1. Behavioral Signs
2. Emotional Signs
3. Physical Signs
4. Mental/Cognitive Signs
5. Social & Environmental Signs
100

Skipping therapy sessions or support group meetings.

What is avoidance?

100

Feeling more irritable or easily angered than usual.

What is irritability?

100

Changes in sleeping patterns, like insomnia or oversleeping.

 What is disrupted sleep?

100

 Difficulty concentrating or focusing

 What is impaired concentration?

100

Spending more time with people who use substances.

What is associating with high-risk peers?

200

Neglecting daily responsibilities like work or chores.

What is decreased motivation?

200

Experiencing sudden mood swings or emotional ups and downs.

What is emotional instability?

200

Noticeable changes in appetite or weight.

What is appetite or weight change?

200

 Forgetting important commitments or appointments.

What is forgetfulness?

200

 Avoiding social events that support sobriety.

What is social avoidance?

300

Isolating oneself from family and friends.

What is social withdrawal?

300

Increasing feelings of anxiety or panic.

What is heightened anxiety?

300

Experiencing headaches or stomachaches with no clear cause.

 What is psychosomatic symptoms?

300

Negative thinking patterns or self-doubt.

What is cognitive distortions?

300

Returning to places associated with past substance use.

What is environmental cue exposure?

400

Engaging in risky behaviors like driving under influence.

 What is reckless behavior?

400

Feeling hopeless or overwhelmed by emotions

 What is despair or emotional overwhelm

400

Increased fatigue or low energy.

What is exhaustion or fatigue?

400

Feeling mentally “foggy” or confused.

What is brain fog?

400

 Financial problems related to substance use behaviors.

What is financial instability?

500

 Increasing use of substances or old addictive behaviors.

What is escalation?

500

Experiencing intense cravings or urges.

 What is craving?

500

Trembling, sweating, or other withdrawal symptoms

 What is physical withdrawal symptoms?

500

Obsessing over past use or substance-related thoughts.

What is rumination or preoccupation?

500

 Increased conflict or arguments with loved ones.

What is interpersonal conflict?

600

Hiding or lying about substance use or behaviors.

 What is denial or deception?

600

 Feeling numb or disconnected from emotions.

What is emotional numbness or dissociation?

600

Experiencing restlessness or inability to stay still.

What is psychomotor agitation?

600

Underestimating risks or consequences of relapse.

What is minimization or denial?

600

Losing support from family or friends.

What is social isolation or alienation?

700

 Losing interest in hobbies or activities once enjoyed

What is anhedonia (loss of pleasure)?

700

 Feeling guilty or ashamed about recent behaviors.

 What is guilt or shame?

700

Physical illness or weakened immune system.

What is health deterioration?

700

Having unrealistic plans or overconfidence about staying clean.

What is grandiosity or overconfidence?

700

Neglecting to plan or maintain a safe environment.

What is poor environmental management?

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