The Drug Epidemic

Substance use disorder (SUD) affects millions of lives. By understanding it, we can help break the cycle and support recovery.

SUD is a complex, treatable condition. Learn the facts, dispel the myths, and find hope

  • The drug epidemic impacts people in many ways, and overdoses can happen to anyone. Some are the result of accidental exposure, others involve medications prescribed by a doctor, and some happen to those experimenting for the first time. Every story matters, and every life lost deserves to be honored, regardless of the circumstances.

  • The American Society for Addiction Medicine (ASAM) defines substance abuse disorder as a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. 

    Simply put — substance abuse disorder is a treatable, long-term medical condition caused by complex interactions between the brain, genetics, environment, and life experiences. It leads people to use substances or engage in behaviors compulsively, even when it causes harm.

  • Substance abuse disorder changes how the brain works, especially in areas that control rewards, decisions, and emotions. These changes make it hard to stop using substances, even when someone wants to. Here's how it works:

    1. Reward System (Dopamine Pathway):

      • What it does: This system helps us feel pleasure and encourages behaviors that make us happy, like eating or spending time with loved ones.

      • How addiction affects it: Substances like drugs or alcohol cause a flood of dopamine, which feels really good. Over time, the brain adjusts and starts to expect the substance to feel pleasure, making everyday activities less rewarding.

    2. Prefrontal Cortex (Decision-Making and Self-Control):

      • What it does: This part of the brain helps us make choices, solve problems, and control impulses.

      • How addiction affects it: Substance use weakens this area, making it harder to resist cravings or think about long-term consequences.

    3. Amygdala (Emotions and Triggers):

      • What it does: The amygdala processes emotions and forms strong memories, especially those linked to pleasure or fear.

      • How addiction affects it: Triggers like seeing a place or person connected to substance use can activate the amygdala, creating strong cravings.

    How the Process Works:

    1. Dopamine Flood: Substances cause a huge release of dopamine, creating intense feelings of pleasure.

    2. Tolerance: Over time, the brain needs more of the substance to get the same "high."

    3. Dependence: The brain starts relying on the substance to feel normal.

    4. Cravings: Triggers like stress or memories of using can cause powerful urges to use again.

    5. Weakened Control: The prefrontal cortex struggles to override these urges, making it harder to quit.

    Why It’s Important to Understand:

    These brain changes show that addiction isn’t just about making bad choices. It’s a medical condition that affects how the brain works, and it often requires treatment and support to overcome.

    Citation: Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 2, THE NEUROBIOLOGY OF SUBSTANCE USE, MISUSE, AND ADDICTION. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424849/

    • Genetics: Some people are more likely to develop substance abuse disorder because of family history.

    • Environment: Stressful or traumatic events, peer pressure, or availability of substances can increase the risk.

    • Mental Health: Conditions like anxiety, depression, or PTSD often make people more vulnerable to substance abuse disorder.

    ————————————————

    Imagine substance abuse disorder as a tree.

    Genetics are the roots—a foundation you don’t see but plays a big role.

    Environment is the soil—the circumstances that make growth more likely.

    Mental health challenges are the rain—adding extra pressure that feeds the problem.

    ——————————————-

    Citation: Substance Abuse and Mental Health Services Administration. (2019). Risk and protective factors for mental, emotional, and behavioral disorders across the life cycle. Retrieved from https://www.samhsa.gov/sites/default/files/20190718-samhsa-risk-protective-factors.pdf

  • Substance abuse disorder can show up in different ways. Here’s what to look for:

    Physical Signs:

    • Weight changes, poor hygiene.

    • Withdrawal symptoms like shaking, sweating, or nausea.

    Behavioral Signs:

    • Secretive behavior or lying.

    • Ignoring responsibilities at work, school, or home.

    Emotional Signs:

    • Sudden mood swings or irritability.

    • Increased anxiety, depression, or hopelessness.

  • Recovery is possible! Many people go on to live happy, healthy lives with the right treatment and support.

    • Treatment often includes therapy, medication, and support groups.

    • Recovery looks different for everyone, but it’s always worth it.

    • Relapse doesn’t mean failure—it’s a step in the process.

  • Offer non-judgmental support, encourage seek help, and educate yourself on substance abuse disorder. Meet them where they’re at.

Myths and Misconceptions

  • Myth 1: Substance abuse disorder is a choice.

    Substance abuse disorder may start with a choice to use a substance, whether illicit or prescription, but it becomes a medical condition that changes how the brain works. Over time, the brain’s reward system gets hijacked, making it incredibly hard to stop, even when someone wants to.

  • Myth 2: People with substance abuse disorder just need more willpower.

    Fact: Substance abuse disorde is not about weak willpower. The changes in the brain caused by substance use disorder affect self-control, making it difficult to resist cravings. Recovery requires support, treatment, and time.

  • Myth 3: Only weak people get Substance abuse disorder.

    Fact: Substance abuse disorder doesn’t discriminate. It can happen to anyone, regardless of age, gender, race, or income. Factors like genetics, environment, and mental health can increase the risk, but substance use disorder isn’t limited to one type of person.

  • Myth 4: People with substance abuse disorder could quit if they really wanted to.

    Fact: Quitting is not just a matter of wanting to stop. The brain’s dependency on the substance causes withdrawal symptoms and intense cravings that are often impossible to manage without professional help. There is help available if you are struggling. Learn More

  • Myth 5: Relapse means failure.

    Fact: Relapse is a normal part of recovery for many people. It doesn’t mean someone has failed; it means they need continued support and possibly a new approach to their treatment.

  • Myth 6: Treatment doesn’t work unless the person wants it.

    Fact: People don’t always seek treatment because they want to; often, they are encouraged or required to by family, employers, or the legal system. Many of these people still find recovery through treatment.

  • Myth 7: If someone relapses, they didn’t try hard enough.

    Fact: Substance use disorder is a chronic condition, like diabetes or heart disease, which means it requires ongoing management. Relapse is a sign that treatment needs to be adjusted, not that the person failed.

  • Myth 8: People with substance abuse disorder are bad people.

    Fact: Substance abuse disorder is a medical condition, not a moral failing. People struggling with SUD are often in immense pain and deserve compassion and support, not judgment.

  • Myth 10: Medications like methadone or buprenorphine just replace one substance with another.

    Fact: Medications used in substance abuse disorder treatment (Medication-Assisted Treatment or MAT) don’t create a “high.” They help stabilize the brain and reduce cravings so the person can focus on recovery.

  • Myth 11: Anyone who overdoses is an addict

    Overdoses can happen to anyone. Not all overdoses are linked to substance use disorder (SUD). Some occur due to accidental exposure to substances like fentanyl, medication errors, or experimentation. Others involve individuals who were prescribed medications or used drugs recreationally without a history of substance use disorder. Every life lost in the drug epidemic matters, and it's important to recognize the diverse circumstances behind these tragedies.

Evidence-Based Treatment Options

Here’s an overview of the most effective, evidence-based treatments for substance use disorder, each addressing different aspects of recovery:

    • What It Is:
      MAT combines medications with counseling and behavioral therapies to treat substance use disorders, particularly opioid and alcohol use.

    • Common Medications:

      • Buprenorphine: Reduces withdrawal symptoms and cravings for opioids.

      • Methadone: Helps manage opioid dependency by reducing cravings and blocking the effects of other opioids.

      • Naltrexone: Prevents the "high" from alcohol or opioids and reduces relapse risk.

    • How It Works:
      These medications stabilize the brain’s chemistry, block the euphoric effects of substances, and ease withdrawal symptoms, making it easier to focus on recovery.


      MAT is not substituting one disorder for another. It’s a tool to help people manage their condition and rebuild their lives.

  • Behavioral therapies focus on changing harmful thought patterns and behaviors linked to substance use.

    • Cognitive Behavioral Therapy (CBT):

      • Teaches people to recognize triggers, manage stress, and replace negative behaviors with positive ones.

      • Effective for various addictions and co-occurring mental health conditions.

    • Dialectical Behavior Therapy (DBT):

      • A type of CBT that focuses on managing intense emotions, improving relationships, and reducing harmful behaviors.

      • Especially useful for people with addiction and underlying mental health issues like borderline personality disorder.

    • Behavioral therapies give people tools to manage cravings, cope with stress, and prevent relapse.

  • Support groups provide a sense of community and shared understanding, which can be a vital part of recovery.

    Find options here