Alcohol and Substance Abuse: When Is It Time to Ask for Help?

Alcohol abuse, drug abuse, and substance use problems do not always look dramatic from the outside. Sometimes the first sign is realizing that something you once controlled is starting to control you.

There is a point when drinking or drug use stops feeling like something you are choosing and starts feeling like something that is controlling you.

And unfortunately, that point does not always look dramatic.

You can still go to work. You can still take care of your family. You can still pay your bills and look completely “fine” from the outside while privately realizing that alcohol, marijuana, prescription medications, cocaine, opioids, or another substance is becoming harder and harder to control.

That is something I think we need to talk about more.

Substance Abuse Does Not Always Look Like Addiction in the Movies

When people hear words like alcohol abuse, drug abuse, addiction, or substance abuse, they sometimes picture someone who has completely lost everything.

But substance use problems exist on a spectrum.

The medical term commonly used today is substance use disorder (SUD). Similarly, problematic alcohol use may be diagnosed as alcohol use disorder (AUD).

Signs Alcohol or Drug Use May Be Becoming a Problem

• You hide how much you are drinking or using.
• You spend a lot of time thinking about drinking or using.
• You continue despite knowing it is hurting your physical or mental health.
• You feel anxious, shaky, sick, uncomfortable, or unable to sleep when you stop.
• You have tried several times to quit but keep returning to the substance.

One of these signs does not automatically mean someone has an addiction. But patterns matter.

If you are already asking yourself, “Do I have a problem with alcohol or drugs?”, that question may be worth discussing with a professional.

Alcohol and Mental Health Are Often Connected

This is another reason substance use treatment cannot always focus on the substance alone.

Sometimes alcohol or drugs are being used to cope with something else.

That does not mean one automatically causes the other. But if someone is drinking every night because it is the only way they know how to quiet their anxiety, simply telling them to “stop drinking” does not address the whole problem.

We also have to understand what alcohol or drugs have been doing for that person emotionally—and help them build healthier ways to manage what they are experiencing.

Therapy Can Be an Important Part of Substance Abuse Treatment

There is no single treatment that works for everyone.

Substance use disorder treatment may include therapy, behavioral interventions, medications when clinically appropriate, peer support, recovery programs, and sometimes a higher level of care depending on the severity of the condition.

You Do Not Have to Wait Until Everything Falls Apart

Some people are embarrassed. Some believe their problem is not “bad enough.” Some think they should be able to fix it themselves. Others are afraid of being labeled an alcoholic or an addict.

Substance Use Support at Brain Health Psychiatry

One Important Warning About Alcohol Withdrawal

You Are Allowed to Ask for Help Before Rock Bottom

You do not have to lose your job.

You do not have to lose your relationship.

You do not have to get arrested.

You do not have to end up in the hospital.

And you certainly do not have to wait until substance use has taken everything from you before deciding that you want something different.

Sometimes recovery begins with something as simple as admitting: “This isn't working for me anymore.”

This article is for educational purposes only and does not replace an individualized evaluation, diagnosis, detoxification plan, or treatment recommendation from a qualified healthcare professional.