Understanding
Substance Misuse
Understanding addiction, dependency, and the complex relationship between substances and mental health
Understanding
Substance Misuse
Understanding addiction, dependency, and the complex relationship between substances and mental health
Understanding
Substance Misuse
Understanding addiction, dependency, and the complex relationship between substances and mental health
What does substance misuse feel like?
Living with substance misuse means experiencing a loss of control over substance use that continues despite negative consequences to health, relationships, work, or legal situations. Whether involving alcohol, prescription medications, illegal drugs, or other substances, the experience often involves feeling trapped in a cycle where temporary relief or escape is followed by shame, guilt, and promises to stop, only to find yourself using again. This creates increasing tolerance, requiring more of the substance to achieve the same effects, whilst withdrawal symptoms make stopping feel impossible.
The experience encompasses both physical dependence and psychological reliance, with substances becoming the primary coping mechanism for stress, emotional pain, or mental health challenges. Many people describe feeling like they're living a double life, managing secrecy and lies whilst struggling with cravings and compulsions that interfere with daily functioning, relationships, and personal values, creating profound isolation and self-blame.
Common Symptoms
Inability to control or limit substance use despite wanting to
Continued use despite negative consequences to health or relationships
Developing tolerance requiring increasing amounts for same effects
Experiencing withdrawal symptoms when attempting to stop or reduce use
Neglecting responsibilities, hobbies, or relationships due to substance use
Spending significant time obtaining, using, or recovering from substances
Using substances to cope with stress, anxiety, depression, or other difficulties
Lying or being secretive about substance use with family or friends
What does substance misuse feel like?
Living with substance misuse means experiencing a loss of control over substance use that continues despite negative consequences to health, relationships, work, or legal situations. Whether involving alcohol, prescription medications, illegal drugs, or other substances, the experience often involves feeling trapped in a cycle where temporary relief or escape is followed by shame, guilt, and promises to stop, only to find yourself using again. This creates increasing tolerance, requiring more of the substance to achieve the same effects, whilst withdrawal symptoms make stopping feel impossible.
The experience encompasses both physical dependence and psychological reliance, with substances becoming the primary coping mechanism for stress, emotional pain, or mental health challenges. Many people describe feeling like they're living a double life, managing secrecy and lies whilst struggling with cravings and compulsions that interfere with daily functioning, relationships, and personal values, creating profound isolation and self-blame.
Common Symptoms
Inability to control or limit substance use despite wanting to
Continued use despite negative consequences to health or relationships
Developing tolerance requiring increasing amounts for same effects
Experiencing withdrawal symptoms when attempting to stop or reduce use
Neglecting responsibilities, hobbies, or relationships due to substance use
Spending significant time obtaining, using, or recovering from substances
Using substances to cope with stress, anxiety, depression, or other difficulties
Lying or being secretive about substance use with family or friends
What does substance misuse feel like?
Living with substance misuse means experiencing a loss of control over substance use that continues despite negative consequences to health, relationships, work, or legal situations. Whether involving alcohol, prescription medications, illegal drugs, or other substances, the experience often involves feeling trapped in a cycle where temporary relief or escape is followed by shame, guilt, and promises to stop, only to find yourself using again. This creates increasing tolerance, requiring more of the substance to achieve the same effects, whilst withdrawal symptoms make stopping feel impossible.
The experience encompasses both physical dependence and psychological reliance, with substances becoming the primary coping mechanism for stress, emotional pain, or mental health challenges. Many people describe feeling like they're living a double life, managing secrecy and lies whilst struggling with cravings and compulsions that interfere with daily functioning, relationships, and personal values, creating profound isolation and self-blame.
Common Symptoms
Inability to control or limit substance use despite wanting to
Continued use despite negative consequences to health or relationships
Developing tolerance requiring increasing amounts for same effects
Experiencing withdrawal symptoms when attempting to stop or reduce use
Neglecting responsibilities, hobbies, or relationships due to substance use
Spending significant time obtaining, using, or recovering from substances
Using substances to cope with stress, anxiety, depression, or other difficulties
Lying or being secretive about substance use with family or friends
History of Substance Misuse
From moral failing to understood medical condition requiring comprehensive treatment
Ancient Times-1800s
Substance problems viewed primarily as moral weaknesses or character flaws, with punitive rather than therapeutic approaches dominating societal responses to addiction and dependency
Early-Mid 1900s
Growing medical understanding recognises addiction as disease rather than moral failing, with development of early treatment programmes and recognition of withdrawal as medical emergency requiring professional care
1970s-90s
Research advances understanding of addiction neurobiology and genetics, whilst development of evidence-based treatments like methadone maintenance and cognitive behavioural approaches improve outcomes significantly
Present
Modern addiction medicine integrates medical, psychological, and social approaches, recognising substance misuse as complex condition requiring individualised treatment addressing underlying mental health, trauma, and social factors alongside addiction itself
History of Substance Misuse
From moral failing to understood medical condition requiring comprehensive treatment
Ancient Times-1800s
Substance problems viewed primarily as moral weaknesses or character flaws, with punitive rather than therapeutic approaches dominating societal responses to addiction and dependency
Early-Mid 1900s
Growing medical understanding recognises addiction as disease rather than moral failing, with development of early treatment programmes and recognition of withdrawal as medical emergency requiring professional care
1970s-90s
Research advances understanding of addiction neurobiology and genetics, whilst development of evidence-based treatments like methadone maintenance and cognitive behavioural approaches improve outcomes significantly
Present
Modern addiction medicine integrates medical, psychological, and social approaches, recognising substance misuse as complex condition requiring individualised treatment addressing underlying mental health, trauma, and social factors alongside addiction itself
History of Substance Misuse
From moral failing to understood medical condition requiring comprehensive treatment
Ancient Times-1800s
Substance problems viewed primarily as moral weaknesses or character flaws, with punitive rather than therapeutic approaches dominating societal responses to addiction and dependency
Early-Mid 1900s
Growing medical understanding recognises addiction as disease rather than moral failing, with development of early treatment programmes and recognition of withdrawal as medical emergency requiring professional care
1970s-90s
Research advances understanding of addiction neurobiology and genetics, whilst development of evidence-based treatments like methadone maintenance and cognitive behavioural approaches improve outcomes significantly
Present
Modern addiction medicine integrates medical, psychological, and social approaches, recognising substance misuse as complex condition requiring individualised treatment addressing underlying mental health, trauma, and social factors alongside addiction itself
Take our free self-test
Take our free self-test
Take our free self-test
Take a short self-test to see if counselling might make a difference.
Take a short self-test to see if counselling might make a difference.
Instructions
Answer based on the last 2 weeks. Choose the option that fits best. You’ll see your results at the end.
This short self-test screens for social anxiety over the last 2 weeks. It isn’t a diagnosis, but it can help you decide next steps.
How therapy can help
Therapy for substance misuse uses evidence-based approaches like Cognitive Behavioural Therapy (CBT), motivational interviewing, and relapse prevention training to address both the addiction and underlying factors contributing to substance use. Treatment focuses on identifying triggers and high-risk situations, developing healthy coping strategies, and addressing co-occurring mental health conditions like depression, anxiety, or trauma that often fuel substance use. Many programmes integrate group therapy, family involvement, and peer support to build comprehensive recovery networks.
Treatment emphasises building motivation for change, developing practical skills for managing cravings and avoiding relapse, and creating meaningful life goals that support long-term recovery. Many people find significant improvement through combining therapy with medical support when needed, with treatment focusing on sustainable lifestyle changes rather than quick fixes, recognising that recovery is often an ongoing process requiring continued support and skill development.
Benefits of Therapy
Understanding triggers and underlying causes of substance use
Developing healthy coping strategies for stress and difficult emotions
Learning relapse prevention techniques and crisis management skills
Addressing co-occurring mental health conditions like depression or anxiety
Building motivation and commitment to recovery goals
Improving relationships and repairing trust with family and friends
Developing meaningful activities and purposes beyond substance use
Frequently Asked Questions
Understanding addiction and the journey to recovery
Is addiction really a disease, or is it a choice?
Addiction involves both biological changes in the brain and behavioural choices, making it a complex medical condition rather than simply a moral failing or lack of willpower. While initial substance use involves choice, repeated use changes brain chemistry and neural pathways, making stopping extremely difficult without professional help and support.
Can someone recover from addiction completely?
Yes, many people achieve long-term recovery from substance misuse and go on to live fulfilling, productive lives. Recovery is often an ongoing process rather than a one-time cure, with many people benefiting from continued support, therapy, or peer groups even years after stopping substance use.
What if I'm not ready to stop using completely?
Treatment can help even if you're not ready for complete abstinence. Harm reduction approaches focus on reducing risks and negative consequences whilst working towards readiness for change. Many people find that reducing use or making safer choices can be important stepping stones towards recovery.
How do I know if I need professional help versus handling this myself?
Professional help is recommended if substance use interferes with work, relationships, or daily functioning, if you've tried to stop unsuccessfully, if you experience withdrawal symptoms, or if you're using substances to cope with mental health problems. Early intervention often prevents more serious problems from developing.
How therapy can help
Therapy for substance misuse uses evidence-based approaches like Cognitive Behavioural Therapy (CBT), motivational interviewing, and relapse prevention training to address both the addiction and underlying factors contributing to substance use. Treatment focuses on identifying triggers and high-risk situations, developing healthy coping strategies, and addressing co-occurring mental health conditions like depression, anxiety, or trauma that often fuel substance use. Many programmes integrate group therapy, family involvement, and peer support to build comprehensive recovery networks.
Treatment emphasises building motivation for change, developing practical skills for managing cravings and avoiding relapse, and creating meaningful life goals that support long-term recovery. Many people find significant improvement through combining therapy with medical support when needed, with treatment focusing on sustainable lifestyle changes rather than quick fixes, recognising that recovery is often an ongoing process requiring continued support and skill development.
Benefits of Therapy
Understanding triggers and underlying causes of substance use
Developing healthy coping strategies for stress and difficult emotions
Learning relapse prevention techniques and crisis management skills
Addressing co-occurring mental health conditions like depression or anxiety
Building motivation and commitment to recovery goals
Improving relationships and repairing trust with family and friends
Developing meaningful activities and purposes beyond substance use
Frequently Asked Questions
Understanding addiction and the journey to recovery
Is addiction really a disease, or is it a choice?
Addiction involves both biological changes in the brain and behavioural choices, making it a complex medical condition rather than simply a moral failing or lack of willpower. While initial substance use involves choice, repeated use changes brain chemistry and neural pathways, making stopping extremely difficult without professional help and support.
Can someone recover from addiction completely?
Yes, many people achieve long-term recovery from substance misuse and go on to live fulfilling, productive lives. Recovery is often an ongoing process rather than a one-time cure, with many people benefiting from continued support, therapy, or peer groups even years after stopping substance use.
What if I'm not ready to stop using completely?
Treatment can help even if you're not ready for complete abstinence. Harm reduction approaches focus on reducing risks and negative consequences whilst working towards readiness for change. Many people find that reducing use or making safer choices can be important stepping stones towards recovery.
How do I know if I need professional help versus handling this myself?
Professional help is recommended if substance use interferes with work, relationships, or daily functioning, if you've tried to stop unsuccessfully, if you experience withdrawal symptoms, or if you're using substances to cope with mental health problems. Early intervention often prevents more serious problems from developing.
How therapy can help
Therapy for substance misuse uses evidence-based approaches like Cognitive Behavioural Therapy (CBT), motivational interviewing, and relapse prevention training to address both the addiction and underlying factors contributing to substance use. Treatment focuses on identifying triggers and high-risk situations, developing healthy coping strategies, and addressing co-occurring mental health conditions like depression, anxiety, or trauma that often fuel substance use. Many programmes integrate group therapy, family involvement, and peer support to build comprehensive recovery networks.
Treatment emphasises building motivation for change, developing practical skills for managing cravings and avoiding relapse, and creating meaningful life goals that support long-term recovery. Many people find significant improvement through combining therapy with medical support when needed, with treatment focusing on sustainable lifestyle changes rather than quick fixes, recognising that recovery is often an ongoing process requiring continued support and skill development.
Benefits of Therapy
Understanding triggers and underlying causes of substance use
Developing healthy coping strategies for stress and difficult emotions
Learning relapse prevention techniques and crisis management skills
Addressing co-occurring mental health conditions like depression or anxiety
Building motivation and commitment to recovery goals
Improving relationships and repairing trust with family and friends
Developing meaningful activities and purposes beyond substance use
Frequently Asked Questions
Understanding addiction and the journey to recovery
Is addiction really a disease, or is it a choice?
Addiction involves both biological changes in the brain and behavioural choices, making it a complex medical condition rather than simply a moral failing or lack of willpower. While initial substance use involves choice, repeated use changes brain chemistry and neural pathways, making stopping extremely difficult without professional help and support.
Can someone recover from addiction completely?
Yes, many people achieve long-term recovery from substance misuse and go on to live fulfilling, productive lives. Recovery is often an ongoing process rather than a one-time cure, with many people benefiting from continued support, therapy, or peer groups even years after stopping substance use.
What if I'm not ready to stop using completely?
Treatment can help even if you're not ready for complete abstinence. Harm reduction approaches focus on reducing risks and negative consequences whilst working towards readiness for change. Many people find that reducing use or making safer choices can be important stepping stones towards recovery.
How do I know if I need professional help versus handling this myself?
Professional help is recommended if substance use interferes with work, relationships, or daily functioning, if you've tried to stop unsuccessfully, if you experience withdrawal symptoms, or if you're using substances to cope with mental health problems. Early intervention often prevents more serious problems from developing.
Meet our Therapists
Meet our Therapists
Meet our specialists who can help guide your recovery
Jayne Tamsett is a BACP accredited counsellor with a BA (Hons) in Counselling & Psychotherapy and over 4,700 clinical hours. She works with adults experiencing anxiety, trauma, depression, and relationship challenges. Her practice offers an inclusive and compassionate space where clients feel heard, understood, and supported in their personal growth
More
Adults (18+)
Waqas Maqsood is an integrative counsellor and registered member of the BACP with over 600 clinical hours. Holding an MA in Integrative Counselling and a BSc in Neuroscience, he offers a holistic, flexible approach that supports clients with anxiety, trauma, low self-esteem, and life transitions.
More
Adults (18+)
Victoria is a compassionate and down-to-earth therapist with an MSc in Counselling and Psychotherapy and more than 1,900 clinical hours of experience. A registered member of the BACP, she supports both individuals and couples, offering a warm, collaborative space to explore relationships, self-worth, anxiety, and personal growth in a supportive environment.
More
Adults (18+)
Couples
Matt is an integrative counsellor holding a Diploma in Integrative Counselling with experience delivering more than 500 clinical sessions. He combines counselling, mindfulness, and meditation techniques to support clients with anxiety, depression, trauma, self-esteem issues, and life transitions, helping people build resilience, clarity, and a stronger sense of emotional wellbeing.
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Adults (18+)
At Manchester Counselling, we are pleased to introduce Grant Fairlie (MBACP), a counsellor with over 1,900 clinical hours and more than three years of practice. Grant brings a background in drama education and specialist experience supporting neurodiverse adults and adolescents.
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Adults (18+)
Introducing Andrea Szentgyorgyi, a UKCP-registered integrative psychotherapist with over 1,000 clinical hours. Andrea combines person-centred, solution-focused therapy with advanced techniques including hypnotherapy and EMDR, creating a tailored and flexible approach for each client. With 6 years of experience, she provides a safe and supportive space to explore challenges and promote lasting emotional wellbeing.
More
Adults (18+)
Jayne Tamsett is a BACP accredited counsellor with a BA (Hons) in Counselling & Psychotherapy and over 4,700 clinical hours. She works with adults experiencing anxiety, trauma, depression, and relationship challenges. Her practice offers an inclusive and compassionate space where clients feel heard, understood, and supported in their personal growth
More
Adults (18+)
Waqas Maqsood is an integrative counsellor and registered member of the BACP with over 600 clinical hours. Holding an MA in Integrative Counselling and a BSc in Neuroscience, he offers a holistic, flexible approach that supports clients with anxiety, trauma, low self-esteem, and life transitions.
More
Adults (18+)
Victoria is a compassionate and down-to-earth therapist with an MSc in Counselling and Psychotherapy and more than 1,900 clinical hours of experience. A registered member of the BACP, she supports both individuals and couples, offering a warm, collaborative space to explore relationships, self-worth, anxiety, and personal growth in a supportive environment.
More
Adults (18+)
Couples
Matt is an integrative counsellor holding a Diploma in Integrative Counselling with experience delivering more than 500 clinical sessions. He combines counselling, mindfulness, and meditation techniques to support clients with anxiety, depression, trauma, self-esteem issues, and life transitions, helping people build resilience, clarity, and a stronger sense of emotional wellbeing.
More
Adults (18+)
Jayne Tamsett is a BACP accredited counsellor with a BA (Hons) in Counselling & Psychotherapy and over 4,700 clinical hours. She works with adults experiencing anxiety, trauma, depression, and relationship challenges. Her practice offers an inclusive and compassionate space where clients feel heard, understood, and supported in their personal growth
More
Adults (18+)
Waqas Maqsood is an integrative counsellor and registered member of the BACP with over 600 clinical hours. Holding an MA in Integrative Counselling and a BSc in Neuroscience, he offers a holistic, flexible approach that supports clients with anxiety, trauma, low self-esteem, and life transitions.
More
Adults (18+)
Victoria is a compassionate and down-to-earth therapist with an MSc in Counselling and Psychotherapy and more than 1,900 clinical hours of experience. A registered member of the BACP, she supports both individuals and couples, offering a warm, collaborative space to explore relationships, self-worth, anxiety, and personal growth in a supportive environment.
More
Adults (18+)
Couples
Matt is an integrative counsellor holding a Diploma in Integrative Counselling with experience delivering more than 500 clinical sessions. He combines counselling, mindfulness, and meditation techniques to support clients with anxiety, depression, trauma, self-esteem issues, and life transitions, helping people build resilience, clarity, and a stronger sense of emotional wellbeing.
More
Adults (18+)