General signs of addiction include changes in behavior and appearance, lack of hygiene, neglect of daily responsibilities, and uncontrollable urges to use more of the drug. Fortunately, through the right combination of treatments, full recovery from substance use disorder is possible.
Alcohol use disorder is a medical condition in which people are unable to control their consumption of alcohol, even when they face negative consequences for doing so. Alcohol use disorder, or alcoholism, exists on a spectrum ranging from mild to severe. In 2021, over 28 million adults and nearly 900,000 adolescents in the U.S. struggled with an alcohol use disorder.
Symptoms of an alcohol use disorder include the following:
- Drinking more than intended
- Being unable to cut back alcohol use, even when you want to
- A large focus on thinking about drinking more alcohol
- Drinking and its side effects interfering with daily responsibilities, such as caring for family and going to work or school
- Loss of interest in other activities you once enjoyed and instead choosing to drink
- Increase in risky behaviors while drinking
- Continued drinking despite mental health issues it causes, such as anxiety and depression
- Tolerance to alcohol, or needing to consume more to achieve the same desired effects
- Withdrawal symptoms, such as shakiness, nausea, sweating, seizures, or a general sense of being unwell, when alcohol use is suddenly stopped
Any combination of the above symptoms may indicate a problem with alcohol. Fortunately, no matter how severe it is, alcohol use disorder can be effectively treated.
According to the Centers for Disease Control and Prevention (CDC), approximately 2.7 million people suffered from an opioid use disorder in 2020.
Opioid use disorder is defined as a problematic pattern of opioid use that causes significant distress and impairment of the individual. An opioid use disorder can develop in someone who was prescribed opioids for the treatment of pain and in individuals who use them for recreational reasons.
Opioids can be obtained legally via a doctor’s prescription as a painkiller or purchased illegally. Legal opioids include pain medications like oxycodone, morphine, codeine, and hydrocodone. Illegally manufactured opioids include heroin and often fentanyl. Such opioids are particularly dangerous, as their potency and ingredients are not controlled.
Signs of an opioid use disorder include the following:
- Cravings for opioids
- Risky and increased use of opioids
- Withdrawal symptoms when use is stopped or reduced
- Continued use despite health, safety, and financial problems
- Changes in sleep and exercise habits
- Drowsiness and weight loss
- Flu-like symptoms
- Lack of hygiene
- Stealing prescribed opioids from family and friends
Opioid misuse is a significant public health concern across the United States. Illicit opioids have contributed to a substantial rise in opioid-related deaths in recent years.
Benzodiazepines are a type of sedative medication prescribed for the treatment of conditions like anxiety, insomnia, muscle spasms, and seizures. They are depressant medications that help to relax the body and mind.
Examples of common benzodiazepines are Valium, Xanax, Halcion, Ativan, and Klonopin, though there are many other prescription benzodiazepines.
Signs of benzodiazepine abuse include the following:
- Obtaining benzodiazepine prescriptions from multiple doctors
- Faking prescriptions or buying benzodiazepines illegally
- Needing to take higher doses to achieve the same effects
- Combining benzodiazepines with other drugs, such as alcohol or opioids
- Taking them in ways other than intended, such as crushing them up and snorting them to get high
- Excessive drowsiness
- Changes in mood
Antidepressants are not generally considered addictive, as they alone do not produce a pleasurable high that reinforces use. However, they can be misused, especially when taken in combination with other substances, such as alcohol.
When used appropriately, antidepressants are prescribed for the treatment of depressive disorders, obsessive-compulsive disorder, panic disorder, PTSD, bulimia, and anxiety disorders. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed type of antidepressant, with Prozac being the most common SSRI.
Signs of antidepressant misuse include the following:
- Taking more than prescribed by your doctor
- Combining antidepressants with alcohol in an effort to increase effects
- Extreme drowsiness
- Reduced alertness
- Searching for prescriptions from multiple doctors
- Serotonin syndrome
- Suicidal thoughts
- Overdose, including irregular heartbeat, low blood pressure, rigid muscles, confusion, and coma
Hallucinogenic drugs temporarily impact how someone feels, thinks, and perceives the world around them. They can elicit strong emotions ranging from euphoria to fear. They can leave lasting impacts on how the individual thinks after the effects of the drug have worn off.
Types of hallucinogenic drugs include psilocybin (mushrooms), LSD, DMT, mescaline, ketamine, and PCP.
Signs of hallucinogenic drug misuse include the following:
- Development of tolerance
- Continuing taking hallucinogens despite negative side effects, including nausea and headaches
- Cravings and withdrawal
- Combining hallucinogens with other drugs
Hallucinogens refers to drugs also called psychedelic or dissociative drugs. A growing body of research is exploring the potential therapeutic effects of certain psychedelic drugs on some mental health problems. Hallucinogenic drug misuse occurs when taken outside of any therapeutic or medical setting.
Inhalant addiction can occur following repeated use of the drug. Inhalants are substances that are typically only taken by being inhaled. They include a variety of substances, including solvents, aerosol sprays, gases, and nitrites. Many types of inhalants, such as spray paint, markers, glues, and cleaning fluids, can be easily purchased in a store.
Addiction to inhalants increases the risk of harmful effects on the brain and body. Signs of inhalant misuse include the following:
- Distorted or slurred speech
- Reduced control of body movement
- Dizziness or lightheadedness
- Hallucinations or delusions
- Nausea and vomiting
- Kidney and liver damage
- Brain damage
Someone with an inhalant addiction will also likely experience withdrawal symptoms when they suddenly stop use. Changes in mood, sleep, and appetite are likely to occur during withdrawal.
An estimated 30% of marijuana users have a marijuana use disorder. Adolescents who begin using marijuana before the age of 18 are up to seven times more likely to develop a marijuana use disorder than adults. In 2021, over 16 million people, or approximately 5.8% of people aged 12 and older in the U.S., had a marijuana use disorder.
People who regularly use marijuana are likely to develop a dependence on it and then experience subsequent withdrawal symptoms when they stop consuming it. Common signs of marijuana misuse include the following:
- A sense of euphoria and relaxation while high
- Increased appetite
- Anxiety or panic
- Fear or distrust
- Acute psychosis, with hallucinations, delusions, and a loss of sense of self
- Continued use of marijuana despite it interfering with daily life
- Withdrawal symptoms, including sleep and mood issues, irritability, and decreased appetite
Studies have found that the severity of lasting impacts of marijuana misuse vary depending on how old the person was when they began using, how much marijuana they used on average, and how long they used marijuana. Long-term effects on memory, learning, impulse control, and reduced cognitive functioning have been observed.
Stimulant abuse can happen with legal and illegal stimulant drugs. Prescription stimulants include Adderall and Ritalin, and they are commonly prescribed for the treatment of attention deficit hyperactivity disorder. Illegally manufactured stimulants include cocaine, amphetamine, methamphetamine, and MDMA (also called Molly or ecstasy).
Stimulant use disorder is defined as ongoing use of stimulants despite the user experiencing harm. Symptoms of stimulant abuse include the following:
- Increased heart rate and blood pressure
- Dilated pupils
- Nausea and vomiting
- Chest pain
- Significant weight loss
- Dental problems
- Heart attack or stroke
- Violent behavior
- Psychosis and paranoia
- Anxiety and confusion
Stimulant abuse becomes especially dangerous when combined with opioids. The rate of fatal overdose to stimulant drugs has increased significantly in recent years. More than half of the deaths related to overdose from illegal stimulants like methamphetamine and cocaine also involved fentanyl or other opioids.
Sleeping pills can be purchased over the counter or prescribed by a doctor. They are intended for people who have difficulty falling asleep and are best used for the short-term treatment of sleep problems. Long-term use of sleeping pills can lead to dependence and addiction.
Sleeping medications that can be bought in a standard store often contain an antihistamine that makes people feel drowsy and better able to fall asleep. Prescription sleeping pills are much stronger than those available in stores and can only legally be obtained from a doctor.
Antidepressants and benzodiazepines are prescribed as sleep pills. Common Z-drugs, another type of sleeping pill, are Ambien and Lunesta.
Individuals who rely on sleeping pills to fall asleep nightly for an extended period are at risk of experiencing negative side effects. Signs of sleeping pill abuse include the following:
- Physical dependence on sleeping pills
- Mixing sleeping pills with alcohol or other sedatives
- Development of disruptive sleep disorders
- Difficulty focusing, thinking, and completing tasks the day after taking sleeping pills
- Chronic fatigue
- Memory issues
- Upset stomach
- Dizziness and balance issues
- Interference with completing daily tasks, school, and work
Mixing sleeping pills with alcohol or sedatives is particularly dangerous as it poses the risk of overdose, which can be fatal. The majority of people who take sleeping pills report feeling a “hangover effect” the day after taking them, and they cannot function to their fullest.
Getting Help for a Substance Use Disorder
Treatment for a substance use disorder is not a one-size-fits-all approach, explains the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Effective treatment depends on the individual’s personal situation, history of substance use, social and familial support, response to treatment, and long-term goals.
To ensure the right treatment approach, experts recommend you start by speaking with your healthcare provider. They can conduct an initial screening and make appropriate treatment referrals. If treatment is more urgent, hospitals and emergency room departments can ensure your initial safety while detoxing and then refer you to the next best step in the treatment process.
Substance use disorders are chronic but treatable diseases. Treatment is likely to include a combination of medication, outpatient counseling, inpatient treatment, and ongoing behavioral health care. Addiction treatment must cover any medical concerns as well as underlying mental health issues.
Online free resources are available to support people searching for addiction treatment services for themselves or a loved one. Here are some of your options:
- The Substance Abuse and Mental Health Treatment Association’s (SAMHSA) Behavioral Health Treatment Services locator
- The U.S. Department of Health and Human Services Health Center Locator and Mental Health Substance Use Insurance Help page
- SAMHSA’s Opioid Treatment Program Directory
- The CDC’s Information for Patients page
There is no shame in seeking help for a substance use disorder. The above resources can help you or a loved one begin the journey toward long-term recovery.
Sustained sobriety in an ongoing process that requires continual care, attention, and effort. Recovery from addiction to each of the above substances is possible, as is a return to a life full of meaning and free from substance abuse.
- Alcohol’s Effects on Health. (April 2023). National Institute on Alcohol Abuse and Alcoholism.
- Cannabis (Marijuana) Research Report. (July 2020). National Institute on Drug Abuse.
- Drug Fact Sheet: Benzodiazepines. (October 2022). Department of Justice/Drug Enforcement Administration.
- Inhalants DrugFacts. (April 2020). National Institute on Drug Abuse.
- Opioid Use Disorder. (August 2022). Centers for Disease Control and Prevention.
- Psychedelic and Dissociative Drugs. (April 2023). National Institute on Drug Abuse.
- Recovery is for Everyone: Understanding Treatment of Substance Use Disorders. (September 2022). Centers for Disease Control and Prevention.
- Stimulant Use Disorder. (August 2022). U.S. Department of Veteran Affairs.
- Opioid Use Disorder. (April 2023). StatPearls.
- Antidepressants, Withdrawal, and Addiction; Where Are We Now? (May 2019). Journal of Psychopharmacology.
- Medical Students’ Attitudes Toward Sleeping Pill Usage: A Cross-Sectional Study. (December 2022). Frontiers in Psychiatry.
- Drugs, Sleep, and the Addicted Brain. (January 2020). Neuropsychopharmacology.
- The Use of Over-the-Counter Sleep Aid Containing Diphenhydramine Hydrochloride Among Saudis. (December 2021). Cureus.