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If you're concerned about someone in your life, consider these telltale signs:

Isolation: Is your once-close daughter suddenly unreachable and uncharacteristically out of touch? Does it seem like she has stopped returning calls or emails for weeks on end?

Extreme irritability: Has your dear old Dad transformed from Dr. Jekyll into Mr. Hyde? Do minor snafus send him over the edge? Does he strike the family dog just for being in the way? Fly into a rage when the car in front of him is going too slow? Seem antisocial when he once looked forward to visits from the grandkids?

Shifts in sleep patterns, energy and motivation: Does your best friend seem tired and distracted all the time now? Has she lost her spark? Does she seem to be gaining weight? Is she no longer interested in going out and making plans with you? Is she deeply in debt or lying about how much money she spends on unhealthy habits?

Increased dependency on drugs of alcohol: This may seem obvious, but social drinking or prescription drug use may have become an addiction if your love one seems unstable or unable to function until she has a stiff drink or pill to steady nerves. Have you increasingly heard desperate statements such as: "I need my Xanax," or "I need my Klonipin", "I need my glass of wine and I'll be okay" or "Just get me a drink and give me a minute"?

If the person you're thinking about seems like a changed person, it's because she truly is. You need to understand that dependency on something to self-soothe is an affliction of the body, mind and spirit—and it has a neuro-physical base. Over time, the habitual user has transformed her central nervous system and her brain chemistry in such a way that perpetuates the cycle and the disease. At that point, impulse control has gone out the window.

What I find really alarming is there are an estimated 22 million Americans who are struggling with addiction and only 3 million who seek help for it. Part of the resistance to seeking help and change is that we have a broken, hurried healthcare system. For instance, some doctors would rather prescribe quick-fix pills for a patient's anxiety, sleeplessness, difficulty focusing and fatigue rather than help them reduce and relieve it.

I am not issuing a condemnation of all doctors or medical institutions—far from it—but here's an interesting development in the ongoing legal case of model Anna Nicole Smith that outraged me. It illustrates what we are up against.

Next: The epidemic of drug use
The opinions expressed by Oprah.com contributors are strictly their own.

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