Mental Health and Substance Use: a Delicate Dance

Overall well being is all encompassing and can be enhanced or diminished by choices and behaviors. One major contributing factor to mental health is whether one uses alcohol, marijuana and other addictive substances. A drink or two with friends on weekends or while relaxing after a taxing day can help a person relax; taking a low dose of a narcotic after major surgery is sometimes a necessity, but at what point does substance use become a problem?

Roughly 51.5 percent of Americans are regular drinkers, which means they have at least 12 or more drinks a year. Hazardous drinking is more than 7 drinks per week or more than 3 drinks per occasion for women, and more than 14 drinks per week or more than 4 drinks per occasion for men [U.S. Preventive Services Task Force 2004, p. 554].

Hazardous drinking reaches a harmful level when a person starts to experience physical, social, or psychological consequences from regular alcohol consumption [U.S. Preventive Services Task Force 2004, p. 554].

The key is to identify when recreational drug use and moderate drinking becomes a problem. A simple and straightforward gauge to measure if you or a loved one has an with drugs or alcohol is the CAGE screening:

  • Has one tried to Cut back on drinking or drug use and has been unable?
  • Have others grown Angry at the person’s drinking or drug use?
  • Does one feel Guilty about their alcohol or drug use?
  • Has one drank alcohol or used drugs in the morning as an Eye opener to soothe a hang-over or prevent withdrawal symptoms?

In terms of prescribed narcotics, taking more than directed could be indicative of a problem. With the recent legalization of marijuana, prevalence has risen, and data around safe use is still developing.

During the pandemic and its associated stress, people’s use of substances has gone up. As we start to move slowly into restoration (we hope) it is a good time to assess some of the harmful coping mechanisms we employed–such as drinking more than we want. Cutting back is an option for many. For those with a family history of substance use, and with co-occurring mental health conditions, such as anxiety, depression and trauma, more formal help may be indicated.

Help for addiction can take many forms: from mutual support groups, such as Alcoholics Anonymous, to more structured outpatient treatment or inpatient treatment. Like many issues, in order to change, the person seeking help needs to acknowledge that they have a problem. The good news is that people can and do get better!

National Institute of Alcohol and Alcoholism (NIAAA). pubs.niaaa.nih.gov

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