HiddenMany families experience great confusion over the powerful effects drugs have over a loved one. Substance use seems to render the individual using the drug(s) and the individual’s family extraordinarily helpless. The powerful effects on the brain, behavior, cognitive abilities, decision-making skills, awareness of life, and impulse control have always perplexed me.

What a lot of people fail to acknowledge is that substance-related problems are often a sign of a deeper problem, a dependency or an illness such as untreated depression, bipolar disorder, and even schizophrenia. Many families cannot understand why their depressed loved one would turn to street drugs or why an adolescent with chronic schizophrenia would ever turn to marijuana or psychedelic drugs for relief. Believe it or not, some drugs such as marijuana or cocaine are used to self-medicate a mental illness and for many families unable to afford psychiatric medication, street drugs are often the drug of choice. This is a great concern for families and healthcare providers.

Families should be aware that there are two kinds of substance use that help clinicians determine the need for intervention. Substance dependency is often the most severe form of substance use:


1. Substance dependency

Includes a maladaptive pattern of use followed by significant impairment and includes:

  • Tolerance: a need for increased amounts of the drug to achieve the desired effect (or high), despite repeated use of the same amount of the drug.
  • Withdrawal: a physiological response to the immediate discontinuation of a drug such as fear, anxiety, nausea, tremors, sweating, nervousness, and sometimes vivid hallucinations.


 2. Substance abuse (dose not include withdrawal or tolerance, but is still problematic)

A maladaptive pattern of use followed by significant impairment or distress and includes:

  • Failure to fulfill responsibilities: not going to work, school, or fulfilling major role obligations.
  • Use in dangerous situations: recurrent use of the drug while driving or operating heavy machinery or engaging in another task that requires full awareness or wakefulness.
  • Use despite legal problems: continued use of the drug despite arrests, DUI’s, etc.
  • Social & interpersonal problems: use of the drug despite arguments with spouse, physical fights, problems with co-workers, etc.

If you see the above signs in a loved one, I encourage you to reach out. Anytime an individual is unable to stop the use of something despite great effort, this is a problem. No matter how many times your loved one may state “I am fine, I can stop anytime,” they have a problem.


You can locate local substance abuse treatment services at SAMSHA’s site by clicking on your state.

To read more about substance abuse/dependency, visit HelpfulGuide.org


We must remember that substance use is never simple “casual use” of a drug; it can be abuse or dependency.  There is a reason why a person returns to use a drug.

Many people also believe that if they are not seeking “street drugs” they are not problematic. The truth is that even OTC (over-the-counter) or prescription drugs such as Ritalin (methylphenidate) or vicodin (narcotic) can be dangerously addictive.


Keep your eyes open on your loved one, they need you.

All the best to you


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