Topic Overview

The overuse of alcohol or other drugs is called a substance use problem. One of the signs of a substance use problem is that you keep using alcohol or drugs even though you know it's causing problems in your life. Another sign is that you have a strong need or craving to drink or use drugs.

Using alcohol or drugs can affect your health, work, school, and relationships. It can change how well you make decisions, how well you think, and how quickly you can react. And it can make it hard for you to control your actions. In young people, using alcohol or drugs can affect their general health, physical growth, and emotional and social development.

If you think you may have a problem with alcohol or drugs, take a short quiz to evaluate your symptoms:

• Assess Your Substance Use

Alcohol

You may have an alcohol problem if drinking alcohol affects your health or daily activities. You may be dependent on alcohol if you physically or emotionally need alcohol to get you through your day.

Symptoms of an alcohol problem include personality changes, blackouts, drinking more to get the same effect, and denial of the problem. If you have an alcohol problem, you may gulp or sneak drinks, drink alone or early in the morning, and have the shakes. You may also have family, school, or work problems or get in trouble with the law because of drinking.

The use of alcohol with medicines or illegal drugs may increase the effects of each.

Alcohol use patterns vary. Some people drink and may be intoxicated every day. Other people drink large amounts of alcohol at specific times, such as on the weekend. It is common for someone with an alcohol or drug problem to call in sick for work on Monday or Friday. He or she may complain of having a virus or the flu. Others may be sober for long periods and then go on a drinking binge that lasts for weeks or months.

People who are dependent on alcohol may have withdrawal symptoms, such as sweating and feeling sick to their stomach, feeling shaky, and feeling anxious. In rare cases, severe symptoms of withdrawal can occur such as delirium tremens, or DTs. Treatment for withdrawal from alcohol requires medical care.

Drugs

People who have a drug problem may use a number of substances. They may use drugs—such as cannabis (marijuana), methamphetamines, cocaine, heroin, or other "street drugs." Or they may misuse legal prescription and non-prescription drugs. Some people use drugs to get a "high" or to relieve stress and emotional problems. Many people use more than one substance at a time.

Club drugs, like ecstasy (MDMA), and date rape drugs, such as gamma-hydroxybutyrate (GHB), flunitrazepam (Rohypnol), and ketamine, are often used at all-night dances, raves, or trances. These drugs can be dangerous, especially in overdose or when combined with other drugs or alcohol. Inhalants like nitrous oxide may also be used at these clubs.

Drugs come in different forms and can be used in different ways. They can be smoked, snorted, inhaled, taken as pills, put in liquids or food, put in the rectum or the vagina, or injected with a needle.

Prescription medicines that may be misused include opioids (morphine and codeine), diazepam (Valium), hydromorphone, methylphenidate (Ritalin), and oxycodone (OxyNEO).

Some non-prescription medicines, such as cold medicines that have dextromethorphan as an ingredient, are being misused as a way to get high. What effects these drugs may have on your health depend on the type, strength, and amount of these drugs you use and whether you take them with illegal drugs or alcohol. The use of prescription and over-the-counter medicines with alcohol or illegal drugs may increase the effects of each substance. Glue, shoe polish, cleaning fluids, and aerosols are common household products with ingredients that are also being used to get high.

Signs of a drug problem depend on the drug you use and how that drug affects you. Not all drugs affect people the same way. One of the signs that your drug use may be becoming a problem is that you take more of a drug over longer periods of time and need more of the drug to feel "high." Another sign is that you spend a lot of time trying to get the drug, and you give up other activities to do this. When you have a drug problem, you or others may notice some changes in your behaviour. You may be moody, have problems sleeping, or pay less attention to how you dress or look. Or you may lie, steal, or hide things from people and act sneaky.

You may have a drug problem if your drug use affects your health or daily activities. You may be dependent on drugs if you physically or emotionally need drugs to get you through your day. You may not be aware that you have become dependent on a drug until you try to stop taking it. People who are dependent on drugs may have withdrawal symptoms, such as sweating and feeling sick to their stomach, feeling shaky, and feeling anxious.

Drug problems in older people may go unnoticed, since the signs may be similar to those of aging. Older adults often take medicines, such as sleep medicines and painkillers, that can lead to a drug problem.

Health risks of alcohol and drug use

When you use alcohol or drugs, you may be putting your health and safety at risk.

Alcohol or drug use can:

• Make car crashes more likely. If you drink and drive, or if you drive while you are high, you can easily hurt yourself or others.
• Lead to unprotected sex and/or sexual assault. This can lead to pregnancy and sexually transmitted infections (STIs), including HIV.
• Increase the risk of overdose, injury, and death.
• Cause you to do things you wouldn't usually do. You may say things that hurt your friends. Or you may do something illegal that could result in paying a large fine or going to jail, like being arrested for driving while intoxicated.
• Affect your work or schoolwork. It can cause you to lose your job or drop out of school.
• Change how you feel about your life. It can lead to depression and suicide.
• Cause mood swings and affect your sleep and your ability to think, learn, reason, remember, and solve problems.
• Harm many organs and systems in the body, such as the liver, pancreas, heart, brain, and nervous system.
• Contribute to the development of some cancers, such as cancers of the mouth, throat, esophagus, liver, colon, and breast.
• Cause high blood pressure, stomach problems, or sexual problems.
• Cause harm to a developing baby (fetus) if alcohol or drugs are used during pregnancy.

Recognizing a problem

Alcohol

Alcohol is part of many people's lives and may have a place in cultural and family traditions. So it can sometimes be hard to know when you begin to drink too much.

You're at risk of drinking too much if you are:

• A man who has more than 3 standard drinks a day on most days, or more than 15 drinks a week.
• A woman who has more than 2 standard drinks a day on most days, or more than 10 drinks a week.

Drugs

You may not feel that using drugs can become a problem. Maybe you feel that you're a casual user because you use drugs only now and then. But drug use can quickly become a habit and start to affect your life.