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Some people who drink alcohol, use marijuana or other drugs, or misuse prescription or over-the-counter medicines 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.
Not doing important activities because of their substance use.
Using substances in situations where doing so is dangerous, such as 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 might not use alcohol or drugs in large amounts at one time. Or they might go for days or weeks between drinking episodes or using drugs. But even if they don't drink or use drugs very often, their substance use could still be harmful and put them at risk.
Alcohol and drug use may be a person's way of trying to self-treat another condition, such as depression.
Using alcohol or drugs can 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, behavior, and ability to learn.
Children who are exposed to alcohol or drug use in the home may develop mental health conditions, such as depression and anxiety. They may have behavioral problems and trouble with learning and do poorly in school. And they may be more likely to develop substance use disorder.
Alcohol and drugs can affect a teen's brain development. They can also affect emotional and social development. Alcohol 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 good choices.
People who use alcohol or drugs may be more likely to engage in risky behaviors. 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 when "high" or when they've had too much to drink. This may increase the risk of injury or car crashes.
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 and when it's a sign of alcohol use disorder.
People who drink too much alcohol are more likely to have poor grades or job performance. They're more likely to use tobacco products and to experiment with marijuana or other drugs. And their drinking may increase their risk of getting hurt or being in a car crash.
Over time, drinking too much 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, marijuana, or other drugs may increase the effects of each. Using alcohol along with opioids increases the risk of opioid overdose.
Recreational drugs
People who use drugs such as marijuana, cocaine, heroin, or meth, may develop substance use disorder. People use many drugs for recreational purposes, including some that are also used as medicines. Examples include opioids, ketamine, and LSD. People may use drugs to get a "high" or to relieve stress and emotional problems.
Drugs 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.
Teens and young adults may be at higher risk of being victims of sexual assault or violent behavior in situations where drugs are used.
Prescription and over-the-counter medicines
Some people misuse prescription medicines, like opioids (such as OxyContin and Norco), benzodiazepines (such as Valium and Xanax), and stimulants (such as Ritalin and Adderall). Misusing prescription medicines can cause serious harm and, in some cases, even death.
Some over-the-counter medicines, such as cold medicines that have dextromethorphan in them, are being misused by teens and young adults as a way to get "high."
Inhalants
Glue, shoe polish, cleaning fluids, and aerosols are common products with ingredients that can also be used to get a "high."
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Actionsets are designed to help people take an active role in managing a health condition.
Are you concerned about an alcohol or drug problem?
Yes
Concerned about alcohol or drug problem
No
Concerned about alcohol or drug problem
How old are you?
11 years or younger
11 years or younger
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Male
Male
Female
Female
The medical assessment of symptoms is based on the body parts you have.
If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
If your symptoms aren’t related to those organs, you can choose the gender you identify with.
If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Did you pass out completely (lose consciousness)?
Yes
Lost consciousness
No
Lost consciousness
If you are answering for someone else: Is the person unconscious now?
(If you are answering this question for yourself, say no.)
Yes
Unconscious now
No
Unconscious now
Are you back to your normal level of alertness?
After passing out, it's normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.
Yes
Has returned to normal after loss of consciousness
No
Has returned to normal after loss of consciousness
Did the loss of consciousness occur during the past 24 hours?
No, you're not pregnant, or you're not sure if you're pregnant.
Pregnancy
Do you ever have blackouts while using alcohol or drugs?
Yes
Has had blackouts
No
Has had blackouts
Do you have any other concerns about an alcohol or drug problem?
Yes
Concerns about alcohol or drug problem
No
Concerns about alcohol or drug problems
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Try home treatment to relieve the symptoms.
Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
If you are with a person who is drunk or high, it's a good idea to seek medical help right away if:
The person may have an injury.
The person is hard to wake up or cannot stay awake.
The person has vomited more than once and is not acting normal.
You're not comfortable taking care of the person, or you're not in an environment that is safe enough for you to take care of the person.
When you use drugs or alcohol over time, you may feel that you need them to get through the day. You or a loved one may notice that:
You need more and more of the substance to get the same effect, or you get less effect from the same amount over time.
You have strong cravings for the substance.
You aren't able to stop using or to use less of the substance, even if you try.
You spend a lot of time getting, using, or recovering from using the substance.
You can no longer do your main jobs at work, school, or home.
You no longer do things you used to enjoy.
You keep using the substance even though it causes health problems or makes them worse. These health problems are different depending on the substance, but they can include:
High blood pressure.
Stomach or liver problems.
Repeated infections.
Sleep problems.
Loss of appetite.
Less interest in sex.
Severe withdrawal symptoms may include:
Being extremely confused, jumpy, or upset.
Feeling things on your body that are not there.
Seeing or hearing things that are not there.
Severe trembling.
Chest pain.
Shortness of breath.
Mild withdrawal symptoms may include:
Intense worry.
Nausea or vomiting.
Shakiness.
Sweating.
Feeling a little tense or edgy.
The risk of a suicide attempt is highest if:
You have the means to kill yourself, such as a weapon or medicines.
You have set a time and place to do it.
You think there is no other way to solve the problem or end the pain.
The use of alcohol and drugs can affect your behavior. Here are some questions to think about:
Has your use of alcohol or drugs harmed your relationships with your family or friends?
Do you ever drive a car or operate machinery when you are drunk, high, or hungover?
Have you missed any days of work or school during the past year because you were drunk, high, or hungover?
Have family members or friends tried to get you to cut down on alcohol or drugs?
Do you sometimes go on binges with alcohol or drugs?
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care in the next hour.
You do not need to call an ambulance unless:
You cannot travel safely either by driving yourself or by having someone else drive you.
You are in an area where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
Call your doctor today to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care today.
If it is evening, watch the symptoms and seek care in the morning.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
Make an appointment to see your doctor in the next 1 to 2 weeks.
If appropriate, try home treatment while you are waiting for the appointment.
If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Where to get help 24 hours a day, 7 days a week
If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:
Call the Suicide and Crisis Lifeline at 988.
Call 1-800-273-TALK (1-800-273-8255).
Text HOME to 741741 to access the Crisis Text Line.
Consider saving these numbers in your phone.
Self-Care
If you are concerned about your own or another person's alcohol or drug use, learn what steps to take to help yourself or someone else.
Do not ignore the problem.
Know the signs of substance use. These include being unable to cut down or control use, continuing to use even though it hurts a person's relationships, and having problems at work, school, or home.
Make an appointment with a doctor or another health professional, such as a counselor, to discuss steps for getting treatment.
Find out when support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), meet. These self-help groups help members get sober and stay that way. There are also support groups for family members and friends.
Ask the other person if they would accept help. Don't give up after the first "no." Keep asking. If the person agrees, arrange for help that same day.
Provide support for the other person during detox or other treatment.
Help set up community services in the home, if needed. Older adults may benefit from services like home care, nutritional programs, transportation programs, and other services.
Help with decision-making. Some people who misuse substances can't process information or communicate their decisions well.
Check out what services are available in your area.
If you work, talk to your human resources department about getting a referral to your employee assistance program, if your employer offers it.
Contact the national Substance Abuse and Mental Health Services Administration (SAMHSA) to learn about treatment programs in your area. Call the SAMHSA help line at 1-800-662-HELP (4357) or go online to www.samhsa.gov/find-help. Talking to someone about your feelings about substance use can help.
When to call for help during self-care
Call 911 if the following occurs during self-care at home:
You feel you cannot stop from hurting yourself or someone else.
Where to get help 24 hours a day, 7 days a week
If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:
Call the Suicide and Crisis Lifeline at 988.
Call 1-800-273-TALK (1-800-273-8255).
Text HOME to 741741 to access the Crisis Text Line.
Consider saving these numbers in your phone.
Go to 988lifeline.org for more information or to chat online.
Call a doctor if any of the following occur during self-care at home:
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.
Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
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