Overview
Some people who drink alcohol or use other substances, including prescription or over-the-counter medicines used in ways they are not intended, may develop substance use disorder. This means that a person uses these substances even though it causes harm to themself or others.
A person who has substance use disorder will have two or more of these symptoms:
- Using more of the substance or using it for a longer time than they ever meant to.
- Not being able to cut down or control their use.
- Spending a lot of time getting or using the substance or recovering from the effects.
- Having a strong need, or craving, for the substance.
- Not being able to do their main jobs at work, at school, or at home.
- Continuing to use, even though the substance use hurts their relationships.
- Substance use becomes the most important activity to do.
- Being unable to see situations where using substances is dangerous, such as when caring for children or driving.
- Using the substance even though they know it's causing health problems.
- Needing more of the substance to get the same effect or getting less effect from the same amount over time (tolerance).
- Having uncomfortable symptoms when they stop using the substance or use less (withdrawal).
Substance use disorder can range from mild to severe. The more symptoms of this disorder you have, the more severe it may be.
A person might not realize that their substance use is a problem. They may use alcohol or substances in small amounts. They may go days or weeks between drinking or using substances. They may not consider that substance use becomes a problem when it causes harm and puts them or others at risk.
Substance use may be a person's way of trying to self-treat another condition, such as depression, anxiety, chronic pain, or trouble sleeping.
Using alcohol or substances may put others at risk. For example:
- Using alcohol while pregnant puts the baby at risk for problems from fetal alcohol syndrome. Alcohol may affect the baby's growth and development, behaviour, and ability to learn.
- Children who are exposed to substance use in the home may experience mental health conditions, such as depression and anxiety. They may have a tough time at school because they experience behavioural problems or trouble with learning. And they may be more likely to develop substance use disorder.
- Alcohol and substances may affect a teen's brain development. They can also affect emotional and social development. Substance use can cause changes in a teen's alertness, perception, movement, judgment, and attention. This can make it harder for teens to think, learn, reason, and make healthy choices.
People who use alcohol or substances may be more likely to engage in risky behaviours. For example, they may not use condoms during sex. Or they may have more than one sex partner. This increases the risk of unintended pregnancy and sexually transmitted infections (STIs). They may drive after using alcohol or other substances. This increases the risk of injury or car crashes.
If you are concerned about your substance use, talk to your doctor or other healthcare provider. If you are concerned about someone else's substance use, call the Addiction Helpline at 1-866-332-2322.
Alcohol
Alcohol is part of many people's lives. It may have a place in cultural and family traditions. So it may be hard to know when someone is drinking too much. If you choose to drink alcohol, try to drink less. It's important to remember that drinking alcohol is not risk-free. Your risk of harm from alcohol is:
- Low if you have 2 standard drinks (Figure 1) or less per week.
- Moderate if you have between 3 and 6 drinks per week.
- High if you have 7 or more drinks per week. (Each additional standard drink increases the risk of alcohol-related consequences.)
Having more than 2 standard drinks per occasion is linked with an increased risk of harms to yourself and others, including injuries and violence. And not drinking has benefits, such as better health and sleep. If you are pregnant or trying to get pregnant, there is no known safe amount of alcohol use. If you are breastfeeding, not drinking alcohol is safest.
Teens who use alcohol are more likely to use tobacco products and to experiment with cannabis or other substances.
Over time, drinking alcohol may cause health problems, like high blood pressure, problems with digestion, and liver, heart, brain, and nervous system problems. It may also cause sexual problems, osteoporosis, and cancer.
The use of alcohol with medicines or other substances, including cannabis, is not recommended. It may increase the effects of each substance. Using alcohol along with opioids increases the risk of opioid overdose.
Recreational substances
People may use substances for recreational purposes: to get "high", relieve stress, or cope with physical and emotional pain. People who use cannabis, cocaine, opioids, LSD, ketamine, meth, or other substances may develop substance use disorder.
Substances come in different forms and can be used in different ways. They may be smoked, snorted, inhaled, or taken as pills. They may be put in liquids or food. They may be put in the rectum or vagina or be injected with a needle.
When people are in situations where substances are used, there is a higher risk of becoming the victim of sexual assault or violent behaviour.
Prescription and over-the-counter medicines
Using prescription or over-the-counter medicines in ways they are not intended may cause substance use disorder and lead to serious harm and sometimes death.
Some people misuse prescription medicines, like opioids (such as Oxyneo and Dilaudid), benzodiazepines (such as Valium and Xanax), and stimulants (such as Adderall). Some over-the-counter medicines, such as cold medicines that have dextromethorphan in them, can also be used in ways they are not intended. An OTC example is cold medicines with dextromethorphan.
Inhalants
Glue, shoe polish, cleaning fluids, gas, and aerosols are common products with ingredients that can also be used to get a "high."
Health and safety risks of alcohol and substance use
When you use alcohol or other substances, you may be putting your health and safety at risk.
Alcohol or substance use can:
- Make car crashes more likely. If you drink or use substances and drive, you can easily hurt yourself or others.
- Lead to unprotected sex and/or becoming a victim of sexual assault. This can lead to unplanned pregnancy and sexually transmitted infections (STIs), including HIV.
- Increase the risk of overdose, injury, and death.
- Cause you to be less self-conscious, which can make you do or say things you wouldn't usually do or say. This can lead to problems with friends and family. It may also cause legal problems like being arrested for impaired driving or assault.
- 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, digestive system, and nervous system.
- Contribute to the development of some cancers, such as cancers of the mouth, throat, larynx, esophagus, liver, colon, and breast.
- Cause high blood pressure, stomach problems, or sexual problems.
- Cause harm to a developing baby (fetus) if alcohol or other substances are used during pregnancy.
Figure 1 - Standard alcoholic drink
Beer, wine, and hard liquor (distilled spirits) all contain alcohol. The following common alcoholic drinks contain equal amounts of alcohol and are often referred to as a drink or a standard drink.
- One mixed drink containing 43 mL (1.5 fl oz) of 40% hard liquor, such as vodka, gin, rye whiskey, or rum
- One 142 mL (5 fl oz) glass of 12% wine
- One 341 mL (12 fl oz) bottle of 5% beer, hard cider, or hard seltzer.
Proof is the amount of alcohol in hard liquor or distilled spirits. The percentage of pure alcohol in the hard liquor is usually one-half the proof. For example, a 100-proof liquor is about 50% pure alcohol. Thus, the higher the proof, the more pure alcohol the hard liquor contains.
Current as of: November 15, 2023
Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
