How can I identify harmful substance use or addiction?

Dr. Mike Dow, PsyD
Addiction Medicine
Watch as Dr. Mike Dow discusses how you can identify the signs of harmful substance use or addiction in yourself or a loved one. 

James Smith
James Smith on behalf of MDLIVE

You can identify any harmful addiction by being aware of the following indicators:


Early stage

  • Are you able to drink more without feeling the effects?
  • Have you ever had "blackouts" i.e., when there are hours or days you cannot remember?
  • Do you desire to continue use when others stop
  • Are you preoccupied with use?
  • Do you have feelings of guilt about use/morning after regrets?

Middle stage

  • Do you lie about your use?
  • Do you hide your use?
  • Is there an increasing dependence on substance?
  • Do you suffer from persistent remorse or regret?
  • Have there been unsuccessful efforts to control use or abstain from use?
  • Do you use alone?
  • Do you have legal problems related to use?
  • Do you have work/school problems related to use?
  • Do you have problems with family/significant others that are related to use?
  • Do you have financial problems related to use?
  • Do you have physical problems related to use (includes accidents/injuries)?
  • Do you continue to use despite knowledge of problems caused, or exacerbated by use?
  • Have you lost or changed friends?
  • Have you attempted a geographical cure?
  • Do you protect your supply of substance?
  • Do you give up or reduce important social, occupational or recreational activities because of use?
  • Have your promises and resolutions failed?
  • Have you become completely dishonest?

Late stage

  • Have you had an overdose experience?
  • Do you now experience lengthy periods of use or binge patterns of use?
  • Have your ethics deteriorated?
  • Do you have tremors and use substances to relieve withdrawal symptoms?
  • Has your job, family, finances or legal status been more severely affected recently?
  • Do you neglect food, hygiene or health care?
  • Do you have indefinable fears or paranoia?
  • Has your tolerance for drugs/alcohol decreased with little or no change in level of use?
  • Have you physically deteriorated?
  • Are you unable to initiate action?
  • Are you obsessed with use?
  • Are your alibis exhausted?
  • Are you ready to admit defeat?


    The following are some of the questions that may help you identify harmful substance use or addiction:

    • When faced with a problem, do you often turn to alcohol, tobacco, or drugs for relief?
    • Do you find that you have to take increasing amounts of alcohol, tobacco, or drugs to achieve the same effects?
    • Do you drive when under the influence of alcohol or drugs?
    • Has your alcohol, tobacco, or drug use caused any problems in relationships with family, friends, or coworkers?
    • Are you sometimes unable to meet home or work responsibilities because of drugs or alcohol?
    • Have you had distressing physical or psychological reactions when you've tried to stop using alcohol, tobacco, or drugs?
    • Has someone close to you expressed concern about your use of alcohol, tobacco, or drugs?
    • Have you - or has anyone else you know - ever needed medical attention because of your drinking, smoking, or drug use?
    • Have you ever tried to stop or cut down on alcohol, tobacco, or drugs and not been able to?
    • Do you find yourself spending a lot of time thinking about when and where you will get the next drink or use cigarettes or other drugs again?

    If you answered yes to any of these questions, your smoking, drinking, or drug use may be interfering with your life in ways serious enough for you to seek help. Remember, we can make changes in our use long before we become addicted or hit bottom.

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    Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.