How to overcome loneliness without friends

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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    It's Not Your Fault (NACoA) (PDF | 12 KB)
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Last Updated: 08/30/2022

Alcohol, Tobacco, and Other Drugs

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Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present estimates from the 2021 National Survey on Drug Use and Health (NSDUH).



  • Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million people (or 45.1%) were past month binge drinkers. The percentage of people who were past month binge drinkers was highest among young adults aged 18 to 25 (29.2% or 9.8 million people), followed by adults aged 26 or older (22.4% or 49.3 million people), then by adolescents aged 12 to 17 (3.8% or 995,000 people). (2021 NSDUH)
  • Among people aged 12 to 20 in 2021, 15.1% (or 5.9 million people) were past month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.3% (or 3.2 million people) and 1.6% (or 613,000 people), respectively. (2021 NSDUH)
  • In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
  • Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44.4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
  • The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31. 4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
  • Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily


  • STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Talk. They Hear You.
  • Underage Drinking: Myths vs. Facts
  • Talking with your College-Bound Young Adult About Alcohol

Relevant links:

  • National Association of State Alcohol and Drug Abuse Directors
  • Department of Transportation Office of Drug & Alcohol Policy & Compliance
  • Alcohol Policy Information Systems Database (APIS)
  • National Institute on Alcohol Abuse and Alcoholism



  • In 2020, 20. 7% of people aged 12 or older (or 57.3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH)
  • Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
  • Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
  • The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes

Electronic cigarette (e-cigarette) use data:

  • In 2021, 13.2 million people aged 12 or older (or 4.7%) used an e-cigarette or other vaping device to vape nicotine in the past month. The percentage of people who vaped nicotine was highest among young adults aged 18 to 25 (14.1% or 4.7 million people), followed by adolescents aged 12 to 17 (5.2% or 1.4 million people), then by adults aged 26 or older (3.2% or 7.1 million people).
  • Among people aged 12 to 20 in 2021, 11.0% (or 4.3 million people) used tobacco products or used an e-cigarette or other vaping device to vape nicotine in the past month. Among people in this age group, 8.1% (or 3.1 million people) vaped nicotine, 5.4% (or 2.1 million people) used tobacco products, and 3.4% (or 1.3 million people) smoked cigarettes in the past month. (2021 NSDUH)
  • Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey. Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
  • E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals


  • Tips for Teens: Tobacco
  • Tips for Teens: E-cigarettes
  • Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
  • Synar Amendment Program


  • Truth Initiative
  • FDA Center for Tobacco Products
  • CDC Office on Smoking and Health
  • National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
  • National Institute on Drug Abuse: E-Cigarettes



  • Among people aged 12 or older in 2021, 3. 3% (or 9.2 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 9.2 million people who misused opioids in the past year, 8.7 million people misused prescription pain relievers compared with 1.1 million people who used heroin. These numbers include 574,000 people who both misused prescription pain relievers and used heroin in the past year. (2021 NSDUH)
  • Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
  • According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose


  • Medication-Assisted Treatment
  • Opioid Overdose Prevention Toolkit
  • TIP 63: Medications for Opioid Use Disorder
  • Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
  • Opioid Use Disorder and Pregnancy
  • Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
  • The Facts about Buprenorphine for Treatment of Opioid Addiction
  • Pregnancy Planning for Women Being Treated for Opioid Use Disorder
  • Tips for Teens: Opioids
  • Rural Opioid Technical Assistance Grants
  • Tribal Opioid Response Grants
  • Provider’s Clinical Support System - Medication Assisted Treatment Grant Program


  • National Institute on Drug Abuse: Opioids
  • National Institute on Drug Abuse: Heroin
  • HHS Prevent Opioid Abuse
  • Community Anti-Drug Coalitions of America
  • Addiction Technology Transfer Center (ATTC) Network
  • Prevention Technology Transfer Center (PTTC) Network



  • In 2021, marijuana was the most commonly used illicit drug, with 18. 7% of people aged 12 or older (or 52.5 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (35.4% or 11.8 million people), followed by adults aged 26 or older (17.2% or 37.9 million people), then by adolescents aged 12 to 17 (10.5% or 2.7 million people).
  • The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34.5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
  • Marijuana can have significant health effects on youth and pregnant women.


  • Know the Risks of Marijuana
  • Marijuana and Pregnancy
  • Tips for Teens: Marijuana

Relevant links:

  • National Institute on Drug Abuse: Marijuana
  • Addiction Technology Transfer Centers on Marijuana
  • CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

  • Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
  • Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
  • Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.


  • Tips for Teens: Methamphetamine
  • Tips for Teens: Cocaine
  • National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.

Last Updated: 01/05/2023

How not to suffer from loneliness

September 7, 2020 Life

Accept your feelings and don't blame yourself or others for them.

Stop being ashamed of loneliness

It is dangerous to keep silent about your feelings

It so happened that loneliness is perceived by society as something shameful. And many are afraid of what others will say about them: call them uncharismatic, losers or strange. Therefore, they prefer not to talk at all about the feeling of being useless and cut off from society.

Sometimes lonely people experience difficulties because they consider themselves somehow wrong or unworthy of communication. After all, “if you don’t have friends, then most likely something is wrong with you.” Therefore, they prefer not to share their real self with anyone.

This uncertainty hinders the establishment of relationships with others. However, if no one knows what you really are, most likely, you will have to remain alone.

The inability to openly talk about your loneliness only exacerbates the problem. If you judge yourself for your own feelings, it becomes even more difficult to take any steps to change the situation. Because on top of everything else, you start judging yourself for not taking any action to solve the main problem.

Loneliness is not always correctly defined by us

In fact, this feeling does not depend on how many friends you have. It does not at all mean the absence of a soulmate or acquaintances with whom you can spend the weekend. This is an inner feeling. Someone may just rarely communicate with others, and someone is constantly surrounded by people, but experiences the same thing.

Hundreds and thousands of "friends" in social networks are not the same as a person with whom it is pleasant to watch a movie or drink a cup of coffee. It is possible to experience a deep sense of loneliness in the company of acquaintances, with a significant other or an old friend, realizing that you feel absolutely no connection with these people.

At the same time, you need to remember that loneliness is not solitude when you want to be alone with yourself and enjoy it.

Being lonely means not feeling meaningful connection with other people and the world around you.

Psychologist John Cacioppo and popularizer of science William Patrick in their study identified three factors that influence how lonely a person feels.

1. Vulnerability to lack of communication. Everyone has a genetically determined need for social integration, so your level of required socialization will be different from anyone else's. That is, the greater the need for communication you experience, the more difficult it is to satisfy it and the higher the risk of starting to feel lonely.

2. The ability to control emotions. And not only externally, but also internally. Any person suffers when his need for communication is not satisfied. And if loneliness continues for too long, it can turn into a real depression.

How well you manage your feelings affects your emotional state. Being constantly depressed can lead to misinterpreting other people's intentions. It starts to look like they're trying to avoid talking to you, but that's not always the case.

One must learn to accept one's own feeling of loneliness without judging either oneself or others for it. And keep looking for a way to deal with it.

3. Expectations and perceptions of others. Just because you feel unwanted doesn't mean you don't have the ability to communicate. Although, of course, in this case, both the desire and the ability to use them will be small.

Lonely people often feel like they are doing everything they can to make friends and feel connected to someone. It's just that no one reciprocates them.

In the end, such self-deception only makes things worse - dissatisfaction begins to appear. People suffering from loneliness become prone to blaming and reacting negatively to criticism. Their feelings are expressed in resentment and anger. And this is what most often becomes the reason that they stop communicating with them.

Some lonely people develop social fears. They see danger in others, they begin to fear criticism and condemnation from the outside. Their body language betrays the insecurities and anguish they feel, and their facial expressions seem repulsive to others. At the same time, in fact, they may crave communication, but not notice that their body broadcasts the opposite.

Everyone feels lonely sometimes

Often people feel that their situation is special and that the feelings they experience are not normal. But everyone has to experience loneliness at least once: a simple move, graduation from school, or other life changes.

An unhappy person often focuses not on those people who are in a situation similar to him, but on those who are not currently suffering from it. Temporary feeling of loneliness can be called a part of our life. This is because humans are social beings. And most of us value love, intimacy, and social connections more than wealth and fame, for example.

Loneliness can be good

An MRI study showed that when you suffer from a lack of communication, the same area of ​​the brain that is responsible for the emotional signals it perceives during physical pain is activated.

Just as physical pain protects people from danger, loneliness - social pain - protects against the risk of separating from society. She suggests that it's time to somehow change your behavior or start paying more attention to relationships with people important to you.

If this pain persists for a long time, it may become chronic. And simple communication will not help here.

Don't judge yourself

1. Stop judging your feelings. This is the main thing. Blaming and scolding yourself for them is ineffective and wrong. Feeling alone without having a serious and meaningful relationship is normal.

2. Realize that your problem is not unique. Today's mobile society is in constant flux, and this makes it difficult to establish and maintain relationships. The very acceptance that loneliness is part of the human condition will help you find the energy to overcome it.

3. Remember that being alone isn't always your communication skills. Even if you are great at communicating, sometimes the very thought of crawling out of your hole to meet people can be unbearable. Loneliness leads to depression and a desire to isolate.

4. Analyze your childhood. The loneliness that we experienced in school or kindergarten is closely related to what we experience in adulthood and how we relate to it.

We may feel unwanted because we received little love as children. Sometimes the problem is exacerbated by discrimination and negativity from other people due to any physical or psychological characteristics.

Often loneliness begins with fighting for friends at school, ridicule, simply having no one to chat with at lunch or play on the playground. Even differences in interests - for example, everyone loved video games, and you love football - also lead to separation from the group. Or maybe as a child you had one single best friend who moved away, or you quarreled with him.

There is no single right way to quickly get rid of loneliness. But these general rules work. And the most important of them is to accept yourself and your feelings.

Read also 😩🧐

  • How loneliness affects the body
  • 13 tips on how to enjoy being alone
  • How to love loneliness if you are an extrovert

Personal experience: how to live without friends and not suffer

March 4, 2021 One on one Life

Denis never managed to strike up a strong friendship. At first he was upset, but over time he found his pluses in this.

Some make lifelong friends at school, others find them among colleagues or just by chance. Our hero was less fortunate: he did not get along with friends from childhood. People whom he considered close disappeared from his life without a trace or let him down, and in the end he decided to rely only on himself in everything. Nothing to regret.


The hero's name has been changed at his request. 24 years. Came a long way to feel comfortable being alone.

"I wasn't the coolest guy"

I've never been the life of the party. But also for those who are constantly on the sidelines, too. If you draw a parallel with stereotypical American films about teenagers, then I was always between the main and secondary characters. I had some circle of friends, but I could not be called the coolest guy.

Before school, I was completely immersed in computer games. For me, it was the most comfortable and safest way to have fun. My parents tried to socialize me, but they never pressured me: “Come on! Go to some circle already! They simply limited the time I could spend in front of the screen, so I had to look for some alternative. In fact, it was great, because without a computer, I experienced boredom, which is usually called useful. It allowed me to come up with all sorts of ways to have fun. I read books, drew - built my own comfortable little world.

Then I went to school, and suddenly a huge number of new people fell on me, filling the stereotypical class: beautiful girl, nerds, hooligans.

Many children, unlike me, have already crossed paths before in preparatory courses. Therefore, I had to somehow maneuver between the formed groups.

This is where my interest in video games came in handy, because in elementary school all the boys played on the computer. At breaks, we constantly discussed who cut into what, exchanged discs, invited each other to visit.

But I didn't have my own company. Almost every year I chose some favorite in the class - the person with whom I was most friends. We went to each other's house or to the cinema. Our parents knew each other. But such communication never lasted more than two or three years.

Perhaps this is due to the fact that in elementary school children develop especially quickly and their interests are constantly changing. For the summer holidays, everyone left the same people, and came completely different. And every September 1, it was as if we all got to know each other again. You could meet someone’s eyes on the school line and understand: “Oh, we will communicate!” It happened completely spontaneously.

For example, in the fifth grade, a boy named Anton came to our school. He was smart, with a good sense of humor. We had a lot of common interests, so we quickly found a common language. The only negative: Anton was always busy. He wanted to become a programmer, so after school he went to extra classes and could never just take a walk. Over time, Anton became crowded in our school, and he went to another.

Illustration: Anna Guridova / Lifehacker

When you are a high school student, these things matter a lot. It seems that a person has gone to live in another world. Therefore, our communication immediately came to naught and we stopped being friends. The strangest thing for me was to realize that we did not quarrel - we just parted ways.

“There wasn't a single person I could write to and complain to.”

In high school, things got even more complicated. When you change companies often, new people tend to run out. Then you have to make a double effort to talk to those with whom you once were friends. Also in adolescence, almost everyone has a personal life that mercilessly pushes friends into the background. It happened to me as well. The lack of constant friendship has developed in me an unhealthy tendency to dramatize everything and seek relationships.

I thought: “Now everything is bad, but girls will appear, everything will change.”

Seeing in a relationship only a way to escape from non-existent troubles, I was actively looking for a girlfriend. And when he found it, he instantly obsessed over it, pushing other people away from him. For example, in the tenth grade, I dated a girl. When we broke up, I realized that I had no friends at all. There was not a single person to whom I could write and complain about my problems. If I tried to talk about it with someone unfamiliar, then people did not care at all about me.

Feeling completely alone, I wrote to my ex-girlfriend's new boyfriend, because he was a roofer - he liked to climb on the roofs of houses. I asked to be introduced to someone who does the same. He gave me a couple of phones, and two days later we were picking locks together to get to the very top of the building.

It was a breath of fresh air. I learned that life outside of school can be completely different. Previously, in my environment there were mostly refined children. All of them are parental daughters and sons from decent families who want to get good grades, learn languages, enter the best universities. And here I was faced with a world of completely different people. For example, one roofer had difficulty with speech and hearing, but he was also the most fearless. If it was necessary to climb somewhere on the roof along the eaves, he always took it upon himself. The other guy was the son of a criminal who was in jail for robbery. We communicated quite well with him outside the roofs. He taught me to play the guitar, and I taught him English.

This roofing company has brought me a lot of experience. Firstly, I saw a well-coordinated and strong team, which was united by a very stupid goal - to climb onto the roof and take a picture. It helped me understand that you don't have to be friends with someone to communicate well. Secondly, the company of motley roofers showed me that we are not on the same path with our classmates. I was no longer interested in them.

"Decided never to rely on anyone again"

After school, I went to university to become a psychologist. Few guys studied with me, so we immediately gathered in a bunch and stuck together. For several years we talked as a foursome, then we split into two duets. How and why it happened, I don't know. It's just that two guys stopped talking to the other two. With the remaining classmate after graduation, we also cut off contact due to too different outlooks on life.

The final disappointment in friendship came when I had already graduated from the university and tried my hand at directing courses. There I had a very good friend (as it seemed to me then), with whom we had common interests.

My final work was a web series that the jury liked. They even gave me money to take it off. But there was a catch: I knew how to work well with my head, but I could not organize everything. I needed a person who would take over such moments. I suggested this to my friend and he agreed.

Then I began to notice that things weren't moving, and I wrote to the guy: “Where have you gone? We agreed that you would help." To which he replied: “Sorry, I can’t, I have my own project.” It turned out that he was offered another job and he dumped me. If I had not written to him, he would have simply disappeared without explanation. Although I put on our project not only expectations, but also money.

Then I realized that this is already the hundredth case when a person disappears from my life without explanation. It doesn't matter if we have any obligations to each other or not. I thought it was out of the blue and decided never to rely on anyone again. After that, life became much easier and more interesting.

“When you are alone, you have no limits”

Now I am absolutely comfortable being alone. And I wouldn't want to change anything.

I recently went to Ireland for two and a half weeks, all by myself. At first I was scared. I thought I was going crazy because I just couldn't find anyone to talk to. But in the end, I discovered a whole world of independent travelers.

I rented a room in an apartment where another guy lived. We talked with him, and then spent two days together. Then I moved to another city and settled in a hostel. There I met two Canadians, and we still keep in touch.

When you are alone, you have no limits. Nothing stops you. You are more easy going. You don't have to wait for a friend to go somewhere. You just take and go. And there already appear some people who are interested in this world just as you are. You just approach a person to ask for directions, without ulterior motives, and he calls you to visit. It is amazing.

Sometimes I still get a feeling of loneliness, but this happens very rarely and because of some nonsense. I rent a room in an apartment. My neighbors are also young guys. Recently, I came home at 11 pm, and there was still no one there. And I thought, “Do I have such an inactive social life? Why am I always the first to arrive?” But it went away after a week.

I call my lifestyle single player mode. Relying only on myself, I began to expect something from people less and to be disappointed.

Probably the most important thing for me was to understand that everyone puts their own goals at the forefront. It's natural, I do it too. You just need to take it a little easier. No matter how a person swears friendship, when he has a choice between another and himself, he will always choose himself. Knowing this helps take off the rose-colored glasses.

If you, like me, are worried about the lack of friends, then I would advise you to figure out what exactly is bothering you. Are you really so lonely that you have no one to talk to? Or are the people around just not right for you? After all, there are parents, classmates, colleagues. You never know which relationships will turn into friendships. Perhaps it will be a classmate, or maybe a guy from a neighboring entrance. It sounds trite, but even mom can be the best friend or someone who will help make new acquaintances.

Illustration: Anna Guridova / Lifehacker

A funny thing happened to me. I had a girl visiting me, and she wanted to drink wine. He was not at home, so we went across the street to the store. We bought one bottle there, drank it and returned to the supermarket for two more. We got all the time to one cashier who watched all this.

The next morning I had a headache and I went to the same store to buy water. My hands were busy with bottles, I dumped them at the checkout and realized that the same saleswoman was serving me. She lowered her mask, laughed and said: “Give me a pill?” And immediately my heart felt so warm.

Since then, the cashier and I have been constantly greeting each other, asking each other how things are going.

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