substance use and mental health
Substance use and mental health conditions often go hand in hand, often triggering or worsening symptoms. It can create a difficult cycle that affects a person’s physical health, relationships and everyday life.
Substance use is common in Scotland, with around 1 in 7 adults reporting drug use in the past year [Scottish Health Survey]. Scotland also has some of the highest drug- and alcohol-related death rates in the UK and Europe [National Records of Scotland] . These figures highlight the serious impact substance use can have on individuals, families and communities.
People may turn to substances such as alcohol, nicotine, cannabis, ketamine, cocaine or LSD to cope with mental health conditions, such as anxiety, depression and post-traumatic stress disorder (PTSD). However, regular use can worsen existing symptoms or contribute to new mental health problems, creating a cycle that can be difficult to break.
Stigma around both mental health and substance use can make it harder to ask for help. Understanding the link between them can help reduce stigma and make it easier for people to access the support they need.
myths about substance use and mental health
addiction is the person’s ‘own fault’. It is always a choice.
Substance use is not the result of moral failure, personal weakness or poor willpower. Substance use can often stem from underlying mental health conditions, social environments, genetics or traumatic experiences.
mental health problems caused by substance use will resolve once the person stops using it
While stopping can improve mental health, many individuals may need ongoing treatment for underlying mental health conditions that predate or were worsened by substance use.
medication for mental health conditions is another form of ‘substance use’
Medications prescribed for mental health conditions are scientifically validated treatments that are often crucial for managing symptoms and improving quality of life. It’s important that there is access to non-clinical, person-centred support concurrently and thereafter.
how do substances affect mental health?
Regular use of substances can negatively impact your mental health. Although people turn to substances for a variety of different reasons, it is important to be aware of the risks they can have on your wellbeing.
Worsen symptoms
Using substances regularly can increase your risk of developing a mental health condition, such as anxiety or depression, or worsening symptoms.
Psychosis
Certain substances, like psychedelics, can produce psychosis-like symptoms where people may temporarily lose touch with reality. For example, this can include experiencing hallucinations (like hearing voices) or delusions (false, often paranoid beliefs) due to substance-induced psychosis.
Self-harm and suicide
Those who use substances are more likely to experience self-harm and suicidal thoughts. Substance use can cause impulsivity and feelings of hopelessness, which may increase the chances of self-injury or suicide attempts.
Interactions with medication
Some substances can interfere with prescribed medication and affect how well they work. For example, antipsychotics and antidepressants can be made less effective.
Physical health
Substance use can affect physical health by causing poor sleep, changes in appetite and low energy. It can also increase the risk of illness, injury and damage to the body.
why do people use substances?
Curiosity or experimentation
Some people try drugs or alcohol simply to see what it feels like, especially during adolescence or early adulthood when peer influence and risk-taking are common.
To cope with emotional pain
Some people turn to substance use to deal with difficult emotions, stress, trauma or untreated mental health conditions. It is more common for men to self-medicate [British Journal of Psychiatry] with drugs or alcohol to soothe emotional distress than women.
Dependence or addiction
Repeated use of substances over time can lead to dependence. When this happens, stopping becomes extremely difficult – even when the person wants to – because their brain and body have adapted to the substance.
“For so long, I used drugs and alcohol to numb pain, fear, shame – anything uncomfortable. In recovery, I had to relearn how to feel everything and not let it break me.”
Sonny talks about how he turned to drugs to cope with difficult emotions. Read about his recovery from addiction here
how do I know if I am using substances?
Recognising substance use can be challenging, especially if you are using substances to cope with mental health issues. Here are some signs that you may be using substances:
- Increased tolerance: Needing more of the substance to achieve the same effect.
- Withdrawal symptoms: Experiencing physical or psychological symptoms when not using the substance. These can include sleeping problems, nausea, sweating, dissociation, shaking or sensory disturbances.
- Neglecting responsibilities: Failing to fulfil obligations at work, school or home because of your substance use.
- Loss of control: Consuming more of the substance than intended or being unable to cut down despite wanting to.
- Social problems: Facing issues in relationships or social activities because of substance use.
- Addiction: Feeling a persistent desire or craving for the substance, spending a significant amount of time obtaining, using or recovering from its effects.
If you think you may be experiencing dependence or addiction, or are concerned about someone you know, it’s important to seek medical support from your GP. They can help you reduce your usage safely and, if needed, refer you to specialist support services. Stopping some substances suddenly and abruptly can be dangerous to your health, so it’s important to seek professional advice before stopping.
how to help yourself
If you are struggling with both substance use and mental health issues, it is essential to take proactive steps towards recovery:
- Seek professional help: Contact your healthcare provider to discuss your symptoms and receive a proper diagnosis. In Scotland, integrated treatment programmes that address both mental health and substance use simultaneously are highly recommended. You can read more about this on the NHS inform website.
- Practice self-care: Engage in activities that promote physical and mental wellbeing, such as regular exercise, a healthy diet and sufficient sleep. Mindfulness practices like meditation or yoga, or grounding techniques, can also be beneficial.
- Build a support network: Surround yourself with supportive friends and family who understand your struggles and can offer encouragement. Try to integrate with different social circles that might not revolve around substance use. Peer support groups specifically for substance use and mental health like those listed at the bottom of this page can provide additional communal support.
how to support someone else
Supporting someone with co-occurring substance use and mental health issues requires empathy, patience and understanding:
Gain a deeper understanding
Learn about their conditions to better understand what they are going through and how you can help.
Offer non-judgmental support
Listen to them without judgement and offer a safe space for them to express their feelings. Avoid giving unsolicited advice and instead offer to help them in finding professional support.
Encourage treatment
Recommend that they seek professional help and support them in attending appointments or following treatment plans. Be patient and understand that recovery is a process that takes time.
support
Our National Advice and Support Service can help you and people you care for with mental health concerns and money worries.
We can link and signpost you to relevant local and national support, including our own Change Mental Health services, as well supporting with debt, grants and benefits.
The service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm to 1.30pm). Contact 0808 8010 515, email advice@changemh.org or fill in the form on the service webpage.
For full details about the service, visit the National Advice and Support Service webpage.
other Support
- Frank: Information and advice for anyone concerned about drugs use, for individuals, their families, friends and carers. Call 0300 123 6600 or join a webchat
- Narcotics Anonymous (NA) is a community of people who support each other to achieve and maintain a drug-free life. Call 0300 999 1212, Monday to Sunday, 10am to 12am.
- Turning Point Scotland: Provides specialised support for people with complex needs, including those with co-occurring substance use and mental health conditions.
- Scottish Families Affected by Alcohol & Drugs (SFAD): Offers support to families affected by substance use, including counselling and support groups.
