What Is Substance Abuse and How Can I Treat It?

Substance use disorder, sometimes called substance abuse, involves the excessive use of an illegal or legal substance, including recreational and prescription drugs. A person with substance use disorder can put themselves or others in danger.

People with substance use disorder, or substance abuse disorder, may have difficulties keeping a job, maintaining personal relationships, or staying out of legal trouble. The exact cause of substance use disorder is unknown, and researchers are not completely sure why some people form an addiction to certain drugs while others do not.

Read on to find out more about the dangers of substance use disorder and what you can do to recognize and help those who have the disorder.

Exhausted man at home having a glass of wine.

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Common Types of Substance Use Disorder

There are many different types of substances that are used by a person struggling with substance use disorder. Each type has its own effects, consequences, and prevalence.


Alcohol is a legal mind-altering substance that is often seen as a social beverage. Alcoholic beverages contain a chemical known as ethanol, a drug that is produced by fermenting fruits, grains, or other sugar sources.

When you drink alcohol, it suppresses certain actions in the brain and can affect your reflexes, memory, vision, and more. While not everyone who drinks alcohol overuses it, many do. Roughly 17 million Americans over the age of 12 engage in alcohol misuse.

Research has shown that alcohol misuse can increase the risk of many different health issues such as:

Research surrounding alcohol misuse while a person’s brain is still developing, between the teenage and young adults years, has found that the structure and function of the brain are altered. The result of these changes include decreased abilities in learning, memory, executive functioning, reading, and attention span.

Alcohol and Suicide

Alcohol misuse has also been shown to increase suicide rates. According to the Department of Health and Human Services, a lower minimum drinking age was associated with higher rates of suicide in young adults.   

Prescription Medication

Prescription medications are given to people by doctors to help with specific medical conditions. There are many prescription medications and most of them are not misused. Research has shown that roughly 2.3 million to 2.8 million people misuse prescription drugs each year.

The most notable substance that is prescribed but leads to substance misuse is opioids, which are strong painkillers. Studies have found that treatment for opioid addiction was 5 times higher in 2010 than it was at the turn of the 21st century. Because of the increase in usage, as well as other factors, overdoses increased by over 400% during that same time frame.

While opioids are the biggest influencer of increased rates of substance misuse in the United States, other prescription medications are also misused regularly. They can include:

  • Benzodiazepines
  • Stimulants
  • Sleep medications

While these medications are designed to help people with their medical and psychiatric conditions, their overuse can lead to severe health consequences such as:

  • Gastrointestinal issues such as vomiting or nausea
  • Decreased respiratory (lung) function
  • Seizures
  • Mood changes
  • Dangerously high body temperatures
  • Declines in brain functions such as memory and the ability to think clearly
  • Paranoia or aggressive behaviors
  • Coma
  • Death

Prescription Substance Misuse in Children

When a child misuses prescription medications, it can lead to toxicity. For example, many children benefit from the use of Ritalin, however, taking too much of it can cause delirium, psychosis, hallucinations, confusion, and euphoria. Other symptoms may include convulsions, coma, headaches, and a racing heartbeat.

OTC Medications

Medications that are available over the counter (OTC) are designed to help people manage certain health symptoms on their own. However, they can also cause substance misuse. A review published in the Journal of Substance Abuse found that as many as 63% of pharmacists noticed OTC drug misuse in their pharmacies. The most widely used medications that people abuse include:

  • Cough products containing dextromethorphan, which is a cough suppressant.
  • Sedating antihistamines, which are often used to help reduce allergy symptoms.
  • Decongestants, which are used to relieve congestion.
  • Laxatives, which are used to help relieve constipation.

That being said, research has found that OTC medications are typically a second or third choice for people who are already dealing with substance use disorder who can’t gain access to their substance of choice. 

OTC Medication and Young Adults/Adolescents

The OTC medication misused most by young adults and adolescents is cough suppressants. A survey done in 2006 found that roughly 3.1 million young Americans used the drugs to achieve a mind-altered state.


Heroin is an illegal type of opioid drug that is made from morphine. Morphine is a naturally occurring substance that is extracted from poppy plants and typically used in medicine to help people battle pain.

Heroin can enter the brain quickly and bind to certain receptors that are involved in feelings of pain or pleasure throughout the body. People that abuse heroin are often looking to achieve the feelings of euphoria associated with the drug.

According to the National Survey on Drug Use and Health, over 5 million people used heroin in 2015.

The long-term use of heroin can lead to many health consequences such as:

  • Liver disease
  • Lung disease
  • Chronic constipation
  • Depression
  • Kidney disease
  • Infections of the heart or skin
  • Hepatitis (liver inflammation)
  • HIV (human immunodeficiency virus)
  • Deterioration in certain parts of the brain
  • Infertility and miscarriage

Is Heroin Addictive?

Heroin is highly addictive. The body becomes physically dependent on it, and when a person uses the drug for a long period of time and then stops, they will go through withdrawal. Withdrawal symptoms can include vomiting, muscle pain, and restlessness.


Hallucinogens, also known as psychedelics, are a class of drugs that causes hallucinations. Hallucinations are images or sensations that feel as though they are real, but they are not.

These types of drugs have been used throughout history by many cultures in religious rituals. In some cases, hallucinogens are used to help spark creativity.

When used recreationally, hallucinogens can lead to substance abuse. Roughly 200,000 Americans over the age of 12 misused hallucinogenic drugs in 2015 alone. However, addiction to hallucinogens is much less common than other drugs.

The four types of hallucinogenics are:

  • Psychedelics, including low dose allergen (LDA), psilocybin, mescaline, N-dimethyltryptamine (DMT), and ayahuasca
  • Entactogens such as MDMA (ecstasy or molly)
  • Dissociative anesthetics, including ketamine, phencyclidine (PCP), d extromethorphan (DXM), and nitrous oxide
  • Atypical hallucinogens, such as ibogaine, Salvia divinorum, and cannabinoids

There has been some recent research surrounding hallucinogens being able to help people battle substance misuse. One study published in 2014 found that psychedelic drugs have a lower mortality risk, and there is some evidence to support that they could be a viable treatment option for people who are addicted to other substances.

For people misusing these drugs, however, some negative side effects can occur such as:

Tolerance: Using too much of a drug can lead to tolerance, which is a reduced reaction following the repeated use of a drug. Because of this, a person will have to take more to feel the same effects.

Withdrawal symptoms: When someone stops taking the drugs, they can experience withdrawal symptoms, such as drug cravings, increased sweating, shaking, and heart palpitations (fast heartbeat, fluttering heart, or pounding heart).

Medicine or Not

While there is some preliminary research to suggest that hallucinogens can be used medicinally, it’s important to always speak to your healthcare provider about this type of medical treatment. They are still mind-altering substances and can have negative effects.


Cocaine is an addictive stimulant that is derived from the leaves of coca plants. Research published by Transactions of the American Clinical and Climatological Association found that an estimated 900,000 Americans over the age of 12 abused cocaine in 2015.

According to some research, using cocaine even just a few times can lead to brain changes that may end up triggering a addiciton. The drug affects dopamine, which is a chemical messenger in the body that is designed to regulate pleasure responses and cognitive functions, such as learning and motor system function.

The drug also affects the hormone cortisol, which is a stress hormone. When this happens, it can lead to a variety of physical issues including damage to the cardiovascular system.

The long-term abuse of cocaine can lead to:

  • Depression
  • Auditory hallucinations or hearing things that aren’t there
  • Paranoia, which is the irrational fear that people are out to get you
  • Restlessness
  • A sustained rise in blood pressure
  • Anxiety
  • Panic disorder
  • Aggressive or violent behaviors or moods
  • Chronic headaches
  • Blood clots
  • Seizures
  • Brain cell death

Cocaine and the Brain

A recent study has found that people who misuse cocaine can lose significant gray matter in the brain. Gray matter is important for many brain functions, including proper control of movement, memory, and emotions.


Cannabis, also referred to as marijuana, is a psychoactive drug that is derived from cannabis plants. Although it has been recently legalized for recreational or medicinal use in many states across the country, the drug is still highly misused, second only to alcohol. In 2015, it’s estimated that roughly 4.2 million people had substance use disorder with cannabis.

Using cannabis can cause some seemingly positive effects, such as an increased feeling of relaxation or euphoria, changes in visual perception, increased appetite, and feelings of joy. However, when the drug is used in excess, it can also lead to negative effects such as:

  • Extreme and persistent nausea or vomiting
  • Anxiety, depression, or other mood disorders
  • Suicidal thoughts or tendencies
  • Impaired coordination
  • A decreased ability to think clearly
  • Worsened memory
  • Heart and lung disease if the drug is smoked

Marijuana Use in Adolescence

Studies have shown that people who use cannabis during their formative years can suffer from a diminished brain capacity and structural changes to the brain that affect proper brain development. It may also increase the risk of developing psychiatric disorders later in life.


Smoking or consuming tobacco to any degree is bad for your health, and it can be exceptionally worse if done in excess. Although the use of tobacco products has decreased in recent years, as many as 14% of Americans still partake in tobacco use.

Smoking and using tobacco can harm every part of the body, and consequences of long-term abuse of tobacco can include:

Secondhand Smoke and Children

When a child is exposed to secondhand smoke, their health is put at risk. Health consequences of secondhand smoke exposure in children include sudden infant death syndrome (SIDS), respiratory infections, middle ear disease, severe asthma, and slowed lung growth.

Signs of Drug Misuse

It can be hard to tell if someone is misusing drugs if you don’t know what signs to look for. Some general signs of substance misuse are:

  • Difficulties or disinterest in school, accompanied by poor grades
  • Having difficulties at work, such as not being on time, being disinterested in performing tasks, and getting poor performance reviews
  • Changes in how someone takes care of their physical appearance
  • Changes in behavior that may present as an increased need for more privacy
  • Lack of energy
  • Spending or borrowing more money than usual
  • Money issues and not being able to pay bills
  • Decreased appetite and unexplained weight loss
  • Appearing rundown and having an altered skin tone or bloodshot eyes
  • Being highly defensive when asked about their drug use

Signs of Drug Use in Adolescents

Adolescents that are misusing substances may exhibit extreme changes in mood or behavior. They may also be more withdrawn, tired, or hostile toward members of their family or friends. You may also notice a change in their friend group and their sleeping or eating habits.

Symptoms of Substance Use Disorder

If you use certain substances on a regular basis, you may not notice that you have a substance use disorder. There are some signs that may indicate you should seek help. They can include:

  • You continue to take a drug even if you don’t really need it or want it.
  • It takes more of a specific substance to feel the same effects.
  • You feel physically or emotionally ill when the drug wears off.
  • You lack control over using a substance.
  • You think or spend a lot of your time talking about the drug, where to get it, and how you feel when you’re on it.
  • You have difficulties limiting your use even if you want to.
  • Daily tasks become increasingly more difficult because of the drug abuse.
  • You drive while under the influence.
  • Your sleeping patterns have changed drastically.
  • You start hanging around a new group of people that also participate in drug use.
  • You have been to more than one doctor in search of multiple prescriptions of the same drug.

How to Seek Help

The minute you notice any signs of addiction you should seek help. This will make recovering from substance abuse that much easier. You can talk to your healthcare provider about your substance use or seek out help from substance use disorder organizations such as the Substance Abuse and Mental Health Services Administration (SAMHSA).

Risk Factors

While there are many reasons why people use, there are certain risk factors that come into play. They include:

  • Genetics: Some people are genetically predisposed to having addictive behaviors.
  • Peer pressure: Feeling pressure from people you care about can increase your risk of using drugs.
  • Other mental health conditions: Emotional distress or mood disorders such as anxiety or depression can increase your likelihood of misusing substances.
  • Environmental factors: Some environmental factors such as living in a low-income area may also increase the risk of drug use.

Adolescents may look at drug use differently than adults and may be more susceptible to addiction because of several factors, including:

  • A poor relationship with parents
  • Peer pressure
  • The accessibility of certain substances
  • Inadequate knowledge of the consequences of drug use
  • Lack of parental supervision
  • Affordability of substances
  • Boredom


Substance use disorder is diagnosed using a set of criteria outlined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5). The criteria that must be met to reach a diagnosis include:

  • Taking a substance in large amounts or for a longer period than is necessary
  • Wanting to stop or decrease use but not being able to
  • Spending an increased amount of time acquiring, using, or recovering from a substance
  • Uncontrollable cravings or urges to use a substance
  • The inability to complete daily tasks such as school, work, or chores because of substance abuse
  • The continued use of a substance even after it has caused problems in personal relationships
  • Disregarding one’s own safety to use the substance
  • The continued use of a substance following the development or worsening of health conditions
  • Building up a tolerance to a substance and needing more to achieve the same result
  • Experiencing withdrawal symptoms that can only be relieved by using the substance

Levels of Substance Misuse Severity

Doctors will use these criteria to determine the severity level of someone’s substance misuse. If only two or three symptoms are present, mild substance use disorder is identified. As the number of symptoms present increases, so does the severity.


There are various forms of treatment designed to help people overcome substance use disorders, including:

  • Detoxification: Detoxification consists of medically supervised detox of the substance. A detox is a process that rids the body of a substance over time.
  • Inpatient rehab: This treatment option is a live-in rehabilitation program that is designed to help people overcome their disorder through supervised and structured treatment plans. 
  • Outpatient Rehab: An outpatient rehab requires a person to attend therapy and treatments on their own schedule and is typically reserved for people whose symptoms don't require a detox or inpatient setting.

During treatment, people will likely undergo one or several types of therapies such as cognitive behavioral therapy (CBT); group therapy or family therapy, or both; contingency management, which provides rewards for maintaining sobriety; and 12-step programs that encourage sobriety through peer support groups and recovery steps.

Unique Treatment for Substance Use Disorder

Treatment options for substance use disorder will differ from person to person. Not all types of treatment will work for everyone and that is why there are a variety of options available for people with varying degrees of the disorder.


Preventing substance use is the best way to avoid developing a substance abuse disorder. According to Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, the three substance abuse prevention tactics are:

  • Universal: Universal tactics are designed to eliminate certain risk factors that can lead to substance use disorder. For example, a government may enact certain policies such as a legal drinking age to reduce alcohol availability.
    Selective: Selective interventions are focused on specific families, communities, or groups who are most at risk. Some groups that may be targeted include people who live in areas with few resources and residents with inadequate incomes, and children who live with parents who have substance use disorders.
  • Indicated: Indicated interventions are designed to address an already-existing problem before it grows out of control. People who already partake in substance misuse may be targeted in this form of prevention.


Substance use disorder is highly common in the United States. Millions of people each year develop a substance use disorder. There are many types of drugs that can be misused or abused, some of which are accessed freely at a local drugstore or corner store.

Knowing the signs and symptoms of substance use disorder in yourself or in others can help in seeking treatment as soon as possible. When treatment begins quickly, many people can overcome their disorders and live a happy and sober lifestyle.

A Word From Verywell 

Misusing a substance that causes problems in your life can be difficult to cope with. You, like many others, may want to break the addiction and regain control over your life but that is a difficult thing to do.

The good news is that there is help for people with substance abuse disorder. Getting over the disorder will be difficult but with the right support, you can accomplish recovery.

Frequently Asked Questions

  • What is substance abuse?

    "Substance use disoreder" is the term used to describe when someone uses a drug too frequently or when they don’t need to. People that have substance use disorders often find it difficult to stop using a drug even in the face of adverse consequences of that use.

  • What are common causes of substance use disorder?

    While researchers aren’t clear on the exact cause of substance abuse, there are many risk factors that lead to someone being more likely to have the disorder. Being from an area with inadequate opportunities and income, coping with another mental health or physical illness, or dealing with high amounts of stress can all lead to substance use disorder.

  • What is a gateway drug?

    A gateway drug is a drug that is deemed to open the door to something else. For example, many people once thought that cannabis was a gateway drug to doing "harder" substances such as cocaine.

  • What are the stages of substance misuse?

    Sometimes, substance misuse is divided into four stages. A person will often start with experimentation, meaning they will try the drug once or twice to see how they feel about it. Then, if they like it, they will begin using it regularly. When regular use is not enough, a person will progress to the third stage, risky use, which involves more frequent use and damage to a person’s health and life. The fourth and final stage is drug addiction, in which a person cannot stop doing the drug without help from outside sources. 

23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. McLellan AT. Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare? Trans Am Clin Climatol Assoc. 2017;128:112-130.

  2. Iranpour A, Nakhaee N. A Review of Alcohol-Related Harms: A Recent Update. Addict Health. 2019 Apr;11(2):129-137. doi:10.22122/ahj.v11i2.225

  3. Lees B, Meredith LR, Kirkland AE, Bryant BE, Squeglia LM. Effect of alcohol use on the adolescent brain and behavior. Pharmacol Biochem Behav. 2020 May;192:172906. doi:10.1016/j.pbb.2020.172906

  4. U.S. Department of Health and Social Services. Does alcohol and other drug abuse increase the risk for suicide? Updated May 7, 2008.

  5. McHugh RK, Nielsen S, Weiss RD. Prescription drug abuse: from epidemiology to public policy. J Subst Abuse Treat. 2015 Jan;48(1):1-7. doi:10.1016/j.jsat.2014.08.004

  6. Kids Health. Prescription Drug Abuse (For Teens). Updated October 2018.

  7. Hondebrink L, Rietjens SJ, Hunault CC, Pereira RR, Kelleci N, Yasar G, Ghebreslasie A, Lo-A-Foe C, De Vries I, Meulenbelt J. Methylphenidate intoxications in children and adults: exposure circumstances and evidence-based dose threshold for pre-hospital triage. Clin Toxicol (Phila). 2015 Mar;53(3):168-177. doi:10.3109/15563650.2015.1004579

  8. Cooper RJ. Over-the-counter medicine abuse - a review of the literature. J Subst Use. 2013 Apr;18(2):82-107. doi:10.3109/14659891.2011.615002

  9. Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health 2015. Updated September 8, 2016.

  10. American Addiction Centers. Physical Effects of Heroin on the body (Short- and long-term effects). Updated July 9, 2021.

  11. Garcia-Romeu A, Kersgaard B, Addy PH. Clinical applications of hallucinogens: A review. Exp Clin Psychopharmacol. 2016 Aug;24(4):229-268. doi:10.1037/pha0000084

  12. Winkelman M. Psychedelics as medicines for substance abuse rehabilitation: evaluating treatments with LSD, Peyote, Ibogaine and Ayahuasca. Curr Drug Abuse Rev. 2014;7(2):101-116. doi:10.2174/1874473708666150107120011

  13. American Addiction Centers. What are the effects of cocaine on the brain. Updated November 6, 2020.

  14. Ide JS, Zhang S, Hu S, Sinha R, Mazure CM, Li CR. Cerebral gray matter volumes and low-frequency fluctuation of BOLD signals in cocaine dependence: duration of use and gender difference. Drug Alcohol Depend. 2014 Jan 1;134:51-62. doi:10.1016/j.drugalcdep.2013.09.004

  15. Karila L, Roux P, Rolland B, Benyamina A, Reynaud M, Aubin HJ, Lançon C. Acute and long-term effects of cannabis use: a review. Curr Pharm Des. 2014;20(25):4112-4118. doi:10.2174/13816128113199990620

  16. Jacobus J, Tapert SF. Effects of cannabis on the adolescent brain. Curr Pharm Des. 2014;20(13):2186-2193. doi:10.2174/13816128113199990426

  17. Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults in the United States. Updated December 10, 2020.

  18. Centers for Disease Control and Prevention. Smoking and Tobacco Use: Health Effects. Updated April 28, 2020.

  19. American Addiction Centers. How to Tell if Someone Is on Drugs: Opiates, Marijuana, and More. Updated March 18, 2021.

  20. Medline Plus. Substance Use Disorder. Updated November 23, 2021.

  21. Alhyas L, Al Ozaibi N, Elarabi H, El-Kashef A, Wanigaratne S, Almarzouqi A, Alhosani A, Al Ghaferi H. Adolescents' perception of substance use and factors influencing its use: a qualitative study in Abu Dhabi. JRSM Open. 2015 Mar 2;6(2):2054270414567167. doi:10.1177/2054270414567167

  22. American Addiction Centers. Substance Abuse Treatment: Types of Addiction Therapy and Modalities. Updated November 9, 2021.

  23. Substance Abuse and Mental Health Services Administration Office of the Surgeon General. Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. Released November 2016.

By Angelica Bottaro
Angelica Bottaro is a professional freelance writer with over 5 years of experience. She has been educated in both psychology and journalism, and her dual education has given her the research and writing skills needed to deliver sound and engaging content in the health space.