We all know someone or have heard stories about someone with a substance abuse disorder, but it’s easy to think “that would never happen to me” or “my child knows better than to use drugs”. The unfortunate truth is that addiction does not discriminate against any demographic, including age and intelligence. Determining if your child is using drugs can be difficult, especially since the signs of drug addiction in teens could also be due to other mental health disorders, or even just typical adolescent behavior.

Some parents will tell you that hindsight is 20/20, and knowledge about the signs of drug addiction in others is one of the best tools you can have in your toolbelt. Prevention and early action can save lives, so let’s discuss some common and uncommon signs and symptoms to look out for.

How it starts

Tobacco and Alcohol Use

You have probably heard the term “gateway drugs”, a phrase used to describe how exposure to some substances like alcohol and tobacco can lead to the use of more serious drugs. Most adolescents and young adults will be exposed to drinking, smoking, and vaping at some point in their life and experimentation with these “gateway substances” put them at risk of exposure to other addictive substances. An early risk of addiction may be as simple as your child drinking alcohol or smoking a cigarette.

Patterns Supported by Research

A recent study suggested that a majority of adolescents experiment with smoking before moving on to other substances like alcohol and marijuana. This simply means that chances are that a teenager that smokes will also drink. Though drinking is highly normalized in our society, the use of alcohol in younger people can lead to more serious drug use later in life. An in-depth study showed that around 65% of youth that drink also use some form of illicit drugs, compared to only 5% of nondrinkers (Adolescent Substance Abuse and Psychiatric Comorbidities" by Deborah Deas, MD, MPH, published on July 14, 2006). This number is even higher for youth that drink and smoke. Research also tells us that drug use and other mental health disorders go hand in hand.

Common Signs of Drug Addiction

Changes in Behavior and Mood

• Loss of appetite, anxiety, and mood swings
• Forgetfulness, loss of concentration, and inattentiveness
• Reports of bullying or violence at school
• Changes in friends and social circles
• Increase in borrowing money and cash flow problems
• Secrecy and deceitfulness, locked doors, coded language
• Sudden changes in activity level: hyperactivity or excessive tiredness
• Frequently breaking rules or curfew

Physical Signs and Symptoms

• A general decline in health and unexplained weight changes
• Increased accidents and injuries, unexplained cuts and scrapes
• Increased physical ailments like headaches, coughs, and stomach pains
• Reddened eyes, nasal irritation, frequently flushed face
• Increased perspiration
• Messier appearance or general decline in hygiene
• Clumsiness and lack of coordination
• Wounds or marks on the arms, burns on the mouth and fingers
• Slurred speech, speaking too quickly
• Unusual smells on breath or clothing

While many of the above changes are to be expected as part of the average teenage experience, listen to your gut and take note of shifts in your child’s behavior, mood, and physicality. These could be signs someone is on drugs, or they could point to mental health disorders that require your attention, help, and support.

Risks for addiction: Precursors and risk factors for addiction

While these risk factors do not definitively lead to addiction, research shows that there is a much higher prevalence of addiction in young adults and adolescents with certain risk factors. A person could have a picture perfect life and still develop an addiction, but know your child is more vulnerable to addiction if any of these are true:

• Family history of substance misuse and addiction
• Past trauma such as a divorce, death in the family, or abuse
• Depression, anxiety, or other mental health disorders
• An addictive and inhibited personality

New things to look out for: Innovations in the drug industry

New drugs are constantly hitting the market, some of them dubbed “alternative drugs” {"Alternative Drugs of Abuse" by M. E. Sutter, J. Chenoweth, & T. E. Albertson, published on May 1, 2013, in Clinical Reviews in Allergy & Immunology, Volume 46, pages 3–18 (2014)). The biggest market for these “alternative drugs” are young adults aged 17 to 25. Staying up to date on drug trends and research can help open your eyes to changes in your child’s behavior that you may not have previously picked up on. One such alternative drug is a novel stimulant called Clenbuterol. Not only is it being used as a party drug, but it’s often used by athletes and overachieving sport-interested kids. The drug has what is called an “anabolic effect”, meaning it builds muscle and boosts endurance. Stay vigilant of a rapid increase of sporting performance, similar to what you may expect to see with steroid use.

What if I Suspect Drug Use? Where to Start:

The adolescent and teenage years are formative, especially for brain development. These years are extremely important for critical thinking, impulse control, decision making, and emotional regulation. If you’re reading this article, chances are you’ve observed some strange or troubling behavior in your child, or your gut is telling you something may be wrong. It can feel very isolating, and you may be wondering what to do next or where to go from here. The best things you can do is to arm yourself with knowledge, and intervene quickly and early.

1. Start by learning the truth about addiction and people with addictions. There is a lot of stigma around this topic. A good place to start is this article about the myths and misconceptions about those who have an addiction.
2. Familiarize yourself with data and research. There is still so much we need to learn about the youth mental health crisis, but we’re beginning to focus on how this has become a pressing issue for families, professionals, and communities.
3. Establish clear and empathetic communication. It can feel helpless to discover your child is misusing substances, and your natural reaction is probably to lecture and punish them. Being empathetic, practicing healthy communication skills and even starting to set boundaries will make a huge difference.
4. Seek external support if needed. Don’t be afraid to reach out for help. A therapist or psychologist who specializes in adolescent drug use is a great place to start and can help guide you.
5. Prepare for resistance from your child. You’ll likely be met with some resistance from your child, but remember to remain empathetic, and arm yourself with tools to help you navigate their resistance.

Conclusion and takeaways

Ignoring or enabling suspected drug abuse may make your child vulnerable to further addictions later in life, so remember the importance of prevention and early action. It may be our first instinct to do anything and everything we can for our children, but don’t forget to take care of yourself as well. Set boundaries, seek out a therapist or support group, be honest with friends and family, and be patient. The road to recovery can be long and bumpy, but you don’t need to travel it alone. Develop trust with your child by maintaining an open line of communication and remaining empathetic. Be proactive rather than reactive, and supportive rather than punishing.

Pathroot specializes in helping individuals with loved ones in addiction recovery, see how we can help you and your family, Learn more ».

Additional references:

1. Deas, Deborah. 2006. “Adolescent Substance Abuse and Psychiatric Comorbidities.” The Journal of Clinical Psychiatry 67 Suppl 7:18–23.
2. Melzer-Lange, M. D. 1998. “Violence and Associated High-Risk Health Behavior in Adolescents. Substance Abuse, Sexually Transmitted Diseases, and Pregnancy of Adolescents.” Pediatric Clinics of North America 45(2):307–17. doi: 10.1016/s0031-3955(05)70007-9.
3. Nath, Aditi, Sonali G. Choudhari, Sarika U. Dakhode, Asmita Rannaware, and Abhay M. Gaidhane. 2022. “Substance Abuse Amongst Adolescents: An Issue of Public Health Significance.” Cureus 14(11):e31193. doi: 10.7759/cureus.31193.
4. Ren, Michelle, and Shahrdad Lotfipour. 2019. “Nicotine Gateway Effects on Adolescent Substance Use.” The Western Journal of Emergency Medicine 20(5):696–709. doi: 10.5811/westjem.2019.7.41661.
5. Sutter, M. E., J. Chenoweth, and T. E. Albertson. 2014. “Alternative Drugs of Abuse.” Clinical Reviews in Allergy & Immunology 46(1):3–18. doi: 10.1007/s12016-013-8370-2.
6. The Partnership to End Addiction: https://drugfree.org/