Signs of Substance Use

Overview

The following are some obvious signs that a person may be drinking alcohol, using tobacco, or using other substances. This is not a complete list. If you suspect use of a particular substance, get more information on signs of use for that substance.

Alcohol

• Alcoholic beverages missing from the home storage cabinet
• Odor of mouthwash (used to cover up alcohol) on the breath
• Hangover symptoms (such as nausea, vomiting, or headache), if recently used

Tobacco

• A distinctive smell on the breath and clothing
• Tobacco products in the person's possession

Marijuana

• Sweet smell on clothing; bloodshot eyes, if recently used, and frequent use of eyedrops to reduce the redness
• Careless grooming, increased fatigue, and changes in eating and sleeping patterns, if using regularly
• Drug paraphernalia (such as pipes) in the person's possession

Club drugs such as ecstasy (MDMA)

• Skin rash similar to acne
• Small bottles with liquid or powder in the person's possession

Stimulants such as cocaine or methylphenidate (Ritalin)

• Long periods of time without sleep
• Persistent runny nose and nosebleeds, or injection marks on arms or other parts of the body
• Drug paraphernalia, such as syringes, spoons with smoke stains, small pieces of glass, and razor blades

Hallucinogens such as LSD

• Trance-like appearance with dilated pupils, if recently used
• Possession of small squares of blotter paper (sometimes stamped with cartoon characters) or other forms of the drug

Opioids such as heroin or hydrocodone (Norco)

• Very small pupils and a drowsy or relaxed look, if recently used
• Extra pill bottles around the house or in the trash
• "Doctor shopping" (getting multiple opioid prescriptions from different doctors)
• Possession of injecting supplies (an outfit or rig), which may consist of a spoon or bottle cap, syringe, tourniquet, cotton, and matches

Inhalants

• Chemical breath, red eyes, or stains on clothing or face, if recently used
• Soaked rags or empty aerosol containers in the trash

Anabolic steroids

• An unpleasant breath odor
• Mood changes, including increased aggression
• Changes in physical appearance that aren't caused by expected patterns of growth and development
• Possession of medicines or syringes