Worried About Your Alcohol or Drug Use? Start Here

First, check for immediate danger

Call 911 now if you or someone with you is unconscious, cannot be awakened, is breathing slowly or irregularly, has blue or gray lips, is having a seizure, has severe chest pain or may have overdosed. Give naloxone if opioids could be involved and it is available. Stay until help arrives.

Alcohol and benzodiazepine withdrawal can cause seizures, hallucinations and delirium. Do not try to detox alone if you have been using either regularly or have a history of severe withdrawal. A medical team can assess whether outpatient care is safe.

A private self-check

Addiction is not defined by a particular substance, amount or appearance. The central pattern is reduced control alongside meaningful harm. Consider what has changed over the past 12 months rather than judging yourself by one difficult day.

• You use more, for longer, or more often than you planned.
• You have tried to cut back but returned to the same pattern.
• Cravings or thoughts about using take up significant time.
• Work, school, money, sleep, health or relationships have been affected.
• You continue despite knowing it worsens a physical or emotional problem.
• You need more for the same effect or feel unwell when you stop.
• You hide, minimize or feel defensive about the pattern.

One sign does not settle the question. Several signs, increasing severity or a sense that your choices are narrowing are reasons to speak with a professional. Read our guide to signs of addiction for a fuller explanation.

What to do in the next 24 hours

1. Tell one safe person what has been happening. Choose someone likely to listen rather than argue.
2. Write down what you use or do, how much, how often and what happens afterward.
3. Remove immediate risks such as driving after use, mixing substances or using opioids alone.
4. Call your primary care clinic, insurer or SAMHSA to ask for an assessment.
5. Keep emergency numbers and naloxone available if overdose is possible.

You do not have to promise lifelong abstinence during the first call. You can say, ‘I am worried about my use and want an assessment.’ That gives the clinician enough information to begin.

What happens when you ask for help

An assessment usually covers current use, withdrawal history, medications, physical health, mental health, housing, safety and the support available to you. Honest answers help the clinician recommend the least restrictive safe level of care.

Possible recommendations

• Brief counseling and a planned follow-up.
• Outpatient therapy or an intensive outpatient program.
• Medication for alcohol, opioid or nicotine use disorder.
• Medically supervised withdrawal management.
• Residential treatment when a stable, substance-free setting is needed.
• Care for anxiety, depression, trauma, ADHD or another co-occurring condition.

Treatment should be individualized. Explore our comparison of inpatient and outpatient rehab and the federal directory at FindTreatment.gov.

Ways to reduce risk right now

• Do not mix opioids with alcohol, benzodiazepines or other sedatives.
• Do not use alone. If you cannot avoid it, tell someone where you are and keep naloxone nearby.
• Do not drive, swim or operate equipment while impaired.
• Use less after any period of abstinence because tolerance can fall quickly.
• Eat, hydrate and take prescribed medication only as directed.
• Seek medical advice before stopping alcohol or benzodiazepines abruptly.

Harm reduction is healthcare, not approval of continued use. These steps can keep you alive and connected while you decide what change is realistic. Our harm reduction guide explains more.

Choosing support that fits

Look for licensed care that explains its methods, costs, privacy practices and how medications are handled. Be cautious of guarantees, pressure to travel immediately, unclear fees or anyone who offers money or gifts for attending treatment.

Cost and insurance questions are valid. Ask providers for a written explanation of fees, coverage and financial assistance before admission. Our treatment resources include free national locators.

How to prepare for a first appointment

• List substances, medications and supplements, including approximate amounts.
• Note the last time you used and any past withdrawal symptoms.
• Bring insurance details and questions about privacy and cost.
• Mention pregnancy, seizures, heart conditions, severe depression or suicidal thoughts immediately.
• Ask what to do if symptoms worsen before the next appointment.

Shame often makes people edit the story. Clinicians need the clearest version you can give, especially when alcohol, opioids, benzodiazepines or several substances are involved. You deserve care even if you are uncertain, have returned to use before or are not ready for every recommended change.

Frequently asked questions