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Signs and Symptoms of Misuse

How do I know if my loved one is using or abusing substances?

There are many signs, both physical and behavioral, that indicate drug use and each drug has its own unique manifestations. Sometimes it can be difficult to distinguish normal teenage moodiness or angst from signs of drug use.

Some general indications that a person may be using drugs include:

  • Problems at school or work – frequently missing school or work, a sudden disinterest in school a ctivities or work, or a drop in grades or work performance
  • Physical health issues – lack of energy and motivation, red or glassy eyes, sniffly or runny nose
  • Neglected appearance – lack of interest in clothing, grooming or looks
  • Sudden or drastic changes in behavior – withdrawal from family members, barring family members from entering his or her room, being secretive about where he or she goes with friends; or drastic changes in behavior and in relationships with family and friends
  • Spending money – sudden requests for money without a reasonable explanation; or your discovery that money is missing or has been stolen or that items have disappeared from your home, indicating maybe they’re being sold to support drug use
  • Mood swings – irritable and grumpy and then suddenly happy and bright
  • Loss of interest in hobbies, sports, and other favorite activities
  • Change in sleeping pattern – up at night and sleeps during the day

Commonly abused illicit drugs and prescription medications and their associated symptoms:

  • Marijuana, hashish and other cannabis-containing substances – People use cannabis by smoking, eating, or inhaling a vaporized form of the drug.  Symptoms can include compulsive eating, bloodshot red eyes that are squinty (trouble keeping them open), dry mouth, excessive and uncontrollable laughter, forgetfulness, short term memory loss, extreme lethargy, delayed motor skills, occasional paranoia, hallucinations, laziness, lack of motivation, sickly sweet smell on body, hair, and clothes, and strong mood changes and behaviors when the person is “high”.
  • Synthetic cannabinoids and substituted cathinones – Two groups of synthetic drugs – synthetic cannabinoids and substituted cathinones – are illegal in most states.  The effects of these drugs can be dangerous and unpredictable, as there is no quality control and some ingredients may not be know.  Synthetic cannabinoids, also called “K2” or “Spice,” are sprayed on dried herbs and then smoked, but can be prepared as an herbal tea.  Despite manufacturer claims, these are chemical compounds rather than “natural” or harmless products.  These drugs can produce a “high” similar to marijuana and have become a popular, but dangerous, alternative.  Substituted cathinones, also called “bath salts,” are psychoactive substances similar to amphetamines such as Ecstasy (MDMA) and cocaine.  Despite the name, these are not bath products such as Epsom salts.  Substituted cathinones can be eaten, inhaled or injected and are highly addictive.  These drugs can cause severe intoxication that results in dangerous health effects or even death.
  • Barbituarates and benzodiazepines – Prescription central nervous system depressants.  They are often used and abused in search for a sense of relaxation or a desire to “switch off” or forget stress-related thoughts or feelings.  Phenobarbital, amobarbital (Amytal) and secobarbital (Seconal Sodium) are examples of barbiturates.  Examples of benzodiazepines include sedatives, such as diazepam (Valium), alprazolam (Xanax, Niravam), lorazepam (Ativan), clonazepam (Klonopin) and chlordiazepoxide (Librium).  Symptoms of overuse include decreased inhibition, slowed motor coordination, lethargy, relaxed muscles, staggering gait, poor judgement, slow, uncertain reflexes, disorientation, and slurred speech.
  • Meth, cocaine and other stimulants – Stimulants include amphetamines (Adderall), meth (methamphetamine), cocaine and methylphenidate (Ritalin).  They are often used and abused in search of a “high,” or to boost energy, to improve performance at work or school, or to lose weight or control appetite.  Symptoms include seeming “wired”, restless or agitated, sleeplessness for days and weeks at a time, loss of appetite, extreme weight loss, dilated pupils, excited, talkative, deluded sense of power, paranoia, depression, loss of control, nervousness, anxiety or panic attacks, unusual sweating, shaking, hallucinations, short tempered or aggression, violence, dizziness, mood changes, blurred vision, mental confusion or impaired thinking, and decreased sexual drive.
  • Club drugs – Are commonly used at clubs, concerts and parties.  Examples include Ecstasy or Molly (MDMA), gamma-hydroxybutyric asid (GHB), flunitrazepam (Rohypnol, or roofie) and ketamine (special K).  These drugs are not all in the same category, but they share some similar effects and dangers, including long-term harmful effects.  Because GHB and Rohypnol can cause sedation, muscle relaxation, confusion and memory loss, the potential for sexual misconduct or sexual assault is associated with the use of these drugs.  The body may overheat which can lead to fatalities.
  • Hallucinogens – The most common hallucinogens are lysergic acid diethylamide (LSD) and phencyclidine (PCP).  Symptoms include dilated pupils, skin flushing or discoloration, dizziness or loss of coordination, false sense of power, euphoria, distortion of time and space, hallucinations, confusion, paranoia, withdrawal, sweating, numbness, impaired perceptions, nausea, vomiting, loss of control, anxiety, panic, helplessness, and self destructive behavior. Sometimes violent, aggressive or bizarre behavior or suicide have occurred.
  • Inhalants – Some commonly inhaled substances include glue, paint thinners, correction fluid, felt tip marker fluid, gasoline, cleaning fluids and household aerosol products.  Due to the toxic nature of these substances, users may develop brain damage.  Short-lasting euphoria, giggling, silliness, dizziness are symptoms of use. Then come headaches and full-blown “faintings” or going unconscious. Long term use can produce short-term memory loss, emotional instability, impairment of reasoning, slurred speech, clumsy staggering gait, eye flutter, tremors, hearing loss, loss of sense of smell, and escalating stages of brain atrophy.  Sometimes the brain damage is irreversible or only partially reversible.
  • Narcotic painkillersOpioids are narcotic, painkilling drugs produced from opium or made synthetically.  This class of drugs includes heroin, morphine, codeine, methadone, oxycodone and oxycontin, among others.  Symptoms include chemically enforced euphoria,  “nodding,” which is a dreamlike state, near sleep, drifting off for minutes or hours.