It’s not always easy to recognize when substance use has become a problem. It’s not just about how often or how much you drink or use drugs—what matters most is the effect it has on your life. If you’ve tried to stop but haven’t been able to, or if others have expressed concern about your use, it may be time to take a closer look.

According to the DSM-5, substance use disorders range from mild to severe, with 11 key signs that indicate a problem. Meeting three or more suggests a moderate disorder, while six or more indicates a severe disorder. Some of these include:

• Cravings that make it hard to focus on anything else.

• Spending a lot of time using or recovering from substance use.

• Trying to cut back or quit but being unable to stop.

• Using even when it causes problems in relationships, work, or health.

• Needing more of the substance over time to get the same effect.

• Experiencing withdrawal symptoms when not using.

• Neglecting responsibilities because of substance use.

• Giving up activities or hobbies to prioritize drinking or drug use.

• Continuing to use despite social or personal consequences.

• Engaging in risky behavior while under the influence.

• Health issues related to substance use but continuing anyway.

Understanding the Difference Between Substance Use and Addiction

It’s not always easy to tell when substance use has crossed the line into addiction. It’s not just about how often you drink or use drugs, but how it affects your life. Many factors play a role, including age, overall health, what substances are being used together, and whether attempts to cut back have been unsuccessful.

Some key signs that substance use may be turning into addiction include:

• Using more than intended

• Struggling to cut back

• Spending excessive time on substance use

• Experiencing strong cravings

• Neglecting responsibilities

• Continuing use despite relationship problems.

• Losing interest in other activities

• Engaging in risky behavior

• Ignoring health issues

• Needing more to achieve the same effect

• Experiencing withdrawal symptoms

If you’ve noticed these patterns in yourself or someone you care about, it may be time to take a closer look and consider seeking help.

Understanding Addiction as a Medical Condition

Addiction is recognized as a medical condition that can worsen over time if left unaddressed. It is not simply a lack of willpower or a bad habit—it involves changes in the brain that make it harder to stop. While addiction can be serious, treatment and recovery are possible.

Some key characteristics of addiction include:

• It is ongoing

• It often progresses

• It can be managed

How Drug Use Affects the Brain

Substance use alters key areas of the brain, affecting emotions, decision-making, and the ability to experience pleasure. Over time, these changes can make it harder to stop using, as the brain adapts to repeated exposure. Three primary areas impacted by drug use include:

• Basal Ganglia (The Brain’s Reward System): This region is responsible for feelings of pleasure and motivation, reinforcing life-sustaining activities like eating and social interaction. Drugs can overstimulate this system, making natural rewards feel less satisfying. As substance use continues, the brain’s ability to experience pleasure without the drug diminishes, leading to compulsive drug-seeking behavior.
  
  

• Extended Amygdala (The Brain’s Stress Center): This area regulates stress, anxiety, and discomfort, which intensify during withdrawal. With ongoing substance use, this region becomes hypersensitive, leading to heightened feelings of unease when not using. As a result, people may continue using drugs, not to get high, but to avoid withdrawal symptoms and emotional distress.
  
  

• Prefrontal Cortex (The Brain’s Control Center): This part of the brain manages decision-making, impulse control, and judgment. Because it develops last, young people are especially vulnerable to risky behaviors, including substance use. Drug use weakens this area, making it harder to resist cravings and increasing impulsive, compulsive behaviors.

The Impact of Drug and Alcohol Use on Health

Long-term substance use can have serious, and sometimes irreversible, effects on physical and mental health. While the risk of overdose is one of the most immediate dangers, ongoing drug or alcohol use can lead to a range of health complications. Some of these risks are widely recognized—such as the link between smoking and cancer, the damage excessive drinking can cause to the liver, and the risk of contracting diseases like hepatitis C or HIV from intravenous drug use.

However, other long-term consequences may not be as well-known. Depending on the substance used, the following health issues may develop:

• Heart disease and high blood pressure

• Stroke

• Memory problems and cognitive decline

• Chronic respiratory conditions, such as bronchitis or asthma

• Severe digestive issues, including chronic constipation and bowel damage

• Complications from fetal alcohol exposure

• Mental health concerns, such as anxiety, depression, or psychosis

Substance use doesn’t just harm physical health—it can also worsen existing mental health conditions. Anxiety, PTSD, and depression may intensify with ongoing substance use, just as mental health struggles can lead to increased drug or alcohol use. The most effective approach to treatment addresses both addiction and any co-occurring mental health conditions at the same time.

Taking the First Step Toward Getting Help

The first step in addressing addiction is learning about the options available. Whether you're considering help for yourself or a loved one, understanding what resources exist can make the process feel less overwhelming. The right approach will depend on individual circumstances, but a good starting point is a professional assessment.

A confidential self-assessment can help determine whether substance use has become a problem. Many online tools provide initial insight, but a formal evaluation with a doctor or addiction specialist can offer a clearer path forward. In many cases, family and friends play a key role in recognizing the issue and helping someone seek support. If you're concerned about a loved one, you can take a preliminary assessment on their behalf and explore available treatment options together.

For those looking for trusted resources, the following organizations provide valuable information and support:

• Alcoholics Anonymous (AA)

• Narcotics Anonymous (NA)

• Substance Abuse and Mental Health Services Administration (SAMHSA)

• National Institute on Drug Abuse (NIDA)