More than 19 million adults in the U.S. have had a substance use disorder in the past year.

Addiction is incredibly complex and can have profound effects on a person's life. Despite the availability of research-backed medical and behavioral treatments, many people with addiction are impacted by the social stigma of the disease, which can keep them from seeking help.

For example, drinking more than what is considered a moderate amount of alcohol — two drinks in a day for men, one for women — is not necessarily the same as having a dependency or addiction to alcohol.

Drinking early in the day and binge-drinking can be signs of alcohol addiction. But there also are broader signs of addiction that can help you identify if you or someone you love needs help.

Some physical indicators of addiction may include:

• Loss of appetite, increase in appetite, change in eating habits, unexplained weight loss or gain
• Tremors, slurred speech, slowed or staggering walk, poor physical coordination
• Bloodshot, watery eyes; pupils larger or smaller than usual; blank stare
• Needle marks on lower arm, leg or bottom of feet
• Smell of substance on breath, body or clothes

Behavioral changes can also be warning signs of addiction. These might include:

• Change in overall attitude and personality with no other identifiable cause
• Forgetfulness, moodiness, irritability or nervousness
• Excessive need for privacy, unreachable
• Secretive or suspicious behavior, paranoia
• Chronic dishonesty
• Unexplained need for money, stealing money or items
• Deterioration of physical appearance and personal grooming habits

Note that addiction can be present without any of these signs. Someone with a "functioning addiction" may continue to go to work or perform daily responsibilities in spite of their addiction. The person with the addiction may not recognize a problem, but family, friends and peers do.

Like all addictions, a functioning addiction poses risks to both the physical and emotional health of the individual. As tolerance develops and addictions escalate, any of these risks can arise:

• Permanent health problems to the extent that withdrawal without medical support can be dangerous
• Interpersonal and financial problems
• Legal issues, particularly if the addiction involves an illegal substance

Finding Treatment

People with any type of addiction can benefit from cognitive and behavioral treatment programs. These programs address behaviors and thoughts formed by addiction as well as the patterns contributed to substance use. Those dealing with certain addictions may also need medication-assisted detoxification.

Treatment for addiction can be complicated, primarily because the person needing care may not yet recognize or accept there is a problem. If you are concerned that someone in your life might be living with addiction, Skocz says to simply start with a question.

"Aggressive confrontation isn't the best way to go in the beginning," he explains. "But don't ever be afraid to ask someone if they're doing OK."

Skocz says that no matter which kind of treatment is needed, there will be someone to support you or your loved one through the treatment and healing process. "There is always an opportunity for further evaluation and screening," Skocz says. "Wherever you seek treatment, there will be people who keep you engaged and help you stay on track through the process."

Fighting Stigma

Recognizing and normalizing drug and alcohol addiction as a disease — one that can and should be treated — is an important step in removing the stigma of addiction and creating a more encouraging recovery environment. Honest conversations can promote treatment as a positive and healthy course of action.

Open dialogue also can help to reduce the blame, fault or shame that individuals and families can feel about addiction, and help everyone understand that relapse is part of the recovery process and not a sign of failure.

Addiction is a disease, not a choice. If faced with signs of addiction in your life or that of someone you know, do not let stigma stop you from getting help. Awareness and acceptance are crucial to successful treatment.

"It's about seeing the person and not the disease," Skocz says. "We have to stop judging others."