Learn how to identify the signs and symptoms of substance abuse and when to seek help.
Opioid overdoses are on the rise
Our nation is in the midst of an unprecedented opioid epidemic.1 Nearly 841,000 people have died since 1999 from a drug overdose. Over 70% of drug overdose deaths in 2019 involved an opioid.2
Overdose deaths involving opioids, including prescription opioids, heroin, and synthetic opioids (like fentanyl), have increased over six times since 1999.3 Overdoses involving opioids killed nearly 50,000 people in 2019, and nearly 73% of those deaths involved synthetic opioids.4
People struggling with substance abuse may need help from the medical community, family, friends, support groups, employers or organized treatment programs to overcome drug addiction and stay drug-free.
What are the signs and symptoms of drug or substance abuse?
Drug addiction often starts with social or experimental use. For some, the drug use becomes more frequent. The risk of addiction and how quickly dependence strikes varies by individual and by substance. Some drugs have a much higher risk and cause dependency much faster than others. For example, opioids are some of the most addictive drugs in the world.
As time goes on, users can develop a tolerance to drugs and require higher doses to achieve the original effect. Soon they may need the drug just to feel good. As use increases, individuals may find that it's increasingly difficult to go without the drug. Attempts to stop drug use may cause intense cravings or make them feel physically ill (symptoms of withdrawal).
Addiction is a complex condition that cannot be limited to one simple or causal explanation. Genetics, environment, medical or physical history, and mental health can all influence the development of addiction.
Drug addiction symptoms or behaviors can include:
- Needing to use the drug regularly — this can be daily or even several times a day
- Intense urges for the drug
- Needing more of the drug to get the same effect
- Needing to maintain a consistent supply of the drug
- Spending money on the drug, even though they may not be able to afford it
- Not meeting obligations and work responsibilities
- Cutting back on social or recreational activities because of drug use
- Doing things they normally wouldn’t do to get the drug, like stealing
- Driving or doing other high risk activities while under the influence of the drug
- Focusing more time and energy on getting and using the drug
- Failing in attempts to stop using the drug
- Experiencing withdrawal symptoms when attempting to stop taking the drug
Indications that family members or coworkers are using could include:
- Problems at school or work — frequently missing school or work, a sudden disinterest in school activities or work, or a drop in grades or work performance
- Physical health issues — lack of energy and motivation
- Neglected appearance — lack of interest in clothing or grooming
- Changes in behavior — being secretive about plans with others; or drastic changes in behavior and relationships with family and friends
- Spending money — sudden requests for money without reasonable explanation; money or items missing, indicating they being sold to support drug use
When is the right time to seek emergency help?
Seek emergency help if someone you know has taken a drug and:
- May have overdosed
- Shows changes in consciousness
- Has trouble breathing
- Has seizures or convulsions
- Has signs of a possible heart attack, such as chest pain or pressure
- Has any other troublesome physical or psychological reaction to use of the drug
What causes drug addiction and substance abuse?
Like many mental health disorders, several factors may contribute to development of drug addiction and dependence. The main factors are:5
- Environment. Environmental factors, including family beliefs and attitudes or exposure to a peer group that encourages drug use, may play a role in initial drug use.
- Genetics. Once drug use is initiated, the development into addiction may be influenced by inherited (genetic) traits, which may delay or speed up the disease progression.
- Changes in the brain. Addiction may occur when repeated use of a drug modifies the pleasure sensors in the brain. The addicting drug causes physical changes to some nerve cells (neurons) in the brain. Neurons use chemicals called neurotransmitters to communicate. The effects can remain even long after discontinued use.
What are some of the primary risk factors for substance abuse?
Addiction does not discriminate by age, gender or economic status. However, certain factors can affect the likelihood and speed of developing an addiction:6
- Family history of addiction. Drug addiction is more common in some families and likely involves genetic predisposition. If blood relatives, such as a parent or sibling, have alcohol or drug problems, there is a greater risk of developing a drug addiction.
- Being male. Men are more likely to have problems with drugs than women are. However, progression of addictive disorders is known to be faster in females.
- Having another mental health disorder. Mental health disorders such as depression, attention-deficit/hyperactivity disorder (ADHD) or post-traumatic stress disorder, can increase the likliehood of becoming dependent on drugs.
- Peer pressure. Peer pressure is a strong factor in starting to use and abuse drugs, particularly for young people.
- Anxiety, depression and loneliness. Using drugs can become a way of coping with these painful psychological feelings and can make these problems even worse.
- Taking a highly addictive drug. Some drugs, such as stimulants, cocaine or painkillers, may result in faster development of addiction than other drugs. However, taking drugs considered less addicting — so-called "light drugs" — can start someone on a path to further drug use and addiction.
How can I spot a specific substance abuse problem?6
Drug use and intoxication signs and symptoms can vary by substance. If someone you know has a substance abuse problem, visit the Substance Abuse and Mental Health Services Administration website for helpful recovery and addiction treatment options and locations.
SAMHSA National Helpline:
 CDC. (2015). MMWR, 62;1-5
 CDC. (2013). Vital Signs, 1487-1492
 Department of Health and Human Services (Updated 2016, June). Fact Sheet: The Opioid Epidemic [Web log post].
 Prescription Drug Abuse. (2005-2017) WebMD, LLC [web log post].
 Substance Abuse and Addiction. (2005-2017) WebMD, LLC [web log post].