Signs of Substance Use Disorder

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Bill and Margot’s son, William, died of a heroin overdose at the age of 24. In Bill’s words, insurance afforded their son a stint in rehab that was far too short, and the hospitals to which William got admitted did not take his addiction seriously. When he shot up while sitting in front of his parents’ television set, it was for the last time; Bill found his son “slumped over, a needle on the floor.”

Those who work with Pennsylvania’s Blue Guardian Program emphasized in a recent report that families are crucial in the fight against addiction. Officers and addiction specialists in the program observe that family members sometimes don’t know that their loved ones are using, don’t understand the consequences of their using, or may even be enabling their loved ones’ substance use disorder.

If your loved one is using drugs, you want to be one of the keys that help unlock the door to treatment and recovery. Let’s consider the signs that suggest someone is on drugs, the ways that we can talk about substance use disorder with family members, and the solutions that are available to those who are ready to beat addiction.

Signs of Drug Abuse

There are many drugs with the potential for abuse that it can be confusing trying to figure out which drugs are associated with which side effects. The following are major drugs and the physical effects they take on someone’s body.

Depressants: Alcohol, Heroin, Opioids

Signs of Use: What these drugs have in common, generally speaking, is their ability to slow down or depress bodily functions. For example, individuals may abuse alcohol to relax or help them sleep. Any of these drugs, used in excess, can depress the respiratory center in the brain, leading to respiratory failure, followed by possible cardiac failure and death. Signs of use includeimpaired mental functioning, somnolence, slowed breathing, and difficulty moving.

Signs of Withdrawal: Use of these drugs depresses the body. If a person is in withdrawal from opioids or heroin, the depressant effect on their body has been removed, and the body, in response, goes into overdrive. Signs of withdrawal consist of insomnia, irritability, restlessness, diarrhea, vomiting, muscle and joint pain.

Important Additional Information: If someone has been abusing alcohol for some time, and he or she decides to quit cold turkey, this constitutes an emergency situation. About six hours after the last drink, the individual may start having a racing heartbeat, high blood pressure, sweating, and tremors. Left untreated, the individual may go on to experience hallucinations, hyperthermia, delirium, seizures, and continued increased heart rate. An individual who is going through alcohol, heroin or opioid withdrawal needs to be taken to the emergency room immediately so that lifesaving treatment can be started.

Stimulants: Meth, Cocaine, Crack

Signs of Use: What these drugs have in common, generally speaking, is their ability to stimulate bodily functions. For example, amphetamines, like methamphetamine, have been used to increase focus, decrease fatigue, and improve”athletic performance and endurance.” Signs of use includeincreased activity, “increased wakefulness,” anxiousness, enlarged pupils, “decreased appetite,” and even “violent behavior.”

Signs of Withdrawal: Use of these drugs sends the body into overdrive. If a person is in withdrawal from meth or crack, their source of stimulation has been removed, and the body starts to slow down. Signs of withdrawal consist of “depression,” fatigue, and “increased appetite.”

Prescription Benzodiazepines Xanax, Valium

signs of use: Signs of benzodiazepine abuse are slurred speech, memory loss, dry mouth, drowsiness and confusion.

signs of withdrawal: Signs of benzodiazepine withdrawal include; anxiety, nausea, headaches, delusions, hallucinations, paranoia and seizures.


Signs of use include hallucinations, decreased inhibition, hyperthermia, “faintness,” and “chills or sweating.”

Signs of withdrawal consist of“fatigue, loss of appetite, depression, [and] trouble concentrating.”


Signs of use include altered sensation, impaired motor coordination (e.g. loss of balance) and reaction time, and hallucinations.

Signs of withdrawal consist of “irritability, trouble sleeping, decreased appetite, [and] anxiety.”

Behavioral Signs of Substance Use Disorder

All of the signs discussed above are physical signs that someone might be using an illicit substance. What are the other, social signs that someone is abusing drugs?

  • Trouble at school or at work: Your once straight-A student may start doing poorly in school. Or your spouse may be going into work late and not performing as he or she used to.
  • Changing appearance: The individual begins dressing differently or displays poor hygiene/grooming.
  • Changing behavior: Your outgoing and friendly daughter is now irritable and doesn’t want to hang out with the friends she has known for years. Your laid-back brother now flies into fits of rage without warning.
  • Financial issues: Your son keeps asking for advances on his allowance, and he won’t tell you what he needs the money for. You notice that money is missing from your joint checking account, and your spouse can’t provide an explanation for it.

The bottom line is that you know your loved ones well. If something doesn’t look right, sound right, or feel right, speak up.

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Effective Ways to Intervene

Maybe you know that your loved one has a problem with drug use. Your daughter has gotten yet another DUI. Or your brother has called you for what he swears will be the last time asking for money that you know is funding his addiction. What can you do?

Here are some effective ways to help a loved one take the first steps toward recovery:

  • Educate yourself about addiction: Know the signs that your loved one is using drugs. Learn about how addiction hijacks the brain and why it is difficult, if not impossible, for individuals to overcome addiction by themselves. Your intervention will be most effective if you know exactly what you are talking about when it comes to substance abuse.
  • Speak up: Approaching loved ones about their addiction can be daunting. You don’t want to hurt them or push them away. But you do want to tell them that you see that they are using, you love them, and you are worried about them. Do not expect an individual to immediately seek help and stop using once you’ve expressed your concerns. Overcoming addiction is a lifelong process, and you may have to speak up more than once to help your loved ones achieve and maintain sobriety.
  • Acknowledge that recovery is a lifelong process, and support this process: While it remains a hotly debated topic, many scientists and healthcare professionals agree that addiction is a chronic disease. When it comes to other chronic diseases–like type 2 diabetes–we don’t treat patients for their disorder one time and then hope they stay healthy. We understand that their disease process is something that they will deal with for the rest of their life, and we provide them with counseling, nutritional advice, education, medications, and close follow-up with their healthcare providers to ensure the best outcome for them. If we believe that addiction is a chronic disease, then we have to accept that treatment for addiction is going to last a lifetime. Support your loved ones by encouraging them to go to counseling, attending AA meetings with them, or getting them to rehab if they relapse.

Talking About Your Substance Abuse

Maybe you are the family member who is dealing with substance abuse. You’ve read the physical and social signs of drug abuse above and recognized symptoms that you have been experiencing yourself. You know you have a problem. How are you going to talk to your loved ones about it?

  • Make a plan: Figure out what you want to say to your family about your substance abuse and how you want to say it. Do you only want to get the fact that you have a problem with drugs off your chest? Do you want to talk about why you use drugs and ask your family for support in getting treatment? Do you want your family to help you be accountable while you are recovering? In addition, consider beginning this dialogue with what is known as “process” talk. You may wish to prepare your family members to listen to what you have to say. Open the conversation with statements like, “There’s something important that I need to talk to you about, ” or “I’m scared to tell you this, but I really need to share it with you.”
  • Prepare for your family’s reaction: Your family members could have any number of reactions to your disclosure. They may feel guilty that they did not realize that you had a problem. They may feel shame. They may feel angry that you are using drugs. Or they may be in shock and not feel very much of anything. Prepare yourself for what your family might say and how they might respond, and remember that any “initial negative reactions [. . .] could be about the drug and what it is doing to you and your life” and not negative reactions to you as a person.
  • Start outside your family: If you are too fearful of disclosing your problem to your family, that’s ok! You could start by discussing your drug problem with your pastor, your doctor, a friend, or even someone via a drug abuse hotline. Talking about your problem with any of these people first may give you the tools and the courage you need to talk to your family.
  • Realize that your family may already know: Your family members may already suspect that you have a drug problem. They may have noticed the physical and social signs discussed above. They may have been thinking of ways to broach the subject with you, but they didn’t know how or they were scared. If this is the case, then you bringing up the issue first may break the ice and make it easier to discuss your addiction as a family.

Finding Solutions to Substance Abuse

Let’s imagine that your intervention or your conversation with your loved ones was successful. Now what?

Substance abuse is difficult, if not impossible, to overcome alone. That is why getting yourself or your loved ones to rehab is so important. Rehab specialists assess individuals dealing with addiction and determine what treatment would be best for them. Individuals can access counseling, group therapy, and medication to treat their substance abuse disorder. More importantly, rehab specialists go beyond treating addiction to treating the individual. Effective rehabs provide a one-stop-shop for individuals who need counselors for their mental health issues, nutritionists to provide a structured, healthy diet, and social workers to help them gain employment and put a roof over their heads. Effective rehabs also know that “relapse” does not equal “failure,” and they will put in the time that it takes to help you or your loved one get clean and stay clean.

Consider the following testimonial from a woman who encouraged a loved one to enter rehab:

“A close friend came to me and told me they needed help and I didn’t  know where to turn, thankfully however I found this program. This is a  program that truly cares about the individual and strives to do things  based on the individual’s needs [. . .] This program is a blessing to all who  suffer with alcohol and drugs.”

Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance use disorder, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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