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Recognizing Addiction

Updated on April 9, 2018
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Kortney has been a clinical physician assistant for 13 yrs. When not being a PA, Kortney’s hobbies include writing, research, and investing.

Recognizing Addiction: A Step-Wise Approach

The impact of addiction and alcoholism on a family can be devastating. Besides the very obvious emotional impact that addiction can have on a family, there are other very serious consequences, including financial, legal, and social effects. In some cases, the addict is very open and honest about their condition, but in other cases, the addict can go to great lengths to keep their addiction a secret from their family and friends. Denial is a very common symptom in addiction, so the addict themselves may even be reluctant to acknowledge that they have a problem to themselves. While it is difficult to recognize the behaviors associated with addiction in cases where the addict is adverse to sharing their condition or is in denial themselves, there are warning signs, red flags, and personality attributes that are highly specific to this condition.

I am employed as a Physician Assistant and work in occupational medicine where I treat orthopedic injuries and patients with chronic pain. Opioid addiction and dependence is a problem that I regularly treat. Although all patients are unique, I have seen a pattern of behaviors in patients who are addicted to opioids. It is my intention to share these behaviors, red flags, and warning signs with you so that you can assess your own situation.

The Warning Signs to Watch For

The warning signs of substance abuse, addiction, and dependence can vary dependent upon the individual's own situation. However, there are some very common signs that are present in almost all cases of addiction and dependence. It is these signs that help you to identify a problem in a loved one. It is important to note that a combination of these signs should be present in most cases before addiction can be assumed. A loved one who has just one of these signs may not be suffering from addiction, so it is important that you watch for multiple signs. Some of these common signs include:

1. Major changes in personality or behaviors - if a loved one suddenly starts behaving in a different way or has rather drastic personality changes it can sometimes indicate a problem with substance abuse.

2. Emergence of financial problems or a sudden need to borrow money on a regular basis. However, not all financial problems are because of substance abuse or addiction. As such, it is important not to rely on this one sign.

3. Relationship problems

4. Problems at work - this could include being fired, constantly being late to work, or losing interest in a job that one previously enjoyed

5. Lack of interest in things that used to be enjoyable

6. Changes in energy levels, such as days of extreme fatigue and days of extreme energy or mania (pressured speech, flight of ideas, lengthy discussions)

7. Frequent illness/flu-like symptoms

8. Phone calls taken in private/at late hours, as well as frequent errands

9. Dramatic shift in life goals with a lack of progress towards meaningful/career oriented goals (education, career).

10. Change in eating habits, sudden weight loss or sudden weight gain.

11. Aggression, agitation, irritability

12. Lack of sleep/excessive amounts of sleep

If you can identify 4 or more of these warning signs, then your loved one may be struggling with addiction. I would caution you not to be invasive or intrusive in your loved one's life to identify these signs. Proceed with caution at all times because you could cause your loved one to feel defensive. Your goal is to make your loved one feel safe, accepted, and not judged, so consider this when you are looking for warning signs of addiction.

Some of the above warning signs could also be suggestive of another major problem in your loved one's life besides addiction, such as a mental health disorder, loss of a relationship, new relationship, bullying, physical/emotional abuse, and any major life changes that are out of their control. If you sense that they are struggling with an alternate major life problem, then it can also be important to make sure your loved one knows that they can talk to you about that problem.


Steps to Take When You Believe There Is a Problem With Addiction

When you believe that a family member has a problem with addiction, it is important to proceed with caution. The following steps may assist you in this process:

1. Allow yourself some time to accept that a problem exists and to cool off if you feel any anger. This is vitally important because the way in which you approach your loved one directly impacts their response and their willingness to listen and be open and honest with you. I would recommend waiting at least a week so that you have time to process negative emotions.

2. Set up a meeting in a neutral, comfortable setting. Planning to meet at a restaurant may be a good option, but make sure it’s in a setting where your loved one will be able to talk to you without worrying about others over-hearing the conversation.

3. Once you have chosen the meeting place, date, and time, contact your loved one to invite them to attend. When you invite them, make sure you don’t allude to the fact that you plan to have a serious discussion. Make the invitation feel lighthearted and friendly so that your loved one doesn't feel defensive or threatened.

4. When you meet with your loved one, allow some time for small talk and discussions about other topics. Remember that you want your loved one to feel like they are not being judged or cornered into a discussion that they don't feel comfortable having.

5. When you do bring up the topic, don't pose it as an accusatory question. Saying something like, "I've noticed that you seem to have a lot going on in your life right now and I would love to be there for you. I don't like to see you burdened by so many things and I would like to take some of the burden off of you." Then you can ask in a non-judgmental way, "Have you been struggling with something that you want to share with me?" This gives your loved one the opportunity to bring the subject up themselves.

6. If your loved one still doesn't admit that they may have a problem with addiction, then it is important that you don't accuse them of having that problem. Suggest that they meet you for dinner every day so that you can be in their life more. Suggest activities that you can do together. If you have a regular daily activity planned with them, it will help you to make sure that they are not severely struggling with the addiction and it will also allow your loved one to be more open in the near future.

7. If your loved one doesn't agree to meet with you daily or to share their addiction with you, it is important that you respect their decision. If they are an adult, it is usually necessary to step back at that point until they ask for your help. If they are a child, you need to bring them to their pediatrician or to a psychiatrist to get assistance.

8. If you are sincerely concerned for their well being or concerned that they may overdose, then you can involve help of social services. There are things that can be done to help them without you physically needing to be the one that does it. It may be necessary to force a hospitalization, but remember, this is for their well being and hopefully eventually, they will appreciate what you have done.


There ARE several resources available for family members who are dealing with addiction. Contact an interventionalist, your family physician, or a mental health specialist. You should always get professional help before trying to pursue it further in a family member who appears to be resistant or in denial. There are also resources available for the family members of addicts. Your physician can help you find these resources. Your emotional health is very important as well.


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© 2012 Kortney Tholen

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