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​​​​Warning Signs

Those with substance use disorder (SUD) often try to hide their symptoms and downplay their problem. If you're worried that a friend or family member may be misusing drugs, look for common warning signs.​

 Roberta and Don's Story


Physical warning signs of substance use disorder

  • Bloodshot eyes, pupils larger or smaller than usual
  • Changes in appetite or sleep patterns
  • Deterioration of physical appearance, personal grooming habits
  • Runny nose or sniffling
  • Sudden weight loss or weight gain
  • Tremors, slurred speech, or impaired coordination
  • Unusual odors on breath, body, or clothing​

Behavioral warning signs of substance use disorder

  • Using causes difficulties in one's relationships
  • Engaging in secretive or suspicious behaviors
  • Frequently getting into legal trouble, including fights, accidents, illegal activities, and driving under the influence
  • Neglecting responsibilities at work, school, or home, including neglecting one's children
  • Sudden change in friends, favorite hangouts, and hobbies
  • Unexplained need for money or financial problems. May borrow or steal money.
  • Using drugs under dangerous conditions (driving while using drugs, using dirty needles, having unprotected sex)
  • Increased drug tolerance (the need to use more of the drug to experience the same effects one used to achieve with smaller amounts)
  • Misusing drugs to avoid or relieve withdrawal symptoms (nausea, restlessness, insomnia, depression, sweating, shaking, anxiety)
  • Loss of control over drug misuse (using more than intended, unable to stop)
  • Life revolves around drug use (always thinking of using, figuring how to get more, or recovering from use)
  • Abandoning enjoyable activities(hobbies, sports, and socializing) to use drugs
  • Continuing to use regardless of negative consequences (blackouts, infections, mood swings, depression, paranoia)​​

Psychological warning signs of substance use disorder

  • Appearing fearful, anxious, or paranoid, with no reason
  • Lack of motivation; appearing tired or "spaced out"
  • Periods of unusual increased energy, nervousness, or instability
  • Sudden mood swings, increased irritability, or angry outbursts​
  • Unexplained change in personality or attitude​​

Recognizing When a Loved One Has a Drug Problem

If you suspect that a friend or family member has a drug problem, here are a few things you can do:​

Speak up. Talk to the person about your concerns, and offer your help and support, without being judgemental. The earlier SUD is treated, the better. Don't wait for your loved one to hit bottom. Be prepared for excuses and denial by listing specific examples of your loved one's behavior that has you worried.

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Take care of yourself. 
Don't get so caught up in someone else's drug problem that you neglect your own needs. Make sure you have people you can talk to and lean on for support. Stay safe by not putting yourself in dangerous situations.

Avoid self-blame. You can support a person with an SUD and encourage treatment, but you can't force someone to change. You can't control your loved one's decisions. Let the person accept responsibility for his or her actions, an essential step along the way to recovery.

Don't:
  • Attempt to punish, threaten, bribe, or preach.
  • Avoid making emotional appeals that may only increase the person's feelings of guilt and compulsion to misuse drugs.
  • Cover up or make excuses for them, or shield them from the negative consequences of their behavior.
  • Take over their responsibilities, leaving them with no sense of importance or dignity.
  • Hide or throw out drugs.
  • Argue with the person when they are high.
  • Take drugs with the drug abuser.
  • Feel guilty or responsible for another's behavior.​



Content adapted from: The National Clearinghouse for Alcohol and Drug Information, SAMHSA, USDHFS  ​