What is one physical sign of substance abuse displayed by inmates?

Frequent nosebleeds are a recognized physical sign of substance abuse, particularly related to the use of inhalants or drugs that irritate the nasal passages, like cocaine. This symptom can arise when users snort substances, leading to damage of the delicate tissues inside the nostrils and resulting in frequent bleeding.

In contrast, the other choices reflect signs of stable health and personal care. Consistent personal grooming, healthy weight maintenance, and regular sleep patterns indicate a generally well-adjusted lifestyle and do not align with the distress or neglect commonly associated with substance abuse. Therefore, frequent nosebleeds serve as a potential indicator of underlying substance-related issues in inmates.