Chemical dependency, aka addiction is a pressing social, public health, and criminal justice issue. Substance abuse is differentiated from chemical dependency. Substance abuse is defined as the excessive, frequent, and problematic use of drugs and alcohol. Abuse can progress to addiction, or the person may abuse drugs or alcohol for a phase of their life which can last anywhere from days to months. Drug abuse alone can result in multiple problems even if it does not progress to addiction. In this article, the signs and symptoms identified will apply to either abuse or addiction.

What are Drug Abuse and Addiction Symptoms?

Chemical dependency or addiction is more specific and severe than abuse. It is defined by three main symptoms:

1. A high tolerance for the substance
   The person will feel the need to use increasing quantities of the substance in order to get the effect they are seeking. They will use in escalating amounts which would kill a person of the same body weight who did not have this tolerance. 
2. Withdrawal symptoms when they stop using
   This is an objective, definitive indicator that the user’s body has adapted to the presence of the drug, as they become physically ill and psychologically distressed when they don’t use the drug. 
3. Compulsive use despite adverse consequences
   Addiction to drugs and alcohol will negatively impact every part of the person’s life, and cause life to become unmanageable. Despite this they will keep seeking the counterfeit pleasure of the substance. 

Family and friends of the addict or substance abuser will agonize as they watch someone they love deteriorate, their lives will be directly affected by the user’s actions, and they may not be aware of what is happening until it is too late. Addiction kills.  Here are some ways that the descent into addiction can be detected early on: 

Daily Tasks will be Gradually Neglected

Our lives are much more fragile than most of us may realize or want to admit. Our lives require constant maintenance to keep things functioning in a productive and orderly manner. The average single adult on an average day has to complete about 40 tasks. If they are in a relationship or have children or pets, this list will be even longer. Think of everything that must be done every day, down to every detail:

1. Up at a reasonable hour
2. Relieve yourself
3. Brush
4. Floss 
5. Rinse
6. Work out
7. Shower
8. Shave
9. Apply antiperspirant
10. Apply aftershave, cologne, or body spray
11. Dress
12. Clean glasses/insert contacts
13. Take any daily medication
14. Check email/messages
15. Out the door
16. Garbage out on the way out the door
17. Commute to school or work
18. Breakfast or coffee
19. Work/classes
20. Lunch/run errands; bank, post office, wash car.
21. Work/classes
22. Commute home
23. Stop for groceries
24. Get gas
25. Prep dinner
26. Eat
27. Relieve yourself
28. Do dishes
29. Sweep, mop
30. Water plants
31. Answer emails or phone calls
32. Brush
33. Floss
34. Rinse
35. Change into bed clothes
36. Lay out work clothes for next day
37. Watch movies/read/web surf/study
38. Before bed snack
39. To bed at a reasonable hour

Imagine if you crossed one item off that list every day. Or if you crossed one item off the list even every week. What would your life look like in only a month? Six months? This is what happens when one abuses drugs or alcohol, and descends into addiction. Every day the small tasks and not so small priorities become delayed and put off to the next day and stop getting done. Addicts will neglect their personal hygiene, show up late for work or class, grades or productivity at work will suffer, they will not return calls or emails, let their home become a mess, skip meals, stop exercising, and have difficulty getting out of bed or to bed. Life will become unmanageable. If you are the parent, partner, friend, or boss, you will notice these behavioral changes indicating a problem of some sort. The problem could be as simple as overwork and being overwhelmed, or depression, or addiction. 

Drug Paraphernalia

Using drugs requires tools, and drug use will leave behind artifacts. Here are some of the signs by drug type:

• Alcohol: Bottles, from full to a quarter inch in the bottom will be squirreled away throughout home and vehicle. Look for an excessive amount of cough drops, or very strong mints which people use to try and hide the smell of alcohol. 
• Crack or methamphetamine: Glass tubes, and steel wool or scrub pads. A pinch of steel wool or a pinch from a scrub pad is used as a filter in a crack pipe. Pieces of aluminum foil are also used for smoking, and will be covered with burn marks. Heroin can also be smoked in this way. Look for burnt fingers on the user. 
• Heroin, cocaine, and pills: any type of powered water-soluble drug can be mixed with water and injected. Almost any pill can be crushed into a powder, or a capsule opened, and the contents dissolved in water and injected. Look for the obvious; hypodermic needles (be careful and look before you reach) also cotton for swabbing the injection site or as a filter, and burnt or bent spoons or bottle caps which are used to prepare the drug for injection. Also look for track marks which are bruises at the injection site, which often become infected. People will inject in the antecubital space, which is the space between the biceps and the forearm. Other injection sites include between the fingers and toes, under the eyelids, and under the tongue, or in the feet or neck. 
• Cannabis: the obvious joint, pipes that can be made of metal or glass, but also beer or soda cans, hollowed out apples, rolling papers, or hollowed out cigars

New associates

Someone using drugs or heavily drinking will lose romantic partners and friends. They will also begin associating with other people who use: dealers, and middlemen who handle money or drugs, and put the user in contact with dealers. They may be the stereotypically shady looking characters, or they may be very neat and well groomed, wearing fine clothes, and being very polite. 

Abandoned previously enjoyed activities

One of the criteria for addiction is abandoning activities that were important at one time. The avid golfer or fisherman who hasn’t been on the green or the water in months is indicative of a change of some sort. Over time, acquiring the drug or alcohol, using it, and recovering from the effects will occupy more and more time, squeezing out time for leisure activities. 

Loss of funds or assets

Someone who works and earns good money but is always broke is a concern. Where is the money going? Family and friends will constantly be asked for money to buy gas, or pay the heating or electric bills. Cherished possessions, such as gaming consoles or jewelry will be sold off. 

Conclusion

People who are using will go to great lengths to hide it. They will have a very elaborate alibi system, and will deny culpability even when confronted with direct evidence. “Those aren’t my pills, I am holding on to them for a friend: that wasn’t my coke, I gave someone a ride and they left it in my car." These are implausible excuses. 

With the exception of the presence of drugs or drug paraphernalia, none of the above are definitive signs of problematic drug or alcohol use. These are indicators of some sort of a problem in a person’s life. If drug use is confirmed, see these other articles for options on what to do next.