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Real Talks Wisconsin: Substance Use in Wisconsin

Substance use is a health issue that impacts people and communities across Wisconsin. Those affected by substance use should get the same support as those dealing with any health issue. Together we can make this happen by focusing on understanding, hope, and kindness.

Over the shoulder image of a person

What are the terms you need to know?

When talking about drugs, it's important to understand the differences between substance use, substance misuse, and substance use disorder.

  • Substance use is any drug use.
  • Substance misuse is drug use against legal or medical guidelines.
  • Substance use disorder is drug use that impacts a person's health, job, or relationships.

Why do people use substances?

Many things that can lead a person to substance use, including genetic, social, environmental, and psychological conditions. Some risk factors for substance use include:

  • Environment in which a person grows up or lives.
  • Family history of substance use.
  • Mental health challenges.
  • Peer pressure.
  • Trauma, toxic stress, and adverse childhood experiences (ACEs).

Substances can produce intense feelings of pleasure, which can be why some people use substances to decrease stress and anxiety.

Nearly every aspect of the world around us relates to our health in many ways. Resilient Wisconsin offers more information on the factors that affect individual and community well-being and why meeting people where they are at in their life journey is important for a healthy Wisconsin. Go to for more information.

What are the substances of concern in Wisconsin?

Substances can be grouped by the way they affect the body. Some substances affect the body in many ways and can fall into more than one category.

Substance use often involves a combination of drugs. This is known as polysubstance use. Polysubstance use can increase the risk of negative consequences, including overdose and death.


Depressants slow down the messages between the brain and body. This impacts a person's concentration, coordination, and response to what’s happening around them.

Small doses of depressants can make a person feel relaxed, calm, and less reserved. Large doses can cause sleepiness, vomiting and nausea, unconsciousness, and even death.

Depressants include:

  • Alcohol
  • Benzodiazepines [example: Valium®]
  • Cannabis/marijuana [dried flowers and leaves, hashish/hash, tetrahydrocannabinol (THC) oil, delta analogs-delta-8, delta 9)
  • GHB (gamma-hydroxybutyrate)]
  • Ketamine
  • Opioids [examples: heroin, fentanyl, morphine, codeine]

More information


Hallucinogens affect a person's senses and change the way they see, hear, taste, smell, or feel things. For example, a person using hallucinogens may see or hear things that are not really there or they may have unusual thoughts and feelings.

Small doses can cause a feeling of floating, numbness, confusion, disorientation, or dizziness. Large doses may cause memory loss, distress, anxiety, increased heart rate, paranoia, panic, and aggression.

Hallucinogens include:

  • Cannabis/marijuana[dried flowers and leaves, hashish/hash, tetrahydrocannabinol (THC) oil, delta analogs-delta-8, delta 9]
  • Ketamine
  • LSD [lysergic acid diethylamide]
  • Psilocybin [magic mushrooms]
  • PCP [phencyclidine]


Stimulants speed up the messages between the brain and the body. This impacts a person's alertness, confidence, and energy level.

Small doses can cause a faster heart beat, higher blood pressure, higher body temperature, reduced appetite, agitation, and sleeplessness. Large doses can cause anxiety, panic, seizures, stomach cramps, and paranoia.

Stimulants include:

  • Amphetamines [speed, Adderall®, and Ritalin®]
  • Caffeine
  • Cocaine
  • Ecstasy [MDMA – methylenedioxymethamphetamine]
  • Methamphetamine
  • Nicotine [tobacco]

More information

What is the impact of substance use on the brain?

Substance use leads to changes to the brain that impact behavior.

The brain seeks reward.

Our brains are hard-wired to seek pleasure and reward. Nearly all substances directly or indirectly target the brain's reward system, flooding it with feel-good chemicals at higher levels than normal.

One of those feel-good chemicals is dopamine. Dopamine is the reinforcer when it comes to substance use. It links the feeling of pleasure and the behavior that brought it about, creating the desire to want more. It's human nature to want to repeat behavior that makes us feel good.

The brain adapts.

With consistent substance use, the brain adapts. A person may feel flat or unable to enjoy things that were previously pleasurable without the drug. This is due to a change in how the brain processes dopamine. As result, people need to take larger amounts of the substance to produce the similar pleasurable effects. This is called a tolerance.

The brain changes.

After prolonged substance use, the brain often needs the substance just to function. Without it, cravings take over and intense withdrawal symptoms can follow. Areas of the brain critical for judgment, decision-making, and behavior control become impacted. The body has now developed dependence.

What are the signs of a substance use disorder?

It's always recommended to consult a medical professional to diagnose a substance use disorder. People with a substance use disorder may:

  • Take a substance longer or in larger amounts than planned.
  • Have a consistent desire or unsuccessful effort to cut down or control use.
  • Spend a great deal of time on obtaining, using, or recovering from the effects of the substance.
  • Have cravings or a strong desire to use.
  • Have repeated social or personal problems caused or exacerbated by the effects of substance use.
  • Lose interest in important social, work, and other activities that they once enjoyed.
  • Have increased tolerance, meaning the person needs more of the drug to reach the same effect as when they first used it.
  • Experience withdrawal symptoms between use.

Know how to have real talks

You can make a difference in helping to prevent and reduce substance use in your community. How? Simply by having real talks. Real Talks are frequent and open conversations about substance use, and they can happen anytime. Talking with those around us can improve community, family, and work life. The connection also can promote overall well-being by creating supportive environments for people in need of help.

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Last revised December 19, 2023