When you’re worried about your loved one’s substance use, it can be difficult to tell just how severe the problem is. Those with a substance use disorder often try to downplay or hide their symptoms. Trying to determine what kind of support to offer can also be challenging. While it is not always easy to help the individual struggling with drug or alcohol use, studies have shown that your support will increase their chances at having success in treatment and recovery1. If you’re worried that your loved one is misusing drugs or alcohol, look for the following warning signs:

1. Physical Changes

Physical changes can be the most noticeable sign of a substance use disorder. When someone is actively using, there are a multitude of physical signs that they are under the influence. Physical signs of intoxication vary depending on the substance used. Noticeable changes in pupil size, bloodshot eyes, slurred speech, and impaired coordination are all common signs of intoxication2

As use progresses, things like hygiene, sleeping, or eating start to take the back burner.   As a result, you may notice significant fluctuations in your loved one’s weight, personal grooming habits, or dental health. Use of certain substances can also result in skin changes such as coloration or development of sores/scabs on the face or body. 

2. Behavioral Changes

Substance use affects behavior in many ways. The noticeable behavioral signs of substance will vary from user to user, but some common behavioral changes include:

• Loss of interest in things previously enjoyable to them (hobbies, relationships, etc…)

• Neglecting responsibilities at home, work, or school

• Prioritizing substance use over other obligations

• Engaging in high risk behaviors associated with use

• Unexplained or continual need for money; financial issues

• Using more than intended or loss of control over use

In addition to the signs noted above, you may also notice your loved one acting in a secretive or suspicious way. These behaviors are usually an attempt to hide their use and may include prolonged absences, spending more time alone than usual, or becoming reclusive.

3. Psychological Changes

Psychological signs of an SUD may include2:

• Displaying paranoia or uncharacteristic anxiety with no reason

• Appearing unmotivated, tired, or “spaced-out”

• Sudden mood swings

• Periods of increased/decreased energy without explanation

• Unexplained changes in personality traits or attitude

4. Tolerance and Withdrawal

Tolerance to a substance occurs due to repeated use. While tolerance does not always equal addiction or dependence, it can be an early warning sign of a SUD.  Tolerance occurs with both legal and illegal substances and is a physical response to the diminished effect of the substance. In order to counteract tolerance, many individuals will begin to use in larger quantities or at a higher frequency to achieve the desired effect.

Withdrawal occurs when a person becomes physically dependent on a substance. The symptoms an individual experiences while in withdrawal varies based on the substance but can include: 

• Watery eyes/Runny Nose

• Chills

• Hot/Cold Sweats

• Muscle Aches and Pains

• Nausea

• Vomiting/Diarrhea

• Diarrhea

• Dilated pupils 

• Insomnia 

• Heightened Anxiety/ Agitation

• Restless Legs

• High Blood Pressure

• Cravings

• Lethargy

Withdrawal is an indication that a physical dependence has developed and can be a key indicator of an SUD. Withdrawal typically occurs within 48 hours of last use and can last for up to 10 days.

5. Getting into Trouble

Another hallmark of a possible SUD is the presence of legal, occupational, or medical consequences. Substance use disorders can lead to criminal offenses, fines, or imprisonment. Occupational consequences of SUD can be the failure of employer drug screens, excessive absenteeism, declining performance, and eventual job loss. Additionally, if your loved one has developed health issues related to their use, or experienced an overdose, there is a very good chance they are experiencing a substance use disorder.

Next Steps

If you are concerned about a loved one’s substance use disorder , reach out for help. Noticing one or more of the signs above can indicate a serious problem. Contact a qualified treatment provider to learn about resources in your area and available treatment options. Loving someone with a substance use disorder can be challenging, but your support can make a huge difference in their recovery. 

Greenbriar Treatment Center offers comprehensive treatment for Substance Use Disorders. We also recognize that family members play a critical role in their loved ones recovery. Therefore, Greenbriar offers specialized family programming, allowing loved ones to take an active role in our clientsrecovery. For more information, contact(opens in a new tab) today!


1. Polcin DL, Korcha R. Social support influences on substance abuse outcomes among sober living house residents with low and moderate psychiatric severity. J Alcohol Drug Educ. 2017;61(1):51-70.

2. https://www.ihs.gov/asap/familyfriends/warningsignsdrug/