Each year, according to the Centers for Disease Control and Prevention (CDC), more than 100,000 people in the U.S. die from drug overdoses. Many of those deaths were linked to opioids and benzodiazepines—strong medications that are often misused. These aren’t just numbers. Behind every statistic is a person: someone’s sibling, child, parent, or friend. And in many cases, the signs were there, but went unnoticed or unspoken.

Mental health and substance abuse issues don’t usually happen overnight. They build up over time, often in silence. Maybe someone starts skipping school or work, pulling away from loved ones, or acting differently. These might seem like mood swings or stress, but they could be signs of a deeper problem, like addiction or a mental health crisis. That’s why early intervention is so important. The sooner we recognize the warning signs, the sooner we can offer help—and possibly save a life.

Talking about mental health or substance use can feel awkward or scary. No one wants to say the wrong thing or push someone away. But starting the conversation doesn’t have to come from a place of judgment. It can come from a place of love, empathy, and concern for someone’s well-being. Your goal isn’t to diagnose or fix. It’s to care, listen, and guide them toward help.

In this blog, we’ll walk you through how to spot the early signs that someone might be struggling with addiction or a mental health issue. We’ll talk about how to have a caring and respectful conversation, even when it’s hard. And we’ll share where to turn for professional help—whether that’s therapy, substance abuse counseling, or other mental health services. Because when someone you love is at risk, doing something—even something small—can make all the difference.

What are the warning signs of addiction?

Addiction doesn’t always look the way we expect. It’s not just about drinking too much or using drugs—it’s about how those substances start to change a person’s mood, behavior, and even the way their brain works. When someone becomes dependent on drugs or alcohol, it affects their brain’s dopamine system—the part responsible for feelings of reward and pleasure. Over time, their body and mind start to crave that “high,” even when it begins to hurt their life.

Warning signs at different ages

• Teens and young adults may become more irritable, start skipping school, or pull away from family and friends. 
• Adults might begin missing work, showing sudden money problems, or getting into legal trouble. 
• Older adults may seem confused, forgetful, or overly sleepy. It’s easy to mistake these signs for aging, but sometimes it’s substance use. 

Recognizing addiction means paying attention to patterns, noticing changes that don’t seem like “them.” Here’s what to look for:

Behavioral, physical, and psychological signs of addiction

One of the first signs that something might be wrong is a change in how someone behaves. These changes can be subtle at first, building slowly over time. That’s why it’s important to trust your gut if something just feels off. A person who is usually social might start pulling away from friends or family, choosing isolation instead. You might notice sudden mood swings or bursts of aggression that don’t match the situation. They may begin ignoring responsibilities at school, work, or home, which is a sign of neglect. Some may also start lying about what they’re doing or where they’ve been, making it harder to trust what they say.

Addiction also shows up in the body. If someone’s appearance or energy level changes dramatically, it could be more than just a tough week. Watch for unusual weight changes—either gaining or losing a lot quickly. They may seem constantly tired or, on the flip side, overly energetic and restless. Trouble sleeping, or insomnia, is another common sign, along with red or bloodshot eyes. People may also frequently feel sick, complaining of nausea, sweating heavily, or just not seeming well on a regular basis.

But the effects of addiction don’t stop with the body. It can have a deep impact on someone’s mind and emotions, too. You might see signs of anxiety, like constant worry or nervousness, even when there’s no clear reason. Some people fall into deep sadness or hopelessness that doesn’t go away, which could point to depression. In more serious cases, someone may begin to see or hear things that aren’t there—a symptom known as psychosis. And perhaps most concerning, they may talk about death or show signs they’re thinking about suicide.

These signs may not all happen at once, but even a few of them together can mean someone is struggling. The earlier you notice and speak up, the greater the chance there is to help them get the support they need.

Over 20 million people in the U.S. struggle with a substance use disorder, but many go without the help they need. These warning signs aren’t about labeling someone with a mental disorder. They’re about recognizing addiction early and reaching out with care.

How can you tell if someone is in crisis?

Sometimes, it’s more than stress. Sometimes, it’s a crisis, and knowing the difference can save a life.

A crisis happens when someone is overwhelmed and unable to handle what they’re feeling or facing. It might be caused by substance abuse, a mental health disorder, or both at the same time. When someone is in crisis, their thoughts, emotions, and behavior can change quickly and in dangerous ways. It may look like they’ve hit rock bottom, but it’s also a powerful moment to step in and offer help.

Mixing substances

One major red flag is the misuse of prescription drugs or the mixing of substances. If someone is taking medication that wasn’t prescribed to them—or taking more than they should—it’s a serious concern. This includes painkillers like oxycodone, tramadol, or clonazepam, anti-anxiety drugs like alprazolam or other benzodiazepines, and medications for focus or sleep. Using stimulants like amphetamine, methamphetamine, or even dangerous drugs like phencyclidine (PCP) also signals a growing problem. Many people mix these substances with alcohol or other narcotics, putting themselves at high risk for overdose or severe health issues. This isn’t just experimentation—it’s a sign of a serious substance abuse problem.

Making unsafe choices

Another warning sign is getting into legal trouble or making unsafe decisions, like driving under the influence. Even one instance of driving while intoxicated shows a loss of control and poor judgment. If someone has been arrested for drug possession or caught in risky behavior at school or work, it’s often a sign that something deeper is going on, and they may already be in crisis.

Sudden shift in behavior

You might also notice a sudden shift in their daily life. This can look like failing grades, dropping out of school, skipping work, or even getting fired. Bills may go unpaid. They might stop taking care of themselves or start ignoring close relationships. These changes may seem like personal struggles, but often they’re symptoms of a much bigger problem, such as opioid use disorder or prescription drug addiction.

Mental health symptoms

Some people may experience emotional highs and lows that are more than just mood swings, which could be signs of bipolar disorder. Others may seem paranoid, withdrawn, or talk about seeing or hearing things that aren’t there—possible signs of schizophrenia. Some might be stuck in a deep sadness that doesn’t fade over time, which could be prolonged grief disorder. When someone is showing these symptoms and using drugs or alcohol at the same time, they may be dealing with a dual diagnosis—a combination of substance abuse and a mental illness, which requires special care.

The truth is, someone in crisis might not say, “I need help.” But their actions speak loudly. If you notice any of these warning signs, don’t wait. Reaching out with kindness and concern—not judgment—can make all the difference. Even if it’s hard, that first step toward help can be life-changing.

How to approach the conversation about substance abuse

Starting a conversation with someone you care about—especially when it’s about substance use—can feel scary. You might worry they’ll get angry, shut down, or deny there’s a problem. But silence can be more harmful than saying the wrong thing. That’s why it’s important to approach these talks with compassionate communication—a way of speaking that’s based on empathy, not judgment.

One helpful tool is called Nonviolent Communication (NVC), created by psychologist Marshall Rosenberg. NVC helps people talk about hard things without causing more conflict or shame. It focuses on connection and understanding, instead of blame or control.

The four steps of nonviolent communication (NVC)

Observation

Start by calmly describing what you’ve noticed—without exaggerating or accusing. For example, “I’ve seen that you’ve been missing school and sleeping a lot during the day.” Stick to facts, not labels.

Feeling

Share how this makes you feel, using words that reflect your emotions, not your judgments. You might say, “I’m really worried and confused because this doesn’t seem like you.”

Need

Then, express what you need in the situation. This isn’t about controlling them—it’s about sharing what’s important to you. For instance, “I need to know you’re okay, and I want to support you.”

Request

Finally, make a gentle and clear request. Something like, “Would you be willing to talk to a counselor or just let me help you find support?” This opens the door to help, without pressure.

When you have this kind of conversation, your tone and body language matter just as much as your words. Choose a time when you’re both calm, and pick a quiet, private place where you won’t be interrupted. Avoid starting the conversation when the person is under the influence or in a defensive state. Keep your voice soft, make eye contact, and sit at the same level as them—these small things help people feel safe.

It’s also important to manage your own emotions. If you come into the conversation full of guilt, shame, or frustration, that energy can spill over and make the other person feel judged. Try taking a few deep breaths beforehand, or even writing down what you want to say. Remember, the goal isn’t to force them to change—it’s to let them know they’re not alone.

If the conversation gets heated, don’t push. Sometimes people need time to process what’s been said. That’s okay. You’ve planted a seed of understanding. Keep showing up with care, patience, and presence. Over time, this kind of restorative and empathetic approach can build the trust they need to open up and accept help.

How to offer support without pushing someone away

When someone you love is struggling with substance use or mental health issues, it’s natural to want to jump in and fix everything. But the truth is, trying to take control can sometimes push them further away. The key to supporting a loved one is finding a balance—offering help while still respecting their independence.

First, try to talk about treatment or counseling without making them feel ashamed. Instead of saying, “You need help,” try something like, “I care about you, and I think talking to someone could really help you feel better.” Focus on their well-being, not what’s “wrong” with them. Showing understanding goes a long way.

It’s also important to allow them autonomy. That means giving them space to make their own decisions, even if you don’t agree with everything they choose. You can still be honest about your concerns and set healthy boundaries, but let them feel like they’re in charge of their next steps. Feeling powerless is often part of why people avoid help, so offering support without pressure can actually give them hope.

Another way to be helpful is by encouraging small, healthy habits. Getting better sleep, taking a short walk, or doing something creative like art or journaling can be healing. These coping tools may not solve everything, but they can reduce stress and give your loved one moments of relief. Suggest doing these things together—sometimes just being present is the best support.

Don’t forget that supporting mental health is also a team effort. You don’t have to carry it all alone. Peer support groups and family therapy can help both you and your loved one feel heard and understood. Talking to others who’ve been through similar situations can offer comfort and real-life advice. It can also help you feel less isolated as a caregiver or family member.

It’s okay to feel fear or frustration at times, but don’t let those emotions block the connection between you and the person you’re trying to help. Stay patient, keep listening, and remind them (and yourself) that recovery is a journey. With the right mental health resources, open conversations, and steady support, change is possible.

What to do if someone is having a mental health crisis

If someone is talking about ending their life, harming others, or you think they’ve overdosed, it’s a mental health crisis—and it’s time to act. Warning signs can include talking about suicide, showing signs of self-harm, or acting confused, violent, or completely withdrawn. In cases of overdose, you might see slow breathing, trouble staying awake, or even unconsciousness.

Call 911 if someone is in immediate danger or needs emergency help. You can also call 988, the Suicide and Crisis Lifeline, or text “HELLO” to 741741, the Crisis Text Line. These services are free and available 24/7.

Even if it feels uncomfortable, stepping in could save a life. It’s better to act too soon than too late. If there’s any threat of violence, domestic violence, or neglect, get help immediately—don’t try to handle it alone. Help is out there, and making that call can make all the difference.

Helping your loved one find the right mental health treatment

Trying to find the right mental health treatment for someone you care about can feel overwhelming. With so many options, it’s hard to know where to start. Do they need therapy? Medication? Both? And how do you know which mental health professional is the right fit? The truth is, there’s no one-size-fits-all answer—but there’s also no shame in asking for help. Seeking treatment is a sign of strength, not weakness.

Some people may need a treatment center that offers a full support team and daily care, especially if they’re dealing with substance misuse or repeated relapse. Others may do well with weekly therapy, support groups, or brief intervention programs. What matters most is finding a plan that works for them—and sticking with it.

Psychiatry vs. psychology

Understanding the difference between psychiatry and psychology can help you choose the right care. A psychiatrist is a medical doctor who can diagnose mental illnesses and prescribe medicine. Psychiatrists often help people with more serious mental health conditions, like bipolar disorder or schizophrenia. A psychologist, on the other hand, focuses on talk therapy and emotional support. They help people work through feelings, patterns, and challenges using counseling skills and evidence-based strategies.

Both psychiatrists and psychologists are trained professionals, and sometimes, working with both is the best approach. What matters is choosing someone who listens, understands, and helps your loved one feel safe.

What is dual diagnosis care?

Some people struggle with both a mental illness and a substance use disorder at the same time. This is called a dual diagnosis. For example, someone might have substance dependence from misusing drugs or alcohol and also live with depression or anxiety. In these cases, it’s important to treat both issues together. If only one is addressed, the other may get worse or lead to relapse.

Dual diagnosis care uses proven tools like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to help with diagnosis, and relies on clinical trials, randomized controlled studies, and real-world data to guide treatment. It often involves a team of health professionals who provide therapy, medication management, education, and support. These programs are backed by research and empirical evidence, so families can feel confident that they work.

Helping someone get the right treatment takes patience, time, and sometimes a few tries. But the effort matters. With the right mix of intervention services, training, and understanding, healing is possible, and hope is never out of reach.

Write in paragraph form and mention that it can be overwhelming trying to find the right provider or treatment. Also, talk about how there is no shame in seeking treatment.

How to tell if someone is open to treatment

When someone is struggling with mental health or substance use, it’s natural to hope they’ll want help. But how can you tell if they’re ready? Most of the time, it starts with small signs. Maybe they show curiosity about getting better, ask a question about therapy, or just seem more open to talking. These small shifts in mindset—even tiny changes in their tone or emotion—can mean they’re starting to think differently about their situation.

People who are ready for treatment may stop making excuses and start paying more attention to how they feel. They might talk about wanting change or share frustration about their current habits. These moments show desire, and even if they seem unsure, they’re worth leaning into. Perception and intelligence play a role here, too—once someone starts seeing that help isn’t a punishment but a path forward, they may be more willing to give it a try.

What to do if they are resistant

But what if they’re not ready? What if they shut you down or change the subject? That’s okay. Resistance is part of the process. When someone isn’t open yet, your job isn’t to convince them—it’s to plant seeds. You can do this by gently reminding them that support is available, showing love without pressure, and modeling wellness in your own life. Over time, your consistency can build trust.

Sometimes, it helps to back off for a bit and give them space. Knowing when to step back is just as important as knowing when to lean in. If things get worse or feel unsafe, don’t be afraid to bring in a third party, like a therapist, counselor, or someone they trust. Good conversation takes time. And as communication theory reminds us, it’s not just about what we say—it’s about how we listen, respond, and connect. Keep the door open. Healing doesn’t always happen on our schedule, but with patience and care, it can happen.

How Pacific Health Group can help

If someone you love is struggling—or if you’re the one in need—Pacific Health Group is here to help. We understand how hard it is to take that first step, but you don’t have to do it alone. Whether you’re looking for mental health resources, therapy, or support with substance abuse, our team of caring healthcare providers is ready to walk beside you.

We offer a wide range of services, including substance abuse counseling, individual therapy, family therapy, and couples counseling. We also offer telehealth, so you can talk to a licensed therapist from the comfort and privacy of your home. Whether you’re dealing with anxiety, depression, relationship struggles, or addiction, we meet you where you are—with compassion, not judgment.

At our clinic and treatment center, we use a trauma-informed, evidence-based approach rooted in psychology, psychiatry, and emotional intelligence. That means our care is backed by science and focused on your real-life needs. We’re a trusted resource center for mental health support, and as a nonprofit organization, we’re committed to helping everyone access quality care, no matter their situation. Mental illness and substance use can make life feel overwhelming, but sobriety, recovery, and peace of mind are possible. You just need the right support.

Reach out today—support starts with a conversation. Call us at 1-877-811-1217 or visit www.mypacifichealth.com. We’re here when you’re ready.