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How To Recognize Substance
Use Disorder

Substance use disorder (SUD) refers to a condition in which individuals use or consume drugs or other substances despite known harmful consequences. People who suffer from SUD tend to hyper-focus on using or finding their drug of choice, which is typically alcohol, tobacco or an illicit drug. The intense focus and frequent use often interfere with one’s day-to-day functioning. Despite impairment and the known consequences, suffers of SUD continue to use harmful substances with increasing frequency.

SUD — also known as drug addiction — affects approximately 15% of South Africa’s population. This percentage, according to a representative from the country’s government drug control organization, is twice that of the world norm for countries of similar size. Just as alarming is the fact that the percentage only accounts for known cases of SUD. The representative suspects that, following more research, the figure will only rise.

Substance abuse disorder is a very serious condition that, in addition to harming one’s health, can alter one’s behaviour, attitude and priorities. It can affect everything from one’s personal relationships to professional aspirations to overall quality of life. If you suspect that a friend of loved one is on a slippery slope to addiction and its more devastating consequences, you may wonder what signs, if any, you can look for. What does addiction look like, and how can you spot it before it is too late?

Signs and Symptoms of Substance Use Disorder

The warning signs of SUD fall into three distinct categories: physical, behavioural and psychological. Though the symptoms are largely dependent on a person’s unique biological and physiological makeup and the drug in question, some are more common than others.

Physical Signs of SUD

Substance use disorder often manifests in outward signs that friends or loved ones often notice before the affected person realizes he or she has a problem. Those signs may include the following:

  • Bloodshot eyes, or pupils that are smaller or larger than normal
  • Deterioration in physical appearance
  • Sudden weight gain or weight loss
  • Decline in personal grooming and/or hygiene
  • Changes in sleep patterns
  • Changes in appetite
  • Constant runny or sniffling nose
  • Unusual odours on body, breath or clothes
  • Slurred speech, tremors and/or impaired coordination

Behavioural Signs of SUD

In addition to physical signs of substance abuse, you may notice behavioural changes in your friend or loved one as well. Behavioural symptoms of SUD may include the following:

  • Secretive or suspicious behaviours
  • Difficulties in personal relationships
  • Frequent legal trouble, including accidents, fights, illegal activities and driving under the influence
  • Neglecting responsibilities at home, work or school, or neglecting one’s children
  • Unexplained financial troubles or need for money/borrowing money from friends and family members
  • Sudden changes in favourite hangouts, hobbies or friends
  • Increased tolerance of recreational drugs
  • Abandonment of favourite activities, such as hobbies, sports and socialization
  • Continued use of a substance despite the obviousness of adverse consequences, such as blacking out, infections, depression, paranoia and mood swings

Psychological Signs of SUD

Finally, substance abuse disorder takes a toll on one’s psychological well-being. Some outward symptoms you may notice as a person close to an addicted individual are as follows:

  • Lack of motivation
  • Appearing “spaced out” or tired all the time
  • Appearing anxious, fearful or paranoid for no discernible reason
  • Episodes of extreme energy, irritability or nervousness
  • Sudden changes in mood, increased irritability or random angry outburst
  • Unexplainable changes in attitude or personality

Warning Signs of SUD From a User’s Perspective

Many people who are in the midst of or are developing a substance use disorder do not realize what is happening to them. Many do but are in denial. Worrying about how much you drink or use a certain drug is, in and of itself, a sign that you do have SUD. However, if you need more indictors, consider the following:

  • You need to use a substance regularly, daily or several times a day.
  • An intense urge to use a substance constantly blocks out any other thought.
  • You need to take larger amounts of the drug over time to achieve the same effect as when you first used it.
  • You take more amounts of the substance than you intend when you use a substance for the first time a day.
  • You make certain that you always have a supply of the substance available.
  • You spend money on the drug, even though you cannot afford it.
  • You realize the drug or substance is causing problems in your life and/or to your health, but you continue to use it regardless.
  • You fail to meet work or personal obligations because of your substance use, or you slowly cut activities you once enjoyed out of your life because of it.
  • You do things to obtain the drug that you would not normally do, such as lie, steal or cheat.
  • You engage in risky activities when under the influence of the substance, such as driving while high or drunk.
  • You try to stop using the substance, but your efforts inevitably fail.
  • You spend considerable time trying to get the drug, using the drug or recovering from the effects of the drug.
  • When you do attempt to stop using the substance, you experience withdrawal symptoms that go beyond a typical “hangover.”
  • When you do experience withdrawal symptoms, you misuse the drug to make them go away.
  • You take a drug under dangerous conditions, such as by using dirty needles or having unprotected sex on the drug or to get the drug.

If you can relate to any of these statements, chances are that your substance use is out of control and that it is time to seek help.

Why Does Substance Use Disorder Occur?

At the surface level, substance use disorder occurs simply because abused substances have a “feel good” effect on the brain and body, albeit temporarily. According to the National Institute on Drug Abuse, most people begin to use drugs for one or more of the following reasons:

  • To feel good, or to get that “high” feeling that is intoxication
  • To feel better, such as to relieve stress, forget about problems or feel numb
  • To do better, such as to increase performance at work or stay up for longer periods
  • Peer pressure or curiosity, meaning to experiment

Trying a drug one time, or occasional use of a drug, does not mean a person has a disorder. The disorder develops when an individual uses a drug more and more frequently, thereby triggering an actual change in the brain’s structure and function. Brain imaging studies show that frequent use of abused substances, such as drugs and alcohol, causes changes to the areas of the brain that affect learning, memory, decision making and behavioural control. These changes are what contribute to the intense cravings, personality changes, behavioural changes and abnormal movements that are indicative of SUD. Depending on the level of abuse, these changes can be temporary, or they can be long-lasting.

The risk of addiction varies from person to person and is often dependent on the drug in question. For instance, some drugs, such as opioids, have highly addictive properties, with many people becoming addicted within just a few weeks. Alcohol use disorder, however, often develops in stages, with many people taking months or even years to move through the four main stages.

That said, as people become addicted, they often build up a tolerance to the substance in question. What this means is that they eventually require more of the substance to experience the same euphoric effects, thereby exacerbating the brain-changing and other health-related consequences.

How Can You Help a Struggling Loved One?

If you notice that a friend or loved one is struggling with SUD, you will want to tread carefully in how you approach him or her. If your loved one believes that he or she does not have a problem, he or she may become offended and defensive, and possibly isolate him or herself from you. Even if your loved one recognizes that he or she has a problem, he or she will likely deny it and, again, become defensive. In fact, individuals who recognize they have a problem but fail to act on their own are the most difficult to get through to, as their recognition but lack of action indicates they do not want to quit.

That said, though intervening with a loved one’s addiction may prove difficult, there are ways to go about an intervention that may prove effective. Below are tips for what and what not to do when attempting to help a loved one overcome addiction.

What To Do

  • Learn all you can about drug and alcohol use disorders.
  • Approach the individual and express your concerns to him or her. Offer your support, including your willingness to go with him or her to seek help.
  • Be prepared to be met with denial, excuses or anger, and have examples of worrisome behaviour ready.
  • Do not become defensive or angry yourself. Rather, approach the person from a place of love and concern.
  • Do not expect the individual to cease the substance use without help; if he or she is responsive to your concerns, offer to attend a meeting with him or her that day or night. Addicted persons rarely follow through with their promises to “cut back” or cease use.
  • Understand that recovery is an ongoing process, and be prepared to offer your support through the entirety of it.

What Not To Do

  • Do not preach, lecture, bribe, threaten or moralize, as doing any of these things will only anger the addicted individual.
  • Do not cover up, make excuses for or lie about the addicted person’s behaviour.
  • Do not be a martyr. Avoid attempting to appeal to the individual through emotional outbursts, as this will only make him or her feel guilty and therefore increase his or her desire to use the substance.
  • Do not assume responsibility for any obligations the addicted person has let slip, as this only protects him or her from the consequences of substance abuse.
  • Do not assume guilt or responsibility for your loved one’s addiction.
  • Do not join them in their own game.
  • Do not argue with the addicted person while he or she is drunk or high, as impaired persons cannot have rational conversations.

Recognizing signs of substance abuse is the first step toward helping yourself or a loved one get the help you, he or she needs to get better. The next best thing you can do is educate yourself as to why addiction happens and what you can do to help yourself or a loved one overcome it.

 
 
 

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