Signs Your Loved One Has a Substance Use Disorder

External signs of addiction can vary widely depending on the substance abused: people who use opioids will appear dopey and sedated while those who take stimulants can be hyperactive and anxious. But there are general warning signs of addiction that accompany many substances, signs of growing physical and psychological dependence, and the effects of drug use on personality, relationships, and health.

These warning signs include:

• Changes in personality, energy levels, and appetite

• Disinterest in activities they’ve previously enjoyed

• Self-isolation and distancing from family members and previous friends

• Increased conflict with loved ones

• Falling in with a new social circle, possibly revolving around drug use

• Declining performance at work or school, including frequent absences and lateness

• Failing to fulfill responsibilities, from childcare to chores

• Change in physical appearances, such as neglected hygiene and grooming; rapid weight loss or gain; appearing disheveled or wearing dirty clothes; not showering, shaving, or applying cosmetics as they previously would

• Financial difficulties, including overspending, asking to borrow money, not paying bills on time, and even theft

• Defensiveness or anger when asked about their substance use

• Secrecy, lying, and unexplained absences

• Lack of motivation

• Irritability

• Worsening symptoms of mental illness, including depression, anxiety, paranoia, obsessiveness

• Possession of drug paraphernalia

• Arrests and other legal troubles^[1]

While the above warning signs serve as indicators of substance abuse and potential addiction, they can also serve to identify behavioral addictions or process disorders. For example, increased conflict with loved ones, failure to fulfill responsibilities, and secrecy are all signs of porn addiction.

Alcohol is the most commonly abused substance in the United States, with around 5.3% of Americans meeting the criteria for alcohol use disorder (AUD). An additional, 25.8% of American adults report binge drinking, which can easily escalate to alcoholism.^[2] In fact, the normalization of binge drinking, especially among young people, may mask the development of alcoholism, meaning it's all the more important to be aware of these signs.

Signs of alcohol use disorder include symptoms of intoxication and withdrawal and the behavioral and personality changes that accompany heavy drinking. They include:

• Slurred speech

• Staggering, unsteady gait

• Impaired coordination

• Slow reaction times

• Blurry vision

• Sleepiness

• Sexual dysfunction

• Blackouts and memory loss

• Mood swings

• Aggression and violence

• Only engaging in activities that involve alcohol

• Seeming to need alcohol to have fun

• Insomnia and irregular sleeping patterns

• Making excuses for drinking, including that they need it to relax

• Drinking at unusual times, such as early in the morning

• Smell of alcohol on their breath or the scent of something used to disguise the odor, such as mints or mouthwash

• Signs of hangovers: sleeping late, headaches, sensitivity to light and sound, vomiting, dizziness, irritability, and excessive thirst^[3]

• Signs of alcohol withdrawal: anxiety, sweating, insomnia, irritability, shakiness, hand tremors, nausea and vomiting, loss of appetite, dilated pupils, pale skin, seizures, fever, extreme agitation, and hallucinations^[4]

• Frequently drinking out of opaque cups or bottles, which they may claim contain water, coffee, soda, or juice

• Hiding alcohol bottles throughout the house and secretly disposing of empties

• Stealing alcohol from the household liquor cabinet, watering down what remains in the bottles

• DUIs and legal troubles