National Recovery Month: Recognizing When it Might be Time to Speak to a Professional About Substance Use

Why September Can Be a Time for Reflection

Every September, National Recovery Month appears in various forms, from social media feeds to doctor’s office posters. This observance, which began in 1989, aims to highlight that recovery is achievable and that treatment is effective ¹.

In our practice, we view September not just as a celebration, but as a gentle invitation. It’s a month that often prompts reflection on questions you might not consider at other times of the year.

The message from SAMHSA has evolved, aligning with our clinical perspective: treatment isn’t a last resort reserved for those who have suffered extensively. Instead, it’s an active choice for individuals who are still managing their lives, careers, and families ⁸.

So, if September brings certain observations to your attention, it means the month is serving its intended purpose.

Understanding the Prevalence of Substance Use

Before we delve deeper, it’s important to acknowledge a significant statistic that might shift your perspective. In 2022, over one in six Americans aged 12 or older, approximately 16.7 percent, reported experiencing a substance use disorder ².

This isn’t a marginal figure; it represents people from all walks of life: your colleagues, neighbors, parents at school, healthcare providers, and potentially even yourself.

We share this not to diminish your personal experience, which is valid and deserves attention. Rather, we want to counter the shame that often thrives on the belief that you are alone in this struggle. This belief is simply untrue.

If you’ve been quietly carrying this burden, thinking there’s something uniquely wrong with you, please understand that the clinical reality is far more common. Substance use challenges are widespread, treatable, and inquiring about them is a reasonable and proactive step.

Recognizing When It’s Time to Seek Support

Most people don’t have a sudden realization about their substance use. Instead, the signs emerge subtly, often visible only when you pause to honestly assess your patterns.

We find it helpful to categorize these observations into four areas. If several points resonate with you, it’s worth exploring further.

• Physical indicators: You might notice needing more of a substance to achieve the same effect, or experiencing withdrawal symptoms like shakiness, sweating, nausea, or panic when you go without it. Sleep disturbances, such as difficulty falling asleep without using or waking up in the early hours, can also be a sign ³.

• Control challenges: You might find yourself using more than intended, or struggling to take breaks despite planning to. Cravings can appear unexpectedly, and past attempts to reduce use may not have been successful ³.

• Relationship impacts: A partner might express concerns, or you might find yourself concealing the extent or frequency of your use. Avoiding social situations or initiating arguments to create opportunities for use can also be indicators ².

• Daily life disruptions: Your work performance might be subtly declining, or you might be canceling plans you once enjoyed. Hobbies and activities that used to bring you joy may gradually disappear.

You don’t need to experience every single one of these signs. If even a few feel uncomfortably familiar, that’s a valid reason to have a conversation with a professional. The goal isn’t to commit to drastic changes immediately, but simply to talk and gain clarity.

Beyond Crisis: The Often-Overlooked Middle Ground

There’s a significant space between “everything is fine” and “I need immediate inpatient treatment” that many people are unaware of. In the clinical world, this is known as SBIRT, which stands for screening, brief intervention, and referral to treatment ⁴.

To explain it simply:

Screening

Screening involves an honest, brief conversation with a professional about your substance use patterns, frequency, and how it’s affecting you. This is a non-judgmental assessment of your current situation.

Brief intervention

The brief intervention is the next part of this discussion, where you and the clinician explore your observations and any desired changes. This step focuses on building motivation rather than pressuring you into decisions you’re not ready for ⁴.

Referral to treatment

A referral to treatment is only considered if the screening indicates that more intensive support would be beneficial. For some, the conversation itself can lead to positive shifts. For others, it opens the door to options like counseling, group support, or medication-assisted treatment ⁴.

The key takeaway here is that talking to a professional doesn’t automatically mean committing to a major intervention. Sometimes, it simply means gaining an honest, unbiased understanding of your situation from someone who isn’t judging you.

When Substance Use Masks Deeper Issues

In our practice, we frequently observe that substance use is rarely an isolated issue. More often, it serves as a coping mechanism for underlying, unresolved challenges.

These can include persistent anxiety, unaddressed trauma manifesting as flashbacks or emotional numbness, depression that makes evenings unbearable without a drink, chronic sleep problems, or unresolved grief.

The presence of co-occurring conditions is common, and treatment is more effective when both the substance use and the underlying issues are addressed simultaneously, rather than in isolation ³.

This integrated approach is crucial when choosing where to seek help. A conversation with a professional who understands the interplay between trauma, mood disorders, and substance use can prevent you from having to recount your story multiple times to different providers who may not collaborate.

If you’ve suspected that your drinking, medication use, or vaping is serving a purpose that something else should, your intuition is likely correct. This insight isn’t a weakness; it’s the starting point for meaningful healing.

Urgent Situations Requiring Immediate Attention

While many substance use concerns can be addressed at your own pace, certain situations demand faster action.

If any of the following apply, we urge you to seek help without delay:

• Opioid involvement: If you or someone you care about is using prescription opioids outside of their prescribed use, or using heroin or fentanyl in any form, this is an urgent matter. Detox alone is insufficient and can increase the risk of overdose and death ⁹. Medication-assisted treatment is life-saving and should be part of the conversation from the outset ¹⁰.

• Thoughts of self-harm or suicide: If substance use is accompanied by thoughts of ending your life or urges to harm yourself, immediate professional support is critical. Go to the nearest emergency room or contact the 988 Lifeline. 

• Dangerous solo use: Mixing substances, using amounts that cause fear, blacking out, or driving under the influence are all clear indicators that safety has been compromised.

“Faster action” doesn’t mean panic; it means reaching out today. The SAMHSA National Helpline is a free, confidential, and 24/7 resource for immediate support ⁵. It’s a vital starting point when the situation cannot wait.

Supporting a Loved One Through Substance Use Challenges

If you’re reading this on behalf of someone else, we understand the unique challenges and exhaustion that come with it. You’ve likely replayed countless conversations in your mind, none of which feel quite right.

Here are a few approaches that can be genuinely helpful:

• Focus on observations, not accusations: Instead of saying, “You have a problem,” try, “I’ve noticed you’ve been staying up later and drinking more on weeknights, and I miss spending time with you.” One approach invites dialogue, while the other can shut it down.

• Choose the right moment: Initiate conversations when neither person is under the influence or experiencing withdrawal. Sober mornings, quiet weekend afternoons, or a walk can be ideal. Avoid discussions during arguments.

• Don’t demand agreement with a label: They don’t need to identify as having an “addiction” to speak with a professional. A single conversation with a clinician can provide an honest assessment without requiring a commitment to anything major, making it an easier step to accept ¹³.

If your loved one isn’t ready, remember that you are still permitted to seek support for yourself. Their timeline for change doesn’t have to dictate yours.

Support for First Responders, Military, and Medical Professionals

We want to specifically address a particular group of readers: those in law enforcement, fire, EMS, active-duty or veteran military, and medicine. We recognize that the decision to seek help in these professions carries unique considerations.

You’ve witnessed situations most people can’t imagine and made critical decisions under immense pressure. It’s common to develop coping mechanisms, such as using substances after a shift, to manage these experiences.

For you, confidentiality is paramount. It’s also crucial to work with a clinician who understands operational stress, trauma exposure, and the specific culture of your profession. Reaching out for help is about accessing the same evidence-based care that benefits everyone else, delivered by someone who truly understands your context ³.

What to Expect After Reaching Out

One of the primary reasons people delay seeking help is uncertainty about what the process entails. Here’s an honest overview of what typically happens.

Your first appointment will primarily be a conversation. A clinician will ask about your substance use, how it fits into your daily life, what challenges you’ve faced, and what changes you’d like to see. No decisions will be made without your input.

From there, your care plan will be tailored specifically to you. This might involve individual therapy, a skills-based group, family or couples counseling, medication support, or a trauma-focused approach like EMDR or IFS if there are deeper, underlying issues ^{3, 12}.