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Unusual changes in behavior Isolation from usual activities and/or loved ones Lack of self-care, poor hygiene Changes in sleeping and eating patterns Needing more of the substance to feel normal Unusual depression, anxiety or changes in mood Extreme defensiveness when confronted Paranoid or suspicious behavior, such as hiding and feelings of shame Inability to attend work and school without the substance, or a decrease in performance without it Cravings that can lead to putting yourself or others in danger Peninsula, a division of Parkwest Medical Center, offers addiction recovery services in a supportive environment

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In recent years, South Dakota lawmakers have increasingly taken steps to undercut voter-approved initiatives