What are the Signs of Substance Abuse?

What are the Signs of Substance Abuse?

Substance abuse is a deteriorating condition that can, if gone unchecked, devastate people’s lives. Although it can sometimes seem like substance abuse comes out of nowhere, there usually are warning signs and red flags that can alert friends, family members, and loved ones of those suffering from the condition. But what are these signs of substance abuse?

Throughout this article, we’re going to discuss substance abuse as well as important signals and signs of the condition. We hope this information can help you in preventing this condition from becoming worse. At the end, we invite you to ask further questions.

What is a Substance Abuse Disorder?

Substance abuse is defined as the excessive use of a psychoactive drug, including pain medications, alcohol, or illegal substances. A substance abuse disorder is usually deemed as a problem once it has consequential effects on an individual and those around them – causing physical, social, and emotional harm. ¹

How is Substance Abuse Diagnosed?

In order for a person to struggle with drug addiction, they must meet 2 to 3 of the following 11 diagnostic criteria: ²

  1. The substance is often taken in larger amounts or over a longer period than was intended to reach desired effect.
  2. There is a persistent desire or unsuccessful effort to cut down or control use of the substance.
  3. Spending a great deal of time in activities necessary to obtain the substance, use the substance, or recover from its effects.
  4. Cravings, or a strong desire or urge to use the substance, occurs.
  5. Recurrent use of the substance results in a failure to fulfill major role obligations at work, school, or home.
  6. Use of the substance continues despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
  7. Reduction in important social, occupational, or recreational activities because of use of the substance.
  8. Use of the substance is recurrent in situations in which it is physically hazardous.
  9. Continual use of the substance despite knowledge of having a persistent or recurrent physical or psychological problem.
  10. Tolerance, as defined by either of the following:
    1. A need for markedly increased amounts of the substance to achieve intoxication or desired effect
    2. A markedly diminished effect with continued use of the same amount of the substance.
  11. Withdrawal, as manifested by either of the following:
    1. The characteristic withdrawal syndrome for that substance (as specified in the DSM-5 for each substance).
    2. The use of a substance (or a closely related substance) to relieve or avoid withdrawal symptoms.

What Causes Substance Abuse?

When discussing the cause of substance abuse disorder, it’s vital to understand that it can come from a number of sources. Sometimes its a combination of circumstances and factors that result in someone becoming addicted. Currently, most clinicians and researchers see drug dependency as a result of the following:

Biological Causes of Substance Abuse

When it comes to drug dependency and prolonged substance abuse, we have a better understanding of how biological and genetic factors play an integral role in causation. Certain biological traits in certain people make them more susceptible to dependency of substances than others.

When one uses and abuses substances that directly affect thought processes and behaviors, it has a direct impact on the brain. More serious substances – such as heroin, meth, cocaine, and certain prescription medication – can not only impact the neurological functioning but also actively change said functioning.

Certain substances (like cocaine and methamphetamine) can cause an overload of dopamine – a hormone that activates the pleasure feeling centers in our brains. Over time, when one overindulges in these drugs, they can shift the natural balance of dopamine in the brain. In turn, this causes issues with a whole bunch of basic functions, such as: ³

  • Attention
  • Learning
  • Memory retention
  • Mood control
  • Pain processing

Societal Causes of Substance Abuse

You’ve probably heard plenty about how social and financial reasons are to blame for substance abuse. People who struggle with poverty are much more likely to struggle with addiction and, more often than not, they initially began using due to societal influences.

As to what these influences are will vary on who you’re talking to. Some will say the stress of labor within a capitalism market causes enough of a weight to need relief. Others will claim that the necessity to fit in at a young age causes people to give drugs a try. While the answers aren’t always clear, we do know society plays some kind of role in people wanting to take drugs.

There are so many specific cases of these issues that’s impossible to pinpoint them all in a simple list. One person may have struggled through poverty throughout their childhood, resulting in displacement later in life. Another may have gone through an extremely emotional break-up and isn’t sure how to handle the situation. When it comes to addiction, there are so many stories to pick from, identifying them all in one article is almost impossible.

With that said, it’s also impossible to develop a “one-size-fits-all” motto for a treatment facility. When an individual begins the process of recovery, it’s vital medical professionals identify their specific situation.

Spiritual Causes of Substance Abuse

In times of strife and struggle, there are those that might find themselves on the outskirts of where they stand spiritually either due to stress, excommunication, or dissociation from one’s own spiritual belonging in the world. To try and combat this situation, there are those that feel they need to turn to substances that might uplift the user, disconnect them from the mortal tangible world and allow them to feel connect to the universe or a deity in a way never felt or experienced while sober.

The need to connect with one another or other things beyond us is an ancient desire. The practice goes back hundreds of thousands of years and in certain religious sects. Even still, in native tribes, using a substances has been a way to perform rituals.

Alternative methods of trying to reach a particular spiritual connection that cannot be done in a conscious way when sober have come to light in regards to the fear that addiction could be drawn out by drug use. A couple of methods that have become popular over the years is mindful meditation and yoga.

Psychological Causes of Substance Abuse

Those that struggle with a mental health condition are more likely to experiment with drugs. One of their primary reasons is always to self-medicate. And one of the more concerning portions of the population in which this trend is becoming more and more apparent are our youngest and most vulnerable age group: teenagers as well as young adults.

There are psychological reasons as to why teens are more apt to take, experiment, and – with enough time – abuse drugs. Most of these stem from trauma that happen early in their childhood developmental years. And while psychological pain can drive a teen to use substances, there are also societal and social reasons as to why they may be taking drugs, such as peer pressure. ⁵

causes of substance abuse disorder

Signs of Substance Abuse

Although substance abuse does occur in a wide range of people, regardless of age, race, gender or financial positioning, that isn’t to say that it doesn’t have any warning signs. In fact, there are many signs and symptoms that can give those who care and love those who are addicted a clue into how these substances are affecting them.

Behavioral Signs of Substance Abuse

When someone is using and abusing drugs and illicit substances, they will start ot exhibit behavioral signs that reveal that they are struggling with addiction. While some may not exhibit all of these signs, we have outlined the most common ones: ⁶

  • Changes in attitude/personality
  • Depression
  • Dramatic changes in habits and/or priorities
  • Increased aggression or irritability
  • Involvement in criminal activity
  • Lethargy
  • Sudden changes in a social network

Physical Signs

The most apparent and stark way of telling someone is going through a substance abuse problem is through the physical changes that their body and appearance undergoes during the stages of addiction. While it might not be all that noticeable in the beginning, you may notice the following changes over time: ⁷

  • Bloodshot eyes and abnormally sized pupils
  • Deterioration of physical appearance
  • Impaired coordination
  • Slurred speech
  • Sudden weight loss or weight gain
  • Tremors and muscle spasms
  • Unusual smells on breath, body, or clothing

Psychological Signs

Another warning sign of someone struggling with a substance abuse problem is how their psychologically presents itself. While these may not be outwardly apparent, a person dependent on drugs or alcohol may reveal the following: ⁸

  • Depression and anxiety
  • Irritability and mood swings
  • Low self-esteem
  • Poor motivation
signs of substance abuse

Signs of Substance Abuse Among Age and Gender

Substance abuse affects different people in various ways, oftentimes due to differences in age and gender. The most obvious impact that addiction has on a particular segment of the population is that of adolescents. Teens are especially vulnerable to substance use due to the many changes that occur in those developmental years.

As the body and mind of a teenager is developing, implementing outside influences of alcohol and drugs can only hamper the growth and even cause permanent long-term damage. Recent research concerning cannabis use among teens found that teenage girls who use marijuana regularly may have a higher risk of brain structural abnormalities compared to teenage boys. ⁹

Such studies done on lab rodents found a correlation in that when female rats are exposed to illicit substances, they had a different response than their male counterparts. Scientists believe that this is due to the fact that females’ reward centers in their brain chemistry function differently than in males. ¹⁰

Signs of Substance Abuse By Drug

Although those signs we previously mentioned are good ways to check in to see if a loved one is suffering from substance abuse, we have also looked into specific signs from individual sources of specific substance:


Alcohol is one of the most commonly available and widely used substance among Americans. The proliferation of beer, wine, and other such spirits have contributed to an overwhelming number of those who have developed a substance abuse disorder. Annually, around 95,000 people die from alcohol-related causes in the United States. Most of these deaths were caused by health disorders stemming from long-term drinking. Such health disorders that can be spurred from alcohol dependence are: ¹¹

  • Heart disease
  • Liver disease
  • Liver cirrhosis
  • Renal failure
  • Stroke
  • Upper aerodigestive tract cancers

The most common warning signs of continual use and abuse of alcohol are: ¹²

  • Anxiety
  • Appetite changes
  • Binge drinking (or drinking to excess)
  • Depression
  • Fatigue
  • Fluctuations of weigh (either gaining or losing weight)
  • Irritability
  • Loss in social interactions
  • Nausea and or vomiting


Marijuana, also called cannabis, has been seen as a innocuous substance that in recent years has become more popular and widespread through the legality of it in states. However, those that use it regularly can experience side effects and have a decreased quality of life.

Although cannabis has no related overdoses or deaths attributed to it, that isn’t to say that for those more vulnerable that cannabis can’t affect daily life and overall functioning. Someone can be addicted to cannabis just as much as any other other substances and there are warning signs to look out for if you are knowledgeable in noticing them. These include: ¹³

  • An inability to attend to daily responsibilities
  • Cannabinoid Hyperemesis Syndrome (CHS) which is a clinical diagnosis characterized by chronic cannabis use. It relates to an increase of nausea, upset stomach, decrease in appetite as well as fits of vomiting due to abuse of cannabis
  • Changing relationships or activities due to the use of marijuana
  • Continuing to use marijuana despite the problems it causes
  • Decrease in overall happiness and fulfillment that life usually gives someone
  • Depending on marijuana to be creative, relax, or enjoy yourself
  • Regular lethargy and lack of energy
  • Unable to cut back or stop marijuana use
  • Using marijuana to deal with external or internal complications
  • Using more and more marijuana in order to reach the same high

Depressants (Barbiturates and Tranquilizers)

Depressants are medicines that include sedatives, tranquilizers, and hypnotics. They slow brain activity, making them useful for treating anxiety, panic, acute stress reactions, and sleep disorders. However, they can also be used and abused without a prescription and can cause a flurry of complications. Such complications can lead to deterioration of life, confusion, decreased brain function as well as overdoses and death. ¹⁴

The most common warning signs and symptoms of depressant abuse are: ¹⁵

  • Depression
  • Difficulty or inability to urinate
  • Dilated pupils
  • Disorientation, lack of coordination
  • Dizziness
  • Fever
  • Poor concentration
  • Slow brain function
  • Slowed pulse and breathing
  • Sluggishness
  • Slurred speech
  • Visual disturbances

Hallucinogens (LSD and Magic Mushrooms)

Hallucinogens are substances that alter a person’s awareness of their surroundings. They can also change the thoughts and feelings of the user. They are commonly split into two categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP).

Both types of hallucinogens can cause hallucinations, sensations, and images that seem real, although they are not. Additionally, dissociative drugs can cause users to feel out of control or disconnected from their body and environment. Some hallucinogens are extracted from plants or mushrooms and some are synthetic (human-made).

The inherent danger of hallucinogens is two fold; it can cause the user to say, d, and believe things that aren’t really there and it can drastically alter the brain chemistry of the user over time. There have been beliefs that mental disorders can stem from prolonged use and abuse of hallucinogens, such as schizophrenia. ¹⁶

With all that being said the warning signs that someone may be using and abusing hallucinogens are: ¹⁷

  • Bizarre behaviors
  • Changes in sense of time (for example, the feeling that time is passing by slowly)
  • Dilated pupils
  • Dry mouth
  • Excessive sweating
  • Increased heart rate
  • Intensified feelings and sensory experiences (such as seeing brighter colors)
  • Loss of appetite
  • Nausea
  • Panic
  • Sleep problems
  • Uncoordinated movements

Heroin (and Other Opioids)

Over the past decade, the US has seen an alarming rise in opioid use. Opiates are substances that act on opioid receptors to help relieve pain and give a general sense of euphoria. In the medical field, they’re primarily used for short-term pain relief or as an anesthesia.

However, more and more people are being prescribed opiates for general everyday pain which has contributed to a opiate addiction epidemic. The street form of opiates is heroin which too has seen a rise in use, abuse, and overdoses. In 2019, opioids were involved in 49,860 overdose deaths in the United States alone. Heroin was responsible for over 14,000 deaths of those deaths. ¹⁸

The warning signs that someone is on heroin and might be struggling with addiction are: ¹⁹

  • Bruises or scabs from skin picking (heroin causes the body to release histamine which leads to itchy skin, which may be scratched to point of causing a sore or scab)
  • Burn marks on fingers or mouth (from smoking)
  • Constipation (when using heroin), or diarrhea (when withdrawing)
  • Dry mouth
  • Extremely small pinpoint pupils
  • Eyelids and arms/legs appear to be heavy
  • Flu-like symptoms: fever, achy, vomiting, always cold
  • Infections or abscesses (from injecting)
  • Lack of hygiene and disregard for physical appearance, may not shower or bathe, repeat wearing of same clothing
  • Nosebleeds (from snorting)
  • Persistent hacking cough (common if heroin is smoked)
  • Runny nose or constant sniffing (from the release of histamine heroin causes)
  • Sores on nostrils or lips (from smoking)

Stimulants (Cocaine, Crack, and Methamphetamine)

Stimulants are drugs that trigger an increase of dopamine – a “feel good” chemical messenger. Dopamine affects the pleasure and reward center of the brain and can also affect movement, focus, and motivation. Stimulants are highly addictive and only require a small amount to cause an overdose.

The warning signs of an abuse of stimulants could be: ²⁰

  • Agitation
  • Feeling high
  • High body temperature
  • High blood pressure
  • Increased alertness
  • Insomnia
  • Irregular heartbeat
  • Paranoia (or general anxiety)
  • Reduced appetite
signs for substance abuse by drug

How to Help Someone Struggling with Addiction

The biggest thing that can help those who are suffering from substance abuse is to be an understanding presence. When those who are addicted start to look for a way out of their substance abuse issues, they try to turn to those closest to them for support.

The best thing is to avoid the subject of substance abuse when the individual is under the influence of said substance. It’s recommended that once a patient is prepared to do the work towards recovery, then it’s best to refer them to a medical professional. The earlier a person can be intervened on their struggle with addiction, the better chances are at transitioning to sober life.

Outside lines of support that are open to those addicted or those caring for an addict have been listed below. Although these lines of support are optional, it’s highly recommended and can result in better outcomes towards a life clean and sober.

Such support systems include:

Final Word

Addiction is a mental illness that needs to be taken seriously. It should be treated as an disease and not as an escalation of bad behavior. Of course, in order for us to achieve that as a reality, we first have to understand substance abuse at its core. To do that, it’s vital to acquaint ourselves with the causes of drug addiction, how to spot its signs, and how to prevent them.

While we can’t always prevent these causes, they may help us better understand why someone is struggling with drug addiction in the first place. And with that understanding, we have a much better chance at recovering our brains, body, and spirit.

Your Questions

Still have questions concerning what the signs of substance abuse are?

We invite you to ask them in the comments section below. If you have any further knowledge on the topic – whether personal or professional – we’d also like to hear from you.

Reference Sources

¹ John Hopkins Medicine: An Understanding of Substance Abuse & Chemical Dependency

² National Institute on Drug Abuse: How Are Substance Use Disorders Categorized?

³ National Institute on Drug Abuse: How Do Drugs Affect Your Brain?

⁴ Kripalu Organization: How Yoga and Meditation Can Help Heal Addiction

⁵ Child Mind Institute: Mental Health Disorders and Teen Substance Use

⁶ American Addiction Centers: What Are Behavioral Signs of Drug Abuse?

⁷ US Department of Health and Human Services Mental Health Division: Physical Signs of Drug Use & Abuse

⁸ Gateway Foundation: Psychological Symptoms of Drug Use

National Institute on Drug Abuse: Substance Use in Women Research Report – Sex and Gender Differences in Substance Use

¹⁰ National Centers for Biotechnical Information: Cannabinoid self-administration in rats: sex differences and the influence of ovarian function

¹¹ National Center for Alcohol Abuse and Alcoholism: Alcohol Use in the United States

¹² Tennessee Department of Mental Health and Substance Abuse Services: Warning Signs of Alcoholism

¹³ UC Santa Barbara Department of Student Health, Alcohol & Drug Program: Warning Signs and Side Effects of Marijuana

¹⁴ National Institute on Drug Abuse: What are Depressants?

¹⁵ Foundation for a Drug Free World: Warning Signs of Depressant Use

¹⁶ National Institute on Drug Abuse: Research Report Series on Hallucinogens and Dissociative Drugs

¹⁷ National Institute on Drug Abuse: What are the Effects of Hallucinogens?

¹⁸ Centers for Disease Control: Heroin Overdose Data

¹⁹ Nationwide Children’s Health Centers: Warning Signs That a Person Might be Using Heroin

²⁰ Turning point of Tampa Florida: How to Detect Warning Signs of Stimulant Use

Leave a Reply