Addiction, or substance use disorder (SUD), can affect any person regardless of age, occupation, race, income, lifestyle, or gender. It is a disease, like diabetes, glaucoma, or heart disease, that can happen to anyone, and it is treatable.

If you are worried about a child or other loved one, learning about the disease and knowing the signs and symptoms of addiction can bring about earlier intervention and better outcomes.


How to detect an escalating and dangerous pattern of substance use:

  • Are your loved one’s moods volatile?

  • When asked a question, does he launch into an attack on you for asking?

  • Are her sleep and eating patterns unusual? For example, does she stay in bed until two or three in the afternoon? Is she losing weight, and making excuses for not eating?

  • Is money disappearing from your wallet? Not necessarily all of it, but $20-60 at a time? The average drug buy is around $40.

  • Any jewelry or other items of value missing?

  • Have you caught your loved one in lies about where he says he’s been?

  • Have people (work colleagues, teachers, coaches) outside the family noticed a problem? They may have asked subtle questions, careful not to offend.

  • Is your loved one ignoring or neglecting activities she once enjoyed?

  • Do you find yourself compensating for your loved one’s behavior or trying to catch him in a lie?

  • Do you find yourself explaining away the disturbing behavior? He’s been depressed, he hurt his back, she’s under stress at work/school.

Even two or three of these symptoms show that your loved one may developing SUD.

Physical Symptoms of SUD:

  • Rapid weight gain or loss

  • Inability to sleep or awake at unusual times

  • Deterioration of personal appearance or hygiene

  • Unexplained bruises or marks

  • Glazed or red eyes

  • Pupils larger or smaller than usual, blank stare

  • Extreme hyperactivity; excessive talkativeness

  • Runny nose, hacking cough

  • Nausea, vomiting, or excessive sweating

  • Unusual nose bleeds

  • Unexplained breakout of acne/rash

  • Unusual odors

  • Low or no energy

  • Depressed or anxious

  • Slow or staggering walk

  • Cold, sweaty palms or shaking hands

  • Puffy face, blushing or paleness

  • Needle marks on lower arm, leg or bottom of feet

Behavioral symptoms, based on the DSM-V Criteria for Substance Use Disorder:

  • Taking the substance in larger amounts or for longer than you’re meant to.

  • Wanting to cut down or stop using the substance but not managing to.

  • Spending a lot of time getting, using, or recovering from use of the substance.

  • Cravings and urges to use the substance.

  • Not managing to do what you should at work, home, or school because of substance use.

  • Continuing to use, even when it causes problems in relationships.

  • Giving up important social, occupational, or recreational activities because of substance use.

  • Using substances again and again, even when it puts you in danger.

  • Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.

  • Needing more of the substance to get the effect you want (tolerance).

  • Development of withdrawal symptoms, which can be relieved by taking more of the substance.


If you suspect that your loved one is struggling with SUD, talk to them about your concerns. You might be met with resistance, or you  might say exactly what they need to hear. Remember that a person who is struggling with SUD will almost always deny the problem, and there are complicated reasons for this denial, both physical and psychological. Not only is the person likely filled with shame, but the disease has caused brain changes that make it rare for someone to recognize the problem and seek help. It is important to know that your loved one may become confrontational about being questioned.

 What the rest of the family can do:

Not all of this intuitive. Be as patient as you can; we don’t learn it all at once.

  • Do not react emotionally. No anger, no pleading, no tears (in front of user, anyway) and no rushing to help.

  • Find a Nar-Anon, Al-Anon, or other peer recovery meeting that resonates with your needs.

  • Learn to support only the loved one’s acts that lead to recovery.

  • Hate the disease, not the person. This is a reminder for when your wallet, jewelry, or golf clubs have disappeared, and you know they’ve been sold for drugs, for pennies on the dollar.

  • Stay calm. Don’t give up on the person.

  • Love unconditionally. Stay in touch with your loved one. Don’t slam the emotional door, though you may have to shut the literal one for a while.

  • Be positive; praise what you can.

  • In fact, try to say something positive each time you are together.

  • Tell jokes, try to laugh with your family members — all of them, including the user.

  • Learn that relapse is part of the process.

  • Recovery is an inside job. You can’t do it for the person.

  • We don’t change others, but we can change ourselves and how we interact with the user and others.

  • Know that recovery can be a long process. It sometimes takes years.

  • Protect yourself and other loved ones from theft, abuse, and sometimes your loved one’s associates.

  • Be kind to yourself and other members of the family. Visit friends; do your best to live life the way you would want to if you didn’t have an addict in the family. You need to heal, too.

Caring for a loved one after an ER visit:

A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department

PDF: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department

Drug Addiction, When Your Teen Addict


  • Genetic predisposition, other blood relatives who suffer from addiction

  • Early onset of use, or how old the individual is when s/he begins using

  • Risk-taking and novelty-seeking personality traits

  • Co-occurring disorders, which put individuals at a higher risk for substance use disorder and addiction. These include ADHD, depression, anxiety disorders, eating disorders, PTSD

  • Stress and Trauma, often at an early age — can range from divorce, abuse within the family, the observation of abuse, other traumas (accidents, violence, loss)


To find treatment in your area, call Hawai‘i CARES at: 1-800-753-6879. Hours of Operation: 24/7.