Misuse, Dependence and Addiction – Recognizing the symptoms
Signs of Misuse or Addiction for families noticing unexplained behavior changes or physical symptoms they cannot account for
- Misuse: Taking medication not prescribed to you or taking your medication in a way that it was not intended – like increasing the dosage without talking to your provider
- Dependence: When the body needs a medication or drug to function & stopping the medication results in withdrawal symptoms like sweating, nausea, muscle aches, headaches and anxiety
- Addiction: Chronic disorder characterized by compulsive drug seeking and use despite negative consequences. It involves changes to the brain disrupting healthy brain function
Misuse and addiction won’t look the same in everyone and may not be obvious, especially at the beginning. Medications to heal or feel better often require a higher dose over time to create the same feeling. When the medication is self-adjusted to avoid withdrawal and discomfort, the dependency increases making it more difficult to stop. These physical and behavioral changes may indicate you or someone you care about needs help:
- Weight loss, blood shot eyes, nose bleeds and shaking
- Sleeping more than usual
- Stealing, acting out, lying
- Missing school/work or falling behind in schoolwork/job performance
- Aggressiveness/anger/irritability
- Changes in friends or damaging friendships/relationships with family
- Losing interest in activities previously involved in
- Avoiding eye contact
- Being secretive, hiding phone or being secretive about calls
- Avoiding people/isolating
- Neglecting responsibilities like paying bills or attending meetings/appointments
- Inability to focus
- Loss of appetite
What to Watch For and How to Respond
What are the earliest signs that use has become misuse?
Running out of a prescription days or weeks before the refill date is due, taking doses closer together than prescribed, or expressing anxiety about the medication running out all indicate a shift from medical use to dependence.
How does tolerance show up in daily life?
You will hear statements like "it doesn't work anymore" or "I need more to get through the day." The person may increase doses on their own or combine opioids with alcohol or sedatives to intensify effects.
Why do people become defensive when asked about their medication?
Shame, fear of judgment, and the brain’s need to protect access to the substance all contribute. Defensiveness often increases as dependence deepens, even when the person knows something is wrong.
What should you do if you recognize signs of misuse or addiction?
Approach the conversation calmly, express specific observations without accusations, and offer to help them find local resources.
How quickly should you act once you notice signs?
Have a conversation right away. Opioid misuse can progress rapidly, and to delay the conversation, as difficult as it may be, increases the risk of health problems, damaged relationships, legal trouble, and overdose.