How substance use disorder often begins

Oct. 6, 2022
Arrogant teenager sitting at a meeting of support group while his therapist is talking about the beginning of substance abuse..
Understanding how substance abuse begins can help you and your loved ones address the stressors that may lead to substance use disorders. Photo: Getty Images.

Life can be stressful.

Whether you’re dealing with the loss of a loved one, are having financial struggles or are trying to fix a broken relationship, there’s no shortage of stressors people can face. Some who are struggling, however, turn to drugs or alcohol for comfort, which can be the beginning of a substance use disorder.

“Often, the problems in our life can’t be resolved or fixed, and that lack of control can leave us feeling confused, disoriented and stuck,” said Amy Goodwin, a licensed professional counselor and behavioral health counselor at UCHealth Behavioral Health Clinic in Steamboat Springs. “Finding ways to manage unmanageable situations can take time. Substances can give us the illusion that we are relieving our stress or distress without altering or evolving our behavior.”

When people turn to substances as a way to tolerate stress, they can face a serious cost.

“Substance abuse robs us of our innate abilities to take care of ourselves and others,” Goodwin said.

A photo of Amy Goodwin
Amy Goodwin

Physical and mental impacts of substance abuse

“Right there, in the word intoxication, we have a clue about how damaging drugs can be,” Goodwin said. “By definition, once intoxicated, we are now altering our body and brain in unhealthy ways.”

Substances such as alcohol, nicotine, marijuana and cocaine change the production of natural brain chemicals, which in turn impact the central nervous system, organ function and more.

Heavy substance use can cause or exacerbate mental health conditions such as depression, anxiety, post-traumatic stress disorder and insomnia, and can also impact memory, the ability to bond with others, impulse control, and communication and problem-solving skills.

Various health conditions are also associated with substance use disorders, including hypertension, cardiovascular diseases, chronic dehydration, cancer, liver failure, and stomach and digestive issues.

How does a substance use habit start?

“The human body is incredibly effective at letting us know when we are treating it poorly,” Goodwin said. “Hangovers are a wonderful example of our brain and body asking us not to overindulge.”

But to pay attention to the body’s signals, we have to be able to hear them. When someone is abusing substances, those warning signals become easier to ignore or even meaningless.

“The brain and body will start to increase the production of chemicals to balance us back out if we use drugs on a regular basis (drug abuse), so we develop tolerance to the drugs we are using,” Goodwin said. “We feel worse when not using as the body is again out of balance.”

For instance, alcohol causes the brain to over-release pleasure chemicals such as dopamine.

“That allows us to feel a sense of euphoria: things become ‘fun’ that may not have been all that great otherwise,” Goodwin said. “But the more we over-spend our dopamine, the less we have for day-to-day functioning. We can feel like life has become ‘boring’ and we now need alcohol to feel playful and to keep things pleasurable.”

Is it common to abuse more than one substance?

Yes. For instance, using increasing amounts of alcohol (alcohol abuse) to get the same pleasure can chemically bankrupt the body, and someone may turn to another drug – such as cocaine, amphetamines, or nicotine – to provide a stimulant.

“It is not uncommon for people to begin to self-medicate the chemical imbalance they are inadvertently causing through their drug use,” Goodwin said.

Who is most at risk for substance use disorders?

In a word, anyone.

“There is no one demographic that seems more at risk than another,” Goodwin said. “The single most predictive factor for substance abuse is some experience with trauma, meaning high-stress exposure without the developed tools to manage the stress.”

How has the pandemic impacted substance abuse?

An increase in opiate-related overdoses and higher sales of legal, recreational drugs point to increased substance use disorder during the last two years. That trend isn’t surprising to Goodwin given the fear, stress and disruption to regular routines that the pandemic caused.

“We often build coping strategies into our daily routines,” Goodwin said. “When those routines were disrupted by quarantine restrictions, many people lost their stress outlets, and we were left unprepared to manage stress in a radically different way.”

This story first appeared in the Steamboat Pilot.

About the author

Susan Cunningham lives in the Colorado Rocky Mountains with her husband and two daughters. She enjoys science nearly as much as writing: she’s traveled to the bottom of the ocean via submarine to observe life at hydrothermal vents, camped out on an island of birds to study tern behavior, and now spends time in an office writing and analyzing data. She blogs about writing and science at