Drugs, alcohol & mental health
This page explains how using drugs and alcohol can affect your mental health. It also explains how you can get help to stop using drugs and alcohol. In this section, ‘drugs’ means recreational drugs, alcohol, or prescription drugs. When someone with a mental illness also uses drugs, doctors call this ‘dual diagnosis’ or ‘co-occurring diagnosis’.
There are many reasons why you might use drugs and alcohol.
- Some people use them to try and deal with their symptoms of their mental illness, this is known as 'self-medication'
- Drugs and alcohol can make the symptoms of your mental illness worse
- Some drugs may make it more likely for you to get a mental illness, and they may make it harder to treat
- Mental health, and drug and alcohol services should work together to give you the support you need
- If you have any problems getting help, you could make a complaint
People use drugs and drink alcohol for lots of different reasons. Whatever your reason, using drugs or alcohol may have a long-term negative effect on you. The possible long-term effects include the following.
- Needing to take more to get the same effect
- Feeling like you must use the drug or alcohol ('dependence')
- Withdrawal symptoms including feeling sick, cold, sweaty or shaky when you don’t take them
- Having sudden mood changes
- Having a negative outlook on life
- Loss of motivation
- Doing less well at work, school, college or university
- Problems with relationships
- Borrowing or stealing money from friends and family
- Being secretive
- Having episodes of drug-induced psychosis
It may take longer for your mental health to get better if you use drugs or alcohol. Drugs can make you more unwell and more likely to try and harm yourself or take your own life.
There is also some evidence that using some drugs may cause mental illness in the first place. For example, research has shown that cannabis can increase your chances of developing schizophrenia.
You can find more information about ‘Cannabis and mental health’ here.
What does psychosis mean?
If you have psychosis, you might see or hear things, or believe things that other people do not. Some people describe it as a "break from reality". You may also hear terms such as “psychotic symptoms”, “psychotic episode” or “psychotic experience” describing the same thing. It can be a symptom of mental illness and can also be a short-term effect of some drugs.
Drugs and effects
In this section we have listed some of the different types of substances that could have an impact on your mental health. Please be aware that this list is not exhaustive.
Taking any substances can be dangerous. They can also have bad interactions with any medications or other substances you might use.
For more information on different substances you can visit the website of ‘Talk to Frank’. They are a specialist charity that provides information on drugs. You can find their website here.
Cannabis is one of the most commonly used drugs in England. According to one study, about 6.5 per cent of people aged 16-59 measured had used it in the last year. This was around 2.1 million people. Among 16-24 year olds in the study, around 15.8 per cent had used it in the last year.
Some people take cannabis because it makes them feel relaxed or happy, but it can also make you feel anxious or feel paranoid. Some people may experience things that aren't real. This is a sign of drug-induced psychosis. Some studies have shown that the risk of psychosis may be higher if you:
- use cannabis for a long time,
- use it frequently, or
- use ‘high-strength’ cannabis, like skunk.
If you have been using cannabis and you feel that it is affecting your health, make an appointment to see your GP as soon as you can. Your doctor should not judge you, and should not tell other people you use drugs.
Some people with a mental illness have a difficult relationship with alcohol. Alcohol is legal, which means it is easier to get. It can make the feelings of some mental health issues feel worse, and for some people it could cause their mental health to relapse if they have struggled in the past.
The long-term effects of alcohol also depend on how much you drink, and how regularly you drink it. If you drink too much on a regular basis then you could cause yourself serious physical and mental harm. Drinking may also make it more difficult for you to recover from your mental illness, and may reduce your quality of life.
New Psychoactive Substances (NPS)
These are drugs that contains similar ingredients or chemicals to other illegal drugs.
Some of the drugs classed as NPS are known as ‘legal highs’. This is a common term that people use. It is used because some NPS were legal before 2016. However, the name is now wrong, because since 2016 they have been made illegal.
Some NPS that are now illegal include:
- stimulants such as mephedrone (also known as meow meow, mcat, plant food, drone),
- sedatives such as liquid ecstasy (also known as GHB, legal E),
- hallucinogens such as N-bombs (also known as smiley paper, Bom-25, 2-C-I-NBOME), and
- synthetic cannabinoids such as spice and black mamba.
The short-term effects of an NPS depend on what you take. No one knows exactly how NPS will affect you in the long-term. However, as with all drugs, they may have a bad effect on your mental health.
Some NPS can be very dangerous and can cause risk to life. especially when taken with alcohol or other sedatives. Many mental health medications have sedative effects.
Amphetamine and methamphetamine
In the short-term, these drugs can make you feel wide awake and alert. This can make it difficult for you to relax or get to sleep. They might cause you to have a drug-induced psychosis. In the long-term, amphetamines might make you anxious and depressed. They can also be addictive.
When you stop taking the drug, you may feel depressed and you might find it hard to sleep.
There are two types of tranquiliser. Major tranquilisers are often antipsychotic medications. Minor tranquilisers are drugs that may make you feel unaware of your surroundings and can be highly addictive.
One example of a tranquiliser is ‘benzodiazepines’, or benzos. Sometimes a doctor will tell you to take benzodiazepines to help you with anxiety. People also buy them illegally because of their relaxing effects. They can be addictive, and so doctors only give them for a short time.
In the short-term, these drugs can make you feel calmer. Depending on the type you take, they could make you feel confused or moody.
In the long-term, some people become addicted, which can have a big effect on their day-to-day life.
In the short-term, cocaine can make you feel awake, talkative and confident. After this wears off, you can feel tired and depressed. If you take a high dose there is a risk to your life.
In the long-term, cocaine use can affect how you feel. It can affect your relationships with friends and family. Cocaine is also addictive and over time you are more likely to have ongoing problems with depression, paranoia or anxiety.
In the short-term, ecstasy may make you feel energetic, chatty and confident. It can also sometimes make you feel anxious, confused or trigger drug-induced psychosis.
In the long-term, ecstasy may make you feel depressed and anxious, and some people struggle with memory problems.
In the short-term, heroin can make you feel relaxed and calm. It takes away pain and can make you feel sleepy. But there is a higher risk that you could overdose with heroin than some other drugs.
Heroin can be taken in lots of different ways, including by injection. However, there is a high risk of getting an infection if you inject heroin, particularly if you share needles with someone else.
Heroin is very addictive and can have serious long-term effects. When you stop taking it you may feel depressed and find it hard to sleep. You may feel that heroin becomes more important than other things in your life. This might make it harder to keep a job and affect your relationships.
In the short-term, LSD may make you experience things that aren't real. Sometimes the experience will be enjoyable, and sometimes it will be frightening (a 'bad trip').
There is mixed evidence about the long-term effects of LSD. We don’t know exactly how likely it is to cause mental health problems.
How can I get help?
If you have a mental illness and use drugs, the NHS may call this 'dual diagnosis' or ‘co-occurring diagnosis’. Your local NHS trust may have a policy that says how they will help people with dual diagnosis. Check on their website to see if you can find out more about what to expect locally.
If you are not already getting help with your mental health from your local mental health team, a good first step is to make an appointment to see your GP. Your GP may offer you medication and therapy to treat your mental illness. They may refer you to a drug and alcohol service to help you with your drug use.
If your needs are too complex for your GP to deal with alone, you might need more specialist support. A GP can refer you to your local mental health service or Community Mental Health Team (CMHT). They should offer this support and work with drug and alcohol services to give you all the help you need. The Department of Health says that people with dual diagnosis are a key group of people who should get help from mental health services.
Care Programme Approach (CPA)
The National Institute for Health and Care Excellence (NICE) produces guidance for the NHS and other organisations responsible for people’s health and care. They say that people who have a severe mental illness and drug or alcohol problem should get help under the Care Programme Approach (CPA). The CPA is a framework that the NHS uses to plan someone’s long-term care.
Under the CPA you would get a care co-ordinator to plan your care. They will help to write a care plan. This should account for all the different needs you might have such as:
- social care,
- housing, and
- physical health.
NICE also say that you should be able to give your views on the care plan to make sure that it meets your needs and the care plan should be shared with your carers or family if you agree.
You can read the NICE guidance online here.
There may be a team in your area which helps people with dual diagnosis. It is sometimes called the Dual Diagnosis Team. However, not all areas of the country have them, and it may have a different name. If there isn't one in your area, you could try contacting your local Community Mental Health Team (CMHT) for help. However, you will need to be referred to the CMHT by your GP.
As well as NHS services, you could try contacting local charities. Many charities have support services or support groups for people struggling with substance misuse. You can find some national charities listed in the Useful Contacts section below.
You can use the links below to find more information about:
- Community Mental Health Team (CMHT)
- Worried about your mental health?
- Care Programme Approach
What can I do if I have problems trying to get help?
Some people with dual diagnosis have told us that it has been difficult to get the help they need. For example, you may have been told that mental health services cannot help you because of your drink or drugs problem. However, the Department of Health is very clear that mental health services should try to help you if you have dual diagnosis.
The National Institute for Health and Care Excellence (NICE) also say that you should not be turned away from mental health services because you have a drug or alcohol problem.
If your mental health team has turned you away you could ask them why they have done this.
If you are not happy with the services you get, talk to the person in charge of your care. This might be your GP or your 'care coordinator'. They might be able to change things for you. An 'advocate' may be able to help you to get your point of view across. You might need to make a complaint to the NHS if you do not get the help you need.
You can use the links below to find out more about:
What if I am a carer, friend or relative?
Supporting someone struggling with dual diagnosis can be difficult. It might help to speak to the person you are helping, to see what support they want. For example, some people might just want someone to talk with. Other people might want more practical help, such as with booking appointments or helping them speak to professionals.
Addaction and Adfam are two charities that offer support and advice to relatives, friends and carers of those struggling with substance misuse. You can find their contact details in the Useful Contacts section below.
You might also feel that you need support for yourself. The National Institute for Health and Care Excellence (NICE) says that carers (including young carers) who support someone with a dual diagnosis should be offered a carer’s assessment under the Care Act 2014. You may be able to get practical support to help you with your caring responsibilities.
NICE also says that if you are caring for someone with a dual diagnosis you can:
- be involved in their care planning, and
- work with services to help those services improve.
But this can only happen if the person who you care for wants you to be involved. Speak to the mental health team if you have ideas about what services should be available or how things could work better.
You can find more information by using the links below:
- Supporting someone with a mental illness
- Carers’ assessments and support planning
- Confidentiality – for carers, friends and relatives
Addaction is a drug and alcohol treatment agency. Their services deal primarily with drug and alcohol problems including support for families.
Telephone: 020 7251 5860 (admin).
Address: 67-69 Cowcross Street, London, EC1M 6PU
This is a national charity for families and friends of drug users. It offers confidential support and information.
Telephone: 020 3817 9410 (admin)
Address: 2nd Floor, 123 Cromer Street, London, WC1H 8BS
Al-Anon Family Groups
This is a service for families and friends of alcoholics. Al-Anon family groups provide understanding, strength and hope to anyone whose life is, or has been, affected by someone else's drinking.
Telephone: 020 7403 0888 (helpline) Open 10am-10pm, 365 days a year
Address: Al-Anon Family Groups, 57B Great Suffolk Street, London, SE1 0BB
Email: Online form here http://www.al-anonuk.org.uk/node/5456
Alcohol concern is the national organisation for alcohol misuse. It does not provide services but they do produce information on alcohol.
Telephone: 0203 907 8480 (admin)
Address: 27 Swinton Street, London , WC1X 9NW
Alcoholics Anonymous (AA)
AA provides an opportunity for people to get together to solve their problem with alcohol and help others to recover.
Telephone: 0800 9177 650 (helpline)
Address: PO Box 1, 10 Toft Green, York, YO1 7NJ
Cocaine Anonymous (CA)
CA is a fellowship of men and women who use the 12 step, self-help programme to stop cocaine and all other mind-altering substances.
Telephone: 0800 612 0225 (helpline) Open 10am – 10pm every day.
Address: CAUK, PO Box 1337, Enfield, EN1 9AS
Narcotics Anonymous UK (NAUK)
NA is a non-profit fellowship or society of men and women for whom drugs had become a major problem. They are recovering addicts who meet regularly to help each other stay clean. They have groups around the country.
Helpline: 0300 999 1212 (10am – Midnight)
This is the national alcohol helpline. They provide information and self-help materials for callers worried about their own drinking, and to support the family and friends of people who are drinking. They are confidential, you do not have to give your name and they can provide advice on where to get help.
Telephone: 0300 123 1110 (helpline) (weekdays 9am – 8pm, weekends 11am – 4pm)
DrugWise provides information and publications on a wide range of drug related topics.
Frank provides information and advice on drugs to anyone concerned about drugs and solvent misuse, including people misusing drugs, their families, friends and carers.
Telephone: 0300 123 6600 (helpline) Open 24 hours a day.
Email: Online form here: http://www.talktofrank.com/contact
Webchat: www.talktofrank.com/contact-frank Open 2pm-6pm every day.
They offer advice and information on drug problems. They have expertise in legal matters surrounding drugs.
Telephone: 020 7324 2989 (helpline)
Address: Release, Fergusson House, 5th Floor, 124-128 City Road, London, EC1V 2NJ.
This is an organisation that works with people affected by drug and alcohol misuse, mental health problems and learning disabilities.
Telephone: 020 7481 7600 (admin)
Address: Standon House, 21 Mansell Street, London, E1 8AA