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Geisinger becomes the first member of Risant Health

When someone you love has a substance addiction, it affects everyone around them. Learn to identify the signs of addiction and find out how you can help.

Substance misuse isn’t always easy to identify. If you’re not familiar with the signs, it can be difficult to know if someone is using — even if they’re a family member or close friend. So knowing what to look for (and how to support them) can make a difference.

Signs of substance misuse and dependence

Substance use disorders affect everyone differently. But certain physical, emotional, psychological and behavioral symptoms can tip you off when a person needs help. General signs of substance misuse and dependence may include:

  • Chronic, unexplained tardiness
  • Secretive behavior
  • Noticeable changes in mood
  • Losing interest in their regular activities
  • Stealing money
  • Missing work or school

“Symptoms will depend on the type of substance that a person is using, the frequency of use and the duration of use," says Kimberly Kabernagel, DO, medical director at Geisinger Marworth Treatment Center.

Some things to look out for may point to use of specific substances, like alcohol, opioids or stimulants.


Alcohol includes things like beer, wine or liquor.

A person with an alcohol use disorder may display some or all these signs:

  • Being under the influence at inappropriate times
  • Slurred speech
  • Being uncoordinated
  • Smelling like alcohol


Opioids range from illicit substances like heroin and fentanyl to prescription pain relievers like OxyContin®, Vicodin®, morphine and codeine.

If someone is regularly using opioids, they may have some or all of these symptoms:

  • Confusion
  • Drowsiness
  • Poor coordination
  • Nausea
  • Slower breathing rate

Sedative-hypnotics and anxiolytics

This class of substances is commonly prescribed to treat anxiety or panic disorder. Common types include benzodiazepines like Valium®, Xanax®, Klonopin®, Ativan® and Ambien®

Someone who is under the influence of a sedative-hypnotic or anxiolytic substance may have these signs:

  • Confusion
  • Drowsiness
  • Slurred speech
  • Unsteady walking
  • Difficulty concentrating
  • Dizziness
  • Memory lapses
  • Slower breathing


Stimulants are used to increase energy and alertness. Popular types include Adderall®, Ritalin®, cocaine, ecstasy or methamphetamines. Someone using stimulants might have:

  • Diminished appetite
  • Irritability
  • High blood pressure
  • High body temperature
  • Insomnia
  • Paranoia
  • Anxiety
  • Irregular heartbeat

“If you start noticing signs of substance misuse in your loved one, start a conversation with them in a non-judgmental and non-accusatory way. Be gentle and show your concern, reassuring them you’re there for support,” Dr. Kabernagel says.

How you can help

Recognizing the signs of addiction matters — because once you know what to look for you can understand how to help.

It starts with education

The first thing to do when helping a loved one with substance misuse: Educate yourself. Start by learning about addiction and familiarizing yourself with signs you may have missed. That can help you start the conversation.

Have a conversation

Be supportive when you talk to your loved one. Tell them you’re worried about them, and you’ve noticed they’re acting differently or skipping the activities they once loved.

“Many times, those who are using substances don’t feel good about it. There is a degree of shame. Instead of attacking the person and trying to make them feel worse, offer help, but don’t push. The idea is to make the person want help, not make them withdraw further,” says Dr. Kabernagel.

Don’t ignore it

Don’t make excuses for the person — admit they have a problem. Once you can admit that they have an addiction, you can help them. And find ways to cope. 

“Remember that the addiction isn’t your fault, so don’t feel guilty,” Dr. Kabernagel says.

No judgment here

Supporting a person with a substance addiction isn’t the same as condoning the misuse. You can be concerned about your loved one while offering support. Encourage them to seek help, but don’t push if they resist. Instead, be a consistent reminder of how important it is to get help. Understand the person you’re dealing with may not be rational while they are using drugs or alcohol, and that it may take time to get through to them.

“If you have a loved one with a substance use disorder, you can be encouraging and caring without enabling your loved one to use,” Dr. Kabernagel says. 

Find a support group

Consider joining a support group for families who are dealing with substance misuse. Not only can a support group help you develop a deeper understanding of addiction, but it can also connect you with people who can relate. Find a local Al-Anon group or attend a meeting at Geisinger Marworth.

Comprehensive substance misuse treatment at Geisinger Marworth Treatment Center 

If you or a loved one have a substance misuse disorder, the experienced team of addiction medicine specialists, doctors, nurses, counselors and support staff at Geisinger Marworth can help. With inpatient and outpatient programs, as well as numerous counseling resources, we’ll help find the right treatment to meet the need, finding a path to a healthier life without alcohol or drugs.

We also provide a variety of resources for families to help them live with a loved one’s substance misuse.

Next steps:

Get addiction help now
What to look for in a treatment center
Learn more about addiction treatment at Geisinger Marworth Treatment Center

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