Substance use problems, including alcohol and drug misuse, are much more common in people with mental health challenges than in the general population. For example, about 50% of people with serious mental health challenges experience problematic substance use at some point in their lives, compared to only about 15% of people without a mental health condition. Why are the rates of substance use problems so much higher in people with a mental health condition? There is no single answer to this question. Rather, there are multiple different reasons for why alcohol and drug challenges are so common in people with mental health difficulties. Different reasons may apply to different people. And more than one reason may be true for any particular person.

In this article we review different reasons for the high rate of substance use problems in people with mental health challenges. Understanding why you or a loved one may be prone to these problems can help you in taking steps to address them. After reviewing the different reasons for substance use problems in people with a mental health condition, we describe some strategies for coping with these problems and overcoming them.

What are some Common Reasons for Substance Use Problems in People with Mental Health Challenges?
There are several important factors that contribute to substance use problems in people with mental health challenges. Some of the most common reasons are listed below. All of these reasons have some research supporting them:

• Super-sensitivity to the effects of alcohol and drugs
• Self-medication
• Social connection
• Recreation/pleasure enhancement
• Lack of meaningful structure
• Family history of substance use problems

Please click here to read more about reasons why people with mental health challenges may use substances (PDF link).

How Can I Cope More Effectively with Substance Use Problems?
The COVID-19 pandemic has led to multiple challenges in people’s lives, and has been associated with an increase in substance use problems. Considering the common reasons for using substances reviewed above, these increases in substance use are easy to understand. People with mental health conditions be experiencing more severe symptoms due to the confinement and inability to participate in many of the activities that help them cope and keep grounded in their lives. The structure that many people had in their lives before the pandemic has been reduced or is gone, and people are left with a task of creating new structure for themselves.