Addiction Red Flags and Risk Factors

By: Pine Rest Staff Authors

In 2020, an estimated 41.1 million Americans aged 12+ self-reported needing treatment for alcohol or illicit drug use (SAMHSA). Here are some of the red flags and risk factors for addiction:

Common Risk Factors for Addiction

These factors elevate a person’s risk of developing a substance use disorder, though it is important to note that addiction can occur without any risk factors being present.

  • Mental health diagnosis, such as anxiety, depression and/or co-occurring conditions.
  • History of abuse, neglect of past trauma.
  • Family history of addiction.
  • Substance use at an early age.
  • Stress.
  • Poverty.

Common Red Flags/Warning Signs of Addiction

Mental, Emotional and Behavioral:

  • Confusion
  • Depression
  • Anxiety
  • Insominia
  • Illogical thinking
  • Forgetful (may not remember past conversations or promises made)
  • Excessive mood swings
  • Unusual or erratic behavior
  • Poor judgment or impulsive behavior
  • Personality changes when drinking or using substances
  • Loss of interests, activities, friends
  • Angry or defensive if the topic of alcohol or other drug use is brought up
  • Problems at work
  • Financial problems; asking to borrow money
  • Use of prescription tranquilizers, sleeping pills or headache medications
  • Poor hygiene or signs of self-neglect
  • Smell of alcohol or breath at inappropriate times (morning, while at work, etc.)
  • Other addictions, such as smoking
  • Legal problems


  • Impaired physical coordination
  • Slowed, slurred speech
  • Sleepiness, lethargy during the day
  • Pupils dilated or pinned
  • Red eyes
  • Excessive perspiration
  • Runny nose
  • Tremors
  • Lip and finger burns
  • Jumpiness, rapid breath


  • Self or family report of problem
  • Others in family struggle with addiction
  • Friends are heavy users, social environment is accepting of substance use
  • Family isolative, secretive or uninvolved
  • Few friends
  • Chronic relationship problems
  • Blaming others, rationalizing behaviors
  • Children’s behavior problems at school

Checklist: What to Ask …

Are you wondering if you or someone you care about could be developing an addiction to alcohol or other drugs? Here are some questions worth asking.

  • Have you felt you wanted or needed to cut down on your drinking or drug use in the last year?
  • How many times in the past year have you used an illegal drug or prescription medication for non-medical reasons?
  • Are you always able to stop drinking alcohol/using drugs when you want to?
  • Have you had blackouts or flashbacks as a result of alcohol or drug use?
  • Do you feel bad or guilty about your alcohol or drug use?
  • Does your spouse or parent(s) complain about your alcohol or drug use?
  • Have you neglected your family because of your alcohol or drug use?
  • Have you engaged in illegal activities to obtain drugs or alcohol?
  • Have you experienced withdrawal symptoms (felt sick) when you stopped drinking alcohol or taking drugs?
  • Have you had medical problems as a result of your alcohol or drug use (e.g. memory loss, hepatitis, convulsions, bleeding)?

You are not alone! We can support you or your loved one at every step of recovery.

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