When feeling depressed and lonely

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. SAMHSA’s 2020 National Survey on Drug Use and Health reports that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.



  • 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)
  • The 2019 National Survey on Drug Use and Health reports that 139.7 million Americans age 12 or older were past month alcohol users, 65.8 million people were binge drinkers in the past month, and 16 million were heavy drinkers in the past month
  • About 2.3 million adolescents aged 12 to 17 in 2019 drank alcohol in the past month, and 1.2 million of these adolescents binge drank in that period (2019 NSDUH)
  • Approximately 14.5 million people age 12 or older had an alcohol use disorder (2019 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)
  • Data from the 2019 NSDUH reports that 58.1 million people were current (i.e., past month) tobacco users. Specifically, 45.9 million people aged 12 or older in 2019 were past month cigarette smokers (2019 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:

  • 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 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)
  • An estimated 745,000 people had used heroin in the past year, based on 2019 NSDUH data
  • In 2019, there were 10.1 million people age 12 or older who misused opioids in the past year. The vast majority of people misused prescription pain relievers (2019 NSDUH)
  • An estimated 1.6 million people aged 12 or older had an opioid use disorder based on 2019 NSDUH data
  • Opioid use, specifically injection drug use, is a risk factor for contracting HIV, Hepatitis B, and Hepatitis C. The CDC reports that people who inject drugs accounted for 9 percent of HIV diagnoses in the United States in 2016
  • 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



  • 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)
  • 2019 NSDUH data indicates that 48.2 million Americans aged 12 or older, 17.5 percent of the population, used marijuana in the past year
  • Approximately 4.8 million people aged 12 or older in 2019 had a marijuana use disorder in the past year (2019 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: 04/27/2022

Feeling lonely? 11 ways to overcome this feeling.

The great irony is that as we become more and more “connected”—on social media, video calls, and messaging—we simultaneously feel more and more alone. And while we may use technology to feel more connected, it may be exactly what makes us feel alone.

Practice kindness. In difficult times it is important to practice kindness. Blaming yourself when you feel lonely won't help. So stop your harmful self-talk, take care of yourself and take a little break. Perhaps a walk in nature or a day at the spa can be helpful in getting you into a mood of kindness. nine0003

Enjoy the moment. When you like something, immediately share it with others, and I do not mean that you need to post on social networks. You can share by calling or sending a message to a friend. Or share with the people you work with. Keep in mind that the positive things you can share don't have to be big. You could just wake up on the right side of the bed and think, "Hey, I feel great today." By sharing these moments, you create a small connection with other people that can help you overcome loneliness. nine0003

Connect in real life. Connecting in real life may not be as easy as it used to be. We use our smartphones a lot - it's easier and it's now culturally accepted. But we can lessen our loneliness if we build stronger personal bonds. We do this by looking into people's eyes, by listening, by being mindful, and by being careful not to be distracted by phones or other technologies.

Rethink how you spend your free time. When we feel lonely, sometimes we just want to go into a corner and hide. Other times, our endless to-do list can leave us too frazzled to go out and socialize. We have created a life for ourselves that robs us of meaningful social connection, and the only way to get out of it is to start living differently. If instead we use our loneliness as a motivation to reach out to people, then we can strengthen our relationships. By choosing to cope with our loneliness by seeking social support, we create more social moments with the people in our lives that are important to us, which usually reduces our loneliness. nine0003

Do more things with people. Engaging in face-to-face communication improves our mood and reduces depression. Activities that involve other people, such as attending religious services or playing sports, can also have a positive impact on our mental health. So find ways to be around people more often.

Talk to strangers. A growing body of research shows that even seemingly mundane interactions with strangers, such as chatting with a barista or cashier, can overcome loneliness by helping us feel more socially connected. So reach out to other people to say hello, ask how they are, or talk about what's on your mind. These small actions can make a big difference and help you reduce feelings of loneliness. nine0003

Be active online. Instead of passively surfing the web or social media, do something that involves the active participation of other people. For example, you can play games with other people, chat about things you care about, give advice on a forum, or chat with a friend via video. The more you communicate with other people online, the more connections you have.

Stop your negative thought cycles. We could repeatedly think about what we could have done differently so as not to feel so alone. We think about events, people, or reasons because we mistakenly believe that thinking about our loneliness over and over again will help us get rid of it. Unfortunately, it is useless to dive into our thoughts instead of taking the actions we need to feel better. To end these negative thought cycles, we need to take action - do something different that stops these thoughts and changes our perception of the world. For example: "If I'm feeling lonely, I'll go to the gym or schedule dinners with friends for the next few days." And it helps. nine0003

Spend money on experience. If we spend all our money on things, we will have nothing left to spend on experiences with others. And it turns out that spending money on experiences is a lot better for our mental health. So get creative and think about what you want to do with others. For example: "I could go on a boat trip, wine tasting, plan a beach party, or host an arts and crafts evening." What group activities can make you feel less alone? nine0003

Notice the things that matter. How can we expect to get rid of loneliness when we don't know what causes it? It's complicated. Therefore, it is useful to start paying attention to the current moment. What experiences make you feel lonely? Identifying these points can help you reduce loneliness because you can limit your participation in activities that make you feel lonely and increase your participation in activities that make you feel connected to other people. nine0003

Your network trend. Sometimes we may feel lonely, even if we are connected with many people. So it can be helpful to contact these people and schedule time to catch up. Try to schedule at least one hour of socializing per week - coffee, lunch, or happy hour. Who knows, maybe an old friendship can be revived.

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Loneliness together: why we are unhappy in relationships

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Loneliness Relationship crisis Man and woman

Loneliness is a painful feeling. When I work with a client who is struggling with addiction and ask him to look inside himself to understand what feelings he is trying to drown out with food or alcohol, I often hear the same answer: loneliness. You may think that this feeling is experienced mainly by those who live alone and do not have a family, but this is not so. It is in partnerships that many feel abandoned, isolated. After all, relationships do not always relieve loneliness, on the contrary, they sometimes cause it. nine0003

We feel deeply alone when we want to feel soul contact with someone, but this someone is not available to us, does not want or cannot open up to us. This feeling is certainly present when we are alone, but often it occurs in relationships when one or both partners have lost touch with each other - due to the fact that one of them is angry or withdrawn, sick or very tired. .

Having lost contact with ourselves, we cannot connect with others

Being alone and being lonely are not the same thing. The feeling of emptiness occurs when we are out of touch with ourselves—when we are unable to listen to our feelings, judge ourselves, turn to all sorts of addictions to get rid of painful sensations, or hold someone else responsible for our feelings. nine0003

We will always feel lonely and abandoned when we give up on ourselves.

Moreover, having lost contact with ourselves, we cannot connect with others. And these broken ties become a source of deep despair and disappointment. A person who lives alone, but at the same time loves and appreciates himself, may not feel this painful emptiness. He is able to enjoy his solitude and keep in touch with others when they are ready to make contact.

What makes us lonely in a relationship? nine0073

You may feel lonely with a partner if

...your heart is closed because you protect yourself from resentment, anger or possible rejection. You cannot be in contact with a partner when closed.

...the partner is closed, angry or self-absorbed.

...a partner deliberately blocks communication with you, hiding behind work, TV, alcohol, hobbies, the Internet, and so on.

...you adjust to your partner, trying to control his feelings in this way. Giving up yourself for the sake of manipulation interferes with the creation of a genuine soul connection. nine0003

...both of you or one of you does not want to see the brewing conflict. The reluctance to speak openly on sensitive topics creates barriers between you.

Isolation disappears when we are open and open with each other

...you or your partner uses sexual relations as a form of control.

...you go over relationships in your head instead of discussing them together with open hearts. Speculative analysis can be attractive at times, but after a while you feel bored and empty. nine0003

...a partner criticizes your thoughts, feelings, attitudes, or actions. Judgment and criticism divide people.

...you or your partner are too tired, overwhelmed or unwell to keep in touch.

In a word, everything that separates us from ourselves and our partner causes a feeling of loneliness. Conversely, isolation disappears when we are frank and openly contact each other.

We feel connected to each other when

. ..we are not afraid to be ourselves, vulnerable and say what we think without guilt or fear of judgment. nine0003

...ready to face unpleasant experiences, deal with them nurturingly, and learn from them—to take responsibility for all our feelings rather than avoid them with various defenses. When we are in touch with ourselves, we can build connections with others, we are ready to learn something new about ourselves and our partner, especially in conflicts.

...we show care and compassion for ourselves and our partner.

... finding time to be together, talk, play, love, laugh, learn and grow. We are interested in personal growth and development of our relationships. nine0003

When spending time together, developing the ability to love yourself and share love with each other, becomes a priority for both partners, you have a great chance of staying in genuine contact with yourself and with each other. In such relationships, people rarely feel alone.

About the author

Margaret Paul is a family psychologist, co-author of What's Stopping You from Being Happy (with Jordan Paul, Centerpoligraph, 2009).

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