Top of the pageCheck Your Symptoms

Alcohol and Drug Use

Overview

Alcohol and drug use: Overview

Some people who drink alcohol, use recreational drugs or illegal drugs, misuse prescription or non-prescription medicines, or misuse household products may develop substance use disorder. One of the signs of substance use disorder is that you keep using alcohol or drugs even though you know it's causing problems in your life. Another sign is that you have a strong need or craving to drink or use drugs.

Using alcohol or drugs can affect your health, work, school, and relationships. It can change how well you make decisions, how well you think, and how quickly you can react. And it can make it hard for you to control your actions. In young people, using alcohol or drugs can affect their general health, physical growth, and emotional and social development.

Alcohol

You may have alcohol use disorder if drinking alcohol affects your health or daily activities. You may be dependent on alcohol if you physically or emotionally need alcohol to get you through your day.

Symptoms of alcohol use disorder include personality changes, blackouts, drinking more to get the same effect, and denial of the problem. If you have alcohol use disorder, you may gulp or sneak drinks, drink alone or early in the morning, and have the shakes. You may also have family, school, or work problems or get in trouble with the law because of drinking.

Alcohol use patterns vary. Some people drink and may be intoxicated every day. Other people drink large amounts of alcohol at specific times, such as on the weekend. Others may be sober for long periods and then go on a drinking binge that lasts for weeks or months.

People who are dependent on alcohol may have withdrawal symptoms, such as sweating and feeling sick to their stomach, feeling shaky, and feeling anxious. In rare cases, severe symptoms of withdrawal can occur such as delirium tremens, or DTs. Treatment for withdrawal from alcohol requires medical care.

The use of alcohol with medicines or drugs may increase the effects of each.

Recreational and illegal drugs

People who use cannabis or illegal drugs, such as methamphetamines, cocaine, heroin, or other "street drugs," may develop substance use disorder. They may use drugs to get a "high" or to relieve stress and emotional problems.

Drugs like ecstasy (MDMA) and date rape drugs, such as gamma-hydroxybutyrate (GHB), flunitrazepam (Rohypnol), and ketamine, are often used at all-night dances, raves, trances, or clubs. These drugs are known as "club drugs." These drugs can be dangerous, especially in overdose or when combined with other drugs or alcohol. Inhalants like nitrous oxide may also be used.

Drugs come in different forms and can be used in different ways. They can be smoked, snorted, inhaled, taken as pills, put in liquids or food, put in the rectum or the vagina, or injected with a needle.

Prescription and non-prescription medicines

Some people misuse prescription medicines, like opioids (such as Oxyneo and Dilaudid), benzodiazepines (such as Valium and Xanax), and stimulants (such as Ritalin and Adderall).

Some non-prescription medicines, such as cold medicines that have dextromethorphan as an ingredient, are being misused as a way to get high. What effects these drugs may have on your health depend on the type, strength, and amount of these drugs you use and whether you take them with another drug or alcohol. The use of prescription and over-the-counter medicines with alcohol or drugs may increase the effects of each substance.

Household products

Glue, shoe polish, cleaning fluids, and aerosols are common household products with ingredients that are also being used to get high.

Signs of substance use disorder

Signs of substance use disorder depend on the drug you use and how that drug affects you. Not all drugs affect people the same way. One of the signs that your drug use may be becoming a problem is that you take more of a drug over longer periods of time and need more of the drug to feel "high." Another sign is that you spend a lot of time trying to get the drug, and you give up other activities to do this. When you have substance use disorder, you or others may notice some changes in your behaviour. You may be moody, have problems sleeping, or pay less attention to how you dress or look. Or you may lie, steal, or hide things from people and act sneaky.

You may have substance use disorder if your drug use affects your health or daily activities. You may be dependent on drugs if you physically or emotionally need drugs to get you through your day. You may not be aware that you have become dependent on a drug until you try to stop taking it. People who are dependent on drugs may have withdrawal symptoms, such as sweating and feeling sick to their stomach, feeling shaky, and feeling anxious.

Substance use disorder in older people may go unnoticed, since the signs may be similar to those of aging. Older adults often take medicines, such as sleep medicines and painkillers, that can lead to substance use disorder.

Health risks of alcohol and drug use

When you use alcohol or drugs, you may be putting your health and safety at risk.

Alcohol or drug use can:

  • Make car crashes more likely. If you drink and drive, or if you drive while you are high, you can easily hurt yourself or others.
  • Lead to unprotected sex and/or sexual assault. This can lead to pregnancy and sexually transmitted infections (STIs), including HIV.
  • Increase the risk of overdose, injury, and death.
  • Cause you to do things you wouldn't usually do. You may say things that hurt your friends. Or you may do something illegal that could result in paying a large fine or going to jail, like being arrested for driving while intoxicated.
  • Affect your work or schoolwork. It can cause you to lose your job or drop out of school.
  • Change how you feel about your life. It can lead to depression and suicide.
  • Cause mood swings and affect your sleep and your ability to think, learn, reason, remember, and solve problems.
  • Harm many organs and systems in the body, such as the liver, pancreas, heart, brain, and nervous system.
  • Contribute to the development of some cancers, such as cancers of the mouth, throat, esophagus, liver, colon, and breast.
  • Cause high blood pressure, stomach problems, or sexual problems.
  • Cause harm to a developing baby (fetus) if alcohol or drugs are used during pregnancy.

Recognizing a problem

Alcohol

Alcohol is part of many people's lives and may have a place in cultural and family traditions. So it can sometimes be hard to know when you begin to drink too much.

You're at risk of drinking too much if you are:

  • A man who has more than 3 standard drinks a day on most days, or more than 15 drinks a week.
  • A woman who has more than 2 standard drinks a day on most days, or more than 10 drinks a week.

If you think you might have a problem with alcohol, talk to your doctor.

Drugs and other substances

A person might not realize that their substance use is a problem. They might not use drugs in large amounts. Or they might go for days or weeks between using drugs. But even if they don't use drugs very often, their substance use could still be harmful and put them at risk.

If you think you might have a problem with drugs or other substances, talk to your doctor.

Health Tools

Health Tools help you make wise health decisions or take action to improve your health.

Actionsets are designed to help people take an active role in managing a health condition.

Check Your Symptoms

Are you concerned about an alcohol or drug problem?
Yes
Concerned about alcohol or drug problem
No
Concerned about alcohol or drug problem
How old are you?
11 years or younger
11 years or younger
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Did you pass out completely (lose consciousness)?
Yes
Lost consciousness
No
Lost consciousness
If you are answering for someone else: Is the person unconscious now?
(If you are answering this question for yourself, say no.)
Yes
Unconscious now
No
Unconscious now
Are you back to your normal level of alertness?
After passing out, it's normal to feel a little confused, weak, or light-headed when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.
Yes
Has returned to normal after loss of consciousness
No
Has returned to normal after loss of consciousness
Did the loss of consciousness occur during the past 24 hours?
Yes
Loss of consciousness in past 24 hours
No
Loss of consciousness in past 24 hours
Are you thinking seriously of committing suicide or harming someone else right now?
Yes
Thinking seriously of committing suicide or harming someone else
No
Thinking seriously of committing suicide or harming someone else
Did you have a seizure after using alcohol or drugs?
Yes
Seizure
No
Seizure
Do you think you are having withdrawal symptoms?
Withdrawal symptoms are the physical problems and emotional changes you may have when you suddenly stop using a substance that you are dependent on.
Yes
Withdrawal symptoms
No
Withdrawal symptoms
Are the withdrawal symptoms severe or mild?
Severe
Severe withdrawal symptoms
Mild
Mild withdrawal symptoms
If you are answering for someone else: Are you concerned that the person is drunk or high and needs medical care now?
Yes
Person is intoxicated and may need medical evaluation
No
Person is intoxicated and may need medical evaluation
Does your use of alcohol or drugs affect your behaviour?
Yes
Use of alcohol or drugs affects behaviour
No
Use of alcohol or drugs affects behaviour
Have you ever hurt a child or intimate partner while using alcohol or drugs?
Yes
Has hurt a child or partner while using alcohol or drugs
No
Has hurt a child or partner while using alcohol or drugs
Do you need alcohol or drugs to help you get through the day?
Yes
Need alcohol or drugs to get through day
No
Need alcohol or drugs to get through day
Are you pregnant?
Yes, you know that you're pregnant.
Pregnancy
No, you're not pregnant, or you're not sure if you're pregnant.
Pregnancy
Do you ever have blackouts while using alcohol or drugs?
Yes
Has had blackouts
No
Has had blackouts
Do you have any other concerns about an alcohol or drug problem?
Yes
Concerns about alcohol or drug problem
No
Concerns about alcohol or drug problems

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

If you are with a person who is drunk or high, it's a good idea to seek medical help right away if:

  • The person may have an injury.
  • The person is hard to wake up or can't stay awake.
  • The person has vomited more than once and is not acting normal.
  • You're not comfortable taking care of the person, or you're not in an environment that is safe enough for you to take care of the person.

When you use drugs or alcohol over time, you may feel that you need them to get through the day. You or a loved one may notice that:

  • You need more and more of the substance to get the same effect, or you get less effect from the same amount over time.
  • You have strong cravings for the substance.
  • You aren't able to stop using or to use less of the substance, even if you try.
  • You spend a lot of time getting, using, or recovering from using the substance.
  • You can no longer do your main jobs at work, school, or home.
  • You no longer do things you used to enjoy.
  • You keep using the substance even though it causes health problems or makes them worse. These health problems are different depending on the substance, but they can include:
    • High blood pressure.
    • Stomach or liver problems.
    • Repeated infections.
    • Sleep problems.
    • Loss of appetite.
    • Less interest in sex.

Severe withdrawal symptoms may include:

  • Being extremely confused, jumpy, or upset.
  • Feeling things on your body that are not there.
  • Seeing or hearing things that are not there.
  • Severe trembling.
  • Chest pain.
  • Shortness of breath.

Mild withdrawal symptoms may include:

  • Intense worry.
  • Nausea or vomiting.
  • Shakiness.
  • Sweating.
  • Feeling a little tense or edgy.

The risk of a suicide attempt is highest if:

  • You have the means to kill yourself, such as a weapon or medicines.
  • You have set a time and place to do it.
  • You think there is no other way to solve the problem or end the pain.

The use of alcohol and drugs can affect your behaviour. Here are some questions to think about:

  • Has your use of alcohol or drugs harmed your relationships with your family or friends?
  • Do you ever drive a car or operate machinery when you are drunk, high, or hungover?
  • Have you missed any days of work or school during the past year because you were drunk, high, or hungover?
  • Have family members or friends tried to get you to cut down on alcohol or drugs?
  • Do you sometimes go on binges with alcohol or drugs?

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Self-Care

If you are concerned about your own or another person's alcohol or drug use, learn what steps to take to help yourself or someone else.

  • Never ignore the problem.
  • Know the signs of substance use. These include new problems at work or school.
  • Make an appointment with a doctor or another health professional, such as a counsellor, to discuss it as a medical problem.
  • Find out when support groups, such as Alcoholics Anonymous (AA), LifeRing, Narcotics Anonymous (NA), or SMART Recovery, meet. These self-help groups help members get sober and stay that way. There are also support groups for family members and friends. Call them for the times of scheduled meetings.
  • Ask the other person if they would accept help. Don't give up after the first "no." Keep asking. If the person agrees, act that very day to arrange for help.
  • Provide support for another person during detoxification or other treatment.
  • Help set up community services in the home, if needed. Older adults may benefit from services like home care, nutritional programs, transportation programs, and other services.
  • Help with decision-making. Many people who misuse substances can't process information or communicate their decisions well.
  • Check out what services are available in your area.
    • Talk to your human resources department about getting a referral to your employee assistance program, if your employer offers it.
    • Visit Wellness Together Canada online at www.wellnesstogether.ca to learn about treatment programs in your area. Talking to someone about your feelings about substance use can help.

Ways to reduce harm from substance use

Although there is no amount of alcohol or drug use that is safe, there are some things you can do to reduce your risk of serious health problems and injuries caused by alcohol or drug use.

  • Avoid risky situations and activities. Don't drink or get high and drive, and don't get in a car with a driver who has been drinking or using drugs.
  • Make a plan to get home safely. For example, choose a designated driver, have money to pay for a taxi or bus fare, or call a loved one for a safe ride home.
  • Don't take over-the-counter or prescription medicines that interact with alcohol. And don't take these medicines with drugs or other harmful substances.
  • Don't use alcohol or drugs if you're pregnant or trying to get pregnant. These substances can increase your baby's chance of being born with a birth defect or fetal alcohol syndrome.
  • Don't mix alcohol with drugs or other harmful substances.
  • Don't use alcohol or drugs to try to make yourself feel better. Using alcohol or drugs may make your problems worse and may cause you to do things that you normally wouldn't do, like hurt yourself or others.
  • Be aware at all times of your surroundings and the people around you.
  • Limit how much you use alcohol or other substances. The more you use, the greater the risk of getting sick, hurt, or in trouble.

Reducing harm from alcohol

  • Have a meal or a snack with a drink. Don't drink on an empty stomach.
  • Drink slowly. Don't have more than 2 standard drinks in any 3-hour period.
  • Have a glass of water or other non-alcoholic, caffeine-free beverage (such as a soft drink or fruit juice) between drinks.

Reducing harm from drugs

  • Ask your pharmacist or doctor whether any of your current medicines can cause dependence.
    • Be especially aware of pain medicines (such as opioids), tranquilizers, sedatives, and sleeping pills. Follow the instructions carefully, and do not take more than the recommended dose.
    • Make sure that your doctors are aware of medicines prescribed by another doctor. Use only one pharmacy when getting your prescriptions filled.
  • Don't share needles, syringes, and other equipment (such as cookers, cotton, cocaine spoons, or eyedroppers) with others if you use drugs. Be aware of who you get your supplies from. Be sure the supplies haven't been used before. If you use dirty needles or equipment, you can get hepatitis, HIV, or other serious infections.
  • Be aware of who you get your drugs from. Drugs can vary greatly in strength depending on who you get them from.
  • Be aware of how a drug might affect you, especially if you stopped using the drug and then started using again. You may not be able to handle the same amount of the drug as you could before.
  • Don't leave your beverage unattended or accept a drink from an open container.
  • Create a safe environment. If you use drugs, make sure you do it in a place where other people are around so you can get help if you need it.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • Symptoms occur more often or are more severe.

Learn more

Preparing For Your Appointment

Credits

Current as of: November 8, 2021

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
H. Michael O'Connor MD - Emergency Medicine
David Messenger MD - Emergency Medicine, Critical Care Medicine
Donald Sproule MDCM, CCFP - Family Medicine