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The Signs of Substance Abuse

You may think that the signs of drug and alcohol abuse are obvious: If you see someone using, they have a problem. In reality, addiction can be subtle. You may not detect the damage mounting with each hit taken, but it's accumulating every day.

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What You Might Notice First

The most common observable signs of substance abuse are behavioral. People with addictions tend to display:
  • Personality shifts, moving from sedation to excitability and back again with speed.
  • Financial distress, as the family budget is spent on drugs or alcohol.
  • Missed obligations, as the person needs more time to use drugs and alcohol.
  • An inability to quit, even when the person claims that is a top goal.

Other signs could include:

  • Commiting crimes that result in legal troubles
  • Strained relationship among loved ones
  • Drugs and the idea of them consumes the daily life of the user
  • The user experiences intense urges to do drugs
  • Having poor judgment or using risky behaviors
  • The user needs to consume more drugs to achieve the same effect
  • An overall drop in personal hygiene and presentation
  • Physical deterioration of the user’s body
  • Acquiring and infectious disease or being sick more often
Every drug works on the brain in a unique way, and some cause changes others don’t. But they all do damage that can shift use from a choice to a necessity.

How Do Drugs Change Your Body and Mind?

Addiction is defined by the National Institute on Drug Abuse (NIDA) as a chronic disease of brain chemistry. While people do make the initial choice to use substances, their continued use changes the brain and makes repetition compulsory.

Most addictive drugs amend the brain’s reward center. The amount of pleasure chemicals skyrockets, and receptors burn out. People need bigger doses to get the same high, and they may not feel happy unless drugs are on board.

You can’t see these changes happening beneath the skull, but you might notice a preoccupation with substance use and abuse.

To use wine as an example, someone with an addiction to this substance might:
Talk about it frequently
The person might mention a wine that would work well with a meal, or the person might express a desire for a glass.
Buy it often
The person makes a beeline for the wine aisle in the store, and the grocery cart isn’t full unless there are several bottles present.
Drink it every day
You’ll bring your loved ones to meetings with a therapist, and you’ll all talk about addiction recovery together.
Cancel obligations
If a party has no wine available, the person won’t attend.

These habit shifts are driven by brain chemical changes. At the same time, the person experiences damage elsewhere in the body.

Drugs can harm tissues as they slip into veins or slide down the throat. They can damage organs when they’re digested or processed. And they can spark unusual decisions that further hurt the body.

To really understand how that works, we’ll need to discuss drugs individually.


What Specific Changes Do Drugs Cause?

Each drug harms the body in a very specific way, and many of these alterations are visible to the naked eye.

Most people abuse this drug with a needle, and each time the substance moves beneath the skin, bacteria enters too. You might notice holes dotting the arms and legs, and you may see pockets of pus emerging too.Heroin can cause a major high and a terrible low. NIDA says symptoms of withdrawal, including twitching, sweating, and nausea, happen 24 to 48 hours after the last dose.


This drug can be snorted, and when that happens, it can erode nasal tissues. Nosebleeds and a collapsing nose can follow. If cocaine is swallowed, the person may experience bloody diarrhea or vomiting.At high doses, cocaine can cause paranoia and hallucinations. Those can be scary, but they tend to resolve quickly.


This drug can be smoked, snorted, or eaten. It can close up blood vessels, leading to tissue death. The person may lose teeth, and you may see pockets of tissue death on the face and hands. Methamphetamine can also suppress the appetite, leading to dramatic weight loss.


Prescription painkillers can be swallowed, crushed, and snorted, or crushed and injected. You may see needle marks or nosebleeds, or you may see constipation with any mode of use.Opioids are typically bought from street dealers, and often, the pills are contaminated. The user may end up taking a much stronger drug and slipping into an overdose.


Prescription medications are designed to ease distress and concern. They can also boost pleasure chemicals and lead to a high. Someone abusing these drugs may seem sedated and slow. If used in combination with other drugs, other symptoms may apply.


Prescription drugs like Ritalin can be swallowed or snorted. People who abuse them may seem hyped up, and they may stay awake for days at a time. NIDA also says people who abuse these drugs can develop psychotic episodes.


People with an addiction to alcohol develop withdrawal symptoms between drinks. Their hands shake, and their feet twitch. They may feel desperate for a drink.Chronic alcoholism can cause movement disorders that look like Parkinson’s disease. Bleeding ulcers of the throat can also develop, and they cause people to vomit blood.

Some of these changes are reversible. The body is capable of healing itself. But sometimes, people need help from doctors to repair the damage. Without that help, the damage can be permanent.

Unfortunately, some of these changes can be life-threatening. If you see them, you must do something about them. And that something involves treatment for addiction.

Do You Need Help?

It’s scary to see these signs in someone you love. It’s even more frightening to spot them in yourself.

If you’ve tried to stop using drugs and you found that you just can’t do it, you need help. You may make a promise to cut back or quit. You may be unable to keep that promise.

You know what that feels like. And there are better days ahead.

Addiction treatment works. Therapists can help you understand how the problem began. You’ll learn how to make it stop. It takes time, but you can make it happen. When you’ve seen the signs, it’s time to take action.

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