All substance use comes with risk. Know the facts before letting substances take their toll on you and your family.

• Substance use—including marijuana, cocaine, methamphetamine, as well as prescription substance misuse and illicit opioids—among adults is on the rise.
• The COVID-19 pandemic has increased substance use.
• Different substances pose different dangers. Substance use can lead to dependence and addiction, injury and accidents, health problems, sleep issues, and more. Substances use affects you and those close to you. Know there is help.
• Do you or someone you know hide their substances?

The Risks are Real

The pressures on adults are real. Building careers, buying homes, getting married, having kids, and trying to do it all well comes with a lot of pressure. COVID-19 has magnified the stress. Some turn to substances to cope. Just because some substances are legal, doesn’t mean they are less dangerous.

Over time, the regular or habitual use of substances becomes a crutch and only adds to our stress levels. Substances can also cause other harms, including:

• Cocaine: Highly addictive, cocaine is involved in nearly one in five overdose deaths; its health effects include asthma, bowel decay, and increased risk of HIV.
• Methamphetamine (Meth): Meth causes devastating health effects, and sometimes death, even on the first try. Meth speeds up the body’s systems to dangerous levels. Chronic use creates anxiety, confusion, insomnia, paranoia, aggression, and more.
• Prescription and illicit opioids: Highly addictive, these substances are the top cause of overdose deaths; health effects include confusion, nausea, constipation, coma, and brain damage.
• Marijuana: Even though it is legal in many states, studies link marijuana use to various negative outcomes.

Before the risks become real and before substances turn your life—and your family—upside down, know there is help.

The Rise of Substance Use for Adults Ages 26-49

While young adults ages 18-25 have the highest rates of substance use across the board, substance use among adults ages 26-49 is on the rise:

• The percentage of adults, age 26 and older, using marijuana daily or almost daily has nearly doubled since 2015.
• Cocaine use and death rates have risen; cocaine-involved overdose rates in the U.S. have risen annually since 2012.
• Meth use is on the rise and overdose death rates climbed more than five-fold for those ages 25 to 54 between 2011 and 2018
• The nation remains in a prescription and illicit opioids crisis, as 81,230 substance overdose deaths occurred in the U.S.—the highest single year ever reported—in the 12 months ending in May 2020; most of the overdose deaths involved a prescription or illicit opioid.

Mental Illness and Substance Use in Young Adults

Entering adulthood can be an emotional time, but sometimes the ups and downs can mean something more.

• Millions of young adults are living with a mental or substance use concern and many either do not realize they have one or are not paying attention to the signs and not seeking help. In fact, of the 8.9 million young adults who reported having a mental illness in 2018, more than 2 in 5 went untreated and of the 5.1 million with a substance use disorder, nearly 9 in 10 did not get treatment.
• It is important to remember that asking for help is a normal part of life, and you should never feel like you have to take on the world alone. If you are concerned that you or someone in your life may be drinking too much, using substances, or dealing with mental illness, there are resources available to help.

Resources for Families Coping with Mental and Substance Use Concerns

Every family is unique, but all families share a bond that can be used to support one another during trying times.

• While there is no one-size-fits-all solution for helping a family member who is drinking too much, using substances, or dealing with a mental illness, research shows that family support can play a major role in helping a loved one with mental and substance use disorders.
• When a family member is experiencing a mental or substance use conceern, it can affect more than just the person in need of recovery. Evidence has shown that some people have a genetic predisposition for developing mental and substance use disorders and may be at greater risk based on environmental factors such as having grown up in a home affected by a family member’s mental health or history of substance use. Families should be open to the options of support groups or family therapy and counseling, which can improve treatment effectiveness by supporting the whole family.
• It is also important to remember that the unique challenges that come from helping a loved one with a mental or substance use concern can be taxing, so caregivers should take steps to prioritize their own health as well.
• Family members may be more likely to notice when their loved ones are experiencing changes in mood or behavior. Being able to offer support, family members can connect those in need with treatment, resources, and services to begin and stay on their recovery journey

The Case for Screening and Treatment of Co-Occurring Disorders

Many adults have a mental illness and a substance use disorder (co-occurring disorder). Integrated care is recommended.

• The presence of two or more disorders can complicate diagnosis and treatment. Integrating both screening and treatment for mental and substance use disorders leads to a better quality of care and health outcomes for those living with co-occurring disorders by treating the whole person.
• SAMHSA offers evidence-based resources to help providers screen, diagnose, and deliver integrated care to patients with co-occurring disorders.

Diagnosing and Providing Integrated Treatments

People with co-occurring disorders are more likely to be hospitalized than people with a mental or substance use disorder alone. Integrated treatment coordinates mental and substance use interventions by linking people to other providers who can deliver individualized and personalized services to treat the physical and emotional aspects of mental and substance use disorders.

There are three models for delivering care for co-occurring disorders: coordinated, co-located, and fully integrated. With integrated care, a more complete recovery is possible.

Integrated Treatment Leads to Better Outcomes

Together with early detection, integrated treatment can improve outcomes and quality of life for people with co-occurring disorders, including:

• Reduced or discontinued substance use
• Improvement in psychological symptoms and functioning
• Increased chance for successful treatment and recovery for both concerns
• Improved quality of life
• Decreased hospitalization
• Reduced medication interactions
• Increased housing stability
• Fewer arrests and legal involvement

Effective Treatment Providers Ensure “No Wrong Door” to Enter Treatment

SAMHSA’s “no wrong door” policy states that effective healthcare systems must ensure that a person who needs treatment will be identified, assessed, and receive treatment, either directly or through appropriate referral, no matter where he or she seeks services.

“No wrong door” means that people presenting for treatment for a mental health concern should be routinely screened for substance use disorder, and all people presenting for treatment for substance use disorders should be screened for mental disorders.