What is substance misuse?
Substance misuse refers to a pattern of using drugs in ways that cause harm or fall outside their intended purpose. In the UK, this term is generally preferred over "drug abuse." It covers illegal substances such as cocaine and heroin, as well as legal substances like alcohol, nicotine and prescription medications. Cannabis remains illegal for recreational use, though it can be prescribed medicinally under certain conditions.
When someone takes prescription drugs in higher doses than directed, uses them without a prescription, or takes them for reasons other than their medical purpose, this counts as misuse. The same applies to using over the counter medicines in ways not recommended, or using vaping products inappropriately.
According to the Crime Survey for England and Wales 2022/23, approximately 1 in 11 adults aged 16 to 59 reported drug use in the past year. Rates are higher among younger age groups. Current statistics are published regularly by the Office for National Statistics.
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Try our Therapy Options Guide free, here on this site →How drugs affect the body and brain
Drugs enter the body through various routes, including swallowing, injection, inhalation or absorption through the skin. The method of intake affects how quickly substances reach the bloodstream and how they interact with different organs. Eventually, substances reach the brain, where they can interfere with normal function.
Different drugs affect the brain in different ways. Depressants slow down activity in the central nervous system, stimulants speed it up, and hallucinogens alter perception. Over time, repeated drug use can change how the brain processes information, stores memories and controls movement.
With short term or occasional use, these changes often reverse once the substance leaves the system. With long term or heavy use, the effects can persist even after someone stops taking the substance. Social and environmental factors, including stress, trauma and availability of support, also influence how substance misuse develops and its overall impact on health.
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Substance misuse and communication problems
The brain controls how we form words, understand what others say, recall vocabulary and coordinate the muscles we use to speak. Because different drugs affect the brain in different ways, the impact on communication varies depending on the substance and pattern of use.
Substance misuse can lead to several communication difficulties. These include slurred or unclear speech due to reduced muscle control, difficulty finding the right words or following conversations, and memory problems that make it harder to recall names, facts or recent discussions. People may also experience slower processing when trying to understand what someone has said, along with changes in voice quality or volume.
These effects may appear only while someone is under the influence of a substance. With prolonged misuse, some communication problems can become more lasting. Alcohol is well known for causing slurred speech even after moderate consumption. Stimulants may cause rapid, disorganised speech. Opioids can slow speech and dull responses.
Getting help and support
If substance misuse is affecting your speech, language or overall communication, speaking with a healthcare professional is a sensible first step. Your GP can refer you to appropriate services, which may include speech and language therapy or structured treatment programmes through the NHS.
You can contact your local drug treatment service directly without needing a referral. The charity FRANK provides free, confidential advice and information about drugs. In Scotland, services are available through the Scottish Drugs Forum. In Wales, DAN 24/7 offers a bilingual helpline. In Northern Ireland, support is provided through the Public Health Agency.
Many people also benefit from harm reduction strategies, which aim to minimise health risks associated with substance use. For those experiencing mental health difficulties alongside substance misuse, services for co-occurring conditions can address both issues together.
Recovery from substance misuse is possible, though it often involves challenges and setbacks. Many people find that communication difficulties improve once they stop using substances. Speech and language therapy can help rebuild affected skills. The outcome depends on individual circumstances, including how long the misuse lasted, which substances were involved, and any underlying health conditions.
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