Addiction Symptoms: How to Recognize the Signs in Yourself or a Loved One

The 11 DSM‑5 symptoms of addiction (SUD)

Clinicians identify a substance use disorder when someone meets two or more of the following 11 symptoms within a 12‑month period. Severity is based on the count: 2–3 (mild), 4–5 (moderate), 6+ (severe).

Impaired control

• Using more or for longer than intended
• Wanting to cut down but not managing to
• Spending a lot of time getting, using, or recovering
• Craving or a strong desire to use

Social impairment

• Problems at work/school/home due to use
• Continuing despite relationship problems caused or worsened by use
• Important activities given up (social, hobbies, work roles)

Risky use

• Using in physically dangerous situations (e.g., driving)
• Continuing despite physical or psychological problems caused/worsened by use

Pharmacological

• Tolerance (needing more for the same effect)*
• Withdrawal (symptoms when stopping/reducing; relieved by taking more)*

*Tolerance and withdrawal do not count toward a diagnosis when they occur during appropriate medical use under supervision alone.

Quick‑glance checklists: common physical, behavioral, and mental signs

Real‑world symptoms fall into patterns you can observe. The lists below are informational only, not a diagnosis.

Are these symptoms “normal stress”… or addiction?

Many signs above overlap with other health or mental‑health conditions. That’s why self‑diagnosis is tricky and why a professional assessment matters. A clinician will screen for co‑occurring disorders (e.g., anxiety, PTSD, depression) and rule out medical issues before confirming a substance use disorder.

Am I addicted?”, fast self‑screeners (informational)

Self‑screeners are not diagnoses, but they can help you decide whether to seek a professional evaluation:

• CAGE (alcohol) – 4 questions about Cutting down, Annoyance, Guilt, Eye‑opener
• AUDIT (alcohol) – 10 questions; more sensitive for hazardous use
• DAST‑10 (drugs) – 10 questions on drug‑related problems
• DSM‑5 SUD checklist – 11 criteria scored for severity (mild/moderate/severe)

Alcohol

• Physical: slurred speech, poor coordination, blackouts, gastritis, sleep problems; withdrawal may include tremors, anxiety, insomnia, sweating: severe cases risk seizures/DTs (medical emergency).
• Behavioral: conflicts at home/work, risky driving, morning “eye‑openers.”
• Mental: cravings, denial/minimization, mood swings.

More on Alcohol

Opioids (e.g., oxycodone, hydrocodone, heroin, fentanyl)

• Physical: pinpoint pupils, drowsiness, slowed breathing, constipation; withdrawal brings flu‑like symptoms (aches, sweating, GI upset), insomnia, anxiety.
• Behavioral: doctor shopping, using more than prescribed, isolating.
• Mental: cravings; using to avoid withdrawal more than to feel “high.”

Stimulants (methamphetamine, cocaine, prescription stimulants)

• Physical: reduced appetite/weight loss, dilated pupils, elevated heart rate/blood pressure; meth may cause dental problems and skin picking.
• Behavioral: bursts of energy → crashes, agitation, risk‑taking, financial strain.
• Mental: anxiety, paranoia, irritability; intense cravings.

Cannabis

• Physical: red eyes, increased appetite; with heavy use: cough, bronchitis‑like symptoms; in some, cannabinoid hyperemesis (cyclic vomiting).
• Behavioral: reduced motivation, memory problems, time misperception.
• Mental: anxiety or paranoia in some users; cravings in daily heavy use.

Sedatives/Hypnotics (benzodiazepines like Xanax; sleep meds like zolpidem)

• Physical: drowsiness, slowed reaction time, dizziness; withdrawal can be dangerous (risk of seizures), medical supervision is vital.
• Behavioral: escalating doses, combining with alcohol, doctor hopping.
• Mental: memory problems, rebound anxiety/insomnia.

Nicotine (cigarettes, vaping)

• Physical: increased heart rate/blood pressure; withdrawal: irritability, restlessness, difficulty concentrating, strong cravings.
• Behavioral: frequent breaks to vape/smoke, difficulty cutting down despite intentions.

Early warning signs (before life blows up)

• Escalating use to manage stress, boredom, or sleep
• Using alone or at odd hours
• Rules keep shifting: “I’ll only use on weekends” → “Only after work” → daily use
• Substance becomes central to planning and time
• Growing secrecy and defensiveness
• Drifting from non‑using friends/activities
  These patterns often precede full DSM‑5 criteria, a perfect time to seek help.

Withdrawal symptoms vs. addiction symptoms: what’s the difference?

• Addiction symptoms describe the pattern of behavior and consequences (the 11 DSM‑5 criteria).
• Withdrawal symptoms are physical/psychological effects that occur when the substance leaves the body after dependence has formed (e.g., tremors, sweating, insomnia, cravings).
• You can develop dependence (and withdrawal) with some prescribed medications without having a substance use disorder, context matters.

When to seek professional help (and when to call 911)

Seek an evaluation if two or more of the DSM‑5 items fit your recent year, or if the checklists above feel familiar. Certain signs require urgent attention:

• Stopping breathing, blue lips/skin, or unresponsiveness
• Seizures, severe confusion, or chest pain
• Severe alcohol or benzodiazepine withdrawal symptoms
  Call 911 for emergencies.