Drug Addiction: Signs and Side Effects of Drug Abuse

Drug use can become drug addiction when someone experiences a loss of control over use or feels harmed physically, mentally or emotionally by use without being able to stop. This guide discusses the signs of drug addiction, details patterns common in various stages of substance use disorder and offers some information for getting help.

Substance use disorder, the technical term for drug addiction, involves:

• A loss of control over substance use. Someone may want to stop using drugs or alcohol but finds they can’t.
• Compulsive drug use. A person may use substances even when they didn’t set out to do so.
• Continued use despite harm. Someone may use substances even if they’ve had uncomfortable or scary consequences with previous use, such as legal challenges, overdose scares or relationship fallout.

Addiction can occur with many types of substances, including legal and illicit drugs, prescription drugs and over-the-counter medications when they’re used incorrectly.

According to a 2024 survey from the Substance Abuse and Mental Health Services Administration, more than half of individuals aged 12 or older had used an addictive substance within the prior month. Almost 17% had used an illicit drug, and 47% had used alcohol. But drug use isn’t the same thing as addiction.

Drug abuse or drug misuse are terms used to refer to risky or harmful use patterns. Drug misuse is the clinically correct term. Addiction occurs when someone has lost control over drug misuse.

Tolerance and dependence can occur with a variety of substances and don’t mean someone has an addiction. However, needing more of a substance to get the same effect or experiencing even mild withdrawals if you stop taking a substance raises the risks of addiction.

While each person’s journey is unique, addiction often follows general patterns.

Early substance use patterns can include:

• Using drugs or alcohol to cope with hard emotions or stress
• Self-medicating using drugs to address sleep, pain or mental health symptoms
• Increasingly using drugs as tolerance starts to build up or you get a “good” effect you want again

As tolerance and cravings build, substance use may increase. During this stage, many individuals begin to realize they can’t stop using a certain drug. They may experience withdrawal symptoms that drive them back to use or feel like they can’t get through a normal day without using.

During the middle stage of addiction, someone may have made repeated attempts to cut back or stop without success. Their work and relationships may be suffering.

Compulsive substance use may continue in later stages despite serious consequences. Severe addiction signs include using drugs or alcohol even after negative outcomes, such as a major health scare or a loss of a relationship or job. Withdrawal symptoms may be worse when you try to stop at these stages, and persons in late-stage addiction patterns may engage in high-risk activities to maintain their supply of drugs.

Spending more time ensuring access to drugs and the ability to use them can lead to isolation, and the impact of substances on cognitive and emotional states can lead to mental health symptoms. It’s during this stage that many people experience a loss of daily functioning.

Getting an addiction assessment from a professional healthcare provider may make sense when:

• You’re using substances that can lead to dangerous withdrawal risks or overdose.
• You’re mixing substances.
• You’ve experienced multiple relapses when trying to quit on your own.
• You have a dual diagnosis treatment need due to co-occurring depression, anxiety or trauma.
• You aren’t living in a safe environment or have unstable housing.

Common signs of drug addiction include:

• Escalating use and cravings. If you need more of a drug or need it more often to satiate cravings or get the same effect, you have a physical tolerance.
• Secrecy around use. Lying about or hiding drug use often indicates a lack of control.
• Neglecting obligations. Compulsive drug use can cause you to ignore or be unable to manage work, family and social responsibilities.
• Using drugs in new ways. If you start injecting drugs or using them in other ways to get a faster or stronger high, it’s a sign of problematic use.
• Physical symptoms. Physical signs such as changes in sleep, appetite and energy levels are associated with substance use disorder. Constantly dilated pupils and other tell-tale signs like red eyes can also indicate chronic drug use.
• Psychological symptoms. Mood swings, anxiety and irritability are also associated with addiction.

The side effects of drug addiction vary widely depending on a person’s health and what substances they use.

Common drug use impacts include:

• Health problems, which might include sudden weight loss, cardiovascular issues or other concerns
• Mental health symptoms, including anxiety, depression or paranoia
• Negative impacts on family and relationship structures, often tied to lost trust or addiction-related conflict
• Poor outcomes at school or work tied to substance use
• Legal or financial challenges related to drug or alcohol use

Data published in World Psychiatry indicates that overdose deaths in the U.S. exceed 100,000 annually. While overdose can happen with a variety of substances, it’s a bigger risk with certain drug classes, including opioids and sedatives.

Mixing substances can also increase overdose risks, because the effects of each may compound. For example, opioids and sedatives both impact breathing systems; when mixed, the outcomes can be extremely dangerous.

Your risks of overdose with some drugs can increase if you stop using them for a while. A rebound effect can occur that causes you to be much less tolerant after a break from a substance than you were when you took it regularly.

Common drug overdose symptoms and warning signs include:

• Slowed breathing or stopping breathing for many seconds at a time
• Confusion
• Lips or nails that look blue in tone
• Not being able to wake someone up

An overdose is a medical emergency. If you suspect someone has overdosed, call 911.

Withdrawal symptoms occur because your body has become used to having a certain amount of a substance. When the drug clears your body and you don’t replace it, your brain reacts as if something is wrong because what has become the status quo is disrupted.

Drug withdrawal varies widely depending on the type of substance you use. Alcohol, benzodiazepine and opioid withdrawals can be especially intense and dangerous for the body. In these cases, medical detox can help support safety through the withdrawal period before you begin more active rehab.

According to the National Institute on Drug Abuse (NIDA), genetics and family history can account for 40% to 60% of a person’s addiction risk.

Other risk factors include:

• Early experimentation with drugs as a child or teen
• Living in a community that has a high rate of poverty
• Challenges navigating peer pressure
• A co-occurring mental health condition
• Previous traumatic experiences
• Easy access to drugs or alcohol
• A social environment that normalizes substance use, such as party culture
• Physical pain or other conditions that involve prescription drug use

A dual diagnosis occurs when you have more than one behavioral health condition.

Co-occurring diagnoses might be:

• PTSD and substance use disorder
• Addiction and depression
• Addiction and anxiety
• Any combination of a mental health disorder and substance use disorder

Integrated care matters when multiple diagnoses are present. Treating one in isolation doesn’t usually resolve anything, because the conditions are typically related. For example, someone might start using alcohol to help deal with depression symptoms. But substance use can worsen mental health symptoms over time, leading to a vicious cycle.

Addiction treatment professionals diagnose substance use disorder by looking at use patterns and other behaviors.

An addiction assessment usually considers:

• What substances you’re using
• How much you’re using
• Whether you’re engaging in unsafe behavior
• Your withdrawal history

Assessments usually fold in mental health evaluations. A comprehensive substance use evaluation lets providers make treatment recommendations based on your risk and severity of addiction.

Unfortunately, many people with substance use disorders don’t get the treatment they need. SAMHSA estimates that in 2024, only around 20% of individuals who might benefit from substance use treatment received it. But there are many options you can choose from to ensure you get the right help for your situation.

Drug addiction treatment options include:

• Inpatient detox. This stage of treatment works to provide stabilization and get you through withdrawal periods. Medication-assisted treatment (MAT) is often used when opioids and certain other drugs are part of the picture.
• Residential rehab. Inpatient care offers structured support in a safe, calm environment.
• Patient hospitalization programs (PHP) or intensive outpatient programs (IOP). These outpatient programs offer structured care that doesn’t require you to stay at a residential facility. They may be used as a first step in addiction treatment or for step-down care when someone leaves a rehab.
• Evidence-based therapies. Cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and other approaches help build healthier coping skills. These methods are used in individual, group and family therapy in inpatient and outpatient settings.
• Medication support. When it’s appropriate, medication may help with detox or support relapse prevention.
• Support groups. Peer support groups are a common part of aftercare, as they can provide ongoing accountability after inpatient or outpatient addiction treatment.

To find a quality addiction treatment program, look for:

• Accredited rehab centers, which hold third-party recognition
• State-licensed rehabs and credentialed individual providers
• Rehabs with clear policies and processes around assessing needs, treatment planning and discharge planning
• Appropriate staffing numbers to meet patient needs safely
• Support for co-occurring mental health diagnoses
• Transparency around costs and payment expectations

Rehab red flags are signs that a provider or center may not provide quality treatment. Rehab warning signs include:

• Lack of accreditation or licensing
• Too-good-to-be-true promises about treatment outcomes
• Pushy sales tactics that try to pressure you into treatment choices
• One-size-fits-all treatment plans
• Lack of discharge planning
• Staff who aren’t able to clearly answer questions about emergency procedures
• Refusal to explain costs or help with an insurance verification

The cost of rehab varies depending on factors such as:

• The level of care you need and how long you need addiction treatment
• Whether you need medical services for detox or have a co-occurring diagnosis that requires integrated care
• Whether a rehab is in-network with your insurance company and how your benefits are set up
• How much of your deductible you’ve already met this year

If you believe a friend or family member has a substance use disorder, it’s natural to want to support and help them.

Some steps you can take when talking to a loved one about drug use include:

• Making specific observations. Use a calm tone and avoid accusations or labels. Simply let them know what you’ve observed and why it concerns you.
• Offer actionable help. You might make calls, help them research rehabs or provide transportation to an assessment appointment.
• Set reasonable boundaries. Protect yourself and other family members while providing support.

Addiction recovery is an ongoing walk, and you don’t come out of inpatient rehab “cured.” Aftercare planning that connects you with support resources and continuing care can help support better long-term outcomes. Recovery support after treatment varies according to a person’s needs.

Common options include:

• Sober living. If you don’t have a safe and stable home to return to, time in a sober living home can help you establish stronger recovery foundations.
• Peer groups. Peer support groups provide accountability and reduce feelings of isolation in long-term recovery.
• Ongoing therapy. Many people continue weekly or periodic therapy to support relapse prevention.
• Personal routines. Healthy routines can help you live sober and well.

Help.org can help you find a drug or alcohol rehab that meets your needs, including residential rehab near you.