What is substance misuse?

Substance misuse (or drug use) is the harmful use of substances (like street drugs, prescriptions, alcohol and anabolic steroids) for non-medical purposes. The term “substance misuse” often refers to illegal drugs, such as cocaine, heroin or cannabis. Many substances can become addictive and even patterns of behaviour. Prolonged substance misuse can lead to addiction and other mental health problems.

However, legal substances can also be misused, such as alcohol, prescription medications, caffeine, nicotine and volatile substances (e.g. petrol, glue, paint).

If you have been using a substance regularly and continuously, you are at an elevated risk of developing an addiction to it. This means experiencing a physical and/or psychological need for a substance, often manifesting itself through the negative withdrawal symptoms.

Some substances are highly addictive. Others are less addictive. However, the symptoms of addiction are similar no matter which substance is used.

Is drug use a mental illness?

Many people start using substances out of curiosity, to have fun, or because their friends are doing it. Some use substances to cope with difficult feelings, situations, or memories, such as grief, stress, the break-up of a relationship or childhood abuse. Although substance misuse in itself is not a mental illness, prolonged and regular use can lead to an addiction, create more problems in your life and develop into a mental illness, such as depression, anxiety, or psychosis.

What causes substance misuse?

There are several causes of substance misuse, and it usually is a mix of several factors that can lead to someone becoming substance dependent. These include:

  • Mental health problems or emotional difficulties, such as depression, anxiety, bipolar disorder
  • High levels of stress – people often use substances, such as cannabis or alcohol to help them relax
  • Traumatic experiences
  • Difficulties in your personal and work life.
  • Personality factors, particularly being someone who constantly seeks excitement or disregards risk or someone who is less inhibited.
  • Chronic physical health problems, such as pain – this can particularly increase the risk of developing an addiction to pain medication or opioids (e.g., heroin).
  • A long history of using substances or using substances a lot – drugs rewire the brain so that you desire and start to depend on it.
  • Genes – some people are more prone to developing an addiction. However, it is still unclear to what extent our genes are to blame.
  • Environment – plays a key role in people developing an addiction, and it includes experiences of trauma, difficulties at home or having friends who use substances.
  • Age – you are more likely to develop an addiction to substances if you were exposed to substance abuse in childhood.

Symptoms of drug use and withdrawal signs

If you are worried that you may be using substances uncontrollably or that you may be becoming addicted, here are some of the most common symptoms of substance misuse:

  • Repeatedly neglecting your responsibilities at home, work, or school because of your drinking. For example, doing poorly at work, missing classes or appointments, or neglecting your children because you are on drugs or hangover.
  • Using drugs in situations where it is physically dangerous, such as driving while high, using dirty needles or having unprotected sex.
  • Experiencing legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit.
  • Problems in your relationships, such as fights with your partner or family members or the loss of friends.
  • Using more drugs or using more often than you used to experience the same effects as in the past.
  • Using substances to avoid or relieve withdrawal symptoms.
  • Loss of control over your drug use – using more or more often, feeling unable to stop.
  • Planning your life around the substance – spending a lot of time thinking about it, how to get it and to recover from its effects.
  • Abandoning activities you used to enjoy, such as hobbies, sports, and socializing, because of your drug use.
  • Continuing to use a substance, despite knowing it’s causing major problems in your life, such as blackouts, financial issues, infections, mood swings, depression, paranoia.

While different substances provide different physical and emotional effects, all abused substances can alter how the brain functions after repeated use. Those changes can be so profound that you will likely start experiencing a range of unpleasant symptoms or withdrawal symptoms if you try to stop using them. They can vary a lot in intensity but commonly include:

  • Nausea
  • Restlessness
  • Insomnia
  • Depression
  • Anxiety
  • Sweating
  • Shaking
  • Hallucinations
  • Headaches

It is often the fear of experiencing withdrawal symptoms that stops people from quitting.

Treatment for drug use

Realising and accepting that you are misusing or are addicted to a substance is the first step in finding solutions. Treatment for substance misuse varies depending on the type of substance you have been using. Often the best place to start is by discussing things with a mental health professional as they can suggest treatments that are best for you.

If you decide to seek help for drug use, you will likely be given a key worker who will guide you through treatment options, agree on a treatment plan with you and support you through the process.

Below is a list of the most common treatments:

  • Talking therapies, such as cognitive-behavioural therapy (CBT), where the focus is on how your thoughts and beliefs about the substance impact on your behaviours. CBT can also help you identify triggers to your substance use and teach you more helpful ways of managing stress and problems. A Clinical Psychologist can offer this treatment.
  • Medication – if you’re dependent on heroin or another opioid drug, you may be offered a substitute drug, such as methadone. Medication can also be offered to help you manage some of the withdrawal symptoms, such as anxiety or depression.
  • Mutual support groups, such as Narcotics Anonymous (NA), provides support based on the 12-steps model, where one addict helping another is an essential part of the program.
  • Detox, or ‘going cold turkey, is a process where you stop using the substance in a controlled way with support from a trained professional.
  • Self-help, including online resources and communities.
  • Residential rehabilitation, or rehab, is provided within a residential setting; it is usually abstinence-based and provides an intense programme of support and care aimed at people who have difficulty becoming drug-free in the community.

Can I recover from substance misuse?

Yes, a lot of people have recovered from substance misuse and drug use. However, recovering from substance misuse often involves lifestyle changes, distancing yourself from unhelpful influences in your social circle and accepting a life without drugs. It often takes more than one attempt to break the cycle of substance misuse. A Clinical Psychologist can support you on your journey towards recovery.

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Alcoholism and Alcohol Misuse