How To Recognize a Substance Use Disorder
How do I know if my adult friend or loved one has a substance use problem?
This page is filled with resources and information to help someone you care about who might have a drug* use problem. First, try to answer the questions below as honestly as possible. If the person is willing, you can include him or her in the discussion. (*"Drugs" is used here to refer to illicit drugs, prescription drugs, or alcohol.)
- Does the person take the drug in larger amounts or for longer than intended?
- Do they want to cut down or stop using the drug but can’t?
- Do they spend a lot of time getting, using, or recovering from the drug?
- Do they have cravings and urges to use the drug?
- Are they unable to manage responsibilities at work, home, or school because of drug use?
- Do they continue to use a drug, even when it causes problems in relationships?
- Do they give up important social, recreational, or work-related activities because of drug use?
- Do they use drugs again and again, even when it puts them in danger?
- Do they continue to use, even while knowing that a physical or mental problem could have been caused or made worse by the drug?
- Do they take more of the drug to get the wanted effect?
- Have they developed withdrawal symptoms, which can be relieved by taking more of the drug? (Some withdrawal symptoms can be obvious, but others can be more subtle—like irritability or nervousness.)
If the answer to some or all of these questions is yes, your friend or loved one might have a substance use problem. In the most severe cases, it is called an addiction. It can happen to people from all backgrounds, rich or poor, and it can happen at any age. See NIDA's video, below.
Anyone Can Become Addicted to Drugs
Through scientific research, we now know more than ever about how drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop using drugs and lead productive lives.
If you think your adult friend or loved one might be addicted, you cannot fix the problem by yourself, but there are some steps you can take. Encourage your loved one to explore the issue by reviewing this page: What to Do If You Have a Problem with Drugs: For Adults. Offer to walk the person through the information and to help access the resources.
If the person is initially not willing to be helped, you can read the information below to learn more about drug addiction and to see if there are resources or information that might convince your loved one to seek help.
Why can't people stop using drugs on their own?
Repeated drug use changes the brain, including parts of the brain that give a person self-control. These and other changes can be seen clearly in brain imaging studies of people with a drug addiction. These brain changes explain why quitting is so difficult, even when an addicted person feels ready. See NIDA's video, below.
Why Are Drugs So Hard to Quit?
If my friend or loved one refuses to cooperate, should we conduct an intervention?
Many people are compelled to enter treatment by the pressure of their family, friends, or a court system. However, there is no evidence that confrontational "interventions" like those familiar from TV programs are effective at convincing people they have a problem or motivating them to change. It is even possible for such confrontational encounters to escalate into violence or backfire in other ways. Instead, you should focus on creating incentives to at least get the person to a doctor. Often people will listen to professionals rather than have conversations with friends and family members, as the latter encounters can sometimes be driven by fear, accusations, and emotions.
My friend or loved one is afraid of being forced to stop using drugs and what will happen. Do treatment centers force people to stop taking drugs immediately?
People of all ages with substance use disorders live in fear of what will happen if their drugs are taken away. You can ensure the person you care about that professional treatment centers will keep them safe and as comfortable as possible if a detoxification process is needed.
Treatment is always individualized based on the person’s needs. However, if someone is using a drug upon admission to a treatment program, one of the first things needed is to help safely remove the drugs from their system (often referred to as "detox"). This is important because drugs impair the mental abilities needed to engage with and stay in treatment.
When patients first stop using drugs, they can experience a variety of physical and emotional withdrawal symptoms, including depression, anxiety, and other mood disorders; restlessness, and sleeplessness. Remind your loved one that treatment centers are very experienced in helping patients get through this process and keeping them safe during it. Depending on your loved one's situation, there may also be medications to reduce these symptoms, which makes it easier to stop using.
My friend was in rehab before but relapsed afterward. How do we know treatment will work this time?
This means your friend has already learned many of the skills needed to recover from addiction and should try it again. The fear of relapse should not get in the way of trying treatment again. People being treated or recovering from addiction relapse about as often as do people with other chronic diseases, such as hypertension and asthma. Treatment of any chronic disease involves changing deeply imbedded behaviors, and relapse sometimes goes with the territory—it doesn’t mean treatment failed. A return to drug use indicates that treatment needs to be started again or adjusted, and your friend might benefit from a different treatment approach.
I am worried that my loved one is driving while using drugs. What do I do?
If you share a vehicle, you should demand that your loved one see a physician before using the car again. This can be very inconvenient for both of you, but it is imperative that drug users not drive. Your loved one's life, yours, and others' could be at risk.
In many cases, you may not be able to control your loved one's ability to drive. You must tell them that the single most responsible thing to do is not drive while using drugs (including using prescription medications). All drugs can impair skills necessary for the safe operation of a vehicle, including motor skills, balance and coordination, perception, attention, reaction time, and judgment. Even small amounts of some drugs can have a measurable effect on driving ability.
Drugs also affect people's ability to tell if they are impaired—so you might have to make some difficult choices. If you believe your loved one is driving and impaired, you should consider calling law enforcement. This can be a difficult decision, but sometimes court intervention can actually help force a loved one to seek help. For more see our DrugFacts on drugged driving.
If you are an employer and suspect an employee is using drugs, you should immediately suspend any driving privileges while you get it sorted out. You can contact this government helpline to find out more about workplace drug testing: Drug-Free Workplace Helpline: 800-967-5752 (800-WORKPLACE) or HELPLINE@SAMHSA.HHS.GOV.
If people take drugs because they feel depressed—but are depressed because drugs are overtaking their life---How do we know which problem came first?
It is very possible your loved one needs to find treatment for both depression and addiction. This is very common—it's called "comorbidity," "co-occurrence," or "dual diagnosis" when you have more than one health problem at the same time. Encourage your loved one to discuss all symptoms and behaviors with the doctor. There are many nonaddictive drugs that can help with depression or other mental health issues. Sometimes health care providers do not communicate with each other as well as they should, so you can be your loved one's advocate (with their permission) and make sure all related health care providers know about all of the health issues that concern you. People who have co-occurring issues should be treated for all of them at the same time. For more information see our DrugFacts on comorbidity.
Cite this article
NIDA. (2019, October 18). Step by Step Guides to Finding Treatment for Drug Use Disorders. Retrieved from https://www.drugabuse.gov/step-by-step-guides-to-finding-treatment-drug-use-disorders