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Signs of Addiction & Addiction Treatment

Contributor(s): Shelly F. Greenfield, MD, MPH
8 minute read
A support group meets and discusses together

Something seems off about your loved one.

Lately, they’ve been disappearing without explaining why. When you ask where they’ve been, they give you vague answers. You have been arguing a lot more — often for reasons that feel blown out of proportion. They’ve stopped taking care of themselves.

And, most recently, you’ve noticed some other concerning changes: They have increased their use of alcohol or use it at times of day when they never did before.  You have found an unlabeled bottle of pills.

You think your loved one may be showing signs of addiction, and you don’t know how to help.

In 2020, 40.3 million people aged 12 or older had a substance use disorder (SUD). Substance use can produce changes in the brain that lead to recurrent use of substances despite adverse and harmful consequences.

Addiction — the recurrent use of substances despite harmful consequences — can cause difficulties in a person’s function, mental state, and relationships.

Shelly F. Greenfield, MD, MPH, is a Mass General Brigham addiction psychiatrist, clinician, and researcher. She’s also chief academic officer and director of the Alcohol, Drug, and Addiction Health Research and Education program at McLean Hospital.

Dr. Greenfield shares important risk factors for having an SUD, describes signs of addiction to watch for, and explores effective addiction treatment options.

Who is at risk for addiction?

“Addiction does not discriminate,” says Dr. Greenfield. “It affects all people everywhere, across the country and around the globe, across all sociodemographic groups, across all genders, races, and ethnicities.”

But there are five main risk factors that can make a person more likely to develop a substance use disorder. These are:

  1. Family history of substance use disorders, which may be in a primary relative but can include grandparents
  2. Early age of initial use, which may lead to a substance use disorder later in life
  3. Sex and gender. More men than women (nationally and globally) have a substance use disorder. Women who develop an alcohol use disorder are more likely to progress quickly to serious medical consequences
  4. Adverse experiences in early childhood, such as physical or sexual abuse
  5. Certain mental health conditions, like anxiety disorders

If you suspect you or a loved one may be showing signs of addiction, it’s important to seek the right kind of addiction treatment. Watch this video to learn more about SUDs and addiction.

What are the signs of addiction?

“A substance use disorder is a medical condition that is diagnosed, like other medical conditions, by a constellation of symptoms across several different domains,” Dr. Greenfield explains. Those symptoms include:

  • Loss of control: Marked by multiple unsuccessful attempts to cut back or stop using in the past, use of more of a substance than intended, or use of a substance for longer periods of time than intended
  • Social impairment or social consequences as a result of use: Substance use begins to impair a person’s ability to carry out major life roles, such as work, school, or your family life.
  • Risky substance use: Using substances in a way that physically endangers oneself or others, such as driving under the influence
  • Tolerance: Requiring more and more of a substance to achieve a certain effect
  • Withdrawal: Experiencing negative physical symptoms when abstaining from a substance

Signs of addiction in others

Signs of addiction can include:

  • Sudden weight gain or weight loss
  • Changes in sleep patterns or energy levels
  • Poor or worsening personal hygiene
  • Changes in eyes or skin color
  • Changes in personality, including mood swings
  • Loss of interest in activities and hobbies
  • Social withdrawal and secretive behaviors
  • Depression
  • Suicidal thoughts

You may also observe behavioral changes, like:

  • Poor performance in work or school
  • Financial struggles
  • Neglecting responsibilities
  • Spending a majority of time under the influence
  • Using substances for fun

Please note: This is not an all-inclusive list.

Signs of addiction in ourselves

We can also identify signs of substance problems in ourselves, although often this can be much harder to do. Dr. Greenfield explains that if you suspect you may have a problem with substances, you may consider asking yourself:

  • Am I using more than I intended to use, or for longer periods of time?
  • Have I tried to cut back or cut down on my use and had a difficult time doing so?
  • Am I spending less time doing something I used to really like to do because I’m spending more time using substances or recovering from substance use?
  • Am I craving that substance?
  • Is substance use creating problems for me in some of the major ways I spend my life, like at work, in school, or in my family or community?
  • Has somebody told me that it would be better for me to stop or cut back my use because of a medical condition or mental health condition but I find I am using anyway?
  • Have I noticed that when I abruptly stop using a substance I feel really bad?
  • Am I needing to use more of a substance than I was before to achieve the same effect?

“If you’re thinking about any of those things, or worrying and wondering about them, it’s a really good idea to talk with a trusted clinician who can help you assess whether substances are creating problems for you in your life and whether you have a substance use disorder,” Dr. Greenfield says.

Addiction does not discriminate. It affects all people everywhere.

Shelly F. Greenfield, MD, MPH
Addiction Psychiatrist
Mass General Brigham

What is addiction treatment?

Addiction treatment is a particular kind of care given to people struggling with addiction and substance use disorders. Depending on your insurance and the institution where you seek treatment, the out-of-pocket cost for addiction treatment can vary. 

“Mass General Brigham offers many excellent treatments available for substance use disorders that are based on decades of research, including medication treatments and behavioral treatments,” says Dr. Greenfield. These include:

  • Three FDA-approved medications for opioid use disorders
  • Three FDA-approved medications for alcohol use disorders
  • Multiple FDA-approved medications for tobacco use disorders
  • Behavioral treatments, including individual group and family counseling
  • Specific therapies and treatments for women
  • Specific therapies and treatments for people with substance use disorders that co-occur with mental health conditions like bipolar disorder

“In many cases, clinicians will be able to provide treatment from their offices,” says Dr. Greenfield. “Other times, it will be important for a person to have more services, and those can actually take place as inpatient or residential programs, or in outpatient programs. It depends on what will be most helpful to an individual with substance use disorder to get them well and help them stay well.”

Beyond these therapies, Dr. Greenfield explains that people struggling with addiction have other options. “Mutual health therapies can also be helpful to patients,” Dr. Greenfield explains. “Those include things like Alcoholics Anonymous and Narcotics Anonymous.”

Does addiction treatment work?

"Treatment for substance use disorder works,” says Dr. Greenfield. “There are effective treatments available for patients and their families.”

It is important to remember that recovery is not a linear process. People with substance disorders may need a range of treatments over time as is true with many health conditions. With the right support and resources at hand, recovery from addiction is possible — and it’s within reach.

Shelly F. Greenfield, MD, MPH headshot


Addiction Psychiatrist