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Warning Signs: How to Recognize Substance Use Disorder

Early recognition can save lives. Understand the behavioral, physical, and emotional signs that may indicate a loved one is struggling.

Recognizing substance use disorder early can make the difference between a manageable intervention and a devastating crisis. While every person's experience is different, there are common warning signs that families can learn to identify.

Important: Having one or two of these signs doesn't necessarily indicate addiction. Look for patterns of multiple signs occurring together, especially if they represent a change from previous behavior.

Behavioral Warning Signs

Changes in behavior are often the first indicators that something is wrong:

Secrecy & Isolation

Withdrawing from family, hiding activities, unexplained absences

New Social Circle

Sudden change in friends, avoiding old relationships

Work/School Problems

Declining performance, absences, loss of interest

Financial Issues

Unexplained money problems, borrowing, missing valuables

Legal Problems

DUIs, arrests, or other encounters with law enforcement

Schedule Changes

Erratic hours, sleeping at unusual times, unreliable patterns

Physical Warning Signs

Substance use often produces visible physical changes:

  • Appearance changes — Neglected hygiene, dramatic weight loss or gain, looking tired or unwell
  • Eye changes — Bloodshot eyes, dilated or constricted pupils
  • Speech patterns — Slurred speech, unusually fast talking, incoherence
  • Coordination issues — Unsteady movements, tremors, impaired motor skills
  • Unusual smells — Alcohol on breath, smoke, or chemical odors on clothes

Emotional & Psychological Signs

Mood Swings

Rapid shifts between euphoria and depression, irritability, unpredictable emotional reactions

Personality Changes

Acting unlike themselves, loss of motivation, apathy toward things they once cared about

Defensiveness

Becoming angry when asked about activities, making excuses, blaming others

Anxiety & Paranoia

Increased fearfulness, suspicion, or nervousness without clear cause

What to Do If You Recognize These Signs

If you're seeing multiple warning signs in someone you love:

  1. 1
    Don't panic — Your calm response is important
  2. 2
    Document what you're seeing — Keep notes on concerning behaviors
  3. 3
    Educate yourself — Learn about addiction before confronting
  4. 4
    Seek professional guidance — An expert can help you respond effectively

Trust Your Instincts

If something feels wrong, it probably is. Families often sense problems before they have concrete evidence. Early intervention is always better than waiting for a crisis.

Matthew Mattone

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