Recognizing the Signs of Substance Abuse

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Substance abuse is a complex issue that affects millions of people and their families. It doesn’t discriminate based on age, gender, or socioeconomic status, and its signs can often be subtle, making it difficult for loved ones to recognize. Understanding what to look for is the critical first step toward offering help and encouraging recovery.

If you suspect someone you care about may be struggling with drug or alcohol abuse, here is a guide to recognizing the common physical, behavioral, and psychological indicators.

Physical and Health-Related Changes

The most noticeable signs of substance abuse often manifest in the body and overall health.

Appearance and Grooming

  • Deterioration of hygiene: A noticeable decline in personal grooming habits, such as infrequent showering, unkempt clothing, or poor dental care.
  • Weight fluctuations: Sudden, unexplained weight loss or gain.
  • Changes in skin and eyes: Bloodshot or glazed eyes, dilated or constricted pupils, frequent nosebleeds (for those abusing inhaled drugs), or needle marks/bruises.

Energy and Sleep Patterns

  • Unusual fatigue: Persistent tiredness, lethargy, or excessive sleep, often paired with periods of high energy or insomnia.
  • Changes in appetite: Loss of appetite or unusual food cravings.
  • Slurred speech or impaired coordination: Difficulty speaking clearly, stumbling, or general lack of motor control.

Behavioral and Lifestyle Indicators

Addiction to drugs or alcohol frequently leads to changes in how a person interacts with the world, impacting their responsibilities and relationships.

Responsibility and Performance

AreaSigns to Look For
Work/SchoolFrequent absences, decline in performance, missed deadlines, or sudden lack of interest in activities they once enjoyed.
FinancialUnexplained need for money, borrowing or stealing cash, secretive transactions, or problems paying bills.
LegalRecurring run-ins with the law, such as arrests for intoxication, driving under the influence (DUI), or other drug-related offenses.

Social and Relationship Dynamics

  • Secrecy and isolation: Becoming overly secretive about their whereabouts, locking doors, making private calls, and withdrawing from family and friends.
  • New peer groups: Abruptly switching friends, particularly associating with individuals known to use substances.
  • Unexplained mood swings: Rapid and intense shifts in emotion, often disproportionate to the situation.
  • Lying and defensiveness: Habitually fabricating stories or becoming extremely defensive when questioned about their behavior or activities.

Paraphernalia

  • Finding drug paraphernalia such as pipes, rolling papers, syringes, small plastic bags, or bottles of medication not prescribed to them.
  • Missing prescription medications, either their own or those belonging to others in the household.

Psychological and Emotional Signs

The internal struggle of addiction often surfaces as shifts in personality, attitude, and mental state.

Mood and Temperament

  • Increased anxiety or irritability: Seeming constantly on edge, restless, or easily frustrated.
  • Depression: Persistent sadness, hopelessness, or loss of interest in life.
  • Lack of motivation: Apathetic toward future goals, hobbies, or personal growth.
  • Personality changes: Exhibiting uncharacteristic behaviors, such as increased aggression, paranoia, or reckless decision-making.

Cognitive Function

  • Memory problems: Difficulty recalling events or conversations that took place while under the influence.
  • Difficulty concentrating: Inability to focus on tasks or follow complex instructions.

What Comes Next?

Recognizing these signs is not about diagnosing an addiction, but about acknowledging that a problem exists and that help is needed. If you notice several of these indicators, it’s crucial to approach the situation with compassion, not judgment.

  1. Educate Yourself: Learn about addiction and available resources.
  2. Speak with Care: Choose a private, safe time to express your concerns without accusatory language. Use “I” statements (e.g., “I am worried about you because…”)
  3. Seek Professional Help: Consult with a doctor, therapist, or addiction specialist who can provide a proper assessment and guidance on intervention and treatment options.

Substance abuse is a treatable condition. By recognizing the signs early, you empower yourself and your loved one to take the first courageous steps toward lasting recovery. Learn more about our drug rehab program in San Diego, or call our caring admissions team any time, 24 hours a day. We’re here to help you and your family get the caring, medical support they need.

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Meet Our Team

Coastal Detox of Southern California is composed of an entire team of highly trained substance abuse professionals in recovery.
Phil Castagnola SUDCC program director at Coastal Detox of Southern California

Phil Castagnola, SUDRC

Program Director

Kay Saffe LPCC clinical director at Coastal Detox of Southern California

Kay Saffe, LPCC

Clinical Director

Jeff Swem SUDRC director of operations at Coastal Detox of Southern California

Jeff Swem, SUDRC

Director of Operations

Coastal Detox of Southern California is only a call away.

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Phil Castagnola

Case Manager

Philip Castagnola, SUDCC, is the Program Director for Coastal Detox of Southern California. He holds an Associate’s in Science and Certification in Alcohol and Other Drug Studies from San Diego City College.

Phil has over 15 years of continuous sobriety and is an active Sponsor in the San Diego Alcoholics Anonymous (AA) community. He struggled with substance abuse issues throughout his youth. He started using drugs at the age of 15, having been raised in an environment that normalized heavy drug and alcohol use. He spent a lot of time in and out of various rehab programs before being incarcerated in federal prison, which is where he finally completed an 18-month treatment program and used that time to work the 12 Steps.

After completing his sentence and serving his debt to society, he vowed to continue to give back to others who are going through similar hardships. Phil is passionated about sharing his experience with openness and honesty so that others may find hope for their future and find the strength to break free from the bondage of addiction.

In addition to a successful career as a certified counselor, Phil is also reconnecting with his passion for surfing. Phil surfed professionally in competitions for a few years in his early 20s and even owned his own surf shop (Select Surf Shop) before losing everything to his addiction. Now in his sobriety he is able to once again surf recreationally and in contests, showing that it’s never too late to reclaim your own narrative, overcome substance use disorder, and pursue the life you were always meant to have.

Kay Saffe, LPCC

Clinical Director

Kay Saffe, LPCC,  is a Licensed Professional Clinical Counselor and Clinical Director at Coastal Detox of Southern California. She holds a Master’s Degree in Clinical Mental Health Counseling from the University of San Diego and a Bachelor’s Degree in Psychology from New College of Florida. 

Kay grew up in Miami, Florida and is a first generation American with Argentinian roots. Throughout her youth, she struggled with drinking and substance abuse. Today, she has been in recovery for over 4 years and strives to prioritize her spiritual, mental, and physical health.

A lifelong athlete and ocean lover, she moved to San Diego to pursue her Master’s degree and progress her surfing. She has spent years working as a surf instructor and therapist, working with local non-profits that treat at risk individuals and families in both English and Spanish. She incorporates a mindful and holistic approach to therapy. She is passionate about positive psychology and helping others through their recovery journey.

Jeff Swem, SUDCC

Director of Operations

Jeff Swem, SUDCC, is a Substance Use Disorder Certified Counselor and the Director of Operations at Coastal Detox of Southern California. He holds an Associate’s in Science and Certification in Alcohol and Other Drug Studies from San Diego City College.

Jeff has 6 years of continuous sobriety and is active in the San Diego Alcoholics Anonymous (AA) community. Jeff struggled with substance abuse from a young age and endured some harrowing, near-death experiences before “settling down” into a career as a professional beer brewer. It was during the COVID outbreak that he surrendered to his higher power and made the choice to get sober for good.

After completing an inpatient rehab program and IOP aftercare, Jeff quit the brewing industry and pivoted to become a Substance Use Disorder Certified Counselor so he could surround himself with a caring and supportive sober community and help others who struggle with addiction by leading through example and sharing his personal experience.

Born and raised in San Diego, Jeff is married to his wife of 25 years. They have a son and daughter together, and thanks to the 12 Steps and a successful career at Coastal Detox, Jeff is able to be fully present for them every day, be a positive role model, and show them how it is possible to thrive in recovery.