People often ask why someone continues drinking or using drugs when it is clearly causing harm.

From the outside, the answer may seem simple: stop using the substance.

But addiction and substance use are rarely that straightforward.

For many people, alcohol or drugs are not only about pleasure, partying or poor choices. They may become a way of coping with emotional pain, stress, trauma, loneliness, anxiety, depression or difficult memories.

A substance may offer temporary relief when nothing else seems to work.

It may quiet racing thoughts, reduce fear, create confidence, numb sadness or make sleep feel possible. The problem is that this relief is usually short-lived. Over time, the substance can create new difficulties and make the original problems worse.

Understanding why people use alcohol or drugs to cope does not mean ignoring harmful behaviour. It means looking beyond judgement and recognising the distress underneath it.

Substances Can Provide Temporary Relief

Alcohol and drugs can change how a person feels very quickly.

Someone who feels tense may experience a temporary sense of calm after drinking. A person who feels socially anxious may become more confident. Someone living with emotional pain may feel numb for a while.

That relief can feel powerful.

The person may think:

“This is the only thing that helps.”

“I can finally switch my mind off.”

“I feel normal when I use it.”

“I cannot face the day without it.”

When someone is overwhelmed, immediate relief may feel more important than long-term consequences.

The substance may not solve the problem, but it can create a short break from it. That temporary escape can become something the person begins relying on.

Anxiety Can Lead to Substance Use

Anxiety can make everyday situations feel threatening.

A person may worry constantly, experience panic attacks or feel physically tense and restless. They may struggle in social situations or feel unable to relax.

Alcohol may appear to reduce these feelings in the short term. It can lower inhibitions and make conversations feel easier.

Some drugs may create confidence, energy or emotional distance.

However, the effects do not last.

When the substance wears off, anxiety may return more strongly. The person may also feel embarrassed about what they said or did, which creates additional worry.

They may then use the substance again to manage the new anxiety.

This can create a cycle in which the person becomes increasingly dependent on alcohol or drugs to feel able to cope.

Depression and Emotional Numbness

Depression can leave a person feeling hopeless, empty or disconnected.

They may have little energy or interest in life. Activities that once brought pleasure may feel meaningless.

Some people use substances to feel something.

Stimulants may create temporary energy or confidence. Alcohol may help someone forget painful thoughts. Other drugs may provide excitement or emotional numbness.

For a short time, the person may feel different from how they usually feel.

But substance use can worsen sleep, motivation, mood and physical health. It may also contribute to relationship problems, debt or job loss.

These consequences can deepen depression and strengthen the belief that there is no way forward.

Trauma and Painful Memories

Trauma is a common factor in substance use.

People may use alcohol or drugs to cope with memories of abuse, violence, combat, accidents, bereavement, neglect or other distressing experiences.

Trauma can cause:

Flashbacks
Nightmares
Panic
Hypervigilance
Emotional numbness
Anger
Shame
Difficulty trusting others
Sleep problems

Substances may provide temporary distance from these symptoms.

Someone may drink to sleep, use drugs to avoid nightmares or become intoxicated to block memories.

The person may not consciously connect their substance use with trauma. They may simply know that being sober feels emotionally unbearable.

Trauma-informed support recognises that substance use may have developed as a survival strategy.

The behaviour may now be harmful, but it may originally have helped the person endure something they did not know how to manage in another way.

Stress and Overwhelming Pressure

People may also use alcohol or drugs to cope with ongoing stress.

Pressure may come from work, money, caring responsibilities, housing problems, relationships or physical illness.

Someone may spend the day appearing capable while feeling overwhelmed inside.

Alcohol may become a way of switching off after work. Drugs may provide energy to keep going or create temporary relief from constant pressure.

At first, use may seem controlled.

A person may drink only at weekends or use substances occasionally. Over time, the amount may increase as the original dose becomes less effective.

What began as a way to unwind can gradually become something the person feels unable to manage without.

Loneliness and Social Isolation

Loneliness can be deeply painful.

Someone may feel disconnected from family, friends or community. They may have nobody they trust enough to speak to.

Alcohol or drugs can provide temporary comfort or make social situations easier.

Substance use may also create a sense of belonging within a group.

For someone who feels excluded elsewhere, being accepted by people who use substances can feel important.

Unfortunately, addiction may eventually increase isolation.

Relationships can become strained, trust may break down and the person may withdraw further because of shame.

The substance then becomes both the cause of loneliness and the way the person tries to escape it.

Difficulty Expressing Emotions

Some people have never learned how to describe or manage emotions.

They may have grown up in families where feelings were ignored, mocked or punished.

A person may know that they feel uncomfortable but be unable to identify whether the feeling is sadness, fear, anger or shame.

Alcohol or drugs may become a way of managing emotions without having to name them.

This can be particularly common among people who were taught that showing vulnerability is a weakness.

Instead of saying, “I am frightened,” they may drink.

Instead of saying, “I am grieving,” they may use drugs.

Instead of saying, “I need help,” they may withdraw.

Substance use can become a language for pain that has never been spoken.

Physical Pain and Health Problems

Some people begin using substances because of physical pain.

They may have been prescribed medication following an injury, operation or long-term health condition.

Over time, the body may become tolerant, meaning that a larger amount is needed to produce the same effect.

The person may also begin relying on the medication emotionally, particularly when physical pain has affected work, sleep and independence.

Alcohol or illegal drugs may also be used to manage pain when healthcare feels inaccessible or ineffective.

Physical and emotional pain often overlap. A person living with long-term pain may also experience depression, anxiety and isolation.

Effective support needs to consider both.

Grief and Loss

Grief can feel unbearable.

A person may struggle with the death of someone they love, the end of a relationship, loss of employment or another major change.

Alcohol or drugs may offer temporary escape from memories and emotions.

The person may use substances to avoid silence, sleep without dreaming or get through anniversaries and reminders.

Grief does not follow a simple timetable.

When support is unavailable or the person feels pressured to move on, substances may become the only place they feel able to hide.

However, numbing grief does not remove it. The emotions often return, sometimes with additional shame and health problems.

Shame Can Strengthen the Cycle

Shame is one of the strongest barriers to recovery.

A person may feel ashamed of using substances, losing control or hurting people they care about.

That shame can make them withdraw and hide the problem.

They may believe:

“I have ruined everything.”

“Nobody would understand.”

“I do not deserve help.”

The shame itself becomes painful, and the person may use substances again to escape it.

This creates a cycle:

Emotional pain leads to substance use.

Substance use creates consequences.

The consequences create shame.

Shame leads to more substance use.

Breaking this cycle requires honesty, support and compassion.

Shame rarely helps someone recover. It usually makes them hide.

Tolerance and Dependence

Over time, the brain and body can adapt to regular substance use.

The person may need more alcohol or drugs to experience the same effect. This is known as tolerance.

They may also experience withdrawal when they try to stop.

Withdrawal can involve:

Shaking
Sweating
Anxiety
Nausea
Sleep problems
Irritability
Cravings
Low mood
Physical pain

With some substances, withdrawal can be medically dangerous.

At this stage, the person may continue using not to feel good, but to avoid feeling worse.

What began as emotional coping has become physical dependence.

This is why telling someone to simply stop may be unrealistic and unsafe.

Why Judgement Does Not Help

People who use alcohol or drugs are often judged as selfish, irresponsible or weak.

Judgement can prevent them from asking for help.

They may expect professionals, relatives or employers to reject them.

Compassion does not mean accepting harmful behaviour or ignoring its impact.

It means recognising that people are more likely to change when they feel safe enough to be honest.

A helpful question is not:

“Why are you doing this to yourself?”

A more useful question is:

“What is happening in your life that makes this feel necessary?”

That question opens the door to understanding.

Recovery Needs More Than Stopping

Recovery is not only about removing alcohol or drugs.

If the substance was helping someone cope with trauma, anxiety, loneliness or depression, those problems still need attention.

Without alternative support, stopping may leave the person facing the same emotional pain with fewer ways to manage it.

Recovery may involve:

Counselling
Addiction treatment
Medical support
Trauma therapy
Mental health care
Peer-support groups
Family support
Housing assistance
Debt advice
Employment support
Building healthier relationships
Developing new coping strategies

The exact support will be different for each person.

Some people work towards complete abstinence. Others begin with harm reduction.

Recovery should be realistic, safe and based on the person’s needs.

Healthier Ways of Coping

Learning new coping strategies takes time.

A person may benefit from:

Talking to someone they trust
Attending counselling
Joining a recovery group
Exercising or spending time outdoors
Writing down thoughts and feelings
Practising breathing techniques
Creating a daily routine
Reducing contact with people or places linked to substance use
Planning for cravings
Addressing sleep problems
Seeking help with practical pressures

These strategies may not provide the immediate effect of a substance.

They become more useful through repetition, support and practice.

The goal is not to remove difficult emotions completely. It is to develop safer ways of moving through them.

When to Seek Help

It may be time to ask for support if alcohol or drugs are affecting:

Physical or mental health
Sleep
Work
Money
Relationships
Parenting
Housing
Personal safety
Ability to complete everyday tasks

Other warning signs include hiding substance use, needing increasing amounts, experiencing withdrawal or repeatedly trying and failing to stop.

Speak to a GP, addiction service, counsellor or local mental health organisation.

Do not stop suddenly without medical advice if there may be physical dependence.

Seek emergency help if someone has overdosed, is unconscious, having seizures, experiencing severe confusion or is at immediate risk of harming themselves or someone else.