Signs and Symptoms of Addiction (Physical and Mental)

What is Addiction?

Addiction is a chronic disease characterized by continually engaging in a certain behavior despite it causing significant impairment in the person’s life. While this can involve behaviors like gambling, shopping, or sex, addiction is most understood in terms of substance use that fundamentally changes how dopamine and other neurotransmitters associated with the reward system are managed in the brain. Behavioral characteristics of addiction involve an inability to control behaviors, cravings and withdrawal symptoms, and physical side effects, including damage to major organ systems.

Signs of Drug or Alcohol Addiction

Signs of drug use include intoxication, hangover, and paraphernalia related to substance use.

Only a doctor or mental healthcare provider can diagnose a substance use disorder, the clinical term for addiction. They use the criteria in the Statistical and Diagnostic Manual of Mental Disorders, 5th Edition (DSM-5) to assess the probability and severity of a substance use disorder. It may be helpful to know the criteria to assess if your substance use or that of a loved one has become problematic. The criteria healthcare professionals use include:¹

• Taking the substance for long periods of time or in larger amounts than intended.
• Being unable to cut down or stop substance use.
• Spending a lot of time obtaining, using, and recovering from the effects of the substance.
• Experiencing cravings, or intense desires or urges for the substance.
• Failing to fulfill obligations at home, work, or school due to substance use.
• Continuing substance use despite having interpersonal or social problems that are caused or worsened by substance use.
• Giving up social, recreational, or occupational activities due to substance use.
• Performing risky behaviors while intoxicated.
• Continuing substance use despite having a physical or mental problem that is probably due to substance use.
• Developing tolerance, so it’s necessary to take more to feel the original euphoria or the same amount no longer
• Experiencing withdrawal symptoms when substance use stops.

While the signs of addiction are the same for all substances, the signs of use, which can include misuse, may differ by substance.

Alcohol

For individuals aged 21 and older, alcohol is a legal intoxicating substance in the United States. In 2023, nearly 29 million people aged 12 or older had an alcohol use disorder.²

Signs that a person may be struggling with alcohol misuse include:

• Being drunk on a regular basis, evident by slurred speech, loss of coordination, impaired attention and memory, and poor decision-making.
• Drinking beyond moderation on a regular basis. Moderate drinking is defined as 2 drinks per day for men and 1 drink per day for women.³
• Feeling sick after drinking and using alcohol to ease the symptoms.
• Drinking alone, in the mornings, or giving up other activities specifically to drink.
• Taking risks or participating in risky behaviors, like driving drunk.
• Drinking in secret.
• Changes in appearance as health declines.
• Choosing to drink rather than eat meals.
• Experiencing behavioral changes when drunk versus when sober.
• Blacking out frequently due to drinking too much.
• Experiencing health issues, including memory problems, stomach upset, heart and blood pressure problems, and damage to the liver and kidneys as a result of drinking.
• Experiencing mental health problems, including anxiety, depression, or insomnia.
• Being unable to stop drinking.

Marijuana

Symptoms of marijuana intoxication include:

• Sleepiness, relaxation, mild euphoria, hunger (“the munchies”), pain relief, loss of coordination, depression, or anxiety or paranoia.
• Decreased short-term memory, dry mouth, red eyes, impaired perception, and cravings.
• Anxiety or psychosis triggered by use.
• Lung infections, if smoked; digestive issues, if consumed.
• A constant need for marijuana to feel normal or good.
• Experiencing withdrawal symptoms, including nightmares, insomnia, nausea, disinterest in food, or depression if marijuana use stops.
• Neglecting financial obligations in order to buy marijuana.
• Forgoing or quitting social obligations, work, or school to use marijuana.

Opioids

Opioids include illicit substances like heroin and prescription painkillers such as hydrocodone (Vicodin, Lortab, Norco, Zohydro), oxycodone (OxyContin, Percocet, Oxycocet, Tylox), fentanyl, codeine, and tramadol.

Signs of opioid misuse include:

• Experiencing drowsiness, euphoria, depression, constipation, pinpoint pupils, confusion, delirium, changes in appetite, and depressed breathing.
• Experiencing withdrawal symptoms, many of which manifest as severe flu symptoms, when opioid use stops.
• Escalating use, or changing how the drug is taken (e.g., taking the drug orally initially but then crushing and snorting the pills to get a more rapid effect).
• Running out of prescriptions early, doctor shopping to get multiple prescriptions, stealing money to buy more opioids, or purchasing them on the black market.
• Experiencing pain and feeling the need to take more of the drug to alleviate the pain.
• Prioritizing opioid use over work, school, friends, and family.
• Suffering an overdose.

Heroin

Heroin, as previously mentioned, is an opioid drug and a Schedule I substance, according to the Drug Enforcement Administration (DEA), because it has a high potential for misuse and offers no medical benefit.

Heroin is typically injected into a vein—although it can be snorted—and has a very rapid onset, usually taking effect within 5-15 minutes. The pleasurable effects do not last long, and effects begin within an hour after the drug is injected.

Signs of heroin use include:

• Possessing paraphernalia like needles, tubing, used spoons, and lighters.
• Lacking the ability to stop taking heroin, even if you want to stop.
• Experiencing euphoria followed by reduced consciousness or “nodding,” a condition characterized by slipping in and out of consciousness.
• Getting infections from sharing needles, including hepatitis, HIV, bacterial blood infections, myocardial infarctions, pneumonia, tuberculosis, skin diseases, and liver and kidney disease.

Benzodiazepines

Benzodiazepines like Klonopin, Xanax, or Valium, are sometimes misused alone or in combination with other substances.

Signs of benzodiazepine misuse include:

• Exhibiting a loss of coordination, slurred speech, reduced inhibitions, memory loss, and blurred or double vision
• Experiencing confusion and cognitive impairment.
• Feeling physically weak.
• Experiencing withdrawal symptoms such as anxiety, paranoia, panic attacks, and insomnia when benzo use stops.
• Having changes in appetite and weight.
• Experiencing headaches.
• Having trouble breathing.
• Coma.

Methamphetamines

Methamphetamines can cause adverse effects, and can be addictive.

Signs of meth misuse include:

• Feeling a sense of well-being, happiness, excitability, and even invincibility that you want to repeat.
• Experiencing delusions, commonly paranoia or feelings of grandeur.
• Having changes in reflexes.
• Feeling depressed when the initial euphoria wears off.
• Experiencing compulsive movements, such as scratching or picking at the skin.
• Being excessively excited or talkative.
• Experiencing aggression, irritability, or mood swings.
• Having a reduced need for sleep and food.
• Experiencing hallucinations.
• Having tremors.
• Getting dry mouth, bad breath, and damage to the teeth and gums.
• Experiencing headache.
• Clenching your jaw.
• Feeling dehydrated.
• Experiencing an elevated body temperature, which can become dangerous.
• “Tweaking,” which can happen after ingesting a large amount of meth and then not sleeping for days. This can lead to cognitive issues.

Cocaine

Cocaine is a potent stimulant and is commonly found as a white powder or as whitish or yellowish rocks called crack cocaine.

Symptoms of intoxication include:

• Dilated pupils.
• Talkativeness and excitability.
• Increased body temperature.
• Raised heart rate and blood pressure, which can lead to a stroke or heart attack.
• Decreased appetite or a desire to sleep.
• Insomnia and restlessness.
• Aggression.
• Paranoia and anxiety.
• Depression or anxiety when coming off the drug or experiencing withdrawal.
• Intense cravings.
• Lying or stealing to get the drug.
• Performing risky behaviors.
• Developing tolerance, so more cocaine is required to experience the same result or the same amount of cocaine no longer produces the desired effects.

Steroids

Steroids increase muscle mass, physical energy, and extroversion; however, these effects can come with consequences, too.

Signs of anabolic steroid misuse may include:

• A rapid increase in muscle mass.
• Changes in body hair, weight, and breast size.
• Increased aggression.
• Manic behavior.
• Hallucinations or delusions.
• Acne.
• Baldness.
• More serious health consequences can include heart attack, stroke, blood clots, liver cancer, infections in the veins or skin around injection site, endocarditis, hepatitis, or HIV.

Get Help to End Drug Addiction

Regardless of the drug, continued substance use can cause serious problems in every aspect of life. Thankfully, with professional help, you can end the cycle of substance use.

If you or a loved one struggle with substance misuse or aggression or if you’re worried that your use or someone else’s use of substances has become problematic, American Addiction Centers (AAC) can help. AAC has treatment centers throughout the country, provide individualized treatment plans, and can help you find lasting recovery.

Call to connect with a knowledgeable and compassionate admissions navigator, who can listen to your needs, answer your questions, explain your options, and help you or your loved one take the first steps to recovery by beginning the admissions process.