Hygiene Decline and Self-Neglect as Substance Use Signs

… more less Hygiene means keeping your body and clothes clean and cared for. When substance use takes over a person's life, self-care can slip. You may see unwashed hair, body odor, or the same dirty clothes visit after visit. Teeth may go without care. Cuts and sores may go without a bandage. Medicines for other health problems may be skipped. The key word is change. Some people have always dressed in a messy way, and that is not a sign. What matters is a drop from this person's own usual level. Many things cause that drop besides drugs. Depression drains the energy to shower or do laundry. A person without a home, running water, or a washer cannot stay clean easily. Dementia, pain, a disability, or a new illness can make self-care hard. Poverty is not a sign of drug use. So treat self-neglect as one piece of a bigger picture. Compare what you see now with your earlier notes. Write facts with dates, such as 'same shirt as last two visits, strong body odor.' Then ask gently how the person is doing and whether they have what they need to keep clean. After this Concept you can spot a drop in self-care compared with what is usual for that person and list causes other than substance use.