90 Signs of Substance Abuse Problems

Recognizing Substance Use in a Loved One

Often, people using drugs or alcohol are unaware of their dependencies or otherwise go to great lengths to disguise their behavior. The burden of recognizing substance abuse often lies with loved ones – particularly spouses and partners.

Unfortunately, a drug or alcohol abuse problem can go unnoticed for long periods of time, taking partners and family members by surprise when the addiction is finally apparent. After all, how could a substance abuse problem go undetected in the home they share together?

Partners are often the first to suspect a substance abuse problem, but they may feel guilty imagining a scenario in which a loved one could have an addiction. Others may need proof or confirmation before they feel comfortable discussing the topic, which may not happen if the partner is actively hiding their drug or alcohol use.

There are obvious signs of substance abuse or addiction even if the person using is trying to hide them. These signs may be physical, behavioral, or psychological. Some signs are drug-specific, meaning they tend to occur only when a person takes a specific type of substance, such as cocaine or alcohol.


A Common Problem in Today’s Society

Substance abuse is a silent epidemic in America, affecting thousands of victims and their families. As of 2010, approximately 8.9 percent of American teenagers and adults over age 12 were using illicit drugs.

Some use more than one illegal substance or combine drug use with alcohol. This is most likely to occur in young adults under age 25, who have the highest rates of combined alcohol and drug abuse disorders.

Primary Signs of Substance Abuse or Addiction

The following are 90 signs of possible substance abuse or addiction. If a partner is demonstrating several of these signs, it’s very possible that they have a problem with drugs or alcohol.

Some times, these signs are a result of an underlying mental health condition, such as depression or anxiety, and the individual may be trying to self-medicate in order to cope with symptoms.

Physical Signs of Substance Abuse

  1. Sudden changes in appetite or weight. Some drugs cause people to eat more and gain weight. Others suppress appetite and increase metabolic rates, resulting in noticeable weight loss.
  2. Changes in sleep patterns. Drugs and alcohol can cause someone to frequently wake up in the middle of the night, experience insomnia, or sleep much longer than normal.
  3. Changes in hygienic habits. Complacency or lethargy can cause a partner to stop showering, shaving, brushing his or her teeth, wearing makeup, or caring for his or her appearance.
  4. Impairments. A major sign of substance abuse is a temporary physical impairment. This may be in the form of slurred speech, difficulty walking, poor coordination, or even shakes and tremors.
  5. Lethargy or hyperactivity. Drugs and alcohol can alter a person’s energy levels, causing them to feel relaxed and lethargic or energized and hyperactive. Every substance is different, and some of the effects vary from person to person.
  6. Physical Signs of Substance Abuse

  7. Changes to the eyes. Both drugs and alcohol can cause eye changes such as bloodshot eyes or changes to pupil size.
  8. Changes to the nose. Snorting a substance can lead to frequent nosebleeds or chronic, unexplained sniffling.
  9. Injection marks. Marks on the skin are telltale signs of drug use, especially when the marks appear on the arms, legs, or lower torso.
  10. Frequent itching. Scratching or picking at the skin is commonly associated with drug use, particularly due to the release of histamine in the body or the perception that there may be worms or bugs under the skin.
  11. Changes in skin coloration. Some substances, such as alcohol, can cause skin discoloration due to liver damage or other internal problems.
  12. Seizures. Seizures are a side effect of many prescription medications, illicit drugs, and alcohol. Unexplained seizures without a history of epilepsy may indicate a substance abuse problem.
  13. Finding evidence of drug or substance use. One of the most obvious signs of substance abuse is finding drug paraphernalia or empty beer, wine, or liquor bottles in the trash or in hiding places.

Behavioral Signs of Substance Abuse

Behavioral Signs of Substance Abuse

  1. Suspicious behavior. A partner who is abusing substances may suddenly engage in secretive or suspicious behavior. They may lock themselves in a room for long periods of time or appear very private in their actions or intentions.
  2. Monetary changes. It costs money to maintain an addiction. Loved ones may find that money has been withdrawn from cash accounts or cash advances have been taken on credit cards. Cash may go missing, and bills may not be paid on time. Eventually, the family member who is abusing a substance may begin borrowing from friends, selling valuable items for cash, or stealing to get enough money to buy drugs or alcohol.
  3. Personality changes. Drugs and alcohol can significantly affect a person’s personality. It is not uncommon for people engaged in substance abuse to experience major and rapid mood swings.
  4. Diminished interest in hobbies or social activities. Interest or favorite pastimes may now be on the back burner. People with substance abuse problems may appear apathetic or indifferent toward hobbies or friendships.
  5. Changes in friendships. A partner may spend less time with close friends and begin striking up new relationships or rekindling old ones. These may be fellow people who abuse substances or people who enable by supplying the substance.
  6. Sudden reduction in motivational levels. People with substance abuse disorders may suddenly appear to be less motivated to go to work, attend school, or aspire toward goals.
  7. Criticisms from peers and superiors. A person who attends college or works for an employer may begin receiving complaints from teachers, co-workers, and bosses because of poor performance, tardiness, or absences from work or school.
  8. Disputes and contention with others. Substance abuse can lead to extreme responses. A person may notice their loved one is easily irritated or suddenly “explodes” into angry outbursts. Drug and alcohol abuse can also lead to poor management of feelings, resulting in physical fights or heated arguments.

Psychological Signs of Substance Abuse

  1. Problems paying attention. People with substance abuse problems may have difficulty focusing on a single topic or carrying a conversation.
  2. Paranoia. Some people respond to substances by becoming paranoid. This is best described as irrational fear or worry that does not subside.
  3. Defensiveness. Loved ones who know they have a drug or alcohol problem, but are hiding it, may become defensive when asked about it.

People who are aware their loved ones are using drugs or abusing alcohol may wonder how to discern abuse from addiction. When a person becomes physically or emotionally dependent on a substance, additional symptoms could be present. These red flags indicate that the person may need to enter a drug and alcohol treatment center.

Additional indications

  1. Expressing cravings for drugs or alcohol (feeling a “need” to use)
  2. Trying unsuccessfully to stop using a substance
  3. Losing control, using more of a substance than intended
  4. Prioritizing drug or alcohol supply above other necessities, such as food
  5. Borrowing money or withdrawing from savings accounts to pay for a substance
  6. Taking extreme measures to obtain a substance, such as stealing or selling valuables
  7. Turning to a substance to cope with stress or to manage problems
  8. Putting one’s health and life at risk to achieve a “high”
  9. Putting the health or lives of others at risk while using a substance (such as driving under the influence)
  10. Spending excessive time and energy on acquiring and using a drug or alcohol
  11. Continuing to use a substance despite negative consequences

Drug-Specific Signs of Substance Abuse or Addiction

In addition to the primary signs of substance abuse or addiction, some warning signs can indicate a problem with a specific substance. Substance abuse can include legal and illegal substances; it is important to pay attention to any physical, behavioral, or psychological symptoms that could indicate a problem.


Alcohol Abuse Signs

Alcohol is a widely abused substance, primarily because it is legal and easily obtained in the U.S. According to the Centers for Disease Control, excessive alcohol consumption is responsible for approximately 88,000 deaths every year in America. Many Americans consume alcohol on a somewhat regular or social basis, making it less obvious when someone has a drinking problem.

Some of the signs a partner could have an alcohol abuse problem include:

  1. Frequent hangovers
  2. Drinking and driving
  3. Frequent binge drinking (five or more drinks in a single sitting)
  4. Smelling alcohol constantly on a partner’s breath
  5. Rarely being without a drink at home, restaurants, or at parties
  6. Making non-alcoholic beverages alcoholic by adding liquor to them, especially in inappropriate settings, such as family gatherings or work functions


Heroin is a highly addictive substance typically taken via injection. Use of this substance has been steadily increasing in recent years. In September 2013, CBS News reported a nearly 8 percent increase in heroin use between 2011 and 2012. With 669,000 people using heroin that year, it represented a nearly 80 percent increase in use over 2007.

Signs and symptoms a partner could be abusing heroin include:

  1. Scarring from needle marks
  2. Collapsed veins
  3. Skin inflammation near injection sites
  4. Dry mouth
  5. Disorientation
  6. Shortness of breath
  7. Burned silver foil, gum wrappers or spoons
  8. White powdery residue
  9. Paraphernalia, such as plastic bags, needles, syringes and pipes
  10. Wearing unseasonable clothing in an effort to hide needle marks and scars
  11. Loss of menstrual cycle
  12. Skin infections



Methamphetamines, frequently referred to as “meth,” are often associated with club drugs. Many people use these stimulants to feel energized and alert. Many different types of methamphetamines exist — both illicit and available by prescription — including crystal meth, cocaine and prescription medications like Adderall.

In May 2013, The Drug Abuse Warning Network reported 2.5 million drug-misuse emergency room visits in 2011. Of those, nearly 103,000 involved methamphetamines. The 2012 National Survey on Drug Use and Health, also reported that approximately 5.5 percent of all adults over age 26 will have used methamphetamines at some point in their lifetimes.

Signs a partner may be using methamphetamines include:

  1. Periods of intense alertness
  2. High self-esteem
  3. Sense of well-being
  4. Rotting teeth
  5. Twitching
  6. Violence and aggression
  7. High body temperatures
  8. Hallucinations
  9. Convulsions
  10. Panic attacks
  11. Disorientation or lack of balance
  12. Euphoria, followed by sudden, severe “lows” or periods of depression
  13. Fast speech

Prescription Medication Abuse

Prescription drugs are widely abused. Like alcohol, they are legal if prescribed by a doctor. Together, prescription and over-the-counter drugs are the third most commonly abused substances by people over age 14 in the U.S.

People abuse prescription medications because they may perceive them as somehow less dangerous. Others prefer prescription medications because they are convenient and often have a strong effect on the central nervous system.

There are a Multitude of RX Drugs Abused

Prescription Drug Abuse Signs

Different types of prescription drugs are frequently abused, the most common including antidepressants, anxiety medications, and pain relievers. As of 2010, the most commonly abused prescription medications were opiates, followed by tranquilizers like benzodiazepines. Other commonly used prescription medications included stimulants and sedatives.

Signs a person may be abusing prescription drugs include:

  1. Visiting multiple doctors to get a diagnosis of pain, mental health disorders, or insomnia
  2. Taking prescribed medications in a manner not ordered by a doctor
  3. Having unmarked, unknown pills
  4. Owning prescription bottles in someone else’s name
  5. Stealing medications from other family members
  6. Drowsiness
  7. Low blood pressure or slow breathing
  8. Dizziness
  9. Low sense of pain
  10. Constipation

Ecstasy and Other Club Drugs

Club drugs in the form of liquids, powders, and pills may not be commonly used among adults in committed relationships, but anyone can develop a dependence on them. These are drugs like ecstasy, GHB, and ketamine that are often used to achieve a sense of euphoria and lowered inhibitions at clubs or parties.

The National Criminal Justice Reference Service estimates that about 628,000 teenagers and adults have used Ecstasy within the past month. Many of these people end up in hospital emergency departments from side effects or overdoses. The Drug Abuse Warning Network reports that ketamine, GHB, and ecstasy are responsible for more than 26,000 emergency department visits in the U.S. every year.

Signs a partner may have a club drug abuse problem include:

  1. Lowered inhibitions
  2. Poor judgment
  3. Symptoms that mimic those of methamphetamines


More than a million people use hallucinogens like PCP and LSD for the first time every year as reported by the National Survey on Drug Use and Health. And as of 2007, more than 9 percent of the total teen and adult population had used LSD at any point in their lifetime.

The many signs and symptoms that accompany use of these drugs include:

  1. Hallucinations
  2. Poor perception of reality
  3. Flashbacks to prior hallucinations
  4. Delusions


If a partner is using an inhalant – a process known as “huffing” – he or she may be doing so to achieve their high. Inhalants are usually made up of everyday household items, such as aerosol sprays, gasoline and cleaning products. The effects of inhalants are usually brief, but these are very dangerous chemicals and are the fourth most frequently abused substances in America.

Signs that a partner may be abusing inhalants include:

  1. Excessive amounts of empty household cleaners, aerosol sprays, etc.
  2. Rags hidden in a partner’s car, office or bedroom
  3. The smell of chemicals on a partner’s breath or clothes
  4. Spots or sores surrounding the mouth
  5. Nausea
  6. Lightheadedness
  7. Runny eyes
  8. Paint stains on the hands, face or clothing

Help for a Loved One with Addiction

If you suspect your partner may have a substance abuse problem, you are not alone. According to the Substance Abuse and Mental Health Services Administration, more than 23 million adults and teens needed treatment for a substance abuse problem in 2009.

Help is available. For more information about substance abuse, addiction, and the path to recovery contact us immediately. Start the healing and get help for yourself or a loved one. All information is completely confidential.

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