Signs and Symptoms of Substance Use

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For those who haven’t been directly impacted by addiction, it’s easy to assume that one would know if their loved one was using drugs or alcohol. After all, the media portrays addiction as being destructive, putting people on the streets and causing them to lose their families and jobs.

However, this is only a stereotype. In reality, many people with addiction are working, raising families and managing daily responsibilities. According to data from the National Survey on Drug Use and Health, of the 46 million Americans who struggle with substance use disorder, 60 percent are employed.

Even though substance use disorder is protected under the Americans with Disabilities Act, most don’t seek help because they are worried about losing their job or being judged harshly at work. Therefore, many people who are experiencing addiction go to great lengths to hide or downplay their substance use.

Below are the signs and symptoms of substance use. If you notice these signs in a loved one, it’s important to approach them in the right manner and at the right time. A licensed therapist, substance use counselor or other addiction treatment professional can help with this.

Behavioral Signs of Addiction

Nearly everyone can have a moment of problematic behavior, but behavioral problems are consistent and disruptive. Using drugs or alcohol changes how a person behaves, resulting in the following:

  • Change in overall attitude/personality
  • Avoiding friends and family members
  • General lack of motivation
  • Believing drugs or alcohol are needed to have fun
  • Engaging in secretive or suspicious behaviors
  • Neglecting responsibilities at work, home or school
  • Giving up enjoyable hobbies
  • Misusing drugs or alcohol
  • Increasing tolerance
  • Lying and dishonesty
  • Legal problems, such as fights, accidents, illegal activities, DUIs, etc.

Physical Signs of Addiction

The physical effects of addiction can be both short- and long-term. Over time, drug or alcohol use can lead to organ damage, cognitive problems, lowered immunity and poor overall health. The short-term, or immediate effects, that can happen with substance use are:

  • Bloodshot eyes
  • Pupils larger or smaller than usual
  • Deterioration of physical appearance
  • Runny nose or sniffling
  • Sudden weight loss or gain
  • Tremors, slurred speech
  • Unusual odors on breath or body
  • Nausea or vomiting
  • Excessive sweating

Psychological Signs of Addiction

Substance use can cause changes in the brain, putting the person at a higher risk for cognitive changes and mental disorders. And, if the person had a pre-existing mental health disorder such as anxiety or depression, drug or alcohol use can exacerbate these symptoms. Be on the lookout for psychological signs of addiction such as:

  • Appearing anxious or paranoid for no reason
  • Bursts of increased energy and nervousness
  • Sudden mood swings
  • Increased irritability
  • Angry outbursts
  • Changes in personality or attitude

Drug-Specific Symptoms

It’s also important to know that the symptoms of addiction can vary depending on the substance being used. Families play an important role in the healing process, which is why you should be aware of drug-specific symptoms like the following:


  • Clumsiness
  • Poor judgment
  • Slurred speech
  • Nausea or vomiting
  • Shakiness
  • Hiding alcohol in other drinks
  • Excessively using gum, mints or mouthwash


  • Glassy, red eyes
  • Weight gain
  • Inappropriate laughing
  • Fatigue/sleepiness
  • Delayed reactions


  • Anxiety or irritability
  • Dilated pupils
  • Hyperactivity
  • Weight loss
  • Able to go long periods without sleeping or eating


  • Contracted pupils
  • Coughing and sniffling
  • Loss of appetite
  • Needle marks on arms or bottoms of feet
  • Sweating


  • Anxiety or irritability
  • Headaches and nausea
  • Poor muscle control
  • Nose secretions
  • Rashes around the mouth


  • Bizarre and irrational behavior
  • Detachment from people
  • Mood swings

Having a Conversation about Substance Use and the Next Steps

When approaching a conversation about drugs or alcohol, the first step is to learn more about substance use. This way, you’ll have a better idea of what to look for. Next, you’ll want to choose a good time and place to talk. Start by explaining your concerns, use “I” statements and refer to specific examples.

Try to end the conversation by discussing the next steps. Some options for recovery include medical detox, inpatient/outpatient treatment, individual counseling, group therapy, family therapy, recovery meetings and sober companions. Remember, there is no single path to recovery.

Spearhead Health is a private consulting and concierge case management company that helps individuals experiencing mental health and substance use problems. We can guide you through all stages of the recovery process while aligning you with the treatment resources that fit your needs. To learn more about our services and how to find the best path for you, contact our team today at 310-561-1704.