How to Recognize the Signs of Substance Use Disorder
If you think you or someone you love might be struggling with a substance use disorder, there are signs that you can look for. This article discusses some of the features of drug and alcohol addiction, and provides helpful clues that could indicate someone has a drug or alcohol problem. In addition, it offers some suggestions on how you can support someone in getting the treatment they need.
It is important to remember that the some of the signs of alcohol or drug use listed in this article are not specific. Healthcare professionals trained in addiction medicine may be in the best position to diagnose someone with a substance use disorder (SUD), but any observant person can identify some of the potential risks with a little information.
What Are the Main Signs of Drug or Alcohol Addiction?
Substance use disorders are diagnosed based on the presence of several characteristic signs, symptoms, and behavioral changes associated with problematic patterns of substance use.
According to the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5), a person may be struggling with a substance use disorder if they:1
- Take the substance in larger quantities or for longer than originally intended.
- Have unsuccessfully tried to reduce their substance use, want to decrease substance use, or have difficulty limiting the amount of substance use.
- Spend a significant amount of time obtaining, using, or recovering from substance use.
- Experience strong cravings to use substances.
- Aren’t able to complete responsibilities at work, at home, and at school due to substance use.
- Continue to use substances despite experiencing both relationship and other social problems because of substance use.
- Give up or abandon important social, recreational, and occupational tasks that were once important to them.
- Continue to use substances in physically unsafe and dangerous situations.
- Experience physiological or physical problems related to substance use and they continue to use anyway.
- Have developed tolerance, which is defined as a need for increased amounts of a substance to achieve the original effect or a decreased effect with the same amount of substances used.
- Experience withdrawal symptoms after they stop using substances or they continue to use substances to avoid or alleviate withdrawal symptoms.
A medical or mental health professional may use the above criteria to make a formalized substance use disorder. A person who meets 2 or more of these criteria within a 12-month period may be diagnosed with an SUD.1
Though the above represents the specific criteria that healthcare professionals use to make addiction diagnoses, there are screening tools—such as the CAGE-AID—that have helped many. The responses to just a few questions on a screening questionnaire such as the CAGE-AID may help people problematic patterns of substance use and the potential need for professional treatment help.10
Though such a tool is not used to make an official diagnosis, the questionnaire could help someone wondering whether a substance use problem exists. Answering yes to even one question or could be indication that a more thorough assessment for addiction or substance use disorder is advised:11
C – Have you ever felt the need to cut down on your drinking or drug use?
A – Have people annoyed you by criticizing your drinking or drug use?
G – Have you ever felt guilty about drinking or drug use?
E – Have you ever felt you needed a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (i.e., eye-opener)
Signs of Alcohol Use Disorder
The above-mentioned criteria apply to substance use disorder in general. Regarding alcohol use disorder, healthcare professionals may ask questions to better assess these criteria as they pertain specifically to problematic drinking.
Similarly to SUD, an alcohol use disorder (AUD) may be diagnosed based on the presence of 2 or more of 11 diagnostic criteria. Some of the questions asked regarding the potential physical, mental, and behavioral signs of alcohol addiction—or alcohol use disorder—may include :2
- Are you drinking more or drinking for longer than you intended?
- Have you found yourself unable to think about anything other than having a drink?
- Is drinking, or being sick from drinking, interfering with work, school, or other responsibilities?
- Are you continuing to drink despite experiencing a memory blackout, feeling depressed, anxious, or developing other health problems related to alcohol?
- Do you have to drink more than before to get the same desired effect (i.e., developing alcohol tolerance)?
- Are you experiencing the following symptoms at some point after the intoxicating effects of alcohol wear off (i.e., alcohol withdrawal):
- Racing heart
- Difficulty sleeping
Potential Signs of Drug Misuse
As previously stated, in addition to the diagnostic criteria used to make a diagnosis of the various types of substance use disorders, there may additionally be relatively non-specific signs of drug misuse, or certain adverse side-effects of such use that are dependent on the type of drug used.
Below are lists of potential signs of problematic substance use based on the different types of substances involved.
Potential signs of benzodiazepine misuse include:3
- Clumsiness or poor coordination.
- Drowsiness or sleepiness.
- Slurred speech.
- Difficulty concentrating.
Potential signs of cocaine use include:4
- Unusual bursts of energy.
- Dilated pupils.
- Hypersensitivity to auditory, tactile, and visual stimuli.
- Muscle tremor.
- Increased body temperature, blood pressure, and heart rate.
- Erratic and violent behavior.
- Loss of sense of smell (with nasal routes of use).
- Nosebleeds (with nasal routes of use).
Potential signs of compulsive opioid misuse include the following examples of a loss of control, craving or preoccupation with use, and continued use despite negative consequences characteristic of some opioid addictions:5
- Reporting prescription opioid medications lost or stolen.
- Calling for refills early.
- Trying to get opioids from other sources.
- Exhibiting opioid withdrawal symptoms at doctor appointments.
- Requesting increases in opioids repeatedly.
- Reporting increased pain regardless of there being no corresponding progression of a health condition.
- Being dismissive on any non-opioid treatments offered by the doctor.
- Being overly sedated.
- A decrease in functioning, activity, and/or relationships.
Methamphetamine, like cocaine, is classified as a stimulant.6 Signs that a person may be struggling with chronic methamphetamine use include:7
- Mood disturbances.
- Memory loss.
- Decline in cognition and motor skills.
- Repetitive motor activity.
- Psychotic features, including auditory and visual hallucinations, paranoia, and delusions.
- Aggression or violent behavior.
- Severe dental problems.
What to Do if You Suspect Someone Is Addicted to Alcohol or Drugs
Whether you are helping a loved one with addiction or someone else you care about, there are actionable steps you can take to help the person struggling with a substance use disorder. You can:8,9
- Create a safe and judgment-free environment that helps the person feel comfortable opening up about their challenges.
- Talk to them about your concerns from a compassionate and caring place.
- Be open and willing to disclose any family or personal history about substance use if it applies to the conversation.
- Help the person research different treatment options.
- Be patient and keep in mind that change takes time.
- Listen to them and validate their feelings without criticism.
Helping someone with an addiction can be challenging. If you feel confused or overwhelmed, you are not alone. Remember that in addition to helping the person showing signs of alcohol or drug addiction, it is also important that you take time to care for yourself.8 You may want to consider joining a support group or seeking help for yourself by talking to a mental health provider.
Fortunately, substance use disorder is a treatable disease and you don’t have to battle addiction alone.8 If you or someone you know is struggling with a substance use disorder, assistance is available. Recovery First is a top inpatient addiction rehab facility near Miami, Florida, that can help those struggling with addiction live a fulfilling life in recovery.
Our treatment center is in-network with many of the major insurance providers. To find out what your insurance coverage for rehab is, call or complete our confidential . A compassionate admissions navigator will answer your questions and can go over various ways to pay for rehab.
Begin the recovery journey today. Reach out to an admissions navigator and start the admissions process.