5 reasons why climate change may see more of us turn to alcohol and other drugs

Climate change will affect every aspect of our health and wellbeing. But its potential harms go beyond the body’s ability to handle extreme heat, important as this is.

Extreme weather events, such as floods, droughts, storms and wildfires, are becoming more frequent and severe. These affect our mental health in a multitude of ways.

Coping with climate change can be overwhelming. Sometimes, the best someone can do is to seek refuge in alcohol, tobacco, over-the-counter and prescription drugs, or other psychoactive substances. This is understandable, but dangerous, and can have serious consequences.

We outline five ways climate change could increase the risk of harmful substance use.

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1. Mental health is harmed

Perhaps the most obvious way climate change can be linked to harmful substance use is by damaging mental health. This increases the risk of new or worsened substance use.

People with a mental disorder are at high risk of also having a substance-use disorder. This often precedes their mental health problems. Climate change-related increases in the number and nature of extreme events, in turn, are escalating risks to mental health.

For example, extreme heat is linked to increased distress across the whole population. In extreme heat, more people go to the emergency department for psychiatric problems, including for alcohol and substance use generally. This is even true for a single very hot day.

Post-traumatic stress disorder, depression, anxiety and other mental health problems are common at the time of extreme weather events and can persist for months, even years afterwards, especially if people are exposed to multiple events. This can increase the likelihood of using substances as a way to cope.

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2. Worry increases

With increasing public awareness of how climate change is endangering wellbeing, people are increasingly worried about what will happen if it remains unchecked.

Worrying isn’t the same as meeting the criteria for a mental disorder. But surveys show climate change generates complex emotional responses, especially in children. As well as feelings of worry, there is anxiety, fear, guilt, anger, grief and helplessness.

Some emotional states, such as sadness, are linked with long-term tobacco use and also make substance use relapse more likely.

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3. Physical injuries hurt us in many ways

Physical injuries caused by extreme weather events – such as smoke inhalation, burns and flood-related cuts and infections – increase the risk of harmful substance use. That’s partly because they increase the risk of psychological distress. If injuries cause long-term illness or disability, consequent feelings of hopelessness and depression can dispose some people to self-medicate with alcohol or other drugs.

Substance use itself can also generate long-term physiological harm, disabilities or other chronic health problems. These are linked with higher rates of harmful substance use.

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4. Our day-to-day lives change

A single catastrophic event, such as a storm or flood, can devastate lives overnight and change the way we live. So, too, can the more subtle changes in climate and day-to-day weather. Both can disrupt behaviour and routines in ways that risk new or worsened substance use, for example, using stimulants to cope with fatigue.

Take, for example, hotter temperatures, which disrupt sleep, undermine academic performance, reduce physical activity, and promote hostile language and violent behaviour.

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5. It destabilises communities

Finally, climate change is destabilising the socioeconomic, natural, built and geopolitical systems on which human wellbeing – indeed survival – depends.

Damaged infrastructure, agricultural losses, school closures, homelessness and displacement are significant sources of psychosocial distress that prompt acute (short-term) and chronic (long-term) stress responses.

Stress, in turn, can increase the risk of harmful substance use and make people more likely to relapse.

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Why are we so concerned?

Substance-use disorders are economically and socially very costly. Risky substance use that doesn’t meet the criteria for a formal diagnosis can also harm.

Aside from its direct physical harm, harmful substance use disrupts education and employment. It increases the risk of accidents and crime, and it undermines social relationships, intimate partnerships and family functioning.

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Politicians take note

As we head towards the COP28 global climate talks in Dubai, climate change is set to hit the headlines once more. Politicians know climate change is undermining human health and wellbeing. It’s well past time to insist they act.

As we have seen for populations as a whole, there are multiple possible ways for climate change to cause a rise in harmful substance use. This means multidimensional prevention strategies are needed. As well as addressing climate change more broadly, we need strategies including:

supporting vulnerable individuals, especially young people, and marginalised commmunities, who are hit hardest by extreme weather-related events

focusing health-related policies more on broadscale health promotion, for example, healthier eating, active transport and community-led mental health support

investing in climate-resilient infrastructure, such as heat-proofing buildings and greening cities, to prevent more of the destabilising effects and stress we know contributes to mental health problems and harmful substance use.

There is now no credible pathway to avoiding dangerous climate change. However, if increasing rates of climate protests are anything to go by, the world may finally be ready for radical change – and perhaps for reduced harmful substance use.