Substance Use & Addiction
If you think you might be living with substance use disorder, you’re not alone. Recovery is always possible.
What is substance use disorder?
Substance use disorder is defined by compulsive use of alcohol, drugs, or medications despite harmful consequences. It's when your brain's reward system changes in ways that create powerful cravings and make it hard to stop, even when you want to.
Many people use alcohol, nicotine, prescription medications, or drugs to change how they feel, sometimes to escape anxiety, stress, or depression. These substances may offer short-term relief, but often make you feel worse over time. What begins as a way to self-medicate can quickly become a cycle of dependence. The good news is that substance use disorder is treatable with the right plan and support system.
Signs & symptoms
Signs and symptoms of substance use disorder appear as physical, behavioral, and social changes. You might notice some or many of these signs and symptoms.
Behavioral
- Drop in work or school performance
- Loss of motivation or interest in things you used to enjoy
- Mood swings, irritability, or anger
- Risky behavior (like driving while intoxicated)
- Secretive behavior (such as lying about or hiding your substance use)
Physical
- Loss of memory or periods of blackout
- Poor coordination or slurred speech
- Red eyes or changes in pupil size
- Sudden weight loss or gain
- Uncontrollable tremors or shaking
Social
- Changes in friendships or social activities
- Legal or financial problems
- Withdrawal from family or responsibilities
Treatment & recovery
Recovery is possible with the right support and treatment plan. Treatment is effective when you're ready for change and committed to seeking support. Talk to your doctor or an addiction medicine expert to find out what's right for you.
Treatment options include:
- Inpatient or outpatient care: Structured programs can break the cycle of dependence and give you tools to stay sober. This may include medically supervised detoxification to help you interrupt your substance use safely.
- Psychotherapy (talk therapy): Individual or group therapy helps people get to the root of the issues that cause substance use.
- Medication: Certain medications reduce cravings and ease withdrawal symptoms, making early recovery more manageable.
- Peer support groups: Free, community-based recovery groups — including 12-step programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), and other peer-led recovery groups — can connect you with people who understand what you’re going through.
Frequently asked questions
Why do some people become addicted while others don’t?
Addiction develops differently for everyone. A combination of factors — genetics, mental health, environment, age of first use, and how a substance is used — can all influence risk.
For example, people with a family history of addiction or conditions like depression or bipolar disorder are more vulnerable. Growing up around substance use or starting young increases that risk, too. Drugs that are smoked or injected reach the brain faster and produce stronger effects, making addiction more likely.
These influences work together, not alone, which is why addiction is best understood as a medical condition, not a personal weakness.
What’s the difference between substance use and addiction?
Substance use refers to drinking alcohol, taking medication, or using drugs — sometimes in ways that can be risky or harmful, like taking more than prescribed or using in unsafe situations. Not everyone who misuses substances becomes addicted.
Addiction (substance use disorder) happens when the brain changes in a way that creates a powerful urge to keep using a substance despite harm. It’s not about willpower; it’s a medical condition that affects motivation, judgment, memory, and emotional control. Over time, the brain’s “reward system” adapts, making it harder to feel pleasure from anything other than the substance. That’s why recovery often requires medical care, therapy, and support — not just determination.
References
Merikangas, K. R., & McClair, V. L. (2012). Epidemiology of substance use disorders. Human Genetics, 131(6), 779–789.
Mental Health Services Administration, & Office of the Surgeon General (US). (2016). Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health.
Swendsen, J., Conway, K. P., Degenhardt, L., et al. (2010). Mental disorders as risk factors for substance use, abuse, and dependence: Results from the 10-year follow-up of the National Comorbidity Survey. Addiction, 105(6), 1117–1128.