Sorry about the length of this, but your quetion is a complicated one due to the variety of drugs and different effects on each individual has to each drug.
Besides the physical signs and symptoms, which vary with the drug, I would pay attention to comprehension, short attention span, erratic behaviour, indecision, unnecessary elaboration or getting lost in the middle of an explanation. Agitation is common. Unreasonable impatience with the small stuff. they literally “sweat” the small stuff. I would observe change in mental accuity and emotional instability in general.
A lot of the signs and symptoms associated with substance abuse are actually the symptoms of withdrawl, or the state of being “in between”. In between hits. The sad thing is, the addict doesn’t get high anymore unless they dramatically up the dosage and risk an OD.
So, after awhile, it’s all about getting the monkey off theiir back, chasing away the “sick”. They hit to get functional again. That’s why they hit before they leave the house and start their day, hit before they go to work. Hit before they visit mom. And not hitting regularly will produce the above stated symptoms.
So, the addict will appear normal when in actuality, the drug is running through their system. When that is metabolized, the ugly starts. You have to observe an addict for a couple of days before you are sure that they aren’t using. If the addict begins to show signs of impatience and the slightest agitation, then disappears for a few moments to the bedroom or the bath, and then seems A-OK for a few more hours, you probably have a user on your hands. That’s one of the reasons why the standard observation time for involuntary psych admissions are usually 48 to 72 hours. This applies to opiates, benzos, speed, barbiturates, and advanced alchoholism—all the shit that has been with us for generations.
But dependence on some drugs, such as MDMA, Extacy under all it’s other names and the other new hallucinogens and psychotropics, don’t create the urgency to fix like the drugs described above. Dependency is more subtle and the need for a fix becomes situational rather than time related. They are associated in the user’s mind to situations like parties, just like the early stages of alcoholism can be.
These drugs produce subtle changes over time that can become noticeable within a couple of months of mere weekend use. The person begins to slowly lose mental acuity, isn’t as patient with other people and minor situational disturbances as they once were, tends to unnecessarily create “drama” wherever they are when not high.
Grades begin to slip, or they become less interested in work and relationships. A malaise sets in between weekends. When this is observed by someone who cares, it calls for investigatory conversation and possibly a recommendation for professional intervention—not that stupid shit yo see on TV.
All drug users will be more receptive to accepting help during withdrawls provided they don’t have a fix lying around somewhere. Withdrawls are when they are most vulnerable, but also most volatile. So, watch it.
Spice, once considered as harmless as marajuana by the public, is now known to produce rapid long-term change in brain chemistry, and over time, even brain architecture, like methamphetamine. Both these changes have been observed using PET scans in users after a short time of daily use It is so new that it is still unknown if these changes are permanent. But changes in brain achitecture is never good and almost never makes for a positive diagnois for complete recovery.
Spice is huge in Florida among the poor. It is called “the poor man’s marajuana”. Marajuana my ass. It is sold under many different names and the recipe is constantly changing. Therefore the buyer never knows what they are going to get. But there is one commonality among all Spice products, it is extremely potent and addictive—and I call bullshit on anyone who thinks otherwise.
It is cheap and a little bit can give a very potent high—if you want to call it that. The resultant behavior of a spicehead when high can run the spectrum from somnolence to high agitation. A spicehead while high will have the look of an extremely stoned person. Behaviour is unpredictable.
A spicehead ran through the crowd on Mallory Pier in Key West stabbing people in the ass with a penknife for no apparent reason. He got me from behind right in the left buttcheek, the mutherfucker. I couldn’t sit down comfortably for nearly a goddamned month.
A notable instance happened a couple of years ago under a Miami overpass. Two homeless guys had got their hands on some Spice. A pedestrian called police when they observed what they initially thought were two males harmlessly kissing, then realized one was eating the face of the other. The other wasn’t resisting.
The cops have a blood test for Spice now, because there is always at least one chemical common it all the recipes—Benzine, which is what people in the Germanic languages call gasoline. I have no idea what it actually is in chemistry, but it is certainly not meant for human consumption.
The Spice addict after only one month of continuous use, whether high or not, becomes a totally different, usually very nasty person. The change is extremely dramatic and noticeable to all around them.