Alcohol and other psychoactive substances can cause harm when use becomes difficult to control, creates health problems or interferes with relationships, work and everyday life. Dependence is a health condition, not a moral failure.
Signs of harmful use
Warning signs can include needing increasing amounts, unsuccessful attempts to cut down, withdrawal symptoms, using despite clear harm, neglecting responsibilities or spending substantial time obtaining, using or recovering from substances.
Physical and mental health are connected
Substance use can interact with anxiety, depression, trauma, sleep problems, chronic pain and other conditions. Effective care often needs to consider both substance use and mental health.
Stopping suddenly can sometimes be dangerous
People who are physically dependent on alcohol or certain medicines may require medically supervised withdrawal. Seek professional advice rather than assuming abrupt cessation is always safe.
Treatment works in different ways
Support may include counselling, peer support, medical treatment, rehabilitation programmes and treatment of associated health problems. The right approach depends on the substance and individual circumstances.
If someone is severely unwell, confused, unconscious or in immediate danger, seek emergency medical assistance.
Make the first conversation practical
You do not have to decide on a label before asking for help. Tell a clinician what you use, how often, the amounts, when you last used it and what happens when you reduce it. Include prescribed sleeping tablets, sedatives and pain medicines. Honest information helps the team assess withdrawal risk and avoid dangerous interactions.
Emergency warning signs
Seizures, hallucinations, severe confusion or marked shaking during alcohol withdrawal need emergency care. An unresponsive person or someone breathing abnormally after substance use also needs immediate help. Stay with them and follow the dispatcher’s instructions.
Practical appointment checklist
- Choose a confidential healthcare or addiction-support service.
- Write down substances and medicines used, without minimising or judging.
- Ask whether medically supported withdrawal is needed.
- Plan transport, childcare and a trusted contact if treatment is arranged.
- Agree on follow-up and support after the initial appointment.
Common question
Does a return to substance use mean treatment failed?
It means the plan needs review and support. Speak with the care team about triggers and safety rather than hiding the change or giving up on care.
Sources and further reading
Related support
Use our appointment preparation guide, resources and community support to plan your next step.
Sources checked 22 September 2026. General education, not individual medical advice. International service arrangements may differ from South Africa. Featured artwork is illustrative, not a patient testimonial.
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