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8 Drug Abuse Warnings Signs Everyone Should Know About

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It's been five months since the world went into mourning over the death of Prince—and then went into even deeper shock when it was revealed that the "Purple One" was actually fighting demons in the form of substance abuse. But last night, Today Show anchor Tamron Hall made a startling admission about her best friend Prince on Watch What Happens Live: Even she had no clue that he was struggling with an addiction of any kind. Prince's close friends and family were blindsided that his cause of death was a prescription drug overdose. Hall told Andy Cohen that she's "learned a lot about substance abuse since then, and I think that people hide these dark secrets from the people they love." And months later, she still questions whether she missed the signs. "I never saw him even drink!" she said on the show. "So for me it was a devastating thing that I'm still dealing with."

Unfortunately, Prince's story is not an uncommon one. Many addicts are private about their drug habits and suffer through addictions without telling their loved ones. "The most significant and destructive characteristic of addictions is that they occur in isolation," says Paul Hokemeyer, Ph.D., senior clinical fellow at Caron Ocean Drive, an addiction treatment program with locations in Pennsylvania and Florida. "I've had many patients who, from all outside appearances, are highly successful. Lurking in the depths of their being, however, is the insidious effect of a substance abuse disorder." About 90 percent of the patients Hokemeyer treats for drug and alcohol addiction are considered "high-functioning addicts" meaning they're in the top 1 percent of income earners, have advanced educational degrees, are celebrated by their field, and are engaged with their friends and family. "This external presentation makes their addictions difficult to identify and challenging to treat," he explains.

Still, there are subtle signs and behavioral changes you can look out for if you ever feel concerned that a loved one is acting strange or could have a problem with substance abuse:

Defensiveness
Perhaps someone gets defensive for no reason when you ask innocent questions about their day or what they were doing during a time when you weren't together. "Addictions are layered in denial and rationalizations about their existence," Hokemeyer says. "They work like mad to stay alive and healthy—often at the expense of the person's physical, relational and emotional well-being."

Mood swings
"If a characteristically low-key person become highly agitated at times, or if an extrovert becomes introverted, there's typically a substance abuse disorder in play," he says. "Substances change a person's emotional state."

Irrational thinking and behaviors
What if your loved one is successful and normally logical, and usually makes smart, linear decisions on a daily basis—and then stops? That's cause for concern. "Chaotic and disorganized decision-making is a strong indication there's an underlying addiction," says Hokemeyer.

Physical changes
Bluntly, "addictions make beautiful people ugly," he says. Pay attention if someone who normally has bright, glowing skin suddenly starts looking gray or if their once-sparkly eyes start appearing dull and less focused.

Fiscal irresponsibility
Stone cold truth? Addictions are incredibly expensive to maintain, so look for changes in spending patterns. Consider taking further action if your once-extravagant friend becomes inexplicably frugal—with nothing to show for it.

Change in sleep patterns
We all change up our sleeping habits every once in a while if we're stressed or have a lot going on. But if it's a prolonged change, it could mean something more. Sleep habits can become unpredictable in someone who is abusing drugs. "Depending on the drug, these habits can result in the person keeping very abnormal hours, or even falling asleep in the middle of a conversation," says Indra Cidambi, M.D., founder and medical director of the Center for Network Therapy in Middlesex, New Jersey.

Changing doctors frequently
Changing doctors frequently may not seem like a big deal—but for an addict, it's actually a deadly habit. "Drug addicts who change doctors often do so because they might be trying to get additional prescription medications," says Cidambi. "They may have exceeded the amount of medication they can get from their former doctor."

You feel disconnected
The bottom line? Trust your instincts. If you feel disconnected from a loved one or friend, don't shrug it off or feel like you're making a big deal out of nothing. "Too many people have been lost to addictions' deadly grasp," reminds Hokemeyer. "And no one is immune."

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