14th February 2025

Overview of alcohol and substance misuse

Alcohol and substance misuse disorders describe substance use that continues despite harmful consequences. These include injury, physical illness, mental illness and functional impact. Cannabis is the globally most used drug, second is amphetamines. In recreational drug users, polysubstance use is common. National alcohol intake recommendations are a maximum of 14 units per week for any gender.

The patient may present seeking help for the substance dependence itself, its harmful consequences, or substance withdrawal.

Risk factors for alcohol and substance misuse include:

• History of other alcohol or substance misuse
• History of mental illness
• Alcohol: family history of alcohol or substance misuse, anxiety traits, pre-existing anti-social behaviours
• Opioids: male, young, history of prescribed opioid therapy

Risk assessment is always important, including physical, psychological, social and neglect-related harms. If the patient is responsible for the care of children or dependents, safeguarding must be considered.