Signs of Substance Abuse: Warning Signs to Look For

Content Medically Reviewed By: Dr. Robbie Westerman, DNP-PMHNP – Chief Medical Officer

If you notice unexplained behavioral, financial, or physical changes in yourself or someone you love, you do not have to navigate the uncertainty alone. At Camelback Integrated Health & Wellness on North 16th Street in Phoenix, we provide substance abuse treatment through clinical assessment and structured outpatient care. When appropriate, care may include medication-assisted treatment for opioid or alcohol use disorders and intensive outpatient treatment. We first consider substance use, withdrawal risk, mental health, medical history, and current functioning before recommending next steps.

Call our team at 480-631-9623 if you are unsure what these changes mean. We can talk through your concerns and help you understand what kind of evaluation may be appropriate.

Warning signs can appear through behavior, physical health, mental health, relationships, and loss of control. You may notice secrecy, missed responsibilities, financial problems, mood swings, physical changes, or more time spent using or recovering from substances.

A cluster of changes usually matters more than one isolated behavior. Concern increases when several changes persist and substance use begins causing harm.

Substance Abuse vs. Substance Use Disorder

Substance use disorder, or SUD, is the clinical term for a problematic pattern of alcohol or drug use that causes impairment or distress. NIDA’s DSM-based substance use disorder criteria include loss of control, craving, risky use, continued use despite harm, tolerance, and withdrawal.

You do not need every possible sign to meet diagnostic criteria. Severity can vary, and tolerance or withdrawal may not be present in every case.

Behavioral changes can be easier to notice when you know what has shifted from the usual routine.

Social and Routine Changes

You may notice:

• Increased secrecy about whereabouts or substance use
• Changes in friendships or social routines
• Giving up hobbies or recreational activities
• More time spent obtaining, using, or recovering from substances
• Making excuses for unexplained absences

Work, Money, and Responsibility Changes

Other signs may include:

• Missing work, school, or household responsibilities
• Unexplained financial problems
• Repeated unsuccessful efforts to cut down
• Using more alcohol or drugs than intended
• Continuing despite relationship, health, work, or legal problems
• Driving or taking other risks while impaired

When Substance Use Is Harder to Recognize

You do not need to see job loss, unpaid bills, or obvious physical decline before substance use deserves attention. Problems can remain hidden behind a stable career, intact finances, or polished appearance.

Subtler changes can include relying more on alcohol or drugs to unwind, sleep, cope with stress, or get through demanding routines. You may notice defensiveness around use, rigid scheduling that protects opportunities to use, emotional withdrawal, or growing tolerance.

Physical signs vary by substance, dose, frequency, timing, and health history. You may notice bloodshot eyes, unusual pupil changes, weight changes, declining hygiene, unusual fatigue or energy, slurred speech, impaired coordination, tremors, sleep changes, or unusual odors.

How Physical Signs Can Differ With Alcohol and Opioid Use

These signs can overlap with medications, other substances, or medical conditions. A professional assessment is needed to determine the cause.

If an assessment identifies an opioid or alcohol use disorder, medication-assisted treatment may be considered as part of a broader treatment plan.

Increased Drug Tolerance and Withdrawal

Tolerance can mean needing more of a substance to produce the same effect. Withdrawal symptoms differ by substance and may include nausea, sweating, shaking, anxiety, agitation, or sleep problems. SAMHSA guidance on alcohol withdrawal describes shakiness, sweating, anxiety, irritability, and insomnia.

Questions about cost or coverage? Call 480-631-9623. Our care team can check your insurance benefits while you are on the phone and help you understand your coverage before you commit to treatment.

Concern increases when alcohol or drug use becomes difficult to control or continues despite harm.

Higher-concern patterns can include:

• Repeated inability to reduce or stop use
• Strong cravings
• Increasing time devoted to substances
• Using in dangerous situations
• Neglecting major responsibilities
• Giving up important activities
• Continuing despite physical, psychological, social, or financial consequences
• Tolerance or withdrawal when applicable

An online checklist cannot diagnose SUD. A professional assessment can clarify the substance involved, severity, withdrawal risk, mental health needs, and appropriate level of care.

When warning signs persist, our substance abuse treatment in Phoenix can provide a pathway to assessment and individualized treatment planning.

If you are worried about someone you love, focus on what you have observed instead of assigning a label.

Talk About Specific Changes You Have Observed

Choose a calm time when intoxication or conflict is not dominating the conversation. Describe changes such as missed work, unexplained money problems, risky behavior, worsening health, or increasing secrecy. Explain why they concern you.

Avoid arguing about whether your loved one is “an addict.” Focus on concern and encourage an evaluation.

Set Boundaries Without Trying to Control the Outcome

You can protect your safety and finances while still offering support. Clear boundaries can reduce enabling behaviors. You can encourage care, but you cannot control whether your loved one accepts it. Support groups or counseling may also help you manage stress.

Some warning signs require emergency care. Call 911 if you notice:

• Unresponsiveness or inability to wake
• Stopped or severely impaired breathing
• Seizures
• Severe confusion
• Chest pain after substance use
• Immediate danger to you or someone else

For a suspected opioid overdose, CDC guidance on naloxone and overdose response recommends giving naloxone when available and calling 911. Stay with your loved one until emergency help arrives.

If suicidal thoughts or an acute mental health crisis are also present, call or text 988.

Professional assessment can help determine which substances are involved, severity, withdrawal risk, and what level of care fits your needs.

At Camelback Integrated Health & Wellness, our substance abuse treatment in Phoenix provides a broader pathway for substance use and co-occurring mental health needs. If you need structured care while continuing to live at home, our intensive outpatient program in Phoenix may be appropriate after assessment. For opioid or alcohol use disorders, medication-assisted treatment may also be considered when clinically appropriate.

We use assessment findings to match treatment with your current needs.

Call 480-631-9623 to speak with our team and take the next step toward substance use treatment in Phoenix.

• National Institute on Drug Abuse. (n.d.). Media guide: How to find what you need to know about drug abuse and addiction. National Institutes of Health.
• Substance Abuse and Mental Health Services Administration. (n.d.). Alcohol use. U.S. Department of Health and Human Services.
• Substance Abuse and Mental Health Services Administration. (n.d.). Co-occurring disorders and other health conditions. U.S. Department of Health and Human Services.
• Centers for Disease Control and Prevention. (n.d.). 5 things to know about naloxone. U.S. Department of Health and Human Services.