It can be hard for substance users to realise or acknowledge when their use is affecting their life negatively and that they may need support. It’s often friends or family members that are the first to notice something has changed, so don’t dismiss their concerns.

If you’re worried that you might have a substance use problem, here are some signs and symptoms to look out for. If you experience any of the below, you may wish to reach out for help:

  • Having a strong craving to use drugs or alcohol every day or several times throughout the day
  • Always having drugs or alcohol with you
  • Buying drugs or alcohol when you can’t afford them
  • Needing more of the same drug or drinking more alcohol to have the same effect
  • Doing things you wouldn’t normally do to get drugs or alcohol, such as stealing or lying
  • Finding yourself hiding your use from friends, family or colleagues
  • Doing risky or dangerous things while on drugs or when drunk, like driving or having unsafe sex
  • Continuing to use drugs or alcohol even though it’s causing problems with your loved ones, work, and other commitments
  • Using more drugs or alcohol than you want to and for longer than you thought you would
  • Spending a lot of your time thinking about, getting, using, or recovering from drug or alcohol use
  • Often feeling guilty or ashamed about your behavior when using
  • You can’t stop yourself from using, even if you want to
  • Feeling physically sick when you stop using or try to quit

Changes to Usual Behavior

Drugs and alcohol can change personalities and behaviors, or make you act in ways that you usually wouldn’t. At first, these behaviors may happen infrequently. Over time though, they may occur more regularly as usage increases.

  • Spending more time alone
  • Changing friends a lot
  • Losing interest in your hobbies or usual activities
  • Lack of motivation
  • Not taking care of your appearance (e.g. not showering, brushing teeth, changing clothes)
  • Having mood swings or being more irritable, tired, or sad
  • Sleeping for longer or less, or at different hours than usual
  • Eating more or eating less than usual
  • Missing appointments or forgetting to do things you would normally do

Changes to Physical Health

Has your health been affected? Drug and alcohol addiction is associated with a variety of physical health issues, including:

  • Bloodshot or glazed eyes
  • Constant or recurring illness
  • Frequent injuries/bruises
  • Sudden weight changes
  • Poor hygiene or bad skin, hair, teeth, and nails
  • Sweating, body shaking, or vomiting (physical symptoms associated with withdrawal)
  • Speech changes like slurred words, rambling, or fast-talking

Changes to Mental Health

Addiction is also associated with mental health changes, including the worsening of existing conditions, such as:

  • Sudden mood swings
  • Aggressive or violent behavior
  • Irritable mood
  • Depression
  • Blackouts or memory loss or problems with recalling information
  • Apathy, or lack of motivation or care
  • Suicidal thoughts or self-harm

It is important to remember that physical or mental health changes can occur for other medical reasons besides addiction, so you should also consult a health professional to rule out any other causes or conditions.

How can we help?

  • If you would like to talk to a peer harm reduction counsellor (someone who understands what you may be experiencing), WhatsApp/Telegram the EMH health line on 082 607 1686. We can arrange a free, one-on-one online session for you (subject to availability). Alternatively, reach out to us on the anonymous chat option at the bottom of the page.
  • Check out our support resource list for substance use, addiction and other related services:
  • Engage Men’s Health offers free and professional HIV and STI services in Johannesburg, Nelson Mandela Bay and Buffalo City. This includes free HIV treatment, PrEP and PEP. Call or WhatsApp Engage Men’s Health on 082 607 1686.