What Is it?
Substance use disorder is when a person uses a substance despite it being harmful to them. The person becomes preoccupied with using the substance. They want/continue to use it even though it negatively impacts their daily lives. Substance use disorders can also be called addictions.
Addictions begin to impact the brain and its functioning. There may be changes in the person’s personality, logic, reasoning, memory, and learning. It begins to impact the brain’s structure. In the brain, there is a reward pathway. When it is activated, it feels good. It rewards the person which makes them want to keep doing that thing whatever it may be. When a drug is taken excessively, it activates the reward pathway. This encourages behaviour because the brain is rewarding the person. As the person seeks this reward, this may result in neglecting daily activities.
People commonly associate addictions with substances, but people can also have addictions to behaviours (activities). These behaviours can also activate the reward pathway in the brain. These behaviours can include gambling, gaming, shopping, and more. Behavioural addictions also negatively impact a person’s life and relationships.
Myths and Facts
FACT – Addiction is not a choice.
While it can feel like a person prioritizes the substance or behaviour over other aspects of their life, it is not that simple. Addiction is a brain disease (Hill, 2019). It is not a person simply choosing the substance over other things. A big part of addiction is a person’s inability to stop or moderate their use. This loss of control is the result of changes in the brain from the addiction (Alberta Adolescent Recovery Centre, n.d.).
FACT – Marijuana is addictive.
There is a common misconception marijuana is not addictive. This is incorrect. The psychoactive ingredient in marijuana is tetrahydrocannabinol, commonly referred to as THC (Juergens, 2021). THC imitates a naturally occurring chemical in the brain, which results in the brain producing less of the chemical when a person consumes THC. This changes the brain. The person now needs THC to feel like themselves and for the brain to function. This also builds tolerance so the person will need to consume more marijuana to feel the effects of it. If a person stops using marijuana, it can result in withdrawal symptoms (moodiness, tiredness, feeling on edge, irritability, etc.). If a person uses marijuana before their brain is fully developed (mid-20s), it has been linked to an increase in memory problems, difficulty thinking clearly/paying attention, higher risk of mental health concerns (like depression and anxiety), decreased school performance, and a greater chance of addiction (Centers for Disease Control, n.d.).
FACT – Addiction is a compulsion and the person does not have control.
A person with addiction is not in control of their cravings (Ackermann, 2021). The reward pathway in their brain has been activated repeatedly which makes the craving stronger. The brain compulsively wants the activity or the substance. It is not a personal weakness. It is biology. The brain and body are craving the substance/activity and go through withdrawal (either physical or psychological) without it. This brings the question of why do some people become addicted to certain things, and others do not? According to research, genetics and other factors play a role. It is how the brain processes things. It is about how the brain processes the substance and how the person perceives the feelings they receive from it.
FACT – While some people see experimentation as a rite of passage, substance use in teens can have negative consequences.
A little experimenting never hurt anyone, right? This unfortunately is not true. Before a person is in their mid-20’s, their brain is not fully developed (Arain, et al, 2013). If someone uses drugs before their brain is fully formed, it can increase the chance of negative consequences. As noted by the Centers for Disease Control, substance use in teens can lead to:
- Contribution of poor health problems as an adult (heart disease, liver disease, sleep disorders, etc.)
- Increase the risk of mental health concerns as an adult (anxiety, depression, suicidal ideations, addiction, bipolar disorder, schizophrenia, etc.)
- Increases the change of other risky behaviour
- Negatively impact growth and development, especially brain development
Many people have been educated on the fact “drugs are bad” but people do not really talk about why or the consequences. It makes the consequences seem less real, but they are very real.
For example, using marijuana as a teen has been linked to a higher risk of depression, anxiety, suicidal ideations, schizophrenia, addiction, and paranoia. If a teenager uses cocaine, it makes changes to the cells in the brain which results in behavioural, developmental, and cognitive (thinking) impairment (Vertava Health, 2021).
FACT – It is possible to be addicted to prescription drugs like any other substance.
When someone uses a prescription outside of a doctor’s recommendation, it can have dangerous consequences (Mayo Clinic, 2018). This is drug abuse (Hilmas, 2018). Some people think they are safe because they come from a pharmacy, but that is incorrect. While prescription drugs are safe for the person who has been prescribed the medication, it is not safe for others to use without doctor assessment and recommendation. People who abuse prescription drugs often do so for fun, better studying, to fit in, or lose weight. They often use them because they can be easier to obtain than illicit or street drugs. There are several dangers of abusing prescription medications, such as addiction, overdose, heart failure, seizures, and slowed heart rate. Complications increase when prescription drugs are mixed with other substances such as alcohol.
FACT – Relapse is common in recovery.
Addictions can cause changes in a person’s brain which may impact self-control and the capability not to act on cravings. It is important to work on relapse prevention during recovery because the risk of relapse can be high (American Addictions Centers, 2021). Without relapse prevention, it can be very challenging to abstain from the substance or behaviour to which the person is addicted. If relapse does occur, it is important to seek help. It is not hopeless. There are ways to work to prevent relapse. It takes time and effort, but it is possible.
FACT – Treatment is not simply one size fits all. There are many types of treatments for addiction.
There are many different types of treatments to help someone with an addiction. Typically, treatment starts with detoxification and managing withdrawal symptoms (National Institute on Drug Abuse, 2020).
Treatment can be:
- Long-term residential treatment
- Short-term residential treatment
- Outpatient treatment programs
- Individualized drug counselling
- Group counselling
It is about finding what works best as everyone is different.
FACT – Medication can help a person cope with the withdrawal symptoms and make it easier to stay sober (Juergens, 2021).
Medication to treat addiction is used under the supervision of a doctor. The medication helps to treat withdrawal symptoms. There are different types of medications to help with different substance addictions. It is safest and easiest to seek treatment for addiction with the help of a medical professional (Juergens, 2021).
Seeking help from a professional is very important when recovering from an addiction. Otherwise, a person can replace one addiction for another, like trying to quit drinking and switching to marijuana or vice versa.
FACT – In addition to being addicted to substances, a person can be addicted to a behaviour or action.
People have long accepted addictions to substances. They are well-known, but addictions to actions are lesser known. Behavioural addictions can be to activities such as food, gaming, social media, the internet, and shopping (Smith, 2021). The person can feel calm or happy when they do the activity they are addicted to. Addictions to substances and actions have similar characteristics, like increased tolerance, cravings, change in mood, issues with relationships, and a hard time controlling or stopping the behaviour (Alavi et al., 2012). Behavioural addictions do not have physical symptoms like substance addictions.
Causes of Substance Use/Abuse
There are several reasons why someone might start using drugs or using the behaviour. The person might be trying to escape, deal with stress, peer pressure, experimentation, or enhance performance (Colon-Rivera & Balasanova, 2020). It depends on the person and their experiences. Not everyone who tries drugs (or the activity) will become addicted, so why do some people become addicted, and others do not?
That is a very complex question. There is not just one reason. For some people, it could be due to genetics or family history (Hartney, 2021). A family history of addiction increases the risk of developing an addiction. It also can depend on how long and frequent the person has been using the substance or activity. The more a person uses the substance/activity the higher the risk they will become addicted.
What Does It Look Like?
According to the American Psychiatric Association (APA), the symptoms can be separated into 4 categories.
- Cravings or strong urges to use substances
- Hard time cutting back or controlling the substance
- Thinking about using the substance
- Using more than intended
- Neglecting responsibilities
- Problems with relationships
- Spending a great deal of time obtaining the substance
- Lying, stealing, etc. from loved ones
- Problems at work, school, or home because of substance use
- Treating loved ones poorly
- Isolating self
- Hiding addiction
- Engaging in addiction despite negative consequences
- Using in risky settings
- Neglecting self
- Spending money on the addiction even when there is no money for it
- Risky behaviours like driving while under the influence
- Building tolerance (needing more of the substance to feel it or get the same effect)
- Withdrawal (physical or psychological symptoms of not using the substance)
There could also be physical symptoms which are different for each substance. They could include, but are not limited to:
- Change in pupil size (big or small)
- Not taking care of self (showering, changing clothes, brushing hair/teeth)
- Change in speech (slurred, slow deliberate, fast, etc.)
- Not sleeping or sleeping more
- Bloodshot or puffy eyes
- Changes in weight (gain or loss)
- Poor coordination
- Muscle tension
What to Do if You Are Struggling With Substance Use/Abuse
If you feel like you are struggling with addiction, it is important to seek help. You deserve to feel good about yourself. You deserve help.
- Identify that you are not doing well. It is not an easy thing to admit. Just remember, we cannot be tip-top all the time. It is okay not to be okay. It is about seeking help.
- Talk to someone. Seek help from someone you trust whether a loved one, elder, spiritual leader, doctor, or mental health professional. You deserve to feel better. It is important to take care of yourself and feel better. You are having a hard time dealing with it, it is important to reach out for help. Talk to someone you trust about your struggles. There is no shame in asking for help. Asking for help is a great sign of strength.
- Practice self-care. Self-care is taking time to take care of yourself and your health/wellness. Make healthy choices to support your mental health. Take some time for yourself to feel better, to unwind, and to take care of yourself.
- Remember you’ve got this! You deserve to feel happy and healthy. Be kind and patient with yourself!
In addition to seeking professional help and reaching out, there are many things you can do to support your mental health. Check out the wellness tips below or the wellness sessions.
How to Cope With Disclosure?
The following are some guidelines as to what to do when your loved one tells you they are struggling and how to handle those difficult conversations. This is not to counsel the person. This is to get the person connected with a helping professional. Please remember the conversation will not be linear like on the page. These are guidelines of some things to consider.
These are guidelines of some things to consider:
The person is telling you something scary and personal to them. This is terrifying for both of you. Take a moment to gather yourself and take a deep breath. Remember this is about them and their experience. When we care about someone and they tell us about their struggles, we sometimes react with what seems like anger. This is often an outward display of fear which comes across as anger. This can make it difficult for the person to open up to you.
Take a moment to recognize your own biases or judgements about mental health issues. You are entitled to your opinion, but remember this conversation is about your loved one. It is about their emotions, experiences, and perception. It is all valid and real for them. If you are going to have the conversation, place your judgements or preconceived notions aside to allow for understanding and compassion.
Give the person the time and consideration you would like if you were struggling. Be the person you would like to help you in this situation. Give them your full attention. They deserve it. Listening will also help you know what the person is trying to tell you. While you are listening, be understanding and compassionate. Give them the space to talk.
Remember the acronym VEER (Validate, Encourage, Empower, Refer). (This is not counselling the person. It is connecting them with help.)
Your loved one needs to get help. This is not something you can deal with without professional help. Help the person think of someone they trust/who they would like to talk to about their challenges. Everyone connects with different type of help. Give your loved one options, like a doctor, individual counseling, group counseling, or an elder. You can also offer them some helplines they can call when they are struggling, too.
Facing mental health concerns can be very challenging and scary, but your loved one needs help. Without help, the problems can escalate.
Talking to a loved one who is struggling is challenging. Talk to someone about it to help cope with the stress of the situation. Practice self-care. Do something you enjoy. For self-care ideas, visit the self-care section here.
Sometimes, people will not want to talk to you. That is okay. It is their choice. Simply let them know you are there to talk if they need someone and give them resources, like hotlines they can call whenever they want to talk to someone.
Remember the acronym VEER
(Validate, Encourage, Empower, Refer). (This is not counselling the person. It is connecting them with help.)
Validate – Validating is so important. It is letting the person know what they are feeling is okay. It is acknowledging their emotions as understandable.
- Yeah, that would be frustrating.
- I am sorry that happened to you.
- It is understandable you feel that way. I would feel that way, too.
- I believe you.
- From what you are saying, I am hearing you are…because of… Is that correct?
Encourage – This is letting the person know they did a good thing by telling you. Talking about mental health struggles can be very challenging. Let them know they are doing the right thing by telling you.
- Thank you for telling me. That must have been challenging.
- You did the right thing by telling me.
- I am here for you.
Empower – Struggling with mental health issues can be overwhelming, so it is important to let the person know there is help and they can feel better.
- I know things seem really overwhelming, but there are resources and people to help.
- Let’s find some things which can help you feel better.
- You deserve to feel happy! We will find a way to get there.
Refer – Connect the person with help. They deserve to feel happy and healthy again. There are resources to help them.
- Here are some phone numbers you can call when you feel like you need someone to talk to.
- Let’s look up some resources and see what you like best.
- There are many options of people you can talk to. We could talk to the doctor, find a counsellor, or elder. What would you be most comfortable with?
- Be understanding. – Addiction is hard! Show your friend compassion
- Support your youths healthy choices
- Give them a choice of helplines to call when they need someone to talk to
- Have fun with your youth – Connect with them by having fun
- Practice boundaries. – You need to take care of you too! Boundaries are healthy for everyone.
- Be honest – For example, if you have no idea what addiction is like, tell them! Do not pretend to know what they are going through. How does their addiction impact you? Use “I” statements to reduce blame
- Respect their privacy – If they do not want to talk about their therapy appointment, that is okay. It is their choice.
- Let them know you are there to help
- Try to consider things from their perspective
Things to Avoid:
- Gossiping about your child/youths mental health
- Threatening or shaming them
- Telling them how to feel
- Acting as their counsellor
- Using the substances around them
- Putting them in situations which would trigger their addiction
- Doing it alone – There are people to talk to and help! Find someone your youth feels comfortable talking with and someone you feel comfortable talking with about your feelings.
Tips for Wellness
- Be patient and kind to yourself
- Seek professional help with coping with addiction and any underlying issues
- Get help with withdrawal symptoms
- Try to avoid replacing one addiction with another
- Build healthy connections with others and focus on positive relationships
- Learn what triggers your addiction
- Develop positive coping skills
- Go outside
- Connect with family, friends, or pets
If you would like to speak to someone about mental health issues, the Alberta Health Services Mental Health Help Line is available 24/7, offering information and referrals on any aspect of mental health.