Signs Someone Needs Addiction Treatment

When substance use becomes a disorder

There is a meaningful difference between substance use and substance use disorder. Most people who drink alcohol don't develop alcohol use disorder. Most people who are prescribed opioids after surgery don't develop opioid use disorder. The distinction lies in loss of control, compulsive use despite consequences, and the neurobiological changes that make stopping so difficult without help.

Substance use disorder exists on a spectrum from mild to severe. The earlier it's recognized and addressed, the better the outcomes. Here are the signs that someone — or you — may need professional help.

Behavioral signs

• Using more of a substance than intended, or using for longer than planned
• Repeated unsuccessful attempts to cut down or stop
• Spending significant time obtaining, using, or recovering from substance use
• Giving up activities — hobbies, work, relationships — that were previously important
• Continuing to use despite knowing it's causing problems at work, home, or in relationships
• Using in physically hazardous situations — driving, operating machinery
• Hiding use, lying about how much or how often

Physical signs

• Tolerance — needing more of the substance to achieve the same effect
• Withdrawal symptoms when not using — sweating, shaking, nausea, anxiety, seizures in severe cases
• Significant weight loss or gain
• Deteriorating physical appearance and hygiene
• Track marks, bloodshot eyes, or other substance-specific physical signs
• Sleep disruption — sleeping too much or too little

Psychological signs

• Intense cravings — the substance occupies significant mental space
• Mood swings, irritability, or aggression — especially when not using
• Anxiety or depression that seems connected to substance use patterns
• Paranoia or other changes in thinking
• Loss of motivation, interest, or pleasure in things previously enjoyed

When to act urgently

Seek immediate help if someone is experiencing overdose symptoms — unconsciousness, slow or stopped breathing, blue lips or fingernails, unresponsive. Call 911 immediately. If naloxone (Narcan) is available and opioid overdose is suspected, administer it while waiting for emergency services.

If you're concerned about someone but they're not in immediate danger, a substance use counselor or addiction specialist can provide guidance on how to talk to them and what treatment options are available.

Finding help

The SAMHSA National Helpline (1-800-662-4357) is free, confidential, and available 24/7. BehavioralHealthGuide.org lists verified substance use treatment providers across all 50 states — search by location to find counselors, MAT providers, and treatment programs near you.