Diagnosis is important in general because it helps doctors to know how to treat a problem. The diagnosis of a substance use problem (abuse or dependence) is important because it helps justify getting an addicted person into treatment.
Getting an addict to the point where a substance abuse or dependence diagnosis can be made is often a difficult task. People with drug and alcohol problems are often secretive about their use, or blind to the idea that a problem exists. It is helpful then to have a list of behaviors that one can look for that, when present, may suggest that someone has a substance use problem.
Behaviors to look for include:
- A repeating failure to meet social, occupational or familial duties:
- Repeated lateness or absence
- Poor work performance
- Neglect of children, etc.
- Bizarre or lame excuses for social, occupational or family failures
- Borrowing (or stealing) money without good reasons.
- Uncharacteristic mood or personality changes
Physical signs may include:
- Puncture marks, or long thin lines along the arms or legs (IV drug use such as heroin)
- Skin Infections
- Nose and throat problems (snorted drugs such as cocaine)
- Bloody nose
- Nasal and/or sinus infections
- Loss of the sense of smell
- Drowsiness, or loss of coordination (depressant drugs such as alcohol)
- 'Pinned' (tiny, constricted) pupils in the eye (secondary to opioid abuse)
- Eye movement disturbances:
- Nystagmus: back and forth eye movements during an extreme lateral gaze (secondary to alcohol abuse)
- Red or bloodshot eyes (secondary to smoking marijuana)
- Drug-related smells on clothing (drugs that are smoked)
- Drug-related paraphernalia (pipes, 'works', pill bottles, small plastic bags or vials, lighters, etc.)
Medical signs (only apparent upon formal testing) may include:
- Positive findings of drug related metabolic (break-down) byproducts in the urine, blood or hair.
- Hypertension (High Blood Pressure) (may point to alcoholism)
- Elevated levels of the liver enzyme 'delta-glutamic transferase' (GGT) (may point to alcoholism)
- Enlarged red blood cells (may point to alcoholism)