If you think a loved one is misusing drugs, it’s important to look for signs of drug addiction that can help you determine what drug is being used.

Article at a Glance:

  • It may be challenging to know if someone has a drug addiction but knowing warning signs can help.
  • Common physical signs include lethargy, bloodshot eyes, runny nose, irregular sleep and weight changes.
  • Behavioral signs include shifts in social circles, poor work/school performance, secretive behavior and neglecting responsibilities.
  • Psychological signs include paranoid thoughts, negative self-image, lack of motivation and feelings of apathy.
  • Certain factors put people at a higher risk of addiction but drug addictions are treatable for everyone.

Understanding the Signs of Addiction

drug addiction or alcohol use disorder can be difficult to identify without understanding the signs of addiction. Substance use disorders can change the way people look, how they act and how they feel, and the symptoms of drug abuse can be physical, behavioral and psychological in nature.

Not everyone who uses drugs or alcohol has a substance abuse problem. However, about 10% of Americans struggle with substance abuse. Understanding the signs and symptoms of drug addiction is the first step towards getting help.

Fortunately for concerned family members and friends, many characteristics of addiction are easy to identify, and many types of drug addictions share similar signs and symptoms. If someone can recognize the symptoms of addiction, they may be able to help a friend or family member who struggles with this disease.

How to Tell if Someone is on Drugs

When you’re wondering how to tell if someone is using drugs, physical signs can be your first indicator, followed by behavior and psychological changes.

Physical Signs of Drug Addiction

If someone misuses drugs or alcohol, they may exhibit numerous physical signs of drug abuse. Some of these signs may be readily apparent, while others are easily hidden or occur as gradual changes.

Some physical signs of drug use are:
  • Frequent runny nose (common with cocaine addiction)
  • Tremors or seizures
  • Loss of physical coordination
  • Extreme lethargy
  • Chemical odor on breath or clothes
  • Pinpoint pupils (common with opioid and heroin addiction)
  • Bloodshot or watery eyes
  • Changes in weight
  • Changes in appetite and eating habits
  • Clenching of the jaw
  • Irregular sleeping patterns or difficulty falling asleep
  • Marks on skin
  • Poor personal hygiene

Behavioral Signs of Drug Addiction

A person who misuses drugs or alcohol may act like a different person, too. There are just as many behavioral signs of addiction as there are physical symptoms, and some of the most significant include:

  • Changes in activities or hobbies
  • Shifts in social circles
  • Decreased participation in family activities
  • Poor performance in work or school
  • Repeated lying, dishonesty or deceit
  • Legal issues
  • Secretive behavior
  • Self-isolation
  • Neglecting responsibilities
  • Financial issues
Secretive Behavior

Of the behavioral signs of drug abuse, secretive behavior may be one of the most common and telling. Someone who struggles with addiction may become increasingly withdrawn from loved ones and often seeks privacy to obtain or use drugs. They may feel they need to keep their drug or alcohol use a secret and may lie about their whereabouts or activities.

Isolating Oneself

Social, emotional and mental isolation are common signs that someone needs help for a drug or alcohol addiction. People who face a substance use disorder may isolate themselves from their partners, friends or family members to keep their addiction a secret. They’ll try to avoid questions about unexplained physical changes, like track marks or weight loss, or odd behaviors.

Neglecting Responsibilities

If someone is repeatedly high or under the influence of alcohol, they may disregard their daily responsibilities, like attending work or school, running a household or taking care of pets and children. They may have difficulty remembering details of important appointments or blatantly ignore pressing deadlines or obligations.

Financial Problems

Drug addictions can be extremely costly, depending on the substance used. A person may repeatedly ask to borrow money from friends or family members or sell their possessions to maintain their drug addiction. If someone does not get help for their substance use disorder, they may risk extreme financial stress and could face bankruptcy.

Psychological Signs of Drug Addiction

When someone misuses drugs or alcohol, they may look and act in uncharacteristic ways. They may also think and feel differently than they normally do. Psychological signs of drug abuse can include changes in a person’s thought patterns, attitudes, beliefs and priorities.

Some psychological signs of drug and alcohol abuse can include:

  • Changes in personality traits
  • Mental illness like depression or anxiety
  • Paranoid, fearful or obsessive thoughts
  • Negative self-image
  • Dismal outlook on or attitude toward life
  • Withdrawing emotionally from loved ones
  • Lack of motivation
  • Feelings of apathy or disinterest
Sudden Mood Swings

Unexplained or seemingly unprovoked mood swings can occur when someone is struggling with addiction. When the person is high, they may be hyperactive, affectionate or excitable. As soon as the high wears off and withdrawal symptoms set in, they may become angry, irritable or even verbally abusive.


Paranoid thoughts can happen in people who struggle with substance use disorders. Individuals who misuse drugs may mistrust the people around them, become highly suspicious of family and friends or ascribe unrealistic motives to other people’s actions. During addiction treatment, paranoid delusions can be addressed through counseling options like cognitive behavioral therapy.

Lack of Motivation

Someone who struggles with a substance use disorder may feel like a slave to their disease, unable to stop using drugs even when they attempt to. Feelings of hopelessness and despair may accompany withdrawal symptoms like extreme lethargy, which can cause someone to feel unmotivated or unable to overcome addiction.


Drastic changes in mood can occur in substance use disorders, along with hypersensitivity and increased irritability. Someone who experiences painful physical withdrawal symptoms may be incredibly irritable and lash out at others in anger unexpectedly. However, like other substance-induced changes in mood, feelings of irritability can be addressed by a therapist in individual counseling.

Signs of Drug Abuse/Addiction by Drug


Signs of alcohol abuse may include:

  • Sleepiness
  • Clumsiness or staggering
  • Slurred speech
  • Impaired judgment
  • Slow reaction times
  • Missing alcohol, or finding that alcohol has been diluted with water to replace missing alcohol

Signs of marijuana abuse may include:

  • Red, bloodshot eyes
  • Dry mouth
  • Unexplained cough
  • The scent of sweet smoke in clothing
  • The scent of cigarettes, cloves, or incense in clothing (used to mask the marijuana smell)
  • Talking too loudly
  • Inappropriate or excessive laughter
  • Sleepiness
  • Loss of motivation
  • Eating excessively or at unusual times, particularly sweet or salty food
  • Weight gain

Signs of hallucinogen abuse (LSD, PCP, magic mushrooms) may include:

  • Bizarre behavior, including inappropriate affection, aggression or paranoia
  • Excessive self-absorption or focus on objects
  • Difficulty interacting with others
  • Mood swings or confusion
  • Dilated or irregular pupils

Signs of stimulant abuse (cocaine, methamphetamine, ecstasy, prescription stimulants [Adderall, Ritalin]) may include:

  • Hyperactivity or excessive talking
  • Anxiety or irritability
  • Giddiness or euphoria
  • Flushed skin
  • Grinding teeth
  • Dry mouth
  • Sore jaw
  • Dilated pupils
  • Skipping meals or sleep
  • Sudden episodes of depression or paranoia
  • Weight loss
Heroin and prescription opioids

Signs of heroin and/or prescription opioid abuse (codeine, morphine, Vicodin, Percocet, Dilaudid, OxyContin, fentanyl) may include:

  • Needle marks in arms, legs, or feet
  • Wearing long sleeves or pants to cover needle marks
  • Sleeping during the day
  • Sniffling or coughing
  • Sweating or clammy skin
  • Loss of appetite
  • Vomiting
  • Loss of bowel movement regularity
  • Constricted pupils that do not respond to direct light
  • Missing prescription painkiller pills

Signs of inhalant abuse (such as glue or aerosols) may include:

  • Difficulty seeing
  • Nausea
  • Headaches
  • Watery eyes
  • Runny nose
  • Rashes around the mouth or nose
  • Impaired memory
  • Drowsiness
  • Clumsiness
  • Irritability or anxiety
  • An unusual number of spray cans or cream charging cylinders in the trash

Signs of benzodiazepine abuse (Ativan, Xanax, Klonopin, Valium) may include:

  • Similar symptoms as alcohol intoxication, without the smell of alcohol on the breath
  • Missing prescription pills

How Drug Use Starts

For some individuals, substance abuse begins when they start socially experimenting with various substances. This can be the case with drugs such as amphetamines, alcohol, marijuana and prescription drugs.

Opioid abuse can begin differently. People who become addicted to opioids are often prescribed prescription drugs, such as painkillers, often following something like an accident or surgery. They can then start taking higher doses of those prescription drugs, which can lead to abuse. They may also seek cheaper forms of opioids, such as heroin. Overall, 75% of heroin users report that the first opioid they took was a prescription drug.

When someone begins using drugs of any kind, they may start feeling as if they need larger and more frequent doses to get the same effects, even with something that started as social experimentation. This is called tolerance.

Drug use can start at any age. However, starting during childhood or adolescence is linked to an increased risk of dependence on the substance, where they feel like they need the drug to function normally.

Risk Factors for Addiction

Many studies on addiction risk factors have been conducted. Risk factors for addiction can be internal (i.e., psychological or physical) and external (i.e., environmental). Some addiction risk factors include:

  • Family history of addiction
  • Mental illness
  • Traumatic life events
  • Past abuse or domestic violence
  • Lack of a social support system, like family or friends
  • Little understanding of health maintenance
  • Poverty
  • Homelessness

Related Topic: Risk Factors for Substance Abuse and Factors that Lower Risk

How to Help Someone with a Drug Addiction?

If you suspect that someone you love is addicted to drugs, then it’s time to get help. Here are some tips to keep in mind when discussing drug addiction and treatment (See: Intervention) with a loved one:

  • Remember that addiction is a mental illness. Once drug or alcohol abuse has gotten out of control, willpower alone often isn’t enough to recover. Addiction is a chronic disease, physically changing the brain and making it harder to stop. Blaming them for their sickness won’t give them any motivation to stop using drugs. In fact, it may promote feelings of shame or guilt that further feed the addiction.
  • Be nonjudgmental.
  • Make sure they know that you love them and are here to support them. It’s normal to cycle through relapse and recovery several times before entering long-term remission, and your loved one needs your help every step of the way. Relapse is not a failure, just a part of the process.
  • Understand their situation. Why have they started using drugs? It may be because of stress, to self-medicate their mental health, or to fit in with a new peer group. Once physical dependence sets in, their body will experience uncomfortable or painful withdrawal symptoms without the substance. Knowing their motivations for using drugs can help you figure out how best to help them quit.
  • Make sure you’re ready. Before talking to your loved one about their addiction, make sure you’ve taken the time to work through your own feelings on the topic. This conversation isn’t about you — it’s about them. If you are going to work with others to stage a group intervention, such as family, friends, clergy, or mental health professionals, work with them beforehand to plan what each person will say. Decide what consequences, if any, you will impose if they do not get help. Research treatment options and contact treatment centers to make sure your loved one can begin treatment as soon as they agree to get help so that you have concrete solutions to present.
  • Time your conversation. Avoid discussing treatment or staging a group intervention when your loved one is in the middle of using substances or experiencing a high. Time your conversation for a moment when they are relatively sober or have recently faced clear consequences for their substance abuse that you can reference. The place is also important, with the goal of making the person feel safe and comfortable.
  • Be constructive and concrete. Present treatment as an opportunity for help and improvement rather than as a criticism or punishment. Keep a positive, non-confrontational tone – you’re here for them. Try not to make hurtful comments or personal attacks, but instead focus on specific examples of how his drug use has affected them, you and their other loved ones.
  • Follow through on consequences. Although it may be painful to watch your loved one suffer, if they don’t agree to treatment, it may be time to start imposing consequences. Giving them a safety net can enable drug use. Follow through on any consequences you propose, and be firm.

Addiction Treatment Options

Drug and alcohol addictions are diseases, but they are treatable. Addiction treatment is offered at drug and alcohol detox clinics, outpatient facilities and full-service rehab centers like The Recovery Village, but the quality of treatment can vary greatly among these facilities.

The ideal treatment for substance use disorders involves a combination of individual counseling and clinical care, which are key components in most rehab programs. The Recovery Village offers a continuum of treatment programs that allow clients to heal progressively. These programs include:

If you or a loved one need treatment for a drug or alcohol use disorder, you can search recovery resources by zip code or call The Recovery Village. Representatives are available to take your call, answer your questions about addiction and treatment and guide you toward a program that meets your needs. To get started with comprehensive substance use disorder treatment, contact The Recovery Village today.

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Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

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Substance Abuse and Mental Health Service Administration. “Age of Substance Use Initiation among Tr[…]ssions Aged 18 to 30.” July 17, 2014. Accessed February 21, 2021.

National Institute on Drug Abuse. “Prescription opioid use is a risk factor for heroin use.” January 2018. Accessed February 21, 2021.

State of Hawaii Department of Health. “Alcohol and Drug Abuse Prevention.” Accessed February 21, 2021.

National Institute on Drug Abuse. “Treatment and Recovery.” July 2020. Accessed February 21, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.