U.S. Department of Health and Human Services

Warning Signs of Substance and Alcohol Use Disorder

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 the following warning signs:

Physical warning signs of SUD

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 SUD

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 SUD

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

Adapted from: HelpGuide.org

Warning Signs from Commonly Misused Drugs

Signs of SUD often depend on what substance is being used. If you suspect someone you know may be misusing substances, and one or more of these signs are present, you can locate treatment options for detox and rehabilitation with the Indian Health Service Treatment locator.

Alcohol

Examples: Beer, wine, mixed drinks

Underage drinking and/or binge drinking.
Needing greater quantities of alcohol to achieve the desired effects or to function "normally."
Drinking more alcohol to get rid of or ease alcohol withdrawal symptoms.
Attempts to stop or limit drinking are unsuccessful
Extensive amount of time needed to recover from the effects of alcohol.
Spending lots of time thinking about the next drink.
Drinking alone or trying to hide one's drinking patterns.
Discontinuing use causes withdrawal symptoms such as nausea, mood swings, irritability, tremors, inability to sleep, and overall sickness.
Displaying anger when questioned about one?s drinking patterns.
Acting as if drinking is more important than one's friends and family; isolating oneself from one's social support system.
Becoming anxious or stressed if a social gathering does not include alcohol.
Continuing to drink regardless of the negative physical or psychological difficulties.
Drinking frequently or in excess, which may include blackouts when drinking.
Making excuses to continue to drink and/or drinking at unacceptable times or places.