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.
Recognizing Signs of Misuse in Peers
In a work environment where substance is to be expected at times, and is normalized at all hours of the day, it can be difficult to recognize signs of misuse. Pay attention to some of these signs:
- Increased irritability and anger
- Bloodshot eyes and/or constricted pupils
- Memory issues (forgetfulness that isn’t characteristic of the person without substances)
- Excessive fatigue
- Slurred speech or delayed processing
- Changes in personality
- Sleeping through call times
- Missing deadlines, call times, or downbeats
- Impaired motor functioning (stumbling, dropping things, difficulty playing, tuning, or setting up instruments)
- Noticeable changes in behavior
How Substance Misuse Impacts Mental Health
More than 1 in 3 adults struggle 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.
The flip side of this is that maintaining positive mental health and working on creating a balance, and clear boundaries, between work and life can actually improve work performance, connection with friends and family, career prospects, and overall wellness. Whether you seek individual therapy to work through something specific, try support groups with peers, or utilize mindfulness and positive psychology strategies to improve your mindset, working on your mental health directly affects your sense of wellbeing.
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 or get through the work day
- 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, cognitive function, and motor coordination
- Red eyes or enlarged pupils
- Slurring words or lyrics
- Tremors
- Coordination issues, such as stumbling on stage
- Neglecting your hygiene
How to Approach a Peer in Need
If you have a concern that one of your peers might be engaging in misuse, you can be a source of support. Try the following steps to help your peer get the help they need:
- Initiate the conversation in a private and neutral setting, or outdoors while walking but away from busy areas
- Use nonjudgmental language: Try phrases like, “I’ve noticed you seem more stressed than usual lately and just want to check in. How can I support you?” or “I know this has been a difficult time. I’m here to listen if you need to get anything off your chest.”
- Practice active listening skills by nodding, asking clarifying questions, validating struggles, and empathizing with what they share.
- Avoid accusations or labels.
- Offer to be a source of support by planning daily walks, coffee chats, or other activities that don’t include substances.
- Gently suggest resources, including virtual recovery groups and support groups through Musicares.
Reach Out
Reaching out for help is a sign of strength and self-compassion. We all need support at times, and seeking help from peers, professionals, or both can be both life enhancing and life saving.
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.
- Download the MusiCares Resilience on the Road toolkit for resources to help you and your tour-mates thrive on the road.
- 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.
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.