Addiction is among the most serious public health issues facing the United States today. Over 20 million Americans are estimated to have a substance abuse disorder of some sort, with drug addiction challenges costing our healthcare system around $740 billion annually. Without proper treatment, drug abuse and addiction can change lives forever, harming friendships and family relationships, hampering career and educational growth, and even ending lives: over 72,000 overdose deaths occurred in 2017 alone. Addiction doesn’t stop at illicit drugs, either; any substance, from shopping to gambling to sex, can create both physical and mental compulsions based on the reward centers in the brain, driving behavior in unhealthy and obsessive ways.
Even with the differences in forms of addiction and the behaviors caused by addiction, the end result is largely the same. While users can often remain reasonably functional for a time, like alcoholics who still manage to hold down a job and care for a family, things eventually start to slide. At this point, many users are resistant to get help, assuming that when it’s time, they’ll be able to stop. When the plates start to fall – job loss, breakups, or legal issues, for example – an effort to quit may begin in earnest, but by this point, the bonds are too strong and without help, it’s extremely challenging to return to a normal way of life.
This is what you need to know to identify addiction in its early stages before rock bottom draws near, highlighting red flags to look for in your friends, family members, and even yourself.
Seeing the Signs of Addiction
Addiction often starts slow. Maybe a friend will try a common drug at a party, or take a drink in a dorm room away from home for the first time. Maybe addiction will start with a great night out at the poker table, or with the use of legitimate prescription medication to treat a medical condition. Whatever the reason, use starts somewhere, and it’s generally not chronic from the beginning. As such, it can be extremely difficult to accurately interpret the signs before it’s too late.
In the earliest days of addiction, when it is viewed as an indulgence without addiction, it is used as a pleasure that is fun and entertaining – or, for those who develop addictions to medications legally prescribed, it may offer a euphoric escape from chronic pain. Use may be frequent or semi-frequent, but generally isn’t dominating. However, in time, this will change. This may depend on the individual, some are able to continue using in secret for months or years, but as dependence grows, so does abuse. Use will accelerate from occasionally to always, with a substance dominating all or most of the time an individual spends doing anything. Before long, the substance in question will surpass virtually everything else in life.
In evaluating signs of addiction, it’s important to understand how lifestyles and attitudes change in time. It’s easy to make excuses for those who are close to you, mistakenly assuming that new behavior patterns were always in place or failing to see the signs out of denial or simple naivete. For this reason, be objective about the signs you’re seeing in those around you, even if it’s tempting to rationalize them away.
- How has behavior changed? Has a previously studious individual given up on school, or a once-dedicated employee quit work?
- Were there any triggers that may contribute to a growing substance problem, like divorce or the death of a loved one?
- Is an addictive drug taking over in a way it never used to?
- Has a once-open relationship changed to one of secrets and hiding things, like plans and whereabouts?
- Has substance use become a crutch or a form of stress relief never previously needed?
While it’s only natural to idealize loved ones, in evaluating addiction, being as realistic as possible is always an advantage.
The Evolution from ‘Want’ to ‘Need’
For many users, the most critical turning point comes at the intersection between want and need. Many Americans live life balancing the things they want to do – sleep all day, or skip work to spend time with family and friends, for example – with the things they know they need to do – go to work and cook dinner – and most adults are at the very least competent in achieving an appropriate split. However, for those with a burgeoning addiction, ‘wants’ begin to cross the lines into needs. While many people like drinking, an alcoholic needs to drink, and his motivations will begin to change greatly with this in mind.
Those who need an addictive substance or activity will be far less flexible and compliant than those who simply like to relax or indulge from time to time. From a disinterest in previous hobbies to reluctance to change plans, as addiction sinks in, outside activities and obligations become far less important.
Extreme Behavioral Shifts
Those who are addicted or on the brink of abuse or reliance will often show behavioral signs. These include:
- Secretive behavior, like hiding plans, failing to give explanations for whereabouts and covering up potentially suspicious activities
- Inability or extreme reluctance to change plans
- Lying about plans; for example, pretending to spend more time at the office rather than admitting to an increasing presence at the bar
- Financial troubles; most addictions can be quite expensive, and the average individual will not be able to spend hundreds or thousands of dollars a month on a vice without raising suspicion
- Stealing, either money or substances
- Interest in isolation; those hiding addictive behaviors will not want others around
- Disregard of others, including friends and family
A single sign can be indicative of any number of personal or behavioral problems, but as the evidence begins to mount, denying addiction becomes far less likely.
How to Spot Withdrawal
For those stuck in a downward spiral, it’s not uncommon to attempt to quit without intervention, whether due to want, need, or a combination of both. This may be done out of shame due to conflicts in life, like challenges at work or at home, or to attempt to take control the situation without letting anyone else know how bad an addiction is getting. Unfortunately, this is generally easier said than done.
Trying to quit, whether going cold turkey or using detox guides available on the Internet, can be both challenging and dangerous, and it’s not uncommon to see rapid relapse rates in patients attempting recovery without professional support. For this reason, these individuals may show withdrawal signs, whether short-term or long-term. While withdrawal will differ from one substance or activity to another, it is often characterized by symptoms that include:
- Anxiety and paranoia
- Irritability, anger, and mood swings
- Nausea, vomiting, and intestinal discomfort
- Muscle weakness or cramping
- Apathy or depression
- Intense, obsessive cravings
For many substances, these symptoms are derived from the physical components of addiction; when the brain chemistry adjusts due to prolonged use, removing the presence of a substance can be deeply uncomfortable. The unpleasant nature of withdrawal is a direct contributor to relapse.
Physical Changes from Addiction
Emotions and attitude aren’t the only things that change with addiction; the body changes, too. While the physical results of addiction aren’t necessarily uniform – there will be a big difference in, for example, a gambling addiction versus an alcohol addiction – all abusive behavior has the ability to create harmful reactions.
For many addicted individuals, hygiene, fitness, and healthy eating are often neglected in favor of using substances. It’s not uncommon for those with substance use disorders to stop going to the gym, eat increasingly more junk food, take up habits like smoking, and get less sleep than a healthy person. This can lead to weight gain, lethargy, nutritional deficiencies, and increased likelihood of conditions like heart disease.
Some substances have the ability to create further physical challenges, like decaying teeth and gum disease, liver damage, brain damage, muscle damage, psychological disorders, pockmarked skin, and damage to the nasal passages.
Hitting Rock Bottom
For every addiction, there is a limit. Often colloquially known as hitting rock bottom, this period of extreme desperation occurs at the peak of addiction, after all, other interests, relationships, and obligations fade away.
What defines rock bottom differs from one person to another, but may include losing a job due to addiction, filing for bankruptcy or ending up homeless, losing a relationship with a spouse or children, or even ending up in jail or with other forms of legal problems. The lowest point of addiction is different for everyone, but for those who don’t get help before it’s too late, little else will make a difference in getting a substance abuser back on the right track.
The destruction of the good things in life, from career to family, is among the strongest signs of addiction. When things spiral so far out of control that there may be no returning to normal, the only direction left to go is up.
A Brighter Future
When you see signs of addiction or abuse in those you love, or even in yourself, the right outreach is critically important. By promoting the ability to seek assistance and serving as a support system for those pursuing recovery, it’s possible to help the most important people in your life to overcome addiction, one step at a time.