How to Tell If Someone Is Using Drugs

Drug abuse is a very serious problem with far-reaching consequences. Abuse of a drug is any misuse, including using a drug to cope with negative emotions or to self-medicate for a mental illness, using an illicit or prescription drug to get high, or using a prescription drug in a way other than how it was intended. There are some characteristic behavioral and physical signs of drug abuse as well as signs that are specific to abuse of different classes of drugs.

Abusing drugs can lead to addiction, which is difficult to treat. It is important to recognize signs of abuse so that the person abusing drugs can get help sooner. Professional treatment is not just for addiction. Anyone abusing drugs can benefit from dedicated treatment to change behaviors and to avoid becoming addicted and all of the repercussions that come with addiction.

If someone is abusing drugs, expect to see behavioral changes. Regardless of the type of drug, substance abuse usually causes significant alterations to the way someone normally behaves. Many of these are common behaviors that most people abusing substances exhibit. Everyone is different, though, and any behavior that is new, unusual, or that can’t be explained by something else, like an illness or a traumatic experience, should be cause for concern. These are some of the more common signs that someone is abusing drugs:

• Problems in relationships. Drug abuse can cause a lot of conflict in families and couples, leading to fights and break-ups. Relationships at work and with friends may also suffer.
• Legal and financial problems. A drug habit can be expensive, and it is also illegal. Abusing drugs can lead to overspending, getting into debt, maxing out credit cards, borrowing too much, and also to trouble with the law.
• Decrease in performance. The altered state that drugs create can lead to a drop in performance at work or at school, even in someone who normally excels.
• Neglect of responsibilities. Someone who is abusing drugs is often more focused on the drugs than on other responsibilities to family and at home.
• Social withdrawal. Drug abuse often leads a person to hide his or her activities from family and friends, which can ultimately lead to withdrawal and little social contact.
• Lack of motivation and changes in thinking. While abusing drugs a person may become apathetic and uninterested in accomplishing much of anything. They may also struggle to remember things, make decisions, or think normally.
• Risky behaviors. Drug abuse can lead a person to do things he or she normally wouldn’t—things that are risky or dangerous, like stealing, driving under the influence, or having unprotected sex.
• Unusual mood changes. A drug can have many effects on the body and mind and can cause serious changes in mood. A person on drugs may be unusually depressed or anxious or may be more energetic and euphoric than usual for no obvious reason.

Behavioral changes are important signs of drug abuse, but they can also be hidden to some extent. Some people abusing drugs are very good at masking the changes that are occurring, hiding their poor performance at school, pretending to be engaged with family, or withholding information about their financial problems. The physical warning signs of drug abuse are more difficult to hide, however. While different types of drugs cause specific physical symptoms, some are common with any type of drug abuse, including:

• Changes in sleeping habits, including sleeping more or sleeping less
• Eyes that are red or watery, or pupils that are too large or too small
• Poor coordination, stumbling when walking
• Slurred speech, or saying things that are hard to understand or don’t make sense
• Tremors or shaking in any part of the body
• A persistent cough
• A runny nose
• Poor physical hygiene
• Changes in eating habits, with either weight loss or weight gain
• Paleness, flushing, or puffiness in the face
• Any unusual smells on clothing, on the body, or on the breath

Many of the signs of drug abuse are common to all types of drugs, but there are also some more specific symptoms caused by specific drugs and substances. There are warning signs that can indicate a person is abusing drugs, but also that they are abusing one or more particular types of drugs. This is important to understand, because while all drug abuse is harmful, some substances can be more damaging than others and may require more pressing intervention and treatment. Some of the signs of abuse of common substances include:

• Marijuana. Use of marijuana causes red eyes, a glassy, blank stare, giddiness and inappropriate laughter, talking too loud, apathy and lack of motivation or interest in activities, and changes in weight.
• Opioids. Opioids include heroin and prescription opioid painkillers like OxyContin, hydrocodone, Vicodin, Percocet, Demerol, and others. These drugs cause the pupils to contract even in good lighting, loss of appetite, excessive sleeping, vomiting, coughing, sweating, twitches, and sniffling. Someone using heroin is likely to have needle marks on the arms or feet.
• Stimulants. Stimulants are drugs that increase the activity of the central nervous system and include prescriptions like amphetamine and methamphetamine, as well as cocaine, crack, and crystal meth, a crystallized form of methamphetamine. Stimulants cause euphoria, increased energy, alertness and less sleep, decreased appetite, weight loss, dry mouth, irritability, and anxiety. Someone on stimulants may be hyper, talkative and cheerful, and then suddenly depressed.
• Depressants. Depressants are sedatives that cause relaxation and sleepiness. Prescription sedatives are used to treat insomnia and anxiety. They include barbiturates, tranquilizers, and benzodiazepines. These drugs cause sleepiness, poor coordination, poor judgement, slurred speech, trouble concentrating, and other signs similar to being drunk.
• Hallucinogens. These are drugs that cause hallucinations and include LSD, peyote, mushrooms, and PCP, or angel dust. In addition to hallucinations they cause dilated pupils, confusion, slurred speech, paranoia, mood swings, detachment, aggression, and preoccupation with certain things.
• Inhalants. Inhalants are household chemicals that can be inhaled to produce a high, like glues, aerosols, and paints. They cause memory problems, rashes around the mouth or nose, runny nose, vision problems, headaches, drowsiness, anxiety, nausea, poor control of muscles, and changes in appetite.

The signs of drug abuse should be taken seriously because misuse of substances can cause harmful side effects, long-term health consequences, and addiction, not to mention potentially fatal overdoses. Not all people who abuse drugs will become addicted to those substances, but any misuse of a drug puts someone at risk for addiction. Addiction to a drug causes many of the same signs as drug abuse, but there are also specific signs that a person has crossed the line from abusing to being addicted, including:

• Developing a tolerance and needing greater quantities of a drug to get the same high or experience
• Using a substance to avoid or stop withdrawal symptoms
• No longer having control over use of a drug; trying to stop or use less but failing over and over again
• Continuing to use substances in spite of the harm it causes
• Everything revolves around getting more of the drug

It is a common misconception that someone has to hit rock bottom before they can be helped. Waiting for drug abuse to develop into an addiction is very dangerous. If you or someone you care about is misusing drugs, get professional help as soon as possible. Someone who is abusing drugs can benefit from time spent in a residential treatment facility where they can be evaluated by addiction and mental health specialists, get individualized treatment plans, and dedicate their time and energy to getting better.

Treatment and rehab for substance use and addiction may involve medications in some cases, but behavioral therapy is the backbone. This kind of therapy teaches people how to recognize their negative thoughts and behaviors, how to change them, and how to use healthy strategies for coping with negative emotions and avoiding using substances in the future. Treatment may also include overall wellness and alternative therapy programs including nutrition, exercise, meditation, art or music therapy, and more.

Drug abuse is damaging to individuals, to their physical and mental health, to their futures, and to their relationships with families and loved ones. The signs of drug abuse can be hidden to some extent, but if you suspect someone you care about is using, don’t hesitate to offer help and to ask others to step in as well so that he or she can get needed treatment.