Substance Misuse FAQ’S



As with any other disease, there are signs and symptoms, but often these signs and symptoms, or changes in individuals, are hard to notice.

If you are concerned about a friend or loved one, pay attention to the following:

  • Increase in consumption or the increase in seeking out the substance
  • Uncharacteristic self-isolation
  • Loss of interest in activities they once enjoyed
  • Opposite demeanor – becoming loud, angry, and violent OR silent and reclusive
  • Really sad or tired more than typical
  • Irregular sleep schedule
  • Missing work, appointments, class, or meetings
  • Talking very quickly and/or saying things that don’t quite make sense
  • Quick changes in mood
  • Becoming more secretive
  • Defensive or dismissive when confronted about the misuse

An easy way to remember what to look for is: A-CPR

A = Attitude changes (denial; pessimism; argumentative, isolating; aggressive – when under the influence or having gone without for a time)
C = Competency changes (work, school, or around the home; tasks such as financial responsibility, home maintenance, attention to detail, etc.)
P = Physical changes (depending on the substance – weight gain or loss can occur; eye pupil size – opioids cause pinpoint pupils, others cause dilation; skin color and tone; slurred speech; nodding off at inappropriate times; agitation; skin scratching; chills – usually withdrawal or dosage change, etc.)
R = Relationships (isolating and argumentative with those close; short, unexplained phone calls; decrease in money available for unexplainable reasons; meeting with strangers or being in strange locations, etc.)

For resources with additional information on signs and symptoms, visit:

2. HOW CAN A FRIEND or family member HELP someone struggling with substance use?

If you feel safe, intervene. Many individuals in recovery credit a friend or family member for encouraging them to seek help.

  • Educate yourself on substance misuse. Attend community educational workshops offered by PreventEd, universities, treatment centers, etc. Read information from reputable internet resources (usually .gov or .edu sites or CDC, SAMSHA)
  • Find a time to sit down and have a conversation.
  • Remind the person how much they mean to you.
  • Listen; do not judge or lecture.
  • Have specific examples of the behavior that concerns you. Focus on their behaviors and actions, not their character. Share how these behaviors affect you and your relationship.
  • Use I statements.
  • Be patient.
  • Educate yourself on resources and offer to help connect the individual to them.
  • Offer to attend meetings or drive them to appointments/treatment facilities
  • Understand that change may not happen overnight, but you are laying the foundation for change.
  • Take care of yourself and recognize your own limits. 

3. Who is at risk for developing a Substance Use Disorder?

Anyone can develop a substance use disorder (SUD). It is a progressive disease which progresses from non-use, legal use, misuse, and then the development of a SUD. Just like other diseases, there are certain things that can put someone at greater risk for developing a SUD. One of the greatest predictors of someone developing a SUD is early use/experimentation because of the impact on brain development in early years. Other factors include:

  • Genetics
  • Environment/ease of availability/peer influence
  • Not having a trusted adult or strong support system
  • History of physical, mental, or sexual abuse and other trauma
  • Lack of connections
  • Mental health concerns, especially if untreated


Opioids come from the drug family produced by the opium poppy. Some are naturally occurring, such as opium and morphine, others are chemically produced and have opiate properties such as heroin, Percocet, Oxycodone, Fentanyl, etc.

5. HOW DID the OPIOID Overdose epidemic Begin?

The overuse and misuse of this drug family is a complex issue. Some would espouse the over-prescription of pain relievers to be the main cause. While others would attribute this problem to the huge marketing push by pharmaceutical companies. A piece of the problem could be attributed to society’s attitude of eliminating pain. Regardless of the source of the problem, our community and society need to work toward viable solutions of intervention and prevention.

Today, Fentanyl is the leading cause of fatal overdoses. Fentanyl is a synthetic opioid that is 80-100 times stronger than morphine and is cheaper to make than other opioids, contributing to its increase in use. Once an individual becomes accustomed to using opioids, it is difficult to stop, but there are lots of resources that can help including medications, recovery support groups, and treatment centers.

An opioid overdose does not have to be fatal. Opioid overdoses can be reversed with the medication, naloxone or Narcan. Narcan is the most common form available as a nasal spray. Narcan is a completely safe medication with the only use to reverse a fatal overdose and enable an individual to start breathing again. Narcan is effective for all opioid-related overdoses, including fentanyl, and can reverse a fatal overdose if administered in time. Naloxone is available through pharmacies with a state-wide standing order or through other community organizations such as PreventEd.

6. Is recovery possible?

Yes!! Substance use disorders are treatable and there are many research-based treatment options including counseling, treatment centers, support groups, medications, and more. Please remember that a return to use is part of the recovery process and it does not mean failure. Recovery is a journey. If you need help finding the right resources for you, a friend, or a family member, please contact PreventEd.

7. What are substance Use Treatment Options?

Treatment can take on various forms and the individual, along with therapists, doctors, and/or insurance companies, will work to find the best treatment option (s). An assessment can also help determine the best approach. Below are some examples of types of treatment:

  • In-patient: a multiple day/week/month scenario where personal counseling and group support is provided along with medical and psychological services. Medical detox may be needed depending on the substance(s) used. The individual enrolled at an in-patient treatment facility will remain at the facility for the duration of treatment.
  • Out-patient: full or partial day sessions conducted over several weeks or months that also include personal counseling and group support. Sessions might include understanding the impact of substances on the brain and body; working through relational and behavioral triggers; developing strategies for successful recovery; learning healthy strategies for stress management, etc.
  • Professional therapeutic counseling – one-on-one counseling that helps individuals with their substance use goals. Some counselors specialize in substance use treatment. Connect with PreventEd for referrals.
  • Mutual support groups like Alcoholics Anonymous (AA), Al-Anon, Narcotics Anonymous (NA), etc. Celebrate Recovery, SMART Recovery, LifeRing, and Women for Sobriety are groups that are outside of the traditional 12-step program. These groups also provide support and guidance to those seeking recovery.
  • A variety of medications for substance use disorders are also available for individuals that can help manage their wellness and recovery.

Recovery can look different for everyone and it should not be a one size fits all approach. Each individual’s recovery plan is unique to them and may include several treatment options.


A Certified Peer Specialist (CPS) is an individual that identifies as being in long-term recovery from substance use disorder and has completed coursework through the Missouri Credentialing Board to become certified as a peer. CPS are often employed by treatment organizations, hospitals, treatment courts, and other substance use agencies to assist individuals in finding their own path to recovery. CPS bring an authentic, genuine understanding of substance use disorder to their work and are able to truly “meet people” where they are to provide support. As the field of CPS expand, the impact of working with someone with a lived experience has proven to be very powerful for many people.


 PreventEd is a private, non-profit organization serving the Greater St. Louis area and surrounding counties since 1965. PreventEd works to reduce or prevent the harms of alcohol and other drug use through education, intervention, and advocacy. They provide counseling, assessment, and referral services for adults as well as adolescents and their families. PreventEd also provides community education and awareness, advocacy, and school-based prevention programs.


Prevention of substance use disorder involves reducing risk factors and increasing protective factors for individuals and communities. This can include providing skills training to young people on how to manage conflict, develop friendships, and build self-esteem. It also involves sharing age-appropriate information and facts on substances with everyone in the community. This can begin with conversations between adults and young people. (Talking Kits are available at: One of the strongest protective factors for a young person is having a caring, trusted adult present in their life.

Opportunities for success and addressing other social determinants of health should be prioritized to make sure everyone has access to things like housing, education, employment, and connection in their own schools or neighborhoods.

Substance use disorder is a progressive disease. It is important to recognize early signs or symptoms of substance misuse and know the resources available for early intervention. The earlier we can connect a person with help, we can decrease the likelihood of the impact of their substance use.

More information can be found on websites such as;;; Search; etc.


(source:,,, and

  • In 2020, 21% of U.S. adults and 30.6% of young adults (18-25) reported having a mental illness. Approximately 46% received care for their mental illness.
  • In 2020, 50% of people aged 12 or older used alcohol in the past month. Approximately 14.5 million people were classified as having an alcohol use disorder.
  • Overdose deaths continue to rise, reaching 100,000 deaths in 2020. On average, 128 Americans die every day from an opioid overdose.
  • Alcohol and other drug addiction costs the American economy over $600 billion each year.

Questions and answers provided by PreventEd February 2022.


6101 Telegraph Rd., Saint Louis, MO US 63129| Map It | 314.846.8612|