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Signs and Symptoms of Substance Abuse

From the American Council for Drug Education, an affiliate of Phoenix House.

The following are some of the more common signs and symptoms of drug use. It is important to keep in mind that if a person has any of these symptoms, it does not necessarily mean that he or she is using drugs. They could be due to a mental or physical health problem. They might also be due to adolescent development (in the case of teens). Whatever the cause, they may warrant attention, especially if they persist or occur in a cluster.

The key is change – it is important to watch for any significant changes in the person’s physical appearance, personality, attitude or behavior.

Physical Signs

  • Inability to sleep, awake at unusual times, unusual laziness.
  • Loss of or increased in appetite, changes in eating habits
  • Cold, sweaty palms; shaking hands.
  • Red, watery eyes; pupils larger or smaller than usual
  • Unusual smells on breath, body or clothes.
  • Extreme hyperactivity; excessive talkativeness.
  • Slowed or staggering walk; poor physical coordination.
  • Needle marks on lower arm, leg or bottom of feet.
  • Nausea, vomiting or excessive sweating.
  • Tremors or shakes of hands, feet or head.
  • Irregular heartbeat.
  • Runny nose; hacking cough
  • Puffy face, blushing, or paleness
  • Frequent rubbing of the nose
  • Frequent twisting of the jaw, back and forth
  • Deterioration of hygiene or physical health

 

Behavioral Signs

  • Change in overall attitude/personality with no other identifiable cause.
  • Drop in grades at school or performance at work; skips school or is late for school.
  • Change in activities or hobbies.
  • Chronic dishonesty.
  • Sudden oversensitivity, temper tantrums, or resentful behavior.
  • Difficulty in paying attention; forgetfulness.
  • General lack of motivation, energy, self-esteem, “I don’t care” attitude.
  • Change in habits at home; loss of interest in family and family activities.
  • Paranoia
  • Silliness or giddiness.
  • Moodiness, irritability, or nervousness.
  • Excessive need for privacy; unreachable.
  • Secretive or suspicious behavior.
  • Car accidents.
  • Change in personal grooming habits.
  • Possession of drug paraphernalia.
  • Changes in friends; friends are known drug users.
  • Unexplained need for money, stealing money or items
  • Possession of a false ID card
  • Missing prescription pills
  • Complaints of a sore jaw (from teeth grinding during an ecstasy high)
  • Presence of unusual number of spray cans in the trash

 

Signs of Intoxication, by Specific Drug:

  • Marijuana: Glassy, red eyes; loud talking and inappropriate laughter followed by sleepiness; a sweet burnt scent; loss of interest, motivation; weight gain or loss.
  • Alcohol: Clumsiness; difficulty walking; slurred speech; sleepiness; poor judgment; dilated pupils.
  • Cocaine, Crack, Meth, and Other Stimulants: Hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; go long periods of time without eating or sleeping; dilated pupils; weight loss; dry mouth and nose.
  • Heroin: Needle marks; sleeping at unusual times; sweating; vomiting; coughing and sniffling; twitching; loss of appetite; contracted pupils; no response of pupils to light.
  • Depressants: (including barbiturates and tranquilizers) Seems drunk as if from alcohol but without the associated odor of alcohol; difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness; and contracted pupils.
  • Inhalants: (Glues, aerosols, and vapors ) Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; anxiety; irritability
  • Hallucinogens: Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion.