People from all walks of life can experience problems with substance use/misuse, regardless of age, race, or background. While some can use recreational or prescription drugs without experiencing negative effects, others find that substance use takes a serious toll on their health and well-being.
Substance use/misuse disorder and addiction is one of the most stigmatized diseases and this can stop individuals who need help from seeking it. Having an addiction can leave you feeling helpless, isolated, or ashamed.
If you’re worried about your own or a loved one’s substance use/misuse, learning how addiction develops, and why it can have such a powerful hold, will give you a better understanding of how to best deal with the problem and begin your road to recovery.
An addiction is an illness, just as heart disease and cancer are illnesses.
An addiction is not a weakness. It does not mean that someone is a bad person.
People from all backgrounds can get an addiction.
It doesn’t matter if you are rich or poor.
It doesn’t matter where you live. It doesn’t matter if you went to college or not.
An addiction can happen to anyone and at any age.
People start using drugs for many different reasons. Some experiment with recreational drugs out of curiosity, to have a good time, because friends are doing it, or to ease problems such as stress, anxiety, or depression. However, it’s not just illegal drugs, such as cocaine or heroin, that can lead to misuse and addiction. Prescription medications such as painkillers, sleeping pills, and tranquilizers can cause similar problems. In fact, next to marijuana, prescription painkillers are the most misused drugs in the US and more people die from overdosing from powerful opioid painkillers each day than from traffic accidents and gun deaths combined. An addiction to opioid painkillers can be so powerful it has become the major risk factor for heroin misuse and addiction.
Of course, drug use- either illegal or prescription- doesn’t automatically lead to misuse and addiction. There is no specific point at which drug use moves from casual to problematic. Drug misuse and addiction is less about the type or amount of the substance consumed or the frequency of the use, and more about the consequences of that drug use. If your drug use is causing problems in your life- at work, school, home, or in your relationships- you likely have a substance misuse disorder or addiction.
Recognizing and being aware of a problem is the first step on the road to recovery, one that takes tremendous courage and strength. Facing your problems without minimizing the issue or making excuses can feel frightening and overwhelming, but recovery is within reach. If you’re ready to seek help, you can overcome your addiction and build a satisfying, substance free life for yourself.
Signs and Symptoms of Substance Use and Misuse Disorders
Although different drugs have different physical effects, the symptoms of addiction are similar. If you can recognize yourself in the following signs and symptoms of substance use/misuse and addiction, know that there is help and hope for you.
Common Signs of Substance Use/Misuse
Neglecting responsibilities:at school, work, or home (failing classes, skipping work, neglecting your children)
Using drugs under dangerous conditions or taking risks while under the influence: such as driving while intoxicated, using unclean needles, or having unprotected sex
Problems in your relationships:such as fights with your partner or family members, an unhappy boss, or loss of friends
Experiencing legal trouble:such as arrests for disorderly conduct, stealing, vandalism, driving while intoxicated
Common Signs and Symptoms of Addiction
You’ve built up a tolerance to substances:You need more of the drug to experience the same affects you used to attain with smaller amounts.
You use a drug to avoid or relieve withdrawal symptoms: If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.
Loss of control over your drug use:You often use substances or use more than you planned, even though you told yourself you wouldn’t. You may want to stop using the drug, but you feel powerless.
Your life revolves around substance use:You spend a lot of time using and thinking about drugs, figuring out how to get them, or recovering from the drug’s effects.
You’ve abandoned activities you used to enjoy: such as hobbies, sports, socializing, because of your substance use.
You continue to use drugs, despite knowing it’s hurting you: It’s causing major problems in your life- blackouts, financial issues, mood swings, depression, paranoia- but you continue to use the substance.
Signs that a friend or loved one may be misusing substances:
Those suffering from substance use/misuse disorders often try to conceal their symptoms and downplay their problem. If you’re worried that a friend or loved one might be misusing drugs, look for the following warning signs:
Physical signs: Bloodshot eyes, pupils larger or smaller than usual, changes in appetite or sleep patterns, sudden weight loss or weight gain, deterioration of physical appearance, personal grooming habits, unusual smells on breath, body, or clothing, tremors, slurred speech, or impaired coordination.
Behavioral signs: Drop in attendance or performance at work/school, unexplained financial problems, borrowing or stealing, engaging in secretive or suspicious behavior, sudden change in friends, favorite hangouts, or hobbies, frequently getting intro trouble (fights, accidents, illegal activities, legal trouble).
Psychological signs: Unexplained changes in personality or attitude, sudden mood swings, irritability, or angry outbursts, periods of unusual hyperactivity, agitation, or giddiness, lack of motivation, appears lethargic or “spaced out”, appears fearful, anxious, or paranoid
If you believe a loved one or friend may have a substance use/misuse disorder or addiction, here are a few things you can do:
Speak up:Talk to the person about your concerns and offer your help and support without judging them (look at the LANGUAGE MATTERS page). The earlier an individual can enter into treatment, the better. Don’t wait for your loved one to hit bottom. List specific examples of your loved one’s behavior that you are concerned about and help them find ways to seek help.
Take care of yourself:Stay safe. Don’t put yourself in dangerous situations. Don’t get so caught up in someone else’s problem that you neglect your own needs. Make sure you have people you can talk to and lean on for support. There are a lot of local groups and resources that you can use for support.
Avoid self-blame:You can support a person with a substance use/misuse/addiction and encourage treatment, but you cannot force someone to change. You cannot control your loved one’s decisions. Letting the person accept responsibility for their actions is an essential step along the way to recovery.
Attempt to punish, threaten, bribe or preach. Don’t try to be a martyr. Avoid emotional appeals that may only increase feelings of guilt and the compulsion to use drugs. Don’t cover up or make excuses for your loved one, or shield them from the negative consequences of their behavior. Don’t take over their responsibilities, leaving them with no sense of importance or dignity. Don’t hide or throw away drugs. Avoid arguing with them if you believe they are under the influence. Don’t every participate in substance use with them. And don’t feel guilty or responsible for their behavior.
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How does substance use/misuse become an addiction?
Our brains want us to keep doing things that we need or enjoy- like eating tasty foods. That’s why you sometimes eat more dessert than you know you should. That’s why a little child often shouts “again!” when you do something to make them laugh.
Drugs that people use or misuse excite the parts of the brain that make you feel good. After you take a drug for a while, your brain gets used to it. Then you need to take more of the drug to get the same good feeling. Soon, your body and brain must have the drug just to feel normal. You feel sick without the drug.
Risk factors for substance use/misuse disorders and addiction
While anyone can develop problems when using/misusing drugs, vulnerability to substance addiction differs from person to person. While your genes, mental health, family and social environment all play a role, risk factors may increase your vulnerability.
Family history of addiction
Abuse, neglect, or other traumatic experiences
Mental disorders such as depression and anxiety
Early use of drugs
Method of administration- smoking or injecting a drug may increase its addictive potential
Drug addiction and the brain
While each drug produces different physical effects, all misused substances share one thing in common: repeated use can alter the way the brain functions. This includes commonly abused prescription medications as well as recreational drugs.
-Using a drug causes a rush of the hormone dopamine in your brain, which triggers feelings of pleasure. Your brain remembers these feelings and wants them repeated.
-When you develop an addiction, the substance takes on the same significance as other survival behaviors, such as eating and drinking.
-Changes in your brain interfere with your ability to think clearly, exercise good judgment, control your behavior, and feel normal without drugs.
-No matter which drug you’re addicted to, the uncontrollable craving to use grows more important than anything else, including family, friends, career, and even your own health and happiness.
-The urge to use is so strong that your mind finds many ways to deny or rationalize the addiction. You may drastically underestimate the quantity of drugs you’re taking, how much it impacts your life, and the level of control you have over your substance use.
Substance Use/Misuse and Mental Health
Dealing with drug or alcohol addiction and co-occurring mental health disorders
When you have both a substance use/misuse disorder and a mental health illness, such as depression, anxiety, or bipolar disorder, it is called a co-occurring disorder or dual diagnosis. Dealing with substance use, alcoholism, or addiction is never easy, and it’s even more difficult when you’re also struggling with mental illness. But there is hope. There are plenty of treatments and steps you can take to help you on the road to recovery. With the right support, self-help, and treatment, you can overcome a co-occurring disorder, reclaim your sense of self, and get your life back on track.
What is the link between substance use/misuse and mental health?
In co-occurring disorders, both mental illness and the drug or alcohol addiction have their own unique symptoms that may get in the way of your ability to function at work or school, maintain a stable home life, handle life’s difficulties, and relate to others. To make it more complicated, the co-occurring disorders also affect each other. When a mental illness goes untreated, the substance use/misuse problem usually increases too. But you’re not alone. Co-occurring substance use/misuse problems and mental illness are more common than people realize.
-Roughly 50% of individuals with severe mental disorders are affected by substance use/misuse disorders
-37% of individuals with alcohol misuse disorders and 53% of substance use/misuse disorders also have at least one serious mental illness
-Of all people diagnosed with a mental illness, 29% misuse either alcohol or drugs
While substance use/misuse disorders and mental illness don’t get better when they’re ignored- in fact, they are likely to get much worse- it’s important to know that you don’t have to feel this way. There are things you can do to conquer these challenges, repair your relationships, and start enjoying life again.
Dual diagnosis and denial
Complicating a dual diagnosis is denial. Denial is common in substance use/misuse. It’s often hard to admit how dependent you are on alcohol or drugs or how much they affect your life. Denial frequently occurs in mental disorders as well. The symptoms of depression or anxiety can be frightening, so you may ignore them and hope they go away. Or you may be ashamed or afraid of being viewed as weak if you admit you are struggling. Substance use/misuse and mental illness can happen to any of us. And admitting you have a problem and seeking help is the first step on the road to recovery. You have nothing to be ashamed of and you are not alone.
The chicken or the egg:
What comes first? Substance misuse or mental illness?
Substance use/misuse and mental illness such as depression and anxiety are closely linked, and while some substance misuse can cause prolonged psychotic reactions, one does not directly cause the other. However:
Alcohol and drugs are often used to self-medicate the symptoms of mental health disorders. People often misuse alcohol or drugs to ease the symptoms of an undiagnosed mental illness, to cope with difficult emotions, or to temporarily change their mood. Unfortunately, misusing substances causes side effects and in the long run often worsens the symptoms they initially helped to relieve.
Alcohol and drug use/misuse can increase the underlying risk for mental illness.Mental health disorders are caused by a complex interplay of genetics, the environment, and other outside factors. If you are at risk for a mental illness, misusing alcohol or other drugs may worsen an underlying mental health issue. There is some evidence, for example, that certain misusers of marijuana have an increased risk of psychosis while those who misuse opioid painkillers are at greater risk for depression.
Alcohol and drug use/misuse can cause symptoms of a mental illness worse.Substance misuse may sharply increase symptoms of mental illness or even trigger new symptoms. Misuse of alcohol or drugs can also interact with medications such as anti-depressants, anti-anxiety medications, and mood stabilizers, making them less effective at managing symptoms.
Do I have a substance misuse disorder and co-occurring mental illness?
It can be difficult to diagnose a substance use/misuse problem and a co-occurring mental illness. It takes time to tease out what might be a mental disorder and what might be an alcohol or drug issue. The signs and symptoms vary depending upon both the mental illness and the type of drug being misused.
-Do you use alcohol or drugs to cope with unpleasant memories or feelings, to control pain or the intensity of your moods, to face situations that frighten you, or to stay focused on tasks?
-Have you noticed a relationship between your substance use and your mental health? For example, do you feel depressed when you use alcohol?
-Has someone in your family been diagnosed with either a mental health disorder or an alcohol/substance misuse disorder?
-Do you feel depressed or anxious even when you’re sober?
-Do you have unresolved trauma or a history of abuse?
-Have you previously been treated for either addiction or mental health disorders?
Signs and symptoms of substance misuse
While these questions do not encompass all that may identify a substance misuse disorder, they are helpful in beginning to explore what you may be facing:
-Have you ever felt you should cut down on your drinking or drug use?
-Have you tried to cut back, but couldn’t?
-Do you ever lie about how much or how often you use alcohol or other drugs?
-Are you going through prescription medication at a faster than expected rate?
-Have your friends or family members expressed concern about your alcohol or drug use?
-Do you ever feel bad, guilty, or ashamed about your drinking or drug use?
-On more than one occasion, have you done or said something while drunk or under the influence of drugs that you later regretted?
-Have you ever blacked out from drinking or drug use?
-Has your alcohol or drug use caused problems in your relationship?
-Has your alcohol or drug use gotten you into trouble at work or with the law?
Signs and symptoms of common mental health disorders that
co-occur with substance use/misuse disorders
-Feelings of helplessness and hopelessness, strong feelings of worthlessness or guilt
-Loss of interest in daily activities
-Inability to experience pleasure
-Appetite, weight, or sleep changes
-Loss of energy, difficulty concentrating
-Anger, physical pain, reckless behavior
-Excessive tension and worry, irritability or feeling “on edge”
-Feeling restless or jumpy
-Racing heart or shortness of breath
-Nausea, trembling, or dizziness
-Muscle tension, headaches
Mania in Bi-polar Disorder
-Feelings of euphoria or extreme irritability, anger or rage
-Unrealistic, grandiose beliefs
-Decreased need for sleep, hyperactivity
-Increased energy, rapid speech and racing thoughts
-Impaired judgement and impulsivity
Treatment for substance use/misuse and mental illness
The best treatment for co-occurring disorders is an integrated approach, where both mental health and substance use are treated simultaneously. Whether your mental health or substance use disorder came first, long-term recovery depends on getting treatment for both disorders by the same treatment provider or team.
Treatment for your mental health may include medication, individual or group counseling, lifestyle changes, and peer support
Treatment for substance use/misuse disorders may include detoxification, managing withdrawal, behavioral therapy, and support groups to maintain your sobriety.
Keep in Mind
There is always hope: Both mood disorders and alcohol and drug misuse are treatable conditions. Recovering from co-occurring disorders takes time, commitment, and courage. Individuals CAN and DO get better with commitment and patience.
It’s important to maintain your sobriety during treatment:If your doctor needs to prescribe medication for your mental illness, mixing it with drugs or alcohol could have serious negative effects. Similarly, many treatment options are far less effective if you’re under the influence of mind-altering substances.
Relapses are a part of recovery: Don’t get too discouraged if you relapse. Slips and setbacks happen, but with hard work, most people can recover from their relapses and move forward with positive change.
Peer support can help: Peer Recovery Coaches are a form of support in your community that can be highly effective in supporting your treatment plan. There are also groups such as Alcoholics Anonymous or Narcotics Anonymous. A peer support environment gives you a chance to lean on others who know exactly what you’re going through and learn from their experiences.
Any program you participate in should be licensed and accredited with the treatment methods backed by research. Additionally, you should make sure the program has experience with your specific disorder.
-Treatment should address both substance use and mental health.
-You should share in the decision-making process and be actively involved in setting goals and developing strategies for change.
The Path to Recovery
Developing an addiction isn’t a character flaw or a sign of weakness, and it takes more than willpower to overcome the problem. Misusing illegal or certain prescription drugs can create changes in the brain, causing powerful cravings and a compulsion to use that makes sobriety seem like an impossible goal. But recovery is never out of reach, no matter how hopeless you may feel. With the right treatment and support, change is possible. Don’t give up- even if you’ve tried and failed before. The road to recovery often involves bumps, pitfalls, and setbacks. By examining the problem and thinking about change, you’re already on your way.
Decide to make a change
For many people struggling with addiction, the toughest step toward recovery is the very first one; recognizing that you have a problem and deciding to make a change. It’s normal to feel uncertain about whether you’re ready to make a change, or if you have what it takes to quit. If you’re addicted to a prescription drug, you may be concerned about how you’re going to find an alternate way to treat a medical condition. It’s okay to feel torn. Committing to sobriety involves changing many things, including:
-the way you deal with stress
-who you allow in your life
-what you do in your free time
-how you think about yourself
-the prescription and over-the-counter medications you take
Making the commitment to change
It’s normal to feel conflicted about giving up your drug of choice, even when you know it’s causing problems in your life. Recovery requires time, motivation, and support, but by making a commitment to change, you can overcome your addiction and regain control of your life.
Think about it:
Keep track of your drug use, including when and how much you use. This will give you a better sense of the role addiction plays in your life.
List the pros and cons of quitting, as well as the costs and benefits of continuing your drug use.
Consider the things that are important to you, such as your partner, your kids, your pets, your career, or your health. How does your drug use affect those things?
Ask someone you trust about their feelings on your drug use.
Ask yourself if there’s anything preventing you from changing. What could help you make the change?
You are not alone, and we are right beside you.
Preparing for change
1. Remind yourself of the reasons you want to change
2. Think about your past attempts at recovery, if any. What worked? What didn’t?
3. Set specific, measurable goals, such as a start date or limits on your drug use.
4. Remove reminders of your addiction from your home, workplace, and other places you frequent.
5. Tell friends and family that you’re committing to recovery and ask for their support.
The keys to finding the best treatment for YOU
No treatment works for everyone: Everyone’s needs are different. Whether you have a problem with alcohol, illegal, or prescription drugs, addiction treatment should be customized to your unique situation It’s important that you find the program that feels right for you.
Treatment should address more than just your substance use/misuse/addiction:Addiction effects your whole life, including your relationships, career, health, and psychological well-being. Treatment success depends on developing a new way of living and addressing the reasons why you turned to drugs in the first place. For example, your addiction may have developed from a desire to manage pain or to cope with stress, in which case you’ll need to find a healthier way to relieve pain or to handle stressful situations.
Commitment and follow-through are key: Drug addiction treatment is not a quick and easy process. In general, the longer and more intense the drug use, the longer and more intense the treatment you’ll need. And in all cases, long-term follow up care is crucial to recovery.
There are many places to turn for help: Not everybody requires medically supervised detox or an extended stint in rehab. The care you need depends on a variety of factors, including your age, drug-use history, medical or psychiatric conditions. In addition to doctors, psychologists, therapists, there are therapists, peer recovery coaches, clergy members, and others who are there to support you.
Find support for your recovery
There is no reason you should do this along- reach out for support. Whatever treatment approach you choose, having positive influences and a solid support system is essential. The more people you can turn to for encouragement, guidance, and a listening ear, the better your chances are for recovery.
Lean on close friends and family:
Build a sober social network:
Consider moving into a sober living home:
Make your treatment and sobriety a priority.
Learn healthy ways to cope with stress
After addressing your immediate needs with addiction and starting treatment, you’ll still have to face the problems that led you to your addiction. Did you start using to numb painful emotions? Calm yourself after an argument? Unwind after a bad day? Or to forget about your problems?
Once you are substance free, the negative feelings that you dampened with substances may resurface. For treatment to be a success, you’ll first need to resolve your underlying issues.
Once you have resolved your underlying issues, you will, at times, continue to experience stress, loneliness, frustration, anger, shame, anxiety, and hopelessness. These emotions are all normal. Finding ways to address these feelings as they arise is an essential component to your treatment and recovery.
There are healthier ways to keep your stress level in check. You can learn to manage your problems without falling back onto old habits. When you’re confident in your ability to quickly de-stress, facing strong feelings isn’t as intimidating or overwhelming.
Quickly relieve stress without drugs
Different quick stress relief strategies work better for some people than others. The key is to find the one(s) that work for you.
Movement: a brisk walk around the block can be just what you need. Yoga and meditation are also excellent ways to busy stress and find balance.
Step outside, savor the sun, and take in the fresh air:enjoy something simple in your surroundings, watch the leaves move from the wind.
Pet your animal, hug a friend: taking a moment to stop and appreciate those around you. Give someone a smile or say hello to a stranger.
Lay down and listen to music: take a moment and clear your mind.
Identify, then avoid, your triggers
Your recovery doesn’t end at getting sober. Your brain still needs time to recover and rebuild connections that changed during your substance use. During this rebuild, drug cravings may become intense. You can support your continued recovery by avoiding people, places, and situations that trigger your urge to use:
Step away from your friends who use: Don’t hang with friends who are still using/misusing substances. Surround yourself with people who support your sobriety, not those who tempt you to slip back into old, destructive habits. THERE ARE SEVERAL DIFFERENT GROUPS IN OUR COMMUNITY FOR YOU TO JOIN. NOTE PAGE _____
Avoid bars and clubs: Even if you don’ have a problem with alcohol, drinking lowers inhibitions and impairs judgment, which can easily lead to a relapse. Drugs are often readily available and the temptation to use can be overpowering. Also, avoid any other environments and situations that you may associate with your substance use.
Be upfront about your history or drug use when seeking medical treatment:If you need a medical or dental procedure done, be upfront and find a provider who will work with you in either prescribing alternatives or the absolute minimum medication necessary. You should never feel ashamed or humiliated about previous drug use or be denied medication for pain.
Use caution with prescription drugs: If you were misusing prescription drugs, such as an opioid painkiller, you may need to talk to your doctor about finding alternate ways to manage your pain. Regardless of the drug you experienced problems with, it’s important to stay away from prescription drugs with the potential for misuse or use them only when necessary and with extreme caution. Drugs with high misuse potential include painkillers, sleeping pills, and anti-anxiety medications.
Recovery: a process of change through which individuals
improve their health and wellness, live a self-directed life,
and strive to reach their full potential.
You can support your own path and protect your successes by having activities
and interests that provide meaning to your life. It’s important to be involved in things
that you enjoy, where you feel needed, and add meaning to your life.
When your life is filled with rewarding activities and a sense of purpose,
you will be reaching your full potential.