Substance Use

When Is Substance Use A Problem?

Using substances is different from having a substance use issue. Many people are able to use substances, like alcohol, caffeine or cannabis, from time to time without significant problems. Simply using a substance, any substance, does not necessarily mean someone has a substance use problem.

Substance use is problematic when it involves a pattern of harmful substance use that persists despite negative consequences of using. Substance use issues can impact various areas of life, including physical health, mental health, relationships, and work or school performance. Substance use issues often co-occur with other mental health conditions, such as anxiety, depression, and bipolar disorders. Substance use can also impair judgment and cognitive functions, thus leading to risky behaviours and poorer academic or occupational performance. Relationships with others may become strained or damaged as a result of substance use issues, resulting in isolation and loss of social support.

What Are Substance Use Disorders (SUDs)?

A Substance Use Disorder (SUD) may apply when someone has significant difficulty managing their substance use and the negative impacts it has on their life.

Key signs that someone may have substance use issues or an SUD include:

  • Difficulty with controlling use (e.g., using the substance in larger amounts or with greater frequency than intended)

  • Being unable to stop using the substance despite a desire to cut down

  • Investing a lot of time into getting, using the substance, or recovering from use

  • Persistent cravings or urges to use the substance

  • Not being able to do usual tasks or giving up on social, occupational, or recreational activities because of substance use

  • Continued use despite harms (e.g., health, relationship, work, or legal problems) and putting yourself in dangerous, risky, or unsafe situations to use substances

  • Needing more of the substance to achieve desired effect (i.e., developing tolerance)

  • Experiencing withdrawal symptoms when substance use is reduced or terminated

How Do We Treat Substance Use Disorders?

Substance Use Disorders (SUDs) are usually treated with a combination of therapeutic interventions and medication to alleviate withdrawal symptoms. Treatment varies depending on severity and what type of substance was used. In severe cases, individuals may require medical supervision to ensure safe withdrawal and detoxification from substances such as alcohol, opiates, and nicotine. Therapeutic interventions, such as Cognitive-Behavioural Therapy (CBT), can help people with SUDs identify and reframe unhelpful thinking patterns related to substance use.

Understanding what triggers their substance use, limiting access to substances, and developing alternate coping strategies for managing distress are important steps to prevent relapse. Practicing mindfulness can be helpful for accepting feelings of discomfort and pain without using substances and learning how to let cravings come and go without acting on them. Contingency management can help by providing individuals with small rewards for successfully abstaining from substance use for a certain period of time or meeting treatment goals. Peer support groups can also help encourage and keep people accountable as they navigate recovery.