In a world full of temptations, it’s possible for a person to become addicted to just about anything. And while it’s not always obvious, there are often warning signs that suggest there’s a problem. These tend to fall into three broad categories: physical signs, behavioral indicators and relationship and social signs.
[READ How to Support Someone With a Drug Addiction]
The Warning Signs of Addiction
Physical signs of addiction
A sudden noticeable deterioration of physical appearance or hygiene can be a red flag that something’s going on, says David Campbell, a doctor of social work, licensed psychotherapist and clinical and program director of Recover Together Bend, a drug and alcohol treatment facility in Bend, Oregon.
Other physical indicators of addiction can include:
— Sudden weight loss
— Unexplained changes in weight and appetite
— Slurred speech
— Changes in pupil size or bloodshot eyes
— Disrupted sleep patterns
— Changes in energy levels
— Sweating, shaking or flu-like symptoms
— Needle marks or bruises on the skin near veins
— Scabs from uncontrollable skin picking
— Burns on the lips or fingers
— A smell of alcohol on the person’s clothes or breath
— Hand tremors or other hard-to-control movements
— Nausea or vomiting
— Headaches or body aches
Behavioral and emotional changes
Oftentimes, behavioral changes are the first noticeable signs of a problem, Campbell says. Common signs can include:
— Secretive behavior
— Reclusive or suspicious behavior
— Losing interest in hobbies
— Mood swings and irritability
— Changes in personality patterns
— Worsening anxiety
— Difficulty concentrating
— Doctor shopping, or going from doctor to doctor, looking for someone to prescribe the drug of choice
— Medication hoarding, particularly pain medications
— An increase in unpredictable, impulsive or risk-taking behavior
[READ: 9 Signs of Depression: Symptoms to Watch for]
Relationship and social signs
The physical and emotional changes associated with substance use can create problems in relationships and make it difficult for the user to maintain their social standing and responsibilities. Common issues include:
— Problems at work or school
— Changing social groups or new or unusual friends
— Financial instability
— Legal troubles
— Social withdrawal
— Difficulty fulfilling social obligations
— Neglecting responsibilities
— Increased conflict
— Lying or manipulation
Behavior-based addictions, such as gambling, shopping or sex, are characterized by compulsive behaviors that persist despite negative consequences. In contrast, substance-based addictions, such as alcoholism and drug dependency, may offer more physical clues, including weight changes and tremors.
The specific signs and symptoms of addiction depend on the substance or behavior that’s at issue, but there’s nearly always several signs that span physical, emotional and social manifestations.
[See: Signs You May Have a Gambling Disorder or Sports Betting Addiction]
What Is Substance Misuse?
Substance misuse and addiction can take many forms. From alcohol to sports betting, there’s a whole constellation of potentially addictive substances and behaviors that some people have difficulty with. Some of the most common substances and behaviors that can lead to addiction include the following:
[CHART]
Alcohol is the most commonly misused substance; nearly 10% of the adult population of the U.S. met the qualifications for alcohol use disorder in 2024, according to data from the National Institute on Alcohol Abuse and Alcoholism.
Addiction often occurs alongside other mental health conditions, such as anxiety and depression, says Deena Manion, a doctor of psychology, licensed psychotherapist and executive director and chief clinical officer of Westwind Recovery in Los Angeles.
“Estimates suggest that approximately half of all people who have a mental disorder will also have a substance use disorder at some point during their life. So, if you notice yourself or your loved one struggling with mental health issues, they might also be struggling with substances.”
[See: Ways Alcohol Affects the Aging Process.]
Dependency vs. Addiction
While addiction and dependency can go hand-in-hand and the terms are often used interchangeably, they’re actually two separate things.
“Addiction is a disease characterized by behavioral issues,” Manion explains, while “dependence refers to a physical reliance on a substance.”
With dependence, something in the brain or body has changed; the body has adapted to the substance and needs it to continue functioning. Removing the substance leads to withdrawal because the body has become reliant on that substance. Those symptoms can be both physical and psychological, such as feelings of anxiety at the mere suggestion of going without the substance.
“The two conditions often occur at the same time, but a person can be dependent on a substance without being addicted to it,” Manion adds. Dependence often means that addiction is soon to follow, but it doesn’t always.
“Physiologic dependence is an adaptive process that happens when our brains become used to something we are putting into our bodies on a regular basis. This happens to us all and is not the same thing as addiction,” says Dr. Orman Trent Hall, a board-certified addictionologist and addiction researcher at the Ohio State University Wexner Medical Center.
For example, you might feel unwell if you forget to take a prescribed medication before you go to work in the morning, but that doesn’t mean you’re addicted to that medication.
Addiction occurs when something you do — such as smoking or watching pornography — starts feeling out of control and you have trouble stopping, even after you realize it’s harming you.
[READ: How Yoga and Exercise Help With Addiction Recovery.]
How Is Substance Use Disorder Diagnosed?
Substance misuse and addictive behaviors are diagnosed by qualified clinicians using criteria from the most up-to-date edition of the Diagnostic and Statistical Manual of Mental Disorders, the primary diagnostic manual that describes recognized mental illnesses and their signs and symptoms.
DSM-5-TR Criteria for Substance Use Disorders
The latest edition, the DSM-5-TR, lists 11 specific criteria to diagnose substance use disorders:
— Using the substance in larger amounts or for a longer time than originally intended
— Being unable to cut down or stop using the substance, even if you want to
— Spending a lot of time obtaining, using and recovering from the effects of the substance
— Experiencing intense urges or desires to use the substance, known as cravings
— Failing to fulfill obligations at home, work or school due to substance use
— Continuing substance use even though it causes or worsens social or interpersonal problems
— Giving up social, recreational or occupational activities due to substance use and withdrawing from family or friends to use the substance
— Using the substance in dangerous situations, such as while driving or operating machinery
— Continuing substance use even though you know there’s a physical or psychological problem that’s probably caused or worsened by substance use
— Needing to use more of the substance to experience previous effects, also known as tolerance
— Experiencing unpleasant or uncomfortable symptoms if they try to stop using, which is known as withdrawal
“If someone has two of these criteria, they can be diagnosed with a substance use disorder,” says Dr. Natalie Klag, an assistant professor in the department of psychiatry and behavioral health at the Ohio State University Wexner Medical Center in Columbus. “The severity of that disorder depends on the total number of criteria they meet, with greater than six correlating with a severe substance use disorder.”
In addition to the DSM-5 criteria, other tools have been developed to assess substance use disorders, says Robert Cuyler, a clinical psychologist and chief clinical officer of Freespira Inc., a Kirkland, Washington-based company that offers at-home behavioral health treatment for PTSD and panic disorder symptoms.
For example, a simple series of questions called the CAGE questions can be used to assess a loved one’s or your own patterns of behavior around alcohol use:
— C: Do you feel a need to cut down on drinking?
— A: Are you annoyed about criticism of your drinking?
— G: Do you feel guilty about your drinking?
— E: Do you feel the need for an eye-opener to deal with a hangover?
When to Seek Help for Substance Misuse
If you or a loved one notices signs of substance use disorder, it’s important to contact a trained professional for advice and support.
“Only qualified health professionals such as medical doctors, psychiatrists or other licensed and appropriately qualified mental health professionals can diagnose substance use disorders,” Manion says.
And getting a proper diagnosis is important, as that will dictate the best course of treatment.
Where to Find Help for Substance Misuse
Different substances have different life impacts. With that, “a professional evaluation by a health professional, particularly one with substantial experience, is vital,” Cuyler says. “But, a family physician is always a good starting place.”
There are many resources available for individuals looking for support in dealing with substance use disorder, including:
— Substance Abuse and Mental Health Services Administration
— National Institute on Drug Abuse
— Your primary care provider
— Local public health authorities
If you or a loved one is in crisis, call the 988 Suicide and Crisis Lifeline for support.
How Is Substance Use Disorder Treated?
While recovery from substance use disorder isn’t easy — and there’s no quick fix — it can be managed. It’s possible to live a happy, productive life after addiction.
“Even during the darkest moments in our lives, people are much greater than any health condition they might have. Treatment works. People recover,” Hall says.
But it may take some time and trial and error. “There is no one-size-fits-all approach to treatment. Most people benefit from some combination of available resources,” Klag adds.
Campbell notes that “research has demonstrated that the best recovery outcomes arise from an integrated and multidisciplinary approach that includes aspects of behavioral and clinical therapy, medication options, skills training, trauma-informed and evidence-based practices, as well as community and peer support.”
Depending on the specifics of the case, treatment options may include:
— Detox
— Enrollment in a treatment program
— Support groups
— Therapy
— Medication
Detox
Detox is typically the first step toward breaking the cycle of substance use. This process, which can be very uncomfortable or even painful, sometimes takes place at a treatment facility while under the supervision of medical professionals and addiction specialists.
Detoxing from alcohol or drugs may trigger a range of unpleasant symptoms including:
— Nausea and vomiting
— Body aches
— Tremors and convulsions
— Disorientation
— Sweating
— Racing heart rate or palpitations
— Anxiety
— Headaches
— Disrupted sleep
In severe cases, it’s usually best to start treatment under the supervision of a health care professional, as the withdrawal symptoms can be dangerous in some instances and could include an increased risk of heart attack or stroke.
Enrollment in a treatment program
This can take place at a residential facility, sometimes called a rehab facility, where the person lives for a period of time to work through the issues related to the substance use disorder.
Many treatment facilities use a 30-day treatment period for inpatient treatment, but depending on the severity of the situation, a 60- or 90-day stay or a longer-term option may be indicated.
Such programs typically feature a multipronged approach to treating and managing the addiction, which can include:
— One-on-one counseling or behavioral therapy
— Medication
At the conclusion of the treatment period, the person may be encouraged to follow up with additional support and ongoing therapy indefinitely.
Treatment can also sometimes be delivered as outpatient care from the start, where the person lives at home but travels regularly to a treatment center for sessions and support.
Support groups
Groups such as Alcoholics Anonymous, or AA, and Narcotics Anonymous are widely available and have a lengthy history of helping people who are dealing with substance use disorder. These types of support groups often use the 12-step process developed by AA that helps people work through several phases of recovery one step at a time.
For family members and loved ones of the person with the addiction, there are also many support groups available, including:
— Al-Anon
— Gam-Anon
— Nar-Anon
— National Association for Children of Alcoholics
“While addiction thrives in isolation, recovery thrives in community,” says Melissa Johnson, a licensed clinical social worker who specializes in severe and persistent mental illness, homelessness and addiction with Victory Starts Now, a Los Angeles-based nonprofit that supports previously incarcerated people and others affected by the justice system. “Having support is one of the biggest factors in long-term recovery from any kind of diagnosis.”
Therapy
“All substance use disorders benefit from treatment with therapy, both individual and group therapy,” Klag says.
Because substance use disorder and mental health issues often occur together, therapy can help the individual gain a better understanding of why they are using this substance or engaging in this problematic behavior and develop coping strategies and tools to change their patterns.
In addition, “many people have significant trauma in their lives, and trauma-informed psychotherapy can be a critical part of a successful treatment plan,” Cuyler points out.
Medication
For some types of substance use disorders or behavioral health issues, medication can help keep the person from falling back into their old patterns of use or behaviors that could damage their health.
For example, for people with opioid use disorder, two medications — buprenorphine and methadone — have been proven to lower the risk of dying from overdose or serious medical complications, Hall says.
“Another medication, called naltrexone, has helped many people recover from OUD but has not been shown to reduce risk of dying from this condition.”
Cuyler notes there are several medications approved for use to treat alcohol use disorder, and there also been some promising research showing that GLP-1 weight loss drugs may impact of a wide range of addictive disorders spanning alcohol, nicotine and opioid use.
However, “there has been no ‘magic bullet’ for addiction treatment, so continuing research, openness to innovation, and focus on individualization of approaches is our best strategy,” he says.
How to Help a Loved One With a Substance Use Disorder
Loving someone who has a substance use disorder can be challenging. “A person may keep using substances even though it hurts their friendships and family relationships,” Manion says. It’s not because they don’t care about loved ones, she adds, “but because their brain has changed due to the addiction.”
If you suspect a loved one is struggling with substance misuse, Campbell adds, “I recommend a calm, compassionate conversation that avoids shame and blame, and instead focuses on concern, support and a willingness to help them with seeking professional assistance.”
But ultimately, it’s up to the individual with the disorder to seek help and do the work of recovering; you can’t force someone into sobriety. However, there are several things you can do to support a loved one going through this process:
— Educate yourself about addiction.
— Express hope that change is possible.
— Maintain your commitment to loving and encouraging them.
— Maintain healthy boundaries.
— Realize that the person can’t stop using without help.
— Research treatment facilities and discuss treatment options.
— Present your loved one with options.
— Consider a professional intervention if they are unwilling to get the help they need.
— Understand that relapses are common and don’t have to be the end of the journey toward sobriety.
You also need to make sure you’re looking after yourself too. Hall says there are resources out there that can help support family members of people with addiction. “Connecting with others and taking care of your own physical and emotional health is the best way to support your loved one’s recovery.”
Lastly, Klag notes that substance use disorders are tough. “It often takes people multiple attempts at treatment to find what works for them.” But remember, she says, “this is a treatable, chronic medical illness. It is not a moral failing. It is important to know that there is hope, and there are people who want to help you achieve the life you want.”
More from U.S. News
Migraine Hacks and Remedies for Fast Relief
Mood Swings: Recognize Symptoms and Explore Potential Causes
13 Signs and Symptoms of a Medical Emergency
The Warning Signs of Addiction, Alcoholism and Substance Misuse originally appeared on usnews.com
Update 01/14/26: This story was published at an earlier date and has been updated with new information.
Correction 10/31/22: A previous version of this story misidentified the American Psychiatric Association.