Understanding Substance Use and Addiction: Mental Health Issues, Not a Moral Failing

May is Mental Health Awareness Month, a time to shed light on the complexities of mental health and the challenges faced by those who struggle with various conditions. We’re going to specifically focus on substance use and addiction as an often misunderstood issue. It's time we recognize addiction for what it truly is: a mental health challenge deserving of our understanding, empathy, and support.

What is addiction?

Addiction is not merely a lack of willpower or a choice someone makes. It is a complex brain disorder characterized by compulsive substance use despite harmful consequences. Whether it's drugs, alcohol, gambling, shopping, eating, or even technology (hi doomscrolling), addiction hijacks the brain's reward system, leading to uncontrollable behaviors and cravings.

At its core, addiction shares many similarities with other recognized mental illnesses. Like depression or anxiety, it can stem from genetic predispositions, trauma, environmental factors, or a combination of factors. Yet, despite the overwhelming evidence stating that substance use, misuse, and addiction is a mental health issue, stigma continues to cloud public perception.

In addition to therapy, inpatient, outpatient, and 12-step programs exist to support folks depending on the severity of dependence on alcohol/substances or desire to moderate. These programs offer structured support and therapy sessions. Many different programs exist to support both the maintenance of moderation and abstinence, like Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery, Moderation Management, and Al-Anon/Alateen, among others.

What if I don’t think I am addicted, but I still think my drinking or drug use might be a problem?

For a lot of people, drugs and alcohol start out as casual and fun, something you do socially or at parties. But if somewhere along the way, they became a crutch for you to lean on when things were tough, and now it feels like the substances are controlling you instead of the other way around, it might be time to address your habits. If the thought of quitting completely feels overwhelming, know that there are other ways to reduce the impact of your substance use on you and those around you.

Harm Reduction

Harm reduction is a relatively new approach in helping people who use drugs and alcohol. It includes mental health and other drug treatment, taking into account that people may not be ready to totally abstain but still can and should receive support in whatever way they are interested. Harm reduction helps you to make healthier decisions, and can be part of larger work towards helping you achieve total abstinence, if that is a goal.  

Breaking the Stigma

The stigma surrounding addiction as a whole is pervasive and damaging. It manifests in the form of judgment, discrimination, and shame, preventing people from seeking the help they desperately need. When society views addiction as a moral failing rather than a medical condition, it erects barriers to treatment and perpetuates cycles of suffering.

Misconceptions About Addiction, Substance Use and Mental Health:

  1. Addiction is a moral failing: Contrary to popular belief, addiction is not simply a matter of weak willpower or lack of moral character. It is a complex brain disorder influenced by genetic, environmental, and neurobiological factors.

  2. Addiction is a choice: Addiction alters the brain's chemistry, leading to compulsive behaviors and cravings that are difficult to control. While individuals may initially choose to use substances, the development of addiction involves changes in brain circuitry that diminishes their ability to stop.

  3. Addiction only affects certain demographics: Addiction can impact anyone, regardless of age, gender, race, or socioeconomic status. It is a widespread issue that transcends societal boundaries and affects people from all walks of life.

  4. Treatment is always successful on the first try: Recovery from addiction is often a lifelong journey filled with ups and downs. Relapse is common and does not signify failure but rather a need for ongoing support and adjustment of treatment approaches. Many people refer to this stage as “in recovery” rather than “recovered” to acknowledge that commitment to recovery is an active process.

  5. Addiction is solely a behavioral issue: While addiction involves problematic behaviors, it is rooted in changes to the brain's structure and function. Understanding the neurobiological aspects of addiction is crucial for developing effective interventions and reducing stigma.

One of the most significant consequences of stigma is the reluctance to seek treatment. This reluctance to seek help only exacerbates the problem, leading to worsening health outcomes and increased societal costs. There are, however, many treatment options for those struggling with their substance use. 

How Will Therapy Help Me?

Professional therapists and counselors specializing in addiction can provide individualized support and coping strategies, all rooted in science and evidence. Our Clinical Director, Wendy Levine, LCSW, specializes in substance use and addiction, particularly with folks over 40 who are realizing they’ve been leaning on substances as a crutch and want to learn healthier ways to cope with the stress of their lives. 

As a social worker for the past 25 years, she brings deep expertise and training to your work together, leading with empathy and understanding to bring clients to their “a-ha” moments right when they need them most. There's no one-size-fits-all approach to managing substance use and you don't have to figure this out alone. Wendy will help you navigate your unique path to a healthier you. She’ll never judge, pressure you into stopping if you don’t want it, or set rigid rules.

Wendy will work with you to uncover the reasons behind your substance use and create a plan that fits your needs, whether you want to completely stop or just cut back. Addressing substance use isn't just about quitting. It's about understanding what you’ve been trying to avoid by numbing your feelings with substances. By healing the root cause, you'll gain true freedom – the kind that leads to lasting change. Together, you'll define what "healthy" means for you and create a plan to achieve and maintain it.

The Impact of Stigma on Family Members and Loved Ones

Stigma not only affects people experiencing addiction, but also their families and communities. Loved ones may experience guilt, embarrassment, or frustration, unsure of how to support their struggling family member without succumbing to judgment from others. This ripple effect reinforces the cycle of stigma, making it even more challenging to break free from its grip.

How to Support People You Love Who Suffer From Addiction

If you have friends or family members who have chosen a path of moderation or abstinence from alcohol, your support can make all the difference. Here are a few ways you can support your sober loved ones during the festive season.

Open Communication:

  • Encourage open and honest communication about your family member's decision to abstain or moderate alcohol. Create a space where they feel comfortable discussing their boundaries and concerns. Ask them nonjudgmental questions like, “Is there anything I can do to make things easier for you?” or “What’s your favorite non-alcoholic beverage that you’ve tried so far?”

Respect Their Choices:

  • Respect is key. If your friend or family member has chosen abstinence or moderation, support their decision without judgment. Avoid pressuring them to have "just one drink" and instead celebrate their commitment to a healthier lifestyle. Their choices have nothing to do with you, so if you feel comfortable in your drinking, you don’t need them to join you in order for you to have a good time.

Plan Alcohol-Free Activities:

  • Suggest and plan activities that don't revolve around alcohol. Whether it's a movie night, a game marathon, non-alcoholic events can be just as enjoyable and inclusive.

Provide Non-Alcoholic Options:

  • When hosting gatherings, ensure there are plenty of non-alcoholic beverage options available. Having a variety of enticing drinks reduces the focus on alcohol and ensures everyone can participate in toasting and celebrating.

Be Mindful of Triggers:

  • If your family member has identified specific triggers, be mindful of these and try to create an environment that minimizes potential challenges. This may include avoiding certain topics or situations.

Offer Supportive Words:

  • Share words of encouragement and express your pride in their commitment to a sober lifestyle. Your support can be a powerful motivator during times when they might feel tempted.

Educate Others:

  • If you're gathering with extended family or friends, help educate them about your loved one's choice to be sober. This can prevent unintentional pressure or uncomfortable situations. 

Get Support for Yourself: 

Addiction is not only hard on the person suffering, but for the people who love them too. There are options available for individual support, such as therapy with an addiction informed practitioner, or Al Anon, a 12 step program dedicated to supporting those whose loved ones suffer from addiction. 

As we observe Mental Health Awareness Month, let us remember that overreliance on substances is not a choice but a disease that requires compassion and support. By challenging stigma and promoting empathy, we can create a world where people struggling with addiction and substance use feel empowered to seek help and embark on a journey of healing and recovery. Together, we can break the chains of stigma and build a society that values the well-being of all its members, regardless of their struggles.

If you are struggling with anxiety or depression, we’re here to help. You can reach out to us today to schedule a consultation with one of our clinicians who can help you understand what you’re going through and find solutions to your difficulties.