In the United States, roughly 8 percent of all people age 12 or older have diagnosable problems with excessive drug or alcohol use[i]. This high rate of occurrence makes it likely that almost everyone knows someone who is affected. However, not everyone knows what to look for when they suspect that a friend or loved one is engaged in substance abuse. A brief explanation of the likely signs will make it easier to determine who needs help.

Changes in Behavior

A sudden or unexplained change in typical behavior is one of the most common indicators of substance abuse[ii]. Things to look for include:

  • Changes in normal sleep patterns
  • A lack of interest in activities that used to bring pleasure
  • Increases or decreases in normal appetite
  • Disinterest in good hygiene
  • Rapid mood fluctuations
  • An increase in secretive behavior
  • A significant increase in voluntary social isolation
  • Withdrawal from family relationships
  • A changing circle of friends or frequent shifting between groups of friends

Other General Changes

People who begin abusing drugs or alcohol may also go through a range of other life changes. Examples include:

  • Poor performance in school
  • An increase in school truancy
  • Poor job performance
  • An increase in job absences
  • An unexplained need for money

Friends and family of people involved in substance abuse may also notice the theft of money or the unexplained disappearance of valuable items.

Signs of Alcohol Abuse

Each form of substance abuse produces its unique telltale signs. Alcohol is the world’s most widely consumed addictive substance. Indications of alcohol use and abuse include[iii]:

  • Rapid alcohol intake
  • Consumption of large amounts of alcohol
  • An inability to set limits on alcohol intake
  • Frequent drunkenness
  • Rapid drunkenness
  • Drinking until the point of blacking out (blackout syndrome)
  • Hiding alcohol intake from others (by drinking alone or using other techniques)
  • The use of alcohol in clearly dangerous situations
  • Increasing intake of alcohol over time
  • Feelings of stress, anxiousness or dissatisfaction when alcohol is not served at a social event
  • Frequent hangovers

Signs of Stimulant Abuse

In people who abuse cocaine or other stimulant drugs or medications, signs of a developing pattern of abuse may include such things as[iv]:

  • Unexplained periods of elation
  • Unusual restlessness or physical agitation
  • Sleeplessness
  • Pupil dilation
  • An increase in irritable mental states
  • An increase in paranoid or anxious mental states
  • Incoherent speech
  • Unusually aggressive behavior
  • Frequent snorting or nasal congestion
  • Delusional thinking
  • Sensory hallucinations

Signs of Opioid Abuse

In some ways, the signs of abuse in people who consume opioid drugs or medications are the opposite of the signs in people who consume stimulants. However, the indicators can also be quite similar. Things to look for include:

  • Unexplained drowsiness
  • Pupil constriction (i.e., narrowing)
  • A “down” or depressed mental state
  • A confused or agitated mental state
  • Slurring of words
  • Poor muscle and body coordination
  • Needle-marked skin

Signs of Marijuana/Cannabis Abuse

Many people view marijuana/cannabis as a harmless recreational drug. However, excessive consumption of this drug can lead to serious problems with abuse and/or addiction. Possible signs of marijuana/cannabis abuse include:

  • The obvious smell of cannabis on clothing or in a room or vehicle
  • Eye redness
  • Poor muscle and body coordination
  • Poor reaction times
  • An unusually paranoid or anxious state of mind
  • Unusual or intense food cravings
  • Memory problems
  • Concentration problems
  • A reduced ability to think clearly

Signs of Benzodiazepine/Tranquilizer Abuse

Benzodiazepines are a group of widely prescribed tranquilizer/sedative medications. Other members of this medication category include barbiturates and hypnotics. A person who abuses a tranquilizer can show signs such as:

  • Frequent bouts of lightheadedness
  • Unexplained sleepiness
  • Uncontrolled movements of the eyes
  • Recurring involvement in accidental falls and other types of accidents
  • Poor impulse control
  • Poor muscle and body coordination
  • Unusually slowed or labored breathing
  • Memory disruptions
  • A reduced ability to think clearly
  • Unexplained mood changes
  • An increase in irritability

Signs of Club Drug Abuse

Club drugs are a loosely defined group of substances that includes MDMA (Ecstasy, Molly), ketamine, Rohypnol (flunitrazepam) and GHB (gamma-hydroxybutyric acid). While these substances differ from each other, they can produce similar signs of abuse in users. These signs include:

  • Pupil dilation
  • Uncontrolled muscle tremors
  • Paranoid thinking
  • Sensory hallucinations
  • Involuntary jaw clenching
  • Poor impulse control
  • Poor muscle and body coordination
  • Memory disruption
  • Lack of responsiveness in conversations

Signs of Inhalant Abuse

Inhalants are widely used commercial products that sometimes get turned into targets of improvised substance abuse. While other forms of abuse occur more often in adults than teenagers and children, inhalant abuse occurs most often at a young age. Signs of inhalant abuse include:

  • The unexplained odor of substances such as solvents, glue, aerosol sprays or gasoline
  • Uncontrolled muscle tremors
  • Rashy skin around the mouth
  • Rashy skin around the nose
  • Possession of glue or some other inhalant product in unusual or unexplained circumstances
  • Unusual outbursts of anger or aggression
  • Poor impulse control
  • Episodes of nausea and/or vomiting

Things to Consider

Not everyone who shows signs of substance abuse is actually involved in substance use. Detection of problems in teenagers can be especially difficult, since teens naturally go through periods of defiance, mood changes and behavioral changes. However, anyone who suspects a pattern of abuse in a friend or loved one should not discount this possibility. In many cases, family members and friends provide the push required for a person with drug or alcohol problems to commit to substance treatment.

Seeking Treatment

Transformations Treatment Center provides premier services for people affected by drug or alcohol problems. Whether the extent of these problems is mild, moderate or severe, our staff of certified addiction specialists is here to help.

In addition to primary substance treatment, we feature individualized programs for people affected by secondary issues that can complicate the treatment process. These issues include PTSD associated with military service or the aftereffects of trauma and sexual abuse. No matter what kind of assistance you or your loved one need, our goal is to create the smoothest possible transition from addiction into sobriety and a substance-free daily routine.

  1. Substance Abuse and Mental Health Services Administration: Key Substance Use and Mental Health Indicators in the United States – Results from the 2016 National Survey on Drug Use and Health
  2. National Institute on Drug Abuse: What Are Some of the Signs and Symptoms of Someone with a Drug Use Problem?
  3. U.S. Department of Health and Human Services – Indian Health Service: Warning Signs of Alcohol Abuse
  4. Mayo Clinic: Drug Addiction (Substance Use Disorder)
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