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Addiction is a sensitive subject that’s not often openly talked about, causing many people to hesitate to ask for help or acknowledge their disease. And, as someone who cares about them, you may have a suspicion, but don’t know how to tell if someone is using drugs.

You may have a hunch that your child is using drugs when they come home late often, exhibit strange moodiness, or start isolating themselves. Or you may question your spouse’s unusual behavior lately, but aren’t quite sure what it is. However, certain signs indicate a person may need support, and knowing these could potentially save the life of a loved one.

If you’re thinking about confronting a loved one about their drug use, it’s important to know the common signs that someone is using drugs. We’ve helped thousands of families since 2016 get a loved one on the path to recovery, and we know that it often starts with education and awareness. By understanding these signs, you can be more confident and assured in yourself before taking that first step to help your loved one.

How to Tell if Someone is Using Drugs: Physical, Behavioral, Psychological

There are 3 types of signs of someone who is using drugs; however, keep in mind that not everyone reacts in the same way, and this list is not all-inclusive. Some individuals may demonstrate each sign while others are better at covering them up. You know your loved one best, so be sure to observe and reflect on their behavior using this as just a guide.

The main signs of someone using drugs can boil down into these 3 categories:

1. Physical Signs: Includes changes in the eyes, skin, and weight.

2. Behavioral Signs: Includes mood swings and changes in routine.

3. Psychological Signs: Includes paranoia, depression, and hallucinations.

Let’s go into more depth about these signs.

1. Physical Signs of Someone Using Drugs

Physical changes are arguably the most obvious or noticeable signs of drug use. Physical changes can include changes in the eyes, skin, weight, and any other visible physical aspect of a person. However, although these are the most evident signs, it’s important to remember that these aren’t definitive symptoms of drug use.

Changes in the Eyes

When a person has a drug addiction, their eyes go through many physical changes. Depending on the drug they use, the whites of their eyes may be bloodshot, and their eyes may be watery. Additionally, their pupils might be affected as well, either being extremely dilated or so small they look like pinpoints.

It’s important to note that you cannot indicate the level of intoxication solely based on the condition of the eyes. Some substances may cause dilated pupils at recreational doses, while others (like benzodiazepines) only dilate the eyes when the person has overdosed. Keep a lookout for whether the loved one is on prescription medication or has any other outside factors that affect the eyes.

Changes in the Skin (Injection Marks & Color Change)

Another way to tell if someone is using drugs is itchy skin, injection marks, a puffy face, and unusual skin color. For this reason, people with an addiction may constantly wear long sleeves or clothing inappropriate for the weather to hide any physical signs of substance use. This is also a big sign for people using heroin; keep a lookout for injection marks or covering clothing, especially on the arms and legs.

Abnormal & Abrupt Weight Loss

Because nausea and vomiting are symptoms of some drugs like heroin, abrupt weight loss can be a sign of drug use. Weight, however, can be a sensitive subject, so approach this sign with caution. Only confront this change if it’s concerning without any real reason, such as no change in diet, exercise, or medication.

2. Behavioral Signs of Someone Using Drugs

In addition to the physical signs, there are several behavioral signs of drug addiction. Generally, someone who has a drug addiction will not be “themselves.” Drugs of all shapes and sizes will alter the way people behave, so be sure to watch out for someone acting out of the ordinary.

Rapid Mood Swings

Many drugs cause behavioral changes in a person with an addiction. However, when determining if the mood swings are rapid or out of the ordinary for the person, you must consider what is normal for them. Someone who is typically very calm and collected may be hyper and out of control while using drugs. If that person is typically very upbeat and pleasant, and they’re suddenly miserable and depressed, it may be one of the signs of drug use or addiction.

Private, Reclusive Behavior

Substance use and drug abuse can be isolated activities, so the person who is using may seem very secretive. They might have the appearance of hiding something, spend a lot of time locked in their room or alone, or refuse to answer questions. If your loved one is typically an open book but suddenly becomes private or secretive, it might be a sign that there’s something else going on behind the scenes.

Strange Changes in Routines

If your loved one has a set routine in their work, school, or home life that they suddenly abandon, it may have developed from drug abuse or drug addiction. Things that are “normal” in their daily routine, like studying, going to the gym, or walking the dog, may quickly take a backseat to the need to acquire drugs. It’s important to be aware of these changes, as they can point to addiction as drugs begin to take over responsibilities.

Other Behavioral Signs

In addition to these, there are other, smaller behavioral signs that may indicate a drug addiction. Some other signs can include:

• Slurred speech due to disruptions in cognitive function.

• Being overly sensitive about the subject of drug use.

• Being more defensive of their behaviors when pointed out by someone.

• Being more argumentative, such as finding a way to turn a conversation about their problems into something else.

Be sure that you think about your loved one’s typical behaviors and compare them with how they’re acting now, as it can quickly snowball into something greater down the road.

3. Psychological Signs of Someone Using Drugs

It’s important to note that psychological signs of drug use depend on their drug of choice. For instance, hallucinogens like LSD will intensify feelings and sensory experiences, while stimulants like cocaine will provide a short or long-term energy boost and improved attention. Additionally, depressants like alcohol and heroin will reduce energy and make the user tired. Keep this in mind when discerning a loved one’s drug use, and be sure to understand the differences between them.

Increased Paranoia

People who use certain drugs like marijuana, cocaine, LSD, meth, and alcohol may become overly paranoid or anxious. Although paranoia is a real mental health issue outside of addiction, the experience can be made worse by drugs. For instance, the person may believe that special hidden messages are being transmitted just to them through radios and TVs. Or they may have an inflated sense of self and that they have a special role or significance that’s unrecognized.

Other indicators of paranoia include overthinking interactions, questioning other people’s motives or actions, or having extreme trust issues. Keep these indicators in mind when assessing drug use.

Sudden Depression Symptoms

People with depression experience feelings of hopelessness, sleeping too much or too little, lack of motivation, feelings of guilt, and, in acute cases, suicidal thoughts and tendencies. Drug use can make depression worse in those who already have it or cause it in people who didn’t have it previously; in fact, many studies show that drug abuse and mental illnesses like depression can be linked together.

People also experience depression in different ways. Some exhibit hostility, irritability, and anger instead of a lack of motivation or general sadness. Regardless of how depression is expressed, if you notice a sudden presence of these issues, drug use may be something to consider.

Heightened Anxiety About Different Things

Everyone gets anxious, but those with an addiction or drug use problem will experience near-constant anxiety about a wide variety of things, both related and unrelated to their drug use. Additional anxiety can include:

• Anxiety about their habit being discovered.

• Anxiety about where to get their next fix.

• Anxiety about how to pay for their habit.

• Anxiety caused by symptoms of their drug use.

If you notice your loved one appearing more nervous, jittery, or “always on the lookout,” it could be a symptom of excessive drug use.

Hallucinations

Hallucinations are one of the more severe psychological signs of drug use. These often occur when the person has taken a hallucinogen such as LSD, psilocybin (mushrooms), or DMT. A person experiencing hallucinations will see things that are not there, hear voices or sounds, and experience body sensations such as things crawling on their skin. This is another more evident sign of drug use, but be sure to seek help immediately if it’s an underlying mental illness.

Questions to Ask Yourself About a Loved One

We know it can be scary to think about a loved one addicted to drugs, and even scarier to confront them about it. That’s why it’s important to first take some time to really think about their recent behaviors and patterns before coming to a conclusion. We recommend asking yourself:

• Have I noticed a major change in their appearance?

• Are they just having a bad day/week/month, or is there something deeper?

• Has anyone else noticed these changes?

• Has there been any major transitions or stressors in their life lately (job promotion, medication change, new semester, etc.)?

• Are these physical and behavioral changes a one-time thing, or is this a pattern?

Depending on your answers to these, it might be time to consider getting help.

Next Steps: Support Resources for You

After carefully reviewing how to tell if someone is using drugs, if you think your loved one may be using drugs, there are plenty of resources available. You can always find information online, in books, from educational classes, and community support groups. Here at Master Center, our Family & Friends Program offers a variety of services, including a library of digital resources and group therapy, all focused on supporting you in your own journey with addiction.

You can also get all the information you need in our FREE downloadable e-book, “A Loved One’s Guide to Life with Addiction,” to help you find the tools to take back control of your life.

We know that drug abuse and addiction can feel scary to think about, but knowing how to tell if someone is using drugs can be lifesaving for your loved one. With the right knowledge, support, and push, your loved one can be on the path to recovery from addiction. Until they’re ready, explore our Family & Friends Program today to get more information and resources on taking care of yourself and your loved one in life with addiction.

About Master Center

Master Center is a groundbreaking addiction treatment program headquartered in Glen Allen, Va. Based on a vision of comprehensive outpatient care, Master Center was launched in 2016 and now includes locations throughout the Commonwealth.

Master Center offers a coordinated, multidisciplinary approach rarely seen in the outpatient setting, staffed by experienced addiction physicians, psychiatrists, counselors, therapists, and peer recovery coaches.