Signs and Symptoms of Drug Abuse/Overdose


Common guide to detect alcohol and drug use. It includes: General Guide to Detection; Definition of Addiction; Pupil Dilation; Signs and Symptoms; Paraphernalia a) S/S Chart Version; Drug Facts; Articles and Other Resources; Drug Pictures/Resources; NI-COR Topics; Additional Articles (Alcoholism, Drugs, Teenage Addiction and Interventions)

Overdose and Emergency Intervention Techniques

Common guide to detect alcohol and drug use. It includes: General Guide to Detection; Definition of Addiction; Pupil Dilation; Signs and Symptoms; Paraphernalia a) S/S Chart Version; Drug Facts; Articles and Other Resources; Drug Pictures/Resources; NI-COR Topics; Additional Articles (Alcoholism, Drugs, Teenage Addiction and Interventions)

I. Specific: General Guide to Detection

Abrupt changes in work or school attendance, quality of work, work output, grades, discipline.

Unusual flare-ups or outbreaks of temper. Withdrawal from responsibility. General changes in overall attitude. Deterioration of physical appearance and grooming.

Wearing of sunglasses at inappropriate times. Continual wearing of long-sleeved garments particularly in hot weather or reluctance to wear short sleeved attire when appropriate. Association with known substance abusers. Unusual borrowing of money from friends, co-workers or parents. Stealing small items from employer, home or school. Secretive behavior regarding actions and possessions; poorly concealed attempts to avoid attention and suspicion such as frequent trips to storage rooms, restroom, basement, etc.

II. Specific: DSM-IV Definition of Addiction

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

(1) Tolerance, as defined by either of the following:

a. A need for markedly increased amounts of the substance to achieve intoxication or desired effect.

b. Markedly diminished effect with continued use of the same amount of the substance.

(2) Withdrawal, as manifested by either of the following:

a. The characteristic withdrawal syndrome for the substance

b. The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms.

3) The substance is often taken in larger amounts or over a longer period than was intended (loss of control).

(4) There is a persistent desire or unsuccessful efforts to cut down or control substance use (loss of control).

5) A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects (preoccupation).

(6) Important social, occupational, or recreational activities are given up or reduced because of substance use (continuation despite adverse consequences).

(7) The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (adverse consequences).

III. Specific: Pupil Dilation

Before you do anything, consider this. There are two trains of thought prior to detection and intervention. One thought is to catch and punish, and the other is to identify and help- remember why you are doing this, and the intervention will turn out much better.

Note: A 6mm, 7mm, or 8mm pupil size could indicate that a person is under the influence of cocaine, crack, meth, hallucinogens, crystal, ecstasy, or other stimulant. A 1mm or 2mm pupil size could indicate a person under the influence of heroin, opiates, or other depressant. A pupil close to pinpoint could indicate use. A pupil completely dilated could indicate use. Blown out wide pupils are indicative of crack, methamphetamine, cocaine, stimulant use. Pinpoint pupils are indicative of heroin, opiate, depressant use.

Other causes of pupil dilation

IV. Specific: Signs and Symptoms

Alcohol: Odor on the breath. Intoxication. Difficulty focusing: glazed appearance of the eyes. Uncharacteristically passive behavior; or combative and argumentative behavior. Gradual (or sudden in adolescents) deterioration in personal appearance and hygiene. Gradual development of dysfunction, especially in job performance or school work. Absenteeism (particularly on Monday). Unexplained bruises and accidents. Irritability. Flushed skin. Loss of memory (blackouts). Availability and consumption of alcohol becomes the focus of social or professional activities. Changes in peer-group associations and friendships. Impaired interpersonal relationships (troubled marriage, unexplainable termination of deep relationships, alienation from close family members).

Marijuana/Pot: Rapid, loud talking and bursts of laughter in early stages of intoxication. Sleepy or stuporous in the later stages. Forgetfulness in conversation. Inflammation in whites of eyes; pupils unlikely to be dilated. Odor similar to burnt rope on clothing or breath. Tendency to drive slowly - below speed limit. Distorted sense of time passage - tendency to overestimate time intervals. Use or possession of paraphernalia including roach clip, packs of rolling papers,pipes or bongs. Marijuana users are difficult to recognize unless they are under the influence of the drug at the time of observation. Casual users may show none of the general symptoms. Marijuana does have a distinct odor and may be the same color or a bit greener than tobacco.

Cocaine/Crack/Methamphetamines/Stimulants: Extremely dilated pupils. Dry mouth and nose, bad breath, frequent lip licking. Excessive activity, difficulty sitting still, lack of interest in food or sleep. Irritable, argumentative, nervous. Talkative, but conversation often lacks continuity; changes subjects rapidly. Runny nose, cold or chronic sinus/nasal problems, nose bleeds. Use or possession of paraphernalia including small spoons, razor blades, mirror, little bottles of white powder and plastic, glass or metal straws.

Depressants: Symptoms of alcohol intoxication with no alcohol odor on breath (remember that depressants are frequently used with alcohol). Lack of facial expression or animation. Flat affect. Flaccid appearance. Slurred speech. Note: There are few readily apparent symptoms. Abuse may be indicated by activities such as frequent visits to different physicians for prescriptions to treat "nervousness", "anxiety"," stress", etc.

Narcotics/Prescription Drugs/Opium/Heroin/Codeine/ Oxycontin: Lethargy, drowsiness. Constricted pupils fail to respond to light. Redness and raw nostrils from inhaling heroin in power form. Scars (tracks) on inner arms or other parts of body, from needle injections. Use or possession of paraphernalia, including syringes, bent spoons, bottle caps, eye droppers, rubber tubing, cotton and needles. Slurred speech. While there may be no readily apparent symptoms of analgesic abuse, it may be indicated by frequent visits to different physicians or dentists for prescriptions to treat pain of non-specific origin. In cases where patient has chronic pain and abuse of medication is suspected, it may be indicated by amounts and frequency taken.

Inhalants: Substance odor on breath and clothes. Runny nose. Watering eyes. Drowsiness or unconsciousness. Poor muscle control. Prefers group activity to being alone. Presence of bags or rags containing dry plastic cement or other solvent at home, in locker at school or at work. Discarded whipped cream, spray paint or similar chargers (users of nitrous oxide). Small bottles labeled "incense" (users of butyl nitrite).

Solvents, Aerosols, Glue, Petrol: Nitrous Oxide - laughing gas, whippits, nitrous. Amyl Nitrate - snappers, poppers, pearlers, rushamies. Butyl Nitrate - locker room, bolt, bullet, rush, climax, red gold. Slurred speech, impaired coordination, nausea, vomiting, slowed breathing. Brain damage, pains in the chest, muscles, joints, heart trouble, severe depression, fatigue, loss of appetite, bronchial spasm, sores on nose or mouth, nosebleeds, diarrhea, bizarre or reckless behavior, sudden death, suffocation.

LSD/Hallucinogens: Extremely dilated pupils, (see note below). Warm skin, excessive perspiration and body odor. Distorted sense of sight, hearing, touch; distorted image of self and time perception. Mood and behavior changes, the extent depending on emotional state of the user and environmental conditions Unpredictable flashback episodes even long after withdrawal (although these are rare). Hallucinogenic drugs, which occur both naturally and in synthetic form, distort or disturb sensory input, sometimes to a great degree. Hallucinogens occur naturally in primarily two forms, (peyote) cactus and psilocybin mushrooms. Several chemical varieties have been synthesized, most notably LSD, MDA , STP, and PCP. Hallucinogen usage reached a peak in the United States in the late 1960's, but declined shortly thereafter due to a broader awareness of the detrimental effects of usage. However, a disturbing trend indicating a resurgence in hallucinogen usage by high-school and college age persons nationwide has been acknowledged by law enforcement. With the exception of PCP, all hallucinogens seem to share common effects of use. Any portion of sensory perceptions may be altered to varying degrees. Synesthesia, or the "seeing" of sounds, and the "hearing" of colors, is a common side effect of hallucinogen use. Depersonalization, acute anxiety, and acute depression resulting in suicide have also been noted as a result of hallucinogen use. Note: there are some forms of hallucinogens that are considered downers and constrict pupil diameters.

PCP: Unpredictable behavior; mood may swing from passiveness to violence for no apparent reason. Symptoms of intoxication. Disorientation; agitation and violence if exposed to excessive sensory stimulation. Fear, terror. Rigid muscles. Strange gait. Deadened sensory perception (may experience severe injuries while appearing not to notice). Pupils may appear dilated. Mask like facial appearance. Floating pupils, appear to follow a moving object. Comatose (unresponsive) if large amount consumed. Eyes may be open or closed.

Ecstasy: Confusion, depression, headaches, dizziness (from hangover/after effects), muscle tension, panic attacks, paranoia, possession of pacifiers (used to stop jaw clenching), lollipops, candy necklaces, mentholated vapor rub, severe anxiety, sore jaw (from clenching teeth after effects), vomiting or nausea (from hangover/after effects) Signs that your teen could be high on Ecstasy: Blurred vision, rapid eye movement, pupil dilation, chills or sweating, high body temperature, sweating profusely, dehydrated, confusion, faintness, paranoia or severe anxiety, trance-like state, transfixed on sites and sounds, unconscious clenching of the jaw, grinding teeth, very affectionate.

V. Specific: Paraphernalia Click Here

”When I started using this One Proven Method, I began to experience tremendous growth and positive changes in my own recovery.” Rev. Stephen J. Murray, MCRC, NICD

V. a) Chart Version of Signs and Symptoms of Use


Stimulants (Cocaine, Ecstasy, Meth, Crystal)

Depressants (Heroin, Marijuana, Downers)

Hallucinogens (LSD)

Narcotics (Rx. Medications)

Inhalants (Paint, Gasoline, White Out)



Note: Paraphernalia- Keep in mind, that you may not find drugs, if you are searching for them, but you can usually find the paraphernalia associated with use.

VI. Specific: Drug Facts

Includes identifiers, definitions, language of users and dealers. Drug Terms Slang and Street Terms

VII. Specific: Drug Pictures/Resources from the DEA



NARCOTICSNarcotics of Natural Origin


Semi-Synthetic Narcotics


Synthetic Narcotics


Narcotics Treatment Drugs



Controlled Substances Uses and Effects (Chart)BenzodiazepinesGamma

Hydroxybutric AcidParaldehydeChloral HydrateGlutethimide 7


Newly Marketed Drugs




CANNABISMarijuanaHashishHashish Oil

HALLUCINOGENSLSDPsilocybin & Psiocyn and Other TryptaminesPeyote & MescalineMDMA (Ecstasy) & Other PhenethylaminesPhencyclidine (PCP) & Related DrugsKetamine



IX. Specific: NICD Topics

Do you have questions relating to addiction / addictions / substance abuse? Contact Us... Health Info and Videos Medical issues updated weekly. Family Resources for the family, intervention information, support, and counseling. Medical Medical information, doctor and specialists directory, terminology and dictionary of terms. Treatment Treatment center locator. Halfway Houses National halfway house/sober living homes locator. Research A great resource for students, professionals, family, and others. Keywords Locate information on any subject relating to addiction/addictions. Click on the icons below to contact us or visit our site map. NICD ABM Articles- it will take you to articles and resources on addictions, recovery, prevention, mental health, medical, and spiritual issues, produced exclusively by our Advisory Board Members for NI-COR.

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The Villa at Scottsdale- Providing a full continuum of care for the treatment of alcoholism and drug addiction.

NI-COR Recovery Link Our sister site includes information on: signs and symptoms of use, pupil dilation chart, exploring benefits and entitlements, discharge from treatment, housing and aftercare planning, inmate transition assistance, medications, employment, and much more.

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Alcohol and Drug Addiction Survival Kit

General: A series, for the individual, family, friends, employers, educators, professionals, etc. on prevention, intervention, treatment, recovery, relapse prevention, support, and other issues relating to alcoholism and drug addiction.

1. Prevention- Includes tips on how to talk to your kids about alcohol, tobacco, and drugs.

2. Detection of Signs and Symptoms- A guide to detection of alcohol and various drug usage.

3. Definition of Addiction- A DSM-IV definition of exactly what constitutes alcoholism and drug addiction.

4. Intervention- Interventions can and do work. We will show you how to do it effectively.

5. Treatment & Housing- A treatment center and halfway house locator.

6. Support- Some guides to how to support someone while they are in treatment.

7. After Care- What to do prior to and after release from treatment.

8. Recovery / Relapse Prevention- Addiction can surface again, in the form of relapse.

9. Other Issues- Issues to think about regarding those affected by substance abuse, as well as those around them.

10. References- A list of those who contributed to this series of articles.

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A.A. History Author Dick B. will take you back to a time when the recovery rates were as high as 93%.

Journaling Today A series of informative articles by Author Doreene Clement on how, why, and what to write about.

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The Steps and Action Pages This is an overview of Steps 1-12, and the action taking pages for each.

X. Specific: Additional Articles

Health and Medical News News, videos, text from the world of medicine, health, and medical.

Ecstasy information.

How Do I Talk With My Kids About Alcohol?

How Do I talk to my kids about drugs?

How Do I talk with my teenager about drugs and alcohol?

What does a crack pipe look like?

Family assistance for substance abuse.

Addiction treatment for my teenager.

Overdose or OD Information

XI. Specific: Overdose & Emergency Intervention Techniques

Drug Overdose- Drug overdoses can be accidental or on purpose. The amount of a drug needed to cause an overdose varies with the type of drug and the person taking it. Overdoses from prescription or over-the-counter (OTC) medicines, "street" drugs, and/or alcohol can be life-threatening. Know, too, that mixing certain medications or "street" drugs with alcohol can also kill.

Physical symptoms of a drug overdose vary with the type of drug(s) taken. They include: Abnormal breathing Slurred speech Lack of coordination Slow or rapid pulse Low or elevated body temperature violent outbursts Delusions and/or hallucinations Unconsciousness which may lead to coma, Reddish face heavy sweating, Enlarged or small eye pupils Drowsiness.

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