stage 2: Contemplation

This is a stage where you may not be willing to change a certain behavior immediately, but you are beginning to think about the pros and the cons of it.

Stage 3: Preparation

During this stage, you have the intent to change and you even take certain actions to change. For instance, you may look up treatment options or seek out online groups to communicate with others dealing with the same issue.

Stage 4: Action

This is an important stage. This is where you actually make the commitment to change. This generally involves checking into some level of treatment.

Stage 5: Maintenance

During this stage, you have an ongoing commitment to staying sober and not undoing all the work you did during the “action” faze. This may involve going to a weekly support group.

What Prevents People from Seeking Help Before They Hit Rock Bottom?

There are many reasons why people who are dealing with substance abuse do not seek out the help that they need, and these reasons vary greatly from person to person. Some of the common reasons people don’t seek help for their substance abuse include cravings, denial, desire to avoid painful withdrawal symptoms, stigma, and fear.

Cravings are one of the most profound effects of substance abuse, dependence and addiction. Cravings are often so strong that they overwhelm a person’s ability to approach everyday situations rationally. The result of craving is that a person who is addicted to a substance may:

  • Lie, manipulate and steal to attain the object of their craving.
  • Forgo prior commitments to friends family and work to appease cravings.
  • Place themselves in situations that could be life-threatening, such as driving to put an end to craving.


Denial is often one of the most pronounced defense mechanisms of someone dealing with substance abuse. Denial involves denying the truth of your own substance abuse even when others have shown you evidence to the contrary.

Denial could also involve your admitting that there is a problem but minimizing the consequences to yourself and others and/or pushing the responsibility of your addiction onto others in your life. Denial is a strong defense that comes in many forms but ultimately prevents a person from seeking help.


Stigma is one of the most difficult factors to overcome when admitting that you have a substance abuse issue. What friends, family, coworkers and employers or society at large has to say about someone who is an “addict” is a strong force that reinforces the defense mechanism to deny a substance abuse problem.

You may ask: but if I have a heart condition, diabetes, liver failure or kidney failure and I do not seek help for that disorder am I not signing my own death sentence? The comparison to such physical disorders is valid.

Substance addiction is, in fact a disorder of the brain, and just like other physical disorders there is help and healing—but only if you move beyond the stigma and seek help.


Fear tends to rear its ugly head in many ways. It often includes a fear of what life may be like without a substance, fear of what withdrawal will be like, fear that treatment won’t work or even fear that you will fail and not make it to the maintenance phase of recovery.

Fear can prevent us from doing what we really want to do. Fear is said to be the opposite of faith, and at some point you can get the courage to take a leap of faith and believe that what is waiting on the other side of addiction is a path to a more fulfilling future. It is a future where you are completely engaged, present, and happy with your life!

If you are wondering whether you have to hit rock bottom before you get the help you need, please remember that you don’t. Help is a phone call away.

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