Signs of Substance Use

Topic Overview

The following are some obvious signs that a person may be smoking cigarettes, drinking alcohol, or using other substances. This is not a complete list of signs to look for. If you suspect a particular drug or drugs, get more information on signs of use for those substances. For more information, see Alcohol and Drug Use in Young People, Drug Use and Your Health, or Alcohol: Drinking and Your Health.


  • A distinctive smell on the breath and clothing
  • Cigarettes and lighter in his or her possession
  • Cigarette butts outside a bedroom window or in other odd places around the home


  • Alcoholic beverages missing from the home storage cabinet
  • Alcohol or mouthwash (used to cover up alcohol) breath or hangover symptoms (nausea, vomiting, or headache), if recently used


  • Sweet smell on clothing or bloodshot eyes, if recently used, and frequent use of eyedrops to reduce the redness
  • Drug paraphernalia (pipes) in his or her possession
  • Carelessness in grooming, increased fatigue, and changes in eating and sleeping patterns, if using regularly


  • Chemical breath, red eyes, or stains on clothing or face, if recently used
  • Soaked rags or empty aerosol containers in the trash

Club drugs

  • Skin rash similar to acne
  • Small bottles with liquid or powder in his or her possession


  • Persistent runny nose and nosebleeds, injection marks on arms or other parts of the body, or long periods of time without sleep
  • Possession of drug paraphernalia, such as syringes, spoons with smoke stains, small pieces of glass, and razor blades

LSD or other hallucinogens

  • Trance-like appearance with dilated pupils, if recently used
  • Small squares of blotter paper (sometimes stamped with cartoon characters) or other forms of the drug in his or her possession


  • Very small pupils and a drowsy or relaxed look, if recently used
  • Possession of injecting supplies, called an outfit or rig, that may consist of a spoon or bottle cap, syringe, tourniquet, cotton, and matches

Anabolic steroids

  • An unpleasant breath odour
  • Mood changes, including increased aggression
  • Changes in physical appearance that can't be attributed to expected patterns of growth and development
  • Possession of medicines or syringes

Other general signs

  • Changes in sleeping patterns
  • Changes in appetite or weight loss
  • Changes in dress
  • Loss of interest and motivation
  • Hoarseness, wheezing, or persistent cough

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ByHealthwise Staff

Primary Medical Reviewer Patrice Burgess, MD - Family Medicine

Brian D. O'Brien, MD - Internal Medicine

Specialist Medical Reviewer Peter Monti, PhD - Alcohol and Addiction

Current as ofFebruary 20, 2015