The Most Common Signs of Substance Abuse

passed out drunk on couch

Have you ever heard of a “super-frequent user” in the context of medicine and health? Doctors and others in the field use that term to refer to those patients who they see all the time in the emergency room, specifically those who end up in the ER at least 10 times per year. Understandably, doctors are concerned about these patients and want to find out what the problem is so that they can help them improve their health and lead a happier existence. There has long been a widespread assumption that in most cases, super-frequent users were probably by and large drug addicts or alcoholics, and this assumption appears to have been confirmed by a study released recently by the Henry Ford Health System.

Specifically, the study found that 77% of super-frequent users are patients who suffer from some type of substance abuse addiction. Prescription painkillers lead the pack in terms of being the most common type of drug that ends up in frequent ER visits, followed by street drugs and then alcohol. What can the general public take away from this study? A very important lesson, namely that if you have a friend or family member who seems to be always going to the emergency room, this may be a sign that he or she has a problem with addiction.

It may be true that the vast majority of super-frequent users are drug addicts, but the inverse is not necessarily true; not all drug addicts and alcoholics go to the hospital frequently. On the contrary, a high percentage of people who engage in substance abuse are “high-functioning addicts,” people who manage to get by in life and maintain a degree of normalcy while at the same time spending lots of time getting high or drunk. How can you spot such a person? How can you tell if your friend or family member is an addict?

Signs of Substance Abuse

Here are a few of the common signs of substance abuse:

  • Changes in personality and mood
  • Erratic behavior
  • Frequent illness
  • Sluggishness or lack of energyLack of motivation and drive
  • Increasing secrecy and withdrawn behavior
  • Irrational outbursts
  • Seeming to “never have any money”
  • Foul body odor
  • A sudden change in friends and social circles
  • Unaccustomed absence from the home
  • Excessive sleeping
  • Major changes in appetite, whether increased or decreased
  • Significant and unexplained weight loss or weight gain
  • Jitters or tremors
  • Unexplained marks or bruises, especially on the arms
  • Drop in attendance at school or work
  • Shifts between periods of manic activity and elevated mood, followed by deep slumps of depression and lethargy
  • Difficulty thinking or solving problems
  • Impaired communication skills
  • Neglected responsibilities and broken promises
  • Bloodshot eyes or dilated or contracted pupils
  • Slurred speech

Of course, there could be many explanations for why your loved one is displaying one or several of these symptoms. It could be too much stress at work or perhaps a nutritional deficiency. But if your loved one is acting in ways that concern you and which seem to line up with the items on the list above, by no means should you hesitate to take action just because you’re worried that you could be wrong about it.

Approach your loved one with a patient and caring demeanor, rather than being accusatory, and offer your help with open ears and a stable shoulder to lean on. Ask your friend or family member what is going on and express your love and concern for his or her well being. Hopefully, it will turn out that you were wrong, but if you are right you will have now opened the door to a handling of the situation.



Sue Birkenshaw

Sue has worked in the addiction field with the Narconon network for three decades. She has developed and administered drug prevention programs worldwide and worked with numerous drug rehabilitation centers over the years. Sue is also a fine artist and painter, who enjoys traveling the world which continues to provide unlimited inspiration for her work. You can follow Sue on Twitter, or connect with her on LinkedIn.