According to CombatHeroin.NY.gov substance use disorder is a progressive disease. Young people may start with alcohol, tobacco and other drugs, but, all too frequently, their use progresses until it is out of control. A key risk factor is the misuse of prescription painkillers.  Anyone may use drugs, anyone can become addicted, and anyone can overdose. It is important that you have information and resources to recognize the warning signs of heroin and opioid abuse. Pay attention to significant changes in you or your family member’s physical appearance, attitude or behavior. Expand the blue links below to view various signs of substance abuse.