There are many unmistakable signs of narcotic addiction and it might be easy to recognize if the person is using compulsively using while disregarding important issues in their lives. You might be aware that they are frequently under the influence of the drugs or going through turmoil when they are without them, sometimes several times a day.

Then, there are those hidden signs that the addict tries so hard to deny, cover up, or make excuses for, and even some that, they themselves don’t recognize until a catastrophic event or loss takes place. Following, are the top 5 hidden signs of narcotic addiction you should be aware of.

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1. Addiction Without Dependency

It’s possible to be addicted without being dependent on narcotics. For example, although a person has detoxed from the narcotic drugs, the signs of narcotic addiction do not end. They may still experience intense cravings and are vulnerable to relapse which are signs of narcotic addiction that can only be diminished over time and managed, but, never really cured.

The person will remain susceptible to environmental cues or “triggers” to use from stress, emotions, reminders, and motivational stimuli that became a basic part of their brain conditioning until other, more positive changes in conditioning can overpower the negative responses to those processes. According to a perspective supported by the National Institutes of Health (NIH), “Drug-related stimuli can also elicit automatic responses that lead to drug-seeking and relapse without recruiting conscious desire or distinct feelings of craving.”

2. Physical Health Impairments

Progressive narcotic use deteriorates the health in multiple ways. You may recognize current signs of narcotic addiction in someone who lacks the regard for their hygiene and other basic health needs such as shelter, sleep, or food and who would choose narcotics before any of these basic survival needs. You may notice the track marks on the person’s arms or their lack of energy, focus, and motivation with frequent bouts of sickness from withdrawal, but, what about the hidden physical signs of narcotic addiction?

Those signs that represent co-morbidity of infections, diseases, cardiovascular, pulmonary, and renal problems caused or exacerbated by the narcotic use and which the addict continues to ignore or even tries to hide from their families and medical providers. These hidden signs of narcotic addiction tend to not show up until the person has an overdose or other medical emergency or is screened through assessments upon entering a treatment program. They are also a leading cause of increases in early mortality in individuals both currently using and those who have a history of narcotic addiction.

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3. Never Ending Pain

Narcotics are essential medicines used in the treatment of pain and they can be prescribed for a variety of conditions and pain severities from minor surgeries or dental appointments to the chronic pain suffered by cancer patients. According to a report from the University of California San Francisco, “Under-treatment of pain will be considered a deviation from the standard of care” as stated by the Federation of State Medical Boards, 2003.

Never ending pain can be a hidden sign of narcotic addiction causing the person to frequently use more medication than prescribed and exaggerate their pain levels as reasoning for the behaviors. As time goes by, these individuals indeed, can have lowered thresholds to pain. Although it is the physician’s responsibility to minimize the abuse, too often, addicts are able to manipulate or work their ways around their prescriptions problems via doctor shopping or illicit street purchases.

4. Isolation

Losing interest in once enjoyable activities, having no motivations to socialize, or hiding out to enjoy the “high” may not be so easily noticed in some individuals and in others, it can lead to significant relational damages. This hidden sign of narcotic addiction is perpetuated by the need to mask the problems and avoid scrutiny from others.

Although narcotic addicts often socialize with other addicts to locate their drugs, they may begin to secretly hide their use in order to keep more for themselves and this too, leads to isolations. Withdrawals or anticipating withdrawals can cause extreme anxiety and the addict’s main focus will be on getting more drugs, despite their obligations to family, friends, or others. Not showing up at important family events, showing up hours late, or showing up intoxicated usually leads to confrontations that the addict is just not interested in having and will do just about anything to avoid including disappearing for a while.

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5. Deceitfulness and Insincerity

Deceitfulness and insincerity comes in the form of lying or stealing to support the habit, making excuses for behaviors, denying use or drug involved activities and neglecting responsibilities with family, work, finances, or other obligations. Family members may know something is going on, but, the denials and insincere responses often put them in fear of pushing the person further into the addiction if they interfere.

According to the Institute of Medicine (US),”Drug abuse leads to reallocation of economic support away from the family; lack of participation in family activities, including caregiving; lack of emotional commitment and support for parents and children; and the inability to provide a reliable and adequate role model for other family members, especially children. This impact on the family affects children’s development, learning, and social relations whether or not actual child abuse and neglect occur.”