How to recognize the signs of substance abuse

Natalie McGill

Using substances such as alcohol or prescription drugs to relax or get to sleep can seem like an easy solution when you’re stressed. But the reality is, such substances can lead to abuse, creating serious problems that interfere with your life.

Substance abuse means that you’re dependent on a drug that’s considered dangerous to your health and well-being. Such substances can include alcohol, prescription painkillers such as oxycodone and codeine, or illegal stimulants such as cocaine. The Substance Abuse and Mental Health Services Administration also considers tobacco to have the potential for substance abuse.

Substance abuse is a common problem. According to a national survey, 4 million Americans received treatment for a problem with alcohol or illicit drug use in 2012, and 23.9 million said they'd used an illicit drug or misused a mood-altering medication such as tranquilizers or sedatives in the past month.

Signs of substance abuse include skipping school or a job, a lack of care for physical appearance and losing interest in activities you used to do regularly, says the National Institutes of Health.

Relying on drugs or alcohol to make it through the week despite their negative effects on your health and work are also signs you may be abusing them, SAMHSA says. If you feel that you may have a problem, there are ways to get help.

NIH says the first step is to call your health care provider and schedule an appointment to talk about your problem.

Another tip is to create a worksheet where you list the pros and cons of your substance use, SAMHSA says. You should list the reasons why you want to make a change, the steps you will take, people who will support your decisions and things that could get in the way of your goals.

It’s also a good idea to avoid temptation. Instead of going to a bar or party, go somewhere that people don’t abuse substances. Working out at a gym, doing volunteer work or spending time with friends and family members you know don’t have substance abuse problems are ways to cope, SAMHSA says.

Helping others with substance abuse

In many cases, it may not be you who is dealing with substance abuse — it could be a friend or family member.

If you know someone who is abusing addictive substances and want to help, don’t be afraid to talk to them. Let them know that you’re concerned about their substance use and that you’re there for them. Even if they aren’t ready to talk now, you should give them the number of a hotline, such as the National Institute on Drug Abuse’s 24-hour referral line at 1-800-662-HELP. That way, they can reach out for help when they’re ready.

Teens are at an especially high risk for substance abuse, says Ruben Baler, PhD, health scientist in the Science Policy Branch at NIDA. Young people may use drugs at a higher rate because of peer pressure or because they are in a stage in life where they engage in more risky behavior, he says.

“Some people have a very high level of self-control and they have the wherewithal to resist,” Baler says. “Some kids may not have that stamina to prevent them from falling victim to peer pressure, so we can do things to protect and identify people who may not be able to observe that self-control.”

Parents or guardians who suspect their child may have substance abuse problems should look for a “marked change in behavior in a way that a person is relating to their peers and their loved ones,” says Onaje Salim, EdD, LPC, acting deputy director for the Center for Substance Abuse Treatment at SAMHSA.

“If they’re perhaps behaving in a way where it looks like they’re hiding something, that would be a concern as well,” Salim says.

Reaching out to professionals for help

People with substance abuse issues can benefit from support groups, such as Alcoholics Anonymous or Narcotics Anonymous. Such groups provide counseling and link you with people who are battling similar addictions. One-on-one sessions with a trained substance abuse counselor are another option.