Substance use refers to the use of alcohol, tobacco, cannabis, or other substances like prescription, illegal, or over-the-counter drugs.
Substance use comes in many forms and can range from someone having an occasional glass of wine at a social event to developing a long-term dependence. Regardless of the reason or type of substance used, there are serious risks that can result from progressing along the continuum from occasional use to problematic use. A substance use problem results from using any substance in a way that is harmful to you or that leads you to harm others, like family or friends.
Addiction involves a mental or physical dependence on a substance. Mental dependence may include thoughts about and cravings for the substance. Physical dependence is when a person needs the substance to function normally. In cases of physical dependence, it is common that negative symptoms of withdrawal will occur when a person stops using the substance, such as sweating, anxiety, or tremors.1 Substance use disorder (SUD), is a clinical term used when a person has a formal diagnosis of a problematic use of a substance. Substance use disorders develop as result of complex biological, psychological, social, and environmental factors that can affect a person’s path from substance use to a substance use disorder or addiction.
There are two important signs that a person’s substance use might already be a problem. Harmful consequences, such as injuries while under the influence, blackouts, missing work due to a hangover, legal or relationship problems, and feeling anxious or hopeless, may indicate that there is a problem. The loss of control, such as using more than intended or in situations where they did not want to use, is another sign there may be an issue2
The decision to seek help is a personal choice, but people often look for help when the negative effects of substance use become stronger than the positive effects they experience.
A good place to start is by talking with a healthcare provider or by calling ConnexOntario (1.866.531.2600). This is a free and confidential service for people experiencing problems with gambling, drugs, alcohol, and/or mental health illness and may be a helpful first point of contact for those looking for help for himself or herself, or a family member or friend.
Here is a quick tool that is widely used to assess if a person may have a problem.
When thinking about alcohol or drug use, including illegal drug use and the use of prescription drugs other than as prescribed:
- 1. Have you ever felt you ought to Cut down on your drinking or drug use? YES NO
- 2. Have people Annoyed you by criticizing your drinking or drug use? YES NO
- 3. Have you felt bad or Guilty about your drinking or drug use? YES NO
- 4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (Eye-opener)? YES NO
Each YES response earns one point. One point indicates a possible problem. Two points indicate a probable problem.
 Health Canada. (2017). Information about substance abuse. Retrieved from https://www.canada.ca/en/health-canada/services/substance-abuse/about-substance-abuse/about-substance-abuse.html
 Centre for Addiction and Mental Health. (2010). Addiction: An information guide. Retrieved from https://camh.ca/-/media/files/guides-and-publications/addiction-guide-en.pdf
 Brown, R. L., & Rounds, L. A. (1995). Conjoint screening questionnaires for alcohol and other drug abuse: Criterion validity in a primary care practice. Wisconsin Medical Journal, 94 (3), 135-140.