Diseases and Conditions

Drug addiction (substance use disorder)

Symptoms

Drug addiction symptoms or behaviors include, among others:

  • Feeling that you have to use the drug regularly — daily or even several times a day
  • Having intense urges for the drug that block out any other thoughts
  • Over time, needing more of the drug to get the same effect
  • Taking larger amounts of the drug over a longer period of time than you intended
  • Making certain that you maintain a supply of the drug
  • Spending money on the drug, even though you can't afford it
  • Not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use
  • Continuing to use the drug, even though you know it's causing problems in your life or causing you physical or psychological harm
  • Doing things to get the drug that you normally wouldn't do, such as stealing
  • Driving or doing other risky activities when you're under the influence of the drug
  • Spending a good deal of time getting the drug, using the drug or recovering from the effects of the drug
  • Failing in your attempts to stop using the drug
  • Experiencing withdrawal symptoms when you attempt to stop taking the drug

Recognizing unhealthy drug use in family members

Sometimes it's difficult to distinguish normal teenage moodiness or angst from signs of drug use. Possible indications that your teenager or other family member is using drugs include:

  • Problems at school or work — frequently missing school or work, a sudden disinterest in school activities or work, or a drop in grades or work performance
  • Physical health issues — lack of energy and motivation, weight loss or gain, or red eyes
  • Neglected appearance — lack of interest in clothing, grooming or looks
  • Changes in behavior — exaggerated efforts to bar family members from entering his or her room or being secretive about where he or she goes with friends; or drastic changes in behavior and in relationships with family and friends
  • Money issues — sudden requests for money without a reasonable explanation; or your discovery that money is missing or has been stolen or that items have disappeared from your home, indicating maybe they're being sold to support drug use

Recognizing signs of drug use or intoxication

Signs and symptoms of drug use or intoxication may vary, depending on the type of drug. Below you'll find several examples.

Marijuana, hashish and other cannabis-containing substances

People use cannabis by smoking, eating or inhaling a vaporized form of the drug. Cannabis often precedes or is used along with other substances, such as alcohol or illegal drugs, and is often the first drug tried.

Signs and symptoms of recent use can include:

  • A sense of euphoria or feeling "high"
  • A heightened sense of visual, auditory and taste perception
  • Increased blood pressure and heart rate
  • Red eyes
  • Dry mouth
  • Decreased coordination
  • Difficulty concentrating or remembering
  • Slowed reaction time
  • Anxiety or paranoid thinking
  • Cannabis odor on clothes or yellow fingertips
  • Exaggerated cravings for certain foods at unusual times

Long-term (chronic) use is often associated with:

  • Decreased mental sharpness
  • Poor performance at school or at work
  • Reduced number of friends and interests

K2, Spice and bath salts

Two groups of synthetic drugs — synthetic cannabinoids and substituted or synthetic cathinones — are illegal in most states. The effects of these drugs can be dangerous and unpredictable, as there is no quality control and some ingredients may not be known.

Synthetic cannabinoids, also called K2 or Spice, are sprayed on dried herbs and then smoked, but can be prepared as an herbal tea. Despite manufacturer claims, these are chemical compounds rather than "natural" or harmless products. These drugs can produce a "high" similar to marijuana and have become a popular but dangerous alternative.

Signs and symptoms of recent use can include:

  • A sense of euphoria or feeling "high"
  • Elevated mood
  • An altered sense of visual, auditory and taste perception
  • Extreme anxiety or agitation
  • Paranoia
  • Hallucinations
  • Increased heart rate and blood pressure or heart attack
  • Vomiting
  • Confusion

Substituted cathinones, also called "bath salts," are mind-altering (psychoactive) substances similar to amphetamines such as ecstasy (MDMA) and cocaine. Packages are often labeled as other products to avoid detection.

Despite the name, these are not bath products such as Epsom salts. Substituted cathinones can be eaten, snorted, inhaled or injected and are highly addictive. These drugs can cause severe intoxication, which results in dangerous health effects or even death.

Signs and symptoms of recent use can include:

  • Euphoria
  • Increased sociability
  • Increased energy and agitation
  • Increased sex drive
  • Increased heart rate and blood pressure
  • Problems thinking clearly
  • Loss of muscle control
  • Paranoia
  • Panic attacks
  • Hallucinations
  • Delirium
  • Psychotic and violent behavior

Barbiturates, benzodiazepines and hypnotics

Barbiturates, benzodiazepines and hypnotics are prescription central nervous system depressants. They're often used and misused in search for a sense of relaxation or a desire to "switch off" or forget stress-related thoughts or feelings.

  • Barbiturates. Examples include phenobarbital and secobarbital (Seconal).
  • Benzodiazepines. Examples include sedatives, such as diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin) and chlordiazepoxide (Librium).
  • Hypnotics. Examples include prescription sleeping medications such as zolpidem (Ambien, Intermezzo, others) and zaleplon (Sonata).

Signs and symptoms of recent use can include:

  • Drowsiness
  • Slurred speech
  • Lack of coordination
  • Irritability or changes in mood
  • Problems concentrating or thinking clearly
  • Memory problems
  • Involuntary eye movements
  • Lack of inhibition
  • Slowed breathing and reduced blood pressure
  • Falls or accidents
  • Dizziness

Meth, cocaine and other stimulants

Stimulants include amphetamines, meth (methamphetamine), cocaine, methylphenidate (Ritalin, Concerta, others) and amphetamine-dextroamphetamine (Adderall, Adderall XR, others). They are often used and misused in search of a "high," or to boost energy, to improve performance at work or school, or to lose weight or control appetite.

Signs and symptoms of recent use can include:

  • Feeling of exhilaration and excess confidence
  • Increased alertness
  • Increased energy and restlessness
  • Behavior changes or aggression
  • Rapid or rambling speech
  • Dilated pupils
  • Confusion, delusions and hallucinations
  • Irritability, anxiety or paranoia
  • Changes in heart rate, blood pressure and body temperature
  • Nausea or vomiting with weight loss
  • Impaired judgment
  • Nasal congestion and damage to the mucous membrane of the nose (if snorting drugs)
  • Mouth sores, gum disease and tooth decay from smoking drugs ("meth mouth")
  • Insomnia
  • Depression as the drug wears off

Club drugs

Club drugs are commonly used at clubs, concerts and parties. Examples include ecstasy or molly (MDMA), gamma-hydroxybutyric acid (GHB), flunitrazepam (Rohypnol ? a brand used outside the U.S. ? also called roofie) and ketamine. These drugs are not all in the same category, but they share some similar effects and dangers, including long-term harmful effects.

Because GHB and flunitrazepam can cause sedation, muscle relaxation, confusion and memory loss, the potential for sexual misconduct or sexual assault is associated with the use of these drugs.

Signs and symptoms of use of club drugs can include:

  • Hallucinations
  • Paranoia
  • Dilated pupils
  • Chills and sweating
  • Involuntary shaking (tremors)
  • Behavior changes
  • Muscle cramping and teeth clenching
  • Muscle relaxation, poor coordination or problems moving
  • Reduced inhibitions
  • Heightened or altered sense of sight, sound and taste
  • Poor judgment
  • Memory problems or loss of memory
  • Reduced consciousness
  • Increased or decreased heart rate and blood pressure

Hallucinogens

Use of hallucinogens can produce different signs and symptoms, depending on the drug. The most common hallucinogens are lysergic acid diethylamide (LSD) and phencyclidine (PCP).

LSD use may cause:

  • Hallucinations
  • Greatly reduced perception of reality, for example, interpreting input from one of your senses as another, such as hearing colors
  • Impulsive behavior
  • Rapid shifts in emotions
  • Permanent mental changes in perception
  • Rapid heart rate and high blood pressure
  • Tremors
  • Flashbacks, a re-experience of the hallucinations — even years later

PCP use may cause:

  • A feeling of being separated from your body and surroundings
  • Hallucinations
  • Problems with coordination and movement
  • Aggressive, possibly violent behavior
  • Involuntary eye movements
  • Lack of pain sensation
  • Increase in blood pressure and heart rate
  • Problems with thinking and memory
  • Problems speaking
  • Impaired judgment
  • Intolerance to loud noise
  • Sometimes seizures or coma

Inhalants

Signs and symptoms of inhalant use vary, depending on the substance. Some commonly inhaled substances include glue, paint thinners, correction fluid, felt tip marker fluid, gasoline, cleaning fluids and household aerosol products. Due to the toxic nature of these substances, users may develop brain damage or sudden death.

Signs and symptoms of use can include:

  • Possessing an inhalant substance without a reasonable explanation
  • Brief euphoria or intoxication
  • Decreased inhibition
  • Combativeness or belligerence
  • Dizziness
  • Nausea or vomiting
  • Involuntary eye movements
  • Appearing intoxicated with slurred speech, slow movements and poor coordination
  • Irregular heartbeats
  • Tremors
  • Lingering odor of inhalant material
  • Rash around the nose and mouth

Opioid painkillers

Opioids are narcotic, painkilling drugs produced from opium or made synthetically. This class of drugs includes, among others, heroin, morphine, codeine, methadone and oxycodone.

Sometimes called the "opioid epidemic," addiction to opioid prescription pain medications has reached an alarming rate across the United States. Some people who've been using opioids over a long period of time may need physician-prescribed temporary or long-term drug substitution during treatment.

Signs and symptoms of narcotic use and dependence can include:

  • Reduced sense of pain
  • Agitation, drowsiness or sedation
  • Slurred speech
  • Problems with attention and memory
  • Constricted pupils
  • Lack of awareness or inattention to surrounding people and things
  • Problems with coordination
  • Depression
  • Confusion
  • Constipation
  • Runny nose or nose sores (if snorting drugs)
  • Needle marks (if injecting drugs)

When to see a doctor

If your drug use is out of control or causing problems, get help. The sooner you seek help, the greater your chances for a long-term recovery. Talk with your primary doctor or see a mental health professional, such as a doctor who specializes in addiction medicine or addiction psychiatry, or a licensed alcohol and drug counselor.

Make an appointment to see a doctor if:

  • You can't stop using a drug
  • You continue using the drug despite the harm it causes
  • Your drug use has led to unsafe behavior, such as sharing needles or unprotected sex
  • You think you may be having withdrawal symptoms after stopping drug use

If you're not ready to approach a doctor, help lines or hotlines may be a good place to learn about treatment. You can find these lines listed on the internet or in the phone book.

When to seek emergency help

Seek emergency help if you or someone you know has taken a drug and:

  • May have overdosed
  • Shows changes in consciousness
  • Has trouble breathing
  • Has seizures or convulsions
  • Has signs of a possible heart attack, such as chest pain or pressure
  • Has any other troublesome physical or psychological reaction to use of the drug

Staging an intervention

People struggling with addiction usually deny that their drug use is problematic and are reluctant to seek treatment. An intervention presents a loved one with a structured opportunity to make changes before things get even worse and can motivate someone to seek or accept help.

An intervention should be carefully planned and may be done by family and friends in consultation with a doctor or professional such as a licensed alcohol and drug counselor, or directed by an intervention professional. It involves family and friends and sometimes co-workers, clergy or others who care about the person struggling with addiction.

During the intervention, these people gather together to have a direct, heart-to-heart conversation with the person about the consequences of addiction and ask him or her to accept treatment.