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

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.

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:

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.
  • Ask for specific help

    Though making a specific ask when you're going through difficult times might feel strange, well-intentioned friends who say “Let me know if I can do anything” will be glad to have a clear idea of how to be helpful. If you aren’t sure where to start, consider: Practical support: errands, cooking, babysitting, etc.; Social/well-being activities: taking a walk, going to coffee or lunch, etc.; Emotional support: spending time together—to talk, or just spend time together.
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  • Recognize when to get help

    If you feel things getting worse instead of better, notice you've lost interest in people and things you used to enjoy, or have trouble doing everyday things like eating, getting dressed, and getting out of the house, you may be experiencing a more serious mental health issue and it’s important to seek out help from a therapist or psychiatrist who can help you find relief. It can be hard to recognize changes in symptoms, so consider tracking them in a journal or mood-tracking app. If you or a loved one is having thoughts of self-harm, talk to someone you trust or call or text 988 to get free and confidential support from the 988 Suicide & Crisis Lifeline. Learn about more crisis resources
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  • Volunteer

    Aside from helping others, volunteering has amazing feel-good effects for you. You'll also experience elevated oxytocin levels and a dopamine release along with a sense of meaning that can help reduce stress and burnout. Volunteering is also a great way to build and strengthen social connections, which is increasingly important as social isolation is on the rise. In addition to making new connections when you volunteer, you might make existing connections even stronger when you volunteer with loved ones. (One study even shows that couples who volunteer together were more likely to stay together.)
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More Things To Try

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.

Citations

  1. NIAAA (National Institute on Alcohol Abuse and Alcoholism). Alcohol Use in the United States: Age Groups and Demographic Characteristics