Drug dependence : Symptoms & Signs, Diagnosis & Tests

Symptoms & Signs


Symptoms of opiate and narcotic use:

  • Needle marks on the skin in some cases (called “tracks”)
  • Scars from skin abscesses
  • Rapid heart rate
  • Small “pinpoint” pupils
  • Relaxed or euphoric state
  • Coma, respiratory depression leading to coma, and death in high doses

Symptoms of opiate and narcotic withdrawal:

  • Anxiety and difficulty sleeping
  • Sweating
  • Goose bumps
  • Runny nose
  • Stomach cramps or diarrhea
  • Enlarged (dilated) pupils
  • Nausea and vomiting
  • Excessive sweating
  • Increase in blood pressure, pulse, and temperature


Symptoms of cocaine use:

  • Exaggerated feeling of well-being (euphoria)
  • Dilated pupils
  • Fast heart rate
  • Restlessness and hyperactivity

Symptoms of cocaine withdrawal:

  • Fatigue and malaise
  • Depression
  • Very clear and unpleasant dreams


Symptoms of alcohol use:

  • Slurred speech
  • Lack of coordination
  • Decreased attention span
  • Impaired judgment

Symptoms of alcohol withdrawal:

  • Anxiety
  • Shaking (tremors)
  • Seizures
  • Increased blood pressure, pulse, and temperature
  • Delirium


Symptoms of LSD use:

  • Anxiety
  • Frightening images of things that aren’t there (hallucinations)
  • Paranoid delusions
  • Blurred vision
  • Dilated pupils
  • Tremors

Diagnosis & Tests

Drug tests (toxicology screens) on blood and urine samples can show many chemicals and drugs in the body. How sensitive the test is depends upon the drug itself, when the drug was taken, and the testing laboratory. Blood tests are more likely to find a drug than urine tests. However, urine drug screens are done more often.

Opiates and narcotics are usually in the urine 12 to 36 hours after the last use, depending on the amount used and how often the drug was used.

CNS stimulants such as cocaine can be found in urine for 1 to 12 days, again depending on how often the drug was used.

CNS depressants such as Valium and Xanax are found up to 7 days after the last day of use, mostly depending on the substance used and how quickly the body removes it (its half-life).

Most hallucinogens also can be found in the urine up to 7 days after the last use. However, evidence of marijuana can be found for up to 28 days after its last use in regular users.

Review Date : 5/20/2009
Reviewed By : David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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