It’s the most wonderful time of the year — or the most challenging for the 48.5 million Americans who battle a substance use disorder. During this time, there are countless parties for celebration, family and friends to commiserate with, and festive alcoholic beverages and food around. However, the very reasons why the holiday season can be so joyous for some can be the very reasons why relapse feels inevitable for others. Instead of appearing like a Scrooge or a Grinch, many suffer in silence, or in some cases, relapse entirely.

Because holiday celebrations are so ingrained in American culture, it can be challenging to pinpoint what exactly exacerbates substance use behaviors around this time of year. However, we wanted to figure out why. To do so, we surveyed over 1,000 Americans about how they genuinely feel about the holidays and whether the season impacted their substance use habits. The results revealed that for many, substances like alcohol weren’t just part of holiday parties, but a way to endure the season. Read on to uncover what really drives holiday relapse risk, from grief and loneliness to social pressure and beyond.

Key Takeaways

• Up to 45% of Americans say their urge to drink or use increases during the holidays, rising to 51% for Gen Z, 56% for millennials, and 73% among those with a substance use history.
• Half of Americans pre-game to take the edge off before holiday family gatherings, with 51% drinking beforehand, and about one in three using cannabis, rising to 43% among Gen Z and millennials.
• Nearly three in four Americans (73%) say the holidays trigger emotions tied to a past loss, and 57% say they experience emotional hangovers after holiday events — most common among millennials (66%) and Gen Z (60%).
• 74% feel lonely at least some of the time during the holidays. Nearly half of Gen Z (42%) turn to social media or doomscrolling to cope with holiday loneliness — more than any other generation.
• Half of Americans use substances to cope with holiday financial stress, including 40% who turn to alcohol and 33% to cannabis, while two in five adults hide holiday purchases or debt, most often from a partner (28%).
• About 1 in 4 Americans feel pressured to drink or use substances at holiday gatherings, rising to 1 in 3 among Gen Z and millennials.
• One in four Americans (23%) skip holiday gatherings to avoid heavy substance use. Of those who attend, 30% have a code word or signal to de-escalate or exit if things get uncomfortable.

Holiday Substance Cravings and Pre-Gaming

For many Americans, the holidays spark seasonal cravings for eggnog, deviled eggs, and cranberry sauce. For others, the stressors that come with the holidays incite a craving for alcohol, cannabis, prescription drugs, and other substances. These emotional stressors are present long before anyone takes a drink. At family holiday gatherings, 36% of Americans describe themselves as “stressed but manageable,” 15% feel “overwhelmed or emotionally triggered,” and 9% feel “disconnected or numb.”

For respondents who reported a substance use history, the emotional load is even heavier: just 19% feel calm and connected, while 38% feel stressed, 22% feel triggered, and 15% feel numb.

Even without an alcohol use disorder diagnosis, many people often normalize alcohol misuse around the holidays and even pressure others to do so as well. Our survey revealed that nearly half of Americans (47%) feel pressured at least sometimes to drink or use substances at holiday events; this climbs to around three in four among those with a substance use history.

However, if we remove social pressures, the holidays can directly increase our cravings for vices. We found that 45% of Americans say their desire or temptation to drink or use increases during the November–December holidays; 17% say it increases significantly, and 28% say it increases slightly. For those with a history of substance use disorders in the survey, 72% say their desire to drink or use increases during the holidays.

During the holidays, many survey respondents talked about “pre-gaming” before holiday celebrations, which involves consuming substances before celebrations begin. It is also a symptom of substance use disorder. Before holiday family gatherings, 41% of Americans say they have pre-gamed to prepare emotionally by drinking alcohol, 31% by using cannabis, and 12% by using psychedelics or other mood-altering substances. This activity was also far more common for those with a substance use history, with 66% drinking, 48% using cannabis, and 24% using psychedelics before holiday family events.

Grief, Loneliness, and Emotional Hangovers During the Holidays

For many people, the holidays are a time when they can reflect on holidays of years past and the memories made with loved ones. However, for many, the holidays can bring feelings of grief or loneliness if you’ve lost someone or if you’re alone.

On the flipside, if you’ve spent weeks surrounded by family, returning to your routine can present an “emotional hangover” that can derail your life. We found all of these emotional responses in our survey, especially among those with substance use disorders, indicating that grief, stress, and loneliness can all be factors behind relapses.

For those who surround themselves with loved ones but may be struggling with mental health disorders, such as depression, loneliness can be a common feeling during the holidays. In our survey, we found that 73% of Americans feel emotionally isolated or lonely at least sometimes during the holiday season. Among those with substance use disorders, 93% reported feeling lonely at least sometimes. Each generation also experienced holiday loneliness, with about 79% of Gen Z, 77% of millennials, 71% of Gen X, and 56% of baby boomers feeling lonely at least sometimes.

Loss was ubiquitous in our survey. Up to 74% of Americans say they have lost a loved one whose absence still emotionally impacts them during the holidays; 36% say the loss still feels recent, and 38% say it’s older but still resurfaces. Among people with a substance use history, 90% carry grief into the holidays, with 51% saying the loss still feels recent and 39% saying it is older but still painful.

While every generation felt some level of grief during the holidays, the way it felt differed for each generation. For example, 41% of millennials said their loss still felt recent, while 49% of baby boomers said the loss occurred a while ago, but the holidays still brought back the grief. For baby boomers, it didn’t matter how long they’ve been experiencing grief; the holidays have the power to bring back feelings they long felt were dormant.

After the last Christmas song plays and the holiday decorations are packed up, the emotional hangover starts to set in. Up to 57% respondents reported feeling emotionally hungover from the holidays. This feeling was more common among younger generations, with 66% of millennials and 61% of Gen Z reporting the feeling.

However, those with substance use disorders reported emotional hangovers the most of any demographic, with 80% reporting the feeling often or sometimes. Since one of the biggest battles with addiction is facing daily life without a quick fix of serotonin, it’s no wonder that people with a history of substance use struggle with the adverse feelings that follow the manic energy surrounding the holidays.

Hidden Holiday Money Stress and Secret Spending

According to a 2024 Gallup survey, the average American spent over $1,000 on holiday gifts.

When faced with this kind of financial stress, many people will turn to substance use to cope and even hide purchases from their family and loved ones.

Nearly half (43%) of Americans say they have used alcohol to cope with holiday-related financial stress, 31% have used cannabis, and 12% have used psychedelics or other mood-altering substances. Among those with a substance use history, 68% have used alcohol, 50% cannabis, and 26% psychedelics to manage holiday money stress. 

Despite financial stress being a common experience during the holidays, not every generation turned to substances. For example, 42% of Gen X and 68% of baby boomers said they had not used substances to cope with holiday financial pressure. On the other hand, millennials reported the most self-medication when faced with financial stress, with 54% using alcohol and 45% using cannabis.

Shame and guilt are common feelings. When faced with these notions, many may try to hide their cause, even from those they love the most. During the holidays, financial shame is even more common, causing Americans to hide their spending. In our survey, 41% of Americans admitted to hiding a holiday-related purchase, expense, or debt from someone close to them, with 28% hiding from a partner, 24% from family, and 12% from friends.

Hiding was even more common among those with a substance use history. This may reflect deeper patterns of financial stress, shame, or the desire to avoid conflict during a high-pressure season. Around 44% have hidden spending from a partner, 37% from family, and 21% from friends; only 38% say they have never hidden holiday money issues from anyone close.

There was also a generational gap in hiding financial spending. Generation Z and millennials were more likely to hide their spending, while an overwhelming 72% of baby boomers reported never hiding financial spending from anyone during the holidays. This fact, in combination with baby boomers’ report on not turning to substance use when faced with financial stress, may indicate that this generation turns to different coping mechanisms when faced with budgetary concerns.

Boundaries, Exit Plans, and Grounding Rituals

Many Americans simply set more boundaries during the holidays. Avoiding events with alcohol or substances, limiting their time at gatherings, and using secret signals are all common ways to set boundaries among our respondents. Over half (53%) avoided or limited substance-heavy events. Nearly one in four respondents (23%) refrained from any holiday activity in the general public, regardless of whether or not substances would be around. To them, avoiding the holidays altogether was an easier way to maintain sobriety.

However, this response differed across each generation and even among genders. For example, 42% of men were more likely to avoid or limit holiday events where alcohol or substances would be present. In contrast, only 28% of women reported doing the same. Likewise, Gen Z, millennials, and Gen X were more likely to avoid or limit events (36-38%) than baby boomers (24%).

For those who still went to holiday events, using a code word with a loved one was a common way to de-escalate a stressful situation at said holiday event. About 30% of Americans did so; 12% use one regularly, and 18% have used one once or twice. This method was even more common among those with a substance use history, with 46% saying they use a secret signal at least once and only 25% saying they do not.

Survey respondents also had a wide variety of ways to stay grounded. The best way to achieve this differed from person to person, but 35% of respondents said they simply stayed connected with others. Likewise, 27% reported relying on a specific daily routine, 25% avoided known triggers, 12% used mindfulness or spiritual practices, and 3% used professional support to stay emotionally grounded.

More often than not, people with a substance use history would list avoiding known triggers as their top grounding tool, at 33%, compared with 25% overall. To them, steering clear of inflammatory situations was simply the best and most reliable tool for staying stable and sober.

Holiday Coping: Support Systems vs Self-Medication

When it comes to coping, many may think of different strategies in a black-and-white divide. Healthy coping mechanisms, such as reaching out to friends, going to therapy, and practicing mindfulness, sit on one side of the line. Meanwhile, alcohol, cannabis, shopping, and screens lie on the other side. You either use healthy coping mechanisms or you don’t.

However, around the holiday season, coping can turn a little gray for those who are trying to get through. Even though 64% of Americans turn to friends or family when they feel low, 20% also reach for quick relief through alcohol or cannabis, and 32% disappear into social media or screens.

For people with a substance use history, this gray zone becomes even more pronounced. Many still rely on connection — 62% lean on loved ones — and 23% turn to therapy or recovery meetings for support. At the same time, 29% report using alcohol, 31% report cannabis, and 9% turn to psychedelics when they’re struggling during the holidays.

Younger adults experience a similar tension between grounding habits and escapist ones. Gen Z shows the strongest pull toward emotional connection, with 72% turning to friends or family. Millennials follow close behind at 63%. Yet, both generations still reported screen time as another tool to cope, with 42% of Gen Z and 35% of millennials relying on it. To these younger generations, social connection — whether in person or online — can be the ultimate way to escape the stress of the holidays.

The Holiday Season: A Perfect Storm for Relapse Risk

Taken together, the findings suggest that many individuals experience intensified emotions during the holidays, with particularly pronounced effects among those with a history of substance use. For many, grief, loneliness, financial strain, and social pressure create an emotional load that’s challenging to manage without support. Younger adults felt this most intensely, reporting higher cravings, stronger social pressure, and more emotional overwhelm at holiday gatherings. And while the season brings opportunities to connect and celebrate, it also creates more moments where untreated stress, emotional triggers, and normalized substance use collide.

These patterns reveal the need for proactive, not reactive, holiday mental health planning. Checking in with a friend, attending an additional recovery meeting, or scheduling decompression time may seem minor. However, they are profound ways to protect yourself and establish a support plan that reduces the risk of a relapse. Families and communities can help by reducing pressure to drink, offering alcohol-free options, and normalizing conversations about emotional strain instead of glossing over it. With more awareness and intentional support, the holidays don’t have to be a season people “survive”—they can become a time where joy, connection, and stability are still possible, even for those navigating recovery.

Methodology

We surveyed 1,000 U.S. adults to understand holiday stress, emotional triggers, coping behaviors, and substance use patterns. The sample was stratified and segmented by age, gender, and whether respondents had experienced issues related to substance use. Percentages may not total 100 percent due to rounding.

About Freeman Recovery Center

Freeman Recovery Center provides comprehensive treatment and support for individuals navigating substance use challenges and co-occurring mental health needs. Our programs focus on personalized care, long-term recovery, and strengthening emotional well-being, areas especially relevant during high-stress seasons like the holidays. With a commitment to compassionate, evidence-informed treatment, Freeman Recovery Center helps individuals and families build stability through every stage of recovery.

Fair Use Statement

If you wish to use the information in this article, you may do so for non-commercial purposes only, and attribute with a link back to Freeman Recovery Center.

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How To Host a Community Naloxone Training: A Step-by-Step Toolkit for Public Libraries, Schools, and Local Organizations

In the past several years, the opioid crisis has hit a crescendo in the United States. In 2022, over 81,000 people died from opioid overdoses. This includes both natural opioids, also known as opiates, that may exist in morphine, and synthetic opioids like fentanyl and tramadol.

There are various reasons for the rising death rate. For one, many public health experts believe that medical health professionals overprescribe painkillers, which has led to a rise in addiction rates. Secondly, many people simply don’t have access to medical detoxification or addiction treatment. Thirdly, many people may not have the financial resources to pay for addiction treatment and education.

There is a light at the end of this tunnel, however, and it comes in the form of increased access to resources and medication that can not only prevent addiction but also overdose deaths. One miracle drug that can assist in overdose deaths is naloxone. In Nashville, Tennessee, for example, the local police department found a 30.4% decrease in overdose-related deaths after releasing 6,000 kits in 2024.

The key, it turns out, comes from community action. The more people and communities that make a change in making this drug accessible, the more we can target the opioid crisis. If your community has yet to take action, you have the power to do so through your public library, school, or other local organizations. Here’s a guide on how to get started by initiating your own naloxone training.

Step 1 – Get Internal Buy-In and Approval

Even though naloxone has proven benefits, you must first obtain approval from your organization, whether it’s a school, public library, or local agency, before initiating your training. Fortunately, you don’t have to rely on emotion alone. Instead, you can use data and values-based reasoning to build your case.

Ideally, your pitch should include:

• Local statistics: How many opioid overdoses have occurred in your city or county in the past year? Is there evidence of increased fentanyl contamination in the drug supply? Many state and local health departments maintain dashboards or publish annual reports that can provide this context. Demonstrating the scope of the problem helps shift the conversation from “Should we do this?” to “How can we afford not to?”
• A connection to your organization’s mission and values. For example, public libraries often emphasize inclusivity, access, and community service. Schools may focus on student and family wellbeing. Local nonprofits may have charters that promote safety and social support. Positioning naloxone training as an extension of these values helps frame the program as a natural and meaningful addition to your organization’s offerings.
• An explanation of broader community impact: Naloxone training doesn’t just save lives — it reduces strain on emergency responders, creates education opportunities, and builds trust between institutions and the people they serve. By illustrating the positive impact, your organization’s leadership will be more likely to agree to your proposition of naloxone training

This, of course, is not an exhaustive list. Don’t be afraid to include additions to your pitch that you can personalize to your organization and leadership in a way that’ll matter the most to them.

How To Address Concerns

Along the way, you’ll likely encounter concerns from your organization’s leadership. Some may worry about liability, public perception, or the potential for attracting controversy. Others may be unfamiliar with harm reduction as a philosophy and need more information before they feel comfortable moving forward.

To address legal concerns, highlight the presence of Good Samaritan laws in most states, which protect individuals and organizations who administer naloxone in good faith. These laws encourage intervention in emergencies without fear of prosecution.

When it comes to stigma, focus on harm reduction. Make it clear that naloxone training is not about condoning drug use; it’s about keeping people alive long enough to access addiction treatment, support, or recovery. Remind leadership that overdoses can happen to anyone: teens experimenting, parents managing pain, or neighbors who unknowingly use a contaminated substance. Framing the training as a public health measure, rather than a controversial stance, can ease discomfort and align the program with shared civic goals.

Step 2 – Secure a Qualified Trainer

Once you gain approval, you’ll need to find an educated expert who not only has experience in responding to overdoses but also has hours of groundwork on harm reduction principles. Some common trainers include:

• Public health nurses: Often employed by county health departments or school health systems, public health nurses have experience in emergency response and community health education. They bring both medical knowledge and communication skills that make them well-suited for public training sessions.
• Local harm reduction organizations: These nonprofits specialize in serving people who use drugs and often offer free or low-cost naloxone training. Their trainers typically bring lived experience, nonjudgmental approaches, and a deep understanding of the drug supply and overdose risks in your area.
• State or city health departments: Many health departments have designated overdose prevention teams or substance use outreach coordinators. These professionals are often certified to train the public in naloxone use and may offer materials, kits, or funding as part of their services.

To find an experienced instructor who can assist in your training, you can either look at your state, district, or county health department website. They either already have an established program of trainers you can work with, or you can help them start a program.

Image source: Pexels

Step 3 – Source Naloxone Kits and Educational Materials

One of the most significant advantages of naloxone training is that it increases access to not only education about the drug and opioid overdose awareness, but also to naloxone kits. As an organizer, your main priority is to either provide access to the kits or point toward areas where people can access kits. If you’re working with a public health agency to provide the training, they will often distribute the naloxone kits themselves. If your trainer doesn’t have them, you can work with either overdose prevention programs or mailing programs that can mail the kits for you for free. For example, NEXT Distro can either mail the drug to you or connect you with a pharmacy that can.

Along with naloxone kits, you should also provide educational materials that participants can use for reference in the future. Within these materials, you should include information about:

• Step-by-step instructions on how to recognize and respond to an overdose.
• Visuals for how to administer naloxone.
• Information about what to do after the administrator gives naloxone.
• Resources for addiction treatment, recovery, and harm reduction in your area.

Many organizations, including the CDC, provide naloxone training templates, including module templates, sample questions, and fact sheets. If you’re using your own presentation, your language should be accessible, nonjudgmental, and multilingual when possible.

Overcoming Participation Fear

During the actual training, you may encounter participants who may be afraid of any legal consequences if they intervene in an overdose situation. Because of this, it’s vital to prepare yourself to assuage participants’ fears by including Good Samaritan law education.

Since each state has different variations on the law, you should do your own research before starting the training. That said, most states’ Good Samaritan laws cover individuals who act in good faith during emergencies, including those who administer naloxone in response to a suspected drug overdose. Providing this information can be crucial to anyone who may be on the fence about administering the drugs themselves. Breaking down this barrier can mean the difference between life and death for someone who is overdosing on opioids.

Step 4 – Plan the Event Logistics

Thoughtful logistics can make the difference between an event that feels empowering and one that feels intimidating or inaccessible. Choosing the right space, arranging chairs, setting the tone — these are all small details, but they can all make your naloxone training welcoming, respectful, and effective for everyone who attends.

Choose a Date, Time, and Location

Start by selecting a date and time that maximizes community participation. Consider polling your audience or reaching out to community partners to find out what time frames work best for your target population. For example, you might find out that evening or weekend sessions are often ideal for working adults, caregivers, and students.

Likewise, your choice of location matters just as much as the timing. It should be:

• Physically accessible with ADA-compliant entrances, ramps, elevators, and restrooms;
• Close to public transportation;
• In a safe and neutral environment such as a library, community center, or school;
• Private to encourage attendance from people who may feel hesitant.

All of these factors ensure the highest number of attendees and can be less intimidating for people who may initially feel uncomfortable attending.

Set Up the Space

When participants walk into your training, the last thing they want is to see a setup that may disrupt engagement. Instead of traditional rows, opt for circle or U-shaped seating to promote discussion and equal participation. Make sure the trainer has a central spot with good visibility for everyone, especially for hands-on demonstrations of naloxone administration.
If space allows, designate a breakout area where small groups can practice responding to a simulated overdose using training kits. This allows for more personalized instruction and encourages participants to build confidence.

Step 5 – Promote the Training

Your training won’t be as successful if no one attends. The best way to prevent this is to put your best effort into marketing the training. The best way to do this is to promote the event in a welcoming way, prioritizing the message that it will benefit everyone — not just those directly impacted by substance use.
You should also use a mix of promotional channels, as varying avenues may target some demographics more than others. This includes:

• Email newsletters;
• Bulletin boards;
• Social media (include sample captions with hashtags like #NaloxoneSavesLives);
• School nurse offices;
• Local news calendars.

When making these materials, save them as templates for future use. If the training proves to be successful, your organization may want to promote it similarly.

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Step 6 – Host the Training

Now comes the most influential step: coordinating the actual training. The first step in ensuring smooth coordination is settling expectations upfront by assigning everyone a role in your staff. Ideally, you should have a:

• Trainer: Leads the session and demonstrates naloxone use
• Greeter: Welcomes attendees, directs them to sign-in tables, and hands out materials
• Tech Support: Manages microphones, projectors, or video streaming
• Kit Distributor: Hands out naloxone kits at the end of the session and explains any follow-up steps

If you’re low on staffing, consider recruiting volunteers from local schools, colleges, or service-learning programs. They can help with some of the minor roles, such as offering light refreshments, running the registration tables, passing out materials, and cleaning up the event. All of these roles can make the event all the more welcoming to everyone there.

Encourage Engagement and Q&A

A good training isn’t just a lecture; it’s an interactive learning experience. To help participants feel comfortable speaking up, consider:

• Starting with an icebreaker question related to community safety.
• Using a small-group breakout format for hands-on practice before reconvening as a full group.
• Providing an anonymous question box (physical or digital) so people can ask sensitive questions without fear of judgment.
• Encouraging the trainer to share real-world examples of successful overdose reversals to reinforce the importance of the presented skills.

By blending structure with an open, supportive atmosphere, you make the training not just informative but empowering. Participants should leave knowing they’re part of a network of people ready to help save lives in their community.

Step 7 – Follow Up and Stay Connected

A naloxone training doesn’t have to be a one-time event; it can be the start of an ongoing community safety effort. Following up after your training keeps the momentum going, strengthens relationships, and shows both your leadership and participants that the event makes a measurable difference.

To show your leadership the impact of the event, you should consider tracking:

• Internal reporting not only documents success but also helps secure continued support for future training. Consider tracking:
• Number of attendees (and how many were first-time participants).
• Number of naloxone kits distributed.
• Feedback from participants (via quick surveys or comment cards).
• Which partner organizations were involved.

Summarize these results in a short report or email update for leadership, staff, and community partners. If leadership approves, you can suggest future events, such as quarterly or semi-annual training, or work with other agencies for co-branded events that could expand your outreach.

Naloxone training can also be the first step in becoming an overdose community resource. For example, you could set up a harm reduction corner in your facility with free kits, fentanyl test strips, and educational materials for anyone to grab year-round. Data-backed updates can help justify future funding, partnerships, and publicity.

Setting up a training may involve a lot of groundwork, but it’s the first step in addressing drug addictions that pervade communities across America. Your effort today could be the reason someone is alive tomorrow.

Resources for Community Naloxone Training:

If you need more information and tools for your naloxone training, use the following resources:

Naloxone Supply and Distribution

• SAMHSA’s Opioid Overdose Reversal Medications (OORM) Resource Guide: Offers information on FDA-approved formulations, legal guidelines, and grant-funded Naloxone access programs across the U.S.
• NEXT Distro: A national mail-based harm reduction service that provides Naloxone directly to individuals and organizations, especially in rural and underserved areas.

Training & Educational Materials

• National Harm Reduction Coalition – Overdose Prevention: Offers printable toolkits, video tutorials, trainer guidelines, and overdose response protocols based on the latest harm reduction science.
• Freeman Recovery Center: Offers education and treatment options that trainers can offer to anyone who needs aftercare recovery after an opioid overdose.
• GetNaloxoneNow.org: Offers interactive online training for bystanders, educators, and first responders, as well as resources to build in-person training sessions.

Legal and Policy Information

• SAFE Project – Good Samaritan Laws by State: Find up-to-date summaries of your state’s protections for those who call 911 or administer Naloxone during an overdose emergency.
• Prescription Drug Abuse Policy System (PDAPS): A research-based legal database from Temple University with detailed maps and summaries of Naloxone access laws nationwide.

Toolkits and Templates for Hosts

• Tennessee Department of Mental Health & Substance Abuse Services: Offers educational materials and overdose prevention specialists to community organizations hosting naloxone trainings.
• Tennessee Harm Reduction: Offers free naloxone kits to Tennessee residents and organizations through the mail, including intramuscular and intranasal administration kits.