How To Manage Substance Use Issues

Substance use and co-occurring mental health issues can create many challenges for those struggling with them. Our latest blog post describes the many effective ways to manage them and get help!


What Are Substance Use Issues?

Let’s start by noting that using substances is different than having substance use issues or a formal Substance Use Disorder (SUD). Using is not the same as misusing / abusing.

Some people who use substances will experience significant distress or dysfunction stemming from their active use or withdrawal from use, and these are situations in which someone should consider seeking help and may meet symptom criteria for a SUD.

What Are Substance Use Disorders?

SUDs are a category of psychiatric diagnoses applicable when someone has significant difficulty managing their substance use and the negative impacts it has on their life. In broad terms, folx with SUDs may experience difficulties across four symptom clusters:

  • Impaired control over the substance use (e.g., experiencing cravings, investing considerable time in using or recovering from use, or a persistent desire to cut down)

  • Negative social, familial, and professional effects that result from using or recovering from use

  • Using substances in unsafe environments or knowing that use may be resulting in negative health effects

  • Needing progressively more of a substance to achieve a desired effect (i.e., developing tolerance) or experiencing notable withdrawal symptoms when the substance is removed

What Mental Health Issues Co-Occur with Substance Use Issues?

Many mental health issues tend to co-occur with substance use issues and SUDs. These include:

  • Social anxiety

  • Generalized anxiety

  • Panic Disorder

  • Depression

  • Bipolar Disorders

Navigating the substance use issue should often involve working on the concurrent mental health issues too. For example, if one of the main reasons that you drink in a problematic way is to manage your social anxiety, you should be working on your social anxiety if you hope to cut back on your drinking.

How Do I Manage Substance Use And Concurrent Mental Health Issues?

It can often be challenging to navigate SUDs without professional support, so consider connecting with professionals for guidance. Psychologists and psychotherapists can help you understand why you use and teach you new strategies meet those same underlying needs in more helpful and sustainable ways.

Medical doctors can discuss potential medications to navigate recovery and possibly supervise detoxification. Medical supervision can be particularly important when withdrawing from substances like alcohol and opiates.

Here are some other ideas to help you navigate substance use issues, whether on your own or alongside professional support:

  1. Identify what your vision for a meaningful life looks like and how or whether that life involves substance use. Connect with your personal values to determine how substances factor into your best, values-aligned life.

  2. Track substance use and moods to understand relevant triggers and the consequences of using, which will help you develop an understanding of the role that substances play in your life.

  3. Try to understand the purposes that using serves for you. Is it to help you manage anxiety or low mood? Is it a way to connect socially? Is it about relieving pain? Once you understand the purposes of your use, you can then find other ways to meet those needs.

  4. Practice mindfulness to increase contact with the present moment and your acceptance of discomfort. Relief from discomfort and pain is often part of why people use, so mindfulness can help meet this need in another way.

  5. Limit access to substances and reminders of using. For example, if you’re trying to reduce your drinking, take a break from having alcohol at home, going to bars, or seeing those friends with whom you always get drunk.

  6. Learn urge surfing to enhance your capacity to let cravings come and go without acting on them, just like learning to surf waves in the ocean.

  7. Develop other strategies to manage acute distress and navigate urges to use. We have some ideas that could help in our posts about anxiety and depression.

  8. Explore communication strategies to improve meaningful relationships and discuss using / not using with others. Many relationships can revolve around substance use, particularly alcohol, so this may take some time to modify your existing relationships or expand your social circle to include new ones.

  9. Reframe unhelpful thinking patterns related to substance use and concurrent mental health issues. For example, if you think, “There’s no way I could go to that party without drinking,” investigate that by using a thought record to see if that’s actually true.

  10. Consider incorporating strategic rewards to increase the likelihood of sticking with your commitments. For example, if your goal is abstinence and you’re able to abstain for a whole day or a whole week, consider treating yourself to a small reward in celebration of this accomplishment.

WG Psychology

WG Psychology is a psychology and psychotherapy clinic in Toronto that helps people live more connected, purposeful lives through compassionate, evidence-based mental health support. Connect with us to see if we’re a fit for you!


Disclaimer: This post is intended for educational purposes only and is not a substitute for psychotherapy. The information provided is general and may not be appropriate for your particular mental health needs. Always consult a qualified health professional to discuss your personal needs and goals.

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