Substance use disorders are all too common. In 2025, roughly one in six Americans aged 12 years or older reported experiencing a substance use disorder in the last year. Yet, these disorders can be invisible to the people around us. Stigma surrounding substance use is pervasive and can prevent people from seeking help or even acknowledge that they may need it due to fear of judgment or repercussions. Additionally, relapse is a common part of the disease process. People can move in and out of treatment as a result, and for some, multiple different levels of care are required before finding a sustainable path toward recovery.
Although relapses can be discouraging for everyone involved, returning to treatment should be viewed as an opportunity to identify remaining barriers and ways to strengthen support. Success in treatment often requires community support, which can include healthcare providers, family members, friends, employers, neighbors, and more. Together, each person can help to provide a sense that the one struggling with substance use is not alone.
Recently, I was working as a resident physician at a 30-day residential treatment program in South Dakota where I provided medication management to individuals with substance use disorders. Throughout treatment, we are always thinking about what lies ahead after discharge. Patients would tell me their various support systems (spouses, children, sponsors, faith groups, and peer support groups, to name a few) that would be imperative to their recovery. In order to learn more about what support looked like in the community, I decided to attend a local Narcotics Anonymous meeting.
What stuck out to me from the beginning of the meeting was how welcoming and warm each participant was to me and each other. The seriousness of the topic was palpable yet was approached with resilience and empathy. Only a few people knew I was a physician, but it did not matter. For the roughly 90 minutes I was there, I was simply another person in the room.
During the meeting, a participant shared a story of a recent relapse and the emotional turmoil it caused for them. They expressed shame, anger, and guilt, but also conveyed a sense of hope. By coincidence, I saw that same person in residential treatment a week later. They did not remember me, but I remembered their story even as I took their initial history on admission. It reminded me that each person at any given time is at one point in their journey towards recovery, and we can all help by approaching them with grace and compassion. Treatment is not confined to an office setting or rehab; it occurs in the community too. Healthcare providers can facilitate different levels of treatment and at the very least have a better understanding of what community support looks like.
If you are struggling or believe that you may be struggling with a substance use disorder, help is available via the APA Foundation’s Mental Health Care Works campaign. Visit mentalhealthcareworks.org to learn how to access health care, how to support a loved one recovering from a substance use disorder, or how to cope with symptoms of anxiety and depression in the lead-up to consulting with a mental health professional. Additionally, see what community groups that support those in recovery exist in your area. Volunteer opportunities at some organizations exist for those interested as well. Treatment of substance use disorders is challenging, but possible with support from loved ones and qualified care providers.
