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Starting to Worry?

It often starts as fun and feels manageable, until problems grow and willpower isn’t enough. Long-term use changes the brain, making “just stopping” difficult and keeping you stuck in a cycle that usually requires professional help to break. If this sounds familiar, now is the time to reach out—no one can decide for you, but choosing help is the first step.

KPC offers comprehensive, medically supervised, state-licensed intensive outpatient care so you can keep working and stay with family while getting the treatment you need. Our program blends medication when appropriate, evidence-based therapy, and skill-building to reduce cravings, address underlying trauma, and support lasting recovery. We accept most commercial insurance plans; we do not accept Medicare or Medicaid.

Self Help Resources

Alcohol misuse can show up as odor on the breath, visible intoxication, glazed or unfocused eyes, flushed skin, irritability, and shifts toward unusually passive or combative behavior. Over time, personal appearance and hygiene may decline, blackouts can occur, and there may be unexplained bruises or accidents, along with increasing absenteeism from work or school, often around Mondays.

Social patterns often change too: drinking becomes a central focus of activities, peer groups and friendships shift, and relationships suffer, including marital conflict, loss of close friendships, or distancing from family. When these signs cluster together, it’s a strong signal to seek a professional evaluation and support.

Opiate abuse warning signs can include extreme lethargy or drowsiness, very constricted “pinpoint” pupils that don’t respond well to light, and physical clues such as raw or reddened nostrils, white powder around the nose, or track marks on the arms or other body areas from injection. You may also notice drug paraphernalia like syringes, bent spoons, bottle caps, eye droppers, rubber tubing, cotton, and needles hidden in lockers, drawers, or around the home.

Opiates are powerful central nervous system depressants that can cause euphoria, deep relaxation, slowed breathing, impaired reflexes, and difficulty thinking clearly. Misuse of prescription pain medications or heroin can quickly lead to tolerance and dependence, and withdrawal often brings intense symptoms such as cold sweats, bone and muscle pain, anxiety, vomiting, and diarrhea. People who inject are also at risk for serious medical complications like infections, heart inflammation, HIV, and hepatitis.

Stimulant abuse may show up as persistent dry mouth and nose, bad breath, frequent lip-licking, and ongoing runny nose, sinus problems, or nosebleeds. People often appear overly active or restless, have trouble sitting still, lose interest in food or sleep, and may seem unusually talkative but jump rapidly from topic to topic.

You might also notice increased irritability, nervousness, or a more argumentative attitude, along with paraphernalia such as small spoons, razor blades, mirrors, tiny bottles of white powder, or plastic, glass, or metal straws.

Inhalant misuse often leaves a chemical odor on breath and clothing, along with runny nose, watery eyes, drowsiness or even brief unconsciousness, and poor coordination. Physical clues can include stained or paint-marked clothing, small “incense” bottles (butyl nitrite), and discarded nitrous oxide chargers from whipped cream cans, as well as bags or rags with glue or solvent residue kept at home, school, or work.

Behaviorally, people may seem unusually drowsy, unsteady, or “drunk” without alcohol, and may gravitate toward group use to normalize the behavior. These substances act rapidly and can be dangerous even with limited exposure, so noticing clusters of signs—chemical odors, nasal irritation, poor muscle control, and paraphernalia—warrants prompt, professional evaluation.

Depressant misuse can be subtle. Watch for patterns like frequent doctor visits seeking prescriptions for “anxiety” or “stress,” signs that resemble intoxication without an alcohol odor, and generally reduced expressiveness or animation. Speech may become slurred, posture slack, and facial affect flat, creating a “slowed” presentation that’s easy to overlook.

Because depressants often co-occur with alcohol, symptoms can blur together and be mistaken for drinking. Persistent lack of facial expression, flaccid appearance, and slurred speech—especially without alcohol smell—are key red flags to take seriously and discuss with a qualified professional.

Hallucinogen misuse can present with markedly dilated pupils, warm or flushed skin, and heavy sweating or noticeable body odor. People may report or display altered perception of sights, sounds, touch, time, or even their own body image, and their mood and behavior can swing quickly depending on setting and emotional state. Episodes may include rapid shifts from euphoria to anxiety, confusion, or paranoia.

While rare, some individuals experience “flashbacks” (recurring perceptual disturbances) long after stopping use. Because responses to hallucinogens are highly variable and context-dependent, clusters of signs—extreme pupil dilation, sensory distortions, and pronounced mood or behavior changes—should prompt timely, professional evaluation.

Fentanyl is a powerful synthetic opioid, up to 50 times stronger than heroin and 100 times stronger than morphine, and is now a leading driver of fatal and nonfatal overdoses in the U.S. While pharmaceutical fentanyl is safely prescribed for severe pain (for example after surgery or in advanced cancer), most overdoses involve illicitly manufactured fentanyl that is mixed into street drugs, counterfeit pills, and even THC products, with no dose control or quality standards. Dealers use it because tiny amounts dramatically increase potency and addictiveness, creating repeat customers—but this same potency makes every use far more dangerous.

Because fentanyl is often hidden in other substances, anyone using street pills or powders is at risk of accidental opioid overdose. Typical overdose signs include very small, pinpoint pupils, extreme drowsiness or loss of consciousness, slow or shallow breathing, choking or gurgling sounds, a limp body, and pale, blue, or cold skin. If there is any concern for overdose, treat it as an emergency: call 911, stay with the person, try to keep them awake and breathing, and use naloxone if available—acting quickly can save a life.

Xylazine, often called “tranq” or “tranq dope,” is a veterinary sedative that is not approved for human use but is increasingly being mixed into street drugs like heroin, fentanyl, cocaine, counterfeit pills, and even some THC products. It causes heavy sedation, can slow breathing, heart rate, and blood pressure to dangerously low levels, and is strongly associated with severe, hard‑to‑heal skin ulcers and tissue death that can lead to infection and even amputation. Because there is no quality control in illicit drug markets, people using these substances often have no idea how much xylazine they are taking, which dramatically increases the risk of serious harm.

Xylazine is especially dangerous in overdoses because it is not an opioid and does not respond directly to naloxone, even though overdoses usually look like opioid overdoses and often involve fentanyl at the same time. People may be deeply sedated or unresponsive, with slowed or stopped breathing and blue or grayish, cool skin. If xylazine exposure is suspected and someone appears to be overdosing, it is still critical to call 911 immediately, administer naloxone (since opioids are usually present), and stay with the person until help arrives.

PCP misuse can cause sudden, unpredictable shifts in behavior and mood—someone may appear drowsy or detached one moment and agitated or violent the next. Physical signs can include rigid muscles, a strange or unsteady gait, slurred or minimal facial expression (a “mask-like” look), and markedly dilated or “floating” pupils that seem to track movement oddly. People may seem intoxicated, disoriented, or unresponsive to pain and external stimuli, and excessive sensory input can escalate agitation.

At higher amounts, PCP can blunt sensation so severely that serious injuries go unnoticed, and in extreme cases lead to a stuporous or comatose state with eyes open or closed. Because reactions are dose-dependent and highly variable, clusters of signs—unpredictable behavior, dissociation, abnormal eye movements, rigidity, and altered pain perception—warrant urgent professional evaluation and, if safety is a concern, immediate emergency care.

Why Do People Use Alcohol & Drugs?

Positive Reinforcement

People continue because effects feel good: euphoria, relaxation, pain relief, better sleep or focus, or feeling more social.

Curiosity

Media, peers, and access spark experimentation, especially among teens and young adults.

Celebration

Alcohol and, in some cultures, other substances are part of holidays, rituals, and family or social events.

Emotional Pressures

Substances can be used to cope with stress, anger, anxiety, boredom, depression, trauma, or to boost confidence.

Social Pressures

Group norms and family modeling matter; using can feel like a ticket to belonging or acceptance.

Previous Use

First use lowers barriers to using again; early, repeated use raises later problem risk.

Dependence

With repeated use, some develop physical or psychological dependence - using to avoid withdrawal or distress rather than to feel good.

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