What is substance use disorder?

Substance use disorder means that a person uses substances even though it causes harm to themself or others. For example, you may neglect school, work, or your relationships. You may keep using a substance even though it affects memory and learning or causes physical problems. Substance use disorder can range from mild to severe. The more signs of this disorder you have, the more severe it may be.

Substance use disorder can develop from the use of almost any type of substance. This includes alcohol, cannabis or other drugs, prescription medicines, and over-the-counter medicines.

Most of the time, substance use disorder starts with casual use. You may not think there will be a problem if you use a substance once or twice. But substance use can lead to substance use disorder. And it sometimes happens quickly.

Substance use changes your brain's structure and how it works. Teens who keep using substances may develop a strong need, or craving, for the substance. You may want to stop using a substance but can't. You may become physically dependent on the substance. You may have uncomfortable symptoms (withdrawal) if you stop using it or use less of it.

Why do teens use alcohol or drugs?

Teens may use alcohol or drugs for many reasons. They may do it because they:

• Want to fit in with (or may be pressured by) certain friends or groups.
• Like the way it makes them feel.
• Believe it makes them more grown up.
• Want to escape from their problems. For example, some teens may use drugs to try to:
  • Avoid the symptoms of mental health conditions, such as attention deficit hyperactivity disorder (ADHD) or depression.
  • Ease feelings of insecurity.
  • Forget about past trauma or abuse.

What problems can alcohol or drug use cause?

Using drugs or alcohol can change how well you think and make decisions and how quickly you can react. It can make it hard to control your actions. Alcohol or drug use also can change how you feel about your life. It can increase the risk of anxiety, depression, and suicide.

Alcohol or drug use can:

• Make car crashes more likely. If you drink and drive, you can easily crash and hurt yourself or others.
• Lead to unprotected sex. This can lead to unwanted pregnancy and sexually transmitted infections.
• Cause you to do things you wouldn't usually do. You may say things that hurt others or do something illegal that could result in a large fine, loss of your driver's license, or other legal problems.
• Cause you to lose interest in school and your future. Poor grades or lack of focus may make it harder to set goals and achieve your dreams.

Do not drive if you have been drinking or using drugs. And do not ride in a car (or any type of vehicle) with someone who is impaired.

How do you say no to alcohol or drugs?

If someone offers you drugs or alcohol, here are some ways you can respond.

• Look the person in the eye and say "No, thanks." Sometimes that is all you need to do. Say it as many times as you need to. Also tell the person not to ask you again: "I'm cool with my decision, so don't bother me again."
• Say why you don't want to drink or use drugs. Here are some examples: "I don't like how I act when I drink or use drugs," "I like to know what I'm doing," "If my parents find out, they won't let me drive," or "I have to practice with my band tomorrow."
• Walk out. It's okay to leave a party or group where others are drinking or using drugs.
• Offer another idea. For example, say "I'd rather play video games" or "Let's listen to some music." By doing this, you might also prevent your friend from using drugs or alcohol.
• Ask for respect. Make it clear that you don't want to drink or use drugs and that continuing to ask you is showing no respect for your opinions: "I don't give you a hard time, so why are you giving me a hard time?"
• Think ahead. If you think you might go someplace where people are using drugs or alcohol, don't go. But if you do go, think in advance about what you will do if someone offers you alcohol or drugs.

How is substance use disorder treated?

If you have substance use disorder, treatment usually includes group therapy, one or more types of counselling, and education. Sometimes medicines are used to help you quit. If you are physically dependent on substances, you may need medical treatment. You may need to stay in a hospital or treatment centre.

Treatment focuses on more than substance use. It also helps you cope with the anger, frustration, sadness, and disappointment that often happen when a person tries to stop using substances.

Treatment also looks at other parts of your life, like your relationships with friends and family, school and work, medical problems, and living situation. It helps you find and manage problems. Treatment helps you take control of your life so you don't have to depend on substances.

Substance use disorder affects the whole family. Family counselling often is part of treatment.