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Understanding Substance Use

Many people think of substance use problems only in terms of addiction, a dependence on alcohol or other drugs where someone needs to continually use the substance in order to feel normal. Substance use is bigger than that. Using substances like alcohol and other drugs can have an impact on mental health, and mental health can have an impact on substance use. When substance use problems are more serious, it may look like someone is simply powerless to do anything about their situation. Research shows that this isn’t the case. We all benefit when we look at our substance use, make changes to reduce risks, and seek extra help when it’s needed.


People use substances like alcohol or other drugs for many different reasons. While it’s easy to think of people who have serious consequences as a result of alcohol or drug use—maybe even unemployment or homelessness—many people use substances without experiencing serious harm. Why is it that some people have problems with alcohol or drugs while others don’t experience harms?

How and why people use alcohol and drugs matters. Every person has their own life experiences, personality, and family history. We also have unique problem-solving skills, support systems, and goals. These are just some of the factors that influence how and why people might use alcohol or other drugs. For example, someone who has a hard time coping with stress might find that alcohol can help them ignore difficult feelings. Someone else might use a drug to find relief from symptoms of mental health problems or other illnesses. Another person might use a drug out of curiosity. And someone may never use a drug because other people they value don’t use that drug.

All substance use is on a spectrum from helpful to harmful, and in some instances can be both. How and why people use alcohol or drugs can move them closer to helpful use or closer to harmful use.

Here are some examples:

  • Imagine a special occasion or holiday. You have a special drink or glass of wine with dinner. You might think of this sort of alcohol use as helpful—it’s adding to a festive celebration.
  • Another night, you go out with friends and have a bit too much to drink. You feel tired and run-down the next day, but otherwise don’t experience many negative consequences. If this situation is not a regular occurrence for you, alcohol may not be very helpful, but it also may not be very harmful.
  • Lately, you’ve been going out several nights a week. Alcohol is becoming a way to deal with stress at work, and it’s the only time you feel like you’re having fun. You may start to see more serious consequences—maybe you feel sick often, your employer is upset that you often come to work late, and you are getting into fights with your friends. In this situation, alcohol use is becoming more harmful.
  • Maybe you drink a lot or often, including by yourself. You’re spending too much money on alcohol, you’re missing a lot of work, and you have alienated important friends and family members. Perhaps you’re using alcohol in risky ways, like drinking and driving.
  • This represents a serious problem, and you see serious consequences as a result of your drinking.

The positive and negative outcomes are important—more important than the substance itself. If we look at people first, we can see that there are opportunities to help them take control of health or other goals no matter where they currently sit on the spectrum of substance use.


The idea that you must hit ‘rock bottom’ and experience serious consequences like losing your job or losing important relationships before you’re ready for help isn’t true. You can seek help or support any time you reflect on your own substance use and would like to make some changes. Some people may be able to deal with substance use problems on their own. Others may need some help, like a support group, psychotherapy or counselling, or medication. Some people may need a significant amount of help and support. And when it comes to treatments and supports, there are many different approaches and philosophies. That might mean self-reflection, a weekly meeting after work, or a stay at a residential treatment facility. Your treatment plan may include a combination of approaches at different times. If you’re not sure where to start, try talking with your doctor or health care provider. They can help you look at different options that fit your needs and your wishes.


It can be difficult to watch someone you care about experience problems with substances like alcohol or other drugs. You may have some very real fears about their safety, or even your own safety.

Remember that change can rarely be forced onto others—in order to see the most benefit, they need to feel like they are part of the process. Forcing someone into treatment is not necessarily a helpful approach.

Recovery is a process that can take a lot of work and time. When someone you care about experiences problems with substance use, one of the most powerful things you can do is help your loved one help themselves. That might mean helping them look at the problems and think about good solutions, helping them reach out to service providers, or simply trying to listen without judgment. You may not be able to relate to the experiences of using substances, but you can focus on the emotions or feelings that your loved one is experiencing. Helping a loved one help themselves also includes trying to respect their wishes and goals. These wishes and goals may not align with your own, but you can still support the desire for change and recovery.

It’s hard to remove all of the factors that might lead to substance use problems. Perhaps the best protection from using substances in a harmful way is feeling connected and supported by people and having the skills to cope with life’s challenges.

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