The Dangers of Hidden Substance Use

Guy in mountains thinking about Substance Use Disorder Recovery

Contributor: Staff at Timberline Knolls Residential Treatment Center

When you think of someone struggling with a substance use disorder, you may remember what you’ve seen in movies and on TV. However, in reality, it can be more difficult to identify someone who is struggling with an addiction. Due to certain stigmas and feelings of guilt and shame, those who are suffering from substance use disorders may become good at hiding it from others.

Hiding this behavior is more common than you may think, and when an addiction goes undetected and untreated, the person suffering is at an even greater risk for developing other dangerous health concerns.

Who Is At Risk for Substance Use Disorders

Substance use disorders can occur at any age and in someone of any gender. Many factors can contribute to the development of substance use disorders, including genetics, environment, and medical history.

Co-occurring mental health concerns such as depression and anxiety can increase a person’s risk for developing a substance use disorder. Studies also indicate a strong link between eating disorders and substance use disorders. One study found that 50% of those who were diagnosed with an eating disorder reported abusing alcohol or other substances [1].

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Substance use may be more common within certain occupations, like those who serve in the military. However, those who are more likely to hide addiction may not fit the usual stereotype.

Since the beginning of the COVID-19 pandemic, there has been a rise in substance use among essential workers, likely due to the increased stress they are under. Healthcare workers once reported the lowest levels of heavy alcohol use when compared with workers in other occupations. Now, 16% of healthcare workers report an increase in drug and alcohol consumption [2]. Stigma may prevent healthcare workers from asking for help themselves, as their job revolves heavily around helping others.

Why People Hide Their Substance Use

Hiding this behavior is a common coping mechanism. There are many reasons why individuals may hide the disease they’re struggling with. They might have trouble even admitting to themselves that their behavior has turned into an addiction.

Feelings of guilt, shame, and embarrassment may keep someone from seeking the help they need, even when the condition they’re suffering from is too severe for them to control on their own.

The fear of potentially losing a job is another reason why many keep their substance use hidden. These potential consequences can prevent someone from asking for help, especially if their role is public-facing.

Substance use disorders can also impact relationships. Individuals who are suffering may keep it to themselves out of fear that they will be judged by loved ones. However, a substance use disorder that is left untreated can lead to further relationship problems and isolation.

The Consequences of Hidden Substance Use

Man dealing with Substance UseA hidden substance use disorder can have dangerous short-term and long-term consequences. In the short term, it can lead to changes in appetite, mood, blood pressure, and heart rate.

Substance use disorders can cause long-term consequences like heart or lung disease if left untreated. It can also increase a person’s risk for heart attack, stroke, overdose, and death.

Other mental health concerns like depression, anxiety, and eating disorders are also common in those who are suffering from a substance use disorder [3]. The longer someone hides that they’re struggling, the more at risk they become for dangerous consequences and long-term damage.

Signs That Someone You Know Is Struggling

Although some may try to hide their substance use, there are some signs to watch for that may indicate that someone you know is struggling.

Signs of a substance use disorder include:

  • Changes in sleep patterns
  • Irritability
  • Memory problems
  • Changes in eating habits
  • Rapid weight loss
  • Impaired judgment
  • Social isolation

If you or someone you know is struggling with a substance use disorder, help is available.


[1] Muhlheim, L. Eating disorders and substance abuse — How are they related and how are they treated? Verywell Mind.
[2] Mensik, H. (2021, April 7). Healthcare workers say they need mental health services, but many aren’t getting them. Healthcare Drive.
[3] NIDA. (2020, June 9). Health consequences of drug misuse. National Institute of Health.

About Our Sponsor:

Timberline Knolls BannerAt Timberline Knolls Residential Treatment Center, located outside of Chicago, Illinois, we provide specialized care for women and girls who are living with mental health conditions such as substance use disorders and eating disorders. Our private residential treatment facility offers female-only treatment programs for eating disorders, addiction, and a range of mental health conditions. We work closely with each person to develop treatment goals to maximize strengths while focusing on individual needs. Our residential treatment team understands that each woman has unique needs and that she must play a role in her journey to wellness.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on April 19, 2021
Reviewed by Jacquelyn Ekern, MS, LPC on April 19, 2021
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About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.