Addiction and substance misuse covers of a range substances. It can have a severe impact on psychological functioning in addition to physical health. It also effects social situations and a persons ability to fulfil their responsibilities.
Alcohol dependence is the one of the most widely abused substances, but any drug, including heroin and cannabis, comes into this category, as does the misuse of glue and aerosols. Substance abuse may also include smoking cigarettes or drinking excessive amounts of coffee.
People may engage in substance abuse for a temporary feeling of well being or of being in control, but ultimately it can damage your health.
Severe forms of substance misuse are often treated by specialist drug and alcohol rehabilitation services. For people with mental health issues who may have additional substance abuse issues there may be the opportunity for specialist services. There is also a lot you can do to help yourself.
What leads to substance abuse?
The reasons for substance abuse are many. A person may have a group of friends who use drugs and enjoy the experience and want to repeat it. A person may use drugs when they are unhappy or stressed as a coping strategy for the problems in their lives. Drugs, alcohol, nicotine, solvents and even food can start as ‘props’ to help people get through difficult times. But the feelings of relief are only temporary and, as the problems don’t disappear, a person may use more and more of these substances and risk developing a dependence on drugs which then may create new problems on many levels (health, financial, social etc.)


See more about alcohol and its effects on mental health the RAMH A-Z Alcohol page.


Coffee, tea and chocolate all contain caffeine in addition to some soft drinks, energy drinks as well as painkillers and cold remedies. A normal cup of coffee contains approximately 40mg of caffeine per cup, a can of a fizzy drink around 23mg, and some energy drinks have nearly 100mgs. Plain chocolate has 40mg caffeine per 100g, nearly three times as much as milk chocolate
Signs you may becoming dependent on caffeine
Caffeine stimulates the brain and nervous system. It makes you feel alert and better able to concentrate, and it also increases acid production in the stomach, which helps digestion. If you regularly drink large quantities of caffeine – more than five cups of coffee a day – you may find your tolerance has increased and therefore you need to drink larger amounts to get the same stimulant effect.
Caffeine has the negative effect of increasing your heart rate and blood pressure and making you pass more urine. Different people respond differently to caffeine in their sensitivity, but too much may make a person anxious, restless, irritable and sleepless. It can also give you a variety of complaints including headaches, stomach pain, nausea and palpitations.
Tips to help you cut down on caffeine
Cutting out caffeine in one go can be difficult because you may experience withdrawal symptoms, including severe headaches as well as nausea, anxiety, and depression. Decreasing the amount of caffeine you consume, either by drinking fewer cups of coffee each day or by gradually switching to decaffeinated coffee, will potential minimise these issues. However it’s important to be aware of not simply switching to other beverages that also have high levels of caffeine, such as cola or chocolate.


Cigarettes contain a highly addictive substance called nicotine which has many detrimental affects on physical health. Furthermore, smoking is now being proven to actually increase tension and anxiety, and to not decrease the symptoms of mental ill health in the long term. More information on the benefits of quitting smoking and how to do it are available at NHS Choices.


Medicinal drugs, such as tranquillisers and sleeping tablets, which have been prescribed for diagnosed medical conditions, can also cause health problems if used for long periods. Tranquillisers are thought only to really help anxiety for a short period and sleeping tablets are only effective for a couple of weeks. After that time a higher dose may be required to get the same effect and even then the anxiety may increase or your sleeplessness return.
Illegal drugs, such as cannabis or ecstasy, may be taken for recreational purposes. How they affect a person may depend on the type of drug, a persons physiology, the amount used, a persons mood and environment. For some people, the first hit can cause problems, especially if the drug contains impurities. For other people, the problems may start as their bodies get used to the repeated use of the drug and they develop a dependence and need higher and higher doses to maintain the same effect.

Types of drugs

Stimulants include caffeine and tobacco as well as amphetamines, anabolic steroids, ‘poppers’, hallucinogenic amphetamines (ecstasy), cocaine and crack. They act on the central nervous system and increase brain activity. Users generally feel more confident and alert, are able to stay awake for longer and can perform physical tasks for a longer period of time. High doses of some stimulants may cause nervousness and anxiety. Stimulants can also cause temporary feelings of paranoia (except for tobacco and caffeine).
These include minor tranquillisers such as Valium, Mogadon and Temazepam, solvents, aerosols and gases. Depressants act on the central nervous system and slow down brain activity. They relax you, making you feel less tense and anxious, but at the same time impair mental and physical activity and decrease self control, lowering your inhibitions.
Analgesics are painkillers and include heroin, opium, pethidine and codeine. They make users less sensitive to emotion and physical pain and produce feelings of warmth and contentment.
These include cannabis, LSD and magic mushrooms. Hallucinogens act on the mind, heightening sensations and distorting the senses and the way users see and hear things.

Signs you may be becoming dependent on drugs

If drugs are your main way to help you feel less anxious or depressed or to improve your mood, you may be becoming psychologically dependent. If you rely on drugs to achieve certain physical effects and cannot manage the unpleasant physical effects of not taking the drugs, you may be becoming physically addicted. Most drug related problems generally involve physical and psychological symptoms and there is often interdependence.
Other signs that you could be becoming dependent on drugs are:
  • if obtaining and taking drugs is the most important thing your life
  • if you use drugs to manage physical and emotional pain
  • if you use drugs to manage other problems such as loneliness, family or relationship problems, low self esteem, poverty, unemployment or a general lack of opportunities.