When the Climate Changes, So Do the Conditions of Recovery

Climate distress, substance use and the importance of social support
By Tutkunur Ünlü
Psychologist | PhD Researcher in Addiction Studies

Ankara University, Institute of Forensic Sciences

A wildfire destroys a neighbourhood. A flood forces families to leave their homes. A prolonged drought threatens a community’s income and sense of security. The immediate consequences are visible: damaged buildings, lost possessions and disrupted daily life. The psychological consequences may be less visible and can continue long after the event itself.

Among these consequences is a question that has received relatively little public attention: How might the climate crisis affect substance use and the lives of people experiencing substance use disorders?

The relationship is complex. Climate change does not automatically lead to addiction, and people respond to environmental stress in different ways. Yet research suggests that climate-related events and changes can influence some of the conditions associated with harmful substance use: psychological distress, financial insecurity, displacement, social isolation and interrupted access to care.

Looking at these connections invites us to see substance use within a broader social and environmental context—and to ask whether our mental health and addiction services are prepared for a changing world.

Beyond the disaster: What happens after the cameras leave?

The psychological impact of a climate-related disaster does not end when the immediate danger passes. People may face months or years of uncertainty about housing, employment, finances and the future of their communities.

For someone whose home has been flooded, the stress may involve more than the experience of the flood itself. It may also include negotiating temporary accommodation, replacing lost documents, worrying about family members and attempting to rebuild a familiar life in unfamiliar circumstances.

These pressures can accumulate. In a prospective study involving 439 adults affected by Hurricanes Katrina and Rita, Cerdá and colleagues (2011) found associations between hurricane-related traumatic experiences and subsequent alcohol use and binge drinking. The risks were particularly marked among people who also had a history of economic disadvantage and earlier traumatic experiences.

This does not mean that a hurricane inevitably causes harmful drinking. Rather, the study illustrates how disaster-related experiences may interact with existing social and personal vulnerabilities. Hurricanes have multiple causes, and an individual storm cannot automatically be attributed to climate change. Nevertheless, research on disaster experiences can help us understand the potential mental health consequences of a world facing more climate-related hazards.

Substance use as an attempt to cope

When distress becomes difficult to tolerate, a person may seek ways to feel relief, sleep, reduce anxiety or temporarily distance themselves from painful experiences. For some, alcohol or other substances may become part of that attempt to cope.

The relief can feel immediate, while the underlying circumstances remain unresolved. Over time, repeated reliance on a substance may create additional difficulties, particularly for someone already facing financial insecurity, trauma or limited access to support.

However, it would be misleading to suggest that everyone who experiences climate distress will use substances, or that all substance use following a disaster constitutes a disorder. Substance use exists on a spectrum, and substance use disorders involve a complex interaction of biological, psychological and social factors.

Vergunst and colleagues (2023) describe several possible pathways through which climate change could contribute to harmful substance use. These include stress related to disrupted social and economic systems, mental and physical health difficulties, changes in established behaviour patterns and worry about the future. These pathways are best understood as a framework for investigation, not proof that climate change produces the same outcome for every individual.

Climate anxiety: A rational response to an uncertain future

Climate distress is not limited to people who have directly experienced a flood or wildfire. Some people feel persistent concern about environmental degradation, future disasters or the kind of world younger generations will inherit. Climate anxiety should not automatically be treated as a mental disorder. Concern about a real and growing threat can be understandable. In some circumstances, it may also motivate collective action, environmental engagement and stronger community connections. The clinical question is therefore not whether a person cares “too much” about climate change. It is whether their distress is affecting their daily functioning, relationships, sleep or sense of hope—and what support would be helpful.

A recent study by Czech and Manczak (2026) explored the relationship between perceived direct experiences of climate change, climate anxiety and substance use among 184 university students in the United States. The researchers found that the combination of perceived climate experiences and heightened climate anxiety was associated with riskier substance use. The findings are thought-provoking, particularly for work with young adults. However, the study relied on self-reported data from one university sample. It cannot establish that climate anxiety causes substance use, and its findings need to be replicated in different populations and settings. For psychologists, this suggests a useful direction: create space for conversations about environmental concerns without assuming that those concerns are either pathological or unrelated to a person’s coping behaviours.

A less visible emergency: Interrupted treatment

The connection between climate events and substance use extends beyond changes in how much a person consumes. A person receiving treatment for opioid use disorder, for example, may depend on regular access to medication, a pharmacy, a treatment centre or a healthcare professional. During a flood, wildfire or evacuation, transport may be interrupted, appointments cancelled or services temporarily closed.

A 2024 scoping review by MacLean and colleagues examined 82 studies on climate-related exposures and alcohol or other drug outcomes. Many studies reported increased use, while others reported decreases or no change. The review also identified problems such as disrupted services, unplanned withdrawal, changes in drug markets and increased vulnerability to extreme heat. These findings remind us that a climate emergency can create a treatment emergency even when an individual’s motivation for recovery has not changed. Missing an appointment during a disaster may reflect a collapsed transport system, displacement or the loss of medication—not a lack of commitment to care. Disaster planning should therefore consider the continuity of addiction treatment alongside other essential health services. Depending on local laws and clinical circumstances, this could involve coordinated referral systems, alternative dispensing arrangements, mobile services and clear communication about where people can access care.

Heat and substance-related health needs

Extreme heat adds another dimension to the discussion. Heat can place pressure on physical health, while housing conditions, access to cooling and existing health needs influence a person’s ability to stay safe. In a study using hospital data from New York State between 1995 and 2014, Parks and colleagues (2023) found associations between temperature and hospital visits related to alcohol and other substances. The patterns were not identical: for alcohol-related disorders, visits generally increased across much of the temperature range, while the relationship for other substance-related disorders did not continue to rise in the same way at higher temperatures. The research examined hospital visits, not the number of people developing an addiction. It also cannot establish that higher temperature alone caused each visit. Still, it indicates that substance-related health needs deserve attention in heat-health planning, especially when people face barriers to shelter, transport or medical care.

Climate vulnerability is also shaped by inequality.

A climate event may affect an entire community, but its consequences are not distributed equally. A person with secure housing, financial savings and access to healthcare may have more opportunities to recover after a disaster. Someone experiencing poverty, unstable housing, discrimination or limited access to treatment may face a longer and more difficult recovery.

Pre-existing stigma can add another barrier. People who use drugs may hesitate to seek assistance if they expect blame, discrimination or punitive treatment. If services are designed without their needs in mind, they may also be overlooked during emergency response and recovery.

MacLean and colleagues (2024) highlight another important inequality in the evidence itself: relatively few studies in their review focused on low- and middle-income countries, and few examined the effects of gradual environmental changes on livelihoods. This limits our ability to generalise findings across countries and communities.

More research is needed in Türkiye and other settings where local patterns of climate exposure, access to mental healthcare, social support and substance use may differ from those in the countries most represented in the literature.

What can psychologists and communities do?

A climate-informed approach to substance use does not require clinicians to assume that every client’s difficulties are caused by climate change. It means recognising that environmental events and uncertainty can form part of a person’s wider life context.

In practice, this may involve asking respectful, open questions:

• Has an environmental event affected your home, work or sense of safety?
• Have worries about the future changed your sleep, mood or daily routine?
• Have alcohol or other substances become more important as a way of managing stress?
• Has an emergency made it harder to access medication, treatment or social support?

These questions should be asked without judgement. A trauma-informed response recognises both the person’s distress and the practical conditions surrounding it.

Support may include psychological care, treatment for substance use when appropriate, assistance with housing or finances, reconnection with social networks and access to reliable information. Community-level responses also matter: accessible services, safe accommodation, continuity of treatment and opportunities for collective participation can help people navigate prolonged uncertainty.

Climate-informed care must also make room for agency. People are not simply passive recipients of environmental stress. They can rebuild connections, participate in local initiatives, support one another and develop new ways of responding to uncertainty—provided that the necessary resources and structures are available.

Recovery takes place in an environment

The climate crisis challenges us to broaden the way we think about mental health and addiction. A person’s ability to cope or sustain recovery is shaped not only by individual choices, but also by whether they have a safe place to live, access to care, social connection and a sense of security.

The evidence is still developing. We cannot claim that climate change will increase substance use in every community, and we need more research into who is affected, how and under which conditions. What we can already see is that environmental disruption can place pressure on the same systems that support mental health and recovery.

Protecting recovery in a changing climate therefore requires more than asking individuals to be resilient. It requires communities and health systems that remain accessible, responsive and connected when people need them most.

Kaynakça

• Cerdá, M., Tracy, M., & Galea, S. (2011). A prospective population based study of changes in alcohol use and binge drinking after a mass traumatic event. Drug and Alcohol Dependence, 115(1–2), 1–8. https://doi.org/10.1016/j.drugalcdep.2010.09.011
• Czech, K. A., & Manczak, E. M. (2026). Climate anxiety moderates the association between perceived direct experiences of climate change & substance use in college students. Journal of American College Health. Advance online publication. https://doi.org/10.1080/07448481.2026.2721436
• MacLean, S., de Nicola, J., Cooper, K., Downey, H., Theobald, J., de Kleyn, L., Denham, T., Costello, E., & Rickards, L. (2024). How does climate change impact people who use alcohol and other drugs? A scoping review of peer reviewed literature. International Journal of Drug Policy, 134, 104649. https://doi.org/10.1016/j.drugpo.2024.104649
• Parks, R. M., Rowland, S. T., Do, V., Boehme, A. K., Dominici, F., Hart, C. L., & Kioumourtzoglou, M.-A. (2023). The association between temperature and alcohol- and substance-related disorder hospital visits in New York State. Communications Medicine, 3, Article 118. https://doi.org/10.1038/s43856-023-00346-1
• Vergunst, F., et al. (2023). Climate change and substance-use behaviors: A risk-pathways framework. Perspectives on Psychological Science, 18(4), 936–954. https://doi.org/10.1177/17456916221132739