Relationships in Recovery - Addiction Recovery

Self-Harm: Types and Its Relationship to Substance Abuse

Self-harm is a reaction against anxiety, depression, stress, and more. Learn about the causes of self-harm and how it can be treated in our blog.

Self-Harm: Types and its Relationship to Substance Abuse

Table of Contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

March 8, 2023

The Edge Treatment Center

Pain is one of the most common things that we share with others in this world. Everyone is vulnerable to feeling pain at some point in their life. While people can suffer through similar things, their coping methods vary greatly. The way to handle and manage pain is known as a coping mechanism. Some people may have a healthy coping tool, while others may not.

Unfortunately, many find comfort in more harmful or hurtful coping mechanisms. Self-harm and substance abuse are two of the most prevalent and damaging coping techniques. All too frequently, they go together.

Building healthier ways to cope with pain may be a challenging endeavor, but they really are better for you in the long run. Learning and gravitating towards more harmful behaviors to navigate painful feelings may seem easier and more satisfying. Still, depending on their length and frequency, they may prove risky or even lethal. 

By the Numbers:

As reported by the American Psychological Association (APA), around 17 percent of young teenagers in the US engage in self-harm at least once. 

What Is Self-Harm?

The act of purposefully hurting yourself for an emotionally or psychologically driven reason is known as self-harm. People hurt themselves for a variety of reasons and in a variety of ways. 

Self-harm can be divided into two major categories. Although both purposes are quite different, they are dangerous, nonetheless. 

  • Non-suicidal: People intentionally harm themselves but do not want to cause death. "Non-suicidal self-injuries," or NSSIs, are the medical term for this category. 

  • Suicidal: When people harm themselves intending to die, whether or not they do. 

Why Do People Engage in Self-Harm?

Scholars have identified three common reasons why people indulge in self-harm, they are:

  • To cope with pain and suffering

  • To punish themselves for something 

  • To affect others 

Although these three factors cover an extensive spectrum of motivations, people may have other reasons to self-harm. Everyone is different, and so are their reasons. Because motives behind self-harm can be as unique as those who define them, the examples below are only a few potential motivations.

Self-Harm as a Coping Mechanism

For many people, self-harm is a coping mechanism. They attempt to regain control over situations that are generally uncontrollable. They use self-harm as a coping strategy when they face painful or stressful conditions. Self-harm helps them momentarily alleviate and overcome states of emotional or physical numbness. 

Self-harm motivations stemming from coping mechanisms include some of the following:

  • To feel/experience something 

  • To calm yourself

  • To distract yourself 

  • To stop yourself from thinking about a traumatic experience

  • To prevent yourself from attempting suicide 

  • To prove to yourself or someone else that you are capable of tolerating intense pain

  • To turn suffering into something tangible, something visible 

How Is Substance Abuse a Way to Self-Harm?

When we talk about the types of self-harm, it is common for people to assume that the acts of manually cutting or burning areas of the body are being discussed. While it is, unfortunately, true that some people resort to such forms of self-injury, these are not the only types of self-harm. In addition, you may cause self-harm by engaging in substance abuse

Although not everyone engages in substance abuse as a way to self-harm and vice-versa, they both are known to be related and addictive. Both substance abuse and self-harm serve a similar purpose – providing the comfort of temporary escape from pain and depressive thoughts and feelings. They are both used by people as coping mechanisms.

It has also been proven that people with untreated mental health issues like personality disorders, mood disorders, behavioral disorders, and psychotic illnesses, or those who have gone through trauma, abuse, and neglect, have an increased risk of suffering through substance abuse disorders and self-harm. 

In some cases, people may start self-harm with substance abuse and progress to other ways of hurting themselves. While in other situations, people may begin hurting themselves physically and then go on to indulge in substance abuse. Whatever the case, studies have shown that each of these problematic behaviors exacerbates the effects of the other. 

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Effects of Drug Abuse on Self-Harm

Substance abuse can affect the frequency and severity of self-harm. While under the influence of alcohol or other drugs, it is common for people to lose self-control. The incapacity to regulate yourself may lead to more cases of self-harm and can cause you to hurt or cut yourself more severely than anticipated. 

Let us now see how different substances are related to self-harm:

Alcohol and Self-Harm

Self-harm is related to alcohol abuse because the more you drink, the more likely you are to get in a gloomy mood and, eventually, hurt yourself. Moreover, drinking alcohol can lead to several risky behaviors, such as:

  • Unstable mood

  • Faulty judgment 

  • Aggressiveness 

When intoxicated, you will likely experience the above side effects of consuming alcohol or alcoholic beverages and take risky actions. In addition, when drunk, you will also be unable to practice healthy coping mechanisms due to reduced inhibitions. 

Stimulants and Self-Harm

Although there is a connection between the abuse of stimulant drugs like MDMA, ephedrine, amphetamines, cocaine, methamphetamine, and prescription ADHD medications and self-harm, the mechanism may differ from alcohol abuse.

Stimulants are worse than alcohol. They may induce self-harm while being used and afterward. You will likely experience hallucinations, delusional thinking, and paranoia while consuming stimulants. These after-effects lead to a problematic detachment from reality. After use stops, the subsequent crash could cause acute sadness and hopelessness, provoking suicidal thoughts and urges to harm oneself.

Not to forget, injecting these substances into the bloodstream would cause physical and emotional discomfort, making them an even more enticing option for people who indulge in self-harm. Intravenous administration of drugs can satisfy the physical pain motive of self-harm. 

Hallucinogens and Self-Harm

Hallucinogens such as LSD, PCP, ketamine, ecstasy, etc., can lead to the following side effects:

  • Users develop a skewed sense of time

  • They feel overconfident and behave rashly

  • They experience intense yet enjoyable hallucinations

However, these side effects can become a nightmare if the dose is slightly altered. People may feel some horrible and risky hallucinations, known as bad trips. When having a bad trip, a person might feel the following:

  • Extreme angst 

  • Panic

  • Shifts in mood

  • Seizures

  • Paranoid thoughts

  • Delusions

  • Nervousness

During bad trips, people may unknowingly act violently and aggressively and injure themselves or others.  

Self-Harm and Opioids

Highly addictive substances, opioids include heroin, fentanyl, and prescription pain relievers like OxyContin, Vicodin, codeine, morphine, etc. Opioid abuse may cause the following:

  • Initial euphoria 

  • Mood swings 

  • Loneliness

Opioids are painkillers. They are known to stimulate the brain areas responsible for releasing endorphins- the happy hormones. Self-harm is also known to have similar effects on people, showing the link between self-harm and opioid abuse.  

Is Addiction a Form of Self-Harm?

Now that we are through with discussing the major classes of drugs and their relation with self-harm let us see how substance abuse, which can lead to addiction in no time, is a form of self-destruction too. 

Addiction to any substance is a disorder that alters how the brain functions by stimulating certain areas. These brain areas or regions are in charge of regulating our behavior, emotions, and thought processes. Addiction is a phenomenon that occurs when the lack of a substance causes uncontrollable desires, leading a person to strive to obtain even a tiny amount of that substance without thinking about the consequences that would ensue.

For many people, breaking this cycle becomes impossible. Even after a long period of abstinence, they could slip back into the abyss of addiction.

Addiction, just like self-harm, is a complicated medical issue that can affect people of all ages. Both of them are especially harmful because, in most cases, users understand the harm they are causing to themselves and those near them. Still, they continue hurting themselves manually or abusing alcohol or other drugs.

But this is not to say that people who develop an addiction or use self-harm as a coping mechanism mean to inflict harm on anyone. Both are complex mental health issues like any other disease and must be treated like that.  

As we have learned, substance abuse and addiction can increase your chances to self-harm; the truth is that vice-versa is equally true. People addicted to toxic substances such as opioids, stimulants, alcohol, hallucinogens, etc., can often develop erratic behaviors to cope with the reality of their addiction. They may also use self-harm as a way to punish themselves for being addicted as well as for disappointing their families, friends, and loved ones. 

Even addiction is a form of self-harm since we are harming ourselves. We are dependent on something that may be slowly killing us. We are ruining our careers, our families, and our lives. 

Treating Self-Harm and Co-Occurring Substance Use Disorders

Several studies and research have been done over the past few decades to create effective and useful treatment strategies that would work well for self-harm and co-occurring substance abuse disorders or a dual diagnosis. And while it is challenging to develop a treatment plan that works for everyone, the greatest recovery programs all share some fundamental beliefs.

Since both addiction and self-harm fall into the category of mental health problems, healthcare professionals usually start with a thorough physical and mental evaluation of their patients to understand the underlying reasons, the extent of self-harm, and the severity of the addiction. The most common diagnoses come out to be one of the following mental health disorders:

  • Depression

  • Eating disorder

  • Anxiety

  • Post-traumatic stress disorder (PTSD)

  • Borderline Personality Disorder (BPD)

As with most diseases, the earlier treatment for self-harm and addiction is started, the better. Treatment may be conducted in a hospital, rehab facility, therapeutic community, outpatient programs, with a therapist or counselor, in a support group, or a combination of these settings. Wherever it happens, it starts with detoxification from the substance of abuse, progresses through a learning phase, and aims toward long-term health maintenance.


Detoxification or drug detox is the primary step in the treatment of any addiction. While people think they can independently manage the detoxification or "going cold turkey" method, it can be tough and dangerous. It can even make the treatment challenging to start. This usually happens because the cravings during the withdrawal period can cause the patient to give up before detoxification.

Relying on expert healthcare professionals to guide you through the procedure is better. During a medical detoxifying process, alcohol and other drugs are physically removed from the body to reduce cravings and to continue with the rest of the treatment program.  


Rehabilitation is a complete recovery package. It includes chances to develop a positive outlook for recovery, stable physical health achieved through medications, learning skills that could help you from relapsing, and learning better ways of dealing with family and friends.

For people recovering from both self-harm and addiction, the rehab program will include a combination of therapies, medicines, and other activities to help them learn better ways to cope with sadness and pain. Rehab even provides small incentives to motivate participants to remain in the program until completion. In addition, inpatient drug rehab and outpatient drug rehab programs offer group and individual counseling for the patients. 

Some programs even offer extra-curricular activities and gyms for people to learn to manage intense emotional distress without self-harm and substance abuse. Rehab centers also help participants gain an insight into the "Post-Acute Withdrawal Syndrome" (PAWS) that may disturb their recovery process during the first few tries of getting sober. Most rehab programs or courses are designed to provide a structure to the patient's life. The participants get access to experienced counselors and therapists, personalized treatment plan, and continuous monitoring for any signs of self-harm or drug abuse during the treatment. Rehab treatment plans also provide follow-up care after the patient has completed their program. 

Longer and more comprehensive recovery programs offer some social services as well. For example, they help patients find work opportunities, improve relationships with parents, spouses, friends, and siblings, and deal with legal issues. Rehabilitation centers may be residential, outpatient, therapeutic communities, long- or short-term, or support groups.

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We’re Here to Help You Find Your Way

Do you have more questions about self-harm and how it relates to substance abuse? Reach out.

Dealing With Self-Harm And/Or Drug Addiction? The Edge Treatment Center Will Help

The Edge Treatment Center offers the ideal environment to recover from addiction, self-harm, and more. With a specialized trauma-informed philosophy driving our care, we'll help you move past self-harm, address the causes behind it, and give you everything you need to build a happy, healthy life for yourself.

Self-harm is never a good way to cope. At The Edge, you'll learn better ways to thrive and survive. Contact The Edge Treatment Center today to learn more.

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