How to Tell if Someone Is High: Signs of Drug Use

Drug use often has telltale signs, including signs of a “high” that comes from the intoxicating effects of the drug. If you suspect a friend, family member, or someone else you care about is doing drugs, knowing the signs can help you make a plan to help.

Signs of Drug Intoxication

Determining if someone is high can be difficult because different drugs cause different effects. Someone high on a stimulant may be hyper-focused and energetic, while someone high on a depressant may be extremely relaxed.

However, there are some general signs of drug use to look out for. The physical signs can include:[1]

• Sleeping problems, such as sleeping too much or too little
• Having unusual energy levels, either high or low
• Changes in eating habits like a low appetite or an increased appetite
• Enlarged pupils or pinpoint pupils
• Bloodshot or glassy eyes
• Strange smells
• Slurred speech
• Coordination problems
• Extreme talkativeness
• Tremors
• Jaw clenching
• Sweating or feeling hot when temperatures are comfortable
• Sudden weight changes
• Disinterest in personal appearance and hygiene

The behavioral changes can be good indicators as well, including:[2]

• Withdrawing from friends and family
• New friends and social circles
• Job loss or relationship problems
• Poor attendance at school or work, low grades, or poor academic or professional performance
• Signs of depression, hostility, or agitation
• Increased secrecy
• Lack of interest in activities once enjoyed
• Suspicious or paranoid behavior
• Lying
• Increased nervousness or restlessness
• Unusual happiness

There are some signs to look for that have to do with the way the drug is administered rather than the drug itself. These signs can include:[3]

• Injection: Track marks on the arm, bruising near veins, or drug paraphernalia like needles, spoons, or rolling papers
• Smoking: Chronic cough, burns on the lips, gum disease or tooth decay
• Inhaling: Nasal congestion, bloody nose, excessive sniffling

How To Tell If Someone Is High on Different Drugs

There are many drugs of abuse, and not all of them cause the same effects. Drug use can have physical, mental, and emotional signs to look out for, depending on the drug involved. Here are some types of psychoactive drugs and the signs someone is high:

Stimulants

Stimulants are drugs that speed up the central nervous system (CNS), such as caffeine, nicotine, cocaine, and amphetamines. In small doses, stimulants may cause someone to be energetic, alert, and confident. With excessive use, stimulants can cause more extreme effects, such as anxiety, headaches, cramping, aggression, paranoia, panic attacks, and seizures.[4]

Depressants

Central nervous system depressants are drugs that slow the CNS, such as opioids, alcohol, and benzodiazepines. Depressants may make people feel sad, relaxed, happy, or joyful in small doses. With excessive use, depressants can cause severe CNS depression and physical symptoms like slurred speech, trouble breathing, confusion, slow heart rate, clammy skin, low body temperature, and unconsciousness.[5]

Opioids

Opioids are depressants, but they’re also powerful drugs that act on the opioid receptors in the brain and dull pain. They can mimic the natural effects of dopamine, but they’re much stronger and more addictive. Some common opioids include prescription drugs like oxycodone and morphine, as well as illicit drugs like heroin.

In therapeutic doses, opioids can cause drowsiness, relaxation, and numbness. In excessive doses, opioids can cause euphoria, constipation, pinpoint pupils, blue or gray skin, excessive fatigue, and unconsciousness.[6]

Psychedelics

Psychedelics are drugs that alter the mind, mood, thoughts, and perceptions of reality. Psychedelics can include drugs like peyote (mescaline), magic mushrooms, and LSD. The effects of psychedelic drugs can be variable and may cause paranoia, euphoria, fear, anxiety, confusion, loss of coordination, and disorganization.[7]

Cannabinoids

Cannabinoids are the active compounds found in the cannabis plant. The main psychoactive compound is tetrahydrocannabinol (THC), which causes many marijuana effects and can cause pain relief and relaxation at low doses. At high doses, THC causes more intense effects like severe nausea, paranoia, hallucinations, recurrent cough, and worsening schizophrenia.[8] Smoking marijuana can have some obvious effects, such as a skunk-like odor and hunger.

Dissociative Drugs

Dissociative drugs like ketamine and phencyclidine (PCP) are substances that affect the communication systems in the brain and limit messages, including bodily sensory perception. They have similar effects to depressants, but they also cause common symptoms like a feeling of disconnect from the body, euphoria, and nausea.

At high doses, dissociative drugs can cause serious effects like engaging in dangerous behavior, depressed breathing and heart rate, and hallucinogen persisting perception disorder (HPPD).[9][10]

Risk Factors for Drug Addiction

Drug addiction, or substance use disorder, is a disease that can affect a person’s brain and behavior. The use of legal or illegal drugs eventually becomes a compulsive need, so they can’t control their use or stop despite the harm it causes.

People of any age, sex, or economic status can become addicted to a drug. Certain factors can increase the risk of addiction, including:[11]

• Family history of substance abuse, particularly a parent or sibling
• Mental health disorders like depression, attention deficit hyperactivity disorder (ADHD), or post-traumatic stress disorder
• Peer pressure to misuse drugs, particularly in young people
• Difficult family situations or lack of support from parents or siblings
• Using drugs at an early age
• Trying highly addictive drugs, such as opioids or cocaine

What to Do If You Suspect Drug Use

Drug misuse or abuse can have devastating consequences, both direct and indirect. Some drugs have a high risk of addiction, overdose, and long-term health effects. Others may not only affect your health and well-being, but they can lower inhibitions, cause delayed reaction times, or other negative effects that can lead to injury or death, such as driving a car under the influence of alcohol or marijuana and sharing needles with IV drugs and contracting bloodborne illnesses.

It’s important not to jump to conclusions with drug use, however. It’s possible that your loved one could be struggling with a mental illness and stress, adjusting to a new medication, or other causes.

If you suspect someone is abusing drugs, it’s important to talk to them about their substance use. Substance use can negatively affect your health, job security, mental well-being, academic performance, and personal relationships.

Here are some tips to talk to a loved one about drug use:

• Start the conversation when they’re sober
• Keep the focus on your concern about substance use
• Don’t accuse or blame
• Explain that you’re worried about them
• Avoid derogatory labels like “addict” or “alcoholic”
• Be empathetic and understanding
• Offer help and support rather than demands

Early intervention is key. The earlier you can get them to seek professional help and get into recovery, the less likely they are to experience the more severe effects of substance use.

Get Help for Drug Abuse

Using a drug regularly can increase the risk of developing dependence and addiction. If you suspect someone you love is getting high, they may have a substance abuse problem already. Getting help as soon as possible can increase the likelihood of recovery and reduce the dangers associated with drug use.