Early Intervention for Substance Use Disorders

Medically Reviewed by Jennifer Casarella, MD on April 21, 2022
5 min read

A substance use disorder (SUD) is a mental health condition that affects your body and brain. If you have an SUD, you’ll lose the ability to control your use of drugs, whether that’s alcohol, nicotine, an illegal drug, or opioids or other prescription medicines.

The good news is that there are ways to treat SUDs. Treatment with medicine, counseling, or other support services can help you manage your symptoms. They also will make a relapse less likely. Treatments for SUDs work about as well as treatments for many other chronic illnesses, like diabetes or high blood pressure.

Millions of people who used to have an SUD are now in remission. But many people also don’t get help for their SUD until they’re in crisis. They may have had an overdose or gotten into trouble. As with other chronic illnesses like diabetes or high blood pressure, it’s best to treat an SUD early, before more serious health or other problems arise.

SUDs can be mild, moderate, or severe. When you get help for an SUD at a mild to moderate stage, a doctor’s advice or a short period of treatment may be enough. That’s why there’s more effort now to catch substance misuse and early signs of an SUD in primary care or other general health care settings. Education and early interventions can help you before an SUD even starts or before it gets worse and harder to treat. If you think you or a loved one has an SUD or is at risk for one due to substance misuse, it’s a good idea to get help with it as early as you can.

Early intervention can happen just about anywhere. You can find early intervention services at school, your primary care doctor’s office, urgent care, the ER, or a mental health clinic.

You may want to seek out early intervention if you think you or a loved one is misusing substances or may have a mild SUD. Most of the time, early intervention happens when you aren’t looking for help with an SUD. You may find it when you go to the doctor for some other health condition or a social service.

The goal of early intervention is to help you before substance misuse or a mild SUD gets worse or does more harm. It can help you to cut back on substances you’re misusing before you become more dependent on them and can’t control your use.

Early intervention can improve your health and ability to function normally from day to day. It can help keep you from moving from substance misuse to an SUD or prevent a mild or moderate SUD from becoming more severe. With early intervention, you may be able to improve your health and avoid the harms that often come with SUDs without the need for longer and more complex treatments at a clinic that specializes in treating SUDs.

Substance use disorders often start early in life. It’s common for them to emerge during adolescence. While SUDs don’t always get worse, they often do get more severe or complex over time. More than 20 million Americans age 12 or older have an alcohol or drug use disorder. More than 1 in every 3 people in the U.S. will develop an SUD at some point in their life.

Adolescents and adults who are at risk or showing signs of substance misuse or a mild SUD can benefit from early intervention. This includes people who binge drink. Binge drinkers are men who have consumed at least five drinks, or women who consumed at least four drinks, at one time in the last 30 days. Young people who binge drink may be at more risk for developing an SUD in the future. Early intervention also may especially benefit people who use substances while driving or during pregnancy. People with other mental health conditions also may have a greater risk for developing an SUD and may benefit from early intervention.

One study of more than 5,000 people found that most who develop symptoms of severe SUD early in life will continue to misuse substances later in life. It also showed that most adults who misuse prescription medicines, including opioids, sedatives, or tranquilizers, had an SUD when they turned 18. This might be because some people are more vulnerable to SUDs throughout life than other people or because early substance use increases the risk of a later SUD.

These findings show the importance of early intervention. By identifying young people who are misusing substances and at risk of SUD, health providers can encourage cutting back on substance use before it becomes a bigger health problem.

Screening is the first step in early intervention. The goal is to find out if you are or may be at risk of harm from the misuse of substances or a developing SUD. Current recommendations say ideally, all adolescents and adults should undergo screening for substance use and possible misuse or SUD.

Doctors have different tools they can use to screen for substance misuse or SUD. They may ask questions such as, “How many times in the past year have you used an illegal drug or prescription medicine for non-medical reasons?” They may ask how many times in the past year you’ve had more than four or five drinks in a day.

The next step, if you’re at risk from your use of substances, is a brief intervention or advice. A doctor, nurse, or other provider can help you understand how your substance use compares to levels that are considered safe. They may give you advice to help you in your own decision-making about your substance use.

If you aren’t sure about changing your substance use, a counselor can help you with an approach called motivational interviewing. They’ll talk you through to help you find the motivation to change the way you’re using substances. There’s evidence that this can help you stick to a treatment plan and avoid future harm from SUDs.

If your provider determines that your SUD is more severe or that a brief intervention isn’t enough, they can refer you for further treatment. They can help you find a specialist for more help and navigate the process to improve your health now and into the future.

If you think you or a loved one could benefit from early intervention or SUD treatment, you can start with your usual doctor, urgent care, or any other medical provider. The Substance Abuse and Mental Health Services Administration (SAMHSA) can help you find a treatment facility if you need it. They also have a free and confidential helpline (800-662-HELP (4357)) for treatment referral and information about SUDs and other mental health conditions.