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Tolerance: needing more of the drug for the same effect, or a diminished effect with the same dose Withdrawal symptoms when the drug is reduced or stopped (the syndrome varies by substance) Changes in sleep patterns, including insomnia, hypersomnia, or disrupted sleep architecture Significant weight loss or gain, changes in appetite Bloodshot or glazed eyes, dilated or pinpoint pupils depending on the substance Deterioration in physical appearance, personal hygiene, and grooming Track marks, skin sores, dental problems, or other substance-specific physical signs Frequent illnesses, slower healing, elevated heart rate or blood pressure in stimulant users What are the psychological symptoms

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Anat Rec (Hoboken) 292:1902–1913