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 deal with mental health issues or struggles with substance use. But according to the Child Mind Institute, young people sometimes turn to drugs or alcohol to try to escape tough feelings like depression or anxiety. A lot of teens just want to feel better or fit in with friends, and using substances can seem like a quick way to cope. It might help for a little while, but those feelings don’t last. Over time, what started as once-in-a-while use can turn into something you feel like you need every day.

Not everyone is affected by substance use the same way. Young people who already struggle with their mental health are more likely to develop problems with drugs or alcohol.

If someone keeps using substances to deal with tough emotions and doesn’t get help, it can lead to serious outcomes—like overdose or even suicide.

In 2022, the National Institute of Health looked at over 10 million people across 33 studies. They found that drinking alcohol was linked to a 94% higher risk of dying by suicide. That means people who drank were much more likely to die by suicide than those who didn’t.

We're sharing this to help everyone understand how untreated substance use and mental health struggles can be connected.

If you or someone you know is having thoughts of suicide, please reach out. Call the Clackamas County Mental Health Crisis and Support Line at 503-655-8585, or call 911 if it’s an emergency. You’re not alone, and there’s help available.

Harm Reduction

According to Harm Reduction International,

Harm reduction is about keeping people safe and healthy, even if they use drugs. It includes programs and practices that try to reduce the negative effects drug use can have on someone’s health, life, or future—without judging them or forcing them to stop using first.

Harm reduction is based on respect, fairness, and human rights. It focuses on supporting people in a kind and honest way, helping them make safer choices at their own pace, without pressure or discrimination.

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

Alcohol and Drug Helpline | Lines for Life, call 800-923-4357
Behavioral Health Resource Network | Clackamas County Behavioral Health
Clackamas County Crisis Line | call 503-655-8585
Community Living Above
Prevention and Positive Youth Development | Clackamas County Children, Family, and Community Connections
Project Hope | Clackamas County Public Health
Substance Use Overdose and Prevention | Clackamas County Public Health