Early Warning Signs of Addiction

Written by Steve Rose

Steve Rose, PhD, is an addiction counsellor and former academic researcher, committed to conveying complex topics in simple language.

Addiction is a complex, chronic, and relapsing disorder characterized by compulsive drug or alcohol use, loss of control over substance use, and continued use despite negative consequences (American Psychiatric Association, 2013).

The importance of early detection cannot be overstated; timely intervention can prevent the progression of addiction and mitigate the associated physical, emotional, social, and financial burdens.

Early warning signs of addiction include behavioral (e.g., impulsivity, neglect of responsibilities), social (e.g., new substance-using friends), physical (e.g., altered sleep, unexplained injuries), and emotional changes (e.g., irritability, depression).

This article aims to provide a comprehensive guide to identifying the early warning signs of addiction, drawing from academic research to help readers recognize the red flags and take appropriate action.

Behavioral Changes

Mood swings and irritability
Mood swings and increased irritability can be early signs of addiction (Koob & Volkow, 2016). Substance use can affect the brain’s reward system, leading to mood fluctuations, which can create a cycle of substance use as individuals attempt to self-medicate their emotional instability (Wise & Koob, 2014).

Shift in priorities and interests
A shift in priorities and interests can signal the development of addiction, as individuals begin to prioritize substance use over other important aspects of their lives (Sussman & Sussman, 2011). This may include neglecting hobbies, recreational activities, and personal relationships in favor of obtaining and using substances (Volkow, Koob, & McLellan, 2016).

Neglect of responsibilities
As addiction progresses, individuals may begin to neglect their responsibilities, such as work, school, or family obligations (Jentsch & Taylor, 1999). This neglect may lead to decreased performance and negative consequences, such as job loss, academic failure, or relationship strain (Sussman & Sussman, 2011).

Impulsive decision-making
Impulsivity is a common characteristic of individuals with addiction, and it can manifest as poor decision-making or engagement in risky behaviors (Dalley et al., 2011). Substance use can impair judgment and increase impulsivity, further exacerbating the risk of poor decision-making (Volkow et al., 2016).

Increased risk-taking behaviors
Individuals developing an addiction may engage in increased risk-taking behaviors, such as driving under the influence or engaging in unsafe sexual practices (Leeman et al., 2014). These behaviors can have severe consequences for the individual and others and may serve as early warning signs of addiction.

Social Changes

Isolation from friends and family
Addiction can lead to social isolation, as individuals may withdraw from friends and family to hide their substance use or prioritize using substances over social interaction (Moos & Moos, 2005). This isolation can exacerbate feelings of loneliness and depression, perpetuating the cycle of substance use (Laudet, 2011).

New social circle with substance users
As addiction develops, individuals may gravitate towards a new social circle comprised of fellow substance users (Van Ryzin, Fosco, & Dishion, 2012). This shift in social connections can reinforce substance use and make it more difficult for individuals to abstain from using substances (Volkow et al., 2016).

Secrecy and deceitful behavior
Individuals struggling with addiction may engage in secretive and deceitful behavior to conceal their substance use from friends, family, and colleagues (Mate, 2010). This deception can strain relationships and contribute to feelings of guilt and shame, further perpetuating the cycle of addiction (Wise & Koob, 2014).

Conflicts with loved ones
Addiction can lead to conflicts with loved ones, as individuals may become defensive or argumentative when confronted about their substance use (Leonard & Eiden, 2007). These conflicts can strain relationships, leading to further isolation and continued substance use.

Withdrawal from social activities
Individuals with addiction may withdraw from social activities they once enjoyed, as they become increasingly focused on using substances (Schulte, Ramo, & Brown, 2019). This withdrawal can contribute to feelings of loneliness and depression, increasing the individual’s reliance on substances for comfort and relief (Wise & Koob, 2014).

Physical Changes

Altered sleep patterns
Substance use can disrupt normal sleep patterns, leading to insomnia or hypersomnia (Brower, 2015). Changes in sleep patterns can negatively impact physical and mental health, further exacerbating the cycle of addiction (Hasler, Soehner, & Clark, 2015).

Changes in appearance and personal hygiene
Addiction can lead to a decline in personal hygiene and appearance, as individuals may become less concerned with their grooming and cleanliness (Sussman & Sussman, 2011). This decline may be a reflection of the individual’s diminished self-care and self-esteem, as well as a possible indicator of addiction.

Unexplained injuries or illnesses
Individuals with addiction may experience unexplained injuries or illnesses as a result of substance use, such as injuries sustained while intoxicated or health issues related to substance use (Volkow et al., 2016). These unexplained health problems can serve as early warning signs of addiction.

Sudden weight loss or gain
Substance use can lead to changes in appetite and metabolism, resulting in sudden weight loss or gain (Cowan & Devine, 2012). These changes in weight can negatively impact overall health and may be an early indicator of addiction.

Tolerance and withdrawal symptoms
Tolerance, or the need for increasing amounts of a substance to achieve the desired effect, and withdrawal symptoms, which occur when substance use is reduced or stopped, are key indicators of addiction (Koob & Volkow, 2010). The development of tolerance and the presence of withdrawal symptoms suggest that an individual’s substance use has progressed from recreational to problematic.

Emotional Changes

Increased irritability and agitation
Irritability and agitation can be early signs of addiction, as individuals may become more sensitive to stress and prone to emotional outbursts (Koob & Volkow, 2016). These emotional changes may result from the impact of substance use on the brain’s reward system and can perpetuate the cycle of addiction (Wise & Koob, 2014).

Anxiety and depression
Substance use can exacerbate pre-existing mental health conditions or trigger the onset of anxiety and depression (Swendsen et al., 2010). These emotional changes can contribute to the cycle of addiction, as individuals may use substances to self-medicate their symptoms (Conway, Swendsen, & Merikangas, 2016).

Loss of interest in previously enjoyed activities
A loss of interest in activities previously enjoyed can signal the development of addiction, as individuals may become preoccupied with substance use and disengage from other aspects of their lives (Volkow, Koob, & McLellan, 2016). This disengagement can further isolate individuals and increase their reliance on substances for comfort and pleasure (Sussman & Sussman, 2011).

Emotional numbness or detachment
Emotional numbness or detachment can be early warning signs of addiction, as individuals may use substances to escape or numb their emotions (Khantzian, 1997). This emotional detachment can contribute to the cycle of addiction, as individuals may become increasingly reliant on substances to cope with their emotions.

Feelings of guilt or shame about substance use
Feelings of guilt or shame about substance use can indicate the development of addiction, as individuals may recognize the negative consequences of their actions but continue to use substances despite these feelings (Dearing, Stuewig, & Tangney, 2005). These emotions can further perpetuate the cycle of addiction, as individuals may use substances to escape feelings of guilt or shame (Wise & Koob, 2014).


In summary, recognizing the early warning signs of addiction can enable individuals and their loved ones to take appropriate action and seek help. These warning signs may manifest as behavioral, social, physical, and emotional changes. By understanding and identifying these red flags, individuals can intervene early in the cycle of addiction and seek appropriate support and treatment to overcome their substance use disorder.

Public awareness and education about the early warning signs of addiction can also play a critical role in reducing the stigma associated with addiction and promoting a more compassionate and supportive approach towards individuals struggling with substance use disorders. Ultimately, a greater understanding of the early warning signs of addiction can help individuals, families, and communities work together to prevent and address addiction, fostering healthier lives and more resilient communities.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Brower, K. J. (2015). Assessment and treatment of insomnia in adult patients with alcohol use disorders. Alcohol, 49(4), 417-427.

Conway, K. P., Swendsen, J., & Merikangas, K. R. (2016). Alcohol, cannabis, and tobacco use disorders: Comorbidity and health consequences. In K. Sher (Ed.), Oxford Handbook of Substance Use and Substance Use Disorders (Vol. 1, pp. 43-63). Oxford University Press.

Cowan, J., & Devine, C. (2012). Food, eating, and weight concerns of men in recovery from substance addiction. Appetite, 58(1), 179-186.

Dalley, J. W., Everitt, B. J., & Robbins, T. W. (2011). Impulsivity, compulsivity, and top-down cognitive control. Neuron, 69(4), 680-694.

Dearing, R. L., Stuewig, J., & Tangney, J. P. (2005). On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addictive Behaviors, 30(7), 1392-1404.

Hasler, B. P., Soehner, A. M., & Clark, D. B. (2015). Sleep and circadian contributions to adolescent alcohol use disorder. Alcohol, 49(4), 377-387.

Jentsch, J. D., & Taylor, J. R. (1999). Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Psychopharmacology, 146(4), 373-390.

Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231-244.

Koob, G. F., & Volkow, N. D. (2010). Neurocircuitry of addiction. Neuropsychopharmacology, 35(1), 217-238.

Koob, G. F., & Volkow, N. D. (2016). Neurobiology of addiction: a neurocircuitry analysis. The Lancet Psychiatry, 3(8), 760-773.

Laudet, A. B. (2011). The case for considering quality of life in addiction research and clinical practice. Addiction Science & Clinical Practice, 6(1), 44-55.

Leonard, K. E., & Eiden, R. D. (2007). Marital and family processes in the context of alcohol use and alcohol disorders. Annual Review of Clinical Psychology, 3, 285-310.

Leeman, R. F., Patock-Peckham, J. A., & Potenza, M. N. (2014). Impaired control over alcohol use: An under-addressed risk factor for problem drinking in young adults? Experimental and Clinical Psychopharmacology, 22(2), 110-121.

Mate, G. (2010). In the realm of hungry ghosts: Close encounters with addiction. North Atlantic Books.

Moos, R. H., & Moos, B. S. (2005). Protective resources and long-term recovery from alcohol use disorders. Drug and Alcohol Dependence, 78(3), 323-334.

Schulte, M. T., Ramo, D., & Brown, S. A. (2019). Gender differences in factors influencing alcohol use and drinking progression among adolescents. Clinical Psychology Review, 66, 101-110.

Sussman, S., & Sussman, A. N. (2011). Considering the definition of addiction: Which is the better term, addiction or dependence? Substance Use & Misuse, 46(13), 1655-1661.

Swendsen, J., Conway, K. P., Degenhardt, L., Glantz, M., Jin, R., Merikangas, K. R., … & Kessler, R. C. (2010). Mental disorders as risk factors for substance use, abuse and dependence: Results from the 10-year follow-up of the National Comorbidity Survey. Addiction, 105(6), 1117-1128.

Van Ryzin, M. J., Fosco, G. M., & Dishion, T. J. (2012). Family and peer predictors of substance use from early adolescence to early adulthood: An 11-year prospective analysis. Addictive Behaviors, 37(12), 1314-1324.

Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363-371.

Wise, R. A., & Koob, G. F. (2014). The development and maintenance of drug addiction. Neuropsychopharmacology, 39(2), 254-262.

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Struggling with an addiction?

If you’re struggling with an addiction, it can be difficult to stop. Gaining short-term relief, at a long-term cost, you may start to wonder if it’s even worth it anymore. If you’re looking to make some changes, feel free to reach out. I offer individual addiction counselling to clients in the US and Canada. If you’re interested in learning more, you can send me a message here.

Other Mental Health Resources

If you are struggling with other mental health issues or are looking for a specialist near you, use the Psychology Today therapist directory here to find a practitioner who specializes in your area of concern.

If you require a lower-cost option, you can check out BetterHelp.com. It is one of the most flexible forms of online counseling. Their main benefit is lower costs, high accessibility through their mobile app, and the ability to switch counselors quickly and easily, until you find the right fit.

*As an affiliate partner with Better Help, I receive a referral fee if you purchase products or services through the links provided.

As always, it is important to be critical when seeking help, since the quality of counselors are not consistent. If you are not feeling supported, it may be helpful to seek out another practitioner. I wrote an article on things to consider here.

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1 Comment

  1. Bobby Oliveira

    Thanks for doing that. It’s one thing when clean and sober guy says it. It’s another thing when clean and sober guy can point to somebody like you saying it.


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