I just feel lost

SAMHSA’s National Helpline | SAMHSA

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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.

Suggested Resources
What Is Substance Abuse Treatment? A Booklet for Families
Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.
It's Not Your Fault (NACoA) (PDF | 12 KB)
Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.
Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.
For additional resources, please visit the SAMHSA Store.

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).

Alcohol

Data:

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

Programs/Initiatives:

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

Tobacco

Data:

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

Resources:

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

Links:

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

Opioids

Data:

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

Resources:

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

Links:

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

Marijuana

Data:

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.

Resources:

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.

Resources:

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

6 simple truths to remember when you feel lost in life

At any stage, life can lead you into a dead end. It is such a strange and unpleasant feeling when it seemed to you that you knew what you wanted and where you were going, but along the way you ran into an endless brick wall with your forehead. Previously, you had everything planned out and quite predictable, but now you feel that you are lost, lost and stuck. And this feeling turns into a feeling of isolation and separation from the world. You no longer move anywhere, but stand still, staring blankly at the wall in front of you. Well, it's time to remind yourself of a few simple truths to understand that it's not as bad as you think.

Truth #1: It's okay to feel lost. Yes, you read that right, this is absolutely normal and acceptable. There is nothing wrong. Your feelings are now based entirely on facts: you have lost your direction; you understand that you are stuck; you don't know what to do next. All this because the future has not yet been written. And this has its own charm - it means that you have a chance to write it. You will need quite a bit of time to navigate the terrain and figure out how to get out of the impasse.

Truth #2: You are doing great. Wherever you are now, this is just your stage of life and your lesson. Finding your place in our world is a process, so trust the process. Your time will come, as it comes for all other people. Just be patient.

Truth #3: Look inside yourself, but don't compare yourself to others. The feeling of being lost can come over you at any age and at any stage in your life. If you see inside yourself a confused and frightened person who seems to have lost everything, most likely this is not so. Perhaps you just need to look at the outside world a little differently, that is, perceive it as your assistant, and not a hostile environment. Do not let others dictate your actions and actions to you, which means focus on yourself, and not on the opinions of others.

Truth #4: Don't be afraid to feel lost. Some things seem to be up in the air now, but they won't always be. Everything that goes up, after some time quite naturally goes down. Just consider that now you just went down, which means that you have a new road up in front of you. Of course, you want immediate solutions and instant results, but as the saying goes, all good things come to those who can wait.

Truth #5: Show love to yourself. Yes, that's right: take the time to be kind to yourself. After all, you are kind to your loved ones and constantly fly to their aid? Therefore, treat yourself now with the same care and compassion. Pamper yourself, sleep and relax. Do what you like. Live your best life.

Truth No. 6: There are no right decisions in life. We are all afraid of mistakes. We are afraid that our plans will not be realized the way we want them to be. We fear that while others are moving forward in their lives, we will always fall behind and stumble. Remember: everyone's paths are different and they are never exactly the same. No one but us can dictate to us how to live. As long as you are happy with your choices and decisions, you will be fine. If you are not satisfied with your choice, you always have the option to choose another path. No matter how difficult it is, only you can determine when, where and how you will go.

Text: Flytothesky.ru

Read also:
10 moments in life when it is better to remain silent

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“I feel lost in my adult life”

Nina, 27 years old, video library director

“I summed up my beginning of adult life. And this is what turned out: I have a permanent job, a car, my own apartment, but I don’t really know where I’m going. I don’t move forward, on the contrary, all the time it’s like looking back in search of the sensations that I had as a child. ”

Robert Neuburger: What feeling are you talking about?

Nina: I have always wanted to be in control of my life. Already from a very early age, from 8–9 years old, I knew that I had to get out of any situation on my own. And at the same time, I felt some kind of heaviness in relations with my relatives. That is, we are talking about two sensations: extreme control and heaviness in relationships.

Robert Neuburger: Are your parents alive?

Nina: My father died almost a year ago; I have a mother and brother, he is 25 years old. Other relatives practically do not communicate with each other.

Robert Neuburger: Do you love your job?

Nina: Very.

Robert Neuburger: What does your brother do?

Nina: He is an investment banker.

Robert Neuburger: At 25?

Nina: Yes, he is a child prodigy. He is an investment expert and is responsible for the decisions the bank makes.

Robert Neuburger: That's it!

Nina: (With pleasure.) Yes, he was always curious, and his brother has a phenomenal memory.

Robert Neuburger: When did you and your brother leave your parents' house?

Nina: He still lives with his mother, and I moved out about a year and a half ago, but I still couldn't really separate. I am either at home or in my parents' house. And since my father died, I often live with my mother and brother. Probably because my mother says she needs me. In our family, I have always played the role of mediator. According to a psychotherapist I once went to, this role is now difficult for me.

Robert Neuburger: Have you had psychotherapy?

Nina: Yes, about an eating disorder. I had anorexia, bulimia. I have not recovered, but now I cope better with these conditions. And I graduated from behavioral therapy when I realized that eating disorders only reflected my psychological problem - I was very insecure.

Robert Neuburger: But if your brother lives at home, why does your mother need you?

Nina: I think she wants to restore her family.

Robert Neuburger: Does your brother have a private life?

Nina: No, I don't think so. Relationships with other people have always been difficult for him. I think he's still a virgin, but we never talk about it.

Robert Neuburger: Did you have lovers?

Nina: I had many one-night stands with men I knew for sure that they were not looking for a serious relationship. And I don’t know why I’m going for it ... And how such relationships can be changed.

Robert Neuburger: How do you meet men?

Nina: Online. I can't get to know someone in real life because I'm sure I can't like them. If someone is interested in me, I, most likely, will simply not notice it.

Robert Neuburger: But there are more or less serious dating sites, right?

Nina: Yes, that's what I'm talking about. I visited almost all sites and in the end I always attacked men of the same type. My acquaintances are not a disaster, but after a while I realize that they were not worth the effort. Men do not linger in my life, but it is they who fill the void. Like TV programs: you take the remote control, switch buttons and watch anything. Just something to fill the void.

Robert Neuburger: Essentially the same mechanism of action for bulimia. In many ways, you are trying to extinguish the fundamental anxiety that you call "emptiness." When did it start? When did you first tell yourself that you have to take life into your own hands? You were 8-9 years old, what happened at that time?

Nina: My brother skipped class for the first time. Then it happened a second time and a third. We can say that he was the star of the town where we lived. When relatives or friends came to visit us, no one talked to me: they only talked to my brother. He even appeared on TV! It was at that time that I realized that I needed to pull myself together, otherwise I would go with the flow, go nowhere ...

Robert Neuburger: It wasn't easy for you...

Nina: I think my brother will haunt me all my life, especially now that he suffers from depression with suicidal tendencies. He needs a lot of attention and seeks to get it through suicide threats.

Robert Neuburger: To whom does he address them?

Nina: Mother and me.

Robert Neuburger: I think I understand his problem: he's been a star since childhood and it's hard for him to stop being one. What he does doesn't really excite him, right?

Nina: Not really. As a child and teenager, he was always the best; then he entered the university and there he saw that the competition is very tough. There he was not always the first. It was then that his brother first had gloomy thoughts.

Robert Neuburger: Is that the situation you had in mind when you mentioned your role as mediator in family relationships?

Nina: Yes, my mother is afraid of making some mistake in communicating with her brother. She says that she takes all his suffering on her shoulders, but is afraid of his reactions.

Robert Neuburger: And yet she shares this suffering with you...

Nina: But that's because I asked her to.

Robert Neuburger: What is your relationship with your brother?

Nina: Very close. He says that I'm the only one who understands him and that I'm actually his "blotter"...

Robert Neuburger: You can be proud of that! You absorb his anxiety, and then what? What are you doing with her? Was there any suspicion that your brother has homosexual tendencies? If he is so closed, closed, suffering from feelings of guilt, there must be some reason for this ...

Nina: But I don't know what the reason is.

Robert Neuburger: Isn't your one-night stand a defense against falling in love with someone and being so far away from home?

Nina: I don't know. I feel like I need a stable relationship. Although, perhaps, I scare men, because I demand too much at once.

Robert Neuburger: But you don't ask them to marry you the next morning!

Nina: (Laughs) No, it doesn't come to that. But maybe I don't give the relationship time to settle...

Robert Neuburger: It's hard for me to imagine that you are leaving your family of origin. Now it seems impossible. But I think that the question should not be put in this way: either I will leave the family, or I will be with him. In addition, you play an important role for your family, and this also supports you. The question, rather, is to find a balance between your professional life, which should be built, and the family, which functions like many single-parent families. I would even say families that have had problems in the past. When the connection between family members is too close, it develops for a reason.

Nina: I know that my father was abandoned by his parents immediately after his birth and was raised by his uncle and aunt. But I don't know if it was a trauma for him.

Robert Neuburger: My first thought is that you should do family therapy.

Nina: Mom will never agree to this. And my brother will refuse: he is undergoing psychotherapy, and when his therapist invited me to come to the appointment with him, he flatly refused.

Robert Neuburger: Understood. Then you have the opportunity to do this work yourself. Knowing that you will need to find a therapist who will not push you to break up with your family, a therapist who will be open enough not to. But it is possible to find it!

Nina: “It's a bit strange to completely trust a stranger. But it was very interesting to finally find the name of that emptiness that torments me. It was as if I discovered another part of my personality. I was also struck by the advice not to move away from the family, but to find the right “distance”. I used to think that you have to make a radical choice, but it's not! I will start psychotherapy to move on. ”

Robert Neuburger: “Nina is undoubtedly too attached to her family, to her role as mother's guardian and brother's blotter. But to offer her as a treatment to leave this environment and thus become independent would be to put the cart before the horse: independence is not a break. Distance does not solve anything, because her family is part of her life. For her, it is more about building your personal life, appreciating yourself more, and then the separation will occur naturally. Those types of psychotherapy that claim that violations are associated with too much closeness with mother, father, spouse and that separation will solve all problems most often lead to unconstructive consequences: either the patient transfers his addiction to the therapist, or he develops an internal conflict over for loyalty, which exacerbates his symptoms."

Robert Neuburger , psychoanalyst, family therapist, head of the European Center for Family Research Association (CEFA).