By Tammy Worth
Substance misuse, which increased during the pandemic, has slowly begun dropping in the United States. But there are still millions of people struggling daily, whether it’s with alcohol or other drugs.
According to the 2025 National Survey on Drug and Alcohol Use, over 44 million adolescents and adults reported having a substance use disorder. That’s about 15% of the U.S. population. The numbers were split relatively evenly between the use of alcohol and other substances.
Substance misuse can show up in different ways. Some people may only use substances occasionally but in a way that can be harmful like weekend warriors binge drinking. Other people may use a drug daily in a way that becomes detrimental to their work and personal lives.
Understanding your risk for substance misuse is a good way to prevent an issue from starting. If you’re concerned that you, or someone you love, may have a problem, knowing the signs and seeking help early can get you on a path toward recovery.
Addiction 101
A general definition of substance use disorder is the use of drugs for purposes other than what they are meant for; use in excessive amounts; or inability to stop using a substance even when it is causing social, emotional, physical or job-related problems.
Addiction is a medical condition that impacts your brain. For instance, drugs over activate your brain’s reward system, which makes you feel good when taking them. But you can become dependent on increasing amounts to maintain that same sense of euphoria. They also impact the area of the brain that makes you uncomfortable when the high fades, increasing your desire to take the drug again to feel better. Drugs also weaken the part of the brain that manages decision making and impulse control. Extended use makes it harder to say no to substances over time .
Know your risk
Knowing that you have a higher risk of substance misuse doesn’t predestine you to having the condition. But understanding if you could be more vulnerable to drug or alcohol misuse can help you catch potential issues early and create good behaviors to avoid getting into an unhealthy cycle with substances.
There are a handful of things that could increase your risk of having a substance use issue. These include:
- Genetics – If you have a blood relative with a substance use disorder, you are more likely to be at risk.
- Mental health disorders – If you have a mental health disorder, you are more likely to use drugs to cope with the feelings of depression and anxiety that come with that condition.
- Trauma – If you’ve suffered physical or emotional trauma, that can increase the risk you will misuse substances.
- Early substance use – If you began using substances – even cigarettes or alcohol – during your youth, it makes you more likely to have a substance use disorder as an adult.
The risk that you may misuse substances also increases during times of heightened stress like losing a job, going through a divorce, losing a loved one, or being diagnosed with a chronic disease. If you are in the midst of a major physical or mental health issue, it may be wise to seek support from friends, family or a therapist. This can reduce the chances you’ll turn to alcohol or other substances to cope with the hardship.
Prevention strategies
Knowing risks and triggers for substance misuse can help you reduce the chances that you will become dependent on drugs or alcohol. These things can also help you come up with some strategies and actions toward prevention.
First is building healthy coping skills. Major causes of substance misuse are life stressors. If you can learn to manage challenging emotions in healthy ways, you could be less likely to reach for a substance to get through them. Some ways to take care of yourself include:
- Meditation,
- Spending time outdoors,
- Getting regular exercise,
- Getting seven hours of sleep a night,
- Eating a wide range of fruits and vegetables, lean protein and whole grains,
- Spending time with family, friends and social groups.
It’s important to take care of yourself and your emotional and physical needs to prevent reaching for a substance. One mantra used for people who want to avoid misuse is H.A.L.T. This means never get too hungry, angry, lonely or tired. All these things are common stressors that can lead someone to rely on substances.
Understanding recommended alcohol guidelines may give you a good idea if you are at risk for overuse. According to the U.S. Centers for Disease Control and Prevention (CDC), there is no safe amount of alcohol to drink. Moderate use, however, amounts to two drinks or fewer a day for men and one drink or fewer a day for women. Excessive drinking, according to the CDC includes:
- Heavy drinking – 15 or more drinks for men and eight or more drinks for women in one week.
- Binge drinking – Five or more drinks for a man and four or more drinks for a woman at once.
How to recognize a problem
Substance misuse can wreak a lot of havoc in a person’s life, but it can also show up more subtly. Three things to think about to understand if you may have an issue are:
How you control the use of a substance – Do you often use it more than you plan to; are you unable to stop; do you have strong cravings; or do you need increasing amounts to get the same effect as you used to?
How it impacts your life – Do you spend more time than you would like using it or getting over it (like a hangover); has it gotten in the way of your work, social or home responsibilities; or are you reducing the activities you used to like because of it?
How risky the use is –Do you use the substance in a dangerous way (like before driving); or do you use it even though it’s causing a physical or mental health problem?
There are several online questionnaires that can help you better understand your relationship with alcohol and drugs. The World Health Organization created AUDIT, which asks 10 simple questions about your alcohol use and ranks the responses. The DAST-10 is a short questionnaire to help you understand if you may have an issue with other substances. The National Institute on Drug Abuse also offers an eight-question online survey to help you understand if you may have an issue with either drugs, alcohol or both.
If you worry that you, or someone you love, may have an issue with drugs or alcohol, seeking treatment early may help the condition from progressing. Unfortunately, a lot of people avoid treatment because of the stigma related to substance misuse. Of the 47 million Americans who needed treatment in 2025, only about 16% sought it out, according to the National Survey on Drug Use and Health. Treatment can be effective and comes in many forms including inpatient care, therapy, peer groups (like AA and NA) and medications for both drug and alcohol misuse.
Understanding your personal risk, learning healthy coping skills to deal with life’s stressors, and seeking care early are all valuable tools to combat substance misuse. To get help or find out more about substance misuse, call the SAMHSA helpline: 1-800-662-HELP or visit Kaiser Permanente’s Addiction and Recovery site.
