Working in the music industry often means exposure to alcohol and drugs. Drink tickets supplement low-paying gigs, stimulants fuel grueling schedules, and winding down can be associated with substance use. Not everyone uses, and not every substance carries the same risks, but the environment can make it easier for use to creep into patterns that affect your health or work.
One of the clearest early signs that something is changing is noticing the thoughts you’re having about your use. If you’ve caught yourself thinking, “Why am I relying on this to get through the night?”, “Why does a day without it feel harder than it should?”, “When did I start planning my day around using?”, or “Why am I hiding how much I’m using?” that’s worth paying attention to. You don’t have to wait for a breaking point to reach out. Support exists, and recovery is absolutely possible.
Substance Use in the Music Industry
Research shows what members of our community already know: 1 in 3 performing artists uses drugs or alcohol to enhance creativity, release their inhibitions, or boost their energy on stage — and more than half of them also turn to substances to cope with stress.
Marijuana use in particular is on the rise. According to the 2024 MusiCares Wellness in Music Survey, 36% of the 2,800 participants reported using marijuana, and more than a third used it daily.
There is a complex relationship between substance misuse and suicide. Recent music industry survey data shows that 11.4% of music industry respondents experienced suicidal ideation in the past year and 15.4% lost a music industry colleague to suicide in the past year, but research indicates that the number may be higher.
In an examination of the death records of over 13,000 popular artists between 1950 and 2014, researchers noted that musicians have a shortened life expectancy and excess mortality from violent deaths (suicide, homicide, and accidental death, including vehicular deaths and drug overdoses) and liver disease compared to the general population.
It’s often hard to figure out when you or someone you care about has developed a problem, especially considering substance use is normalized and occurs on a spectrum from recreational use to substance use disorder. Here’s how to tell the difference between substance use and substance misuse.
When Substance Use Becomes Substance Misuse
Substance use — the use of any mind-altering substance, such as alcohol or drugs — shifts into substance misuse when it’s no longer healthy or safe, but the person cannot stop. (Phrases such as “substance abuse” and “addiction” are commonly used, but professionals recommend nonstigmatizing language such as “substance misuse” and “substance use disorder.”)
Signs of substance misuse may include self-medicating to numb symptoms of anxiety or depression, taking more pain medication than your doctor prescribed, or having to drink — even when you don’t want to — just to feel normal and avoid symptoms of withdrawal. Substance use disorder is not a matter of willpower, an act of rebellion, or a choice to self-destruct; rather, it’s a mental health condition that needs treatment and support just like any other disease.
When left untreated, substance use disorder can become life-threatening. We’ve lost far too many music industry professionals to accidental deaths and overdoses. Musicians are twice as likely to die early compared to the general public, and those who have yet to hit 25 are in the highest-risk cohort.
Substance misuse has been dangerously romanticized, but a culture shift is occurring. Young people are increasingly sober-curious, and many successful musicians are openly in recovery. They show that there is an alternative path forward, and that you can and should have long and healthy lives.
To thrive in this industry, it’s important to take signs of substance misuse seriously, recognize that recovery doesn’t move in a straight line, and remember that setbacks do not erase progress. Look out for your peers, and reach out for support when you need it.
How Substance Misuse Impacts Mental Health
More than 1 in 3 adults struggles with both substance misuse and a mental health condition. Early career musicians could be at an even higher risk due to high-stress environments and easy access to alcohol and drugs. According to a Music Minds Matter survey, 71% of music industry professionals report that they have panic attacks or high levels of anxiety, and 69% report symptoms of depression related to work — and musicians are far more likely than nonmusicians to die from substance misuse. Young people may also be more likely to put off treatment, because many do not have health insurance or access to affordable health care.
A history of childhood trauma and genetic vulnerabilities can increase the risk of both substance use disorder and mental health conditions. Combined with the unique stressors of the music industry, these preexisting factors contribute to heightened risk of substance misuse. It’s common to turn to alcohol and drugs to ease symptoms of anxiety, depression, or PTSD. Drugs may mask symptoms temporarily, but they often make them worse over time.
The relationship between substance misuse and mental health problems is complicated: Mental health problems can lead to substance misuse, and substance misuse can cause or worsen mental health problems.
Alcohol and drugs alter neurotransmitters — chemical messengers in the brain’s reward system. That can disrupt someone’s mood, impulse control, and emotional processing. Depressants such as alcohol, opioids, and sedatives can drive down mood over time, while stimulants such as amphetamines and cocaine can intensify symptoms of anxiety and bipolar disorder. Heavy use of marijuana may also lead to early onset psychotic disorders such as schizophrenia in young people who are at higher risk of developing the conditions.
Signs of Substance Misuse
Look out for these signs and symptoms when you or someone you care about is struggling with substance misuse.
Signs of substance misuse in your relationship to music include:
Feeling like you have to drink or use drugs to write or play music
Frequently missing gigs or interrupting work to use
Irritability toward band members, family, or even the audience
Being too intoxicated or hungover to perform well
Losing opportunities due to substance use
Feeling like you’re not living up to your full potential or falling behind your peers
Lack of interest in other things you used to enjoy
Lack of motivation in your career
Other warning signs of substance misuse include:
Changes in your relationship to alcohol or drugs
Shifting from using recreationally to using daily or several times a day
Having intense and intrusive urges to use
Developing a tolerance
Using even though it causes problems in your relationships
Being secretive about use
Hiding alcohol or drugs
Repeatedly trying to quit or cut down with no lasting success
Changes in health
Reduced or increased appetite
Weight gain or weight loss
Inability to fall asleep or stay asleep
Memory problems, brownouts, or blackouts
Withdrawal symptoms, such as nausea, vomiting, sweating, or trouble sleeping
Changes in behavior
Drifting apart from old friends due to increased use
Dramatic mood swings, irritability, or angry outbursts
Unusual bouts of hyperactivity or agitation
Intense anxiety or paranoia
Financial problems, such as spending money you don’t have on substances or stealing to afford them
Other risky behaviors, such as reckless driving or unsafe sex
Changes in appearance
Red eyes or enlarged pupils
Slurring words or lyrics
Tremors
Coordination issues, such as stumbling on stage
Neglecting your hygiene
Reach Out
If you or someone you care about is struggling or in crisis, the sooner you get help, the greater the chances of recovery. Trying to stop on your own is extremely hard. Having even one person you can be honest with like a therapist, sponsor, bandmate, or partner makes a huge difference. Treatment doesn’t look one way; detox, therapy, medication, support groups, sober tour support, and other approaches can all play a role. The environment matters too. If you’re surrounded by substance use at work, having sober spaces, sober people, or recovery support on the road becomes even more important. And if you slip, you’re not starting over; it’s a signal to lean on support, not a sign you can’t recover. When you’re ready, you have options:
Confide in someone you trust, such as a friend, mentor, or family member, and ask for their help finding treatment.
Contact SAMHSA’s National Helpline at 1-800-662-4357 for free and confidential support 24/7.
Search for treatment options at FindTreatment.gov.
Find a meeting anywhere with the AA Meeting Guide app.
Send Me a Friend sends a sober companion to meet you on the road and help you stay sober.
The Music Industry Therapist Collective has specially trained therapists with experience in the music industry.
Backline offers mental health help, holistic care, and community care.
Download the MusiCares Resilience on the Road toolkit for resources to help you and your tour-mates thrive on the road.
If you’re wondering how to help someone you care about, start by expressing concern without judgment, listening without trying to fix everything, and offering to help them find resources. Learn more about how to manage substance use or help a loved one here.
Substance use disorder can be treated with a combination of holistic treatment, detox, medication, therapy, and a strong support system. Relapses are common, but putting a strong support system in place — especially when you’re hitting the road for long periods of time — can make all the difference.