Recognizing you have a problematic relationship with substance use is not always easy. Our current culture is more accepting of certain types of substance use, such as alcohol or marijuana, and casual use does not always represent a problem. There is also increased scrutiny focused on dubious practices adopted by rehab facilities to onboard patients, making many reluctant to seek professional help.

Recovered receives many questions from the public regarding accessing treatment, being able to recognize when substance abuse is a problem, who is likely to develop an addiction, and more. To get the best answers to these questions, we approached healthcare and addiction experts to get their insights on how to address these issues and to answer your questions.

Is "casual" use of scheduled substances possible without the risk of developing a problem?

According to SAMHSAΓÇÖs annual national survey on drug use in 2022, 70.3 million Americans (24.9% of the population) over 12 years old reported using an illicit substance in the past year. In the same year, 48.7 million (17.3%) reported having a substance use disorder, with nearly half (27.2 million) reporting an alcohol use disorder instead of an illicit substance.

This data suggests that there is a wide margin of Americans who use substances without developing a substance use disorder, or who donΓÇÖt believe they have a problem. This could be down to those who use substances recreationally or casually, such as only at parties or in certain settings, or those who think their use is not a cause for concern.

We asked the experts whether it is possible to have a relationship with substances of abuse without the risk of developing a disorder down the line. HereΓÇÖs what they said:

Dr. Michelle Dees

The question commonly asked is if an individual can use drugs that have been labeled as having a high potential for misuse without eventually developing a substance use disorder. People need to know that while casual use does not always result in addiction, there are many things such as genetics, mental health, social environment, and the drug itself which can greatly increase the chances of this happening. [3]

Medical advisor

Dr. Michael Kane

Even with controlled substances, there is always a risk of developing a substance use disorder. Whether the usage is casual or not, repeated exposure to these substances can lead to physical and psychological dependency.

Many other factors can also contribute to the development of a use disorder, such as genetics, environment, and mental health. You never know when casual use can turn into something more serious, so it's important to always be mindful and cautious of your usage. [4]

Medical advisor

Dr. Jordan Calabrese

Millions of people casually use substances like alcohol and marijuana. We refer to this as recreational use, and it can be done without fear of repercussion if being done so by adults in moderation. This might be true for most people, but it is not true for all.

If you are predisposed to having a substance use disorder, you may want to steer clear of even recreational use of what could be called ΓÇ£safeΓÇ¥ substances. If substance use runs in your family, or if you have a personality that tends toward the addictive side, avoiding substances altogether is your safest bet. [5]

Medical advisor

Are certain individuals more likely to develop a substance use disorder?

We often think of substances themselves as the root cause of addiction. However, this is not always the case, and a wide spectrum of factors can influence substance use disorders.These can include: 

We asked our experts to expand on what exactly makes someone more or less likely to become addicted to substance abuse.

Gary Tucker

Personal History: Individuals who have experienced trauma or stress or have a history of other mental health disorders are at a higher risk.

Genetics: Genetic predisposition can play a significant role in the development of SUD. Individuals with a family history of substance abuse are more likely to develop SUD themselves, as they may inherit certain genes that make them more susceptible to addiction.

Age: Initiating substance use at a young age increases the likelihood of developing SUD.

Cultural Factors: Cultural attitudes towards drug use and availability within a community can influence patterns of use.

Environmental Variables: Peer pressure, family dynamics, and economic status also play crucial roles. [6]

Medical advisor

Gary Tucker

Licensed Psychotherapist

Dr. Michael Kane

Yes, some individuals may be more genetically or psychologically vulnerable to developing a substance use disorder. For example, those with a family history of addiction or who have experienced trauma may be more at risk. Additionally, individuals with mental health conditions may use substances as a coping mechanism, increasing their chances of developing a use disorder. [4]

Medical advisor

Na'ilah Amaru

Anyone can experience substance use disorder. However, certain people may be more predisposed to developing a substance use disorder due to a combination of genetic, environmental, and psychological factors.

Genetic predispositions play a role if there's a family history of addiction or someone inherits traits that make them more susceptible to addictive behaviors.

Environmental factors such as exposure to substance use at an early age, peer pressure, trauma, and socioeconomic status can also contribute to the development of addiction. Also, underlying mental health conditions such as depression, anxiety, or trauma can increase the risk of substance abuse which is important to consider when exploring policy solutions to this issue. [7]

Medical advisor

Na'ilah Amaru

Advocacy & Policy Strategist

How easy or difficult is it to get help for substance use disorders?

Despite substance addiction rehabilitation being one of the biggest industries in the United States, it is not always straightforward for people to access treatment. Financial, geographical, and logistical considerations can act as barriers to those seeking treatment. Another consideration is the range of treatment options available and knowing which one is right to treat the individual's condition.

HereΓÇÖs what the experts had to say on accessing addiction treatment.

Gary Tucker

Access to help varies widely based on location, socioeconomic status, and the substance in question. While there has been significant progress in integrating addiction treatment into healthcare systems, challenges persist:

Availability of treatment centers and qualified professionals might be limited in certain areas.

Insurance coverage for addiction treatment can be variable, leaving some without necessary financial support.

Stigma around addiction can prevent individuals from seeking help. [6]

Medical advisor

Gary Tucker

Licensed Psychotherapist

Dr. Michelle Dees

Getting treatment for addiction may be difficult or easy depending on where you are geographically situated and what resources are available locally as well as nationally whether it be through insurance coverage or personal circumstances like work commitments etc. However, even though treatments exist ΓÇô there still remains barriers between those seeking help such as lack thereof. [3]

Medical advisor

Dr. Michael Kane

Access to treatment and resources for addiction can vary greatly depending on location, insurance coverage, and socioeconomic status. Unfortunately, many individuals may face barriers such as cost, lack of available treatment options, or stigma surrounding addiction that can make it difficult to get the help they need.

For instance, those without insurance may struggle to afford treatment, while others in rural or low-income areas may have limited access to facilities. This highlights the importance of addressing systemic issues and improving access to treatment for all individuals. [4]

Medical advisor

Na'ilah Amaru

It depends on the person's circumstances. The level of difficulty or ease depends on geographical location, financial resources, social support networks, and availability of treatment services.

For example, in some areas, there are long waiting lists for treatment programs, limited resources for those without insurance, or stigma associated with seeking help for addiction, which makes it challenging for people to access the support they need. [7]

Medical advisor

Na'ilah Amaru

Advocacy & Policy Strategist

Related: Racial Disparity in Drug Overdose Deaths in the U.S.

Is government and state funding enough to cope with the current addiction problem?

While many rehab facilities in the U.S. are run by for-profit organizations, some operate on state funding or via charitable donations. The latter is often the only choice for those who donΓÇÖt have insurance or canΓÇÖt access the finances to pay for treatment. As the name suggests, these organizations require government or state funding to operate, which may have an impact on their ability to facilitate treatment to all those who need it. With the opioid epidemic still raging, do state and government-funded rehabs have the capacity to deal with the issue?

Gary Tucker

Government and state funding towards addiction has increased in response to the opioid crisis and rising awareness of SUDs. However, the adequacy of these funds is subject to debate. Many advocates argue that while there has been an increase in funding, it still falls short of addressing the scale of the problem, especially considering the rising trends of addiction and the complexity of effective treatment, which often requires a multidisciplinary approach. [6]

Medical advisor

Gary Tucker

Licensed Psychotherapist

Na'ilah Amaru

Budget constraints and competing political agendas impact the allocation of funds for addiction services from the government. As a result, there are gaps in services, lack of coverage for certain populations, or limited availability of evidence-based treatment options. [7] Back to Knowledge Base

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