Signs That Someone May Have A Drug Or Alcohol Problem
Mark Dombeck, Ph.D.
Diagnosis is important in general because it helps doctors to know how to treat a problem. The diagnosis of a substance use problem (abuse or dependence) is important because it helps justify getting an addicted person into treatment.
Getting an addict to the point where a substance abuse or dependence diagnosis can be made is often a difficult task. People with drug and alcohol problems are often secretive about their use, or blind to the idea that a problem exists. It is helpful then to have a list of behaviors that one can look for that, when present, may suggest that someone has a substance use problem.
Behaviors to look for include:
A repeating failure to meet social, occupational or familial duties:
Repeated lateness or absence
Poor work performance
Neglect of children, etc.
Bizarre or lame excuses for social, occupational or family failures
Borrowing (or stealing) money without good reasons.
Uncharacteristic mood or personality changes
Physical signs may include:
Puncture marks, or long thin lines along the arms or legs (IV drug use such as heroin)
Skin Infections
Nose and throat problems (snorted drugs such as cocaine)
Bloody nose
Nasal and/or sinus infections
Coughing
Loss of the sense of smell
Drowsiness, or loss of coordination (depressant drugs such as alcohol)
'Pinned' (tiny, constricted) pupils in the eye (secondary to opioid abuse)
Eye movement disturbances:
Nystagmus: back and forth eye movements during an extreme lateral gaze (secondary to alcohol abuse)
Red or bloodshot eyes (secondary to smoking marijuana)
Drug-related smells on clothing (drugs that are smoked)
Drug-related paraphernalia (pipes, 'works', pill bottles, small plastic bags or vials, lighters, etc.)
Medical signs (only apparent upon formal testing) may include:
Positive findings of drug related metabolic (break-down) byproducts in the urine, blood or hair.
Hypertension (High Blood Pressure) (may point to alcoholism)
Elevated levels of the liver enzyme 'delta-glutamic transferase' (GGT) (may point to alcoholism)
Enlarged red blood cells (may point to alcoholism)
