How Can You Tell if Someone is High? Find Out What to Look For

If you are worrying about how to determine if someone is high, it is probably because someone you care about has been exhibiting abnormal behavior which brings feelings of worry, apprehension, and possibly even guilt. Perhaps your family member appears different upon returning home from a night out. Maybe their eyes look odd, their voice sounds different, or you just know something about their behavior has changed in a way you can’t ignore.

One thing is true: each person exhibits different signs of intoxication, and signs differ depending on many factors. Recreational marijuana, alcohol, opioids, cocaine, methamphetamine, and many other types of drugs create varying degrees of impact on both the body and mind. A single symptom typically does not signify the consumption of illicit substances. However, a collection of physical symptoms combined with observable behavioral changes or indicators of potential danger may suggest it is worth taking a second look.

Identifying Signs of Being “High”

Symptoms of being high vary based on the substance used, dosage, overall health condition, and whether additional drugs or alcohol are also being consumed simultaneously. Certain individuals will demonstrate signs of being “high” through excessive sleepiness, sedation, or withdrawn behavior. Other individuals may be extremely talkative, restless, anxious, or confidently assertive, or act irrationally.

Potential signs of being “high” include:

• Bloodshot eyes
• Red eyes
• Binge eating
• Runny nose
• Physical signs of being under the influence
• Dilated pupils or constricted pupils
• Slurred speech
• Poor motor skills (lack of coordination)
• Prolonged response time
• Unusual fatigue or lethargic behavior
• Sudden bursts of excessive energy
• Dry mouth
• Increased hunger or appetite
• Nausea or vomiting
• Excessive perspiration or chilliness
• Altered heart rate or blood pressure
• Disorientation or memory loss
• Paranoia
• Anxiety or panic attacks
• Mood swings
• Secretive or deceptive behavior
• Odor emanating from clothing, breath, or paraphernalia

According to the Indian Health Service, some examples of possible signs of drug-related impairment include red eyes, pupils larger or smaller than normal, tremors, slurred speech, coordination difficulties, and indications of intoxication.[1]

How to Identify Whether Someone Is “High” Based on Their Eyes

While the eyes can provide a few hints regarding a person’s state of being “high,” they represent only a portion of the overall picture. For example:

• Marijuana users tend to develop red eyes, a weary expression, reduced reaction rates, and increased senses (smell and hearing)
• Users of opioids can produce very small pupils, heavy eyelids, drowsiness, and reduced respiration
• Users of stimulants (cocaine, methamphetamine) may present with dilated pupils, excessive energy, rapid speech, sweating, agitation, or paranoia
• Hallucinogen users may present with dilated pupils, perceptual distortions, or changes in reality awareness.[2]

In addition to those mentioned above, some general eye-related warning signs of potential drug impairment include bloodshot eyes, glassy eyes, pinpoint pupils, droopy eyelids, rapid eye movement, trouble focusing, or sensitivity to light.

However, multiple other reasons exist why an individual’s eyes may exhibit various signs, including allergy season, prolonged periods without restful sleep, emotional distress, eye irritation, or pre-existing medical conditions. As stated previously, an individual’s entire physical presentation should be evaluated before making conclusions related to their drug use.

What Does Getting High From Using Marijuana Look Like?

Individuals who utilize recreational marijuana may experience relaxation, giggles, quietness, hunger, or disconnection from reality. Others may experience anxiety, panic, paranoia, memory problems, or judgment errors.

Some possible indications that an individual has ingested marijuana include red eyes, dry mouth, increased appetite, laughter that appears unconnected to the situation, sleepiness, impaired reaction time, or forgotten recent events.

Additionally, marijuana use can result in distortion of time and perception, altered sensory perceptions, nausea or vomiting, increased heart rate or respiratory rate, and euphoria. [3] Depending on the amount and frequency of use, marijuana intoxication may continue to negatively affect cognitive functioning (attention, memory, learning), thus potentially affecting daily functions (driving, school, work).

What Does a Stimulant High Look Like?

Abuse of stimulants includes abuse of cocaine, methamphetamine, prescription amphetamines, and possibly other prescription medications. People who are abusing stimulants can appear as though they are wide awake or restless rather than drowsy.

Potential signs associated with stimulant abuse include:

• Dilated pupils
• Speaking rapidly
• Increased energy or energy bursts
• Restlessness
• Excessive perspiration
• Decreased appetite
• Increased confidence, boldness, or impulsive behavior
• Panic attacks or anxiety
• Paranoia, jitters, shaking, or twitches
• Difficulty sleeping
• Increased heart rate or blood pressure, chest pain, anger, or mood swings
• Aggressive behavior or irritability

Users of methamphetamine experience an array of physical and psychological negative effects as a result of chronic use. Methamphetamine users often suffer from dental problems commonly referred to as meth mouth, skin sores, chronic malnutrition leading to dangerous amounts of weight loss, chronic anxiety and paranoia, and cardiovascular disease. In extreme cases, chest pain, extreme agitation, overheating, heart attack symptoms, or convulsions or seizure activity occurring as a result of continued use must be addressed promptly as a medical emergency.

What Does an Opiate High Look Like?

Examples of opiate-related products include prescription medication for pain management, heroin, fentanyl, and other opioid-based products. An individual exhibiting signs of opiate use can demonstrate signs ranging from being excessively sleepy, appearing extremely relaxed, detached, or unresponsive to stimuli, or experiencing significant difficulties waking.

Some potential physical and psychological effects associated with opiate abuse include:

• Small pupils
• Heavy drowsiness or nodding off
• Speech impairment or difficulty
• Slow breathing
• Reduced reaction time
• Itching, nausea, or vomiting
• Disorganized thoughts or confusion
• Limp body
• Cool or pale skin
• Blue or gray lips or fingertips

Opiate overdose can be fatal after repeated use of high doses. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), if an individual demonstrates any of the following signs: difficulty breathing, stopped breathing, cannot awaken, blue or gray lips, gurgling sounds, or a limp body, then call 911 immediately.[4] Additionally, if naloxone is available and opioid overdose is suspected, administer it immediately while awaiting further medical assistance.

Indications of Intoxication Associated With Alcohol and Sedative Use

Substances such as alcohol, benzodiazepines, sleep aids, and numerous other sedatives can slow down the central nervous system.[5] The central nervous system includes the brain and spinal cord.

Potential signs associated with alcohol or sedative intoxication include:

• Slurred speech
• Coordination issues or balance problems
• Fatigue or lethargy
• Disorganization or cognitive confusion
• Judgment errors
• Emotional instability
• Short-term memory loss or blackout episodes
• Delayed response times or vomiting
• Troubled sleep patterns
• Reduced respiratory rates

Alcohol overdose can result in mental confusion, vomiting, seizures, trouble breathing, decreased heart rate, decreased body temperature, and loss of consciousness. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests contacting 911 immediately if an individual is believed to be suffering from alcohol overdose [6].

Combining alcohol with opioid medications, benzodiazepines, or other forms of medication increases an individual’s risk for overdose due to intensified sedative effects as well as respiratory compromise.

Behaviors That Indicate Reasonable Concern for Potential Substance Dependency

Often the most apparent indicators are not physical symptoms themselves but rather observed changes in behavior and priorities along with moods and daily activities. Family members may notice:

• Secrecy or new secrecy around habits
• Money missing or new money missing
• Decreased academic performance
• Workplace conflict or performance issues
• Drastic changes in relationships
• Lying about location
• Avoidance of eye contact
• Loss of interest in hobbies
• Uncommon hours for sleep or waking
• Conflict escalation
• Mood fluctuations
• Hygiene neglect
• Odor concealed using gum, air freshener, or perfume.
• Hidden paraphernalia
• Requesting funds without reason

None of these signs necessarily indicate addiction, but rather depression, mental illness, anxiety, post-traumatic stress, and negative coping mechanisms. However, when combinations of behavioral changes occur alongside physical evidence of intoxication, withdrawal symptoms, or repetitive drug use, it may be time to discuss potential intervention with your loved one.

Emergency Assistance Should Be Provided for the Following Situations

There are situations where waiting is not feasible. Call 911 immediately if the person experiences trouble breathing, loss of consciousness, seizures, chest pain, blue or gray lips, extreme agitation, high body temperature, an abrupt decrease in heartbeat rate, absence of breath, ongoing vomiting, anticipated overdose, or thoughts of self-harm or harm toward others.

Do not assume the individual will just “sleep it off.” Remain near them until help arrives, keep them on their side if they experience vomiting or lose consciousness, and inform responders regarding all substances used by the individual.

Communicating With Your Loved One You Believe May Be Under the Influence of Drugs

If an individual you believe may be “high” yet poses no immediate threat to themselves or others, identify a time when you can engage in an open and non-confrontational dialogue regarding your observations. Due to the fact that a person experiencing the effects of substance use may be less capable of processing complex conversations appropriately at this time, safety should remain your priority.

During communication:

• Maintain calmness and clarity
• Express clearly what has been observed, avoiding name-calling or insulting language
• Utilize personal statements (“I”) and express concern for the well-being of the person
• Do not argue about whether they are high
• Inquire about the safety of the individual and whether additional substances were consumed
• Do not threaten or shame the individual
• Provide information regarding access to medical care or treatment options
• Establish clear boundaries if his or her behavior creates hazardous conditions

A supportive conversation does not equate to turning a blind eye to his or her actions. Rather, it provides an environment where they feel secure enough to be honest with you.

How Do You Know if Someone Is Abusing Drugs?

One-time usage does not automatically signify development into a substance use disorder. Chronic usage, however, can develop reliance or addictive properties. Withdrawal symptoms, intense cravings, or addiction-related damage to health, relationships, social functions, daily routines, or mood may signal that professional treatment may be warranted.

Signs indicating a need for treatment include:

• Attempting to stop yet unable to cease usage
• Consumption of more than initially planned or stated amount
• Expending a considerable amount of time obtaining or recovering from substances
• Intense craving for substance(s) which cannot easily be controlled
• Continued use despite negative consequences
• Evidence of withdrawal symptoms upon cessation of substance use
• Requiring increasing dosages to achieve desired effects
• Consuming substances to manage stress, depression, or other mental illnesses
• Anticipated medical emergencies (e.g., overdose)
• Concerns expressed by concerned parties (friends, family)

Prompt intervention may reduce the severity of future symptoms. Medical detoxification services assist individuals in overcoming withdrawal symptoms, which can be painful, uncomfortable, or unpredictable. Detox programs coupled with subsequent treatment options, counseling, aftercare planning, and support group involvement enable persons affected by addiction to safely transition toward recovery.

Support for Addiction Treatment at New Waters Recovery

At New Waters Recovery in Raleigh, North Carolina, we provide individualized support for people struggling with drug addiction, substance use disorders, and co-occurring mental health concerns. Our detox and stabilization program provides medical support, medication management, and round-the-clock monitoring to help clients safely manage withdrawal symptoms and become medically stable.

We also offer a comprehensive psychological evaluation and assessment program that can include psychiatric evaluation, psycho-diagnostic testing, biopsychosocial assessment, medical assessment, and medication stabilization. This process can help identify underlying mental health concerns and clarify what level of treatment may be appropriate next.

Frequently Asked Questions on Determining if Someone Is High