Warning Signs of Teen Substance Abuse

Several changes are associated with substance abuse in teenagers.

There are many behavioral, psychological, and physical changes associated with substance abuse in teenagers. If you suspect your teenager may be struggling with substance abuse, here are the changes and signs to watch for.

Behavioral Changes

• • Increased irritability, including aggressive or violent outbursts
• • Other behaviors: defiance, uncooperativeness, hostility
• • Ignoring authority figures, rules, and curfews
• • Increased associations with law enforcement
• • Increased conflicts at school with students and staff
• • Poor academic performance
• • Decreased motivation and interest in school and hobbies
• • Truancy and/or skipping extracurricular activities
• • A change in friends or social circles
• • Withdrawing from friends and family
• • Acting secretive or increased demand for privacy
• • Avoiding eye contact
• • Finding drugs or paraphernalia in a teen’s room

Psychological Changes

• • Mood swings, emotional instability, other changes in personality
• • Uncontrollable laughing for no apparent reason
• • Loud, obnoxious behavior
• • Slurred or rapid speech
• • Extreme fearfulness, paranoia
• • Lethargy and decreased motivation
• • Drowsiness followed by bursts of energy
• • Poor concentration and memory problems
• • Family history of substance abuse

Physical Changes

• • Bloodshot eyes
• • Dilated or pinpoint pupils
• • Teeth clenching
• • Poor hygiene
• • Poor appetite and or daily periods of extreme hunger
• • Weight gain or loss
• • Unexplained nosebleeds or runny nose
• • Sleep disturbances
• • Excessive thirst
• • Nausea and vomiting
• • Shakiness, tremors, sweating
• • Headache, stomachache
• • Nausea, vomiting, diarrhea, constipation
• • Coordination problems
• • Seizures
• • Frequent unexplained illness
• • Accidents, injuries
• • Needle track marks, skin infections (intravenous drug use)
• • Wearing long sleeves or turtlenecks year round (to cover needle track marks)
• • Constant scratching (opiate use)
• • Burns on fingers or lips (from smoking marijuana or crack cocaine)
• • Decayed teeth, missing teeth (methamphetamine use)
• • Smelling like alcohol or drugs
• • Smelling like perfume, incense, breath freshener (to mask the smell of alcohol and drugs)

Other Considerations

• • Missing cash or other valuable items from the home (that can be pawned for drugs)
• • Hidden stashes of alcohol or drugs
• • Missing medications, alcohol, tobacco products from the home
• • Drug paraphernalia
• • Drug residue or remains (seeds, stems, powders)

If you observe any of these behavioral, psychological, or physical changes in your teenager, you may take him or her to your family physician or mental health provider and request a substance test. This will confirm which substances the adolescent has been using, and this will also assist any healthcare providers with a treatment plan. If you aren’t certain your teen is using or abusing substances, a drug test will confirm or refute your suspicions. If substance use or abuse is confirmed, it is important to seek the advice of a mental health professional. Depending on the severity of the situation, outpatient therapy or inpatient care may be suggested. Regardless of which treatment is pursued, it is important that the treatment option address the family’s dynamics and coping skills, as well as the issues the teenager is facing. Substance use and abuse is a family issue that affects everyone in the dynamic, not just the teenager.