Substance use and substance use disorder

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Substance use is of alcohol, tobacco and drugs. Learn about the risks of substance use and what it means to have a substance use disorder.

What is substance use?

Substance use is the use of alcohol, tobacco and drugs (including prescription and over-the-counter medications) for pleasure or enjoyment. You and other teens you know may choose, or may have already chosen, to experiment with or try some kind of substance. Some teens may be using substances often, while other teens make a choice not to use any substances, or may try something and then decide that they do not want to use it again.

A smaller number of teens experience problems as a result of their substance use. It’s important to know about the risk factors that increase the risk of developing a problem with drugs or alcohol.


What does it mean to have a substance use disorder?

A substance use disorder is the term used when someone is:

  • using substances (including alcohol) in ways that are dangerous to themselves or others
  • experiencing relationship problems with family, friends or romantic partners as a result of their substance use
  • having difficulty at school or work as a result of their substance use
  • showing signs of physical dependence on the substance

A person with a substance use disorder may have tried to stop using a substance but can’t. They may spend a lot of their time using or trying to get a substance, and have stopped many of the other activities they might have done before they started to use.

Factors that may increase your risk of developing a substance use disorder

A substance use disorder is more likely to develop if a person:

  • has depression, anxiety or another mental health condition such as attention deficit hyperactivity disorder (ADHD)
  • has a family history of substance use problems (addictions)
  • has experienced abuse or trauma
  • identifies as LGBTQ2+
  • is street-involved or experiences insecure housing
  • has a chronic health condition
  • has friends who use alcohol or other drugs

Even without having any of these risk factors, regular use of alcohol or other drugs can cause your brain and body to become dependent on these substances. Dependence (sometimes also referred to as "addiction") can negatively affect your health and wellbeing.

When is substance use something that I should worry about?

The more regularly you use a substance, the more likely you are to experience problematic signs and symptoms because of this use.

Regular substance use can be associated with a range of health problems (both physical and mental), difficulties at school and at home, and trouble with the law. The health risks of substance use increase when a person uses more than one substance at the same time, in particular, combining one or more substances with alcohol.

Substance use can lead to dependence. The level of dependence varies with the substance, the amount you use and how frequently you use it. If you are physically dependent on a substance, you build up a tolerance to it, which means that over time, you must use more of the substance to get the same effect.

When you stop using or try to use less of the substance, you may experience physical symptoms (also known as withdrawal symptoms). Depending on what the substance or drug is, these symptoms might include:

  • trouble sleeping
  • agitation
  • tremors/shakiness
  • seizures (only in some cases)

Do issues with substance use occur with other mental health conditions?

Someone who has a mental health condition is at a higher risk for developing a substance use disorder, just like someone with a substance use disorder is at a higher risk for developing a mental health condition.

About one-third to half of young people with a mental health condition such as depression, anxiety or ADHD will also develop a substance use disorder. This is called a concurrent disorder. Of teens with a substance use disorder, one third to half will develop a concurrent mental health condition.

Other things to think about if you have mental health or physical health conditions and are using or thinking about using alcohol or other substances:

If you are taking prescribed or over-the-counter medication(s) for a mental or physical health condition, there can be interactions between the medication, and alcohol or other substances. Depending on the medication, this interaction could result in lower or higher amounts of the medication in your system; this can have a negative impact on your health.

Alcohol and other drugs affect different organs and systems in your body, including your brain, heart, lungs, liver, intestines, kidneys, muscles and nerves. This can sometimes make the symptoms of your condition worse, or make it difficult for your health-care team to know if the treatments they are prescribing are helping or not.

To learn more about how alcohol and drug use can interact with your prescriptions, you can ask the pharmacist questions when you pick up your prescriptions. You can also check out a website called Developed by health-care experts from across Canada, the website provides information about the combination of prescription and over-the-counter medications, and alcohol, cannabis and other drugs.

When to see a doctor or health-care professional for specific help

If you have any questions or concerns about your substance use (or someone else’s), arranging an appointment with a health-care professional or another helping professional, such as a guidance counselor, is a good first step.

If you have a family doctor or paediatrician you see for regular check-ups or when you are sick, you can use these visits as a time to ask questions and get information about the substances you are using and any mental or physical health issues you might be experiencing.

As with any health care visit, the health-care professional will keep your information private and will not share it with anyone else without your permission (unless you share that someone is harming you and you are under 16 years of age, or you share that you are planning to harm yourself or someone else).

What if my doctor thinks I might have a substance use disorder?

Depending on their assessment, a health-care professional will make some suggestions to you about what might be helpful.

Some options include seeing a counsellor who can help you look at areas where you might want to make some changes.

Other types of treatment include:

  • Day treatment, where you attend a group based program Monday to Friday to get treatment and obtain school credits.
  • Hospital based treatment, which may be helpful if you need to withdraw or "detox" in a safe way, or would benefit from further assessment over a few days or weeks.
  • Residential treatment, where you stay at a treatment centre and receive support and schooling every day.

These different treatments usually include some kind of family and/or parent treatment and support. In most provinces, these treatment programs require a teen to agree to take part. Some provinces have laws that allow parents to make this decision instead if the teen is younger than 16 years of age.

Last updated: November 4th 2019