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5 Warning Signs of Substance Abuse

How to Spot Substance Abuse Signs

Noticing the signs of substance abuse is a skill that anyone can develop. The first step is to first educate yourself as to what the signs are and how to recognize them. After that, it is a matter of staying vigilant and observant. That simply means stay at it, be persistent, and pay attention. It is also very important to stay objective but fair. This means you need to be on guard for denial. None of us wants to believe the worst about someone we care about. We naturally want to believe everything is OK. But it’s important we are honest with ourselves when it isn’t.

One thing that can be very helpful in that area is if you have a person you trust who you can run things by. It may be a simple as a phone conversation. “Hey, I noticed that my son was doing x, y, and z. Do you think I should be worried about that? Does that seem strange?”. Dealing with a loved one who has a substance abuse problem can be a heart-wrenching challenge, but it’s much easier to endure if you have at least one or two people you trust enough to confide in. So put that on your list of priorities as you move through this process. 

What Are the 5 Warning Signs of Substance Abuse?

The primary signs of substance abuse can be broken down into 5 main categories to make them easier to think about. They are:

  1. Physical Changes
  2. Psychological or Mental Changes
  3. Changes in Behavior
  4. Health Issues or Problems
  5. Consequences

Physical Changes from Substance Abuse

Here we rely on our eyes. What changes or signs are you seeing? An unexplained sudden loss or gain in body weight. Dark circles under the eyes. Pale or sallow skin. Bloodshot eyes. Poor personal hygiene. Breaking out with acne or picking at sores or scabs on the skin. Unusual bruising or track marks on the harms. Even signs of self-harm like cutting may be tertiary indicators of a drug problem. 

Psychological or Mental Changes

Drug use invariably has psychological effects. Both the substances themselves and the impact of the lifestyle affect the user’s mental state. Things to watch for include uncharacteristic mood swings. Flashes of anger or impulsivity. Sinking into a deep depression that lasts weeks or even months—becoming unusually anxious, paranoid of nervous. This may even rise to the level of delusion. Imagining they are being watched or someone is plotting against them. Giddiness or overenthusiasm, even bordering on mania, can also be a sign of substance abuse. It is important to be aware that some signs can closely mimic non-drug-related mental disorders, so bear that in mind before accusing anyone of anything. 

Changes in Behavior

Substance abuse almost always leads to changes in behavior sooner or later. The mental effects of drugs can alter judgment and behavior but maintaining the secrecy and getting drugs also leads to changes in behavior. Things to watch for include being unusually secretive about where they have been and who they are with. Lying can be a sign. Also, sudden unexplained financial problems (a drug habit can get expensive quickly). Losing old friends and making new “friends” or spending more time with old friends suddenly who are known ne’er do wells. Irresponsibility is another red flag, especially if it’s out of character. Missing important appointments or always turning up late. Calling out sick to work or school frequently. Reprimands or suspensions at work or even losing a job.

Health Issues or Problems

There are few areas of our lives that substance abuse doesn’t affect. Health is no exception. A person who is abusing opioids will often be excessively itchy and often absently scratching at themselves. They are almost always constipated unless they are taking stool softeners and eating prodigious amounts of prunes. Someone abusing meth will often lose a lot of weight in a short time due to a lack of appetite and speedy metabolism. They may scratch and pick at their skin, leading to scabs and sores, or chew or clip their fingernails very short. People who have alcohol use disorders sometimes gain weight. They will appear bloated and pale and may get clammy or sweaty, and shaky if they go too long without alcohol. They frequently develop digestive problems. 


One of the most dreaded elements of substance abuse is consequences. These can vary depending on what substance is being abused and how severely. Consequences may be anything from DUI charges or other arrests to hospital visits. Destroyed friendships or relationships. Lost jobs. Lost or stolen property. A person who is deep in the throes of their addiction often seems to be moving from one crisis to the next. They seem to be surrounded by drama and forever subject to chaos. But they will rarely take responsibility for any of it. 

Getting Help 

Bear in mind that a handful of the signs above in isolation may not be a sign of substance abuse. But taken together, they present some definite red flags. Use your best judgment. Talk to a trusted friend or family member to see what they think. Remember that it is always better to err on the side of safety, though. It’s much better to risk angering someone with a false accusation than it is to ignore warning signs until it is too late. If you or someone you love may be struggling with drugs or alcohol, Long Island Rehabs can help. Call us at (866) 768-0528 or reach out to us through our contact page here