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Signs & Symptoms of Substance Use Disorders in the Military

Unrecognizable soldier places his hand on fellow soldier while praying for him during a support group meeting.
Addiction can look very different depending on the substance(s) being used. In general, unexplained mood swings, changes in physical appearance, difficulty following through with commitments, and evasive or paranoid behavior can all be indicators of an SUD.

Below is a list of the most common substances of abuse and the symptoms they cause. This is not a complete list, but it is a great starting point to help you identify the signs of addiction in your loved ones, or even yourself:


Regular over-consumption of alcohol can cause redness and swelling in the face and hands. Over time it can lead to confusion and memory loss. People who have become dependent on alcohol may experience irritability, nausea, body aches, shaking, and confusion when they are unable to drink for several hours. This is known as “withdrawal”.

For regular, high-volume users of alcohol, attempting to quit suddenly could lead to life-threatening seizures. It is recommended to obtain the advice and assistance of a knowledgeable doctor or reputable detoxification program when attempting to quit drinking. Most likely they will recommend a course of “Medication Assisted Treatment” (MAT) to steadily reduce the amount of the drug in the body over several days. This is a much safer and more comfortable alternative to going “cold turkey”.

Behaviorally, alcohol abuse may appear as drinking at inappropriate times, looking for any excuse to drink, drinking alone, lying about drinking, and drinking despite harmful consequences.

Within the military, drinking to get to sleep, drinking to calm down, forgetfulness, and a gradual decline in the ability to perform assigned duties may be signs of a problem with alcohol abuse.


Common depressants include Benzodiazepines (Xanax, Valium, Librium, etc), Barbiturates (Amobarbital, Phenobarbital, etc.), and even Marijuana. These drugs tend to have a sedating effect, so look out for excessively slow or slurred speech, drowsiness, inability to pay attention, and poor judgment. Glassy eyes and dilated pupils may also indicate abuse of depressants.

Among military personnel, depressant abuse may show up as frequent tardiness, inability to follow instructions, falling asleep at inappropriate times, difficulty waking up, difficulty coping with stress or calming down without substances, frequent complaints about anxiety, and medication seeking behavior.

Like alcohol, many depressants can carry a risk of seizures during withdrawal so trying to quit “cold turkey” could be potentially deadly. It is important to consult with a qualified medical professional or utilize a licensed detoxification program when attempting to recover from depressant abuse. They will likely utilize “Medication Assisted Treatment” or MAT to slowly decrease the dosage of the drug over time, giving the body a chance to return to its normal state safely and more comfortably.


Inhalants work differently than most drugs, they induce a brief high by momentarily depriving the brain of oxygen. These are particularly dangerous because they are easily accessible, require more frequent use to produce the desired effect, and can rapidly and severely damage brain tissue.

Common symptoms of inhalant use include anxiety, watery eyes, headaches, nausea, and noticeable irritation or rashes around the mouth and nose. In more severe cases, it can begin to cause muscle spasms, confusion, and even psychosis over time.

Inhalant users will often have an unusual amount of aerosol canisters or compressed gas cartridges lying around or thrown away. Within the military, this may manifest as cleaning or other chemical agents going missing from their storage areas or unexplainably turning up among someone’s personal effects.


Hallucinogens (LSD, Psilocybin, Peyote, etc.) can induce a wide range of symptoms. Use of these drugs can lead to confusion, isolation, mood swings, hallucinations, and delusional thinking.

Among military personnel, use of hallucinogens may manifest as vivid flashbacks, avoiding social interactions, difficulty following instructions, and paranoia.


The opioid epidemic continues to significantly disrupt the lives of Americans, both civilian and military, because of the sheer availability and continued overprescribing of these drugs.

Many opioid addicted individuals started their use with a legitimate prescription from a doctor but developed a dependency over time. Once the prescriptions run out, some buy pills illegally from others, and, eventually, turn to cheaper illicit alternatives like heroin. Soldiers and Veterans who have served in the middle east are often more likely to have used heroin due to the high prevalence of the drug throughout those regions.

Visible track marks from needle use are relatively easy to spot, but because opioids can be consumed orally or via smoking, it is important to be able to recognize other symptoms as well. Opioid users may present with slurred speech and drowsiness. Like alcohol users, they may become irritable, confused, shaky, and complain of body pain when unable to use for a long period of time. They may complain of stomach pain, nausea, constipation, and intense headaches as well.

Opioids carry a strong risk of overdose. This risk has become even greater recently as fentanyl, an extremely powerful and deadly opioid, has become more common. If you know, or even suspect, that someone close to you is using opioids, it is recommended that you always keep Narcan accessible. Narcan is a fast-acting medicine, usually administered via nasal spray or swab, that can rapidly counteract the effects of opioid drugs and prevent death from overdose.

A close up photo of an unrecognizable mid adult female soldier as she puts her hands together and leans forward in her seat. She is talking with an unrecognizable female counselor.

Though opioids do not carry a life-threatening seizure risk in withdrawal the same way alcohol or depressants do, quitting opioids “cold turkey” is usually a very unpleasant process. Physicians and detoxification programs may recommend a course of “Medication Assisted Treatment” (MAT) to gradually reduce the body’s dependence on opioids over time. If recommended by a doctor, some medications like suboxone, Subutex, Sublocade, and Vivitrol may also be used indefinitely to reduce future cravings for opioids.


Stimulants may be prescription medications like Adderall or Ritalin, but also encompass illicit substances like cocaine and methamphetamine. Soldiers may be tempted to use stimulants to keep up with the rigorous demands of military life, increase alertness and focus on the battlefield, or as an exercise-aid & appetite suppressant to maintain fitness.

Symptoms of stimulant abuse include unusual and rapid weight loss, hypervigilance, anxiety, paranoia, repetitive or obsessive behavior (pacing, picking at skin, taking things apart, etc.), delusional thoughts, frequent nose bleeds or poor oral health, and rapid speech.

The extreme highs of stimulant use are often followed by a “crash”, or period of extended downtime. Heavy users may go through cycles where they spend several days awake followed by several days asleep.


Cannabis (otherwise known as marijuana or “pot”) comes in a variety of types and potencies. Smoking is the most common method of use, but it can also be cooked into food and eaten or condensed into oil for vape devices to help hide its distinct odor. The effects of cannabis can range from calming & sedating to stimulating and hallucinogenic.

Symptoms of problematic cannabis use might look like red, watery eyes, slowed reaction times, difficulty paying attention, forgetfulness, nonsensical speech, the inability to feel happiness or interest unless under the influence, sexual dysfunction, and excessive appetite or sudden weight gain.

Designer Drugs

Designer Drugs are synthetic versions of certain drugs (typically stimulants, depressants, and cannabis) that are chemically altered to mimic their effect but avoid detection by common drug tests.

They are less prevalent than other drugs, but because they will not show up on drug tests, they are particularly appealing to active duty service members who may be tested at random to maintain their standing in the military.

Common Depressant-derived Designer Drugs include: etizolam, clonazolam, diclazepam, and flualprazolam. Stimulant type designer drugs are often known as “Bath Salts”

Cannabis-derived Designer Drugs include: Spice/K2, “Herbal Incense”, and “Herbal Smoking Blends”.

If you or someone you know is struggling with one or more of these substances,
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