Signs of Substance Use

Overview

The following are some obvious signs that a person may be drinking alcohol, using tobacco, or using other substances. This is not a complete list. If you suspect use of a particular substance, get more information on signs of use for that substance.

Alcohol

  • Alcoholic beverages missing from the home storage cabinet
  • Odor of mouthwash (used to cover up alcohol) on the breath
  • Hangover symptoms (such as nausea, vomiting, or headache), if recently used

Tobacco

  • A distinctive smell on the breath and clothing
  • Tobacco products in the person's possession

Marijuana

  • Sweet smell on clothing; bloodshot eyes, if recently used, and frequent use of eyedrops to reduce the redness
  • Careless grooming, increased fatigue, and changes in eating and sleeping patterns, if using regularly
  • Drug paraphernalia (such as pipes) in the person's possession

Club drugs such as ecstasy (MDMA)

  • Skin rash similar to acne
  • Small bottles with liquid or powder in the person's possession

Stimulants such as cocaine or methylphenidate (Ritalin)

  • Long periods of time without sleep
  • Persistent runny nose and nosebleeds, or injection marks on arms or other parts of the body
  • Drug paraphernalia, such as syringes, spoons with smoke stains, small pieces of glass, and razor blades

Hallucinogens such as LSD

  • Trance-like appearance with dilated pupils, if recently used
  • Possession of small squares of blotter paper (sometimes stamped with cartoon characters) or other forms of the drug

Opioids such as heroin or hydrocodone (Norco)

  • Very small pupils and a drowsy or relaxed look, if recently used
  • Extra pill bottles around the house or in the trash
  • "Doctor shopping" (getting multiple opioid prescriptions from different doctors)
  • Possession of injecting supplies (an outfit or rig), which may consist of a spoon or bottle cap, syringe, tourniquet, cotton, and matches

Inhalants

  • Chemical breath, red eyes, or stains on clothing or face, if recently used
  • Soaked rags or empty aerosol containers in the trash

Anabolic steroids

  • An unpleasant breath odor
  • Mood changes, including increased aggression
  • Changes in physical appearance that aren't caused by expected patterns of growth and development
  • Possession of medicines or syringes

Credits

Current as of: November 8, 2021

Author: Healthwise Staff
Medical Review:
Patrice Burgess MD - Family Medicine
Adam Husney MD - Family Medicine
Martin J. Gabica MD - Family Medicine
Kathleen Romito MD - Family Medicine
Peter Monti PhD - Alcohol and Addiction
Christine R. Maldonado PhD - Behavioral Health

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