In a world full of temptations, it’s possible for a person to become addicted to just about anything. From alcohol and drugs to food, gambling, exercise, sex and even shopping, there’s a whole constellation of potentially addictive substances and behaviors that can become problematic for some people.
While it isn’t always obvious when someone is struggling with addiction, there are some warning signs to look out for.
The Warning Signs of Addiction, Alcoholism and Substance Abuse
Addiction and the road to it is an individual one, says Deena Manion, a doctor of psychology, a licensed psychotherapist and chief clinical officer of Westwind Recovery in Los Angeles. “Each person’s experience of addiction is slightly different,” she explains.
Among the various substances that some people abuse, there can be wide variations in the specific symptoms, but there are some common signs you might notice. These can generally be split into two broad categories: Behavioral/emotional changes and physical changes.
Behavioral and emotional changes
— An increase in lying.
— Mood changes, especially extreme ones.
— Financial or legal troubles.
— Changing social groups or new or unusual friends.
— Changes in personality patterns.
— Worsening anxiety.
— Difficulty concentrating.
— Difficulty fulfilling normal obligations at work, school or home.
— Doctor shopping, or going from doctor to doctor, looking for someone to prescribe the drug of choice.
— Medication hoarding, particularly pain medications.
Physical changes
— Weight fluctuations.
— Changes in sleep patterns.
— Changes in energy levels.
— Sweating, shaking or flu-like symptoms.
— Needle marks on the skin, if injected drugs are being used.
— Scabs from uncontrollable skin picking, which tends to occur with methamphetamine use.
— Burns on the lips, which is common with crack cocaine use.
— A smell of alcohol on the person’s clothes or breath.
— Bloodshot eyes or abnormal changes in pupil size.
— Hand tremors or other hard-to-control movements.
— Nausea or vomiting.
— Headaches or body aches.
Your overall outward appearance may also change, says Dr. Orman Trent Hall, a board-certified addictionologist and addiction researcher at the Ohio State University Wexner Medical Center. “People often begin to neglect themselves,” he explains. How they interact with the world and others may also change. “They may disengage from relationships and activities that previously gave their lives meaning.”
[See: Ways Alcohol Affects the Aging Process.]
Symptoms May Overlap
While the specific signs and symptoms of addiction are sometimes dependent on the substance or behavior that’s at issue, there’s almost always some overlap in signs. That goes for alcohol just as much as heroin. Though it’s widely considered socially acceptable to drink, alcohol is a drug, and some people may struggle with alcohol abuse just like others struggle with drug use. Warning signs of alcoholism or an alcohol use disorder can overlap with signs of other substance use disorders.
“For example, Hall says, “a spouse that is secretive about debts and finances could be struggling with addiction to alcohol, substances or even gambling.”
Manion notes behavior-based addictions, such as gambling, shopping or sex, “are characterized by compulsive behaviors that persist despite negative consequences.” In contrast, substance-based addictions, such as alcoholism and drug dependency, may offer more physical clues, including weight changes and tremors.
Robin Lindeman, a licensed chemical dependency counselor and executive director at Infinite Recovery in Austin, Texas, adds that “if you use a stimulant such as cocaine, you will exhibit symptoms such as difficulty sleeping and increased heart rates. However, if you use a depressant such as alcohol, symptoms can include slowed heart rates, slowed breathing and comas in severe cases.”
[READ: How Yoga and Exercise Help With Addiction Recovery.]
What’s the Difference Between Dependency and Addiction?
While addiction and dependency can go hand-in-hand and the terms are often used interchangeably, they’re actually two separate things. “Addiction is a disease characterized by behavioral issues,” Manion explains, while “dependence refers to a physical reliance on a substance.”
With dependence, something in the brain or body has changed; the body has adapted to the substance and needs it to continue functioning. Removing the substance leads to withdrawal because the body has become reliant on that substance to one degree or another. Those symptoms can be both physical and psychological, such as feelings of anxiety at the mere suggestion of going without the substance.
“The two conditions often occur at the same time, but a person can be dependent on a substance without being addicted to it,” Manion adds. Dependence often means that addiction is soon to follow, but it doesn’t always.
Hall explains that “physiologic dependence is an adaptive process that happens when our brains become used to something we are putting into our bodies on a regular basis. This happens to us all and is not the same thing as addiction. For example, you might feel unwell if you forget to take a prescribed medication before you go to work in the morning. That does not mean you’re addicted. Addiction occurs when something we’re doing — like drinking or gambling — starts feeling out of control and we have trouble stopping even after we realize it’s harming us.”
Lindeman adds that “an example of addiction would be spending more money than you can afford on drinking alcohol or (engaging in) substance use.”
It can be confusing to keep the two terms — addiction and dependence — straight, and in 2013, when the American Psychological Association released the DSM-5, the diagnostic manual that defines all currently recognized mental illnesses, it made some changes to streamline the terminology around abuse, addiction and dependence.
With that update, the organization removed the terms “substance abuse” and “substance dependence” from the manual and started referring to all forms of addiction or dependence as “substance use disorder.”
The DSM-5 lists several criteria that are used to diagnose substance use disorders. These include:
— Using the substance in larger amounts or for a longer time than originally intended.
— Being unable to cut down or stop using the substance, even if the person wants to.
— Spending a lot of time obtaining, using and recovering from the effects of the substance.
— Experiencing intense urges or desires to use the substance (known as cravings).
— Failing to fulfill obligations at home, work or school due to substance use.
— Continuing substance use even though it causes or worsens social or interpersonal problems.
— Giving up social, recreational or occupational activities due to substance use and withdrawing from family or friends to use the substance.
— Using the substance in dangerous situations, such as while driving or operating machinery.
— Continuing substance use even though the person knows they have a physical or psychological problem that is probably caused or worsened by substance use.
— Needing to use more of the substance to experience previous effects (known as tolerance).
— Experiencing unpleasant or uncomfortable symptoms if they try to stop using (known as withdrawal).
[SEE: 11 Tips to Support Someone Struggling with Mental Health.]
When to Seek Help
If you or a loved one notices signs of substance use disorder, it’s important to contact a professional for advice and support.
“Only qualified health professionals such as medical doctors, psychiatrists or other licensed and appropriately qualified mental health professionals can diagnose substance use disorders,” Manion says. “Proper diagnosis is important for the person and their family and friends because it can help identify the problem and provide a starting point for getting the right help with addiction treatment.”
Treatment for Substance Use Disorder
While recovery from substance use disorder isn’t easy — and there’s no quick fix — it can be managed, and the person with the disorder can go on to live a happy, productive life after addiction. “Even during the darkest moments in our lives, people are much greater than any health condition they might have. Treatment works. People recover,” Hall says.
Lindeman recommends seeking help from your primary care physician, a therapist or a psychiatrist to develop a plan to start getting off a substance. You can also seek help from an addiction treatment center if your addiction is severe or if you have signs of withdrawal due to cessation of substance use. “Usually, health care professionals and support groups work better than dealing with addiction alone,” she says. In severe cases, it’s usually best to start treatment under the supervision of a health care professional, as the withdrawal symptoms can be dangerous in some instances and could include an increased risk of heart attack or stroke.
Depending on the specifics of the case, treatment options may include:
— Detox.
— Enrollment in a treatment program.
— Support groups.
— Therapy.
— Medication.
Detox
“This is often the first step in the recovery process, which helps a person safely and more comfortably manage withdrawal while under supervision,” Manion says. This process, which can be very uncomfortable or even painful for the person coming off a substance, sometimes takes place at a treatment facility. Detoxing from a substance like alcohol or drugs may include nausea, body aches, tremors and convulsions, disorientation, sweating, racing heart rate or palpitations, anxiety, headaches and disrupted sleep, among others.
Enrollment in a treatment program
This can take place at a residential facility, sometimes called a rehab facility, where the person lives for a period of time to work through the issues related to the substance use disorder. Many treatment facilities use a 30-day treatment period for inpatient treatment, but depending on the severity of the situation, a 60- or 90-day stay or a longer-term option may be indicated. That’s typically followed up with additional support and ongoing therapy indefinitely thereafter. Treatment can also sometimes be delivered as outpatient care from the start, where the person lives at home but travels to treatment sessions at a treatment center once or more times per week.
Support groups
Groups such as Alcoholics Anonymous, or AA, and Narcotics Anonymous are widely available and have a lengthy history of helping people who are dealing with substance use disorder. These types of support groups often use the 12-step process developed by AA that helps people work through several phases of recovery one step at a time. For family members and loved ones of the person with the addiction, there are also many support groups available, such as Al-Anon, Gam-Anon, Nar-Anon and the National Association for Children of Alcoholics.
Therapy
Ongoing support and therapy, whether individual-, family- or group-based, is often a part of treatment of substance use disorder and behavioral health issues.
Medication
For some types of substance use disorder or behavioral health issues, medication can help keep the person from falling back into their old patterns of use or behaviors that could damage their health. “For individuals with opioid use disorder (OUD), two medications are proven to lower the risk of dying from overdose or serious medical complications,” Hall says. These medications are buprenorphine and methadone. “Another medication, called naltrexone, has helped many people recover from OUD but has not been shown to reduce risk of dying from this condition.” In addition, Hall says, “there are three medications that are approved to treat alcohol use disorder, and early scientific evidence suggests several others may help as well.”
Manion adds that “addiction often occurs alongside other mental health conditions, such as anxiety and depression. Estimates suggest that approximately half of all people who have a mental disorder will also have a substance use disorder at some point during their life. So, if you notice yourself or your loved one struggling with mental health issues, they might also be struggling with substances.”
How to Help a Loved One With a Substance Use Disorder
Loving someone who has a substance use disorder is often a challenging situation. “A person may keep using substances even though it hurts their friendships and family relationships,” Manion says. It’s not because they don’t care about loved ones, she adds, “but because their brain has changed due to the addiction.”
If you’re trying to help a loved one who’s showing signs of substance use disorder, Lindeman recommends letting your loved one know that “you’re concerned about their behavioral or physical changes due to possible substance use. Let them know you will be there for them to fight their substance use.”
She adds that while you can certainly “seek professional help and expert opinions if you want to, it will not help your loved ones deal with substance use.”
Manion agrees you that you can’t force someone to get help. But there are several ways you can support them including:
— Educating yourself on addiction.
— Expressing hope that change is possible.
— Maintaining your commitment to loving and encouraging them.
— Maintaining healthy boundaries.
— Realizing that the person can’t stop using without help.
— Researching treatment facilities and calling places to discuss treatment options.
— Presenting your loved one with options and considering a professional intervention if they are unwilling to get the help they need.
You also need to make sure you’re looking after yourself, too. Hall says there are resources out there that can help “support family members of people with addiction. Connecting with others and taking care of your own physical and emotional health is the best way to support your loved one’s recovery.”
Making sure your loved one knows that you want to help can be critical for getting someone to take that first step in addressing addiction. “There’s nothing to be ashamed of from reaching out to others for help with addiction,” Lindeman says. “It’s better to face your addiction now than to let your addiction control your body and behavior.”
Lastly, Manion says it’s important to remember that no matter how much you love someone, you can’t force them to stop using substances, and you can’t make them enter treatment if they’re not yet ready to do so. “However, you can show your love, support and encouragement and help them enter addiction treatment when the time is right for them,” she says.
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The Warning Signs of Addiction, Alcoholism and Substance Abuse originally appeared on usnews.com
