Substance abuse refers to harmful or hazardous patterns of using alcohol, prescription medications, or illicit drugs that lead to significant impairment or distress. It can involve binge drinking, misuse of opioids or sedatives, and use of stimulants or other substances despite negative consequences at work, home, or in relationships. Substance abuse increases risks of accidents, liver and heart disease, mental health disorders, and overdose. For insurers, it is a major underwriting concern because it affects mortality, morbidity, and persistency. Distinguishing between past, successfully treated abuse and ongoing problematic use is essential when assessing risk and pricing coverage.

When applicants disclose substance abuse histories, underwriters seek details about substances used, duration, treatment, relapses, and current status. Documented completion of rehabilitation programs, long periods of sobriety, and stable employment can support more favorable underwriting decisions over time. Active abuse, recent relapse, or legal issues such as DUIs often result in postponement or decline. Advisors can help by encouraging clients to provide clear treatment records and sobriety documentation and by focusing on carriers experienced with recovery cases. Understanding substance abuse in underwriting helps advisors handle sensitive conversations, set realistic expectations, and support clients' long-term recovery and protection goals.