Addiction Signs and Symptoms

  • Abrupt changes in work or school attendance, quality of work, work output, grades and discipline
  • Unusual flare-ups or outbreaks of temper
  • Withdrawal from responsibility, family and social groups
  • General changes in overall attitude
  • Deterioration of physical appearance and grooming
  • Wearing of sunglasses at inappropriate times
  • Continual wearing of long-sleeved garments particularly in hot weather or reluctance to wear short-sleeved attire when appropriate
  • Association with known substance abusers
  • Unusual borrowing of money from friends, co-workers or parents
  • Stealing small items from employer, home or school
  • Secretive behavior regarding actions and possessions
  • Poorly concealed attempts to avoid attention and suspicion such as frequent trips to storage rooms, restrooms, basement, etc.
  • Size of pupils - blown out pupils are indicative of stimulant use, such as crack, methamphetamine or cocaine; Pinpoint pupils can be indicative of depressant use, such as heroin or opiates.

Specific to ...


  • Odor on the breath
  • Intoxication
  • Difficulty focusing or glazed appearance of the eyes
  • Uncharacteristically passive behavior; or combative and argumentative behavior
  • Gradual (or sudden in adolescents) deterioration in personal appearance and hygiene
  • Gradual development of dysfunction, especially in job performance or school work
  • Absenteeism (particularly on Mondays)
  • Unexplained bruises and accidents
  • Irritability
  • Flushed skin
  • Loss of memory or blackouts
  • Availability and consumption of alcohol becomes the focus of all social and professional activities
  • Changes in peer-group associations and friendships
  • Impaired interpersonal relationships (troubled marriage, unexplainable termination of deep relationships, alienation from close family members)

Marijuana or Pot

  • Rapid, loud talking and bursts of laughter in early stages of intoxication
  • Sleepy in the later stages
  • Forgetfulness in conversation
  • Inflammation in whites of eyes; pupils unlikely to be dilated
  • Odor similar to burnt rope on clothing or breath
  • Tendency to drive slowly, below the speed limit
  • Distorted sense of time passage, tendency to over-estimate intervals of time intervals
  • Use or possession of paraphernalia, such as roach clips, rolling papers, pipes, bongs, etc.

Note: Marijuana users are difficult to recognize unless they are under the influence of the drug at the time of observation. Casual users may show none of the general symptoms. Marijuana does have a distinct odor, and it may be the same color or a bit greener than tobacco.



Stimulants & Depressants

Stimulants — Cocaine/Crack/Methamphetamines

  • Extremely dilated pupils
  • Dry mouth and nose
  • Bad breath
  • Frequent lip licking and jaw moving
  • Excessive activity, difficulty sitting still
  • Lack of interest in food or sleep
  • Irritable, argumentative and nervous
  • Talkative, but conversation often lacks continuity, rapidly changes subjects
  • Runny nose, cold or chronic sinus/nasal problems, nose bleeds
  • Use or possession of paraphernalia, such as small spoons, razor blades, mirror, little bottles of white powder and plastic, glass or metal straws


  • Lack of facial expression or animation
  • A flat or flaccid appearance
  • Slurred speech

Note: There are few readily apparent symptoms. Abuse may be indicated by activities such as frequent visits to different physicians for prescriptions to treat "nervousness," "anxiety," or "stress," etc.


Narcotics & Inhalants

Narcotics/Prescription Drugs/Opium/Heroin/Codeine/Oxycontin

  • Lethargic, drowsiness
  • Constricted pupils that fail to respond to light
  • Redness and raw nostrils from inhaling heroin in power form
  • Scars or tracks on inner arms or other parts of the body from needle injections
  • Use or possession of paraphernalia, such as syringes or bent spoons, bottle caps, eyedroppers, rubber tubing, cotton and needles
  • Slurred speech

Note: While there may be no readily apparent symptoms of analgesic abuse, it may be indicated by frequent visits to different physicians or dentists for prescriptions to treat pain of non-specific origin. In cases where a patient has chronic pain and abuse of medication is suspected, it may be indicated by the amount of medication and frequency it's taken.

Inhalants — Solvents/Glue/Petrol/Aerosols

  • Substance odor on breath and clothes
  • Runny nose
  • Watering eyes
  • Slurred speech
  • Impaired coordination
  • Nausea, vomiting and diarrhea
  • Slowed breathing
  • Brain damage
  • Poor muscle control
  • Pain in the chest, muscles, and joints
  • Heart trouble
  • Severe depression and fatigue
  • Loss of appetite
  • Bronchial spasm
  • Nosebleeds and sores on mouth
  • Bizarre and reckless behavior
  • Drowsiness or unconsciousness
  • Suffocation and sudden death
  • Presence of bags or rags containing dry plastic cement or other solvents at home, in locker at school or at work
  • Discarded whipped cream cans, spray paint cans or similar chargers (containing nitrous oxide)
  • Small bottles labeled "incense" (containing butyl nitrite)


LSD/Hallucinogens & Ecstasy


  • Extremely dilated pupils
  • Excessive perspiration and body odor
  • Distorted sense of sight, hearing and touch; distorted image of self and time perception
  • Mood and behavior changes, the extent depending on the emotional state of the user and environmental conditions
  • Unpredictable flashback episodes even long after withdrawal
  • Synesthesia, the "seeing" of sounds and the "hearing" of colors
  • Depersonalization, acute anxiety, and acute depression sometimes resulting in suicide

Note: Hallucinogenic drugs, which occur both naturally and in synthetic form, distort or disturb sensory input, sometimes to a great degree. Hallucinogens occur naturally in primarily two forms: (peyote) cactus and psilocybin mushrooms. Several chemical varieties have been synthesized, most notably: LSD, MDA , STP and PCP. Ecstasy

  • Confusion
  • Depression
  • Headaches
  • Dizziness
  • Muscle tension
  • Panic attacks and paranoia
  • Unconscious clenching of the jaw and grinding teeth
  • Possession of pacifiers, lollipops and candy necklaces used to stop jaw clenching
  • Severe anxiety
  • Vomiting or nausea
  • Blurred vision
  • Rapid eye movement
  • Dilated pupils
  • Chills or sweating
  • High body temperature, sweating profusely and dehydration
  • Confusion
  • Trance-like state and transfixed on sites and sounds
  • Very affectionate