Self-Harm and Substance Abuse

Self-harm affects about 1 in 10 young people. When paired with substance abuse, the combination can result in many dangers without effective treatment.

Coping skills are tools people use to manage intense feelings and situations. Positive coping skills like exercise and spending time with friends make things better in the long-term. Negative coping skills make life worse in the long-term.

Self-harm and substance abuse are some of the most negative coping skills people use. They may provide short-term relief from stress, depression, and frustration but only create more pain in the future. Appropriate care for self-harm and addiction works to build new coping skills and reduce the reliance on these unhealthy actions.

Effects of Drug Abuse on Self-Harm

Substance abuse and self-harm share a strong connection. People with mental health conditions including depression, anxiety and eating disorders and people who have experienced problematic life events like trauma, abuse and neglect are at a higher risk of self-harm. These same people are at higher risk of regular substance use and substance use disorders.

Substance use can lead to self-harm. As intoxication increases, people may lose self-control, which results in higher rates of self-harm. Being under the influence of substance can also lead to self-injury being more severe than intended.

Alcohol and Self-Harm

Alcohol and self-harm are linked. As alcohol abuse increases, so does the risk of self-harm. Alcohol use may also cause a number of dangerous behaviors, including:

• Aggression
• Mood instability
• Poor judgment

These effects of alcohol intoxication lay a strong foundation for self-harm. If someone is prone to self-harm and alcohol consumption, experiencing increased aggression, mood changes and impaired judgment from alcohol use can diminish their ability to employ healthy coping skills.

Stimulants and Self-Harm

Use of stimulant substances like cocaine, methamphetamine and prescription medications for attention-deficit hyperactivity disorder are linked to self-harm as well, but the mechanism might be different from those abusing alcohol.

Stimulants can encourage self-harm during and after use. During intoxication, stimulants can produce hallucinations, delusional thinking and paranoia. These symptoms result in a dangerous separation from reality. When use ends, the following crash may lead to extreme depression and hopelessness, which can spark suicidal thoughts and a desire for self-injury.

Hallucinogens and Self-Harm

Most people use hallucinogens to produce wanted effects like:

• Distorted perception of time
• A sense of increased understanding of self and the world
• Pleasurable hallucinations

At times, though, the desired effects give way to dangerous hallucinogen reactions called bad trips. During bad trips, the person may experience:

• Intense anxiety and panic
• Paranoia and delusions
  Mood swings
• Feeling they are losing control
• Seizures

In extreme cases, these bad trips lead the individual to engage in violent and aggressive behaviors towards self or others.

Self-Harm and Opioids

Opioids include numerous prescription and illicit substances like pain medications and heroin. Opioid intoxication may result in:

• Disinterest in pleasurable activities
• Low mood following the initial high
• Impaired judgment

Opioid use releases endorphins that stimulate positive feelings like pleasure in the brain. Self-harm may release the same pain-reducing hormones, which creates a connection between opioids and self-harm.

Statistics on Self-Harm and Addiction

Self-harm and substance abuse share another similarity in that they are consistently challenging to track. Since these behaviors generate shame and guilt, people are not always willing to admit their actions.

Concerning self-injury, the American Psychological Association reports:

• About 17 percent of adolescents/ young adults engaged in self-harm at least once
• About 5 percent of adults reported self-injury in their lifetime
• Just over 1 percent of children 5 to 10 admitted self-injury

Females are more likely to self-harm than men, but men are more likely to:

• Purposely bruise themselves
• Incite others to hurt them
• Self-harm while using substances

Can Self-Harm Lead to Drug Addiction?

It is clear that drug use and addiction can lead to self-harm, but can self-harm lead to addiction? It seems the answer is “yes.”

Cutting, burning and punching yourself, pulling out your hair or poking yourself with objects are all ways to self-harm. Consistent substance use and addiction is another form of self-harm, so people who start with cutting may switch to or include alcohol and other drug use as self-harm alternative.

A study of older people identified this connection with people who admitted using opioids with the intention of self-harm. As these self-harm behaviors progress, addiction, dependence and substance use disorders will take hold.

Treating Self-Harm and Co-Occurring Substance Use Disorders

The treatment of self-harm and co-occurring substance use disorders can be a complicated process, but symptoms can diminish with effective interventions. Treatments will help people feel in control of and able to cope with their life without the need for self-injury or substances.

Since self-harm is usually a sign of other mental health conditions, the treatment professional will start with a thorough evaluation to identify the impact of mental health conditions on self-injury and addiction. The most frequently seen diagnoses include:

• Depression
• Anxiety
• Post-traumatic stress disorder
• Borderline personality disorder
• Eating disorders

By treating the underlying mental condition, self-injury and substance use may also decrease.

Professionals may use a combination of psychotherapies and medications to address the thoughts, feelings, behaviors and biology of the person to create and reinforce healthy coping skills. With new coping skills and a relapse prevention plan, the individual will have the ability to manage intense emotions without relying on self-harm or substance use.

People interested in learning more about the connection between self-harm and substance use disorders to help themselves or their loved ones should contact The Recovery Village. Call  877.386.9321 for more information about available treatment programs and availability.

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 – Eric Patterson, LPC

Eric Patterson is a licensed professional counselor in the Pittsburgh area who is dedicated to helping children, adults, and families meet their treatment goals. Read more