Signs and Symptoms of Substance Abuse

The following are some of the more common signs and symptoms of drug use. It is important to keep in mind that if a person has any of these symptoms, it does not necessarily mean that he or she is using drugs. They could be due to a mental or physical health problem. They might also be due to adolescent development (in the case of teens). Whatever the cause, they may warrant attention...

The key is change – it is important to watch for any significant changes in the person’s physical appearance, personality, attitude or behaviour.

Physical Signs from Drug Abuse.

  • Inability to sleep, awake at unusual times, unusual laziness.
  • Loss of or increased in appetite, changes in eating habits
  • Cold, sweaty palms; shaking hands.
  • Red, watery eyes; pupils larger or smaller than usual
  • Unusual smells on breath, body or clothes.
  • Extreme hyperactivity; excessive talkativeness.
  • Slowed or staggering walk; poor physical coordination.
  • Needle marks on lower arm, leg or bottom of feet.
  • Nausea, vomiting or excessive sweating.
  • Tremors or shakes of hands, feet or head.
  • Irregular heartbeat.
  • Runny nose; hacking cough
  • Puffy face, blushing, or paleness
  • Frequent rubbing of the nose
  • Frequent twisting of the jaw, back and forth
  • Deterioration of hygiene or physical health

Behavioral Signs from Drug Abuse

  • Change in overall attitude/personality with no other identifiable cause. 
  • Drop in grades at school or performance at work;skips school or is late for school. 
  • Change in activities or hobbies. 
  • Chronic dishonesty. 
  • Sudden oversensitivity, temper tantrums, or resentful behaviour. 
  • Difficulty in paying attention; forgetfulness. 
  • General lack of motivation, energy, self-esteem, “I don’t care” attitude. 
  • Change in habits at home; loss of interest in family and family activities. 
  • Paranoia 
  • Silliness or giddiness. 
  • Moodiness, irritability, or nervousness. 
  • Excessive need for privacy; unreachable. 
  • Secretive or suspicious behaviour. 
  • Car accidents. 
  • Change in personal grooming habits. 
  • Possession of drug paraphernalia. 
  • Changes in friends; friends are known drug users. 
  • Unexplained need for money, stealing money or items 
  • Possession of a false ID card 
  • Missing prescription pills 
  • Complaints of a sore jaw (from teeth grinding during an ecstasy high) 
  • Presence of unusual number of spray cans in the trash 

Signs of Intoxication, by Specific Drug


Glassy, red eyes; loud talking and inappropriate laughter followed by sleepiness; a sweet burnt scent; loss of interest, motivation; weight gain or loss.


Clumsiness; difficulty walking; slurred speech; sleepiness; poor judgment; dilated pupils.

Cocaine, Crack, Meth, and Other Stimulants

Hyperactivity; euphoria; irritability; anxiety; excessive talking followed by depression or excessive sleeping at odd times; go long periods of time without eating or sleeping; dilated pupils; weight loss; dry mouth and nose.


Needle marks; sleeping at unusual times; sweating; vomiting; coughing and sniffling; twitching; loss of appetite; contracted pupils; no response of pupils to light.

Depressants (including barbiturates and tranquilizers)

Seems drunk as if from alcohol but without the associated odor of alcohol; difficulty concentrating; clumsiness; poor judgment; slurred speech; sleepiness; and contracted pupils.

Inhalants (Glues, aerosols, and vapors)

Watery eyes; impaired vision, memory and thought; secretions from the nose or rashes around the nose and mouth; headaches and nausea; appearance of intoxication; drowsiness; poor muscle control; anxiety; irritability


Dilated pupils; bizarre and irrational behavior including paranoia, aggression, hallucinations; mood swings; detachment from people; absorption with self or other objects, slurred speech; confusion.