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Signs Somebody Needs Substance Abuse Help (& Next Steps)

Young Woman With Schizophrenia

The signs of addiction are not always easy to detect, even for professionals trained in substance abuse treatment. Addiction is characterized by strong elements of deceit and denial, and people who abuse drugs or alcohol can become very adept at hiding the evidence of substance abuse. At the same time, family members and friends may deny that a problem exists because they are afraid of facing the truth about their loved one, or because they worry that if they confront the individual about the problem, the person will get angry or the behavior will become worse.

In reality, reaching out to someone who needs addiction treatment can make a positive difference in the course of the disease. Statistics on drug and alcohol abuse indicate that intervening on behalf of someone you care about could even save that person’s life:

  • According to the Centers for Disease Control and Prevention, 10 percent of deaths among Americans age 20-64 are caused by alcohol abuse.
  • The individuals who died could have lived 30 years or more if they had been able to stop drinking and abstain from alcohol.
  • The International Journal of Environmental Research and Public Health cites studies showing a strong link between alcohol abuse and suicide; in particular, heavy drinkers are five times more likely to commit suicide than people who drink socially.
  • The American Society of Addiction Medicine (ASAM) states that drug overdoses, mostly from opioids like heroin or prescription painkillers, caused over 100 deaths per day in 2013.
  • Heroin overdoses alone are responsible for over 8,000 deaths in the US each year, according to ASAM.

A person who is addicted to alcohol or drugs may not be physically or psychologically capable of taking the first steps to enter rehab. Addiction can interfere with judgment and decrease motivation, making it difficult to make healthy, life-affirming choices. Until the individual has been through detox and is no longer under the influence of intoxicants, a loved one may need to make decisions on the person’s behalf.

Physical Signs and Symptoms to Watch For

Drugs affect the body in different ways, depending on their chemical properties and the individual’s response to the substance. Listed below are a few of the most common physical symptoms caused by the major substances of abuse:

  • Alcohol: As a central nervous system depressant, alcohol has a sedating effect on the mind and body. People who are abusing alcohol have frequent episodes of drowsiness, confusion, slurred speech, slow reflexes, and loss of coordination. They may gain weight due to excessive alcohol consumption, and their faces may take on a puffy or flushed appearance. Alcohol abuse can cause sleep disturbances, leading to insomnia or sleeping for long periods of time. When people with alcohol addiction stop drinking, even for a few hours, they will start to show symptoms of withdrawal, including tremors, anxiety, irritability, nausea, or fatigue. Heavy, long-time drinkers can experience seizures, convulsions, sudden spikes in blood pressure, fever, and hallucinations — a condition called delirium tremens, or DTs — if they suddenly stop drinking.
  • Opioids: Drugs in the opioid family include prescription pain relievers like oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and methadone, as well as street drugs like heroin, that reproduce the chemical effects of opium. Opium is an analgesic compound that is produced naturally by the opium poppy. It is also a powerful and addictive depressant that can suppress the body’s vital functions, including respiration, heart rate, and metabolism. Physical symptoms of opioid addiction include drowsiness, sleeping for long periods of time, shallow breathing, slow heart rate, pallor, constipation, and other gastrointestinal problems. Withdrawal from opioids can cause flulike symptoms, such as a runny nose, muscle aches, cold sweats, nausea, vomiting, diarrhea, and shaking. Between 2000 and 2010, the number of prescriptions written for opioid pain medications in the US increased by over 104 percent, according to Regional Anesthesia and Pain Medicine, making these drugs more widely available and increasing the risk of opioid abuse and addiction.
  • Marijuana: Cannabis, or marijuana, has become one of the most popular drugs of abuse in the US, and legalization of this drug in certain states has made its use even more widespread. Physical symptoms of marijuana use will vary depending on how the drug is abused. People who smoke the drug frequently have reddened eyes and a cough, while those who consume marijuana in food products, known as edibles, will not have these symptoms. Marijuana in any form can cause an increase in appetite, slow reflexes, slow speech, and shallow breathing. There has been some controversy over whether marijuana is addictive, but according to WebMD, long-term users may experience withdrawal symptoms, such as insomnia, irritability, anxiety, or agitation, when they try to stop.
  • StimulantsThis category includes drugs that speed up the activities of the brain and nerves, such as cocaine, methamphetamine, amphetamines, ecstasy, and many other club drugs. The immediate physical signs of stimulant abuse include dilated pupils, a rapid heart rate, high blood pressure, and an elevated temperature. Over time, a person who is addicted to meth, cocaine, or ecstasy will have periods of extreme fatigue and depression alternating with episodes of high energy and rapid speech. The effects of stimulants on metabolism can cause weight loss and muscle wasting. Chest pain, tooth loss, and skin problems may also occur. Dental problems and scattered sores are common in heavy meth users.

In general, people who abuse drugs and alcohol acquire an unhealthy appearance. They often suffer from loss of appetite, loss of sleep, and lack of fluids. They may wear clothing that hides the evidence of drug use, such as needle marks, sores, bruises, and excessive weight loss. Dark glasses can conceal pinpoint pupils or large, dilated pupils. Over time, self-neglect will lead to serious health conditions, such as liver disease, heart problems, kidney failure, cancer, or digestive problems.

Changes in Behavior and Personality

The physical signs of addiction may point to a serious problem, but they are rarely the only signs that a person needs help. Drugs and alcohol can change every aspect of an individual’s appearance, behavior, personality, and general outlook on life. They can also cause noticeable impairment in a person’s ability to do work, perform at school, or participate in social activities.

Drugs and alcohol alter the way an individual thinks and feels. Substance abuse can affect a person’s judgment, making the person take dangerous risks or choose self-destructive habits over healthy activities. An individual whose outlook on life was once optimistic and positive may become depressed, hopeless, and even suicidal. Severe depression, angry outbursts, delusional beliefs, and suicidal thoughts are signs that the individual urgently needs professional help.

Some of the most common behavioral and psychological changes caused by substance abuse include:

  • Frequent, unexplained mood swings
  • Unusual secrecy
  • Isolation from others
  • A decline in grooming and hygiene
  • Withdrawal from friends and social activities
  • Unusual dishonesty (stealing, lying, hiding the truth from others, etc.)
  • Unexplained accidents or injuries
  • Unusual acts of aggression or violence
  • Thoughts of self-harm or suicide
  • Paranoid thoughts or delusional beliefs
How to Intervene When a Loved One Is Addicted

signs-somebody-is-abusingWhen a loved one needs substance abuse treatment, that person will probably be the last one to admit it. Waiting for a loved one to be ready for rehab could put that person at risk of overdose, self-harm, or serious drug-related health problems. While an honest, straightforward discussion of addiction may help to open up the possibility of treatment, it may not be enough to get the individual into rehab. An intervention may be what it takes to persuade a friend or family member to seek help.

At an intervention, relatives, friends, coworkers, and other concerned parties gather to confront the addicted person about the substance abuse. A therapist or professional intervention specialist may be involved to help organize the meeting for optimal outcomes. Interventions are prearranged and rehearsed, but the subject of the meeting is usually not informed ahead of time. This element of surprise helps to overcome denial and keeps the individual from avoiding the confrontation.

As part of the intervention, the individual is usually presented with a treatment plan, which the person has the choice to accept. However, there are consequences to refusing treatment, such as losing custody of children, facing the end of a relationship, or being denied certain privileges in the home.

Whether you decide to approach your loved one individually, or hold an organized intervention, it is important to be as objective and nonjudgmental as possible. In spite of the emotional pain, financial problems, and legal difficulties that addiction can cause, it is crucial to remember that these are the effects of a chronic, progressive disease. With the help of a comprehensive recovery plan that includes detox, rehab, and aftercare, it is possible for the person to overcome substance abuse and achieve health and balance in life.

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