Substance Use


Section Summary 

This section discusses topics like: 

  • What is substance use? 
  • What is the relationship between mental health and substance use?
  • Substance use and youth 
  • Harm reduction, treatment, and recovery

What is Substance Use?

Substance use is the use of substances such as alcohol or illegal drugs and, in some cases, misuse of prescription medications. Substance use can have negative consequences that may involve problems at school, work, home, involvement with the law or in relationships.

Individuals may engage in substance use out of a desire or impulse to feel positive short-term physiological and/or psychological effects, however in most cases substance use leads to negative, undesirable long-term effects on the body and mind.

Youth and young adults are more likely to engage in substance use during times of stress or when around friends or family who also use substances. 

Intersection Between Mental Health and Substance Use

The  National Institute of Mental Health defines Substance Use Disorder (SUD) as a treatable mental health condition “that affects a person’s brain and behavior, leading to their inability to control their use... Symptoms can be moderate to severe, with addiction being the most severe form of SUD”.

Comorbidity refers to the fact that two conditions, such as a specific mental health disorder like anxiety or depression and a substance use disorder, often co-exist together.



Substance Use and Youth 

Anyone can experience mental health conditions and substance use disorders. However, according to the Child Mind Institute, youth and young adults often turn to substances as a way to temporarily escape feelings of depression or anxiety. Young people- especially teens- want to fit in with their peers and be happy, and substances can offer a way to cope with undesirable thoughts and feelings. These short-term coping methods may make adolescents feel more at ease. But these effects do not last, and can lead to dependence – what started off as using once in a while becomes a constant reliance of using every day.

However, substance use disorders do not affect all young people the same: those with pre-existing mental health challenges are statistically more likely to develop a substance use disorder.

Without intervention, data demonstrates that using substances repeatedly to cope with negative emotions can lead to serious consequences, like death by overdose and suicide.

In 2022, the National Institute of Health conducted 33 studies on over 10 million people to find the association between alcohol and suicide. They found that alcohol use was associated with a 94% increase in the risk of death by suicide.  This means that those who drank alcohol were at a much greater risk of dying from suicide than those who did not drink alcohol.

This information is being shared with the goal of informing the community about the relationship between untreated substance use disorder and suicide. If you or someone you know is struggling with thoughts of suicide, please contact the Clackamas County Mental Health Crisis and Support Line at 503-655-8585, or in case of emergency call 911.

Harm Reduction

According to Harm Reduction International, harm reduction refers to policies, programs and practices that aim to minimize the negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.

Disclaimer: The following video includes non-graphic images of substances (an oxycodone tablet) and substance use materials (hypodermic needle).



Harm reduction is an important piece of the puzzle to reducing the stigma associated with substance use. Many individuals may feel hesitancy to seek support or talk about substance use challenges due to self stigma (including fear of judgement and feelings of shame), social stigma (including depictions of drug use in the media), and structural stigma (including the criminalization of drug use and its disproportionate effects on communities of color). 

Locally, the Oregon Health Authority has taken initiatives “to support prevention of substance misuse and harm reduction for those using substances. Efforts have included an increase in access and distribution of naloxone to people with overdose risk, coordination with the state’s COVID-19 community engagement activities with substance use treatment programs, peer recovery support programs, harm reduction and syringe service programs” (Oregon Health Authority | Youth and Young Adult Substance Use Prevention, Treatment, and Recovery). 

Treatment and Recovery

SAMHSA describes recovery as, “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.”

Recovery is when an individual is no longer reliant on a substance to be happy or to live. The recovery process does not look the same for everyone–some are shorter, others longer–and it is not simple, but if someone wants to quit their addiction and they put their mind to it, recovery can be possible for anyone. Learn more here: Recovery Support

Support networks are considered by many to be a valuable part of the recovery process. Being around people who understand addiction can make someone feel less alone and more motivated to stay sober. Friends, family, and support groups can help during tough times by offering advice and reassurance. They also connect people with helpful resources like counseling, medical care, and job opportunities. Most importantly, having a strong support system makes it easier to build a better future and stay committed to recovery.

Relapse (a return to substance use after a period of recovery) may occur because overcoming addiction can be a long and challenging process. It’s important to acknowledge that relapse is not a failure—it can be viewed as an opportunity to learn from mistakes and strengthen coping skills. Support from friends, family, and counselors can help individuals get back on track after a relapse. Recognizing triggers and developing better strategies can make future relapses less likely. Most importantly, recovery is about progress, not perfection, and every step forward matters.

National Recovery Month is held every September, where people celebrate recovering from substance use and spread awareness of the significance of mental health services and substance use programs to help individuals recover.

Resources