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Topic Overview

The overuse of alcohol or other drugs is called a substance use problem. One of the signs of a substance use problem is that you keep using alcohol or drugs even though you know it's causing problems in your life. Another sign is that you have a strong need or craving to drink or use drugs.

Using alcohol or drugs can affect your health, work, school, and relationships. It can change how well you make decisions, how well you think, and how quickly you can react. And it can make it hard for you to control your actions. In young people, using alcohol or drugs can affect their general health, physical growth, and emotional and social development.

Alcohol

You may have an alcohol problem if drinking alcohol affects your health or daily activities. You may be dependent on alcohol if you physically or emotionally need alcohol to get you through your day.

Symptoms of an alcohol problem include personality changes, blackouts, drinking more to get the same effect, and denial of the problem. If you have an alcohol problem, you may gulp or sneak drinks, or drink early in the morning, and have the shakes. You may also have family, school, or work problems or get in trouble with the law because of drinking.

The use of alcohol with medicines or illegal drugs may increase the effects of each.

Alcohol use patterns vary. Some people drink and may be intoxicated every day. Other people drink large amounts of alcohol at specific times, such as on the weekend. It is common for someone with an alcohol or drug problem to call in sick for work on Monday or Friday. He or she may complain of having a virus or the flu. Others may be sober for long periods and then go on a drinking binge that lasts for weeks or months.

People who are dependent on alcohol may have withdrawal symptoms, such as sweating and feeling sick to their stomach, feeling shaky, and feeling anxious. In rare cases, severe symptoms of withdrawal can occur such as delirium tremens, or DTs. Treatment for withdrawal from alcohol requires medical care.

Drugs

People who have a drug problem may use a number of substances. They may use illegal drugs-such as marijuana, methamphetamines, cocaine, heroin, or other "street drugs." Or they may misuse legal prescription and non-prescription drugs. Some people use drugs to get a "high" or to relieve stress and emotional problems. Many people use more than one illegal substance at a time.

Club drugs, like ecstasy (MDMA), and date rape drugs, such as gamma-hydroxybutyrate (GHB), flunitrazepam (Rohypnol), and ketamine, are often used at all-night dances, raves, or trances. These drugs can be dangerous, especially in overdose or when combined with other drugs or alcohol. Inhalants like nitrous oxide may also be used at these clubs.

Drugs come in different forms and can be used in different ways. They can be smoked, snorted, inhaled, taken as pills, put in liquids or food, put in the rectum or the vagina, or injected with a needle.

Prescription medicines that may be misused include opioids (morphine and codeine), diazepam (Valium), hydrocodone (Hycodan), methylphenidate (Ritalin), and oxycodone (OxyNEO).

Some non-prescription medicines, such as cold medicines that have dextromethorphan as an ingredient, are being misused as a way to get high. What effects these drugs may have on your health depend on the type, strength, and amount of these drugs you use and whether you take them with illegal drugs or alcohol. The use of prescription and over-the-counter medicines with alcohol or illegal drugs may increase the effects of each substance. Glue, shoe polish, cleaning fluids, and aerosols are common household products with ingredients that are also being used to get high.

Signs of a drug problem depend on the drug you use and how that drug affects you. Not all drugs affect people the same way. One of the signs that your drug use may be becoming a problem is that you take more of a drug over longer periods of time and need more of the drug to feel "high." Another sign is that you spend a lot of time trying to get the drug, and you give up other activities to do this. When you have a drug problem, you or others may notice some changes in your behaviour. You may be moody, have problems sleeping, or pay less attention to how you dress or look. Or you may lie, steal, or hide things from people and act sneaky.

You may have a drug problem if your drug use affects your health or daily activities. You may be dependent on drugs if you physically or emotionally need drugs to get you through your day. You may not be aware that you have become dependent on a drug until you try to stop taking it. People who are dependent on drugs may have withdrawal symptoms, such as sweating and feeling sick to their stomach, feeling shaky, and feeling anxious.

Drug problems in older people may go unnoticed, since the signs may be similar to those of aging. Older adults often take medicines, such as sleep medicines and painkillers, that can lead to a drug problem.

Health risks of alcohol and drug use

When you use alcohol or drugs, you may be putting your health and safety at risk.

Alcohol or drug use can:

  • Make car crashes more likely. If you drink and drive, or if you drive while you are high, you can easily hurt yourself or others.
  • Lead to unprotected sex and/or sexual assault. This can lead to pregnancy and sexually transmitted infections (STIs), including HIV.
  • Increase the risk of overdose, injury, and death.
  • Cause you to do things you wouldn't usually do. You may say things that hurt your friends. Or you may do something illegal that could result in paying a large fine or going to jail, like being arrested for driving while intoxicated.
  • Affect your work or schoolwork. It can cause you to lose your job or drop out of school.
  • Change how you feel about your life. It can lead to depression and suicide.
  • Cause mood swings and affect your sleep and your ability to think, learn, reason, remember, and solve problems.
  • Harm many organs and systems in the body, such as the liver, pancreas, heart, brain, and nervous system.
  • Contribute to the development of some cancers, such as cancers of the mouth, throat, esophagus, liver, colon, and breast.
  • Cause high blood pressure, stomach problems, or sexual problems.
  • Cause harm to a developing baby (fetus) if alcohol or drugs are used during pregnancy.

Recognizing a problem

Alcohol

Alcohol is part of many people's lives and may have a place in cultural and family traditions. So it can sometimes be hard to know when you begin to drink too much.

You're at risk of drinking too much if you are:

  • A man who has more than 3 standard drinks a day on most days, or more than 15 drinks a week.
  • A woman who has more than 2 standard drinks a day on most days, or more than 10 drinks a week.

Drugs

You may not feel that using drugs can become a problem. Maybe you feel that you're a casual user because you use drugs only now and then. But drug use can quickly become a habit and start to affect your life.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

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
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 light-headed 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?
Yes
Loss of consciousness in past 24 hours
No
Loss of consciousness in past 24 hours
Are you thinking seriously of committing suicide or harming someone else right now?
Yes
Thinking seriously of committing suicide or harming someone else
No
Thinking seriously of committing suicide or harming someone else
Did you have a seizure after using alcohol or drugs?
Yes
Seizure
No
Seizure
Do you think you are having withdrawal symptoms?
Withdrawal symptoms are the physical problems and emotional changes you may have when you suddenly stop using a substance that you are dependent on.
Yes
Withdrawal symptoms
No
Withdrawal symptoms
Are the withdrawal symptoms severe or mild?
Severe
Severe withdrawal symptoms
Mild
Mild withdrawal symptoms
If you are answering for someone else: Are you concerned that the person is drunk or high and needs medical care now?
Yes
Person is intoxicated and may need medical evaluation
No
Person is intoxicated and may need medical evaluation
Does your use of alcohol or drugs affect your behaviour?
Yes
Use of alcohol or drugs affects behaviour
No
Use of alcohol or drugs affects behaviour
Have you ever hurt a child or intimate partner while using alcohol or drugs?
Yes
Has hurt a child or partner while using alcohol or drugs
No
Has hurt a child or partner while using alcohol or drugs
Do you need alcohol or drugs to help you get through the day?
Yes
Need alcohol or drugs to get through day
No
Need alcohol or drugs to get through day
Are you pregnant?
Yes, you know that you're pregnant.
Pregnancy
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 and natural health products 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 can't 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.

Being dependent on alcohol or drugs means that you have a physical or emotional dependence on the substance. When you are dependent on a substance:

  • You are not able to stop using the substance even if you try.
  • You may feel that you should cut down, but you continue to use the substance even though it causes problems in your life.
  • You may have physical signs of dependence. These are different depending on the substance, but they can include problems like:
    • Blackouts, which cause you to not remember what happened.
    • Stomach 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 behaviour. 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.
  • If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

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.

Home Treatment

Keep in mind that most people who drink alcohol or use drugs don't develop a substance use problem. Many people who want to cut back on or stop using alcohol or drugs are able to do so on their own. But others may need help.

If you're worried about your health and want to reduce your alcohol or drug use, ask your family, friends, or doctor for help. Or you could join a support group such as Alcoholics Anonymous (AA), or Narcotics Anonymous (NA). Your family members might want to attend a support group such as Al-Anon, Alateen, or Nar-Anon.

In some provinces, there are telephone helplines you can call for support and to find out what resources are available in your area that can help you manage your alcohol or drug problem.

    • Alberta: Addiction Helpline, 1-866-332-2322 (toll-free)
    • British Columbia: Alcohol and Drug Information and Referral Service, 604-660-9382 (Greater Vancouver) or 1-800-663-1441 (toll-free)
    • Saskatchewan: See the Directory of Alcohol and Drug Treatment Services online at www.health.gov.sk.ca/treatment-services-directory for a phone number in your area.
    • Other provinces: Call your local telephone information line or check the phone book to find out if there is a helpline you can call in your area.

If you're still finding it hard to reduce your alcohol or drug use on your own, or if these support services don't help, you may need medical help. This is especially important if you have withdrawal symptoms when you try to cut back on or stop using alcohol or drugs. Symptoms of withdrawal may include sweating and feeling sick to your stomach, feeling shaky, and feeling anxious.

Talk with your doctor about whether you need treatment for your alcohol or drug problem. In many cases, treatment may focus on helping you reduce your alcohol or drug use to levels that are less harmful rather than stopping completely. You and your doctor can decide what treatment approach is best for you.

Have a healthy lifestyle

When you drink alcohol or use drugs, you often get away from some of the basics of good health. This is also true for young people who use these substances.

Here are some things you can do to stay healthy:

  • Be active. Try to get 30 minutes of activity or more on most days of the week. Being active not only helps you stay healthy and strong but can also help you better deal with stress and anxiety. And it gives you something to do instead of using alcohol or drugs.
  • Get enough sleep. Sleep is important for your physical and emotional health. Sleep may help you stay healthy by keeping your immune system strong. Getting enough sleep can help your mood and make you feel less stressed.
  • Eat a balanced diet. This helps your body deal with tension and stress. Whole grains, dairy products, fruits, vegetables, and protein foods are part of a healthy diet.
  • Find things to do instead of using alcohol or drugs, such as sports or volunteer work.
  • Meditate. It helps you feel calm and can give you a clearer awareness about your life.

Symptoms to watch for during home treatment

Call your doctor if your alcohol or drug use becomes more frequent or worse.

Harm-Reduction Strategies

It's important to remember that drinking alcohol or using drugs can affect your health and isn't risk-free. This is especially true for young people who use alcohol or drugs, because these substances can affect their general health, physical growth, and emotional and social development. The risk of harm from using alcohol or drugs increases with each drink that you have or drug that you use, how often and for how long you drink or use drugs, the type and strength of any drug used, and the method of use.

Although there is no amount of alcohol or drug use that is safe, there are some things you can do to reduce your risk of serious health problems and injuries caused by alcohol or drug use.

Ways to reduce harm from substance use

Reducing harm from any substance

    • Avoid risky situations and activities. Don't drink or get high and drive, and don't get in a car with a driver who has been drinking or using drugs.
    • Make a plan to get home safely. For example, choose a designated driver, have money to pay for a taxi or bus fare, or call a loved one for a safe ride home.
    • Don't take over-the-counter or prescription medicines that interact with alcohol. And don't take these medicines with illegal drugs or other harmful substances.
    • Don't use alcohol or drugs if you're pregnant or trying to get pregnant. These substances can increase your baby's chance of being born with a birth defect or fetal alcohol spectrum disorder.
    • Don't mix alcohol with illegal drugs or other harmful substances.
    • Don't use alcohol or drugs to try to make yourself feel better. Using alcohol or drugs may make your problems worse and may cause you to do things that you normally wouldn't do, like hurt yourself or others.
    • Be aware at all times of your surroundings and the people around you.
    • Limit how much you use alcohol or other substances. The more you use, the greater the risk of getting sick, hurt, or in trouble.

Reducing harm from alcohol

  • Have a meal or a snack with a drink. Don't drink on an empty stomach.
  • Drink slowly. Don't have more than 2 standard drinks in any 3-hour period.
  • Have a glass of water or other non-alcoholic, caffeine-free beverage (such as a soft drink or fruit juice) between drinks.

Reducing harm from drugs

  • Ask your pharmacist or doctor whether any of your current medicines can cause dependence.
    • Be especially aware of pain medicines (such as opioids), tranquilizers, sedatives, and sleeping pills. Follow the instructions carefully, and do not take more than the recommended dose.
    • Make sure that your doctors are aware of medicines prescribed by another doctor. Use only one pharmacy when getting your prescriptions filled.
  • Don't share needles, syringes, and other equipment (such as cookers, cotton, cocaine spoons, or eyedroppers) with others if you use drugs. Be aware of who you get your supplies from. Be sure the supplies haven't been used before. If you use dirty needles or equipment, you can get hepatitis, HIV, or other serious infections.
  • Be aware of who you get your drugs from. Drugs can vary greatly in strength depending on who you get them from.
  • Be aware of how a drug might affect you, especially if you stopped using the drug and then started using again. You may not be able to handle the same amount of the drug as you could before.
  • Don't leave your beverage unattended or accept a drink from an open container.
  • Create a safe environment. If you use drugs, make sure you do it in a place where other people are around so you can get help if you need it.

Helping someone who is using alcohol or drugs

If you know someone who puts himself or herself in situations where risky drinking or drug use is going to occur (such as at a bar or party), here are some things you can do to help reduce that person's risk of harm. You can:

  • Take the person's car keys so he or she won't drive after drinking or while high on drugs.
  • Remove sharp objects and glassware from dance and party locations so the person won't hurt himself or herself or others.
  • Provide water so the person doesn't get dehydrated.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • How often do you drink or use drugs? What drugs do you use?
  • Do you use alcohol and other drugs, both prescription and non-prescription, at the same time?
  • Do you sometimes drink or use more than you mean to?
  • What types of alcohol or drugs do you use? How much do you use each day?
  • Do you drink or use drugs when you feel "stressed"?
  • Do you drink or use drugs when you are alone?
  • Can you drink or use more of a certain drug now than you used to be able to?
  • Have you tried to cut back on your drinking or drug use, but were unable to?
  • Have you had a drink or used drugs today?
  • How old were you when you first used alcohol or drugs?
  • When did you use the highest dosage of alcohol or drugs in your life?
  • Have you ever had a blackout while drinking or using drugs?
  • Is alcohol or drug use causing problems with your work, with your school, or in your family?
  • Have you ever been treated for a seizure or an irregular heartbeat?
  • How often have you changed jobs in the past 5 years?
  • Does anyone else in your immediate family have an alcohol or drug problem?
  • Have your family or friends ever told you they thought you had a problem with alcohol or drugs?
  • Have you ever been treated for a similar problem in the past?
  • Have you or anyone else in your family ever been treated for depression?
  • Have you ever thought about or attempted suicide?
  • Have you ever tried to harm yourself or thought of suicide while drinking or using drugs?
  • Have you ever abused a child or an intimate partner while using alcohol or drugs?
  • Have you ever been hospitalized for a drug or alcohol problem? If so, be prepared to discuss the details with your doctor.
  • What prescription and non-prescription medicines do you take? Bring a complete list with you to your appointment.
  • Do you have any health risks?

Other Places To Get Help

Organizations

Canadian Centre on Substance Abuse
www.ccsa.ca
Centre for Addiction and Mental Health (Canada)
www.camh.ca

References

Other Works Consulted

  • Ewing JA (1984). Detecting alcoholism: The CAGE questionnaire. JAMA, 252: 1905-1907.

Credits

Adaptation Date: 12/3/2017

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

Adaptation Date: 12/3/2017

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC