Substance Use Disorders: How to Recognize the Signs and Symptoms of Addiction

You may feel like your use of alcohol and other drugs is growing out of hand. You might find more of your time and energy spent getting and using drugs. And you could wonder if your substance use is unusual and unhealthy, or if you’re dealing with an addiction.

Unfortunately, the answer to the question “Do I have a substance use disorder?” isn’t always obvious. This is because symptoms of addiction often develop gradually over time. But learning to recognize the signs and symptoms of problematic substance use can help keep you and your loved ones safe. It can also limit the risk of unwanted outcomes of alcohol and other drugs.

Due to secrecy, shame, and denial, you may struggle to see your own symptoms of addiction and substance use disorders. Here’s a guide to help you recognize addiction and substance use disorders in yourself or your loved ones.

What is substance use disorder?

A substance use disorder, or addiction, is a mental health condition where you continue to use drugs or alcohol — even when they’re causing problems in your life. 

There are many different types of substance use disorder, including:

• Alcohol use disorder

• Cannabis use disorder

• Stimulant use disorder

• Opioid use disorder

• Hallucinogen use disorder

• Sedative use disorder

• Inhalant use disorder

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• Dependence versus addiction: Learn about the difference between dependence and addiction when it comes to substance use disorders. 

• What types of therapy can help with addiction? Here are five types of evidence-based therapies used to treat substance use disorders.

Substance use disorders harm your physical and psychological health. They can also influence the way you think, feel, and act.

What are the symptoms of addiction?

When it comes to addiction, symptoms of addiction vary between people — especially between people who are using different substances. 

For example, a person using stimulants like methamphetamine (crystal meth) will have different symptoms from a person using opioids like heroin. And addiction can also affect your actions, thoughts, and feelings in different ways, as well as your appearance.

Let’s take a closer look at some of the common symptoms you might notice if you, or a loved one, have a drug or alcohol use disorder. 

Behavioral symptoms of addiction 

Your behaviors could be very unusual compared to the way they were before substance use started. These might include:

• Sleeping all day or never sleeping

• Spending all of your time alone or bouncing from party to party

• Stealing from and lying to loved ones

• Failing to succeed at work

• Crying often or becoming aggressive toward others

Psychological symptoms of addiction

As you consume alcohol and other drugs, they can sometimes begin to change the way you think. Here are some examples:

• Others are out to get you.

• People don’t understand you.

• No one really cares about you.

• People are being too concerned about your use.

• The things you used to be into just aren’t exciting anymore.

• Your substance use is actually helping you, not hurting you.

Substance use disorders can affect your emotions too. Many people have mood swings, or frequent intense feelings. Or you might notice that the initial highs of substance use are quickly replaced by new lows, including depression or anger.

Changes in appearance

As substance use increases, you may stop taking good care of yourself, change your diet, and show a decline in your grooming. Your appearance may also change in many ways, including:

• Weight gain or loss

• Wearing dirty or tattered clothes

• Hair loss

• Acne, sores, infections, and other skin changes

• Issues with your teeth, gums, and breath

Noticing these changes in yourself may be an uncomfortable experience. Feel free to consult with loved ones and professionals to know if they see these changes in you as well.

How to recognize addiction in a loved one

Recognizing addiction in a loved one can be difficult. Since you can’t know their thoughts and feelings directly, you have to base your opinion on their actions and appearance.

Possible signs that a loved one has a problem with alcohol or other drugs include:

• Changes in relationships

• Poor self-care

• Decreasing performance and productivity at school or work

• Missing work, skipping school, and arriving late to appointments

• Limited interest in healthy relationships or activities

• Breaking the law and having issues with the police

• Major changes to weight, eating, or sleeping patterns

• Failing to pay their bills, keep their house clean, or care for their kids

Your ability to recognize these signs of addiction is important. But convincing your loved one that they have a problem isn’t easy. Try to communicate your thoughts with love and support. Here are more tips on talking to a friend or family member about drugs and alcohol. 

How is a substance use disorder diagnosed?

Just like other mental health conditions, substance use disorders can only be diagnosed by a healthcare professional. This could be your primary care provider, therapist, or another healthcare professional. 

When meeting with you, professionals often use a clinical guidebook called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to make a diagnosis. This guidebook lists the signs and symptoms of different mental health conditions, including substance use disorders. 

According to the DSM, you need to have at least two of the following symptoms to be diagnosed with a substance use disorder: 

• Using the substance more often, in higher doses, or longer than planned

• Wanting to cut down or stop using but not being able to

• Spending a lot of time obtaining, using, or recovering from the substance

• Craving the drug when none is available

• Being unable to keep up with responsibilities at work, school, or home

• Continuing to use, even when it causes problems in your relationships

• Continuing to use even when it’s hazardous or likely to cause harm

• Feeling the need to use substances more or more often to feel drunk or high (tolerance)

• Feeling ill, sick, or uncomfortable without the substance in your body (withdrawal)

Remember: You don't need to have all of these symptoms to be diagnosed with a substance use disorder. Two or three indicate a mild substance use disorder, while six or more would point to a severe condition.

How to get treatment for a substance use disorder

Getting treatment for an addiction may seem complicated. But fortunately, good treatment is available — both online and in person. Some of the best ways to get started include:

• Talking to a trusted friend or family member

• Talking to your primary care doctor

• Phoning your insurance company

• Contacting your local mental health or addiction treatment center

• Calling a national hotline like SAMHSA’s National Helpline at 1-800-662-HELP (4357)

When it comes to treatment, there are many options that can help. Most of the time, treatment includes therapy or medication — or both. Some people can get treatment as an outpatient, while others stay in a hospital or residential facility. 

Learn more about your options for recovery. 

Can I quit on my own?

It’s hard to say. It’s normal to be tempted to quit on your own. But for many people this can be very difficult. Cravings and withdrawal symptoms can make for a risky (and sometimes dangerous) situation. This especially true if your body is physically dependent on drugs or alcohol.

Professional treatment options can help keep you safe, healthy, and focused on recovery while reducing the dangers of going at it alone. Plus, people who use professional treatment are shown to do better in recovery than people who don’t use professional treatment.

The bottom line? If you’re thinking about quitting, it’s a great idea to first check in with a healthcare professional. They can help you put together a plan to cut down or quit as safely and effectively as possible. 

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Written by:

Eric Patterson, LPC

Eric Patterson, LPC, has been a professional counselor in school and outpatient settings — working with clients of all ages to achieve happiness, good mental health, and better lives — for over 15 years. Since 2010, he has provided clinical supervision to other therapists hoping to refine their skills and become licensed professionals.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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