How To Tell If Someone Is High | Drug Abuse Signs

Drug and alcohol abuse are widespread in the United States today, with 48.7 million Americans (17.3% of Americans ages 12 and up) reported to experience some form of substance use disorder (SUD) in 2022, according to the 2022 National Survey on Drug Use and Health. 

This includes 29.5 million Americans who had an alcohol use disorder (AUD), 27.2 million Americans who had a drug use disorder (DUD), and 8 million Americans who were reported to have both an AUD and a DUD simultaneously. However, because addiction also affects these people’s family members, friends, coworkers, or neighbors, the number of Americans impacted by addiction is much higher. 

If you are concerned that a person in your life may be misusing drugs or alcohol, knowing the many signs of substance abuse can be helpful, including what being under the influence of specific drugs looks like. It can help you recognize when a loved one needs help and prepare yourself to talk to them about seeking help. Being informed can also help you avoid engaging in rumors and assumptions about a person’s private struggles, which can be disrespectful, deeply hurtful, and damaging.

There are many different drugs of abuse, each belonging to a specific class of drugs and each producing characteristic physical and psychological effects that can help you know how to tell if someone is high. There are also common signs of addiction that aren’t dependent on the type of substance used.

Signs That Someone Is High On Stimulants (Amphetamines, Cocaine, Etc.)

Amphetamines are a class of powerful stimulants that include both prescription drugs like amphetamine and dextroamphetamine (Adderall), methylphenidate (Ritalin, Concerta), and dextroamphetamine (Dexedrine) as well as illicit drugs like crystal meth. Cocaine is an illicit stimulant drug refined from the leaves of the coca plant and smuggled over international borders.

Stimulant drugs are abused for their potent, euphoric effects that can last for varying amounts of time, often prompting people to take repeated doses in succession, exhausting and wearing down the body and mind. 

Signs and symptoms of recent stimulant abuse include:

• hyperactivity
• increased confidence and social or sexual drive
• aggression
• rapid or rambling speech
• dilated (big) pupils
• elevated heart rate, body temperature, and blood pressure
• rapid breathing
• nausea or vomiting
• reduced appetite
• reduced need for sleep

Signs Of Stimulant Overdose

If someone overdoses on cocaine or amphetamines, they may experience severe cardiovascular events like seizures, a heart attack, or a stroke, which can include sudden death. Or they may have severe psychological reactions including panic attacks or psychosis (losing touch with reality and experiencing paranoia, delusions, and/or hallucinations). 

Signs Of Opioid Painkiller Abuse

Opioids are painkiller drugs related to the natural substance opium, which is derived from the opium poppy. This class includes natural opiates like morphine and codeine, as well as semi-synthetic and fully synthetic substances like oxycodone (OxyContin), hydrocodone (Norco, Vicodin), oxymorphone (Opana), tramadol (Ultram), methadone, heroin (an illicit drug), and hyper-potent opioids like fentanyl and its analogues.

Signs and symptoms of recent opioid abuse include:

• intense pleasure (euphoria)
• drowsiness and sedation
• slurred speech
• problems with attention and awareness
• constricted (small) pupils
• problems with coordination and movement
• mental confusion
• low body temperature
• constipation

Signs Of Opioid Overdose

Opioid overdoses are extremely deadly, with people experiencing respiratory distress, indicated by slow or stopped breathing, and showing other telltale signs, like pinpoint pupils, blue-tinted fingertips or lips, nausea and vomiting, and loss of consciousness/coma. Opioid overdoses can be rapidly treated using opioid antagonist drugs including naloxone (Narcan). 

Signs Of Alcohol Intoxication

While often considered distinct from drugs, alcohol does indeed act as a drug inside the body and is both addictive and dependence-forming, especially for people with a genetic predisposition. On the whole, alcohol acts as a potent central nervous system (CNS) depressant, providing an initial burst of energy and confidence followed by an extended period of fatigue and impairment.

Because of alcohol’s dependence-forming properties, many people with alcohol addiction come to rely on covert alcohol consumption in order to function on a day-to-day basis, often carrying alcohol with them or hiding it in convenient places at home or even at work.

Signs that someone is under the influence of alcohol include:

• a strong smell of alcohol on the breath or clothing
• red, watery eyes
• slurred speech
• sweating
• flushed face
• decreased alertness
• problems with movement and coordination
• reduced inhibition
• loud, aggressive, or morose behavior
• problems with concentration or memory

Signs Of Alcohol Overdose 

Alcohol poisoning, a form of overdose, can occur after periods of heavy alcohol consumption, or binge drinking, and can be fatal without medical attention. Symptoms of alcohol poisoning include confusion, vomiting, seizures, low body temperature, respiratory depression, and loss of consciousness, sometimes referred to as “blacking out.” 

Signs Of Other Depressant/Tranquilizer Abuse

Other CNS drugs, like benzodiazepines, barbiturates, sleeping pills, and others, may be prescribed to help people with seizures, muscle tension, anxiety disorders, insomnia, nerve pain, and other diagnoses. However, depressants and sedatives are also known for being highly dependence-forming, and they are often abused in order to create a pleasurable, tranquil high or in an attempt to change the effects of other drugs of abuse. 

Signs of recent depressant abuse often closely resemble those of alcohol abuse, especially:

• slurred speech
• confusion
• problems with movement and coordination
• reduced inhibition
• fatigue

Signs Of Depressant Overdose

Depressant drugs are most dangerous when mixed with alcohol or other drugs, and can cause a person to lose consciousness and, in extreme cases, experience respiratory depression that may be harmful or even fatal.

Signs Of A Cannabis/Marijuana High

Despite becoming increasingly legal at the state level in the United States, cannabis is known to be habit-forming, with around 30% of people who currently use cannabis products meeting the criteria to be diagnosed with cannabis use disorder, according to Yale Medicine. 

Cannabis is mind-altering, producing a wide variety of potential effects that can be pleasurable or harrowing depending on the dose a person takes and their mindset. 

Signs that someone is high on cannabis include:

• glassy/red eyes
• lack of motivation
• problems with focus, concentration, and memory
• unusual laughter
• increased appetite
• slowed reactions
• signs of anxiety or paranoid behavior

Signs Of Cannabis Overdose

While using high doses of cannabis is not dangerous in the same way as opioids or other drugs, people may still experience unpleasant, distressing symptoms often referred to as “greening out.” This can involve psychosis, elevated heart rate and blood pressure, panic, nausea, and vomiting. 

Signs Of A High Involving Hallucinogens

Hallucinogens include substances as diverse as LSD, mescaline, psilocybin, PCP, cannabis, ecstasy, ketamine, and others. These drugs have different origins and mechanisms of action but are all known for altering the perceptions and experiences of those who use them, sometimes with lingering or even lifelong effects. 

Signs of recent hallucinogen abuse, including microdosing, include:

• unusual changes in attitude or behavior
• dilated pupils
• anxiety or paranoia
• visual or auditory hallucinations
• confusion
• problems with movement and coordination
• becoming unresponsive

Signs Of Hallucinogen Overdose

As with cannabis, hallucinogens are not usually directly dangerous to the body even in high doses, though they can be extremely damaging to the mind. People having a “bad trip” may experience severe emotional distress, psychosis, agitation, aggression, violence, self-harm, or other bizarre and erratic behavior. 

Common Signs Of Ongoing Drug Abuse Or Addiction

Along with the short-term effects of different drugs or alcohol, there are also some important, universal warning signs that can indicate that someone in your life is struggling with an SUD or another serious behavioral health disorder or mental health disorder. 

Changes In Personality And Attitude

The cycle of getting high and coming down can produce short-term emotional volatility, with a person acting very differently depending on when their last dose was. There may also be a steady, long-term change as drug or alcohol abuse distorts a person’s personality and attitude over time. 

Periods of euphoria, paranoia, anxiety, irritability, secretiveness, defensiveness, and a lack of interest, motivation, or emotion are all signs to watch for.

Changes In Sleeping And Eating Habits

Likewise, drug abuse will tend to influence a person’s energy levels, appetite, and desire or ability to sleep. This tends to disrupt a person’s regular eating and sleep schedule and can cause unusual problems with a person either staying awake or falling asleep (or both), and gaining or losing abnormal amounts of weight.

Changes In Personal Responsibilities

SUDs are progressive. The longer and worse they become, the more they will begin to interfere with a person’s day-to-day life, leading to problems being present and on-time, poor performance in the workplace or at school, and falling behind in one’s housework or other activities. 

Drug-seeking behavior may also become increasingly obvious as a person spends more and more time and energy and takes greater and greater risks seeking out supplies of drugs in various ways. 

Changes In Personal Relationships

People who begin abusing drugs or alcohol often pull away from valued, long-standing relationships with friends or loved ones in their lives. They may make new friends who also abuse drugs or alcohol, or they may isolate themselves entirely as their emotions spiral through cycles of shame, guilt, and self-medication. 

Changes In Hygiene And Self-Care

While many people are able to disguise the effects of drug or alcohol abuse for months or even years at a time, the worse an SUD becomes the more likely it is that a person will begin to neglect their own daily needs. Unwashed clothing, unkempt hair or beards, dirty nails, body odor, problems with oral hygiene, poor diet and exercise, and even a lack of proper posture can all be warning signs that a person is struggling to tend to themselves properly. 

Changes In Physical Health

At the same time, drug and alcohol abuse can greatly increase a person’s risk of contracting various illnesses and diseases, further impacting their long-term health and well-being. Chronic coughing, skin abscesses, oral health issues, cirrhosis of the liver, and even cancer are all common examples, along with mental health disorders like depression, OCD and other anxiety disorders, personality disorders, and more. 

Changes In Overall Stability

There are countless ways that a substance abuse problem can disrupt a person’s personal finances, savings, housing situation, relationships, and legal security. The risk of unemployment, financial distress, divorce, homelessness, removal of one’s children, and incarceration increase dramatically as the severity of a person’s SUD escalates. 

Getting Help For Addiction

Drug and alcohol abuse and addiction can be crushing to live with, or to watch a friend or loved one experience. 

Here are some ways that you can help a loved one who may be struggling:

• Share your concerns openly and honestly, instead of ignoring the situation.
• Set healthy personal boundaries so you do not enable your loved one’s substance use.
• Offer to help your loved one get treatment and walk alongside them during the recovery journey.
• Suggest realistic next steps, including professional recovery programs.

At Ark Behavioral Health, we understand how painful substance abuse can be. If you need a next step, please consider contacting us today to learn about our inpatient treatment programs. 

Our expert clinicians are proud to offer evidence-based services for all forms of substance use disorder, with professional services that include medical detoxification, behavioral therapy and other forms of psychotherapy, group sessions, alternative treatment programming, medication-assisted treatment options, dual diagnosis treatment programs for co-occurring mental health disorders, and more.