How to Spot the Signs of Teen or Young Adult Substance Use

    Figuring out if your child is using substances can be challenging. Many of the signs and symptoms are typical teen or young adult behavior. Many are also symptoms of mental health issues, including depression or anxiety.

    If you have reason to suspect use, don’t be afraid to err on the side of caution. Prepare to take action and have a conversation during which you can ask direct questions like “Have you been drinking, vaping or using drugs?” No parent wants to hear “yes,” but being prepared for how you would respond can be the starting point for a more positive outcome.

    What to look for

    Shifts in mood & personality

    • Sullen, withdrawn or depressed
    • Less motivated
    • Silent, uncommunicative
    • Hostile, angry, uncooperative
    • Deceitful or secretive
    • Unable to focus
    • A sudden loss of inhibitions
    • Hyperactive or unusually elated

    Behavioral changes

    • Changed relationships with family members or friends
    • Absenteeism or a loss of interest in school, work or other activities
    • Avoids eye contact
    • Locks doors
    • Disappears for long periods of time
    • Goes out often, frequently breaking curfew
    • Secretive with the use of their phone
    • Makes endless excuses
    • Uses chewing gum or mints to cover up breath
    • Often uses over-the-counter preparations to reduce eye reddening or nasal irritation
    • Has cash flow problems
    • Has become unusually clumsy: stumbling, lacking coordination, poor balance
    • Has periods of sleeplessness or high energy, followed by long periods of “catch up” sleep

    Hygiene & appearance

    • Smell of smoke or other unusual smells on breath or on clothes
    • Messier than usual appearance
    • Poor hygiene
    • Frequently red or flushed cheeks or face
    • Burns or soot on fingers or lips
    • Track marks on arms or legs (or long sleeves in warm weather to hide marks)

    Physical health

    • Frequent sickness
    • Unusually tired and/or lethargic
    • Unable to speak intelligibly, slurred speech or rapid-fire speech
    • Nosebleeds and/or runny nose, not caused by allergies or a cold
    • Sores, spots around mouth
    • Sudden or dramatic weight loss or gain
    • Skin abrasions/bruises
    • Frequent perspiration
    • Seizures and/or vomiting

    How & where to look

    Use your nose.

    Have a real, face-to-face conversation when child comes home after hanging out with friends. If there has been drinking or smoking, the smell will be on their breath, on clothing and in their hair.

    Look them in the eyes.

    Pay attention to their eyes, which will be red and heavy-lidded, with constricted pupils if they’ve used marijuana. Pupils will be dilated, and they may have difficulty focusing if they’ve been drinking. In addition, red, flushed color of the face and cheeks can also be a sign of drinking.

    Watch their behavior.

    How do they act after a night out with friends? Are they particularly loud and obnoxious, or laughing hysterically at nothing? Unusually clumsy to the point of stumbling into furniture and walls, tripping over their own feet and knocking things over? Sullen, withdrawn, and unusually tired and slack-eyed for the hour of night? Do they look queasy and stumble into the bathroom? These are all signs that they could have been drinking or using marijuana or other substances.

    Search their spaces.

    The limits you set with your child don’t stop at the front door or their bedroom door. If you have cause for concern, it’s important to find out what’s going on. Be prepared to explain your reasons for a search though, whether or not you tell them about it beforehand. You can let them know it’s out of concern for their health and safety. Common places to conceal vapes, alcohol, drugs or paraphernalia include:

    • Inside drawers, beneath or between other items
    • In small boxes or cases — think jewelry, makeup or pencil cases, or cases for earbuds
    • Under a bed or other pieces of furniture
    • In a plant, buried in the dirt
    • In between or inside books
    • Under a loose floor board
    • Inside over-the-counter medicine containers (Tylenol, Advil, etc.)
    • Inside empty candy bags such as M&Ms or Skittles
    • In fake soda cans or other fake containers designed to conceal

    Don’t overlook your teen’s cell phone or other digital devices. Do you recognize their frequent contacts? Do recent messages or social media posts hint at drug use or contradict what they’ve told you?

    If your search turns up evidence of drug use, prepare for the conversation ahead and do not be deterred by the argument of invaded privacy. Stand by your decision to search and the limits you’ve set.

    If you discover that your child is not likely to have been drinking or using other substances, this could be a good time to find out if there’s another explanation for any changes in their appearance or behavior that needs to be addressed.

    Last Updated

    July 2020

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