 [ Symptoms ] is a cortisone injection merely a pain reliever or temporary remedy [ Disease ] a lot the symptoms listed in your question do not seem related to inappropriate drug usage perhaps you can tell your girlfriend about your observations do not accuse her of drug usage instead describe what you see and offer to help her to see a doctor to be medically assessed tell her that you care about her health and her happiness offer to pay for the visit and to go with her for support most physicians are pretty savvy about detecting drug abuse and will not hesitate to have a frank discussion about the dangers and rehabilitation on the other hand she may have underling medical problems that can be established by the doctor if you truly care about the well being of this lady please consider taking the above actions