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Updated on September 26, 2022
10 min read

How Can I Tell if Someone I Know is on Drugs?

When someone is on drugs, it usually involves highly addictive substances such as cocaine, heroin, and meth. If you have friends, family, or a loved one that you think is using drugs, you have every reason to worry.

Drug abuse leads to unhealthy behaviors that ruin a person’s life. Even worse, it affects people of all ages.

  • Kids as young as 13 years have reported using illicit drugs.1
  • Illicit drugs resulted in 750,000 U.S. deaths in 2017.2
  • In 2017, it accounted for 100 in every 100,000 emergency room visits among people aged 18 and above.3
  • As of 2019, 7.4 million American adults struggled with drug abuse.4

People use drugs for plenty of reasons, such as wanting to feel good, to improve performance at work or school, or to fit in. Some even try drugs the first time out of mere curiosity.

Then, there are people who misuse drugs unintentionally. This is common with prescription drugs such as opioid painkillers, where patients take more than what is prescribed or consume them with alcohol. 

Many individuals who develop substance use disorders struggle with mental illness. About half of all individuals with mental illness will also experience a substance use disorder (or vice versa).

Whatever a person’s reason for using drugs, continued use will soon lead to drug tolerance, physical dependence, and drug addiction. Knowing the signs and symptoms of drug use gives you the chance to get help before it’s too late.

Different types of drugs produce different effects on a person’s physical and mental health, as well as their behavior. But there are common signs and symptoms that suggest a person needs early intervention.

Physical Signs of Drug Use

How does a person look? How do they present themselves to the outside world? These are good questions to ask when checking for physical signs of drug abuse.

A person’s physical appearance says a lot about them. Since it’s the first thing you will notice, it can help you quickly find out if they’re on drugs. One early sign is an unexplainable change in their looks. For instance, they might have lost weight without dieting or exercising.

Some common physical symptoms of drug use include:

  • Poor hygiene 
  • Red, bloodshot eyes
  • Larger or smaller pupils than usual
  • Poor skin tone
  • Appearing tired or run down
  • Poor physical coordination
  • Slurred speech
  • Unusual odor on breath, body, or clothes
  • Weight loss or weight gain
  • Overall deterioration in physical appearance

How a person uses drugs can also leave visible marks or change their appearance. Drugs that are snorted or administered intravenously may leave the following physical signs.

How to Tell if Someone is Snorting Drugs

Drugs like cocaine, heroin, and crystal meth are available in powder form. Some drug users snort or “huff” them directly up the nose.

Physical symptoms of drug snorting include:

  • Runny or stuffy nose that doesn’t get better
  • Frequent nose bleeding
  • Unusual nasal discharges
  • Recurring nasal infections (e.g., sinusitis)

How to Tell if Someone is Shooting Up Drugs

Heroin, crystal meth, and other drugs can also be administered intravenously - that is, directly into the bloodstream. People who inject drugs into their veins will have track marks on major veins. Track marks can appear as puncture wounds, scabs, or bruises on the forearms, hands, legs, and feet

Other signs and symptoms that someone is shooting up drugs include:

  • Skin infections on needle insertion sites
  • Wearing long-sleeved shirts or pants to cover track marks

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Behavioral Signs of Drug Use

Drug use alters certain parts of the brain, thus leading to changes in behavior and personality. These changes tend to be sudden. So it’s best observed by family and friends who are close to the suspected drug user and are familiar with their normal behavior. 

The most common behavioral signs of drug abuse include:

  • Being less motivated
  • Loss of interest in activities they used to enjoy
  • A decline in performance at work or school
  • Frequent absence from school or work
  • Seeming withdrawn or inactive
  • Lying and secretive behavior
  • Changes in sleeping patterns
  • Changes in eating habits or a loss of appetite
  • Drastic changes in relationships
  • Issues with financial management or spending more money than usual
  • Becomes defensive when asked about substance use
  • Inability to explain reasons for doing something
  • Getting into accidents or injuries more frequently
  • Engaging in risky sexual behavior

Psychological Signs of Drug Use 

Illicit drugs are known for their psychoactive properties or their ability to alter brain function. When someone misuses drugs, they may experience changes in their mood, level of awareness, thoughts, and feelings. 

The psychoactive nature of drugs also causes them to produce behavioral signs. Some of which are more devastating than others.6

Some common psychological signs include:

  • A negative change in personality or attitude
  • Depression and anxiety
  • Irritability and mood swings
  • Low self-esteem
  • Paranoia
  • Hallucinations
  • Difficulty with cognition or thinking
  • Memory loss

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How to Tell if Someone is Using Stimulant Drugs

Prescription stimulants are used in the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. People who use them for other reasons suffer from drug abuse. Cocaine, meth, amphetamine, and crack are also commonly abused stimulants.

Signs and Symptoms of Stimulant Drug Abuse

Stimulants or “uppers” refer to drugs that increase bodily activities. They heighten a person’s attention, boost their energy, and increase their alertness.

Other signs that your loved one is abusing stimulants include:

  • Large dilated pupils
  • Sweating
  • Rapid heartbeat
  • Elevated blood pressure
  • Appears to have excess energy
  • Increased motivation
  • Being jittery and restless
  • Hyperactivity
  • Sudden weight loss
  • Fixating or obsessing over something
  • Flight of ideas and racing thoughts
  • Increased confidence and sense of well-being
  • Insomnia or difficulty sleeping
  • Anxiety or nervousness

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How to Tell if Someone is Using Depressants

Some prescription depressants that are misused include benzodiazepines such as diazepam (Valium®), sedatives like zolpidem (Ambien®), and barbiturates such as phenobarbital (Luminal®).

Signs and Symptoms of Depressant Drug Abuse

Depressants or “downers” are drugs that slow down brain activity. They’re often used in the treatment of muscle spasms, anxiety disorders, and sleep problems.

Here are signs that your loved one is abusing depressants:

  • Dry mouth
  • Decreased blood pressure
  • Slow breathing
  • Poor concentration
  • Slurred speech
  • Confused mental state
  • Lightheadedness or dizziness
  • Headaches
  • Memory problems

How to Tell if Someone is Using Opioids

Opioids are often used in the treatment of chronic pain. Prescription painkillers such as oxycodone (OxyContin®), hydrocodone (Vicodin®), and fentanyl are some of the most commonly abused. However, some opioids like heroin are available on the streets.

Signs and Symptoms of Opioid Drug Abuse

Opioids enhance feelings of pleasure. They create a short-lasting, strong sense of well-being.

Your loved one may be misusing opioids if they exhibit the following:

  • Slow or shallow breathing
  • Slurred speech
  • Shaking
  • Nausea or vomiting
  • Sweating
  • Drowsiness
  • Weight loss
  • Changes in sleeping pattern
  • Decreased libido
  • Loss of coordination

How to Tell if Someone is Using Hallucinogens

Some hallucinogens include lysergic acid diethylamide (LSD) and dimethyltryptamine (DMT). Ketamine, an anesthetic for animals, and dextromethorphan (DM), an ingredient of over-the-counter drugs used in the treatment of coughs and colds, are hallucinogens sold in the black market.

Signs and Symptoms of Hallucinogen Drug Abuse

Hallucinogens are drugs that change the user’s perception. They increase a person’s awareness of their thoughts, feelings, and their surroundings.

Below are signs that a loved one is using hallucinogens:

  • Numbness
  • Elevated temperature and blood pressure
  • Increased breathing and heart rate
  • Disoriented or confused
  • Nausea and vomiting
  • Dizziness
  • Hallucinations
  • Memory loss
  • Feeling detached from oneself and the environment
  • Psychological distress (e.g., panic, paranoia, fear, anxiety)
  • Feelings of invulnerability and increased strength
  • Aggression

Effects & Risks of Commonly Abused Drugs

Heroin, methamphetamine, and cocaine are three of the most commonly abused drugs in the United States.4 Below are some signs of possible drug use in a loved one, along with their side effects and complications.


Common street names: Dope, Hera, Hero, Heron, H, Big H

Heroin is an illegal, highly addictive opioid drug made from morphine, which comes from poppy plants. This drug looks like a white or brown powder or sometimes a black sticky substance. Heroin can be injected, sniffed, snorted, or smoked. As many as 745,000 Americans suffer from Heroin drug abuse.4

Heroin is a depressant that slows down certain functions in the brain and nervous system. It affects heart rate, sleeping, and breathing.

Signs of Heroin Use in a Loved One

  • Pinpoint pupils
  • Sleepiness
  • Slow movement
  • “Track marks” or needle marks on arms
  • Severe itching
  • “Nodding” or going in and out of consciousness
  • Withdrawal symptoms including insomnia, sweating, nausea, and goosebumps

Other Side Effects of Heroin Abuse

  • Warm flushing of the skin
  • Dry mouth
  • Heavy feeling in extremities 
  • Short-lived state of euphoria followed by drowsiness
  • Slowed heart rate, breathing, movement, and brain activity
  • Decreased appetite, thirst, reflexes, and sexual desire

Long-term Complications of Using Heroin

  • Damage to the lungs, liver, kidneys, or brain
  • Contracting Hepatitis or HIV
  • Blood poisoning
  • Convulsions
  • Coma
  • Death

Meth (Methamphetamine)

Common street names: Ice, Crank, Chalk, Rocket Fuel, Speed

Methamphetamine (meth) is an illegal, highly addictive stimulant drug. Meth appears as a white, odorless powder that easily dissolves in water or alcohol. Meth affects about 2 million Americans.4

Meth has one of the highest global rates of misuse. Over 14 million people (5.4 percent of the population) have tried meth at least once.

Methamphetamine is very similar to amphetamines; prescription drugs used to treat medical conditions like ADHD. However, the side effects of taking meth last longer and are often more toxic. 

Signs of Meth Use in a Loved One

  • Excessive itching or scratching
  • Skin sores on arms and face
  • Burns on lips or fingers
  • Nervousness, restlessness, or inability to sit still
  • Rotten teeth or gums
  • Appearing sick or ill
  • Twitching, jerking movements (loss of motor skill)
  • Paranoia
  • Aggression or violence
  • Excessive sweating even in cold temperatures
  • Rapid, irrational, and slurred speech
  • Teeth grinding
  • Runny or bloody nose
  • Sudden weight loss
  • Poor personal hygiene 
  • Extreme or bizarre behavior

Other Side Effects of Methamphetamine Abuse

  • Rapid heart rate
  • Irregular heart rate
  • Increased blood pressure
  • Hyperthermia (elevated body temperature)

Long-term Complications of Using Meth

  • Depression
  • Permanent psychological problems
  • Brain damage
  • Liver damage
  • Fatal lung and kidney disorders
  • Stroke or heart problems
  • Death


Common street names: C, Big C, Coke, Crack, Nose Candy, Speedball, White Rock

Cocaine is an illegal, highly addictive stimulant drug made from the coca plant. Cocaine appears as a fine, white powder. Cocaine can be snorted or rubbed into the gums. It may also be injected into the bloodstream. It is abused by over 5.5 million Americans in the United States.4

Signs of Cocaine Use in a Loved One

  • Increased talkativeness
  • Hypersensitivity to light, sound, and touch
  • Dilated pupils
  • Mood swings
  • Overconfidence
  • Overexcitement
  • Frequent nosebleeds
  • Ability to perform physical and intellectual tasks quickly or more slowly than usual 

Other Side Effects of Cocaine Abuse

  • Brief but intense feelings of euphoria
  • Stimulation of the central nervous system (CNS)
  • Constricted blood vessels
  • Tremors
  • Vertigo
  • Muscle twitches
  • Increase in pulse, body temperature, blood pressure, and respiratory rate
  • Extreme excitability or anxiety
  • Sleeplessness and chronic fatigue

Long-term Complications of Using Cocaine

  • Bleeding and damage to nasal passages
  • Paranoid psychosis, hallucinations, and mental abnormalities
  • Impaired driving ability
  • Abdominal pain and nausea
  • Malnourishment
  • Cardiac arrest
  • Seizures
  • Parkinson’s disease
  • Death caused by heart or respiratory failure

Signs Your Loved One Has a Drug Problem (When to Seek Help)

If you suspect drug use in a loved one, it’s important that you get help and get them started on early invention. That way, you can improve their chances of a successful recovery and ensure that they maintain a drug-free life after rehab.

Friends and family members can stage an early intervention once signs of drug use are apparent. You can seek professional medical advice from rehab facilities and addiction specialists. They can provide valuable resources on how to guide your loved ones for improved outcomes.

An intervention is a great way to show your love and support for a loved one who’s struggling with drug abuse. At the same time, you can learn to set boundaries around their addictive behaviors.

Repeatedly offering help through social support, providing them information about nearby drug treatment facilities or treatment programs, and helping them explore other methods to get sober may prompt them to accept help.

Drug Addiction Treatment Options

Many treatment options are available for drug addiction. Different types of treatment options include an inpatient program, outpatient program, or partial hospitalization. 

Some drug abuse treatment centers cater to specific types of drug addiction. The best drug treatment for an individual will depend on the severity of their addiction, the specific drug or drugs abused, their living situation, and their overall health.

Treatment should include both medical detox and therapy to address the underlying issues related to substance abuse.

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Updated on September 26, 2022

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