Drug and alcohol misuse is a serious problem throughout the UK. According to the charity Alcohol Change UK, a quarter of adults in England and Scotland regularly drink over the Chief Medical Officer’s low-risk guidelines and there are more than 600,000 dependent drinkers in England alone. Figures from the Office for National Statistics (ONS), meanwhile, show that an estimated 9.4% 0f 16-59 year olds (or 3.2 million people) had used drugs in the previous year.
But what exactly counts as substance misuse, what are the dangers and what can you do if you or a loved one are struggling with these issues?
What is Substance Misuse?
Many people use a variety of substances in their day-to-day lives – typically legally available and socially acceptable ones like alcohol and caffeine, or slightly less socially acceptable tobacco products like cigarettes. Most would claim there’s nothing wrong with having a glass of wine or a couple of beers after a hard day. Some might say the same about the occasional use of a drug like marijuana, although there is more of a debate to be had about the societal impact of using illegal drugs along with any potential harm to physical and mental well-being.
While occasional use can all too easily slide into problematic drinking or drug use, there is definitely a big difference between the odd glass of wine and substance abuse or full-blown alcohol or drug addiction.
One NHS Trust offers the following definition:
“Substance misuse develops when you continue to take substances which change the way you feel and think, such as alcohol, drugs or food, even though they may cause problems with your body, your mind and the way you behave.”
It adds that the most commonly misused substances are alcohol, cigarettes, opiates (such as heroin and some strong painkillers), stimulants (such as cocaine and amphetamines) and food. Cannabis is the most widely used drug in the UK and nearly a third (29.6%) of people aged 16-49 in England and Wales report having used it at least once.
Signs and Symptoms of Substance Misuse
Problematic substance misuse can develop gradually and sometimes you might not immediately realise the scale of your problem. Substance misuse often goes hand in hand with denial and the person involved might not admit that they even have a problem – either to the people around them or even themselves.
Everyone’s circumstances are different and the effects of substance misuse can vary depending on the individual, as well as the substance involved and other factors. There are some signs and symptoms to look out for, however.
Potential Symptoms of Substance Misuse
This is not an exhaustive list but you may have a problem if any or all of the following apply:
- Continuing to use the substance despite negative consequences
- Needing to use more for the same effect
- Craving the substance
- Feeling anxious about not having access to the substance
- Spending money you can’t afford/risky behaviour to make sure you have it
- Avoiding situations where you can’t use the substance
- Using it in inappropriate situations (such as drinking in charge of kids)
- Feeling bad (withdrawal symptoms) when you do not use it
Potential Signs of Substance Misuse
The following could be signs that a loved one has a substance misuse problem (although some could also indicate other issues)…
- Witnessing harmful substance use and behaviour
- Being secretive, hiding signs of substance use
- Mood swings
- Aggressive behaviour
- Withdrawing from social activities not related to drinking or substance use
- Avoiding responsibilities
- Lack of concern over personal appearance/hygiene
The Impact of Substance Misuse on Mental and Physical Health
Substance misuse can have a huge impact on both physical and mental health, although again this can vary depending on the individual, the substance involved and a range of other factors.
Alcohol misuse, for example, is often seen as less serious than other kinds due to the legal status of the drug and a widespread drinking culture. Alcohol is a causal factor in more than 60 medical conditions, however, including several types of cancer, high blood pressure, cirrhosis of the liver and depression. In fact, alcohol misuse is the single biggest risk factor for death, ill-health and disability among 15-49 year-olds in the UK, and the fifth biggest risk factor across all ages.
The misuse of illegal and prescription drugs can also have a wide range of negative effects on physical and mental well-being. This could include the risk of overdose and an increased risk of accidents or risky behaviour in the short term, as well as long-term effects that build up over time. The health risks of cigarettes are well documented and the misuse of food can lead to eating disorders that can also have a serious impact on health.
Treatment Options for Substance Misuse
If you or a loved one is being affected by substance misuse, there is plenty of help and professional support available. The treatment options available will depend on the substance involved, the heaviness and duration of usage and other factors. For tobacco and nicotine addiction, for example, smoking cessation services may be available via your community pharmacy.
Serious drug addiction and alcohol addiction will generally need intensive tailored programmes using evidence-backed treatments and techniques at a drug rehab.
Depending on the substance involved, you may need to undergo a drug or alcohol detox first and medication may be available to help you with cravings and withdrawal symptoms. Therapy programmes involving techniques such as cognitive behavioural therapy (CBT), group therapy and counselling can also help you explore the root causes of your substance misuse and address the psychological aspects of addiction.
Support for Families Affected by Substance Misuse
If you or your family is being affected by substance misuse issues, there are a number of places you can turn to for help. Your GP is always a good starting point and even if they cannot offer dedicated addiction or substance misuse treatment, they will be able to signpost you towards drug and alcohol rehab services or other relevant services in your area.
Support groups like Alcoholics Anonymous and Narcotics Anonymous can be very valuable for some people. The charity Mind has a very useful list of resources including websites and charities for people struggling with drug and alcohol problems.
-  more than 600,000 dependent drinkers in England alone - https://alcoholchange.org.uk/alcohol-facts/fact-sheets/alcohol-statistics
-  an estimated 9.4% 0f 16-59 year olds (or 3.2 million people) had used drugs in the previous year - https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/drugmisuseinenglandandwales/yearendingmarch2020
-  “Substance misuse develops when you continue to take substances which change the way you feel and think, such as alcohol, drugs or food, even though they may cause problems with your body, your mind and the way you behave.” - https://www.bsmhft.nhs.uk/service-user-and-carer/service-user-information/common-mental-health-conditions/substance-misuse/
-  Cannabis is the most widely used drug in the UK and nearly a third (29.6%) of people aged 16-49 in England and Wales report having used it at least once - https://www.statista.com/statistics/976850/cannabis-use-in-the-uk/
-  alcohol misuse is the single biggest risk factor for death, ill-health and disability among 15-49 year-olds in the UK, and the fifth biggest risk factor across all ages - https://www.gov.uk/government/publications/the-public-health-burden-of-alcohol-evidence-review