Substance use

Substance use refers to consuming certain substances (such as alcohol, tobacco or drugs) that have the potential to cause ongoing dependence or other negative effects. This guide will help you to consider the role of drinking, smoking or using drugs in your daily life and how to curb your use of them if they begin to disrupt your health, safety or relationships.

Two people sitting down with their hands folded together

What is it?

Substance use—or consumption of addictive substances such as alcohol, tobacco and drugs—is pretty common. A recent survey found that nearly 50% of Americans over age 18 drank alcohol in the past month, and almost a quarter of Americans over age 18 reported binge-drinking within the past month.¹

Because there is a part of our culture that normalizes drinking and other behaviors, many of us are introduced to substance use as a means of being social or even as a way to deal with stress. There are four reasons people begin using substances more regularly:

To feel good: feeling of pleasure, “high” or "intoxication"
To feel better: relieve stress, alleviate pain, forget problems or feel numb
To do better: improve performance or thinking
Curiosity and peer pressure or experimenting

Usually, what starts out as one drink after work can quickly turn into a drink every day. Then it can turn into two or three drinks all day, and then drinking all day. This is because substances like drugs and alcohol can be addictive, and due to our brain chemistry and genetics, it can be tricky to use them in moderation.

This is often how substance use can transform into substance misuse, which can have a lot of negative effects on your health, your relationships with people you love, and your overall quality of life. That being said, there’s a difference between use and addiction, and being aware of the effects on you and your mental health starts with monitoring your own use more closely.

What's causing it?

Using certain substances—whether it be drugs or alcohol—can affect the chemicals in your brain, particularly in the so-called reward systems. These systems developed evolutionarily to reinforce behaviors that we need to survive. For example, when we eat food a chemical in our brain called dopamine makes us feel pleasure and satisfaction. This tells us, if I eat more food, I’ll feel good again, and so, we will find ways to do it again.

When a person becomes addicted to a substance, it’s because that substance triggers a flood of dopamine. The amount of dopamine that gets triggered is often much higher for these types of substances (about 10 times higher) than what would be triggered by any “natural” substance.

Our brain remembers this pleasurable feeling, which becomes associated with using a substance and even situations in which we use the substance (the people we are with, the social environment). As a result, we will continue to seek out that feeling and find ways to feel it again by using the substance.

Over time, however, we build tolerance: We need more and more of the substance to create the same feeling. Seeking drugs is driven by habit and changes in our brains, not rational decisions.

Once someone starts using substances despite negative consequences, it becomes a Substance Use Disorder (SUD). These disorders might require anything from detox to medication to some form of therapeutic treatment.

Beyond escalating amounts and frequency, there are other signs to look out for in your substance use:

Isolating yourself—including putting aside work and social gatherings—to use. Or, no longer waiting to use substances with others, and choosing to do it alone
Using substances every day or even several times every day, including in the morning
Craving substances when you do not have them
Regularly overconsuming or binging substances in private and in social situations
Not being able to stop or moderate substance use, despite the consequences
Dealing with social problems such as failing to finish tasks at home, work or school, or giving up on other activities you enjoy
Changes to sleep, focus or motivation
Doing dangerous activities—such as driving a car or having unprotected sex—while under the influence

Addiction is an illness, and just like other illnesses, there are many ways to treat it. Staying aware of potential warning signs can often help you before it escalates. The first step, however, is identifying and admitting you might have an issue.

How should I deal with it?

One of the hardest steps to take when it comes to substance use is being honest with yourself about your use and when it may be getting out of control. It can take a lot of strength to recognize a struggle with misusing substances, and it starts by noticing changes in your use patterns, frequency and related behaviors.

You might notice you are having trouble concentrating or feeling motivated, or you’re fighting more with your loved ones. Take stock of the relationship between these symptoms and your use.

Once you know you have a problem or are concerned you’re headed that way, there are many ways you can attempt to get help and start to help yourself. These include:

Changing your surroundings and environment so that you’re less tempted to use substances. Often use is triggered by our social lives. It’s important to recognize that and put up healthy boundaries for yourself. If your substance of choice is alcohol, for example, this may include finding friends who are sober, attending alcohol-free social events, or swapping out alcohol for juice or mocktails while at a bar.
Creating a plan for curbing use. Decreasing use is often a gradual process and it can be hard for most people to “just stop.” It can help to set guidelines for yourself about when, how much, and what substance you can use.
Look for alternative coping mechanisms. Substance use often increases to minimize big feelings or deal with stressful events. It’s important to recognize what triggers use and find alternate ways to deal with those situations.
Seeking out therapy or a support group. Substance use can make you feel like you’re alone, especially if it’s affected your loved ones. Turning to someone else, especially a support group of your peers, can help in those circumstances. Most support groups are free to attend, and on top of helping to harness your inner strength, they can offer the chance to make new, great connections with people who are on a similar journey.
Focus on what you can control. One of the tenets of support groups is serenity and inner strength. This can help you adjust your mindset to realize what’s in your control, what’s not, and how you should spend your energy on the things that are.

Of course, there’s not one “correct” approach to addressing substance use and misuse. The best approach is the one that works for you, so it’s worth trying a few different things until you find the right combination.

Things to try

If you’re struggling with substance use, here are a few proven methods that can act as a starting point to tackling it head-on.

Acknowledge and avoid negative self-talk

Ask for specific help
Recognize when to get help
Volunteer

More Things To Try

How to help a loved one

If you find that your loved one’s use of substances has started to negatively affect their life (and maybe yours, too), it might be time to lend support. Offering help from a place of love and trust can have a huge impact.

Research. What you’re doing now is a good starting point. Before speaking with your loved one about their substance use, it’s a good idea to research potential solutions you believe might be effective for them. Remember that substance use is an illness of the brain–so try not to assume they can just “stop.”
Start a conversation when they’re sober. Engaging with your loved one while they’re under the influence could become confrontational rather than productive. Speaking at a time when you’re both present mentally and emotionally is crucial. If it’s tough to find a time when they’re sober, you may consider pulling in other key people in their life to strategize around a good time to chat.

Lend support. Being there for a loved one can mean supporting a new routine, or being a trusted source that gently encourages them to recognize and admit their problem and eventually seek outside help if needed. If you think they might benefit from a support group, you might offer to go with them. There are also groups specifically for family members that can support you in the journey of supporting them.
Be patient and understanding. It’s important to practice compassion with yourself and your loved one. Substance misuse can be a lifetime battle with many setbacks. Relapse is even an expected step for alcoholism. If you’re not careful, a lot of blame can get thrown around. Having loved ones frequently voice their support during tough times can be invaluable.
Avoid stigmatizing language. Addiction is a disease and it’s important to talk about it appropriately when talking with your loved one. Your goal should be to avoid negative stereotypes or beliefs with the language you use. Use "substance use or misuse" instead of "abuse" for example. Learn more about words to use and not use when talking about addiction.

What can I do now?

The fact that you’ve come this far and have admitted to yourself that you might be struggling with your substance use and need help shows tremendous strength. You’re not alone, and there are many resources available to support you as you work through it.