TRUSTED CONTENTMost people arrive in this field with a picture of addiction assembled from films, news coverage and family experience. Some of that picture is accurate. A good deal of it is not, and the inaccurate parts tend to be exactly the ones that make conversations go badly: that people have to hit rock bottom, that dependence and addiction are the same thing, that someone who returns to use has wasted everyone’s time.
This guide covers what a substance use disorder is, what different substances do, how mental health conditions interact with substance use, and how to talk with someone who is struggling. It is the foundation the other guides in this series assume.
Who this is for, and how to read it
New to behavioral health. Read straight through and skip every green dashed box. The main text assumes no prior knowledge.
Already working in treatment. The green dashed boxes cover what has changed, including diagnostic terminology that shifted over a decade ago and is still being used incorrectly, and a drug supply that looks materially different from a few years ago.
This guide describes conditions in general terms. It does not diagnose anyone, and recognizing a pattern in a description is not the same as identifying it in a person. Diagnosis is clinical work.
If you are reading this because you are worried about yourself or someone close to you, that is a reasonable thing to do, and the last lesson is the practical one. In the United States, the 988 Suicide and Crisis Lifeline can be reached by call or text at any hour, and the SAMHSA National Helpline is 1-800-662-HELP (4357).
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Four ideas that do most of the work
If you take nothing else from this guide, take these. Each is expanded in the lessons below.
A substance use disorder is a diagnosable condition, not a quantity
It is defined by a pattern of impairment and consequences, not by how much someone uses or which substance they use.
Physical dependence is not addiction
A person can be physically dependent on a medication and have no substance use disorder at all. Confusing the two harms patients, particularly those with chronic pain.
Mental health conditions and substance use travel together
Co-occurrence is common enough to be the expectation rather than the exception, and treating only one half predictably fails.
Nobody has to lose everything first
The idea that people must hit rock bottom before treatment can work is not supported by evidence, and acting on it costs lives.
The lessons
What a substance use disorder actually is
A substance use disorder is a medical diagnosis, made against defined criteria, describing a pattern of use that causes clinically significant impairment or distress. It is not a description of how much someone drinks or which drug they use. Two people can consume identical amounts and only one meet criteria.
The eleven criteria, in plain terms
The diagnostic manual used in the United States sets out eleven features, grouped loosely into four areas:
- Loss of control. Using more or for longer than intended; wanting to cut down and not managing it; spending a great deal of time obtaining, using or recovering; craving.
- Social impairment. Failing to meet obligations at work, school or home; continuing despite it causing relationship problems; giving up activities that used to matter.
- Risky use. Using in physically hazardous situations; continuing despite knowing it is causing or worsening a physical or psychological problem.
- Pharmacological features. Tolerance, and withdrawal.
Severity follows from how many are present: two or three is mild, four or five moderate, six or more severe. This matters practically, because it means a mild substance use disorder is a real diagnosis rather than a warning sign, and it can be treated at a low level of care before things escalate.
What the pattern looks like from outside
Notice what is missing from that list: how much, how often, and which substance. Someone drinking within ordinary social norms who has tried repeatedly to stop, is preoccupied with it, and continues despite it damaging their marriage meets more criteria than someone drinking heavily at weekends with none of those features. This is why “but they only drink beer” and “they hold down a job” are not reassuring answers.
Refresher — changed in 2013
Abuse and dependence are no longer separate diagnoses. The previous manual split them into substance abuse and substance dependence. Since 2013 they have been merged into a single substance use disorder rated mild, moderate or severe.
This is more than a naming change. The old split implied a threshold a person crossed from one condition into another; the current model describes a continuum of severity. Anyone still writing “substance dependence” as a diagnosis, or treating “abuse” as the milder diagnosis, is using terminology retired more than a decade ago.
Knowledge check: what determines whether someone has a substance use disorder?
- The quantity they consume
- Which substance is involved
- A pattern of impairment and consequences against defined criteria
- Whether they have lost their job or housing
Answer: a pattern of impairment against defined criteria. Quantity and substance type do not by themselves establish a diagnosis.
Tolerance, dependence and addiction are three different things
These words are used interchangeably in ordinary speech and mean distinct things clinically. Getting them wrong causes real harm, and it is one of the most common errors in this field.
Tolerance
The body adapts, so the same dose produces less effect and more is needed for the same result. A normal physiological response. It happens with many medications that have nothing to do with addiction.
Physical dependence
The body has adapted to the point that stopping suddenly produces withdrawal symptoms. Also a normal physiological response, and expected with sustained use of opioids, benzodiazepines, and many ordinary medications including some antidepressants and blood pressure drugs.
Addiction, or substance use disorder
The behavioral pattern described in the previous lesson: loss of control, compulsion, continued use despite harm. It may involve tolerance and dependence, and it is not the same as either.
Why this distinction matters
A person taking opioid medication as prescribed for cancer pain will develop tolerance and physical dependence. They do not have a substance use disorder. Treating them as though they do, refusing them adequate pain relief, or describing them as addicted is a clinical error with consequences.
The reverse also holds. Someone can meet full criteria for a stimulant or cannabis use disorder with minimal physical withdrawal. The absence of dramatic withdrawal does not mean the absence of a disorder, and “I can stop whenever I want, I just don’t get sick” is not evidence of anything.
The diagnostic consequence
Because of this, tolerance and withdrawal are not counted toward a diagnosis when someone is taking a medication as prescribed. It is a specific carve-out in the criteria, and it exists precisely because the distinction is so often collapsed.
Language note
The same confusion drives the false claim that medication for opioid use disorder is “just swapping one addiction for another.” Someone stable on buprenorphine is physically dependent on it. They are not, by virtue of that, addicted to it, and the difference is exactly the one this lesson describes.
Knowledge check: a cancer patient on long-term opioid pain medication has tolerance and would experience withdrawal if it stopped abruptly. What does this establish?
- Physical dependence, which is expected and is not a substance use disorder
- A severe substance use disorder
- That the medication should be stopped
- A mild substance use disorder
Answer: physical dependence only. Tolerance and withdrawal do not count toward a diagnosis when medication is taken as prescribed.
What different substances do, and why it matters clinically
You do not need pharmacology. You do need to know which categories carry dangerous withdrawal, which carry overdose risk, and which have medications available, because those three facts shape every placement conversation.
Alcohol
A depressant. Withdrawal can be life-threatening, involving seizures and delirium tremens, and requires medical supervision. Long-term use damages the liver, heart, pancreas and brain. Three approved medications. Still the substance behind the largest share of treatment admissions, and consistently underestimated because it is legal and ordinary.
Opioids
Heroin, fentanyl, and prescription medications such as oxycodone and hydrocodone. High overdose risk, because they suppress breathing. Withdrawal is severe and distressing but rarely fatal in an otherwise healthy adult, though dangerous in pregnancy. Three approved medications, two of which reduce mortality substantially.
Benzodiazepines and sedatives
Alprazolam, diazepam, clonazepam and similar. Withdrawal is potentially life-threatening like alcohol, and can require a long, carefully managed taper rather than a short admission. Particularly dangerous combined with opioids, since both suppress breathing. Never advise anyone to stop these abruptly.
Stimulants
Cocaine, methamphetamine, and prescription stimulants. Withdrawal is primarily psychological, with heavy fatigue, severe low mood and sometimes suicidal thinking, which makes the early period a genuine risk even without medical instability. Overdose risk is real and works differently from opioids, through cardiac events, stroke and hyperthermia. No approved medication, which is why contingency management matters so much here.
Cannabis
A cannabis use disorder is a real diagnosis, and withdrawal is real though not dangerous: irritability, sleep disturbance, appetite change. Modern products are far more potent than those of a few decades ago, and heavy use in adolescence is associated with worse outcomes, including psychosis risk in vulnerable people. No approved medication.
Hallucinogens, dissociatives and inhalants
Less commonly the primary reason for treatment. Dissociatives such as ketamine carry misuse potential. Inhalants deserve particular attention in adolescents because they are cheap, accessible, and cause direct neurological damage.
Polysubstance use is the norm
Most people entering treatment use more than one substance, and combinations change the risk picture. Opioids with benzodiazepines or alcohol multiply respiratory risk. Stimulants with opioids are increasingly common and complicate both withdrawal management and treatment planning. Always ask what else, rather than what.
Knowledge check: withdrawal from which of these can be life-threatening?
- Cannabis
- Alcohol and benzodiazepines
- Cocaine
- Hallucinogens
Answer: alcohol and benzodiazepines. Both can produce seizures and require medically supervised withdrawal. Opioid withdrawal is severe but rarely fatal in an otherwise healthy adult.
Overdose and harm reduction
Harm reduction means reducing the damage associated with substance use, whether or not someone is ready to stop. It is not opposed to treatment and it is not a lesser goal. A person who is alive can enter treatment later; a person who is not, cannot.
Where the numbers stand
United States overdose deaths peaked at roughly 108,000 in 2022 and have fallen substantially since. Provisional CDC figures released in July 2026 predicted around 68,600 deaths for the twelve months ending February 2026, a decline of about 12 per cent on the previous year and the continuation of the steepest sustained fall on record.
Two cautions when using figures like these. They are provisional, revised monthly, and the current number will differ from the one quoted here, so check the source before publishing anything. And a decline of this size still leaves a toll of roughly 190 deaths a day, with drug overdose remaining a leading cause of death among younger adults. Improvement and crisis are both true statements.
Naloxone
Naloxone reverses opioid overdose by displacing opioids from receptors, restoring breathing within minutes. It has no effect on someone who has not taken opioids, no misuse potential, and giving it to someone who turns out not to be overdosing on opioids causes no harm. Nasal spray formulations are available over the counter in the United States without a prescription.
Practical points worth knowing:
- Call emergency services first. Naloxone buys time; it is not a substitute for medical care.
- Potent synthetic opioids may require more than one dose.
- It can precipitate immediate, severe withdrawal, which is unpleasant and not dangerous compared with the alternative.
- Most states have Good Samaritan laws giving some protection to people who call for help at an overdose, though the detail varies considerably.
Other harm reduction measures
Fentanyl test strips let people check a supply before use. Syringe service programmes reduce transmission of HIV and hepatitis C and act as a route into treatment. Not using alone, or using with someone who can respond, is the simplest protective step available. Safer supply and supervised consumption arrangements exist in some jurisdictions and are contested politically; where they operate, the evidence on overdose deaths at the sites themselves is favourable.
Refresher — the supply has changed
The illicit opioid supply is no longer mainly heroin. Illicitly manufactured fentanyl dominates, and people frequently do not know what they have taken. Counterfeit pills made to look like prescription medication are a major route to unintentional exposure.
Xylazine, a veterinary sedative, is now frequently found mixed with fentanyl. It is not an opioid, so naloxone does not reverse its sedative effect, though naloxone should still be given because opioids are usually present too. It is associated with severe wounds that can require specialist care, which is one reason enhanced biomedical capability in residential settings matters.
Nitazenes, a group of highly potent synthetic opioids, have also appeared in the supply. If your understanding of street opioids dates from the heroin era, the risk picture is materially different now.
Knowledge check: someone is unresponsive and opioids may be involved, but you are not certain. What is true of naloxone?
- It should only be given if opioids are confirmed
- It is dangerous if the person has not taken opioids
- It removes the need to call emergency services
- It causes no harm if opioids are not involved, and emergency services should still be called
Answer: no harm if opioids are not involved. Naloxone only acts on opioid receptors, and it buys time rather than replacing emergency care.
The mental health conditions you will meet most
Brief, practical descriptions. The point is recognition of what someone is describing, not diagnosis.
Depression
Persistent low mood or loss of interest lasting at least two weeks, with changes to sleep, appetite, energy, concentration and self-worth. Highly treatable. Note that heavy alcohol use produces something that looks identical, which is why clinicians often reassess mood after a period of abstinence before concluding anything.
Anxiety disorders
Generalized anxiety, panic disorder, social anxiety and others. Persistent, disproportionate worry or fear that interferes with functioning. Strongly associated with alcohol and benzodiazepine use, because both provide short-term relief and worsen the underlying anxiety over time.
Bipolar disorder
Episodes of depression alternating with mania or hypomania: elevated or irritable mood, reduced need for sleep, rapid speech, impulsivity, inflated confidence. Substance use rates are high, and use often escalates sharply during manic episodes. Mania is frequently mistaken for stimulant intoxication and vice versa.
Post-traumatic stress disorder
Following exposure to trauma: intrusive memories, avoidance, negative changes in mood and belief, and heightened arousal. Very common in treatment populations, and substances are often being used to manage the symptoms.
ADHD
Persistent inattention, impulsivity or hyperactivity beginning in childhood. Associated with elevated substance use rates. Treating it appropriately, including with medication where indicated, is generally associated with better rather than worse substance outcomes, contrary to a common assumption.
Psychotic disorders
Schizophrenia and related conditions, involving hallucinations, delusions and disorganized thinking. Substance use is common. Distinguishing a primary psychotic disorder from substance-induced psychosis takes time and observation, and is genuinely difficult early on.
Personality disorders
Enduring patterns of thinking, feeling and relating that cause significant difficulty. Borderline personality disorder in particular co-occurs frequently with substance use and responds to specific treatment. This is a diagnosis that attracts unusual stigma, including from staff, and that is worth noticing in yourself.
Eating disorders
Frequently co-occur with substance use and are often missed. They carry serious medical risk and need specialist assessment rather than general behavioral health care. If someone raises this, the right response is to help them reach appropriate specialist support rather than to explore it in detail yourself. In the United States, the National Alliance for Eating Disorders helpline can direct people to treatment.
Knowledge check: why might a clinician reassess depression after a period of abstinence?
- Depression cannot be diagnosed alongside substance use
- Heavy alcohol use produces symptoms that look identical to depression
- Antidepressants cannot be prescribed to people who drink
- Insurance requires it
Answer: alcohol produces a very similar picture. Reassessment helps distinguish a primary depression from substance-induced mood symptoms. It does not mean treatment waits.
Co-occurring disorders
When a substance use disorder and a mental health condition are present together, that is a co-occurring disorder, also called dual diagnosis. It is common enough that programmes should be built for it rather than treating it as a complication.
Which came first is usually the wrong question
People want a clean causal story. The relationship generally runs in several directions at once:
- Substances can be used to manage symptoms, which works briefly and worsens things over time.
- Substance use can precipitate or worsen mental health conditions.
- Shared factors, including genetics, trauma and adversity, raise the risk of both independently.
All three are frequently operating in the same person, which is why sequencing arguments tend to go nowhere.
Integrated treatment
The historical approach was sequential: treat the substance use, then the mental health condition, or the reverse. It worked poorly, and people fell between two services that each considered them someone else’s problem. The current standard is integrated treatment, addressing both together in one place by one team.
This is why programmes with advanced co-occurring capability matter, and why a caller with a serious mental health condition needs a programme equipped for it rather than the nearest available bed. A facility that says it will address the substance use first and mental health later is describing an approach that has been superseded.
One practical warning
People are sometimes told to stop psychiatric medication on entering treatment, on the reasoning that recovery means being free of all substances. That reasoning is wrong and the consequences can be serious. Prescribed psychiatric medication is not substance use, and stopping antipsychotics, mood stabilizers or antidepressants abruptly can be dangerous. Any programme that requires this is a programme to ask hard questions about.
Knowledge check: what is the current standard for treating co-occurring disorders?
- Treat the substance use first, then the mental health condition
- Treat the mental health condition first, then the substance use
- Integrated treatment addressing both together
- Refer to two separate services simultaneously
Answer: integrated treatment. Sequential models left people falling between services that each treated them as the other’s responsibility.
Why some people develop a substance use disorder and others do not
No single cause explains it. What research describes is a set of factors that shift probability, none of which is destiny in either direction.
What raises risk
- Genetics. Heritability estimates for substance use disorders are substantial, broadly comparable to conditions like type 2 diabetes. There is no single addiction gene; many variants each contribute a little.
- Adverse childhood experiences. Abuse, neglect, household instability and related adversity are strongly associated with later substance use, in a graded way: more adversity, higher risk.
- Early first use. Starting in adolescence is associated with markedly higher risk than starting as an adult, and the brain regions governing impulse control and judgment continue developing into the mid-twenties.
- Mental health conditions. As covered above.
- Environment and circumstance. Availability, peer and family norms, poverty, housing instability, discrimination, and social isolation all contribute.
What protects
Stable relationships, engagement with school or work, a sense of purpose, secure housing, and at least one reliable adult in childhood. These are not slogans. They map directly onto the recovery environment dimension that drives placement decisions, and they are why treatment that ignores housing and social circumstance tends to fail.
Why the disease framing is useful, and where it stops
Describing addiction as a medical condition rather than a moral failing is well supported and reduces blame. Taken too far, it can imply that people are passive and that only medical intervention matters. Both parts need holding at once: this is a condition with biological underpinnings, and recovery involves choices, effort, relationships and circumstances. Saying the second does not undo the first.
The rock bottom myth
The belief that people must lose everything before treatment can work is not supported by evidence, and it is actively harmful. Earlier intervention is associated with better outcomes. People enter treatment for all sorts of reasons, including pressure from family, work or courts, and externally motivated entry does not predict failure. Waiting for someone to hit bottom is waiting while the risk rises.
Knowledge check: a family asks whether they should step back and let their relative hit rock bottom. What does the evidence suggest?
- Yes, motivation only comes from crisis
- Yes, but only for opioid use disorder
- It makes no measurable difference either way
- No, earlier intervention is associated with better outcomes
Answer: no. Externally motivated entry into treatment does not predict failure, and waiting raises risk.
Talking with someone who is struggling
You will have conversations with people in distress. You are not their clinician, and you do not need to be. What follows is within the scope of any non-clinical role.
What helps
- Listen before solving. Most people have been lectured extensively already. Being heard is unusual for them and disproportionately valuable.
- Ask, do not assume. “What would be most useful right now?” beats guessing.
- Be honest about what you do not know. Saying you will find out and calling back builds more trust than a confident wrong answer.
- Give concrete next steps. One clear action, and who will do what by when.
- Use ordinary language. Person-first, no jargon, no moralized terms.
What does not
Arguing about how serious the problem is. Predicting where they will end up. Promising outcomes, timelines or costs you cannot guarantee. Sharing your own recovery story at length, which shifts the conversation to you. Pressing for a decision they are not ready to make.
When someone may be at risk of suicide
Substance use disorders are associated with substantially raised suicide risk, so this will come up. Signs worth taking seriously include talking about wanting to die or being a burden, expressing hopelessness or feeling trapped, withdrawing from people, giving away possessions, and a sudden calm after a period of despair.
If you are concerned:
- Ask directly. “Are you thinking about suicide?” Asking does not plant the idea. It is one of the few things here the evidence is clear about, and a direct question gives permission to answer honestly.
- Stay with them. Do not end the conversation abruptly or transfer them without explanation.
- Connect them. In the United States, the 988 Suicide and Crisis Lifeline takes calls and texts at any hour. If there is immediate danger, that is 911.
- Escalate internally. Know your organization’s procedure before you need it, and follow it.
- Do not promise secrecy. Be honest that you may need to involve others to keep them safe.
Looking after yourself
This work carries a real risk of secondary traumatic stress and burnout, and neither is a sign of unsuitability. Use supervision and debriefs, notice when calls are staying with you afterwards, and treat that as information rather than weakness. Staff who are supported stay, and continuity of staff is itself good for the people you serve.
On stigma
Stigma is not only public attitudes. It shows up in how services are designed and how staff speak when they think nobody is listening. Notice the language used about people who return to use, who miss appointments, or who arrive intoxicated. That is where it lives, and it is where it can be changed.
Knowledge check: is it safe to ask someone directly whether they are thinking about suicide?
- Yes, asking does not plant the idea and gives permission to answer honestly
- No, it may introduce the thought
- Only if you are a licensed clinician
- Only after they raise it themselves
Answer: yes. Asking directly does not increase risk. Follow it by staying with the person and connecting them to support such as the 988 Suicide and Crisis Lifeline.
Review
Six questions spanning everything above. The first four check the main text. The last two are marked as refresher questions.
1. Someone meets four of the eleven diagnostic criteria. What does that indicate?
- No disorder
- A mild disorder
- A moderate disorder
- A severe disorder
Answer: moderate. Two to three is mild, four to five moderate, six or more severe.
2. A programme asks someone to stop their antipsychotic medication on admission. What is your view?
- Reasonable, since recovery means being substance free
- A serious concern, as prescribed psychiatric medication is not substance use and stopping can be dangerous
- Acceptable if the stay is short
- Standard practice in residential care
Answer: a serious concern. Abrupt discontinuation of psychiatric medication carries real risk and reflects a superseded model of care.
3. Which combination most sharply increases the risk of fatal respiratory depression?
- Cannabis and caffeine
- Stimulants and cannabis
- Hallucinogens and alcohol
- Opioids with benzodiazepines or alcohol
Answer: opioids with benzodiazepines or alcohol. All three suppress breathing, so the combination multiplies risk.
4. Which best describes the relationship between mental health conditions and substance use?
- It runs in several directions at once, often in the same person
- Mental health conditions always come first
- Substance use always comes first
- They are unrelated and coincidental
Answer: several directions at once. Self-medication, substance-induced symptoms and shared underlying factors frequently all apply.
5. Refresher question: what happened to the diagnoses of substance abuse and substance dependence?
- Dependence was retired and abuse retained
- Both remain in current use
- They were merged into one substance use disorder rated mild, moderate or severe
- They were replaced by a single severity-free diagnosis
Answer: merged into a single graded diagnosis. The change dates from 2013, and the old terms are still widely misused.
6. Refresher question: xylazine is increasingly found mixed with fentanyl. What follows for naloxone?
- Naloxone should be withheld if xylazine is suspected
- Naloxone does not reverse xylazine, but should still be given because opioids are usually present
- Naloxone reverses xylazine as effectively as opioids
- Xylazine makes naloxone dangerous
Answer: give it anyway. Xylazine is not an opioid so naloxone will not reverse its sedation, but opioids are usually involved and emergency services are still needed.
Job aid: what to cover in a first conversation
Not a script and not an assessment. A prompt for the things that matter and are easy to forget when a call is emotional.
If someone is in immediate danger, stop and act on that first. In the United States, 988 for the Suicide and Crisis Lifeline, 911 for a medical emergency.
Glossary
Select a term to reveal the definition.
Adverse childhood experiences
Abuse, neglect and household adversity in childhood, associated in a graded way with later substance use and mental health difficulty.
Co-occurring disorder
A substance use disorder and a mental health condition present together. Also called dual diagnosis. Best treated in an integrated way.
Fentanyl test strips
A harm reduction tool allowing someone to check a substance for the presence of fentanyl before use.
Harm reduction
Approaches that reduce the damage associated with substance use whether or not a person stops. Complementary to treatment, not opposed to it.
Integrated treatment
Addressing substance use and mental health conditions together, by one team, rather than in sequence.
Naloxone
A medication that reverses opioid overdose. Available over the counter in the United States, harmless if opioids are not involved, and not a substitute for emergency care.
Physical dependence
Bodily adaptation such that stopping suddenly produces withdrawal. A normal response to many medications and not the same as addiction.
Polysubstance use
Use of more than one substance, which is the norm rather than the exception and changes both risk and treatment planning.
Secondary traumatic stress
Distress arising from repeated exposure to other people’s trauma. An occupational risk in this work, not a personal shortcoming.
Substance-induced disorder
Psychiatric symptoms caused by substance use or withdrawal rather than by a separate underlying condition. Distinguishing the two takes time and observation.
Substance use disorder
The current diagnosis, rated mild, moderate or severe according to how many of eleven criteria are met.
Tolerance
Needing more of a substance for the same effect. A physiological adaptation, not by itself evidence of a disorder.
Xylazine
A veterinary sedative increasingly found in the illicit opioid supply. Not an opioid, so naloxone does not reverse it, and associated with severe wounds.
References and further reading
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. 2022.
Centers for Disease Control and Prevention. Provisional Drug Overdose Death Counts. National Center for Health Statistics. Figures cited from the release of 15 July 2026 and updated monthly.
National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction. National Institutes of Health.
National Institute on Drug Abuse. Words Matter: Preferred Language for Talking About Addiction. National Institutes of Health.
Substance Abuse and Mental Health Services Administration. TIP 42: Substance Use Disorder Treatment for People With Co-Occurring Disorders. HHS Publication.
Substance Abuse and Mental Health Services Administration. Harm Reduction Framework.
SAMHSA National Helpline: 1-800-662-HELP (4357), free, confidential, 24 hours a day. 988 Suicide and Crisis Lifeline: call or text 988.
This guide is educational and is written for people working in and around behavioral health services. It is not clinical training and not medical advice, and nothing in it should be used to diagnose anyone, including yourself. Overdose figures are provisional and revised regularly; verify current data before republishing it. If you or someone you know is struggling, speak with a qualified professional. In the United States, call or text 988 for the Suicide and Crisis Lifeline, or 911 in an emergency.
