How to Tell if Someone is Addicted to Drugs or Alcohol

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Countless people worldwide struggle with drug and alcohol addiction, a chronic condition characterized by compulsive substance use regardless of adverse consequences. It can be difficult to tell when someone you love has a substance addiction, but there are many common signs and symptoms to be on the lookout for—including changes in behavior and appearance. If you can learn to recognize these signs and symptoms of addiction, you will be better able to help a family member, friend, or colleague who needs treatment.

Below we will discuss how to tell if someone is addicted to drugs or alcohol so that you can become empowered to help them.

What are the Warning Signs of Addiction?

It can be challenging to discern if someone you love is experiencing an addiction to drugs or alcohol, but in many cases, some warning signs and symptoms can help you identify if someone needs help. Keep in mind that these signs can vary greatly based on the individual and the substance. Signs that someone is addicted to drugs or alcohol can be mental, physical, and behavioral.

Mental Signs

Substance abuse can negatively affect your loved one’s mental health, either by exacerbating existing mental health conditions or by causing new psychiatric symptoms. Some common mental or psychological signs of addiction include:1,2

  • Sudden mood swings
  • Angry outbursts
  • Atypical hyperactivity
  • Lack of focus
  • Irritability or agitation
  • Paranoia
  • Anxiety
  • Lack of motivation
  • Lethargy
  • Loss of interest in things that a person once enjoyed
  • Intense euphoria followed by a crash
  • Hallucinations
  • Depression

Physical Signs

The physical signs of substance abuse and addiction may vary depending on the drug and how your loved one is using it (e.g. snorting, injecting, or smoking). For example, someone using heroin may have track lines on their arms and have flu-like symptoms (due to withdrawal), whereas someone using marijuana might have red, glassy eyes.1,3

The physical signs of drug and alcohol addiction may include:1,2,3

  • Poor personal hygiene and grooming
  • Poor dental hygiene
  • Changes in skin tone and appearance
  • Track marks, scars, or abscesses from injecting drugs
  • Bruising in the same places over and over again
  • Hair loss
  • Sudden weight loss or gain
  • Extreme fatigue or inability to sleep
  • Falling asleep at unusual times of day
  • Blood-shot eyes
  • Dilated or constricted pupils
  • Loss of coordination
  • Slurred speech
  • Rashes around mouth or nose (from inhalant use)
  • Strange odors on a person’s clothes or breath
  • Tremors
  • Flu-like symptoms (for withdrawal from heroin and prescription opioids)
  • Seizures (for withdrawal from alcohol or benzodiazepines like Xanax)
  • Extremely slowed movements or rapid, purposeless movements (for withdrawal from stimulants)

Behavioral Signs

Just as your loved one’s physical appearance and psychological health may change, you may notice some behavioral changes due to substance abuse and addiction. The behavioral signs of drug or alcohol addiction may include:1,2,3

  • Changing friends and hobbies
  • Avoiding close family and friends
  • Decreased performance or attendance at work in school
  • Financial or legal issues
  • Lying or being deceptive
  • Neglecting responsibility
  • Needing to borrow money frequently
  • Aggressive or violent behavior
  • Sexual dysfunction
  • Loss of inhibitions

What are the Risk Factors for Addiction?

Many factors, including genes and environment, can influence whether a person develops a drug or alcohol addiction. Some of these factors are well-known and others are still being studied. The question of what causes a person to turn to drugs or alcohol in the first place is a complex one with many variables that depend on the individual. But regardless, not everyone who uses substances develops an addiction. Certain risk factors increase the likelihood of drug use progressing to a substance use disorder. For example, early drug exposure is a major risk factor in the development of drug and alcohol addiction. So is smoking or injecting a drug, as opposed to taking a pill.4

The risk factors for developing a drug or alcohol addiction may include:1,4

  • Lack of parental supervision
  • Parents who abuse drugs or alcohol
  • Community poverty
  • Drug availability at school
  • Inability to refuse peers who offer substances
  • Aggressive childhood behavior
  • Academic problems
  • Poor social skills
  • Childhood trauma, such as neglect or abuse
  • Mental health conditions, such as anxiety or depression

Is There a Genetic Component to Drug and Alcohol Addiction?

Yes, genes do play a role in the risk of developing a drug addiction. But genes are only part of the equation and do not necessarily determine if someone will become addicted or not. It is estimated that genes, as well as how the environment affects someone’s genes, accounts for 40% to 60% of an individual’s risk of a substance use disorder.4 That said, genes aren’t destiny; many other factors, such as school, family, trauma, and community affect whether someone develops an addiction or not.

How Can I Help My Loved One?

Drug and alcohol addiction is a complex condition that often requires professional treatment. If you suspect someone you care about has an addiction, early diagnosis and treatment can help save a life. While it may seem overwhelming, and you may not know where to start, there are many options for substance abuse treatment. Addiction treatment is offered in multiple settings through multiple approaches, including:5

  • Inpatient or residential programs: Your loved one resides at the facility for the duration of the program, receiving therapy, counseling, individualized treatment planning, and more.
  • Standard outpatient treatment: Your loved one lives at home while attending scheduled therapy at a clinic.
  • PHPs and IOPs: Partial hospitalization and intensive outpatient programs require a larger time commitment than standard outpatient programs, often meeting for several hours per day.

Although not a substitute for addiction treatment, your loved one may need professional detox before attending a treatment program. Detox can help keep them safe and comfortable while they go through withdrawal, which can be particularly distressing and even dangerous if they are addicted to alcohol, benzodiazepines, or opioids.3

Now that you understand the signs of drug and alcohol addiction, you’re better equipped to help a loved one seek treatment. If you or someone you know is struggling with drug or alcohol addiction, call 800-681-1058 (Info iconWho Answers?) now.


  1. Robinson, L. (2021, April 19). Drug Abuse and Addiction. HelpGuide.
  2. Positive Choices. (2021, May 14). How can I tell if someone is using drugs?
  3. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
  4. National Institute on Drug Abuse. (2020, July). Drug Abuse and Addiction.
  5. National Institute on Drug Abuse. (2019, January). Treatment Approaches for Drug Addiction DrugFacts.
Rachel Nader, RN
Rachael Nayder, BSN
Registered Nurse, Health & Wellness Writer
Rachael has been a registered nurse since 2010. Graduating from Ursuline College, she completed a twelve-week long intensive in mental health and caring for the patient population. As part of this experience, she gained knowledge surrounding issues related to substance abuse, recognizing the presence of addictions and mental health patterns, and the emotional/spiritual help that can act as a guidi