Substance Abuse: Signs and Symptoms (1/3)
This is the first installment of a three-part series on substance abuse.
Substance Abuse can take shape in many forms, whether it be alcoholism, nicotine or tobacco addictions, or excessive drug use. Substance abuse has many dangerous side effects and may appear externally as changes in the body, behavior, and emotions. This part of the series deals with recognizing the signs and symptoms of substance abuse, and how clinicians recognize clients who struggle with this disorder.
Symptoms of Substance Abuse
Physical symptoms of substance abuse may include the following:
Dilated or constricted pupils
Abrupt changes in weight
Interrupted sleep patterns
Changes in complexion (acne, jaundice, or marks)
Lack of cleanliness and personal care
While physical symptoms can be the easiest to spot, substance abuse also manifests itself through psychological and behavioral symptoms. Psychological signs and symptoms may include depression or anxiety, low self-esteem, poor motivation, irritability or mood swings, and changes in attitude or personality. Behavioral signs and symptoms to be aware of can appear as dramatic changes in habits and/or priorities, secretive behavior, ignoring responsibilities, financial distress, absenteeism, poor decision making, and increased conflict. In some cases, substance abuse may lead to involvement in criminal activity, especially if obtaining the substance in question is illegal or risky.
How do clinicians recognize clients who are struggling?
Dan Cooke, a clinician at Telebehavioral Health that specializes in Addiction and Substance Abuse, says that many clients struggling with substance abuse are open about it when they initially begin therapy: “Usually the client has said something about it, then I just learn a lot more with the first interview, and usually I may just ask it as a brief question in my intro assessment.” Additionally, if a client is being referred to him, Cooke will hear about it from the referral source itself. Cooke also notes that “typically, when there’s a problem with substance abuse, there are behavioral health issues as well. We call that co-occurring disorders.” Occasionally, some clients don’t believe they have a problem with substance abuse, however, Cooke says that in such situations “you can clearly tell that there are problems, like a second or third DUI for example, but they may be in denial.” Over time, creating a relationship with the client and establishing trust may help them to recognize the problem.