Mental Health First Aid for Substance Use Disorders

You can deliver mental health first aid to someone with a substance use disorder by providing assessment, information and support before professional help arrives.

The World Health Organization approximates that almost 3% of adults in the world have a substance use disorder and the National Institute on Drug Abuse states that nearly 10% of individuals in the United States have tried an illicit drug. Findings from the 2015 National Survey on Drug Use and Health found that more than 44 million people used an illicit or non-prescription drug in the prior year.

Mental health first aid for substance use disorders provides short-term support to people struggling with addiction until professional intervention or a loved one arrives. Mental health first aid teaches people to recognize and appropriately react to the signs and symptoms of a substance use disorder through assessment, encouragement and referral.

Symptoms of a Substance Use Disorder

Some of the most common symptoms of a substance use disorder include:

• Using a substance regularly
• Experiencing powerful urges to use a substance that take precedence over other thoughts
• Requiring larger amounts of a substance to achieve the same effect
• Using a substance in higher amounts or for longer durations than originally intended
• Ensuring that a steady supply of the substance is maintained
• Purchasing a substance even though it cannot be financially afforded
• Neglecting occupational or academic obligations or limiting social opportunities due to substance use
• Continuing to use a substance despite it causing physical or emotional harm to self or others
• Obtaining a substance or using a substance in risky or dangerous ways
• Spending an excessive amount of time thinking about using, obtaining or recovering from use of a substance
• Being unable to stop using a substance despite multiple efforts and attempts
• Experiencing withdrawal symptoms when an attempt is made to stop using a substance

Causes of a Substance Use Disorder

There are several factors that can contribute to the development of a substance use disorder, including:

• Heredity and genetics
• Environmental factors
• Social encouragement and peer pressure
• Co-occurring mental health conditions

Risk Factors

Risk factors linked to a higher chance of developing a substance use disorder include:

• Having a first-degree relative with a substance use disorder
• Co-occurring mental health conditions
• Lack of parental supervision and familial support
• Using substances with a high abuse potential

How to Provide Mental Health First Aid for Panic Attacks

Everybody is capable of providing mental health first aid for substance use disorders or mental health conditions. If someone is struggling with a substance use disorder, mental health first aid advises people around them to follow the ALGEE action plan. ALGEE is a mnemonic for:

• Assess for risk of suicide or harm
• Listen non-judgmentally
• Give reassurance and information
• Encourage appropriate professional help
• Encourage self-help and other support strategies

By following this action plan, a person offering mental health first aid can provide effective support and diminish the likelihood of harm to a person struggling with addiction until long-term supports and professional interventions are put into place.

Assess for Risk of Suicide or Harm

Before assisting someone with a substance use disorder, it is important to assess whether they are in a crisis situation. Signs and symptoms may differ depending on the substance that is misused along with the person’s level of tolerance. It is always best to be cautious while assessing risk, especially if you are unaware of the type of substance that the person is taking.

According to the Centers for Disease Control (CDC), 43,982 deaths from drug overdoses occurred in 2013 in the United States. If you are witnessing a crisis situation where a person may have overdosed, it is important to recognize the signs and symptoms of overdose and identify the substance that the person overdosed on.

During any overdose, 911 should be contacted immediately for medical assistance. If you identify that a person has overdosed on prescription opioids or heroin (depressant overdose), additional immediate response protocol must be followed until medical personnel can arrive. The person must first be checked for responsiveness and given rescue breathing until they can be administered Narcan, a drug that can counteract the depressant effects of opioids on the central nervous system.

By recognizing the signs and symptoms of various types of overdose, you could save a life.

Signs of a depressant overdose:

• Shallow or stopped breathing
• Tips of fingers and lips blue in color
• Extreme confusion or bewilderment
• Non-responsiveness
• Snoring or gurgling noises

Signs of alcohol poisoning:

• Poor coordination and excessive confusion
• Throwing up while sleeping
• Seizures or firm spasms
• Unregulated or slow breathing
• Clammy, colorless or blue skin tone

Signs of stimulant overdose:

• Chest pains
• Trouble breathing
• Intense headaches
• Confusion and disoriented
• Elevated temperature not accompanied by sweating
• Loss of consciousness

If the situation is assessed to be a non-crisis situation, move on to the next steps.

Listen Non-Judgmentally

One of the most essential elements of mental health first aid is empathetic listening. Listening in a non-judgmental manner shows a person your concern while reinforcing that you will not judge them for their substance use struggles. The ability to listen in a non-judgmental manner could give a person the confidence to speak candidly and honestly about their disorder.

To begin providing mental health first aid, approach the person and ask them if they would like your help. During this time, it is important to actively listen while showing empathy and support. Listen non-judgmentally and respond with an accepting and relaxed tone. Give the person your full attention, while being mindful of withholding unconstructive feedback.

Some helpful hints for active listening include:

• Keep strong eye contact
• Maintain open and relaxed body language
• Show understanding through reflecting what was said and asking questions
• Be at ease with crying, silence or awkward moments in the discussion
• Show patience

Give Reassurance and Information

It is important to relate to the person in a kind and compassionate manner, as opposed to coming off as confrontational or intimidating. Assess whether the person is open to receiving information about substance use disorder treatment or other types of support groups or professional assistance.

The Recovery Village offers an array of resources and educational blogs to help people cope with substance use disorders, including:

• Got a Substance Use Disorder? There’s an App for That!
• Understanding the Difference Between Alcohol Use and Alcoholism
• Does Drug Rehab Work? See Success Rates and Statistics
• Is Drug Addiction a Disease or Choice?
• Drug Addiction News

Encourage Appropriate Professional Help

If the person is open to the prospect of professional treatment, provide them with information about local treatment options and persuade them to make an appointment. It may also be helpful to offer to accompany the person to their first appointment for added support.

You can refer the person to substance use disorder treatment options, mental health practitioners and psychiatric providers such as:

• Substance abuse counseling
• Mental health therapy
• Medication and psychiatric services
• Support groups

What If the Person Doesn’t Want Help?

If it becomes apparent that the person is not ready for or opposed to professional treatment, gently ask them about their concerns and try to address their fears and apprehensions.

Despite your efforts, it is important to understand that a person cannot be forced or coerced into treatment. If they remain hesitant or unsure after you speak to them, provide support along with the assurance that you will be available to help link them to professional treatment in the future if they change their mind.

Encourage Self-Help and Other Support Strategies

Encourage the person to include family, friends, religious groups and trusted others for support in treatment and recovery. Advise them to consider joining support groups that are specific to their substance use disorder, including Narcotics Anonymous or Alcoholics Anonymous.

You can also persuade the individual to engage in self-care routines and strategies to promote healthy coping skills, including

• Daily exercise routines
• Maintaining healthy nutrition
• Participating in mindfulness techniques, such as meditation
• Creating an anxiety crisis kit
• Partaking in minimalism and daily gratitude practices
• Employing anxiety management practices at home
• Using coping skills to manage anxiety at work
• Practicing self-care when needed by planning a mental health day

To learn more approaches for supporting people, consider taking a Mental Health First Aid course, which can educate you about how to find, understand and react to symptoms of substance use disorders.

Helpful Hotlines for Mental Health First Aiders

Individuals can be referred to free, confidential national helplines when mental health first aid is provided. These helplines often have trained mental health practitioners who are standing by to assist people in finding substance abuse treatment resources in their regions.

Some useful helplines include:

• National Suicide Helpline: 1-800-273-8255
• Substance Abuse and Mental Health Services Administration’s National Helpline: 1-800-662-4357
• American Psychiatric Association Answer Center: 1-888-357-7924
• American Psychological Association Public Education Line: 1-800-964-2000
• The National Mental Health Association: 800-969-6642
• The National Poison Control Center: 800-222-1222
• Alcohol and Drug Abuse Helpline: 1-800-821-4357
• National Institute on Drug Abuse Hotline: 1-800-729-6686

If you have the opportunity to provide mental health first aid to someone struggling with a substance use disorder, it’s important to recommend high-quality, comprehensive treatment. That’s where we come in. The Recovery Village provides the full continuum of care for addiction and co-occurring mental health conditions. Reach out to The Recovery Village’s toll-free and confidential hotline today to get started.

Editor – Megan Hull

Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more

Medically Reviewed By – Tracy Smith, LPC, NCC, ACS

Tracy Smith is a Licensed Professional Counselor, a Nationally Certified Counselor, an Approved Clinical Supervisor, and a mental health freelance and ghostwriter. Read more