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There are many reasons why people decide to drink and use drugs. But the increasing use of drugs and drinking can come with serious risk and devastating consequences.

Substance abuse affects an estimated 25 million Americans. In terms of people who are affected indirectly such as families of abusers and those injured or killed by intoxicated drivers, an additional 40 million people are affected. The monetary cost to society and the economy because of reduced productivity, property damage, accidents, and health care are astounding. Alcoholism (heavy drinking) afflicts 16 million adults and almost 300,000 children annually. An estimated 21.6 million Americans (age 12 and older) are addicted to other drugs such as sedative-hypnotics or barbiturates, opiates, sedatives, hallucinogens and psychostimulants.

What's the difference between regular use and addiction?

For many individuals, consuming low or infrequent doses of substances is not uncommon. Sometimes individuals use substances experimentally or casually.  If this is the case, serious negative effects should not occur.

If using substances starts to have a negative effect on life, it's a sign of possible addiction. There are many symptoms and warning signs of substance abuse and dependence including:

  • Continuously using drugs or alcohol even while experiencing negative side effects
  • Finding out that you are using more and more drugs or alcohol to get the same "good feeling"
  • Trying to stop by finding it very difficult
  • Emotionally feeling like you need to use drugs or drink to feel normal
  • Physically feeling like you need to use drugs or drink to feel normal
  • Finding that you're spending more and more time trying to find ways to get drugs or alcohol
  • Feeling sick (withdrawal symptoms) including - trembling, hallucinations, sweating and high blood pressure when you stop using drugs or drinking
  • When doing drugs or drinking interferes with work, school, and relationships

According to the American Psychiatric Association, addictive disorders are caused by 10 classes of substances which include (with common examples):

  • Alcohol
  • Caffeine
  • Marijuana
  • Hallucinogens (PCP or LSD)
  • Inhalants (glue, paint thinner)
  • Opioids (prescribed painkillers, heroin)
  • Sedatives, hypnotics (sleeping pills), anxiolytics (Xanax or Valium)
  • Stimulants (meth, amphetamines, cocaine)
  • Tobacco
  • Other - unknown or emerging drugs like K2 or bath salts.

The specific causes of substance abuse are unclear, though they seem to be a combination of hereditary, environmental and social factors.

Substance Use, Mental Health and Treatment

People with depression or other mental health problems are particularly vulnerable to alcohol and drug use. Some may choose to drink alcohol or take drugs to alleviate stress or emotional pain, but doing so often can develop or worsen mental health conditions.

People who use alcohol or other drugs should get checked for depression, anxiety disorders and other mental illnesses. It's also helpful to screen for the severity of substance abuse problems.  Getting help through education, support groups, or counseling can help get people back on the right track.

Treatment of substance abuse might explore abstinence (staying off alcohol or drugs completely) but often include a variety of therapies. Therapy should explore underlying thoughts and motivations for addictive behaviors and include building self-efficacy and coping with stress. Self-help groups can be effective in helping to establish a support network. In some cases medications such as disulfiram (Antabuse) or methadone may be used with some success to support recovery. Some people find that individual or group support is enough to help, while others need detox or residential treatment.

Tips for friends and family

If you believe someone you know may have substance use issues, there are ways you can help. As previously explained, there are signs and symptoms to watch out for.

Remember your friend or family member may be having a hard time right now. You need to be as supportive and understanding as you can. By letting the person know you care about his well-being, he will be more willing to get the help he needs.

There are a few tips you should remember:

  • Offer support. Let the person know you are there for him no matter what. Don’t be judgmental.
  • Encourage the person to open up. Let the person know you are truly interested in what is going on in his life.
  • Be persistent, but don’t forget to be gentle. The person may not want to share what he is experiencing right now. Don’t feel discouraged. Keep trying because eventually the person may share what he is going through.
  • Don’t lecture; just listen. The person may already be in a fragile state. Therefore, criticizing the person may discourage communication. Also, listen to everything the person has to say before you ask questions.
  • Don’t be afraid to address the issue. You may feel unsure or hesitant about whether the person really has an issue. However, even if you are unsure, you should address the changes you have seen in the person.
  • Be honest. Let the person know the signs you noticed, and why they worry you.
  • Don’t belittle the person’s feelings. The person is sharing personal feelings with you. Take the person seriously.
  • Speak to the person with dignity and respect. Remember that everyone experiences hardships. Don’t treat a person poorly because of an issue they are facing.
  • Be calm. You may feel shocked, angered, sad or scared by what the person will share with you. Remember to remain calm. Staying calm will help you and the person; it will encourage the person to keep communicating with you.
  • Encourage professional help. Let the person know how he can benefit from professional help. Assist in finding help for the person if they ask you to.
  • Seek support. Knowing a friend is going through this can be frightening and stressful. Consider telling a teacher or someone else you trust. And remember, even if you don’t want to share your friend’s secret, you can still talk to a mental health professional about how it is affecting you.

Other Resources:

National Institute on Drug Abuse (NIDA) and
Phone: 301-443-1124

National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Phone: 301-443-3860.

Substance Abuse and Mental Health Services Administration
Phone: 877-SAMHSA-7 (877-726-4727)

American Psychiatric Association. "Understanding Mental Disorders." Washington, DC (2015)

Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.


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